Objective To explore the correlation between the carotid atherosclerosis unstable plaque lipoprotein(a) [ Lp(a)]levels with acute cerebral infarction patients.Methods 120 patients with acute cerebral infarction were selected as the research group,and at the same period,120 health cases were selected as the control group.The level of Lp(a) of the two groups was tested,and neck vascular color dopplar ultrasound examination was conducted.Results The incidence of atherosclerotic plaque in carotid artery and unstable plaques was 70.8％,51.7％,respectively,and significantly higher than that of the control group(25.8％,6- 7％ ) ( x2 =5.12,6.43,all P ＜0.05 ).The Lp(a) level of the research group[ (273.6 ± 221.7 )ag/L] was significantly higher than that of the control group[ ( 81.6 ± 64.9) mg/L ] ( t =6.53,P ＜ 0.05 ).Conclusion High level of LP(a) is the independent risk factor of cerebral infarction.The instability of carotid atherosclerotic plaques is the important cause of cerebral infarction.

Objective To investigate the current condition of essential hypertension in the elderly aged over 60 yrs in rural and urban areas in Jinan. Methods 2 626 subjects aged over 60 years in rural and urban of Jinan were involved and were examined. The investigation was based on the unified questionnaire. The contents of questionnaire mainly included the history, treatment and control of hypertension. Results Prevalence of hypertension and rate of treatment in the male elderly in urban were 64.1% and 61.5% , respectively, and were higher than those in rural (56.9% and 38.3%, respectively). The treatment rate in female was higher in urban (60.8%) than in rural (43.1%) (P

This article is to review the basic principles of renal perfusion in CT and MR,imaging method and perfusion characteristics in kidney diseases.It shows that in addition to the morphologic information,perfusion imaging can also provide functional and metabolic information about the renal neoplasms,which is very helpful for not only the differential diagnosis,but also the evaluation of tumor biological behaviors,it will have a bright future in clinical application.

Objective:This study aimed to investigate the effect of human lymphatic endothelial cells (HLECs) on proteins secreted by epithelial ovarian cancer (EOC) cells SKOV3-pm4 with highly directional lymphatic metastasis. Methods:The supernatants of the four groups of cultured cells (A, SKOV3;B, SKOV3+HLEC;C, SKOV3-PM4;and D, SKOV3-PM4+HLEC) were collected. The proteins of these cells were detected by antibody arrays and iTRAQ-2D-LC-MALDI-TOF/TOF/MS. The screened significantly differential proteins were further analyzed by bioinformatics and validated in the human serum and cell culture medium by ELISA. Results:Progranulin (GRN) and vascular endothelial growth factor A (VEGF-A) were upregulated between groups C and A. In addition, insulin-like growth factor binding protein-7 (IGFBP-7) and secreted protein acid rich in cysteine (SPARC) were downregulated between groups D and C. Comprehensive bioinformatics analysis revealed that IGFBP7 interacted with VEGFA. VEGF exhibited the highest expression in ovarian cancer and IGFBP7 exhibited the lowest expression compared with the serum of the normal control group. Statistically significant differences were observed between the two substances. Conclusion:The HLEC microenvironment is closely associated with directional metastasis in lymph nodes with differential proteins, including matricellular proteins and adhesion factors. In particular, the upregulation of VEGFA and GRN and the downregulation of SPARC and IGFBP7 were closely associated with the directional metastasis of EOC cells in lymph nodes.

Objective To establish the condition cultrue cell system and co-culture cell system with SKOV3/PM4,HUVEC and to study the changes of their biological characteristics. Methods The cells of SKOV3/PM4 and HUVEC were labeled with green and red fluorescent respectively. The cell supernatant of SKOV3/PM4 and HUVEC were collected respectively as the condition medium(e.g:the cell supernatant of HUVEC cells was used as SKOV3/PM4 condition medium)and to establish the condition cultrue cell system and the co-culture cell system of the two cell lines. In the condition cultrue cell system, The morphological changes of cells were observed by HE staining to calculate the mitotic index. The ultrastructural changes of the two cells were observed by transmission electron microscopy(TEM). The growth curve of the cells was determined by methyl thiazolyl tetrazolium (MTT) assay and flow cytometry was used to analyzed the cell cycles.In the co-culture cell system, the interaction of the two cells were detected by laser scanning confocal microscope(LSCM). The expression of matrix metalloproteinase-2(MMP-2) and matrix metalloproteinase-9 (MMP-9) were detected by gelatin zymography. Results Compared with the single culture SKOV3/PM4, the cells which cultured in HUVEC condition medium showed the increase of pseudopodia and nuclear division,the mitotic index respectively were [(4.8 ± 0.8)%,(11.2 ± 0.3)%;P<0.05]. The growth rate was significantly increased. In cell cycles, it showed the declined cell ratio of G0/G1 phase, respectively[(69.4±3.6)%, (48.4±4.6)%;P<0.05] and the raised cell ratio of G2/M phase, respectively [(5.2±1.6)%, (24.9±2.2)%;P<0.05]. Compared with the single culture HUVEC,the cells which cultured in SKOV3/PM4 condition medium showed the significant morphological change and vacuolization in the cytoplasm, Nuclear division was increased and the mitotic index respectively were [(2.7±0.5)%, (5.7±0.6)%;P<0.05]. The growth rate was slightly declined. In cell cycles, it showed the raised cell ratio in G0/G1 phase, respectively [(51.4 ± 2.2)%,(79.0 ± 4.1)%;P<0.05] and the declined cell ratio in G2/M phase, respectively [(19.1±1.2)%, (3.3±0.5)%;P<0.05]. After co-culture for 48 hours, spontaneous fusion between SKOV3/PM4 and HUVEC cell was observed by the laser confocal microscope. Gelatin zymography assay showed that MMP-2 was not expressed in HUVEC cells, low-expressed in SKOV3/PM4 cells and high-expressed in the co-culture SKOV3/PM4+HUVEC cells. The expression of MMP-2 in co-culture SKOV3/PM4+HUVEC cells and SKOV3/PM4 cells respectively were 1 885 ± 84 and 1 209 ± 114 (P<0.05). But there were no MMP-9 expression in HUVEC cells, SKOV3/PM4 cells, and the co-culture SKOV3/PM4+HUVEC. Conclusion The characteristics of SKOV3/PM4 and HUVEC show significant changes after condition culture and co-culture, it may involve in the microenvironment of the cells and the intercellular crosstalk pathway.

