Objective:To study the effect of repeated transient ischemic attacks(TIAs)on cumulative injury of cognitive function.Methods:The cognitive condition of 42 patients with repeated TIAs were assessed after each TIA using the event related potential,modified version of Wisconsin card sorting test,trail making test,digit span task,and verbal fluency test.The cognitive condition was compared and analyzed after different attack times.Results:There were significant differences among the cognitive condition after different attack times,latency and amplitude of P300,and detection rate of mild cognitive impairment.With the increase of the attack times,cognitive impairment aggravated gradually,and the detection rate of mild cognitive impairment increased gradually.Conclusions:Repeated TIAs have cumulative injury on cognitive function.The prevention and treatment of cerebral ischemia may become an important approach in decreasing cognitive impairment.

Objective To investigate the life quality changes and influencing factors of acute coronary syn -drome after stent implantation .Methods 100 cases with acute coronary syndrome received stent implantation were selected .SF-36 life quality questionnaire was used to survey the patients′life quality before operation and 6 months af-ter operation,and the life quality changes and influence factors were analyzed .Results 6 months after operation,the physical activity ,mental health ,social activities ,physical pain ,physical function ,physical role ,energy and health score of the patients were higher than before operation (P<0.05).According to Logistic regression analysis ,female,type 2 diabetes,underwent percutaneous coronary intervention ,ST-T segment elevation myocardial infarction were the im-portant factors affecting patients′recovery(P<0.05).Conclusion 6 months after stent implantation,the life quality of the patients with acute coronary syndrome were improved obviously;the female and underwent percutaneous coro-nary intervention have positive influence on patients′recovery,while type 2 diabetes,ST-T segment elevation myocar-dial infarction affect patients′recovery in negative way .

Objective To observe the effects of MSH2 gene re expression on estrogen-induced apoptosis of colon cancer cells LOVO,and to explore its mechanisms.Methods According to different plasmid and whether with estradiol intervention,colon cancer LOVO cells were divided into empty plasmid with ethanol group,empty plasmid with estradiol group,MSH2 with ethanol group,MSH2 with estradiol group,estrogen receptor (ER) β with ethanol group,ERβ with estradiol group,ERβ with MSH2 and ethanol group and ERβ with MSH2 and estradiol group,and received corresponding treatment.The expression of MSH2,ERβ protein and apoptosis related caspase 3 protein were detected by Western blotting.Cell viability was measured by cell counting kit-8.Cell DNA fragments of each group were isolated with apoptosis DNA fragments isolation kit.And the DNA ladder was observed.The rate of apoptosis was detected by flow cytometer.Single factor variance analysis was performed for comparison among multiple groups,and t test was used for comparison between the two groups.Results After transfection,the expression of the MSH2 and ERβ at protein level in LOVO cells significantly increased and neither of their expression was effected by estradiol.The expression levels of caspase 3 cleavaged active fragments of ERβ with estradiol group and ERβ with MSH2 and ethanol group were higher than other groups,and there was no significant difference between these two groups.The LOVO cell viability of empty plasmid with ethanol group,empty plasmid with estradiol group,MSH2 with ethanol group,MSH2 with estradiol group,ERβ with ethanol group,ERβ with estradiol group,ERβ with MSH2 and ethanol group and ERβ with MSH2 and estradiol group was 1.72 ±0.25,1.74 ± 0.31,1.77 ± 0.35,1.74±0.33,1.70±0.34,1.02±0.48,1.71±0.31 and 1.07±0.18,respectively,and the differences between the groups were statistically significant (F=3.791,P＜0.05).Among them,the LOVO cell viability of ERβ with estradiol group was lower than that of ERβ with ethanol group,accordingly,that of ERβ with MSH2 and estradiol group was lower than that of ERβ with MSH2 and ethanol group,that of ERβ with estradiol group was lower than that of empty plasmid with estradiol group,that of ERβ with MSH2 and estradiol group was lower than that of MSH2 with estradiol group,and the differences were statistically significant (t=3.158,3.075,3.648,3.253,all P＜0.05).DNA ladder formed from DNA fragments of apoptosis cells was seen in ERβ with estradiol group and ERβ with MSH2 and estradiol group.The apoptosis rate of empty plasmid with ethanol group,empty plasmid with estradiol group,MSH2 with ethanol group,MSH2 with estradiol group,ERβ with ethanol group,ERβ with estradiol group,ERβ with MSH2 and ethanol group and ERβ with MSH2 and estradiol group was 7.86±0.19,7.87±0.39,8.39±1.02,9.05±1.54,7.54±0.99,19.77±2.35,7.76±1.32 and 19.30±1.75,respectively,and the differences between groups were statistically significant (F=45.436,P＜0.05).Among them,the apoptosis rate of ERβ with ethanol group was lower than that of ERβ with estradiol group,that of ERβ with MSH2 and ethanol group was lower than that of ERβ with MSH2 and estradiol group,that of empty plasmid with estradiol group was lower than that of ERβ with estradiol group,that of ERβ with MSH2 and estradiol group was lower than that of MSH2 with estradiol group,and the differences were statistically significant (t =8.260,9.133,8.596,7.617,all P＜ 0.05).Conclusions Estrogen may promote colon cancer cell apoptosis through ERβ pathway.The process of apoptosis maybe related with caspase protein,MSH2 may not be involved in the regulation of this signal pathway.

