The systematic teaching does better to help students master and use what they have learned, and it will be good for avoidance of repeated contents and shortening teaching time. It can also help students find more interest in studying neurology.

Objective To establish a standardized middle cerebral artery occlusion (MCAO) model with suture method in rabbits and to investigate the value of the assessment for cerebral ischemia with amplitudeintegrated electroencephalogram (aEEG).Methods A total of 34 male New Zealand white rabbits were randomly assigned to either an MCAO group (n =29) or a sham operation goup (n =5).A model of MCAO was induced with intraluminal suture method and the cerebral function monitor was performed.According to 2,3,5-triphenyltetrazolium chloride staining,the MCAO group was further divided into cortex + basal ganglia infarction,basal ganglia infarction,subarachnoid hemorrhage,and non-lesion subgroups.The differences among the physiological indicators,weight,thread end diameter,and insertion length were compared before and after modeling in all subgroups.Results The success rate of MCAO modeling with suture method in rabbits was 62.07％ (18/29),in which 37.93％ (11/29) involved in the cortex and basal ganglia,24.38％ (7/29) only involved in the basal ganglia,17.24％ (5/29) complicated by subarachnoid hemorrhage,and 20.69％ (6/29) had no infarction.There were no significant differences in the body temperature,heart rate,mean arterial pressure and arterial blood pH,oxygen partial pressure,and CO2 partial pressure among all the subgroups before and after modeling.The weight in the non-lesion subgroup was 2.36 ± 0.10 kg,it was significantly lower than 2.55 ± 0.09 kg in the cortex + basal ganglia infarction subgroup (P =0.001) and 2.50 ± 0.12 kg in the basal ganglia infarction subgroup (P =0.017).The length of suture placement in the cortex+basal ganglia infarction subgroup was 5.59 ± 0.24 cm,and it was significantly less than 6.00 ± 0.50 cm in the subarachnoid hemorrhage subgroup (P =0.036).However,it was significantly longer than 5.20 ± 0.50 cm in the non-lesion subgroup (P =0.033).After modeling there were significant differences in aEEG among all subgroups (F =14.059,P =0.000).Compared to before modeling,aEEG decreased 50.02％ (t =9.573,P ＜ 0.001) and 14.20％ respectively after modeling in the cortex + basal ganglia infarction subgroup and the ganglia infarction subgroup (t =2.908,P =0.027).Conclusions A standardized MCAO model in rabbits may be successfully established with suture method.The significantly decreased aEEG indicates that the MCAO model is successful and the lesions involve in the cortex.

Objective To establish human pancreatic cancer xenografts in nude mice, and to investigate the antitumor efficacy of human endostatin expressed by replication-competent adenovirus AdTPHre-hE in vivo. Methods Pancreatic cancer cells AsPC-1 were injected subcutaneously in BALB/c nude mice to establish the xenografts. Tumor growth was observed and measured after AdTPHre-hE treatment. Expression of endostatin was detected by ELISA assay. The tumors were harvested for pathologic examination and immunohistochemical staining. Results Tumors grew more slowly in the AdTPHre-hE group and their sizes were markedly smaller than those of the Ad-hE group (P＜0.01)and control group(P＜0. 01). Endostatin levels were detected in the sera of nude mice in all treated groups, and endostatin expression in AdTPHre-hE group increased with time. The endostatin level in the AdTPHre-hE treated group was much higher(P＜0. 01)and increased faster than that in the Ad-hE treated group. Immunohistochemical staining for Hexon of adenovirus capsid showed more positive tumor cells in the tumor tissues treated with AdTPHre-hE. Immunohistochemical staining for FⅧ revealed a decreased microvessel density in the tumor tissues treated with AdTPHre-hE. Conclusion The replication-competent adenovirus efficiently expressed high-level endostatin and significantly inhibited tumor growth in vivo.

