Clopidogrel is an essential drug for the treatment of ischemic stroke.It has been recommended by the multinational stroke treatment guidelines and has been widely used in clinical practice.Many patients with ischemic stroke may still have stroke recurrence after the standard treatment of clopidogrel; therefore,we must pay attention to the phenomenon of clopidogrel resistance.This article reviews the biochemical mechanisms,gene polymorphism,laboratory testing,and response measures of clopidogrel resistance.

Objective To understand the risk factors of the elderly in community of Haining city in patients with Alzheimer's disease.Methods Take the elderly Chang street Haining city selected cluster sampling method 7 437 ≥60 years as the research subjects,by using a self-designed questionnaire Alzheimer's disease causes and clinical dementia rating scale,understanding the factors that may affect Alzheimer's disease and aggravating factors,and the data of multi factor regression analysis.Results Multivariate Logistic regression analysis showed that women (Wald x2 =19.96,P ＜ 0.01),aged (Wald x2 =96.01,P ＜ 0.01),widowed (Wald x2 =5.09,P ＜ 0.05),smoking/drinking (Wald x2 =47.77,P ＜ 0.01),living alone (Wald x2 =16.14,P ＜ 0.01),depression (Wald x2 =12.05,P ＜ 0.01) were the risk factors of Alzheimer's disease; Rural (Wald x2 =458.11,P ＜ 0.01) ; Lowculture (Wald x2 =121.39,P ＜0.01) were protective factors for Alzheimer's disease.According to the clinical dementia rating scale of disease severity assessment and pathogenesis of polytomous Logistic regression,the results showed that the elderly (Wald x2 =50.37,P ＜ 0.01),lowculture (Wald x2 =30.39,P ＜ 0.01),widowed (Wald x2 =5.20,P ＜ 0.05),living alone (Wald x2 =16.50,P ＜ 0.01),somatic diseases (Wald x2 =16.58,P ＜ 0.01) and large maternal age (Wald x2 =10.53,P ＜ 0.01) were risk factors for disease.Conclusion Age,widowed,solitude are common risk factors of Alzheimer's disease and aggravating factors,should be combined with risk factors for chronic disease management actively take measures to prevent and delay the occurrence,the development of Alzheimer's disease.

After ischemic stroke, secondary damages such as neuron loss, gliosis, and axonal degeneration occur in the nonischemic remote brain regions that have synaptic connections with the primary infarction site.These secondary damages in the remote brain regions may affect the recovery of neurological function.Several advanced neuroimaging techniques have been used to detect these secondary damages.This article reviews the research progress in this field.

Objective To analyze the clinical effects of thrombolytic therapy in patients with ischemic in-hos-pital stroke (IHS). Methods The clinical data were collected from patients with ischemic IHS in the last five years. The patients were divided into thrombolysis group and non-thrombolysis group, according to the use of recombinant tissue plasminogen activator (r-tPA) treatment. The clinical outcomes were measured by the modified Rankin scale (mRS) at discharge. Results There were a total of 121 patients in this study. There were 6 patients in thrombolysis group and 115 patients in the non-thrombolysis group, respectively. Six patients (100%) in the thrombolysis group achieved favor-able outcomes (mRS 0~2) at discharge whereas only 42 patients (36.5%) in the non-thrombolysis group achieved fa-vourable outcomes. The rate of favorable outcomes was significantly higher in the thrombolysis group than in the non-thrombolysis group (P<0.05). Conclusions R-tPA thrombolytic therapy can improve the prognosis of patients with ischemic IHS.