Objective To explore the effect of preventive management path of breast cancer related lymphedema based on risk reduction program on breast cancer patients underwent axillary lymph nodes dissection (ALND). Methods This study used convenient sampling method to recruit 60 patients underwent ALND. Patients were randomly divided into the control group (n=31) and the intervention group (n=29). All patients received general care while patients of the intervention group also received the Risk Reduction Program. Lymphedema symptom experience was investigated by Breast Cancer and Lymphedema Symptom Experience Index 1 month, 3 months, 6 months, 12 months after surgery. Results Twelve months after surgery, the intervention group had 4.00(8.00)lymphedema related symptoms while the controll group had 9.00(7.00), the difference was significant (Z=-2.023, P=0.043). The score of lymphedema related symptom distress in the intervention group was 3.00(7.00)while it was 7.00(17.00)in the control group, the difference was significant (Z=-2.159, P=0.031). The scores of functional dimension and sexual dimension in the intervention group were 0(2.00)and 0(0), and in the control group were 3.00(5.00)and 0(1.00), the differences were significant (Z=-2.315,-2.334, P=0.021, 0.020). No significant differences of lymphedema rate existed between groups (P>0.05). Conclusion The preventive management path of breast cancer related lymphedema based on risk reduction program can decrease the number of lymphedema symptoms and release lymphedema symptom distress.

Objective To analyze the first aid situation of patients with out-of-hospital cardiac arrest (OHCA) in Zhengzhou City, and to explore the related factors affecting the prognosis of cardiopulmonary resuscitation (CPR) in patients with OHCA. Methods Retrospective analysis of patients with OHCA admitted to Zhengzhou Emergency Medical Rescue Center from June 2016 to June 2018 was performed. General information of patients, such as gender, age, bystander, the quality of bystander CPR (medical personnel, non-medical personnel), 120 reception time (day/night), location (family, public place, hotel, other), emergency medical service (EMS) response time, duration of CPR, first detected heart rhythm, defibrillation, mode of ventilation (balloon mask, laryngeal mask, endotracheal intubation), epinephrine dose, cause of cardiac arrest, outcome of resuscitation [restoration of spontaneous circulation (ROSC) or death] were collected. The risk factors of CPR prognosis were analyzed with univariate and multivariate Logistic regression analysis. Results ① The result of general investigation: 7 728 cases with OHCA in the past two years, among whom 3 891 were clinically dead upon arrival, 1 413 were not rescued, 2 424 were actively rescued, and only 51 got ROSC. There were 73.71% (5 696/7 728) patients calling "120" during 07:01-23:00 and 26.29% (2 032/7 728) patients during 23:01-07:00. The response time of EMS was (9.36±6.75) minutes. Cardiac arrest mostly occurred at home, which accounting for 61.61% (4 761/7 728), followed by public places, which accounting for 16.19% (1 251/7 728). The incidence of cardiac arrest was higher in males than in females [63.11% (4 877/7 728) vs. 36.89% (2 851/7 728)]. 54.94% (4 246/7 728) of patients were over 60 years old. Cardiogenic factors were the most important etiology, which accounting 38.63% (2 985/7 728), followed by trauma, which accounting 19.16% (1 481/7 728). ② The risk factors of prognosis of CPR: univariate Logistic regression analysis showed that age, bystander CPR, 120 reception time, duration of CPR, first detected heart rhythm, epinephrine dose and the cause of cardiac arrest were related to the ROSC in OHCA patients [age: odds ratio (OR) = 0.450, 95% confidence interval (95%CI) = 0.257-0.787; bystander CPR: OR = 6.446, 95%CI = 4.695-8.851; 120 reception time: OR = 1.941, 95%CI = 1.114-3.382; duration of CPR: OR = 0.163, 95%CI =0.074-0.360; first detected heart rhythm: OR = 0.080, 95%CI = 0.042-0.155; epinephrine dose: OR = 0.423, 95%CI =0.241-0.740; cause of cardiac arrest: OR = 1.901, 95%CI = 1.091-3.314; all P < 0.05]. Multivariate Logistic regression analysis showed that non-medical personnel, medical personnel, shockable rhythm, duration of CPR < 10 minutes and epinephrine dose < 5 mg were favorable factors for ROSC in OHCA patients (non-medical personnel: OR = 24.552, 95%CI = 10.192-59.144; medical personnel: OR = 36.960, 95%CI = 17.572-77.740; shockable rhythm: OR = 0.036, 95%CI = 0.015-0.087; duration of CPR < 10 minutes: OR = 0.191, 95%CI = 0.069-0.526; epinephrine dose < 5 mg:OR = 0.259, 95%CI = 0.125-0.537; all P < 0.01). Conclusions ① Male patients with OHCA in Zhengzhou City were more than female patients, and the age of most patients was older than 60 years old. OHCA often happened at home, followed by public places. The etiology was mainly cardiogenic, followed by trauma. EMS response time was a little long, the success rate of recovery was low, and pre-hospital emergency treatment needs to be further improved. ② Bystander CPR, shockable rhythm, duration of CPR < 10 minutes and epinephrine dose < 5 mg were beneficial to ROSC.

