Objective To investigate the correlation between vertebral artery dominance (VAD) and posterior circulation ischemic stroke (PCIS).Methods The consecutive patients with acute ischemic stroke hospitalized from November 2013 to October 2015 were collected.All patients underwent MRI and magnetic resonance angiography (MRA).The dominant vertebral artery was defined as having the larger diameter if left and right diameter difference ≥0.3 mm or the vertebral artery connected to the basilar artery in a more straight fashion if the diameter difference ＜ 0.3 mm.They were divided into either an anterior circulation ischemia stroke (ACIS) group or a PCIS group according to the classification criteria of Oxfordshire Community Stroke Project (OCSP).A multivariate logistic regression analysis was performed to investigate the correlation between VAD and PCIS.Results A total of 226 patients withacute ischemic stroke were enrolled,including 172 patients (76.1％) in the ACIS group and 54 (23.9％) in the PCIS group.Fifty-four patients (23.9％) had VAD,including 38 (70.3％) on the left and 16 (29.7％) on the right.The proportion of the patients with VAD in the PCIS group was significantly higher than that in the ACIS group (55.6％ vs.14.0％;x2 =39.115,P ＜ 0.001).Multivariate logistic regression analysis showed that VAD was an independent risk factor for patients occurring PCIS (odds ratio,13.60,95％ confidence interval 6.90-27.01;P＜0.001).Conclusions VAD is closely associated with the occurrence of PCIS,and it is an independent risk factor for PCIS.

Objective:To understand the application status of precursor drugs in the outpatients of our hospital. Methods:Totally 12 kinds of precursor drugs were included in the management. The data of prescriptions in HIS were collected from July 1 to September 30 in 2015. The defined daily dose (DDD), frequency of drug use (DDDs), drug utilization index (DUI) and the other parameters were calculated and the influencing factors were analyzed by the Pareto method. Results: Among the twelve precursor drugs, DUI of seven kinds was less than or equal to 1. Paracetamol tablets, pseudoephedrine hydrochloride tablets, dextromethorphan hydrobromide and chlorphenamine maleate tablets, nicergoline tablets and compound dextromethorphan hydrobromide tablets II displayed lower DUI, indicating their clinic application was more reasonable. Conclusion:The data showed that the use of precursor drugs in our hospital is basically reasonable.

BACKGROUND:A variety of cytokines such as cytokines, growth factors and inflammatory proteins play an important role in the development of skeletal muscle.
OBJECTIVE:To investigate the biological characteristics of a variety of cytokines and their effects on skeletal muscle cel s and pancreaticβcel s.
METHODS:Relevant articles published from 2002 to 2015 were retrieved in CNKI and PubMed databases using the English keywords“cytokines, adiponectin, leptin, visfatin, skeletal muscle cel s, pancreaticβcel s”. Initial y 253 literatures were obtained, and final y 53 eligible literatures were included based on the exclusion criteria.
RESULTS AND CONCLUSION:As a fat-specific protein newly found, adiponectin can improve the insulin sensitivity by promoting glucose uptake, storage and utilization in skeletal muscle cel s. The activation of muscle satel ite cel s and skeletal myoblast proliferation are both dependent on leptin, so leptin plays a vital role in the skeletal muscle cel growth and development. Visfatin, a pleiotropic cytokine, widely presents in the skeletal muscle, liver and bone marrow, and participates in the regulation of inflammation and immune function. Furthermore, visfatin contributes to glucose uptake and metabolism in the skeletal muscle, and makes considerable effects on the stress and signal transduction of skeletal muscle cel s.

