Objective To explore the main influencing factors of recurrent stroke.Methods 2 065 new stroke patients were selected as study populations.The recurrent stroke status and kinds of influencing factors were followed up.The follow-up study time was 3 years.Single factor and multi-factor analysis methods were carried out for influencing factom of recurrent stroke by Cox proportional hazaIds regression models.Results By the end.1 881 pa%);45 patients were recurrent in 6accepted visit,184 were lost follow-up.327 patients were recurrent(17.38tients months(13.76%);68 patients were recurrent during 6 months to 1 year(20.80%);97 patients were recurrent during 1 year to 2 years(29.66%);117 patients were recurrent after 3 years(35.78%).Single factor Cox regression analysis:The risk factors of recurrent stroke were advanced age(RR=1.48),smoking(RR=1.35),fat intake(RR=1.83),hypertension history(RR=2.54),diabetes history(RR=1.72),high lipemia(RR=1.83),stroke family history(RR=2.62),depression(RR=1.84),life events(RR=2.53),fibrinogen(RR=1.75),carotid plaques(RR=2.68);The protecting favors of recurrent stroke were female(RR=0.64),sports(RR=0.33),social support(RR=0.36).Multi-factor Cox regression analysis:the risk factors of recurrent stroke were hypertension history(RR=1.86),high lipemia(RR=1.95),stroke family history(RR=2.62),life events(RR=2.38),carotid plaques(RR=2.77);The protecting factors of recurrent stroke were sports(RR:0.35),social support(RR=0.32).Conclusion The prevention of hypertension history,high lipemia,the family history of stroke,more supports and the high ability of answering life events could help to prevent the recurrent stroke.

OBJECTIVETo explore the relationship between CD133(+) subsets cells in human gastric cancer (GC) and molecules of drug resistance and their sensitivity to 5-FU.

METHODSThree gastric cancer cell lines therein KATO-III(, SGC7901 and MKN45 were sorted by immunomagnetic beads cell sorting method. Then above cell lines were further divided into un-sorted GC cells, CD133(+) subgroup and CD133(-) subgroup. The expressions of CD133, P-gp, Bax and Bcl-2 were determined by RT-PCR, Western blot and immunoflurescence. Meanwhile, the sensitivity to 5-FU of three subgroups was detected by CCK-8 Kit. The apoptosis induced by 5-FU in three subgroups was determined by Hoechst 33258.

RESULTSExpressions of CD133 in three CD133(+) subgroups were significantly higher than those in un-sorted GC cells and CD133(-) subgroup (all P<0.05). Expressions of P-gp and Bcl-2 in the three GC cell lines were different (all P<0.05). There were significant differences of expressions of P-gp, Bcl-2 and Bax among CD133(+) cells, un-sorted GC cells and CD133(-) cells (all P<0.05). CCK-8 detection showed that CD133(-) subgroup of MKN45 GC cell line was more sensitive than CD133(+) cells to 5-FU (P<0.05). Hoechst 33258 staining showed that there were more apoptotic cells in CD133(-) subgroup as compared to other two subgroups, and the least apoptotic cells were observed in CD133(+) subgroup of MKN45 GC cell line (P<0.05). CD133 sirna was transfected into MKN45 GC cell line and could down-regulate the expressions of CD133, P-gp, Bcl-2 and p-Akt, while the expression of Bax increased (all P<0.05).

CONCLUSIONSCD133 may contribute to the resistance of GC cells to chemotherapy drug through P-gp, Bcl-2 and Bax. PI3K/Akt signal pathway may be involved in this process.

AC133 Antigen ; ATP-Binding Cassette, Sub-Family B, Member 1 ; Antigens, CD ; metabolism ; Antineoplastic Agents ; pharmacology ; Apoptosis ; Cell Line, Tumor ; Drug Resistance, Neoplasm ; Fluorouracil ; Glycoproteins ; metabolism ; Humans ; Peptides ; metabolism ; Phosphatidylinositol 3-Kinases ; Proto-Oncogene Proteins c-akt ; RNA, Small Interfering ; Stomach Neoplasms ; drug therapy ; metabolism ; pathology ; bcl-2-Associated X Protein

Objective To compare the curative effect of tissue-selecting therapy stapler and procedure for prolapse and hemorrhoids in the treatment of patients with stage Ⅲ to Ⅳ hemorrhoids.Methods The patients with stage Ⅲ to Ⅳ hemorrhoids who underwent prolapse and hemorrhoids or tissue-selecting therapy stapler surgery in the department of General Surgery,Shanghai Ninth People's Hospital and Xinhua Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Chongming Branch,from Jan.2013 to Jun.2014 were accepted and allocated to prolapse and hemorrhoids or tissue-selecting therapy stapler group.The peri-operative parameters about operative time,blood loss,postoperative hospital stay and the time required to return to normal activity were compared by t test,The postoperative complications including pain assessment and the incidence of postoperative bleeding,urine retention,faecal urgency,fecal incontinence,anal stenosis,rectovaginal fistula and recurrence rate were compared by t test and chi-square test.Rank sum test was used to compare the recurrence rate and patient's satisfaction between the two groups.Results The operation time,intraoperative bleeding volum,postoperative hospital stay and the time required to return to normal activity in the procedure for prolapse and hemorrhoids group were signifcantly higher than those in the tissue-selecting therapy stapler group (P =0.021,P =0.003,P =0.001,P ＜0.001).The pain score of procedure for prolapse and hemorrhoids group were all higher than those of the tissue-selecting therapy stapler group in the first post-operative defecation and in post-operative 24 hours and 72 hours (all P ＜ 0.001).The incidence of faecal urgency of the procedure for prolapse and hemorrhoids group in post-operative 1 month (18.6％) was higher than that of the tissue-selecting therapy stapler group (6.6％) (P =0.036).There were no statistically significant differences in the incidence of postoperative bleeding,urinary retention,recurrence rate and patient's satisfaction between two group (P ＞ 0.05).Conclusion Tissue-selecting therapy stapler was superior to the procedure for prolapse and hemorrhoids in operation time,intraoperative blood loss,postoperative pain and the incidence of faecal urgency.Long-term results demonstrate that tissue-selecting therapy stapler and prolapse and hemorrhoids have similar effectiveness.