Post-stroke fatigue is one of the most common and painful symptoms of stroke patients, and may persist for a long time, which has a negative impact on the rehabilitation and daily life and work of stroke patients. This article reviews the research progress of epidemiology, pathogenesis related factors, clinical evaluation methods and treatment of post-stroke fatigue.

The exact pathophysiological mechanisms of diabetic retinopathy (DR) remain elusive.The inflammatory reaction,retinal vascular leakage and retinal neovascularization are main features of DR.Adiponectin (APN) is an endogenous biological active protein secreted by adipocytes.It can increase insulin sensitivity,regulate blood glucose and lipid metabolism,and has anti-inflammation and anti-neovascularization functions.It may be involved in the development of DR.This review summarized the studies on the association between APN and DR in recent years.

Objective To investigate the association of fluctuation of anticardiolipin antibody (ACA) levels and clinical manifestations in patients with systemic lupus erythematosus (SLE). Methods Anticar-diolipin antibodies were measured sequentially by commercial enzyme-linked immunosorbent assay (ELISA) in 85 SLE patients. Patients were classified into two groups: group A was persistently positive for ACA, group B was transiently positive for ACA, and the clinical features of the two groups were compared. Results There were 37 patients (44%) in group A, and 48 (57%) patients in group B. 41% patients had occurred thromboeytopenia in group A, 19% patients in group B, the difference was significant (P<0.05); platelet accounts were (24±6)×109/L in group A,and (46±10)×109/L in group B, the difference was significant (P< 0.05), too. 11% patients experienced thrombosis in group A, and none in group B, the difference was significant (P<0.05). 19% in group A and 4% in group B had occurred valvular diseases, the difference was significant (P<0.05.). The prevalence of lupus anticoagulant was 32% in group A, 13% in group B and the difference was significant (P<0.05). There was no significant difference between the two groups in Raynaud's phenomenon, pulmonary hypertension, and lupus nephritis (P0.05). Conclusion Fluctuations of anticardio-lipin antibodies are asso-ciated with thrombosis, thrombocytopenia vascular disease and lupus anticoagulant however, there is no lack of association with other clinical manifestations in SLE patients.

Objective To assess the diagnostic value of Logistic model in differentiating between malignant and benign ovarian lesions. Methods Thirty-five indexes of clinical and ultrasound data were recorded in 601 ovarian lesions confirmed by surgical pathology. The Logistic model was developed on a training set( n - 400) and tested on a test set( n = 201). Results Variable selection resulted in a set of 10 variables for the models: personal history of ovarian cancer, maximal diameter of the lesion, maximal diameter of the solid component, multilocular-solid tumor, solid tumor, ascites, flow within papillation, irregular walls, very strong intratumoral blood flow (i. e. color score 4) and acoustic shadows. Test set area under the receiver-operating characteristics curve was 0.963 with a sensitivity 93.9% and a specificity 93. 1 %. Conclusions Logistic model can accurately separate malignant from benign ovarian masses.