Objective:To analyze the effect of CD100 to monocyte cytotoxicity in non-small cell lung cancer (NSCLC) patients.Methods:Thirty-five NSCLC patients and thirteen healthy controls were included from Zhengzhou Central Hospital between March 2018 and September 2018. Peripheral blood mononuclear cells (PBMC) and bronchial alveolar lavage fluid (BALF) (both tumor site and non-tumor site) was collected from NSCLC patients, while PBMC was collected from healthy controls. Monocytes were purified from PBMC and BALF. Membrane-bound CD100 (mCD100) and CD72 expression on monocytes was measured by flow cytometry. Monocytes from NSCLC patients were stimulated with recombinant human CD100, anti-CD72, matrix metalloproteinase 14(MMP14), or anti-CD100, and were co-cultured with NCI-H1882 cells for 48 h. Tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), granzyme A, granzyme B level in the supernatants, CD16 expression on monocytes, and percentage of target cell death was assessed. Student t test or paired t test was used for comparison. Results:There were no significant differences of peripheral CD14 + mCD100 + percentage, CD14 + CD72 + percentage, CD100 mean fluorescence intensity (MFI), CD72 MFI between NSCLC patients and healthy controls ( P>0.05). CD14 + mCD100 + percentage, CD14 + CD72 + percentage, CD100 MFI, CD72 MFI was remarkably elevated in tumor site compared with in non-tumor site in NSCLC patients ( P<0.05). There was no remarkable difference of peripheral monocytes-induced NCI-H1882 cell death between NSCLC group and control group [(13.95±3.16)% vs (13.22±2.40)%, P=0.451]. Lung-resident monocytes-induced NCI-H1882 cell death was reduced in tumor site when compared with non-tumor site [(11.61±2.81)% vs (14.19±3.57)%, P=0.008 7]. TNF-α, IL-1β, granzyme A, granzyme B level was also decreased in the supernatants of monocytes from tumor site compared with non-tumor site in NSCLC patients( P<0.05). However, there was no statistical difference of CD16 level between two groups( P=0.666). Recombinant human CD100 stimulation promoted NCI-H1882 cell death induced by monocytes from tumor site when compared with unstimulated cells ( P<0.000 1). TNF-α, IL-1β, granzyme A, granzyme B level was also increased ( P<0.05). However, Monocytes, which were pretreated with anti-CD72, induced decreased NCI-H1882 cell death and TNF-α, IL-1β, granzyme A, granzyme B secretion in response to recombinant human CD100 stimulation ( P<0.05). Recombinant human MMP14 stimulation decreased CD14 + mCD100 + percentage and increased soluble CD100 (sCD100) level. NCI-H1882 cell death and TNF-α, IL-1β, granzyme A, granzyme B level was elevated when compared with unstimulated cells ( P<0.05). Anti-CD100 administration decreased sCD100 level. NCI-H1882 cell death and TNF-α, IL-1β, granzyme A, granzyme B level was elevated when compared with MMP14 stimulated cells ( P<0.05). Conclusions:CD100 shedding was insufficient in tumor infiltrating monocytes in NSCLC patients, leading to decreased cytotoxicity. MMP14 might elevate cytotoxicity of tumor infiltrating monocytes via promoting CD100 shedding and sCD100 formation.

Objective To evaluate the cognitive function and its correlative factors in centenarians.Methods Forty-nine subjects in Zhongxiang city were included in this mass screening.Questionnaire was utilized to collect basic data,including age,gender,ability of daily life,depression,life habits,body mass index,and history of chronic diseases on all the subjects.And the mini-mental state examination(MMSE)was adopted to evaluate cognitive function of old people.T test and chi-square test were used to compare the difference in effectiveness of multiple different factors on cognitive function,while binary logistic regression analysis was used to assess the effects of multiple different factors on cognitive function.Results The mean score of the ability of different dimensions of cognitive function was (7.10 ± 2.71) in direction,(1.94 ±± 0.80) in memory,(0.61 ± 1.07) in attention and computation,(1.92 ± 0.86) in recall,and (4.73 ± 2.14) in speech,respectively,with total score of cognitive function of(16.30±6.02) in forty-nine centenarians.Normal cognitive function was found in 25 cases,and decreased cognitive function was found in 24 cases.Single factor logistic analysis indicated that body mass index(t=-3.399,P=0.001)and self-rating depression scale(t=-5.731,P＜0.001) were lower in patients with normal cognitive function than in patients with declined cognitive function.And smoking patients were associated with higher rates of normal cognitive function than the non-smoking patients(87.5％ vs.43.9％,x2 =5.091,P=0.028),and patients with normal hearing were associated with higher rate of normal cognitive function than patients with hearing loss(70.3 ％ vs.27.3 ％,x2 =9.01,P=0.030).Multivariate logistic analysis indicated that depression index(β=-14.40,P=0.001) and body mass index(β=-0.424,P=0.015) were independent effective factors for cognitive function.Conclusions Improvement of the condition of depression and controlling the body mass index are hopeful for recovering or postponing their cognitive impairment in centenarians.

