Objective To investigate the proper depth of muscle relaxant without affecting elec-trophysiological monitoring in patients undergoing posterior fossa surgery under total intravenous an-esthesia (TIVA).Methods Forty patients selected for posterior fossa surgery were randomly divided into two groups A and B.Group A:no muscle relaxants were administered after anesthesia induction until the EMG was completed.Group B:muscle relaxants maintained in range of TOF 2%-25% dur-ing electrophysiological monitor.TIVA were used to all patients and BIS was maintained in range of 40-60.Two electrophysiological data were applied during the electrophysiological monitoring:sponta-neity EMG and evoked EMG.EMG amplitude was recorded at different TOF value.Operation time and the dosages of propofol,sufentanil,rocuronium bromide were recorded.Also,the SBP,DBP,HR at perioperational period and facial nerve function before surgery,one week and six months after sur-gery were recorded.Results The electrophysiological monitoring completed successfully in all pa-tients.The total amount of propofol in group A significantly increased than those in group B(P <0.05).Three patients in group A had body movement during the operation.Four cases in group B couldn??t perform electrophysiological monitor when the TOF had three signals.There were no differ-ence between the two groups in SBP,DBP,HR and facial nerve function.Conclusion Maintaining TOF value in range of 2%-25% under non-depolarizing muscle relaxant during CPA surgery doesn??t affect intraoperative nerve electrophysiological monitor and prevent body movement,total dose of sed-ative anesthetics is also decresed.

Objective To study the effects of treadmill training on the recovery of neurological function and the expression of IGF-1/IGF-1Rin the brain poat focal cerebral ischemia.Metheods Forty-two male,adult Sprague-Dawley rats were randomly divided into a sham group(n=6),a model group(n=18)and a treadmill exercises group(n=18).Focal cerebral ischemia was induced in the latter two groups by right middle cerebral artery occlusion(MCAO)using a modified Longa's metheod.The rats in the treadmill exercises group were given treadmill training 6 days a week for 4weeks beginning 24 h after the MCAO. Rats in the sham group and model groups were reared in standard cages and could move frddly. Before being sacrificed at the 7th 14th and 28th day after the MCAO,the rats' neurological function were tested giving modified neurological weverity scores (mNSS). The expression of IGF-1/IGF-1R was detected using the reverse transcriptsae polymersae chain reaction and immunohistochemical methods.Results Neurological runction in the exercises group at the 14th and 28th day was better than in the control group,and IGF-1 and IGF-1Rexpression were significcantly upregulated on the 7th,14th and 28th day after the MCAO.Conclusion Treadmill training can improve neurological function by upregulating the expression of IGF-1 and IGF-1R in the ischemic brain, at least in rats.

Object To study the antitumor effects of extracts from the fruits, roots and rhizomes of Sinopodophyllum emodi (Wall.) Ying, the roots and rhizomes of Dysosma furfuracea S.Y. Bao and the podophyllotoxin, deoxypodophyllotoxin of Guijiu plants in mice. Methods Tumor borne mice with transplanted HepA and Ehrlich ascites carcinoma (EAC) were used to observe the antitumor and the liver protective effects of the above five samples, which were given orally. Results Extracts of roots and rhizomes of S. emodi, and D. furfuracea showed the significant antitumor effects. Conclusion All the five samples have antitumor activity.

AIM: To explore the effects of adipose-derived stem cell (ADSC) transplantation on the expression of IL-10 amd TNF-α after cerebral ischaemia in Middle cerebral artery occlusion (MCAO) rats. METHODS: 72 male adult Sprague-Dawley rats were randomly divided into 4 groups: sham group, MCAO group, Vehicle group and ADSC group (n=18). Rat's cerebral ischemia model was established by MCAO with Longa' s method. ADSC were labeled by DAPI before transplantation. One day after MCAO, 30 μL of cell suspension containing 1×10~6 ADSCs were injected into the lateral ventricle of ADSC group and the same dose of PBS was given to the Vehicle group. At day 4, day 7 and day 14 after MCAO, the rats were decapitated to detect the expression of IL-10 and TNF-α in ischaemic rat' s brain by ELISA, immunohistochemistry and RT-PCR. RESULTS: Compared with sham group, the expression of IL-10 and TNF-α significantly up-regulated at 4 d, 7 d of MCAO group(P<0.05). There was no statistical difference of IL-10 and TNF-α expression between MCAO and vehicle group ant any time point(P>0.05). Compared with Vehicle group, the expression of IL-10 significantly up-regulated while TNF-α expression significantly decreased of ADSC-treated group at any timepoint post MCAO(P<0.05). CONCLUSION: The transplantation of ADSC could up-regulate the expression of IL-10 and down-regulate the expression of TNF-α in MCAO rat' s brain, which might contribute to its protective role upon cerebral ischaemia.

