Objective:To further optimize the nutritional support program for elderly neurocritical patients, analyze the changes and influencing factors of serum albumin levels in elderly neurocritical patients after surgery, and explore the impact on prognosis.Methods:A retrospective cohort study was conducted to investigate the medical records of neurosurgical intensive patients in Shanghai Tenth People's Hospital from May 2015 to September 2019. All the patients were treated for at least 5 days after operation. Patients with severe liver and kidney dysfunction, mental illness and incomplete medical records were not included in the study. Patients aged ≥65 years were included as the experimental group and patients aged <65 years served as the control group. Generalized estimating equation and other models were used to analyze the difference in the trend of albumin level and its influencing factors between the two groups. Automated machine learning was used to explore the influence of factors such as albumin level, nutrition mode, age, sex, diagnosis, preoperative consciousness level on the prognosis of patients.Results:A total of 284 patients were included in the study, including 85 in the experimental group and 199 in the control group. There were no significant differences in baseline data such as sex, age, and proportion of nutritional patterns between the two groups. Generalized estimating equation and generalized mixed additive equation showed that albumin level in both groups reached the minimum on the 3rd day after operation, and the average level in the experimental group was significantly lower than that in the control group ( P=0.03). Cerebral hemorrhage, emergency surgery, and low preoperative albumin were risk factors ( P<0.05); intravenous supplementation of human albumin might have an adverse effect on the experimental group ( P = 0.047). Machine learning models suggested that the higher the serum albumin level at discharge, the better the prognosis at 1 month after surgery. The area under ROC curve was 0.906, the specificity was 93.7%, and the sensitivity was 67.0%. Conclusions:The changes of albumin level in elderly patients with neurological critical illness after surgery are basically the same as those in young patients, with the lowest albumin level on the 3rd day after surgery, and the albumin levels even lower on the 3rd day after surgery in patients with cerebral hemorrhage, emergency surgery and preoperative low albumin. The higher the albumin level at discharge, the better the prognosis of patients may be.

Objective To observe the effect of Yiqi-huoxue and Huatan formula on inflammation reactivation in stable coronary heart disease(CHD).Methods 60 cases with stable CHD were randomly divided into the control group(30 cases,treated with routine therapy)and study group(30 cases,treated with routine therapy plus Yiqi-huoxue and Huatan formula).Duration was one month.Results There was no significant difference of concentration of CD40L before and after treatment in the control and study groups(P>0.05).There was a significant difference in concentration of matrix metalloproteinase-9(MMP-9)before and after treatment in the control and study groups(P<0.05).There were significant changes of CD40L and MMP-9 in the study group than in the control group(P<0.05).Conclusion Yiqi-huoxue and Huatan formula can decrease serum concentration of CD40L and MMP-9,and inhibit initiation and development of inflammation reactivation,furthermore stable atherosclerotic plaque and reduce coronary events.

OBJECTIVETo investigate the expressions of sphingosine-1-phosphate receptors 1-3 (S1P1- 3) in the corpus cavernosum of castrated male rats and its relationship with the NOS/NO/cGMP and RhoA/Rho kinase signaling pathways.

METHODSWe equally randomized 18 eight-week-old healthy male SD rats into a sham-operation control, a castration, and a testosterone replacement (TR) group and harvested the bilateral testes and epididymides from the rats in the latter two groups, followed by 4 weeks of subcutaneous injection of testosterone propionate at 3 mg per kilogram of the body weight per day for those in the TR group and that of plant oil for those in the control and castration groups. At the age of 12 weeks, we measured the serum testosterone (T) level and maximum intracavernous pressure/mean arterial pressure (ICPmax/MAP) of the animals and determined the expressions of SlP1-3, eNOS, P-eNOS, ROCK1, and ROCK2 in the corpus cavernosum by Western blot and immunohistochemistry.

