ObjectiveTo compare the differences in stroke subtype classification between ASCO and modified TOAST.MethodsAll 425 first-ever ischemic stroke patients were recruited and classified into different stroke subtypes according to the ASCO and modified TOAST criteria.Results Comparing ASCO grade 1 with modified TOAST,more patients were classified as atherosclerosis (60.2％ vs 57.9％ ; x2 =2.68,P=0.132) and fewer as small artery disease and cardiac disease subtype (13.4％ vs 14.8％ and 8.5％ vs 8.7％ ; x2 =1.30 and 0.00,P =0.238 and 1.000,respectively).ASCO grade 1 did not reduce the proportion of cause undetermined patients compared with modified TOAST ( 15.5％ vs 16.2％ ; x2 =0.09,P =0.795 ). Agreement was showed in every subtype categories between the two approaches.Agreement for atherosclerotic cause and small artery disease was very good ( all κ over 0.81 ),and for the cardiac disease subtype was good (κ: 0.61-0.80). Conclusion Agreement can be found in every subtype categories between ASCO and modified TOAST classification.ASCO grade 1 does not reduce the proportion of cause undetermined cases compared with modified TOAST,but the subtype categories characteristics of the two approaches should be considered in practice.

OBJECTIVE:To systematically evaluate the efficacy and safety of simvastatin vs. pravastatin in the treatment of hy-perlipidemia,and provide evidence-based reference for the clinical treatment. METHODS:PubMed,Medline,EMBase,Cochrane Library and CJFD were retrieved to collect the randomized controlled trial(RCT)of efficacy and safety of simvastatin(test group) and pravastatin (control group) in the treatment of hyperlipidemia. The methodological quality of included studies was evaluated. The Rev Man 5.2 software was chosen for data analysis. RESULTS:14 RCT involving 1 019 patients were included. Meta-analysis showed that simvastatin had more significant effect in the decreasing of TC [MD=-0.34,95%CI(-0.52,-0.16),P<0.001] and LDL-C[MD=-0.31,95%CI(-0.45,-0.17),P<0.001] than pravastatin;and simvastatin and pravastatin had the similar effect in TG[MD=-0.06,95%CI(-0.18,0.05),P=0.28)] and HDL-C[MD=0.00,95%CI(-0.04,0.04),P=0.85]. Adverse drug reaction rate results showed they were similar[OR=0.70,95%CI(0.36,1.39),P=0.31]. CONCLUSIONS:Simvastatin is more effective in lipid-lowering than pravastatin with similar safety. Due to the limited number and low quality of included studies,it remains to be further verified with more reasonably designed,multi-center and large-sample studies.

Cardiopulmonary resuscitation board (CPR Board) is an essential tool in emergency care, which can keep the patient's airway open and support the patient in the administration of CPR. This paper introduces the structure, performances and clinical trials of a CPR board.

Objective To develop the physical model of male pelvic organ group and conduct corresponding prostate puncture experiments.Because sufficient research and plenty of surgical training is very important for improving the surgical treatment effect of prostate puncture surgery,in which the deformation of needle and tissue has significant influences on surgical precision.Methods Based on the magnetic resonance images,the 3D reconstruction of human pelvic organs group was performed,and then the monomer organ moulds were designed.The monomer organ models were made by a new type of polyvinyl alcohol (PVA) hydrogel which is a biomimetic material and can simulate biomechanical properties of different tissues by adjusting the proportion of components.The monomer organ models were assembled to simulate the internal environment of pelvic cavity based on the human anatomical structure,and the experiments of insertion force and deformation were conducted.Results The results of insertion force experiments indicated that the mechanical properties of the proposed model of pelvic organ group were coincident with the force variation in real surgury.During the insertion deformation experiments,the deformation of needle and organs could be clearly observed in the ultrasound images,which indicates that the pelvic organ group has good ultrasonography compatibility.Conclusions The proposed physical model of male pelvic organ group can meet the requirements of experiment research and surgical training of prostate puncture,which provides foundation for improving precision and popularization of puncture surgery.