Objective: To understand weekend screen time of preschool children in Nanjing, Jiangsu and to explore its association with parental factors,aiming to provide effective strategies for screen time intervention. Methods: A questionnaire survey was conducted in 6 424 parents of preschool children in 20 kindergartens selected using convenience samping method in Nanjing to understand the association of screen time during weekends and parental factors. Results: The proportion of preschool children in Nanjing with screen time ≥2 h/d was 13.01%, among which the proportion of boys was 14.61%, and girls was 11.34%. The difference was statistically significant(χ2=15.27, P<0.01). Logistic regression analysis showed that there was a positive correlation between 3.5-6 years old, boys, paternal education lower than junior high school or equal to senior high school, and no exercise habits with children’s screen time ≥2 h/d(OR=1.43, 1.42, 2.21, 1.82, 2.47, 2.05, 1.36, 1.38, 1.39, 1.52, P<0.05). Conclusion The video screen time of 3-6 year old preschool children in Nanjing is at moderate level. Parents’ exercise habits and education shows impact on screen time of preschool children, and should be given attention and support.

Cancer immunotherapy refers to the therapeutic effect of controlling or eliminating tumor cells by interfering with the immune system to restore the anti-tumor immune response. Immune checkpoint inhibitor therapy that blocks programmed death -1/programmed cell death ligand-1/cytotoxic T lymphocyte-associated antigen 4 is one of the most commonly used tumor immunotherapies, with good efficacy and wide application. These drugs cause immune-related ocular complications such as uveitis, autoimmune retinopathy, and scleritis, which represent a new etiology of ocular inflammation. The ophthalmologist's grasp of the clinical characteristics of these diseases is helpful for timely diagnosis. At the same time, the ophthalmologist will work closely with the oncologist to make a comprehensive judgment based on the patient's primary tumor, survival prognosis, severity of adverse reactions related to ocular immunotherapy, and visual prognosis, and develop suitable therapeutic strategie, thereby saving the patients' vision and improving the quality of life.

Exposure to occupational noise and heavy metals are common occupational hazards in workplaces. Occupational noise exposure not only leads to noise-induced hearing loss but also cognitive dysfunction. Exposure to common heavy metals such as lead, manganese, and cadmium during work is closely related to cognitive dysfunction in workers. Combined exposure to noise and heavy metals is common in workplaces. However, current research on the combined effects of exposure to occupational noise with lead or manganese on workers' cognitive function is not comprehensive or systematic. The method for cognitive dysfunction identification varies, leading to a lack of comparability. And the causality between occupational exposure and cognitive dysfunction in workers has not been clarified. Therefore, studying the cognitive dysfunction due to combined exposure to noise and common heavy metals is of great significance for workers' occupational health. In the future, it is necessary to unify the method for cognitive dysfunction identification and conduct systematic and comprehensive research on the effects, mechanisms, and combined effects of exposure to occupational noise with lead, manganese, cadmium, and other heavy metals on workers' cognitive dysfunction, to ensure the occupational health rights and interests of workers.

Objective:To observe the changes in hippocampus (CA1) and study the effect of chronic intermittent hypobaric hypoxia (CIHH) preconditioning on the memory and cognitive function of mice exposed to the whole brain irradiation.Methods:A total of 48 C57BL/6 male mice were randomly divided into control group, CIHH group, irradiation group (IR group) and CIHH+ IR group. For IR group, the whole brain of mice were irradiated with 10 Gy of 6 MV X-rays in a single fraction. Pretreatment with CIHH was performed by placing mice in a hypobaric chamber before radiation. The mirrors water maze experiment was performed in the four groups to observe the escape latency, the number of crossing platforms and the target quadrant residence time. Nissl staining was used to observe the changes of neuronal cells in hippocampal CA1 region. Immunofluorescence was used to detect the expression of microtubule-associated protein cells (DCX) in the subgranular zone (SGZ) of hippocampal dentate gyrus (DG) to evaluate neurogenesis.Results:After 30 days of whole brain irradiation, the escape latency of mice prolonged gradually, the frequency of crossing platform decreased ( P< 0.001), and the exploration time in the target quadrant decreased ( P<0.001). X-ray irradiation caused disorder of mice neuronal cells, degeneration and necrosis of neuronal cells, and decrease of DCX expression in CA1 region of mice. Compared with IR group, the CIHH+ IR group had shortened the escape latency, increased the frequency of crossing platform [(2.08±0.26) vs. (0.83±0.24), P<0.001], and also increased the exploration time in the target quadrant [(14.12±0.82)s vs. (7.42±0.73)s, P<0.001]. Pretreatment with CIHH also alleviated the deformation and necrosis of neurons in hippocampus, and increased DCX expression in CA1 region. Conclusions:Pretreatment of mice with CIHH plays a protective role in radiation induced hippocampal injury.