RESULTSThe serum T level was significantly decreased in the rats of the castration group as compared with those of the control and TR groups ([0.41 ± 0.04] vs [16.01 ± 1.02] and [15.84 ± 1.32] nmol/L, P < 0.01), with no statistically significant difference between the latter two groups. The ICPmax/MAP at 0 V, 3 V, and 5 V electric stimulation was remarkably lower in the rats of the castration group (0.088 ± 0.014, 0.323 ± 0.014, and 0.432 ± 0.012) than in those of the control group (0.155 ± 0.011, 0.711 ± 0. 010, and 0.819 ± 0.024) and TR group (0.153 ± 0.012, 0.696 ± 0.017, and 0.763 ± 0.027) (P < 0.01), with no significant difference between the latter two groups. With GAPDH as internal control, the animals of the castration group showed markedly reduced expressions of S1P1 ([49.99 ± 3.39]%), eNOS ([46.82 ± 3.81]%) , and P-eNOS ([45.42 ± 4.35]%) in comparison with those in the control group ([72.57 ± 3.06], [89.76 ± 3.98], and [82.53 ± 8.92] and TR group ([71.77 ± 4.43], [87.19 ± 4.23], and [79.82 ± 7.38]%) (P < 0.01) , while the expressions of S1P2, S1P3, ROCK1, and ROCK2 were significantly upregulated in the castration group ([82.35 ± 4.13], [61.03 ± 5.14], [74.50 ± 4.02], and [69.83 ± 5.75]%) as compared with those in the control group ([41.67 ± 1.68], [31.66 ± 2.67], [35.69 ± 5.56], and [39.85 ± 7.17]%) and TR group ([42.80 ± 3.87], [32.25 ± 4.22], 38.06 ± 5.21], and [42.36 ± 4.44]%) (P < 0.01).

CONCLUSIONAndrogen deficiency induces significant reduction of ICPmax/ MAP in male rats, which is possibly associated with the decline of S1P1 in the corpus cavernosum, inhibition of the eNOS/NO/cGMP signaling pathway, increased expressions of S1P2 and S1P3, and activation of the RhoA/Rho kinase signaling pathway.

Animals ; Male ; Nitric Oxide Synthase Type III ; metabolism ; Orchiectomy ; Penis ; metabolism ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Receptors, Lysosphingolipid ; metabolism ; Testosterone ; blood ; pharmacology ; rho-Associated Kinases ; metabolism

Objective To investigate the effects of stimulation of CD40 on the growth,prolifera- lion and apoptosis of gastric cancer cell lines,and the change of gene expression profiles of gastric cancer cell AGS.Methods The growth and proliferation of AGS cells treated with different concentrations of soluble CD40 ligand were measured by MTT in order to choose optimum stimulating concentration of so- luble CD40 ligand.Cell cycle and apoptosis of AGS cells were analyzed by flow cytometry.Gene expres- sion profiles of AGS cells were analyzed by Affymetrix U133A 2.0 after treated with soluble CD40 ligand for 48 h.Results Two?g/ml of.soluble CD40 ligand was the optimum concentration.After being cul- tured with soluble CD40 ligand for 48h,the growth of AGS cell was inhibited and blockade in G1 phase. There were 414 alterative genes found in AGS cells including 209 up-regulated genes and 205 down-regu- lated genes.Forty-five genes varied significantly(P

Adolescent ; Diagnosis, Differential ; Humans ; Male ; Sturge-Weber Syndrome ; pathology

Objective To understand the current situation of iodine deficient disorder(IDD) 10 years after achieving the stage goal of eliminating IDD in Longyan city and to evaluate the effect of prevention and treatment measures, and to provide the basis for the development of control strategies. Methods There were 7 counties in the city, and each county(city, district) was as a unit to carry out the inspection for organization and leadership,iodine salt management, monitoring and control, health education (referred to as the four management indicators)according to "The County-Level Assessment and Evaluation Implementation Detailed Rules of Realizing the Goal to Eliminate IDD in Fujian Province". According to the east, west, south, north and middle positions in each county,a village and a primary school were selected. Forty 8 to 10 year-old students in each school were randomly selected to check thyroid and among them 20 students were collected urine samples to determine urinary iodine. Nine townships were selected in the 7 counties of the city and among which 4 administrative villages were selected in each township. Eight edible salt samples from each household in each administrative village were collected to test salt iodine. Goiter was examined by palpation, the level of urinary iodine was examined by arsenic and cerium spectrophotometry, salt iodine was detected by direct titration. Results The average score of the four management indicators was 94.1 in Longyan city. The adjusted goiter rate of children aged 8 - 10 years old was 1.9%. The median of urinary iodine was 278.6 μg/L, among which less than 100 μg/L accounted for 4.57%(32/700), 100 -＜ 200 μg/L accounted for 24.00%(168/700), 200 - ＜ 300 μg/L accounted for 25.29%(177/700), and higher than 300 μg/L accounted for 46.14%(323/700). The using rate of qualified iodized salt was 98.86%. The coverage rate of iodized salt was 99.50%, the qualified rate of iodized salt was 99.35%, and the rate of non-iodized salt was 0.50%. All the indicators had reached the national standard to eliminate IDD. Conclusions After achieving the stage goal of eliminating IDD, the disease is stable and the effect of control measures are significantly. But the iodine provided has a trend of more than suitable. Therefore, it is reasonable to reduce the current salt iodine content.

