Objective To investigate status about the heart rate variability and executive function in patients with insomnia.Methods The study involves 165 cases of patients with insomnia and 92 cases normal.The Pittsburgh Sleep Quality Index (PSQI) screening for insomnia,Wisconsin Card Sorting Test (WCST) for the assessment of executive function and Self-generate Physiological Coherence System (SPCS) were used to collect the data of heart rate variability (HRV).Results The SDNN,RMSSD,TP,LF,HF of HRV of the insomnia group were significantly higher than these factors of control group (t=2.712,2.726,2.427,2.542,2.338,P＜0.05 or P＜ 0.01).In the WCST,number of completed categories,conceptualization percentage of the group of patients with insomnia were significantly lower than the control group (t=-2.368,-2.165,all P＜0.05),persistent errors,persistent error percentages,continuous number of responses of patients' group were significantly higher than the control group (t=2.712,2.991,2.690,all P＜0.01).TP,LF,HF,LF/HF of HRV and the number of error responses,persistent errors,persistent error percentages,continuous number of responses of WCST had significant negative correlations (r=-0.171--0.245,P＜0.05 or P＜0.01),while the conceptualization percentage were significantly positively correlated (r=0.198-0.227,P＜0.05 or P＜0.01).Conclusion The results show that insomnia not only cause individual autonomic disorders,but damage the executive function of prefrontal.HRV and executive function in patients with insomnia have close relationships.

Objective To construct vectors expressing small interfering RNA targeting the Toll like receptor-4 (TLR4) gene and obtain TLR4 knock downed vascular smooth muscle cells (SMC). Methods Three small hairpin RNA (shRNA) targeting the TLR4 gene were designed, synthesized and cloned into the pSilence 2.1-U6 neo vector. Positive clones were verified with double enzyme digestion and sequencing. Then the recombinants were transfected to SMC by the cationic lipid method respectively.SMC were stably transfected with an expression plasmid and screened by G418. TLR4 mRNA and protein expression were detected by RT-PCR and Western blot methods. Results The pSilence2.1-siTLR4 ex-pression vectors were successfully constructed and a TLR4 knock-downed SMC cell line was established. RT-PCR and Western blot analysis confirmed that the expression of TLR4 was significantly down-regulated in the infected SMC cell line, and pSilence2.1-siTLR4-1was the most efficacious recombinant vector.Conclusion Recombinant vectors carrying shRNA targeting the TLR4 gene were successfully constructed and the TLR4 expression in vascular SMCs was inhibited.

Minocycline is the second generation semisynthetic tetracycline antibiotics.A variety of animal models and clinical trials have shown that it has neuroprotective effect.Its mechanism is associated with inhibiting apoptosis, alleviating inflammatory reaction, reducing infarct volume, and alleviating vascular injury.This article reviews the neuroprotective effect of minocycline in preclinical phase and early clinical trials of acute ischemic stroke.

Objective To investigate the expression of tumor-associated carbohydrate antigen sTn in breast neoplasm,and analyzed the association between the expression of sTn and size of tumor,age,menopause,axillary lymph node metastasis,clinical stage,pathologic grade and the level of estrogen receptor in breast carcinoma.Methods The monoclonal antibody TKH-2 was used to detect the immunohistochemical expression of sTn in 46 cases of breast carcinoma,4 breast adenoma and 2 gynecomastia.The level of estrogen receptor was detected by S-P method in 46 breast carcinoma.Results Immunohistochemical expression of sTn was not detected in breast adenoma and gynecomastia.The expression of sTn was found in 28 of 46 breast carcinoma(60.9%).The expression of sTn was significantly associated with axillary lymph node metastasis(P0.05).In 46 breast carcinoma,the positive quantity of estrogen receptor was 25(54.3%).Conclusion STn immunostaining appears to be a poor prognostic factor in patients with breast carcinoma.It is more useful in detecting the expression of sTn together with the level of estrogen receptor in breast carcinoma to investigate the prognosis of the patients.

Diabetes mellitus is an independent predictor of high platelet reactivity after antiplatelet therapy in patients with ischemic stroke,and the latter is closely related to the increased risk of recurrence of stroke.The mechanisms of high platelet reactivity in patients with diabetes or insulin resistance are associated with a variety of factors.Some circulating molecules can be used as markers for predicting the reactivity of platelets.Monitoring of platelet reactivity after treatment with new antiplatelet agents may provide basis for individualized antithrombotic therapy in ischemic stroke patients with diabetes or insulin resistance.