Objective To explore the changes on autonomic nervous function of the patients with different Traditional Chinese medicine syndrome types.Methods The cases of anxiety or depressive diseases were divided into different types according to traditional Chinese medicine syndrome types,and then heart rate variability(HRV) were tested and compared with normal controls.Results Indicators of time or frequency of heart rate variability(HRV) in anxiety or depressive disease patients with Gan-Yu-Tan-Zu Zheng or Xin-Pi-Liang-Xu Zheng or Gan-Yu-Qi-Zhi Zheng were lower than those of controls group,especially in parasympathetic nervous.The abever disorders of the patients with Gan-Yu-Tan-Zu Zheng or Gan-Yu-Qi-Zhi Zheng was more significant than those in patients with Xin-Pi-Liang-Xu Zheng.Conclusions The autonomic nervous function of anxiety or depressive diseases with Gan-Yu-Tan-Zu Zheng or Xin-Pi-Liang-Xu Zheng or Gan-Yu-Qi-Zhi Zheng is disordered and their HRV of was lower than that of control(P

Objective To purify and rejuvenate the plant of Curcama kwangsiensis,improve the transplantation survival rate of cultivars,and make the convenience of storagement and management for the cultivars production.Methods The rhizome plantlet formation of C.kwangsiensis was induced by regulating both of macro-element and sucrose concentration in the MS culture medium.Results Both of them were very important influence factors on the rhizome plantlet formation of C.kwangsiensis.Media 1/2 MS and 6% sucrose were adaptable to the rhizome plantlet formation of C.kwangsiensis,had the best effects on the formation rate of the rhizome plantlet,diameter and direct transplanting rate of the rhizome plantlet.Both plantlet and root system development were stronger.Conclusion In the present research,it is successful in inducing the rhizome plantlet formation of C.kwangsiensis.

Objective:To evaluate the prognostic value of combined detection of platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR) and squamous cell carcinoma antigen (SCC) for patients with advanced cervical squamous cell carcinoma undergoing radical radiotherapy.Methods:Clinical data of 127 patients with advanced cervical squamous cell carcinoma who received radical radiotherapy in the Affiliated Tumor Hospital of Nantong University from January 2016 to February 2019 were analyzed retrospectively. The enrolled cases were divided into the survival group and death group according to the survival at the end of 3 years after treatment. The laboratory indexes of peripheral blood were collected before treatment, PLR and NLR were calculated, and the differences of clinical parameters were compared between two groups. The prediction model was established, and the prediction efficiency of PLR, NLR and SCC alone and combined prediction models for 3-year overall survival (OS) in patients with advanced cervical squamous cell carcinoma was compared through the ROC curve. Univariate and multivariate analyses of prognosis were carried out by binary logistic regression model.Results:A total of 127 patients with advanced cervical squamous cell carcinoma were included in the study. There were 96 cases in the survival group and 31 cases in the death group. There were significant differences between two groups in FIGO stage, longest diameter of tumor, lymph node metastasis, PLR, NLR and SCC (all P<0.05). The area under ROC curve (AUC) of PLR, NLR and SCC was 0.660, 0.712 and 0.700, respectively. The AUC of PLR+NLR+SCC combined prediction model was increased to 0.784. Logistic multivariate analysis showed that FIGO Ⅲ, FIGO Ⅳ, lymph node metastasis, PLR≥205.555, NLR≥3.060 and SCC≥6.950 ng/ml were the independent risk factors for 3-year OS in patients with advanced cervical squamous cell carcinoma (all P<0.05). Conclusions:PLR, NLR and SCC have good value in predicting the 3-year OS of patients with advanced cervical squamous cell carcinoma, and the combined prediction model of PLR+NLR+SCC has higher prediction value.