Objective To understand the current situation of iodine deficiency diserders(IDD) in Longyan City and to evaluate the effect of prevention and control measures of IDD in order to provide evidence for formulating prevention and control tactics. Methods During the year of 2006 and 2007, the 30 primary schools were screened by population proportion survey(PPS) from the 7 counties of Longyan City. Forty children aged 8-10 years in each school were randomly selected as a group to examine thyroid, and 7 children in each group were selected to measure the urine iodine and the salt iodine at the same time. The goiter rote, the median urinary iodine, the consumption rate of qualified iodized salt, the iodine salt coverage rate, the rate of qualified iodized salt and the non-iodized rate were detected. Results The goiter rate of children aged 8-10 years old in Longyan City was 0.94%(79/8438). The median urinary iodine was 259.12 μg/L. The consumption rate of qualified iodized salt was 97.86% (1462/1494). The iodine salt coverage rate was 99.46%(1486/1494). The rate of qualified iodized salt was 98.38 (1462/1486), and the non-iodized rate was 0.54% (8/1494). Conclusions All indicators have reached the national standard of eliminating IDD in Longyan City.

Objective To investigate the etiology and clinical characteristics of pediatric pulmonary arterial hypertension(PAH) and improve its early diagnosis and treatment.Methods The clinical and echocardiogram data of all inpatients with PAH in Pediatric Department of Peking University First Hospital between May 1995 and May 2007 were retrospectively analyzed for age,sex,etiology,symptoms and echocardiographic measurement of pulmonary artery pressure.Data were divided into groups according to different etiology and statistics.Pulmonary arterial systolic pressure(sPAP) values estimated from the tricuspid regurgitant velocity by Doppler echocardiography were compared among different groups.Cases who were not belonged to the first category of the Venice Clinical Classification of pulmonary hypertension were not included.Results Totally 276 cases,168 boys and 108 girls were diagnosed to have PAH.Age ranged from 1 month to 17 years,median age was 9 months.Most of pediatric PAH was associated-PAH(267 cases,96.7%),while idiopathic PAH took a small part(9 cases,3.3%).Congenital heart disease-associated PAH(CHD-PAH) was predominant(245 cases,88.7%) and left to right shunt was the main lesion (217 cases,88.6%),while complex lesion-associated PAH comprised 28 cases(11.4%).Connective tissue disease associated PAH(CTD-PAH) was the second common among this group of pediatric PAH patients(19 cases,6.9 %).The incidence of PAH in systemic lupus erythematosus(SLE),juvenile rheumatoid arteritis and takayasu arteritis were 10.3 %(13/126),8.7%(4/46),15.4%(2/13),respectively.The other 3 cases of PAH were associated with portal hypertension(2 cases) and thalassanemia(1 case).The estimated sPAP from tricuspid regurgitant velocity in 8 cases with idiopathic PAH[(74.6?23.9) mmHg(1 mmHg=0.133 kPa)]was higher significantly compared with those of 33 cases of CHD-PAH [(58.0?19.7) mmHg ] and 12 cases of CTD-PAH [(49.6?18.9) mmHg] respectively(t=-2.052,-2.609 Pa

