OBJECTIVE: To investigate the relationship between single nucleotide polymorphism of gene and ischemic stroke and search for predisposing genes of ischemic stroke.DATA SOURCES: The Medline database was searched for articles of gene polymorphism of fibrinogen and ischemic stroke published from 1980 to 2005 with the key words of "stroke, plasma fibrinogen, polymorphism"in English. Meanwhile, Vip Information Database was also searched for literatures of gene polymorphism of fibrinogen and schemic stroke published between 1995 and 2005 with the key terms of "ischemic stroke, fibrinogen,gene polymorphism" in Chinese. Full-texts were gotten by correspondence with the authors.STUDY SELECTION: Included literatures were only case control study literatures. Literatures of contrast study, experience summary, individual case and so on were excluded.DATA EXTRACTION: Totally 50 articles of gene polymorphism of fibrinogen and ischemic stroke were retrieved. Twenty articles were accorded with inclusive criteria, and thirty articles were excluded.DATA SYNTHESIS: Level of plasma fibrinogen was co-affected by heredity and environment. Gene polymorphism of fibrinogen has important regulatory effects on the level of plasma fibrinogen. The fibrinogen accelerates thrombotic formation. As a result, the incidence rate of ischemic stroke increased by participating atherosclerosis, helping thrombocytic aggregation and changing the status of hemorheology. But definite mechanism and molecular function of gene polymorphism of fibrinogen deserved further research.CONCLUSION: The relationship between single nucleotide polymorphism of fibrinogen and ischemic stroke remains obscure. It also needs further study.

Objective To explore, the levels of serum highsensitive C-reactive protein (hs-CRP) in different subtypes of acute ischemic stroke (AIS) and its significance. Methods According to TOAST criteria, 124 cases of AIS were divided into four groups: large-artery atherosclerosis (LAA,47 cases), small-artery occlusion (SVO,37 cases), cardiogenic cerebral embolism (CE,21 cases), acute stroke of other determined etiology and stroke of other undetermined etiology (ODE and UE, 19 cases). The serum concentration of hs-CRP was measured with the immunoturbidimetry in every patient of each group at 72 hours, 7 and 14 days after admitted to hospital. Meanwhile 81 healthy persons were involved in control group. Results The serum concentrations of hs-CRP at 72 hours, 7 and 14 days after onset were (10.77 ± 4.27),(16.41±5.61), (7.63±3.59) mg/L in LAA group;(3.99± 1.56), (6.45±3.25), (4.22±3.21) mg/L in SVO group; (11.60±4.85), (25.14±7.12), (9.24±4.61) mg/L in CE group; (6.09±2.43), (9.65 ±4.65), (5.89 ± 2.68) mg/L in ODE and UE group. The serum concentrations of hs-CRP in LAA group, CE group, ODE and UE group were significantly higher than those in control group [(4.26 ± 1.34) mg/L] (P <0.05) except for that in SVO group, the level of serum hs-CRP in the three groups showed significant difference among the different time (P< 0.05). Conclusions The level of serum hs-CRP in AIS patients is increased and positively correlated with the disease severity. The changes of hs-CRP level are performed in various subtypes of TOAST, and show time-dependent effects. Inflammatory response may play an important role in the pathological mechanism of AIS.

Objective To understand the distribution and fluctuation tendency of infected Oncomelania snails in marshland areas of Jiangsu Province in order to provide the scientific basis for acute schistosomiasis control. Methods In each county(city, district) 5-10 marshland areas with snails were sampled randomly, and of which 5-10 sites were selected. Fifty to one hundred snails were collected in each site and dissected by professionals to determine the natural infection rate. At the same time, the mollusiciding actions were carried out in the schistosome-positive snail sites and beaches. Results In 5 years, a total of 467 beaches have been checked and 102 positive beaches were find out and the snails detected. The positive rate of beaches was 21.84%(102/467). A total of 169200 snails were dissected , and of which 433 were positive snails. The natural infection rate was 0.2559%(433/169200). The infested areas and the number of positive snails in 2002 were 2.71 and 18.33 times of those in 1998 in Jiangsu Province. Conclusion In the continuous 5 years observation, the tendency of the population of positive snails and the infested areas were significantly growing, and there is a apotential threat for the acute infections. So, the keys of the following work should be controlling snails seriously in the marshlands and the rivers in connection with the Yangtze River, increasing the mollusiciding cover rate and improving the quality in the positive beaches, and surveying and treating the cattle time by time.

