Objective To investigate the characteristics and risk factors for cognitive decline in elderly patients with cerebral infarction.Methods A cross-sectional study was performed to investigate the population of Jiang'an Town,Rugao,Jiangsu Province from November 13,2014 to December 21,2014.The samples from the Rugao longitudinal study of aging included 1 788 individuals from 31 villages aged from 70 to 84 years.They were all Han nationality,including 830 males and 958 females.History of cerebral infarction was identified according to the neurological diagnosis confirmed by the secondary hospital and above or brain CT.The modified Kyohko Hasegawa dementia scale was used to evaluate the cognitive function.Five dimensions (orientation,memory,near memory,computing power,and common sense) of this population were assessed.The total score >21.5 was non-cognitive impairment and ≤21.5 was cognitive impairment.Multivariate logistic regression was used to analyze the risk factors for cognitive decline in elderly patients with cerebral infarction.Results (1) In the 1 788 subjects,133 had cerebral infarction (7.4%),and 1 655 did not have cerebral infarction.The proportion of hypertension in patients with cerebral infarction was higher than that without cerebral infarction (63.9% [n=85] vs.41.7% [n=690]).The high-density lipoprotein cholesterol level was lower than that of the non-cerebral infarction group (1.40±0.29 mmol/L vs.1.47±0.33 mmol/L).There was statistically significant difference (all P<0.05).(2) The patients with cerebral infarction were partially impaired in orientation and computational power,and the overall cognitive function score was 20±7,which was significantly lower than patients with non-cerebral infarction (21±6).The difference between the two groups was statistically significant (P<0.05).(3) In 133 patients with cerebral infarction,76 had cognitive impairment,the incidence was 57.1%,and 59 of them were women.The average value of serum creatinine in patients with cognitive impairment was 59±15 μmol/L,which was significantly lower than those with non-cognitive impairment (66±14 μmol/L).There was significant difference (P<0.05).(4) Multivariate logistic regression analysis showed that the education level below primary school (OR,2.86,95%CI 2.19-3.72) and female (OR,1.85,95%CI 1.50-2.28) were the independent risk factors for cognitive decline in elderly patients with cerebral infarction.High serum creatinine concentration (OR,0.96,95%CI 0.95-0.97) was a protective factor for it.Conclusion The cognitive function of the elderly was decreased after cerebral infarction,especially in the aspect of orientation and calculation.The education level below primary school and women were the independent risk factors for cognitive impairment,and high serum creatinine concentration had a certain protective effect.

Objective : To investigate the current status of hearing loss in a fastener manufacturing enterprise, and to analyze its influencing factors, so as to provide insights into occupational disease prevention and control. Methods: The occupational health examination data of noise exposed workers and the workplace occupational disease hazard factors detection data in a fastener manufacturing enterprise in Jiaxing City in 2022 were collected through the Occupational Disease and Occupational Health Hazard Factors Detection System of China Disease Prevention and Control Information System, and factors affecting the development of high-frequency noise-induced hearing loss (HFNIHL) and speech-frequency noise-induced hearing loss (SFNIHL) were analyzed. Results: Totally 625 workers were investigated, with a median age of 44.00 (interquartile range, 13.00) years and a median length of service of 8.00 (interquartile range, 9.00) years, and including 519 men (83.04%) and 106 women (16.96%). There were 309 workers with single noise exposure (49.44%) and 316 workers with joint noise exposure (50.56%), and 518 workers exposed to noise with the normalized continuous A-weighted sound pressure level equivalent to a 40 h working week (LEX,40 h) that exceeded the national standard (82.88%). The detection rates of HFNIHL and SFNIHL were 49.12% and 35.04%, respectively. Multivariable logistic regression analysis indicated that males (OR=10.528, 95%CI: 5.271-21.025), length of service of 10 years and longer (OR=2.451, 95%CI: 1.599-3.759), LEX,40 h of >85 dB (A) (OR=2.227, 95%CI: 1.318-3.764) and joint noise exposure (OR=3.002, 95%CI: 2.080-4.334) were associated with an increased risk of HFNIHL, and male (OR=9.400, 95%CI: 4.211-20.985), LEX,40 h of >85 dB (A) (OR=2.305, 95%CI: 1.345-3.951), and joint noise exposure (OR=3.880, 95%CI: 2.677-5.623) were associated with an increased risk of SFNIHL. Conclusion Gender, length of service, noise intensity and exposure mode are factors affecting the risk of HFNIHL, while gender, noise intensity and exposure mode are factors affecting the risk of SFNIHL.