Objective: To investigate immune responses to influenza virus infections and the immunogenicity of trivalent split-virus influenza vaccine among elderly populations in Jiangbei District, Ningbo City, so as to provide the support for promoting influenza vaccination among elderly populations. Methods: The elderly populations at ages of 60 years and older were recruited in Jiangbei District of Ningbo City from September to November, 2020, and the participants were assigned to the vaccination group and the control group according to vaccination intention. The titers of haemagglutination inhibition ( HI ) antibodies against influenza viruses A ( H1N1 and H3N2 ) and BV were measured using the micro HI test prior to vaccination and 30 days post-vaccination, and the protective rate, geometric mean titer ( GMT ) and seroconversion rate of antibodies were analyzed before and after vaccination. Results: There were 290 participants in the vaccination group, including 132 men (45.52% ), and 290 controls, including 132 men ( 45.52% ). There were no significant differences between the vaccination group and the control group in terms of the protective rate or GMT of antibodies against influenza viruses A ( H1N1 and H3N2 ) and BV prior to vaccination ( P>0.05 ). Following vaccination, the protective rates of antibodies against influenza viruses A ( H1N1 and H3N2 ) and BV were 98.62%, 94.14% and 88.28%, and the GMT of antibodies against influenza viruses A ( H1N1 and H3N2 ) and BV increased by 9.26, 6.19 and 10.09 folds, while the seroconversion rates of antibodies against influenza viruses A ( H1N1 and H3N2 ) and BV were 78.62%, 68.28% and 71.38%, respectively. The protective rates, GMT and seroconversion rates of antibodies against influenza viruses A ( H1N1 and H3N2 ) and BV were all significantly greater in the vaccination group than in the control group post-vaccination ( P<0.05 ). A lower increase was seen in the GMT of antibodies against the influenza virus BV among residents at ages of 80 years and older (increase by 7.91 folds) than among residents at ages of 70 to 79 years ( increase by 12.53 folds ) and 60 to 69 years (increase by 13.32 folds) in the vaccination group post-vaccination ( P<0.05 ), and the seroconversion rate of antibodies against the influenza virus BV was significantly lower in residents at ages of 80 years and older ( 62.57% ) than in those at ages of 70 to 79 years ( 83.33% ) ( P<0.05 ), while the positive conversion rate of antibodies against the influenza virus A ( H3N2 ) was significantly lower in residents at ages of 80 years and older ( 62.57% ) than in those at ages of 60 to 69 years ( 91.30% ) ( P<0.05 ). Conclusions Low-level immune responses are detected to antibodies against influenza virus A ( H3N2 ) and BV among elderly populations in Jiangbei District of Ningbo City, and trivalent split-virus influenza vaccine shows a high immunogenicity among elder populations. An emphases on improvements in coverage of influenza vaccination among elderly populations at ages of 60 to 69 years, and development of influenza vaccines with a higher protective efficacy for residents at ages of 80 years and older are recommended.

Objective To investigate the MRI imaging features, and pathologic basis of the orthotropic transplantation nude mouse model with human pancreatic cancer. Methods Adopting Siemens Magnetom Trio Tim 3.0 Tesla superconductive MRI and breast coil was used to examine 30 orthotropic transplantation nude mouse models of the human pancreatic cancer, these mouse were sampled to acquire TSE-T1 -weighted and T2-weighted transverse axial images. Intraperitoneal injection of Gd DTP A was used to perform continuous dynamic enhancement scanning. Signal intensities of tumors were measured in plain scanning and each phase' s enhancement scanning images, respectively. Intensification rates of tumors were calculated. Pathologic examination of tumors was performed to be compared with the findings of MRI scanning. Results The successful rate of inoculation of 30 nude mice was 100%. The histological findings were comparable with poorly differentiated adenocarcinoma. Compared with signal of adjacent tissues, the MRI findings of the tumors were uniformly slightly hypointensity (90% , 27/30) , or unevenly (10% , 3/30) on TSE-T1WI; uniformly (20% , 6/30) or unevenly (80% , 24/30) hyperintensity with equal or more hyper signal spots on TSE-T2WI. Signal intensities on plain scanning was 228.35 ±11.71, and 1.5,3,6,9, 12 min after enhancement scanning, thesignal intensities were 258.20 ± 11.17, 301.75 ± 17.09, 358.65 ±25.13, 480.05 ± 19.01, 558.35 ± 40.49, which were significantly higher than those in plain scanning (P <0.01). The intensification rate of every phase was 0.13 ±0.04, 0.35 ±0.11, 0.56 ±0.10, 1.10 ±0.10, 1.45 ±0.18, and the difference among these phases was statistically significant (P <0.01). The significantly intensified area was the area where the tumor cells grew actively with rich capillaries; the central area without intensification was the area of necrotic tissue and/or densely packed tumor cells and few capillaries. Conclusions High resolution MRI imaging of implanted tumors can be obtained by intraperitoneal injection of contrast, and it is consistent with pathologic examinations.