Objective To investigate the influencing factors of the protein stability and hemolytic activity of tentacle extract ( TE) from the jellyfish Cyanea capillata .Methods Effects of various factors and treatments on the protein stability and hemolytic ac-tivity of TE were explored by protein detection , hemolytic assay and SDS-PAGE analysis.Results TE caused a significant and dose-dependent hemolytic effect , and the HU50 of TE against 0.5%erythrocyte suspensions from SD rats was 226μg/ml.A 40℃water bath for 1 hour could effectively remove the contaminating proteins in TE .TE retained hemolytic activity at 4℃for 28 days but it was unsta-ble when kept at 25℃over 3 days.TE was active in the range from pH 6.0 to 11.0 and the optimum pH was 8.0.Various buffer solu-tions had significantly different effects on the stability and hemolytic activity of TE , and a good salting-out effect was observed on the hemolytic protein of TE while the concentration of ammonium sulfate solutions was greater than 26%.Conclusion A 40℃water bath for 1 hour could effectively remove the contaminating proteins in TE and reduce its viscosity .The optimum conditions for maintaining stability and hemolytic activity of TE were 4℃ and pH 8.0.The salting-out effect from 26% and more ammonium sulfate solutions would be conducive to the enrichment of hemolytic protein .

Objective:To explore the effect of inpatient palliative care in patients with end-stage heart failure.Methods:From July 2019 to January 2021, convenience sampling was used to select 97 patients with end-stage heart failure admitted to the Cardiovascular Department of Henan Provincial Chest Hospital as the research subject. The patients were divided into the control group ( n=48) and the observation group ( n=49) with the random number table. The control group conducted routine nursing, and the observation group carried out inpatient palliative care on this basis. The 21-Item Depression Anxiety Stress Scale (DASS-21) , General Self-efficacy Scale (GSES) and Minnesota Living with Heart Failure Questionnaire (MLHFQ) were used to compare the adverse psychological state, self-efficacy and quality of life of the two groups of patients. Results:Before intervention, there were no significant differences in DASS-21, MLHFQ and GSES scores between the two groups ( P>0.05) . After intervention, the DASS-21 and MLHFQ scores of the observation group were lower than those of the control group, and the GSES score was higher than that of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Inpatient palliative care can effectively relieve the adverse psychological state of patients with end-stage heart failure and improve their self-efficacy and quality of life.

Objective To analyze the characteristics on demographical,spatial distribution and transmission mode of HIV infections among 50-year-old population.Methods Related information on demography,spatial distribution,high risk behavioral and history of HIV infections among 50-year-old population were collected and analyzed.Possible time of infection based on their first CD4 testing results right after the HIV diagnoses,was estimated.Results Since 2008,the number of new HIV/AIDS cases among the over-50-year-olds was reported increasing annually.The number of aged 50 and above in 2014 was 4.2 times than the number in 2008.50-year-old or older population were infected mainly through heterosexual behavior (88.0％).Among these cases,83.9％ self-reported as having histories on extramarital sex intercourse and the number was increasing yearly.Among male cases who admitted as having heterosexual experience,95.1％ of them reported as having histories of extramarital sex intercourse while 53.4％ of the female cases reported as having the same experiences.46.6％ of spouses of the females or with fixed partners were HIV positive.Through estimating the time of infection and the time interval between infection and diagnosis,we found that the proportion was 15.5％,from infection to diagnosis as 3 years among the 50 and older age groups,but the proportion of 8 years from infection to diagnosis was 43.6％.We estimated that 66.5％ of the new HIV cases who were at age 50 and over,were infected when they were at that age span.The average time from infection and being tested was (6.8 ± 2.7) years.Conclusion The increasing number of being diagnosed on HIV among the 50-year-olds population might be related to both high risk exposure and belated diagnoses among this population,calling for the necessity of deriving the sources of HIV infection and tailoring the HIV prevention strategies in this population.