Tissue engineering is a comprehensive discipline that combines materials science, life sciences, and engineering to repair, and improve and preserve damaged tissues or organs through cell or tissue reconstruction. In recent years, with the rapid development of tissue engineering technology, tissue engineering trachea has gradually become a new approach to tracheal replacement therapy. However, due to the slender and periodic distribution of the blood vessels supplying the trachea, tracheal grafts cannot obtain sufficient blood supply to maintain its demand, making its vascularization problem one of the major obstacles to the development of tissue engineering trachea. In the construction of tissue engineering trachea, the vascularization strategy of seed cells, tracheal scaffold and growth factors have gradually become the focus of research. In this paper, the current researches on tissue engineering tracheal vascularization were reviewed.

Tissue engineering provides an effective treatment for tracheal reconstruction. The key to maintain airway function and ensure long-term survival of tracheal grafts is how to achieve epithelial cell regeneration, chondrocyte regeneration, and angiogenesis of the transplanted trachea. Growth factors are signaling molecules that direct cell development by providing biochemical cues for stem cell proliferation, migration, and differentiation. They play an important role in tissue engineering trachea regeneration. It is particularly important to design a delivery system that provides optimal activity, stability and adjustability for growth factors. This article summarizes the types, characteristics, functions of growth factors applied in the field of tissue engineering trachea, and the value of growth factors in tissue engineering trachea orthotopic transplantation aimed for promoting clinical transformation of tissue engineered trachea.

With the development of precision medicine in the field of tumor,thanks to the latest screening technology,the demand for real-time monitoring of tumor is increasingly high.Traditional tissue biopsy is not suitable for repeated due to clinical problems such as puncture clinical risk and tumor heterogeneity.Ultrasound,endoscopy and other imaging examinations are highly subjective,and it is difficult to detect small lesions,and increasingly unable to meet the requirements of real-time monitoring.However,circulating tumor DNA,with its advantages of simple sample acquisition,small trauma,repeatability and real-time monitoring efficacy,has an important application prospect in tumor diagnosis and treatment.Based on the latest reports at home and abroad,this paper reviews the research progress of circulating tumor DNA in the early diagnosis,treatment and prognosis of esophageal cancer.

Objective To explore the role of deep brain stimulation of subthalamic nucleus (STN-DBS) in treatment of Parkinson's disease (PD) related neuroleptic malignant syndrome (NMS).Methods The medical history,clinical features,STN-DBS programmed treatment process and treatment results of two patients admitted to our hospital in December 2014 and November 2018 were retrospectively analyzed.Results Two patients with post-operative STN-DBS were evoked by dose-reduced treatment of anti-parkinsonian drugs,and presented with high fever,disorder of consciousness,aggravation of the original parkinsonism,and increase of creatine phosphokinase,which were not correlated with outcomes of infection.After admission,anti-parkinsonian drugs and other supportive therapies were supplemented;STN-DBS modulation were given to improve the symptoms;the final parameters of patient one were the left (C+,2-,1-),pulse width 110 μs,frequency 200 Hz,and strength 3.8 V;the right side (C+,6-,5-),pulse width 110 μs,frequency 200 Hz,strength 4.4 V;and those of patient two were the left (C+,3-),pulse width 60 μs,frequency 130 Hz,strength 2.0 V;right side (C+,6-),pulse width 80 μs,frequency 160 Hz,and strength 2.8 V.Both patients were cured,but their motor function and self-care ability were severely impaired.Conclusion STN-DBS may play an important role in the treatment of PD related NMS.

OBJECTIVETo investigate the mechanism of U87 cell apoptosis induced by inhibiting miR-21 expression.

METHODSAntisense oligonucleotides of miR-21 were chemically synthesized and transfected into U87 cells. The apoptosis, proliferation, and invasion of the cells were evaluated. The relationship between miR-21 and PTEN or caspase was identified by bioinformatics and Western blot.

RESULTSInhibiting miR-21 expression led to U87 cell growth suppression, apoptosis induction, invasion reduction, caspase-3 activity elevation and caspase-9 activation, but did not affect PTEN and caspase-8 expression.

CONCLUSIONmiR-21 may function as an antiapoptotic miRNA in U87 cells. Inhibiting miR-21 expression could induce U87 cell apoptosis via caspase-9 and 3 activation, but not PTEN activation.

Animals ; Apoptosis ; drug effects ; genetics ; Caspases ; metabolism ; Cell Line, Tumor ; Cell Proliferation ; Enzyme Activation ; genetics ; Gene Expression Regulation, Neoplastic ; Glioma ; genetics ; pathology ; Humans ; MicroRNAs ; antagonists & inhibitors ; genetics ; Oligoribonucleotides, Antisense ; genetics ; pharmacology ; PTEN Phosphohydrolase ; metabolism ; Transfection