Objective To investigate the effect of rehabilitation on memory deficits after acquired brain injury, to compare different training models of memory rehabilitation and to analyze the possible factors affecting memory rehabilitation. Methods 144 patients with acquired brain injury following memory deficits were randomly assigned to computer-assisted training group, face-to-face training group and control group. Both training groups were given memory-based cognitive training program once a day which sustained 30 minutes for 6 or 12 weeks. The instantaneous memory, short-term memory and long-term memory were evaluated and compared before and after training. The effect of gender, age, education, course, site of injury and coma time on training efficacy were analyszed as well. Results 6 weeks and 12 weeks at training, both computer-assisted and face-to-face training groups showed a significant improvement in memory abilities when compared to controls (P<0.01), with the former making more progress (P<0.01). Negative correlation was found between age and memory performance. Conclusion Effectiveness of memory rehabilitation is proven. 12 weeks training can significantly improve memory. Cognitive training using professional equipment is significantly more effective than the face-to-face training and should be recommended.

Objective:To understand the performance of public health risk assessment in emergencies of institutions for disease control and prevention at different levels in China, and provide suggestions for the improvement of public health risk assessment.Methods:A self-administered survey was conducted in professionals involved in public health risk assessment in emergencies from national institution, provincial institutions and some prefectural institutions for disease control and prevention (1-2 prefectural institutions were selected using convenience sampling in each province) between March and April in 2021.Results:A total of 79 institutions for disease control and prevention were investigated, including 1 national institution, 32 provincial institutions and 46 prefectural institutions. By April 2021, all the 79 institutions surveyed had conducted risk assessment of public health emergencies, in which 61 (77.2%) had established departments responsible for the public health risk assessment, i.e. emergency management office or communicable disease prevention and control office (section), and regular risk assessment mechanisms. The main sources of information for public health risk assessment were public health surveillance systems, including the National Notifiable Diseases Reporting System (100.0%) and Public Health Emergencies Management Information System (97.5%). Compared with the provincial institutions, the prefectural institutions were more likely to use specific disease surveillance systems (84.8% vs. 62.5%; χ2=5.09, P=0.024). The risk management recommendations made by 43 institutions for disease control and prevention (54.4%) after the risk assessment were accepted by the superior health administrative departments and used in epidemic prevention and control. Conclusions:Public health risk assessment in emergencies has been widely carried out by national, provincial and prefectural institutions for disease control and prevention in China. Specialized departments and mechanisms have been established, but the information sources are still confined to public health surveillance systems and the application of the risk assessment results still needs to be further improved.

Objective:To explore the caregiving feelings and needs of caregivers of children with β-thalassemia major.Methods:A semi-structured interview was conducted with 14 caregivers of children with β-thalassemia major who were treated at the Affiliated Hospital of Youjiang Medical University for Nationalities from December 2022 to March 2023, and the data were analyzed using the Colaizzi 7-step analysis method.Results:Caregivers of children with β-thalassemia major felt a greater burden of care, including declining physical and mental health, disruption of daily life rhythms and heavy financial burden. And their caregiving needs included psychological and emotional support, guidance on the physical and mental health of children, assurance of a stable blood supply and medical and social support.Conclusions:Caregivers of children with β-thalassemia major have a heavy burden of care and face various nursing difficulties in the daily care of children. Medical staff should actively take measures to meet their care needs and improve their care quality and quality of life.