Objective To study the effect of night large dose of sodium valproate on epileptiform discharges,and cognitive function of benign childhood epilepsy with centrotemporal spikes. Methods Ninety cases of benign childhood epilepsy with centrotemporal spikes were randomly divided into treatment group and control group (n= 45), both groups received regular total doses of sodium valproate therapy 25-30 mg?kg-1 ?d-1 . Patients in the treatment group received treatment that night doses of sodium valproate was double of morning doses. Every night dose was (17.96±1.21) mg?kg-1 , and every morning dose was (8.92±0.62) mg?kg-1 . The control group received the same dose [(13.37±0.80) mg?kg-1 ] of sodium alproate therapy twice a day, morning and evening. The epileptiform discharges, cognitive function, therapy effect were compared between two groups. Results Total effective rate of treatment group was 82.22% which were was significantly higher than that of the control group 62.22%(P<0.05);Epileptiform discharges reduction of treatment group was significantly higher than that of the control group (P<0.05), the effective rate of EEG improvement (84.44%)in treatment group was significantly higher than that in the control group 66.67% (P<0.05); FIQ, VIQ, PIQ in treatment group were significantly higher than those in the control group (P<0.05); There were no statistical differences of adverse reactions between two groups. Conclusion Night large dose of sodium valproate treatment can help control epileptic discharge, increase the plasma concentration, improve cognitive function, and therapy effect.

Objective To investigate knowledge and attitudes of healthcare workers with respect to HIV/AIDS in Fugong County,Nujiang District and to highlight the difficulties facing local healthcare workers in HIV/AIDS health education in order to help them improve their skills and capability of health education through participatory learning.(note:the major inhabitants in NuJiang are the Lisu ethnic).Methods A survey with questionnaires was carried out before starting a HIV/AIDS health education training course for healthcare workers in Fugong County.Then an interactive and participative HIV/AIDS training was provided for these healthcare workers.A post-training survey was followed.Results Before the training course,the score of HIV/AIDS related knowledge was 56.71 on average.The average score increased to 83.93 after the participatory HIV/AIDS health education,(by SPSS analysis).Such an increase was obviously associated with their participation in the training course.The knowledge the participants learned during the training course was effectively used for conducting health education among local inhabitants.Conclusion We found that a participatory/interactive HIV health education training course is useful in raising the awareness and understanding of HIV/AIDS among healthcare workers in areas such as Fugong.We encourage more efforts to hold such courses in order to prevent the spread of HIV/AIDS.

Objective To assess the diagnostic value of chronotropic index in identifying coronary artery disease (CAD). Methods One hundred and sixty two patients with suspected CAD were referred for a routine treadmill exercise electrocardiogram and subsequently underwent selective coronary angiography within 3 weeks. The magnitude of ST segment depression and chronotropic index were measured by a computerized ECG system. CAD was defined by coronary angiography. Results In detecting CAD, the sensitivity was 70. 1% versus 60.9% (P< 0.05) ,the specificity was 84.0% versus 73.3% (P<0.05), and the accuracy was 76.5% versus 66.7% (P< 0.05) by chronotropic index and standard electrocardiographic test criteria. The value of Kappa statistic for chrono-tropic index consistency in our experiment was 0.534(>0.4). The number of diseased vessels was correlated with the mean value of chronotropic index. The chronotropic index decreased from 0.88±0.09 in patients without coro-nary disease to 0.68±0.06 in those with 3 vessels involved (P<0.01). A more closed relationship was found be-tween chronotropic index and lesion in the fight coronary artery. Conclusions Chronotropic index is possibly a valu-able positive index for the diagnosis of CAD. The sensitivity,specificity and accuracy of chronotropic index are signif-icandy higher than those of standard electrocardiographic test criteria in identifying CAD.

Objective To analyze the related factors of surgical site infections after spine surgery so as to provide basis for clinical prevention. Methods We retrospectively reviewed the clinical data on 2,083 patients who had undergone spine surgery during the period of June 2010 to May 2013, and then conducted a statistica analysis. Results A total of 38 patients developed surgical site infections. The incidence of surgical site infections after spine surgery was 1.8%. 11 risk factors including gender, history of smoking, and history of prolonged uses of medications were related to surgical site infections The logistic regression analysis indicated that surgical site infections were more closely related to gender, length of hospital stay, and spine surgical invasiveness index. Conclusions Multiple factors can be attributed to surgical site infections after spine surgery. Gender , length of hospital stay, and spine surgical invasiveness index are the independent risk factors.