Objective To evaluate the molluscicidal effect of 2 kinds of shamingdan in lab. Methods Under constant temperature (25?1) ℃, the studies were carried out by using different concentrations(dosages) of molluscicide, shamingdan, in various methods of immersing, spraying and dusting power, and the molluscicidal effects were compared with 50% wettable powder of niclosamide ethanolamine salt(WPN). Results The 48-hour's LC_ 50(s) of 4% shamingdan granular formulation and 50% shamingdan soluble powder were 0.1752 mg/L and 0.2713 mg/L, respectively, which were similar to that of 50% WPN. In spraying and dusting powder experiment, the 7-day's LC_ 50(s) were 3.0418, 0.1623 g/m~2 and 2.8752, 1.1101 g/m~2, respectively, and the 50% shamingdan soluble powder was better than 4% shamingdan granular formulation and 50% WPN. Conclusions The molluscicidal effect of 2 kinds of shamingdan using immersing is better than that using spraying and dusting. The molluscicidal effect of the 50% shamingdan soluble powder is remarkably better than that of the 4% shamingdan granular formulation and 50% WPN.

OBJECTIVETo investigate the expression of acetyl coenzyme A synthetase short-chain family member 2 (ACSS2) in patients with colorectal cancer (CRC) and its biological role.

METHODSA total of 74 CRC tissue samples and 40 normal colorectal tissues were tested by immunohistochemical staining to detect the expression of ACSS2 (cell staining intensity score: 0 points: without staining, 1 points: weak staining, 2 points: intensity staining, 3 point: strong staining; the percentage of positive cells in tumor or negative score: 0 points: negative, 1 point: <25% positive cells, 2 points: 25%-50% positive cells, 3 points: 50%-75% positive cells, 4 points: >75% positive cells. The product of above two scores was the final score.). Association of ACSS2 expression with clinicopathological characteristics was analyzed. Small interfering RNA (siRNA, including A and B group) was used to knock down the expression of ACSS2 in colorectal cell lines (Lovo, HCT116) and their proliferation, migration and epithelial-mesenchymal transition (E-cadherin and Snail as markers) after knocking down were observed.

RESULTSThe expression of ACSS2 was significant higher in CRC tissue than that in normal colorectal tissue (tumor average score 6.284, normal tissue average score 3.625, P<0.01) and the percentage of positive cell was higher than that in normal tissue (tumor 69.9%, normal tissue 45.1%, P=0.000). The use of ACSS2 siRNA successfully knocked down the expression of ACSS2 in Lovo and HCT116 cells. A mild suppression of cell proliferation was observed 5 days after planked (A450 value: Lovo-NC 1.758±0.041, Lovo-ACSS2-siA 1.485±10.026, Lovo-ACSS2-siB 1.371±0.049; HCT116-NC 2.609±0.038, HCT116-ACSS2-siA 2.260±0.042, HCT116-ACSS2-siB 2.295±0.029). While a remarkable ability decline of cell migration was found (Lovo-NC 225±5/field, Lovo-ACSS2-siA 40±5/field, Lovo-ACSS2-siB 79±3/field; HCT116-NC 198±7/field, HCT116-ACSS2-siA 96±7/field, HCT116-ACSS2-siB 77±9/field, P<0.05). Real-time quantitative PCR detection showed that in Lovo cells, expression of E-cadherin up-regulated and expression of Snail down-regulated, while in HCT116 cells, E-cadherin up-regulated slightly [E-cadherin: Lovo NC 1.000±0.211, Lovo-siA 3.403±0.207, Lovo-siB 2.658±0.420 (P<0.05); HCT116 NC 1.000±0.121, HCT116-siA 1.349±0.197, HCT116-siB 1.528±0.147(P>0.05); Snail: Lovo NC 1.000±0.085, Lovo-siA 0.468±0.030, Lovo-siB 0.499±0.088 (P<0.05); HCT116 NC 1.000±0.118, HCT116-siA 0.265±0.020, HCT116-siB 0.194±0.017 (P<0.05)].

CONCLUSIONCRC tissues have high expression of ACSS2, which may be associated with cell migration and epithelial-mesenchymal transition.

OBJECTIVETo summarize the experience of minimally invasive treatment in 520 patients with intracranial aneurysms on a retrospective study.

METHODSThe measures used in the treatment of 520 patients were reviewed in terms of timing of surgery, induced-hypotensive anesthesia, brain protection combined with temporal occlusion of the feeding artery, external drainage of CSF, dynamic monitoring of intracranial pressure, blood flow velocity, serum osmolality and CT scanning, anti-vasospasm therapy as well as selected interventional endovascular embolization of aneurysms.

