Nuclear factor erythroid2-related factor 2(Nrf2) is an important protective transcription factor that generally exists in various organisms and cellules.Normally,it is sequestered in the cytoplasm.Environmental stress can activate its signal factor,lead to its nuclear translocation,and enhance the anti-oxidation,deintoxication and anti-apoptosis function of the organism,for which the Nrf2-antioxidant response element(Nrf2-ARE) signaling pathway is one of the most important protective ones.This article updates the cytoprotective effect of Nrf2-ARE signaling pathway.

Objective To evaluate the safety and effect of the use of micro coils in endovascular embolization of anterior communicating artery aneurysms. Methods The clinical data of 27 consecutive patients with anterior communicating artery aneurysm, who were admitted to Yancheng Municipal Third People’s Hospital to receive endovascular embolization treatment with micro coils, were retrospectively analyzed. One patient had multiple anterior communicating artery aneurysms. The efficacy and safety of endovascular micro-coil embolization of anterior communicating artery aneurysm were evaluated by the occlusion rate of aneurysm, the prognosis of the patients, the complications, the neurological function, etc. Results Successful embolization treatment of anterior communicating artery aneurysm was achieved in all 27 patients. Dual catheter technique was employed in 3 patients, stent-assisted technique was used in 3 patients, and the technical success rate was 100%. Dense embolization was obtained in 21 patients, and residual aneurysm neck was observed in 6 patients. The unobstructed parent artery was reserved in all patients, no hemorrhage due to ruptured aneurysm or dropping of steel coil was found. One patient developed recurrent hemorrhage and died two days later. Mild recurrence was seen in one patient six months after the treatment. The modified Rankin scal (mRS) score showed that 0-1 point was seen in 24 patients, 2 points in one patient, and 4 point in one patient. Conclusion The anterior communicating artery aneurysm can be safely and effectively cured when appropriate endovascular embolization technique is used.

Objective To compare the efficacy of the therapeutic alliance of radiotherapy and Semustine (CCNU)chemotherapy with radiotherapy alone after partial resection of high-grade sliomas.Methods Forty-nine cases with partial resection of brain gliomas were randomly divided into two groups.In the control group(sole radiotherapy n=19),patients were only treated with local radiotherapy,with the dose of 40Gy/20f/4W,and then added the amount to 61～64Gy/27～28f/5～6W with low fractionation radiotherapy.In the observation group(therapeutic alliance n=23),patients underwent the above mentioned radiotherapy plus six Courses of adjuvant CCNU chemotherapy.Meanwhile,enhanced GD-MRI was performed to evaluate the changes of glioma volume,the nerve function status was evaluated with Karnofsky scale,and record the survival time.Results Twenty-four weeks after radiotherapy,improvements in glioma size and nerve function status of the observation group were superior than that in the control group(all P＜0.05),meanwhile,the long-term survival rate of observation group war also significantly better than that of the control group(P＜0.05).Conclusion Radiotherapy combined with CCNU could increase the glioma remission rate after partial resection,improve the life quality of patients.and extend their survival time.