Objective To evaluate the clinical value of serum high density lipoprotein cholesterol (HDL-C)in the evaluation of synthetic function of the patients with liver diseases.Methods Abbott Aeroset automatic biochemical analyzer was used to detect serum HDL-C level in control group (30 cases) and liver disease group(87 cases).T test was used to analyze the differences of serum HDL-C level in liver disease group and control group,different liver disease groups and control group,and different liver disease groups.Results HDL-C level was (1.28 ±0.20)mmol/L in the control group,(0.77 ± 0.15)mmol/L in the liver disease group,and (0.81 ± 0.13)mmol/L in the hepatitis group,(0.68 ± 0.14)mmol/L in the liver cirrhosis group,(0.54 ± 0.05)mmol/L in the liver cancer group.The HDL-C level in liver disease group and hepatitis group,liver cirrhosis group,liver cancer group was significantly lower than that in the control group(t =15.5569,14.2463,45.4393,25.6344,all P ＜ 0.01).The HDL-C level in liver cirrhosis group and liver cancer group was significantly lower than that in hepatitis group (t =3.6583,16.9057,all P ＜ 0.01).The HDL-C level in liver cancer group was significantly lower than that in liver cirrhosis group(t =4.4103,P ＜ 0.01).Conclusion Serum HDL-C level can be used to evaluate synthetic function of the liver,the lower of serum HDL-C level,the more serious liver synthesis function is impaired.

The object of medical research is human life,thus the understanding level of human being determines medical mode and the development of medical science.The origin of Marx's theory on human being is the realistic human,which provides methodological basis for reflecting on the biomedical faults from a logical perspective.Marx held that technology is the objectization of the essential power of human being,while technology under the context of capitalist production relations has been turned into certain means to control workers.Tend of dissimilation also arises in some modern medical fields,thus serious reflection and criticism are in great need.The overall development of human being is the core content in Marx's theory on human being.Since modern medicine is during the transition from bio-medical model to bio-psycho-social medial model,the new medical model calls for an overall development of main body in all aspects including qualification,ability,and social relations,etc.

Objective:To explore the correlation between cognitive impairment and intestinal mucosal barrier injury in rats after chronic cerebral hypoperfusion(CCH), and to quantitatively analyze the changes in cognitive behavior of experimental rats caused by chronic cerebral hypoperfusion, as well as the expression changes of the intestinal mucosal barrier claudin-1 and osteopontin.Methods:Thirty male SD rats were randomly divided into CCH group ( n=15) and sham operation (SHAM) control group ( n=15). The CCH model was established by permanent ligation of bilateral common carotid arteries.Rats in the SHAM group only separated the common carotid artery without ligation.Four weeks later, open field experiment, object discrimination experiment, and Morris water maze experiment were used to detect the emotional arousal ability, the ability to explore new things, and the ability of spatial learning and memory in rats.HE staining and immunofluorescence experiments were conducted to detect the damage of rat ileum tissue.Western blot was used to detect OPN expression, and ELISA was used to detect serum OPN.SPSS 23.0 and GraphPad 8.0 statistical softwares were used to process the data, and the t-test and repeated measures one-way analysis of variance were used for data analysis. Results:In the open field test, compared with the SHAM group ((28.70±10.70)times, (1 030.45±81.51)cm), the number of standing and total exercise distance of rats in the CCH group ((16.70±7.13)times, (736.64±136.71)cm) were decreased( t=1.59, 4.16, both P<0.05). In the object discrimination experiment, the discrimination index of rats in the CCH group (0.44±0.26) was lower than that of the SHAM group (0.91±0.07, t=-7.76, P<0.05). Morris water maze positioning navigation experiment showed that the group main effect and time main effect were both significant( F=383.36, 153.87, P<0.05). Simple effect analysis showed that, compared with the SHAM group, the escape latency and total swimming distance of rats in CCH group increased( P<0.05). Space exploration experiment showed that, compared with SHAM group ((7.20±1.81)times, (9.96±2.95)s), the number of crossings of rats in CCH group ((3.00±0.82)times) decreased, and the incubation period ((29.70±6.28)s) was prolonged( t=4.65, 7.04, both P<0.05). The intestinal mucosal pathology score of SHAM group ((1.98±0.34)points) was lower than that of the CCH group ((4.52±0.27)points), and the difference was significant( t=18.53, P<0.01). Immunofluorescence experiment showed that, compared with SHAM group (125 028.58±33 077.39), the cumulative optical density of claudin-1 between the intestinal epithelial cells of the CCH group(47 154.50±7 507.29) decreased( t=16.10, P<0.01). Western blot experiment showed that, compared with the SHAM group (0.38±0.11), the expression of OPN in the intestines of the CCH group (1.20±0.95) increased( P<0.05). ELISA experiment showed that, compared with the SHAM group ((3.42±0.66)μg/L), the serum OPN content of the CCH group ((14.92±1.45)μg/L) significantly increased( P<0.05). The degree of cognitive impairment was negatively correlated with intestinal mucosal epithelial claudin-1 expression and serum OPN content( P<0.01). Intestinal mucosal epithelial claudin-1 expression was negatively correlated with serum OPN content ( r=-0.952, P<0.01). Conclusion:CCH may cause obvious cognitive impairment in rats and the destruction of the intestinal mucosal barrier.Serum OPN may be a potential serological marker of CCH-induced cognitive impairment and intestinal mucosal barrier destruction in rats.