Objective To evaluate the clinical efficacy of pre-procedure simethicone on detection of pharynx by upper gastrointestinal endoscopy. Methods A total of 100 patients with esophageal squamous cell carcinomas ( ESCCs) were enrolled in this prospective controlled trial and randomly assigned into two groups. The study group was given gargle with 5 mL simethicone plus 5 mL water combined with conventional procedure before gastroscopy. The control group was prepared according to the conventional procedure. The age, gender, tumor stage, lesion size, doctor＇s satisfaction and examination time between two groups were analyzed. Results The basic conditions between the two groups, including age, gender, and tumor stage were not significantly different (all P＞0. 05). The detection rate of superficial lesion in pharynx was higher in the study group than that in the control group, with no significant difference [8. 16%(4/49) VS 2. 04%( 1/49), P＝0. 362]. The median time of pharyngeal observation in the study group was less than that in the control group (21. 7 s VS 33. 9 s, P＝0. 000). The doctor was more satisfied in the study group than the control group (P＝0. 001). Conclusion Pre-procedure with simethicone improves the endoscopic visibility and detection rate of superficial squamous cell carcinoma with less observation time.

Objective To evaluate the clinical value of epithelial vessel branch detected by non-magnifying narrow-band imaging ( NM-NBI ) in diagnosis of early esophageal cancer. Methods A retrospective analysis was performed on data of 59 patients, who underwent endoscopy with NM-NBI and iodine staining to screen early esophageal cancer in PLA General Hospital from January 2013 to May 2015. The final diagnosis for all lesions were determined by pathology. The diagnostic accuracy, sensitivity and specificity of NM-NBI and iodine staining for early esophageal cancer were compared. Results The accuracy, sensitivity and specificity of NM-NBI on the epithelial vessel branch in diagnosis of early esophageal cancer were 83. 1％ (49/59), 91. 3％ (21/23) and 77. 8％ (28/36), respectively, and the corresponding statistical values of iodine staining were 55. 9％ ( 33/59) , 95. 7％ ( 22/23) and 30. 6％ ( 11/36), respectively. The accuracy (χ2=1. 45, P=0. 028) and specificity (χ2=21. 4, P=0. 000) of epithelial vessel branch by NM-NBI were significantly higher than those of iodine staining, and there was no significant difference in the sensitivity between the two methods (χ2=22. 3, P=1. 000) . Conclusion The observation of epithelial vessel branch using NM-NBI was useful and reliable in diagnosis of early esophageal cancer with high accuracy and specificity, and can be possible for application in the clinic.