Purpose To explore the expression of autoph-agy-related 7(ATG7)in breast cancer and its effect on the breast cancer development.Methods Immunohistochemistry(IHC)was used to detect ATG7 protein expression in breast cancer tissues and the relationship between ATG7 and clinico-pathological features was analyzed.ShRNA was used to interfere with the expression of ATG7 in breast cancer cell line MCF-7.Puromycin was used to screen for stably transfected cells and Western blot was used to detect transfection efficiency.The effect of ATG7 knockdown cells on proliferation ability was de-tected by CCK8 and clone formation experiments.The effect of ATG7 knockdown cells on tumorigenicity in vivo was detected by subcutaneous tumor formation experiment in nude mice.Results IHC showed that ATG7 expression in breast cancer tissues was mainly localized in cytoplasm,and its expression was significant-ly correlated with tumor size and Ki67 expression(P＜0.05).ATG7-shRNA significantly interfered with ATG7 expression in breast cancer cells MCF-7.CCK8 and clone formation experi-ments showed that ATG7 knockdown promoted the cell prolifera-tion compared with the control group.The experiment of subcu-taneous tumor formation in nude mice showed that the tumor for-mation ability of mice was significantly increased after ATG7 knockdown compared with the control group.Conclusion ATG7 may inhibit the proliferation capacity of breast cancer and could be a potential target for breast cancer therapy.

Objective:To investigate the optimal keV value of a novel dual-layer spectral detector CT virtual monoenergetic images (VMI) for displaying esophageal cancer lesions and to evaluate its diagnostic efficacy for preoperative T staging of esophageal cancer.Methods:The data of 50 patients with esophageal carcinoma in Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School from October 2019 to August 2020 were retrospectively analyzed. There were 42 males and 8 females, aged 49-78(65±7) years. All patients underwent novel dual-layer spectral detector CT chest enhanced scan before treatment, the conventional CT images and 40-200 keV VMI were reconstructed. One-way ANOVA and Kruskal-Wallis H rank sum test were used to compare the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) among conventional CT images and 40-200 keV VMI.The 5-grade grading method were applied for subjective evaluation, and the Friedman test was used to compare the differences in the subjective evaluation of image quality in each group.Spearman test was used to analyze the correlation of images at different energy levels with SNR and CNR. Fisher exact test was used to compare the accuracy of conventional CT and optimal keV value images for preoperative diagnosis of T staging of esophageal cancer. Results:There were significant differences in SNR and CNR among conventional CT images and 40-200 keV VMI images ( P<0.001), and the SNR and CNR of 40 keV images were superior to those of conventional CT images and 70-200 keV VMI images ( P<0.05). The energy level of 40-200 keV VMI was negatively correlated with SNR and CNR (SNR: r=-1.000, P<0.001; CNR: r =-1.000, P<0.001). The overall difference in subjective image quality scores among conventional CT images and 40-200 keV VMI was statistically significant (χ 2=498.37, P<0.001), of which the subjective image quality of 40-60 keV VMI was superior to that of conventional CT images ( P<0.05). The accuracy of preoperative diagnosis of T-stage of esophageal cancer was 62.9% (22/35) for both 40 keV VMI and conventional CT images. Conclusion:The novel dual-layer spectral detector CT of 40 keV VMI has the best display of esophageal cancer, and the accuracy of preoperative diagnosis of T staging is similar to that of conventional CT.

Objective:To investigate the impact of lifestyle, apolipoprotein E (ApoE) gene, and their interaction on the risk for cognitive frailty in the elderly population in China.Methods:The study participants were from the Chinese Longitudinal Healthy Longevity Survey. The information about their lifestyles were collected by questionnaire survey, and a weighted lifestyle score was constructed based on β coefficients associated with specific lifestyles to assess the combined lifestyle. ApoE genotypes were assessed by rs429358 and rs7412 single nucleotide polymorphisms. Cognitive frailty was assessed based on cognitive function and physical frailty. Cox proportional hazards regression model was used to analyze the association of lifestyle and ApoE gene with the risk for cognitive frailty and evaluate the multiplicative and additive interactions between lifestyle and ApoE gene. Results:A total of 5 676 elderly persons, with median age [ M ( Q1, Q3)] of 76 (68, 85) years, were included, in whom 615 had cognitive frailty. The analysis by Cox proportional hazards regression model indicated that moderate and high levels of dietary diversity could reduce the risk for cognitive frailty by 18% [hazard ratio ( HR)=0.82, 95% CI: 0.68-1.00] and 28% ( HR=0.72, 95% CI: 0.57-0.91), respectively; moderate and high levels of physical activity could reduce the risk by 31% ( HR=0.69, 95% CI: 0.56-0.85) and 23% ( HR=0.77, 95% CI: 0.64-0.93), respectively. Healthy lifestyle was associated with a 40% reduced risk for cognitive frailty ( HR=0.60, 95% CI: 0.46-0.78). ApoE ε4 allele was associated with a 26% increased risk for cognitive frailty ( HR=1.26, 95% CI: 1.02-1.56). No multiplicative or additive interactions were found between lifestyle and ApoE gene. Conclusions:Dietary diversity and regular physical activity have protective effects against cognitive frailty in elderly population. Healthy lifestyle can reduce the risk for cognitive frailty in elderly population regardless of ApoE ε4 allele carriage status.