Objective To study the effect of calcitonin on the expression of vascular endothelial growth factor in femoral fracture healing in ovariectomized rats .Methods 80 female rats of 3 months old were randomly divided into four groups :Sham operation group(Sham ,10 cases);Ovariectomized operation group(OVX ,10 cases);Ovariectomy+ fracture+ salinegroup(Control ,30 cases) and Ovariectomy+ fracture +calcitonin group(Experimental ,30 cases) .Rats in Sham group and OVX group were performed ovari-otomy and killed after 4 weeks ,femoral bone mineral density was measured .For rats in Control group and Experimental group ,right middle femoral facture was performed 4 weeks later after ovariectomy .Calcitonin(16 IU/kg)were injected subcutaneously once per 2 days in Experimental group ,while those in Control group were given equal volume of normal saline .Rods in these two groups were killed after 3 ,6 ,9 weeks(10 at a time) ,femoral bone mineral density(BMD)was measured;hematoxylin-eosin staining and im-munohisto-chemical staining were performed at the 3th ,6th and 9th week after fracture ,respectively .Results Compared with Sham group ,rats weight in OVX group gained more(P< 0 .05) ,and BMD in OVX group significantly decreased more(P< 0 .05) .HE staining ,at the 3th week after fracture ,endochondral ossification domained in fracture healing ,and no significant difference existed (P>0 .05)in BMD .At the 6th week after fracture ,bone trabecula in both groups arranged in order ,compared with the control group ,BMD in experimental group increased significantly(P<0 .05) .At the 9th week after fracture ,bone trabecula in both groups arranged closely ,BMD in both groups showed significant difference(P<0 .05) .There was no significant difference of vascular endo-thelial growth factor(VEGF)between experimental group and control group at the 3th ,6th ,9th week after fracture(P>0 .05) .Con-clusion The results suggest that calcitonin treatment could enhance the bone mineral density significantly after fracture ,but it has no impact on the expression of VEGF in osteoporotic fracture healing .

Objective To analyze the clinicopathologic characteristics of atypical polypoid adenomyoma (APA) of endometrium,and investigate the special characteristics of cancerous transformation from APA.Methods Fourteen cases of APA were collected in General Hospital of People' s Liberation Army from January 2007 to March 2013.The clinical data,morphologic features,immunohistochemistry and the related literature were reviewed.Results The median age of the 14 patients was 38 years (ranged from 23 to 72 years),only 1 patient was postmenopausal.The most common symptom was irregular vaginal bleeding (4/14),and 4 patients were identified during routine physical examination for infertility.Among 14 cases,4 cases were diagnosed as well differentiated endometrioid adenocarcinoma originating from APA,and their median age was 35 years (ranged from 28 to 41 years); color Doppler flow imaging (CDFI) of ultrasound showed rich blood flow signal.The tumors with cancerous components were obviously larger than the usual APA (mean diameter:4.7 versus 1.8 cm).Histologically,irregular and branched glands were embedded in fibromuscular stroma and the glandular epithelium were atypical hyperplasia in varying degrees.While carcinoma developed in the APA,the sieve,solid and papillary structures were noticeable,and necrosis were common.Conclusions APA is a rare lesion of the uterus.Although the clinical behavior is benign in most cases,there may be possible for some cases developing carcinomas.If the APA mass is more than 4 cm in diameter,and microscopically demonstrates prominent sieve,solid,papillary structures and necrosis,the diagnosis of carcinoma developed from APA can be made.Thorough analysis should be done before the most proper therapeutic regimen is drawn up.

ObjectiveTo investigate the effect and gender differences of experimental moderate pain on attentional bias towards pain-related words.MethodsWith the tourniquet around the left upper limb,32 healthy college students were asked to perform two dot-probe tasks including five kinds of pain-related words,one task with the tourniquet deflating and the other task with the tourniquet inflating to 200 mm Hg pressure.The reaction time (RT) and the error rate of recognition task were recorded.The pain intensity and distress were recorded too.Results ( 1 ) Compared with no pain condition ( RT of affective and social-threat words were (507 ± 78 ) ms,(504 ±89 )ms respectively),the react time was shorter in female in the condition of tourniquet pain,particularly for affective and social-threat words (the RT were (464 ± 79 )ms,(465 ± 72 )ms respectively,F ( 1,4) =19.157,P ＜0.01 ),but not in male.( 2 ) In condition of no pain,the reaction time of male ( (456 ± 59) ms ) was shorter than that of female (504 ± 79ms).However,in the condition of pain,the significant main effect was not found.ConclusionThe reacting time of female was shorter in condition of moderate tourniquet pain,which imply that female showed significant attentional bias towards affective and social-threat words.