Objective:To explore the correlation between socioeconomic status (SES) and diabetic kidney disease (DKD) in patients with type 2 diabetes (T2D).Methods:A total of 276 T2D patients admitted to the Second Affiliated Hospital of Nanjing Medical University from January to June 2020 were enrolled in this cross-sectional study. The estimated glomerular filtration rate (eGFR) was calculated according to the urinary albumin/creatinine ratio (UACR) and the chronic kidney disease epidemiology collaboration equation(CKD-EPI formula) based on serum creatinine. The patients were divided into simple T2D group (184 cases) and DKD group (92 cases). Collect demographic and laboratory examination data, record education, income and occupation, and calculate standardized SES scores. According to SES scores, subjects were divided in three levels: SES≤9, SES≥10-≤12, and SES≥13. Student's t test was used for comparison of measurement data with normal distribution between two groups, and one-way ANOVA was used for comparison between multiple groups. Non-normal distribution was represented by M( Q1, Q3), and rank-sum test was used for comparison between groups. Counting data were expressed as frequency or percentage, and chi-square test was used for comparison between groups. Bofferoni test was further used for pairwise comparison of indicators with statistical significance among multiple groups. Spearman correlation analysis was used to analyze the correlation between variables. The risk factors were analyzed by binary Logistic regression. Results:The age of the subjects was (53.37±10.68) years, men accounted for 55.8% (154/276), the duration of diabetes was 60.00 (12.00, 134.00) months, and eGFR was (97.56±21.15) mL/(min·1.73 m 2). In simple T2D group and DKD group, prevalence of hypertension were 39.7% (73/184) and 57.6% (53/92), systolic blood pressure were (129.43±14.92) mmHg and (139.29±17.61) mmHg, diastolic blood pressure were (81.86±10.06) mmHg and (87.74±11.19) mmHg, serum albumin were (45.74±4.15) g/L and (43.99±5.05) g/L, triglycerides were (1.82±1.24) mmol/L and (2.64±2.92) mmol/L, high density lipoprotein cholesterol were (1.17±0.37) mmol/L and (1.07±0.26) mmol/L, serum uric acid were (298.44±90.73) μmol/L and (336.22±94.01) μmol/L, serum creatinine were (62.83±14.45) μmol/L and (87.75±57.37) μmol/L, eGFR were (102.6±14.28) mL/(min·1.73 m 2) and (87.47±28.04) mL/(min·1.73 m 2), UACR were (7.60 (4.63, 13.15)) mg/g and (93.95 (47.25, 310.25)) mg/g. Prevalence of hypertension, systolic blood pressure, diastolic blood pressure, triglycerides, serum uric acid, serum creatinine, UACR in DKD group were higher than those in simple T2D group. Serum albumin, high density lipoprotein cholesterol and eGFR in DKD group were lower than those in simple T2D group. There was significant difference between the two groups ( χ2=7.95, t values were 4.87, 4.40, 3.04, 3.26, 2.30, 3.22, 5.56, 5.95, Z=13.07, P values were 0.005, <0.001, <0.001, 0.003, 0.001, 0.022, 0.001, <0.001, <0.001, and <0.001, respectively). The number of males in the three groups with SES ≥13 group, SES≥10-≤12 group, SES ≤9 group were 61 (81.3%, 61/75), 55 (59.8%, 55/92), 38 (34.9%, 38/109), respectively. The number of cases with smoking history were 42 (56.0%, 42/75), 41 (44.6%, 41/92), 35 (32.1%, 35/109), respectively. The number of cases with drinking history were 38 (50.7%, 38/75), 32 (34.8%, 32/92), 26 (23.9%, 26/109), respectively. The ages were (47.77±10.76), (52.76±11.22), (57.74±7.96) years old, respectively. Body mass index (BMI) were (26.17±3.87), (24.96±3.93), (24.27±4.89) kg/m 2, respectively. High density lipoprotein cholesterol (HDL) were (1.03±1.03), (1.16±0.41), (1.21±0.32) mmol/L, respectively. Serum uric acid were (336.56±82.05), (293.78±94.78), (307.99±96.53) μmol/L, respectively. EGFR were (105.03±19.72), (99.77±19.44), (90.57±21.49) mL/(min·1.73 m 2),respectively.The difference between groups were statistically significant (χ 2=39.79, 10.55, 14.08, F=22.69, 4.03, 6.20, 4.53, 12.02, P values were <0.001, 0.005, 0.001, <0.001, 0.019, 0.002, 0.012, and <0.001, respectively). Pairwise comparison shows that male and eGFR in SES ≤9 group were lower than those in SES ≥13 group and SES≥10-≤12 group, age in SES ≤9 group was higher than that in SES ≥13 group and SES≥10-≤12 group. The difference was statistically significant (all P<0.05). Smoking history, alcohol history and BMI in SES ≤9 group were lower than those in SES ≥13 group, and the high density lipoprotein cholesterol in SES ≤9 were higher than that in SES ≥13 group. The difference was statistically significant (all P<0.05). Male, alcohol history and serum uric acid in SES≥10-≤12 group were lower than those in SES ≥13 group, and age and high density lipoprotein cholesterol in SES≥10-≤12 group were higher than those in SES ≥13 group. The difference was statistically significant (all P<0.05). Spearman correlation analysis showed that SES in T2D was positively correlated with male, smoking history, alcohol history, BMI, serum uric acid and eGFR ( r values were 0.38, 0.20, 0.24, 0.16, 0.13 and 0.31, P values were <0.001, 0.001, <0.001, 0.008, 0.028, and <0.001, respectively), and negatively correlated with age, high density lipoprotein cholesterol and UACR ( r values were -0.35, -0.24 and -0.14, P values were <0.001, <0.001, and 0.017, respectively). Logistic regression analysis showed that SES (OR=2.71,95% CI:1.10-6.68, P=0.031) was associated with T2DM combined with DKD. The risk of developing DKD increased when the SES was ≤9. Conclusion:The SES in patients with type 2 diabetes is closely related to DKD. Low SES may be a new risk factor for DKD in type 2 diabetic patients.

Objective:To comprehensively understand the current situation of outpatient management in tertiary medical institutions in Anhui Province under the COVID-19 epidemic, and to provide empirical reference for effective prevention and control of the epidemic.Methods:In December 2020, a stratified cluster sampling method was used to investigate and score the current situation of outpatient management in 56 tertiary medical institutions in Anhui Province. The survey content included four dimensions: appointment and triage setting and management, fever clinic setting and management, nosocomial infection prevention and control management, and medical resource storage management. The scoring results were divided into three grades, namely " good" (total score≥90 points), " acceptable" (85≤total score<90 points)and " inadequate" (total score<85 points). SPSS 21.0 software was used for data statistical analysis. Independent sample t-test was used to compare the outpatient setting and management scores of medical institutions, and the proportion of assessment grades was used chi-square inspection.Results:The outpatient setting and management of 56 tertiary medical institutions in Anhui Province were evaluated as good in 36, acceptable in 6 and inadequate in 14. The outpatient setting and management score was(81.55±24.94), including(16.53±2.66)in " appointment and triage setting and management" , (47.62±19.60) in " fever clinic setting and management" , (8.69±1.44)in " nosocomial infection prevention and control management" , and (8.75±3.02) in " medical resource storage management" . The total scores and four dimension scores of 39 general hospitals were higher than those of 17 specialized hospitals, and the differences were significant( P<0.05). Conclusions:The overall situation of outpatient epidemic prevention and control management in tertiary medical institutions in Anhui Province is good, but the construction and control of specialized hospitals need to be further strengthened.