RESULTSOf the 520 patients, 485 were treated with either direct clipping or endovascular embolization and 35 patients were treated non-surgically. In 449 patients undergoing direct clipping and 36 undergoing endovascular embolization, intraoperative rupture of aneurysm occurred in 27 (6.0%) and 0%, respectively. Death occurred in 13 (2.6%), hemiplegia in 8 (1.6%), and vegetative state in 2 (0.4%). The operative mortality of direct clipping was 3.8% in 210 patients before 1990 and 1.8% in 275 patients after 1990 (36 patients undergoing endovascular embolization, the operative mortality was 0%).

CONCLUSIONThe outcome of patients with intacranial aneurysms can be markedly improved and the operative mortality can be lowered by minimally invasive treatment.

Adult ; Aneurysm, Ruptured ; mortality ; therapy ; Embolization, Therapeutic ; Female ; Follow-Up Studies ; Humans ; Intracranial Aneurysm ; mortality ; surgery ; Intraoperative Complications ; mortality ; Male ; Microsurgery ; Middle Aged ; Minimally Invasive Surgical Procedures ; Retrospective Studies ; Survival Rate ; Treatment Outcome

Objective:To establish a good model of incomplete ablation of ectopic implanted tumor of liver, and explore the changes in the molecular landscape of residual cancer, cancer in nude mice.Methods:Eight immunodeficient BALB/c nude mice were used to establish an ectopic tumor model with the MHCC97-H hepatoma cell line, and they were randomly divided into experimental group and control group, with 4 mice in each group. The experimental group underwent simulated clinical incomplete ablation, and the control group only underwent false ablation. The differences between the models were evaluated by ultrasonic diagnostic equipment, thermal imaging cameras, HE staining and high-throughput whole transcriptome sequencing.Results:Liver cancer ectopic implantations in nude mices were all successful. The experimental group showed that the temperature of the tumor around the tip of the needle monitored by the thermal imaging camera was at 50-73.9 ℃. Compared with the control group, the HE staining of the experimental group mostly showed the coexistence of necrotic area-degeneration area-tumor cell area. The necrosis area was (23.75±13.77)%, and the degeneration area was 50%(30%). High-throughput whole transcriptome sequencing revealed that there were hundreds of overlapping stable molecular landscapes in the incomplete ablation simulation model both in vivo and in vitro.Conclusions:By establishing an ectopic implantion model of nude mice with incomplete ablation of residual liver cancer, it can provide a basis for studying the biological characteristics of incomplete ablation of residual cancer at the molecular level.

AIM: To investigate the molecular mechanism through which DKK1 is transcriptionally regulated in HCC (hepatocellular carcinoma) cells. METHODS: Real time PCR was used to explore whether EGFR was involved in regulating DCLK1 mRNA expression in HCC cells; Western blot assay was used to examine whether EGFR-mediated the up-regulation of DCLK1 protein in HCC cells; Immunohistochemical (IHC) analyses were used to examine the protein expression of EGFR and DCLK1 in 39 human HCC tumor specimens. RESULTS: EGF promoted the expression of DCLK1 mRNA and protein in HepG2 and Huh-7 cells (P<0.05, P<0.01), while knockdown of EGFR with two specific siRNA could reverse EGF-induced the up-regulation of DCLK1 mRNA and protein (P<0.01). IHC analyses revealed that the amount of EGFR correlated significantly with that of DCLK1 (r=0.669 6). CONCLUSION: EGFR promoted DCLK1 transcription in HCC.