Acoustic Stimulation ; Brain Mapping ; Hallucinations ; Humans

ObjectiveTo study the prevalence of depression and the related influencing factors among the frontline healthcare professionals in the prevention and control of risk of imported COVID-19 cases， so as to provide references for improving their mental health status. MethodsBased on Wenjuanxing platform， a total of 984 frontline healthcare professionals participating in the screening and treatment of imported COVID-19 cases in Beijing Xiaotangshan hospital were assessed using Patients’ Health Questionnaire Depression Scale-9 item（PHQ-9）. ResultsA total of 770 questionnaires were collected with a valid rate of 78.3%， among which 344 cases （44.7%） had depressive symptoms. Logistic regression analysis showed that great changes in work content （OR=2.206， P<0.01）， sleep deprivation （OR=2.359， P<0.01）， six hours or less of sleep （OR=2.032， P<0.05）， focusing on epidemic information more than 1 hour per day （OR=1.095， P<0.05） were risk factors for depression， and regular exercise （OR=0.473， P<0.01） was a protective factor for depression relief. ConclusionThe frontline healthcare professionals in the prevention and control of risk of imported COVID-19 cases suffer a high risk of depression， while measures including scientific shift system， adequate sleep， less attention to the epidemic， and regular exercise may be effective in maintaining their physical and mental health.

OBJECTIVETo investigate the clinical value of serum anti-Ku86 in early detection of hepatocellular carcinoma (HCC).

METHODSExpression levels of Ku86 protein in HCC and adjacent normal liver tissues were detected by Western blotting. Serum anti-Ku86 level in 83 patients with early HCC and 124 patients with liver cirrhosis were detected by enzyme-linked immunosorbent assay (ELISA). Chemiluminescence was used to measure the serum level of α-fetoprotein (AFP).

RESULTSExpression of Ku86 protein in HCC was increased when compared with the adjacent normal liver tissues (0.21 ± 0.05 vs. 0.08 ± 0.02, P < 0.01). Serum anti-Ku86 level was significantly elevated in HCC patients compared with that in liver cirrhosis patients (0.47 ± 0.22 vs. 0.22 ± 0.06 Abs at 450 nm, P < 0.01), but there was no significant difference between HBV infection and HCV infection in HCC patients (0.51 ± 0.19 vs. 0.47 ± 0.24, P = 0.267). Of note, serum anti-Ku86 level was significantly decreased after surgical resection of the tumors in the 30 HCC cases tested (P < 0.01). The results of ROC analysis indicated a better performance of anti-Ku86 (0.857) than AFP (0.739) for early detection of HCC. In 83 HCC patients, the positive rate of anti-Ku86 was 61.4% (51/83), significantly higher than that of the AFP positive rate (27.7%, 23/83). The anti-Ku86 level was positive in 37 of 60 HCC cases with negative AFP. Combination assay of AFP and anti-Ku86 could detect 60 of 83 HCC cases (72.3%, 60/83). There was no significant correlation of anti-Ku86 and AFP (r = 0.156, P = 0.161).

CONCLUSIONSSerum anti-Ku86 level is significantly elevated and is not related to HBV and HCV infection in HCC patients. Serum anti-Ku86 antibody may be a potential biomarker for early detection of HCC, and can be used in combination with AFP in clinics.

Adult ; Aged ; Antigens, Nuclear ; immunology ; Autoantibodies ; blood ; Biomarkers, Tumor ; blood ; Carcinoma, Hepatocellular ; blood ; diagnosis ; virology ; DNA-Binding Proteins ; immunology ; Early Detection of Cancer ; Female ; Hepatitis B ; blood ; Hepatitis C ; blood ; Humans ; Ku Autoantigen ; Liver Cirrhosis ; blood ; Liver Neoplasms ; blood ; diagnosis ; virology ; Male ; Middle Aged ; ROC Curve ; alpha-Fetoproteins ; metabolism

Streptococcus suis (S. suis) IgG-binding protein (SPG) was present in all S. suis strains examined. It showed binding activities with IgG from various host species. Little was known about the biological role of this protein, but it was commonly believed that it acted as virulence factor. In this study, the genes encoding SPG were amplified respectively from the total DNA of the S. suis serotype 1/2, 1, 2 and 9 with PCR and expressed in Escherichia coli BL21 by plasmid pET28a as vector. The recombinant proteins were first purified with affinity chromatography (Ni-NTA), and further purified by sephadexG-200 gel chromatography. The recombinant SPG proteins were identified to have binding activities with IgG of different host species, and for human and porcine IgG they showed better binding activities. But the SPG from different serotypes of S. suis showed no great differences in their binding activities with IgG from the same host species.
Bacterial Proteins ; genetics ; metabolism ; Binding Sites, Antibody ; genetics ; Escherichia coli ; genetics ; metabolism ; Immunoglobulin G ; immunology ; Recombinant Proteins ; genetics ; immunology ; metabolism ; Streptococcus suis ; immunology