Objective To evaluate the application of “expert-guided network tracking system” in training community general practitioner for hypertension management.Methods Total 855 general practitioners (GPs) from 20 community health service centers in Hangzhou,Jiaxing and Shaoxing of Zhejiang province were divided into two groups: 430 GPs from 10 community health centers received training for hypertension management using “ expert-guided networking tracking system” (intervention group) in December 2008 and 425 GPs from another 10 health centers received conventional training (control group).Questionnaire surveys about the knowledge and skill of hypertension management were conducted before and 3 y after training.Results The awareness rates of knowledge about hypertension prevention and control,non-drug therapy and drug therapy increased from 37.0％ (159/430),45.6％ (196/430),42.8％ (184/430) to 66.8％ (284/425),81.4％ (346/425),77.6％ (330/425),respectively and the accuracy of case analysis increased from 38.4％ (490/1290) to 73.3％ (946/1290) (P ＜0.01) after training in intervention group.Meanwhile the knowledge and case management abilities in control group were also improved after conventional training,but the degree was significantly lower than that in the intervention group.Conclusions “Expert-guided networking tracking system” can significantly improve the knowledge and skills for hypertension management in community general practitioners.

Using the method of stratified random cluster sampling,8 996 elderly hypertensive patients in community were selected in the study.Patients entered the community-based hypertension program receiving stratified management,individualized treatment and health education.After 3 years of intervention,the disease awareness rate,treatment compliance rate and hypertensive control rate were increased from 68.30％,55.40％ and 38.60％ to 98.90％,86.70％ and 77.80％,respectively (P ＜0.05).The systolic and diastolic pressure,body mass index,triglyceride levels and other hypertensionrelated indicators were improved significantly,the number of individuals with obesity/overweight,smoking and drinking were decreased and those with regular exercise increased (all P ＜ 0.05).The results indicate that community-based comprehensive hypertension management is effective for hypertension control for elderly patients in community.

Objective From October 2010 to explore the current situation of hypertension control and its influencing factors among geriatric patients in Hangzhou,Jiaxing and Shaoxing in Zhejiang province.Methods To April 2011,10 644 geriatric patients aged 60 years and over were included,and related questionnaire survey,physical examination and laboratory examination were carried out.The situation of hypertension control and influencing factors were analyzed.Results The control rate of hypertension was 38.6％,and its standardized rate was 27.6％.It showed that female,inhabited city,high level of education degree and regular exercise were positively correlated with hypertension control,while age,smoking,high salt diet and abdominal obesity were negatively correlated with hypertension control,and standardized treatment had a close relationship with hypertension control.Conclusions The situations of hypertensive control among geriatric patients in Hangzhou,Jiaxing,Shaoxing in Zhejiang province are still unsatisfactory.Strengthening standardization management measures for improving the control rate of hypertension is needed and has actual value.

Objective To observe the clinical efficacy of shenqifuzheng injection combined with sulfasalazine (SASP) in the treatment of ulcerative colitis (UC) ,and to evaluate the effect of CX3CR1 on colonic mucosa of UC in treatment with shenqifuzheng injection .Methods Fifty‐one patients with active mild to moderate UC were collected during the period from January 2012 to June 2014 in the second people′s hospital of Lianyungang ,which randomly divided into experimental group and control group ,and setting up health group of 15 cases .Experimental group were treated with shenqifuzheng injection combined with SASP ,control group were only with SASP ,health group were no‐treatment control .The modified Mayo scoring results and the expression of CX3CR1 on co‐lonic mucosa of the same lesion site were observed before and two weeks after treatment separately .Results The total positive rate of CX3CR1 on colonic mucosa in patients with ulcerative colitis was 88 .37% before treatment ,The total positive rate of CX3CR1 on colonic mucosa in health group was 20 .00% ,There was significant difference between two groups (Z= -2 .689 ,P<0 .01) .Two weeks after treatment ,the expression of CX3CR1 on colonic mucosa and the modified Mayo scoring results in the experimental group were significantly lower than those in the control group (P<0 .05) .The clinical comprehensive efficacy of the experimental group was significantly better than the control group (Z= -2 .085 ,P<0 .05) .Conclusion Combination of shenqifuzheng injection and SASP is more effective than using SASP alone in the treatment of UC .Shenqifuzheng injection may play important role in the treatment of UC by inhibiting the expression of CX3CR1 on colonic mucosa .

OBJECTIVE To evaluate the value of central compartment neck dissection for cN0 papillary thyroid carcinoma.METHODS The clinical data of 46 cases with cN0 papillary thyroid carcinoma in our hospital from Jan.1999 to June 2004 were retrospectively studied.The level Ⅵ lymph nodes were removed during the operation.RESULTS In 46 cN0 cases,there were 11 cases(23.9 %) pathologically proved lymph nodes metastasis after operation.Four patients developed neck recurrence and underwent neck dissection.CONCLUSION It is necessary to probe the level Ⅵ lymph nodes during the operation for cN0 papillary thyroid carcinoma patients.