Objective:To investigate the correlation between sarcopenia and post-stroke cognitive impairment(PSCI)in elderly patients with first-time acute minor ischemic stroke.Methods:This was a prospective study.Elderly patients over 60 years of age with first-time acute minor ischemic stroke admitted to the Department of Neurology of the General Hospital of Western Theater Command from October 2018 to June 2019 were continuously enrolled.Patients received the SARC-F score assessment within 24h after admission and were divided into two groups according to their SARC-F scores: the non-sarcopenia group(SARC-F score<4)and the sarcopenia group(SARC-F score≥4). Cognitive function was assessed by using the Mini-Mental State Examination(MMSE)within 24 h of admission and at 3-month follow-up.Results:A total of 211 patients were enrolled in this study, including 31 patients(31/211, 14.69%)in the sarcopenia group and 180 patients(180/211, 85.31%)in the non-sarcopenia group.The incidence of PSCI was higher in the sarcopenia group than in the non-sarcopenia group(83.87% or 26/31 vs.55.56% or 100/180, χ2=8.814, P=0.003). The total MMSE score, orientation, immediate memory, attention, calculation and language functions were lower in the sarcopenia group compared with non-sarcopenia group( P<0.05). Logistic regression analysis showed that sarcopenia was an independent risk factor for PSCI( OR=3.478, 95% CI: 1.039-11.642, P=0.043)in the elderly with first-time acute minor ischemic stroke. Conclusions:Sarcopenia is an independent risk factor for PSCI in elderly patients with first-time acute minor ischemic stroke.Sarcopenia assessment in the acute phase of stroke might help doctors to assess the risk of PSCI and reduce the incidence of PSCI in stroke patients.

Objective To investigate the influence of Smac to the chemosensitivity of cyclophosphamide (CTX) and doxorubicin (DOX) in MCF-7 cells.Methods MCF-7 cells were exposed to CTX,DOX and the combination of both.3-(4,5-dimethyl-2-thiazoly)-2,5-diphenyl-2 H-tetrazolium bromide (MTT) assay was used to estimate the cell viability.Apoptosis was measured by acridine orange staining and Ho.33342/PI dou-ble staining.The mRNA and protein expressions of Smac were determined by RT-PCR and Western blotting.The study also analyzed the changes of pro-apoptotic proteins active caspase-3 and active caspase-9.Results CTX,DOX and the combination of both drugs reduced the cell survival rates in a concentration-dependent manner.The cell viability after being treated with 4.0 μg/ml CTX or 0.2 μg/ml DOX or 2.0 μg/ml CTX and 0.1 μg/ml DOX for 48 hours was (52.90 ± 8.78) ％,(53.35 ± 6.29) ％ and (34.19 ± 5.43) ％,respectively.The drug combination developed a stronger inhibitory effect compared to the single drugs (t =9.051,P=0.014;t =9.074,P =0.014).The Smac mRNA and protein levels in 2.0 μg/ml CTX and 0.1 μg/ml DOX group were 7.47 ± 0.82 and 4.13 ± 0.36,which were higher than those in 4.0 μg/ml CTX group (3.27 ± 0.40 and 2.28 ± 0.27;t =-50.120,P =0.000;t =-42.588,P =0.000) and 0.2 μg/ml DOXgroup (3.34±0.62and2.45±0.40;t=-46.233,P=0.000;t=-39.541,P=0.000).Furthermore,pro-apoptotic proteins active caspase-3 and active caspase-9 increased activity was confirmed by Western blotting.Conclusion Smac plays a vital role in enhancing the sensitivity of chemotherapeutic drugs CTX and DOX in MCF-7 cell line.

Objective:To study the related factors of severe acute radiation-induced lung injury (SAR) caused by IMRT and concurrent chemotherapy for non-small cell lung cancer. Methods:We retrospectively analyzed the data of 2 323 non-small cell lung cancer pa-tients who underwent IMRT radiotherapy and concurrent chemotherapy at the Department of Radiotherapy of Tianjin Medical Univer-sity Cancer Institute and Hospital from January 2010 to January 2014. We analyzed the clinical factors and parameters that affect dose by univariate and multivariate analysis. Results:A total of 2 323 patients enrolled and 1 241 cases suffering from acute radiation-in-duced lung injury with the rate of 53.4%. Only 185 cases suffered from SARP with a rate of 7.96%. Univariate analysis showed that the gender, histopathological type, total radiation dose, V5 (%), and average dose rate are not related to SARP (P>0.05). By contrast an age of>60 years, 1%predicted FEV, docetaxel+carboplatin/cisplatin chemotherapy, V20 (%), V30 (%), and mean lung dose (MLD) are sig-nificantly related to SARP (P<0.05). Multivariate analysis showed that a patient age of>60 years, docetaxel+carboplatin/cisplatin che-motherapy, V20 (%), and V30 (%) are the independent risk factors of SARP. Conclusion:Among the non-small cell lung cancer patients undergoing IMRT radiotherapy and concurrent chemotherapy, further attention should be given to elderly patients, patients receiving docetaxel and platinum chemotherapy, as well as V20 and V30 with high doses. The necessary preventive treatment should be given to reduce the incidence of SARP, improve the quality of life of patients, and reduce the incidence of respiratory failure and mortality.