Objective To analyze the doctors' working enthusiasm and its influencing factors on county level hospitals.Methods 17 seminars were held in 8 counties of 3 provinces to investigate 1055 doctors with questionnaires, analyzing the three scales of working enthusiasm, working enthusiasm influencing factors, and changes since the 2009 new healthcare reform.Results Working enthusiasm comprises inner drive, working pleasure, work recognition and external recognition, and inner drive of which is found to play the most important part, with 20.55％ variance contribution.Among the six dimensions of the influencing factors, working conditions rank the highest with 19.46％ variance contribution.Conclusion Optimized measures in the healthcare reform, better working conditions and social environment can improve working enthusiasm of these doctors.

Combining theory and practice at home and abroad in recent years ,construction plan of the military infectious diseases syndromic surveillance system was discussed from aspects of data collection and transmission , data analysis and early warning , incident response based on the core business requirements of syndromic surveillance for infectious diseases . The study provides the demand traction for the system construction .

Objective:To investigate the effects of pregnancy and lactation nonylphenol (NP) exposure on the balance of Treg/Th17 cells in the brain of offspring mice and the related mechanisms.Methods:Thirty pregnant C57BL/6 mice were randomly divided into three groups: control group (drinking distilled water), and NP-treated groups (drinking 0.2 μg/ml or 2.0 μg/ml NP water solution). ELISA kit was used to analyze the levels of TNF-α, IFN-γ and IL-17, flow cytometry was used to analyze the frequency of Treg and Th17 cells in spleen, quantitative RT-PCR was used to analyze the RORγt, Foxp3 mRNA, Western blot was used to analyze the protein expression of RORγt, Foxp3 and PI3K/Akt/mTOR signal pathway, and immunofluorescence was used to analyze the expression of Iba1 in the brain tissue of offspring mice.Results:Compared with the control group, NP exposure increased the serum levels of IL-17 and TNF-α in male offspring mice ( P<0.05), and decreased the levels of IFN-γ( P<0.05). Flow cytometry analysis showed that the percentage of Th17 cells in the spleen of male offspring mice exposed to NP (0.2 μg/ml or 2.0 μg/ml) was significantly higher than that of the control group, while the percentage of Tregs cells was lower. Compared with the control group, the expression levels of Foxp3 proteins in the brain tissue of male offspring mice exposed to NP (0.2 μg/ml or 2.0 μg/ml) was significantly lower, accompanied by a dramatic increase in RORγt protein levels ( P<0.05). Similar mRNA expression was also observed in qRT-PCR analysis. The protein expression levels of mTOR (p-mTOR) and its upstream related regulators[PI3K, p-Akt (Ser473), p-Akt (Thr308)] in the brain of male offspring mice increased gradually during the period of exposure to NP( P<0.05). Immunofluorescence analysis showed that compared with the control group, the number of Iba1 positive cells in brain tissue of male offspring mice exposed to NP (0.2 μg/ml or 2.0 μg/ml) increased significantly ( P<0.05). Conclusions:Maternal exposure to NP during pregnancy and lactation may affect the development/function of neurons in offspring through neuroimmune axis, and increase the risk of neurodevelopmental disorders in offspring.

To propose an equipment and technology package for oxygen preparation and supply under hypoxia conditions in order to meet the requirements of populations on the plateau .Different populations were analyzed in terms of their oxygen supply requirements, and the modes, schemes and equipment for oxygen supply were explored accordingly and then applied.Efforts in the past 20 years have resulted in the advances in the equipment for centralized, mobile and portable oxygen preparation and supply, though the equipment for individual use hads to be improved and the diffused oxygen supply scheme also needs to be further evaluated .

Objective:To investigate the effect on the CXCR4/PI3K/AKT pathway after the transfection of miR-155 mimics and miR-155 inhibitor combined with the research on the ability of invasion and migration of human chorionic JEG-3 trophoblast cells. Methods:Chemically synthesized miR-155 mimics and miR-155 inhibitor were transfected into JEG-3 cells. The effect on the ability of invasion and migration were analyzed by Transwell migration assay and Wound healing assay. The expression of CXCR4 mRNA was detected by Real-time PCR. The expression of CXCR4 and p-AKT protein were detected by Western blot. Results: Transfection with miR-155 mimics significantly down-regulated the expression of CXCR4 as compared with the control group(P<0. 05);JEG-3 cells transfected miR-155 mimics had lower levels of migration and invasion capacity than cells in the control group(P<0. 05). However, transfection with miR-155 inhibitor significantly up-regulated the expression of CXCR4 as compared with the control group(P<0. 05);JEG-3 cells transfected miR-155 inhibitor had higher levels of migration and invasion capacity than cells in the control group ( P<0.05).Addition,the expression of p-AKT protein of JEG-3 cells was down-regulated after transfected miR-155 mimics,and the expression of p-AKT protein of JEG-3 cells was up-regulated after transfected miR-155 inhibitor. Conclusion:miR-155 may inhibits the invasion and migration of trophoblast cells by regulating CXCR4/PI3K/AKT pathway contributing to the development of preeclampsia.