Objective To follow up the changes of postnatal cardiac sizes and function in infants of mothers with gestational diabetes mellitus (GDM). Methods Eighteen GDM mothers with euglycemia (GDM group) and 24 gestational age-matched normal pregnant women (control group),having prenatal examination and delivered in Women's Hospital of Fudan University from January to August in 2007, received fetal echocardiographic examination in late pregnancy. Infants of these GDM mothers and 24 age-matched healthy infants of normal pregnancy (control group) received sonographic follow up. Cardiac sizes and function were evaluated and compared. Results At birth, there were six (33.3%) infants of large for gestational age (LGA) and 12(66.7%) appropriate for gestational age(AGA) in GDM group, while in the control group, there were two LGA (8. 3%) and 22(91.7%)AGA infants (x2 =3. 840, P= 0. 05). Both the interventricular septum and left ventricular walls in GDM fetuses were thicker than in control fetuses (P ＜ 0.05). No increase in the thickness of ventricular walls was observed till infantile period. However, the end-systolic thickness of left ventricular walls in LGA infants was still larger than in control infants [(4.55 ± 0.37) mm vs (4. 13±0.39)mm, P＜0. 05], and end-diastolic left ventricular long-diameters were also larger [(37. 3±2.3) mm vs (34.6±2.6) mm] (P＜0. 05). In GDM fetuses, the peak velocities of aorta and pulmonary artery and left cardiac output were higher than in the controls (P＜ 0. 01 ), and right/left cardiac outputs ratios were lower (1.198±0.206 vs 1. 430±0. 321, t= -2.668,P=0. 011). Till infantile period, only right/left cardiac outputs ratios in AGA infants of GDM group were larger than in controls (P＜0. 05). GDM fetuses' left atrial shortening fraction and tricuspid E/A ratios were smaller (P＜0. 05). In infantile period, only left atrial shortening fraction in GDM infants was still smaller than in controls (0. 356 ± 0. 040 vs 0. 386 ± 0. 041, t = - 2. 332, P = 0. 025). Left and right ventricular Tei index in GDM fetuses were 0. 482±0. 129 and 0. 414±0. 094, both larger than those of control fetuses (0. 309 ± 0. 074 and 0. 283 ± 0. 072) (t = 5. 075 and 5. 129, P = 0. 000 ). Till infantile period they both became significantly lower and no differences were found among LGA, AGA and control infants. Conclusions The cardiac sizes and function at 2-3 months of age, in infants of GDM mothers with good glucose control, became better than that in uterus.

Objective To explore the association between HbA1c and acute myocardial infarction(AMI) in youth. Methods Seventy-two AMI patients (≤44y) diagnosed during the period from January in 2009 to August in 2012 were enrolled and 79 young age-matched adults without coronary artery disease at the same period were enrolled to be control group. The relationship between HbA1c, fasting blood-glucose(FBG) and AMI was explored. Results (1)Compared with the control group,the plasma FBG and HbA1C value were significantly higher(P<0.05) in AMI group. (2)Logistic regression analysis showed that HbA1c is the independent risk factor for AMI in youth. (3)In AMI group, the HbA1c level in single vessel disease had remarkable difference with that in double vessel disease and triple vessel disease(P<0.05). Conclusions Increasing HbA1c level is the independent risk factor for AMI in youth,and positively correlated with the degree of coronary artery lesions. Primary intervention of glycometabolism abnormality possibly becomes the new opinion for prevention and cure of AMI.

Objective To analyze the clinically isolated bacterial distribution and drug resistance characteristics in the our hospital during 2016 to provide the pathogenic drug resistance monitoring data for rational bacterial drugs use in clinic.Methods The clinicaly submitted samples were performed the pathogenic bacterial isolation according to the routine method.The isolated pathogens were identified by the Vitek2-Compact system and the drug susceptibility test was performed by adopting the MIC and KB methods.The results were statistically analyzed by adopting the WHONET5.6 software.Results A total of 2 214 non-repeat strains of bacteria were isolated in 2016,including 1 614 strains of Gram-negative bacilli,accounting for 72.9％,600 strains of Gram-positive bacteria,accounting for 27.1 ％.The top five isolated bacteria were Klebsiella pneumoniae,Escherichia coli,Pseudomonas aeruginosa,Acinetobacter baumannii and Staphylococcus aureus.The detection rates of ESBLs producing Escherichia coli and Klebsiella pneumoniae were 51.8％ and 27.6％ respectively.The detection rates of methicillin-resistant Staphylococcus aureus (MRSA) was 26.5％.No vancomycin or linezolid resistant staphylococcal strains were found.Conclusion The main isolated pathogens in our hospital are dominated by Gram-negative bacteria.Hospital should strengthen reasonable and standardized use of antibacterial drugs to reduce the generation of drug resistant bacterial strains.