Objective To construct a grading nursing care system at public hospitals based on the severity of illness and activities of daily living ( ADL). Methods Multi-center stratified random sampling was used to investigate the general adult patients hospitalized in 12 wards of six tertiary-level hospitals in the eastern, central and western parts of China from January to December of 2016. The Barthel index and simple clinical score ( SCS) were used to evaluate their ADL and severity of illness, while a customized direct nursing hour scale was applied to record the direct nursing time needed by patients in 24 hours. Nursing grades were defined according to different conditions and ADL and to the difference of patient needs of 24 h direct nursing hours. Results 7 200 patients were investigated in total, and 7 073 effective questionnaires were collected (98. 24% ). Seven new grades of nursing care were defined based on patients′ severity of illness, ADL and different 24 h direct nursing time. These grades match the existing four grading nursing care levels to become refined sub-levels. Conclusions Patients can be graded according to their conditions, ADL and the 24 h direct nursing time needed. Such a new method is more objective, specific and quantitative than before, conducive to upgrading fine management level of nursing.

One hundred ten patients with Parkinson′s disease(PD)and 110 age-matched healthy controls were enrolled in the study.The non-motor symptoms(NMS)were assessed with Non-motor symptoms of Parkinson′s disease questionnaire(PDNMSQ30).The PD patients were classified as gait abnormality posture type(PIGD, n=73)and tremor type(TD, n=37).The non-motor symptoms were compared between two groups.Results showed that the NMS in PD patients was higher than that in healthy controls[(35.2 ±3.0)vs.(6.0 ±2.0)symptoms, t=6.43, P=0.01].The NMS score of PIGD group was higher than that of TD group[(28.9 ±1.1)vs.(6.2 ±0.7)symptoms, t=2.73, P<0.01]; Mini-mental state examination(MMSE)and Montreal cognitive assessment scale(MoCA)scores of TD group were significantly higher than those of PIGD group(t=11.52,P<0.01; t=8.79,P<0.01).The results indicate that for PD patients with different motor types,their NMS are different,and PD patients with PIGD have more axial involvement,and more NMS.

The purpose of this study was to investigate the formation thermodynamics of baicalein(BE)-nicotinamide(NCT)cocrystals in three solvents including ethyl acetate, acetone and trichloromethane. The solubilities of BE, NCT and BE-NCT in the above solvents at 25 °C were measured. Ternary phase diagrams(TPDs)of the BE-NCT-solvent systems were established. The non-linear fitting equation according to 1 ∶1 complexation mechanism of BE-NCT cocrystals demonstrated a good correlation between calculated and experiment data. ΔG0< 0 suggested that BE-NCT cocrystal formation was a spontaneous process. Among the organic solvents studied, the absolute value of ΔG0 in trichloromethane was significantly lower than that in the other two solvents. In addition, the cocrystallization zone in trichloromethane was far away from stoichiometric line. This study provides a theoretical foundation for solvent selection and preparation-condition optimization of BE-NCT cocrystals.

Objective:To analyze the gastroscopy treatment technology in a Children′s Medical Center based on the diagnosis-related groups(DRG) and put forward suggestions for resource optimization.Methods:The data of the front pages of medical records of 22 medical institutions in a Children′s Medical Center in 2018 were divided into DRG groups. The patients in gastroscope treatment operation group(GK3)were selected, and the disease diagnosis, operation and payment methods of the patients in this group were analyzed.Results:Of the 22 medical institutions, 16 had GK3 group cases, and the number of cases was significantly different, ranging from 2 to 917. Among them, the institution with code M was characterized by multiple endoscopic treatment of esophageal stricture, but most other institutions rarely carried out the treatment of esophageal stricture. In GK3 group, the main payment method of children in Institution M with the highest constituent ratio was at one′s own expense, followed by non-local medical insurance. The main payment type of O and P institutions with the second and third constituent ratio was local medical insurance.Conclusions:The gap of the technology of gastroscopy in the treatment of esophageal stricture is large in all institutions. The high-quality medical resources can be sunk through the construction of pediatric medical alliance, and the gap between the regional medical technology can be continuously leveled.