Objective:To explore and evaluate a appropriate suitable method for detection of Campylobacter and antibiotic sensitivity test for foodborne diarrhea in clinical laboratories. Methods:Pre-experiment:a total number of 400 fecal samples of patients with foodborne diarrhea were prospectively collected from the intestinal disease clinic of Beijing Tongren Hospital from September 2017 to January 2018. Double-hole filtration culture method and modified cefoperazone charcoal deoxycholate (CCD) agar culture method were used for fecal culture in micro-aerobic environment for 48 hours, and then suspicious colonies were identified by matrix assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry. Meanwhile, C. jejuni and C. coli were detected by real-time quantitative polymerase chain reaction(qPCR). Large sample verification: 2 062 fecal samples of patients with foodborne diarrhea in three hospitals of different levels in different areas of Beijing were collected for qPCR detection and culture from April 2018 to March 2019. The antimicrobial sensitivity test (AST) of C. jejuni and C. coli was performed according to the disk diffusion method and agar dilution method recommended by Clinical and Laboratory Standards Institute and National Antimicrobial Resistance Monitoring System for Enteric Bacteria. The results of the three detection methods and the consistency of the two antibiotic sensitivity tests were compared. Results:In the pre-experiment, the positive rates of Campylobacter ( jejuni/coli) detected of qPCR, double-hole filtration culture and modified CCD agar culture were 9.0% (36/400), 5.0% (20/400)and 3.5% (14/400), and the difference was statistically significant ( P<0.01). The samples with negative result of qPCR were negative by both culture methods. The total positive rates of Campylobacter detected by qPCR was 8.1% (168/ 2 062)including 7.0% (144/2 062) for C. jejuni and 1.2% (24/2 062) for C. coli. The samples with positive qPCR results were cultured by double-hole filtration culture method and the positive rate was 61.9%(104/168), among which, the positive rate of C. jejuni and C. coli were 58.3%(84/144) and 83.3%(20/24) respectively, which was not significantly different from the detection rate and culture positive rate in the pre-test ( P>0.1). The resistance rates of C. jejuni and C. coli to ciprofloxacin were 94.0%(94/100) and 100.0%(24/24) and to erythromycin were 6.0%(6/100) and 33.3%(8/24). The results from two antibiotic sensitivity test methods were consistent (Kappa>0.75). Conclusions:qPCR is rapid, sensitive and easy to operate, so it is suitable for routine development in clinical laboratories. The double-hole filtration culture method is beneficial to the acquisition of strains and is essential for the further study of Campylobacter. There was no significant difference between agar dilution method and disk diffusion method in antibiotic sensitivity test. Campylobacter showed a very high resistance rate to quinolones, which was no longer suitable for the treatment of Campylobacter foodborne diarrhea in Beijing area. Macrocyclic lipid antibiotics should be preferred.

Objective To evaluate the efficacy and safety of tacrolimus extended-release (Tac-ER) in the early stage after kidney transplantation. Methods Clinical data of 68 recipients undergoing kidney transplantation from 34 pairs of renal allografts were retrospectively analyzed. Two recipients who received bilateral kidneys from the same donor were treated with Tac-ER (Tac-ER group) and tacrolimus immediate-release (Tac-IR) (Tac-IR group) as one of the basic immunosuppressant. The changes of tacrolimus dosage and blood concentration, intra-patient variability (IPV), renal function, incidence of acute rejection, recipient and allograft survival rates and adverse events were statistically compared between two groups. Results The average daily dose of tacrolimus in the Tac-ER group was significantly higher than that in the Tac-IR group (F=8.386, P=0.005). In the Tac-ER group, the mean trough concentration at postoperative 4 d was (6.14±4.04) ng/mL, did not reach the target concentration, significantly lower than (9.41±5.47) ng/mL in the Tac-IR group (F=7.854, P=0.007). In the Tac-ER group, the IPV of trough concentration of tacrolimus within postoperative 1 month was significantly higher than that in the Tac-IR group (0.44±0.15 vs. 0.36±0.12, P=0.032). At postoperative 6 months, there was no significant difference in the renal function between two groups [serum creatinine level was (126±26) μmol/L vs. (120±28) μmol/L, and the estimated glomerular filtration rate was (56±13) mL/(min·1.73 m²) vs. (60±15) mL/(min·1.73 m²), both P > 0.05]. The allograft and recipient survival rates were 100% in both groups. The incidence of acute rejection within postoperative 1 month was 18% in the Tac-ER group and 3% in the Tac-IR group, with no significant difference (P > 0.05). The overall incidence of adverse events was 94% in the Tac-ER group and 97% in the Tac-IR group, with no significant difference (P > 0.05). Conclusions The efficacy and safety of Tac-ER are equivalent to those of Tac-IR, whereas a higher dose of Tac-ER should be orally given to reach the blood concentration similar to that of Tac-IR. During early-stage drug treatment, Tac-ER should be orally given before kidney transplantation or inittally with loading dose, aiming to increase the systemic exposure to tacrolimus early after kidney transplantation and prevent acute rejection caused by insufficient exposure.