Objective To investigate the effects of stromal cell-derived factor 1 (SDF-1) and an CXC chemokine receptor 4 (CXCR4) antagonist (AMD3100) on the invasion and migration capabilities of the huaman choriocarcinoma cell line JAR for further elucidating the role of SDF-1/CXCR4 axis in the pathogenesis of preeclampsia.Methods JAR cells were divided into four groups: SDF-1 group (treated with 50 ng/ml of SDF-1),SDF-1+AM3100 mixed group (first treated with 100 ng/ml of AMD3100 for 2 hours and then treated with 50 ng/ml of SDF-1),AMD3100 group (treated with 100 ng/ml of AMD3100) and blank control group (without any treatment).RT-PCR was performed to detect the expression of CXCR4 at mRNA level in JAR cells.Western blot assay was used to measure the expression of CXCR4 and p-AKT at protein level.MTT assay was used to analyze the effects of different concentrations of SDF-1 (10,30,50 and 100 ng/ml) on the proliferation of JAR cells at different time points (0,24,48,72 h).Transwell invasion assay and wound-healing assay were used to test the changes in invasion and migration capabilities of JAR cells after different treatments.Results (1) Results of the RT-PCR showed that the expression of CXCR4 at mRNA level in JAR cells was increased in the SDF-1 group (1.839±0.083) as compared with that in the blank control group (1.372±0.086),AMD3100 group (0.694±0.045) or SDF-1+AM3100 mixed group (0.703±0.093).Moreover,the differences between the SDF-1 group and the other three groups were statistically significant (F=30.67,P<0.05).Compared with the blank control group,the expression of CXCR4 at mRNA level in JAR cells was decreased in the AMD3100 group (P<0.01).(2) Results of the Western blot assay showed that the expression of CXCR4 and p-AKT at protein level in JAR cells were enhanced in the SDF-1 group as compared with that in the blank control group,AMD3100 group or SDF-1+AM3100 mixed group.Compared with the blank control group,the expression of CXCR4 and p-AKT at protein level in JAR cells were inhibited in the AMD3100 group.(3) Results of the MTT assay showed that SDF-1,especially at the concentration of 50 ng/ml,could enhance the proliferation of JAR cells (P<0.05) and its best effect on proliferation was seen at 48 h.(4) Results of the Transwell invasion assay showed that the number of transmembrane cells in the SDF-1 group (70.49±2.42) was more than that in the blank control group (54.36±2.26),AMD3100 group (21.68±8.31),or SDF-1+AMD3100 mixed group (28.18±4.61).The differences between the SDF-1 group and the other three groups were statistically significant (F=116.26,P<0.01).Compared with the blank control group,the number of transmembrane cells was reduced in the AMD3100 group (P<0.05).(5) Results of the wound-healing assay showed that the relative migration distance was increased in the SDF-1 group (1.162±0.034) as compared with that in the blank control group (0.823±0.101),AMD3100 group (0.160±0.047),or SDF-1+AMD3100 mixed group (0.183±0.064).The differences between the SDF-1 group and the other three groups were statistically significant (F=30.500,P<0.05).Compared with the blank control group,the relative migration distance was decreased in the AMD3100 group (P<0.01).Conclusion The invasion and migration of huaman choriocarcinoma JAR cells can be enhanced by SDF-1,but inhibited by AMD3100.This study indicates that the blocked biological axis of SDF-1/CXCR4 may play an important role in the pathogenesis of preeclampsia through inducing abnormal activation of PI3K/AKT pathway,which results in inhibited invasion and migration of trophoblast cells and placenta abnormality.