Objective To investigate ultrasonic findings of pure invasive micropapillary carcinoma (PIMPC) of breast. Methods A total of 18 patients with surgically confirmed PIMPC and 40 patients with surgically confirmed invasive ductal carcinoma (IDC) treated between January 2010 and August 2015 in Affiliated Union Hospital of Fujian Medical University, who had undergone preoperative ultrasound examination, were included in the study. To compared with the postoperative pathological examination, the value of ultrasonography in the diagnosis of axillary lymph node metastasis was discussed.Ultrasound findings of PIMPC and pathological results were compared. Results Ultrasound analysis of PIMPC masses identified predominantly hypoechoic lesions and irregular shape 100% (18/18), obscure lesion boundaries 88.9% (16/18), spiculated or angular margins 83.3% (15/18), combined microcalcifications 83.3% (15/18), with posterior acoustic enhancement or normal 88.9% (16/18), dcrab claws changes 77.7% (14/18),witout hyperechoic halo72.2% (13/18) and with 0- Ⅰ grade flow signals 55.6% (10/18). Compared to the IDC, the PIMPC had lower proportions in long speculation, hyperechoic halo, aspect ratio ≥ 0.7, posterior echo attenuation, Ⅱ- Ⅲ grade blood flow signals (P < 0.05), while their lesions in the maximal tumor size,shape, boundary, edge bur, microcalcification has no significance (P>0.05). The rate of lymph node metastasis of PIMPC was 72.2% (13/18), which was significantly higher than that of IDC 45.0% (18/40) (t=3.697,P=0.05). 13 cases were pathologically confirmed lymph nodes metastasis in 18 cases, and among them, the ultrasound indicated abnormal 46.2% (6/13), and showed abnormal cortex and medulla structure 30.8% (4/13), eccentric lymph door 30.8% (4/13), poor blood flow signals 38.5% (5/13). The sensitivity, specificity,positive predictive value, negative predictive value and accuracy of PIMPC lymph node metastasis by preoperative ultrasound were respectively 46.2%, 60.0%, 75.0%, 30.0%, 50.0%. Ultrasound performance of PIMPC has a certain relationship with its special pathological characteristics. Sonography findings were compared with pathological results: Microscopically, PIMPC cell arranged as pseudo-papillary or tubuloalveolar structures floating in empty spaces; PIMPC with 0-Ⅰ grade flow signals were seen that the small amount of new blood vessels of the tumor were mainly found in the pellucid zone around the cell clusters under the microscope, while IDC with Ⅱ - Ⅲ grade blood flow signals were found that more regenerated blood vessels were distributed in the collagen fibers. PIMPC witout hyperechoic halo were noticed that under the microscope, there were no fibrous tissue clusters in the edge of the tumor, meanwhile, IDC with hyperechoic halo were discovered that fibrous tissue was seen at the edge of the mass of the lens. Conclusions Ultrasound performance of PIMPC has a close relationship with its special pathological characteristics. To be familiar with ultrasound characteristic of PIMPC is significant for improving its ultrasound detection rate.

Objective:To investigate the distribution of uric acid in different occupation, age and gender groups, and changes of prevalence of hyperuricemia (HUA) and its influencing factors in healthy adults who receiving physical examination in Nanjing.Methods:The study was conducted in 107 478 subjects who received physical examination from 2012 to 2016. The prevalence of HUA in different genders and different years was compared. Subjects were divided into non-HUA and HUA groups according to serum uric acid. The differences in metabolic indicators and ages between two groups were analyzed. Uric acid levels among different occupations were evaluated. A multivariate logistic regression analysis was used to estimate the odds ratios ( OR) of HUA. Results:The total HUA prevalence was 14.9%, in which the prevalence of HUA in men was significantly higher than that in women [20.5%(15217/74339)vs .2.5%(818/33139), P<0.01]. The prevalence of HUA in men sustained at a high level, while that in women trended to decrease during the five years. The prevalence of HUA increased with age in women (1.0%, 0.7%, 0.9%, 2.7%, 3.8% and 9.6% in subjects within 20-29, 30-39, 40-49, 50-59, 60-69 and ≥70 age groups, respectively, Pfor trend<0.01). The percentages of hypertension, hyperlipidemia and diabetes, and body mass index (BMI) in both men and women were significantly higher in HUA group than those in non-HUA group ( P≤0.01). Among all occupations, subjects in health care had the lowest levels of uric acid (298±91 μmol/L) and prevalence of HUA (10.4%), while, those in public security had the highest levels of uric acid [(342±82) μmol/L] and prevalence (16.5%). Multiple logistic regression analyses revealed that males, high triacylglycerol, high cholesterol, obesity and certain occupation were significantly associated with HUA. Conclusions:The prevalence of HUA in men is significantly higher than that in women. It increased with ages in women. Subjects in health occupations had the lowest levels of uric acid and HUA prevalence, while, those in public security had the highest levels among the six occupations. Obesity, hyperlipidemia, hypertension, occupations and males are positively associated with HUA.