Objective:To evaluate the efficacy of the domestic D-Shant device for the treatment of patients with chronic heart failure (CHF) using echocardiography.Methods:Twenty-four CHF patients who were treated with domestic D-Shant device in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from September 2020 to December 2021 were enrolled in the study. Pulmonary capillary wedge pressure (PCWP)/ left atrial pressure (LAP), right atrial pressure (RAP), pulmonary artery pressure, interatrial septal gradient pressure, cardiac index and pulmonary/systemic blood flow ratio (Qp/Qs) were measured before and after implantation using right heart catheterization.Left atrial end-diastolic area index (LAEDAI), left atrial end-diastolic volume index (LAEDVI), left ventricular end-diastolic volume index (LVEDVI), left ventricular end-systolic volume index (LVESVI), left ventricular ejection fraction (LVEF), right atrial end-diastolic diameter, right ventricular end-diastolic diameter, tricuspid annular plane systolic excursion (TAPSE), right ventricular tractional area change (RVFAC), device shunt aperture, velocity and pressure, together with mitral and tricuspid regurgitation severity were measured using echocardiography before, and 1 month as well as 3 months after D-Shant device implantation. Clinical data were collected and analyzed including 6-minute walking test (6MWT), New York Heart Association (NYHA) classification and the Kansas City Cardiomyopathy Questionnaire (KCCQ). Spearman correlation analysis was used to determine the relation between the changes in PCWP/LAP as well as echocardiographic parameters before and 3 months after implantation and NYHA classification. Binary Logistic regression analysis was performed to determine the predictive factors of NYHA classification improvement at 3-month follow-up after D-Shant device implantation.Results:①D-Shant devices were successfully implanted in all patients. ②Compared with preoperative values, invasive PCWP/LAP systolic, diastolic and mean pressures, transatrial septal gradient, and pulmonary systolic, diastolic and mean pressures decreased significantly after implantation(all P<0.001); Qp/Qs increased significantly after implantation( P<0.001). ③Compared with preoperative values, TAPSE, RVFAC and pulmonary artery flow velocity increased at 1 month after implantation(all P<0.05), whereas a significant reduction in mitral regurgitation grade, and an increase in LVEF and pulmonary artery flow velocity at 3 months after implantation(all P<0.05). Right atrial end-diastolic diameter, right ventricular end-diastolic diameter, LAEDAI, LAEDVI, LVEDVI, LVESVI, ratio of early to late diastolic peak velocities of mitral inflow(E/A), systolic peak velocity of mitral annulus at septal site(S′), ratio of early diastolic peak velocity of mitral inflow to diastolic peak velocity of mitral annulus(E/e′), pulmonary artery diameter, inferior vena cava diameter and degree of tricuspid regurgitation did not change among before, and 1 month as well as 3 months after implantation. There were no significant changes in the device shunt aperture, velocity and pressure between 1 month and 3 months after implantation(all P>0.05). ④The significant improvements in NYHA classification, KCCQ scores and 6MWT were observed at 1 and 3 months after implantation compared with preoperative values (all P<0.01). ⑤NYHA classification at 3 months after implantation was correlated with LVEF pre-post, PCWP/LAP pre-post, TAPSE pre-post and RVFAC pre-post ( rs=0.738, -0.730, 0.738, 0.723; all P<0.001). Logistic regression analysis showed that LVEF pre-post was an independent predictor for NYHA classification improvement at 3 months after implantation ( OR=0.687, 95% CI=0.475-0.992, P=0.045) . Conclusions:Domestic D-Shant device can effectively improve the cardiac function and clinical symptoms in patients with CHF. Echocardiography is a feasible and effective method to evaluate the benefits of domestic D-Shant device for the treatment of CHF.

Femoral neck fracture (FNF) in the elderly patients is currently a major health challenge worldwide, with excessive consumption of medical resources, high incidence of complications as well as suboptimal outcome and prognosis. Hip joint arthroplasty (HJA) has been the mainstream treatment for FNF in the elderly, but the conventional surgical approaches and techniques are still confronted with a series of bottlenecks such as dislocation, limp and limb length discrepancy. In recent years, direct anterior approach (DAA) for HJA (DAA-HJA) has been a major new choice in the field of joint replacement, which achieves improved clinical effectiveness of HJA in the treatment of elderly FNF, due to the fact that DAA approach involves the neuromuscular interface and accords with the idea of soft tissue retention and enhanced recovery after surgery. However, there is still a lack of unified understanding of standard technique and procedure of DAA-HJA in the treatment of elderly FNF. Therefore, relevant experts from the Hip Joint Group of Chinese Orthopedics Association of Chinese Medical Association, Youth Arthrology Group of Orthopedic Committee of PLA, Orthopedic Committee of Chongqing Medical Association, Branch of Orthopedic Surgeons of Chongqing Medical Doctor Association and Sport Medicine Committee of Chongqing Medical Association were organized to formulate the " Chinese expert consensus on the technical standard of direct anterior hip arthroplasty for elderly femoral neck fracture ( version 2023)" based on evidence-based medicine. This consensus mainly proposed 13 recommendations covering indications, surgical plans, prosthesis selections, surgical techniques and processes, and postoperative management of DAA-HJA in elderly patients with FNF, aiming to promote standardized, systematic and patient-specific diagnosis and treatment to improve the functional prognosis of the patients.