Objective: To explore the impairments of the left visual field (LVF) superiority among children with autism spectrum disorder (ASD), for further understanding of the attentional mechanism of social disturbance in ASD. Methods: The mixed design for repeated measured data was used. The case group was consisted of 105 ASD children enrolled from the rehabilitation agencies in Tianjin from Sept. 2016 to Dec. 2019; and 105 typically developed children were enrolled from Tianjin as the control group by matching the chronological age and gender distribution. The preferential looking paradigm was used to explore the LVF superiority by eye tracking system. Fixation count (FC), total fixation duration (TFD) and the proportion of left hemiface were analyzed by the Mixed design ANOVA, in which the main effect of "group", visual field (left vs. right) and gender of the faces was evaluated in addition to the interactions. Results: All the participants in both the ASD group and TD group completed the experiments. For the whole face in LVF or RVF, the main effect of group showed the statistical significance on both FC and TFD [FC： F (1，206) =26.27, P <0.01; TFD： F (1，206) =51.23, P <0.01]. The interaction of group×visual field on FC also was statistically significant [ F (1，206) =4.619， P =0.03], and the case group showed the difference between LVF and RVF (0.33±0.02，0.54±0.03， P < 0.01 ) by further simple effect analysis, none of the rest was statistically significant. Both the left hemiface of FC & TFD showed the main effect of group [FC： F (1，206) =13.77， P ＜0.01；TFD： F (1，206) =12.89， P ＜0.01] and interaction of group×visual field [FC： F (1，206) = 36.99， P ＜0.01；TFD： F (1，206) =38.62， P ＜0.01), similarly, there was higher left hemiface proportion of both FC & TFD in RVF than that in LVF (FC：0.36±0.03，0.56±0.03， P <0.01; TFD：0.36±0.03，0.57±0.03， P <0.01). Conclusion LVF superiority is not presented among children with ASD in this study, while the fixation in RVF remained relatively unaffected. The finding indicates the involvement of the fusiform face area of right hemisphere in the pathogenesis of ASD in addition to the weak central coherence account.

ObjectiveTo explore the beliefs and attitudes about sleep in patients with comorbid depressive disorder and insomnia， and to explore its influence on sleep quality. MethodsPatients with comorbid depressive disorder and insomnia （n=61） and patients with primary insomnia （n=62） who met criteria specified in the Diagnostic and Statistical Manual of Mental Disorders， fourth edition （DSM-IV） in Beijing Anding Hospital Affiliated to Capital Medical University were enrolled， meantime， another 64 healthy controls were recruited. All subjects were assessed using Dysfunctional Beliefs and Attitudes about Sleep （DBAS） and Pittsburgh Sleep Quality Index （PSQI）. Additionally， patients with comorbid depressive disorder and insomnia were evaluated using Hamilton Depression Scale-17 item （HAMD-17）. The PSQI and DBAS scores were compared among three groups using analysis of covariance， and multiple linear regression analysis was used to screen the factors affecting PSQI score in patients with comorbid depressive disorder and insomnia. ResultsCompared with healthy controls， higher scores of PSQI （t=18.932， 18.610， P<0.01） along with lower scores of DBAS （t=-5.561， -5.791， P<0.01） were observed in patients with comorbid depressive disorder and insomnia and patients with primary insomnia. Taking the PSQI score of patients with comorbid depressive disorder and insomnia as the dependent variable， statistically significant equations were generated using multiple linear regression analysis （F=14.095， R²=0.327， P<0.05）， and the predictive and control factors of sleep in DBAS and age were found to be the influencing factors of PSQI score in patients （B=-0.100， -0.279， P<0.05 or 0.01）. ConclusionCompared with the normal，depression patients with insomnia have more dysfunctional beliefs and attitudes towards sleep，and dysfunctional cognition may be the influencing factor of their sleep quality.