Objective To compare magnetization transfer and diffusion characteristics of multiple sclerosis(MS)lesions,normal-appearing white matter(NAWM)from patients,and normal white matter from control subjects,and to investigate the correlation between the magnetization transfer ratio(MTR)and mean diffusivity(MD)in MS patients.Methods Conventional MRI,magnetization transfer imaging(MTI)and diffusion tensor imaging(DTI)were performed in 24 relapsing remitting MS patients and 24 healthy volunteers.Based on these images,the MTR,MD and fractional anisotropy(FA)maps were obtained.Then the MTR,MD and FA values were measured in lesions and NAWM from patients,and in the relevant white matter regions from volunteers.Results Average MTR in lesions(23.49%?5.16%)from MS patients was lower than those both in NAWM(29.49%?3.38%)and in the counterparts of the controls(32.78%?3.42%,F=101.44,P

Objective To investigate the protective effect of bicyclol tablets on drug-induced hepatic injury in patients with severe psoriasis.Methods One hundred and six patients with severe psoriasis and drug-induced hepatic injury were enrolled in this study,and randomly divided into 2 groups:bicyclol group (53 cases) treated with oral bicyclol tablets (25 mg thrice a day) for 8 weeks,diammonium glycyrrhizinate group (53 cases) treated with diammonium glycyrrhizinate capsules (150 mg thrice a day) for 8 weeks.Serum biochemical indices of hepatic function were measured before and after treatment,therapeutic efficacy was evaluated,and adverse reactions were observed and recorded after treatment.Intergroup and intragroup differences in these parameters were assessed.Results During the treatment,3 patients were lost to follow up.After treatment,serum biochemical indices of hepatic function markedly improved in both the bicyclol group (52 cases) and diammonium glycyrrhizinate group (51 cases) (both P ＜ 0.01),and the bicyclol group showed a better treatment response than the diammonium glycyrrhizinate group (P ＜ 0.01).The marked response rate was 71.15％ and 47.06％ (P ＜ 0.05),and the response rate was 84.62％ and 66.67％ (P ＜ 0.05),respectively,in the bicyclol group and diammonium glycyrrhizinate group.No adverse reactions related to tested drugs were observed in either of the two groups.Conclusion Bicyclol can attenuate antipsoriatic drug-induced hepatic injury with good safety.

Objective To investigate the effect of intermittent hypoxia on neuronal apoptosis and inducible nitric oxide synthase (iNOS) expression in rat hippocampus,in order to explore the potential mechanism of hippocampal neuronal apoptosis induced by intermittent hypoxia.Methods Twenty-four Wistar male rats (280-350 g) were randomly divided into three groups:the normal control,intermittent normoxia and intermittent hypoxia group (n=8 each).The animal model of intermittent hypoxia was established by an automated nitrogen/oxygen profile system.The three groups were respectively exposed to continuous normoxia (21 ％O2),cyclical normoxia (21 ％O2),and cyclical hypoxia [alternating between normoxia (21 ％ O2) and hypoxia (5 ％ O2),every 120 seconds] throughout the eight hours of light time(8:00-16:00).The rats were dissected and the hippocampus was removed at the end of the designated duration of exposures for six weeks.TdT-mediated dUTP nick end labeling (TUNEL) was used to detect the apoptotic rate of the hippocampus region in each group.Reverse transcription-PCR,immunohistochemistry (IHC) and Western blotting were used to examine mRNA and protein expressions of iNOS in the hippocampus tissue.Results The apoptotic rate of hippocampal neurons was higher in intermittent hypoxia group than in intermittent normoxia group [(28.236±0.081) ％ vs.(9.341±0.026)％,P＜0.05].The mRNA and protein expressions of iNOS were higher in intermittent hypoxia group than in intermittent normoxia group (3.394± 1.344 vs.0.125±0.040,7.793±0.052 vs.1.356±0.039,both P＜0.05].Conclusions Intermittent hypoxia can induce hippocampal neuronal apoptosis in rats,accompanied by the upregulation of iNOS gene transcription and protein expression,which indicates that iNOS may involve in the process of hippocampal neuronal apoptosis induced by intermittent hypoxia.