Objective:To investigate the correlation between white matter hyperintensities (WMHs) and the outcomes after reperfusion therapy in patients with acute ischemic stroke (AIS).Methods:Patients with AIS treated with reperfusion therapy (intravenous thrombolysis, endovascular mechanical thrombectomy or bridging therapy) in the Stroke Center of Zhongshan Hospital of traditional Chinese Medicine from January 2014 to December 2019 were retrospectively enrolled. The clinical baseline data of the patients were collected. The Fazekas scale was used to evaluate the severity of WMHs according to the MRI images. At 90 d after discharge, the modified Rankin Scale was used to evaluate the outcomes. A score of ≤ 2 was defined as good outcome, and a score of >2 was defined as poor outcome. Binary multivariate logistic regression analysis was used to determine the independent risk factors for hemorrhagic transformation (HT), symptomatic intracranial hemorrhage (sICH), and poor outcomes. Results:A total of 676 patients with AIS treated with reperfusion therapy were enrolled. Among them, 506 patients (74.9%) were complicated with WMHs, and 80 (11.8%) had severe WMHs. One hundred and thirty-two patients (19.5%) had HT, 34 (5.0%) had sICH, and 306 (45.3%) had a poor outcome. Multivariate logistic regression analysis showed that severe WMHs was an independent risk factor for the occurrence of HT (odds ratio [ OR] 1.890, 95% confidence interval [ CI] 1.047-3.413; P=0.035) and poor outcomes ( OR 3.366, 95% CI 1.567-7.232; P=0.002) after reperfusion treatment in patients with AIS, but there was no independent correlation with sICH ( OR 8.403, 95% CI 0.891-79.294; P=0.063). Conclusion:Severe WMHs is an independent risk factor for the occurrence of HT and poor outcomes in patients with AIS after reperfusion treatment, but it has no independent correlation with sICH.

Objective:To investigate the correlations of collateral circulation with hemorrhagic transformation (HT) and short-term prognoses in patients with acute ischemic stroke (AIS) after different reperfusion therapies.Methods:Four hundred and forty-nine patients with AIS after different reperfusion therapies, admitted to our hospital from January 2016 to December 2019, were chosen in our study. These patients were divided into HT group ( n=90) and non-HT group ( n=359) according to whether HT presented or not. The baseline data, clinical characteristics, and prognoses of patients between the 2 groups were compared. And the variables of P<0.05 in univariate analysis were re-analyzed by multivariate Logistics regression to identify the independent influencing factors for HT in patients with AIS; the correlations between cerebral collateral circulation grading (American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology [ASITN/SIR], and modified Thrombolysis in Cerebral Infarction [mTICI]) and modified Rankin scale (mRS) scores at discharge were explored. Results:(1) There were significant differences between patients in the two groups in terms of age, percentages of patients with atrial fibrillation, baseline National Institutes of Health Stroke Scale (NIHSS) scores, emergency blood glucose, platelet count, and percentages of patients used dual antiplatelet agents and statin ( P<0.05). (2) Results of multivariate Logistics analysis: moderate stroke (NIHSS scores of 9-15), severe stroke (NIHSS scores≥16), elevated emergency glucose, atherosclerotic cerebral infarction and bridging therapy were independent risk factors for HT, and good collateral circulation status and dual antiplatelet therapy were independent protective factors for HT. (3) Correlation of collateral circulation with short-term prognosis: mRS scores of patients at discharge were negatively correlated with ASITN/SIR grading of collateral circulation and mTICI grading ( rs=-0.201, P=0.003; rs=-0.222, P=0.001). Further grouping by different reperfusion therapies showed that ASITN/SIR grading in the intravenous thrombolysis group and mTICI grading in the bridging therapy group were negatively correlated with mRS scores of these patients at discharge ( rs=-0.176, P=0.016; rs=-0.271, P=0.010). Conclusion:AIS patients with poor collateral circulation who receive reperfusion therapies are more likely to develop HT than patients with good collateral circulation, enjoying a relatively poor short-term prognosis.