Objective To study the protection against hepatic ischemia-reperfusion injury by human IL-10 gene transduction in rats. Methods Ad-hIL10-EGFP (1. 0 ? 109 plaque forming units/ml) was administered into SD rats by intravenous injection 72 hours before hepatic ischemia-reperfusion injury was induced. Liver function were tested and HE pathology was observed. The expression of hIL-10 was studied with ELISA or immunohistochemical method, the expression of EGFP was observed in frozen sections under the fluoroscopy. The apoptosis of hepatocytes was observed with Tunel's assay. Results Compared with control rats, the expression of EGFP and hIL-10 was observed, serum hIL-10 level was (815.74 ? 284. 76) ng/ml, liver function of treatment rats were improved, the paraffin sections showed that the hepatocytes were not significantly swelling and liver pathology ameliorated, the number of apoptosis cells decreased (P

Secondary immune response is an important endogenous mechanism of neurological injury after ischemic stroke.Spleen and interferon-γγplay an important role in it.Monitoring the spleen size and the level of interferon-γγhave an important reference significance for the severity of stroke and outcome assessment.

Prediabetes is a glucose metabolism status between normal glucose metabolism and diabetes.It can not only increase the risks of occurrence and recurrence of stroke, but also affect stroke outcomes.Prediabetes causes ischemic stroke mainly through the insulin resistance and blood-brain barrier damage.Non-drug or drug intervention in patients with prediabetes can delay progression from prediabetes to diabetes and reduce the risks of occurrence and recurrence of stroke.

Objective To investigate the changes of platelet reactivity and its influencing factors after aspirin treatment in patients with ischemic stroke complicated with diabetes. Methods From September 2016to December 2017, patients with acute ischemic stroke admitted to the Department of Neurology, Weihai Municipal Hospital within 24 h of onset were enrolled. All patients took aspirin (100 mg/d) within 24 h ofadmission, and after taking the drug (7 ±2 d), the PL-11 platelet function analyzer was used to determine the maximum platelet aggregation ratio (MAR) induced by arachidonic acid (AA). The baseline data of the patients were documented. The factors affecting high platelet reactivity (HPR) were analyzed. Results A total of 398 patients with ischemic stroke were enrolled, including 137 in the diabetes group and 261 in the non-diabetes group. MARAA (43. 45％ ± 14. 11％ vs. 31. 55％ ± 19. 39％; t = 6. 996, P < 0. 001) and the incidence of HPR (34. 3％ vs. 19. 9％; χ2 = 9. 946, P = 0. 002) in the diabetes group were significantly higher than in those in the non-diabetes group. Of the 137 patients with ischemic stroke complicated with diabetes, 47 had HPR. The proportions of patients with hyperlipidemia, previous history of stroke or transient ischemic attack and baseline NIHSS score, HOMA-IR (homeostatis model assessment-insulin resistance),high-sensitivity C-reactive protein, fasting blood glucose, and glycosylated hemoglobin in the HPR group were significantly higher than those in the non-HPR group (all P < 0. 05). Multivariate logistic regression analysis showed that HOMA-IR (odds ratio [OR] 1. 153, 95％ confidence interval [CI] 1. 027-1. 295; P =0. 016), high-sensitivity C-reactive protein (OR 9. 416, 95％ CI 2. 271-39. 049; P = 0. 002), fasting blood glucose (OR 1. 125, 95％ CI 1. 025-1. 235; P = 0. 013), and glycosylated hemoglobin (OR 1. 458, 95％ CI 1. 170-1. 816; P = 0. 001) were the independent risk factors for HPR. Conclusion The platelet reactivity during aspirin therapy in patients with ischemic stroke complicated with diabetes mellitus was high, and platelet activity was associated with multiple mechanisms, such as inflammation, insulin resistance, and hyperglycemia.

Objective To screen a set of key techniques for new medical rescue aircraft ICU care for peacetime and wartime.Methods The study used the literature review and field research method to propose the initial technical indicators.The consultation questionnaire was developed by expert panel method.Delphi method was applied to conduct two rounds of consultation among 16 experts from different fields.Analytic hierarchy process and TOPSIS comprehensive evaluation method were used to analyze and summarize data.Results In two rounds of consultation,the positive coefficients of experts were 100％,the authority coefficient of experts was 0.958,and Kendall co ordination coefficients were 0.568,0.525,0.474,and the differences were statistically significant (P＜0.05).The new medical rescue aircraft ICU care key techniques for peacetime and wartime was established finally,including 4 firstlevel indicators,37 second-level indicators,and there were 12 basic care techniques,8 specialty care techniques,10 emergency care techniques,and 7 war wound care techniques.Conclusion Key techniques for new medical rescue aircraft ICU care has high scientificity and feasibility,and experts' opinions are concentrated,which can provide additional safeguard for the transit of critically ill patients in the air.