Objective To investigate the diagnosis and the effect of microsurgery in patients with acute spontaneous spinal epidural hematoma (ASSEH). Method Five patients with ASSEH treated with microsurgery and confirmed pathologically were retrospectively analyzed. Results The main clinical presentations were root pain and palsy. The main manifestations of MRI were long-segment epidural lesion of high intensity in T1 and T2-weighted images without enhancement. With the microsurgery system, laminectomy via posterior approach and hematoma removal were successfully undergone with full recovery in all cases. Conclusions MRI assisted with the main clinical symptoms may aid preoperative diagnosis in symptomatic ASSEH. Microsurgery is an effective method for treating ASSEH. Postoperative (rather than preoperative) spinal DSA is advantageous for exclusion of spinal vascular malformation in treating ASSEH.

Objective To evaluate the diabetes self-management program based on Chinese local patients in Nanjing community. Methods From April 2014 to June 2014, diabetes patients were recruited through health records system screening in the community health service centers, letter invitation, poster announcements at communities, and telephone notification. A total of 53 self-management groups were established. Nanjing diabetes self-management program included six 1-1.5 hours sessions scheduled on consecutive weeks, based on the blueprint of Shanghai Chronic Disease Self-Management Program (CDSMP) developed at Stanford University. Baseline and three-month later interviews were conducted respectively. Results A total of 636 patients were recruited and agreed to enter CDSMP; 603 completed the 6-session activities, with the response rate being 94.8%. Compared to baseline, nine of the patients' the awareness rate of diabetes-related knowledge, six of self-management behaviors, the scores of quality of life in physical component summary [(47.51 ± 9.47) vs. (49.10 ± 8.27) points, t=6.170, P=0.000] and mental component summary [(47.09±11.95) vs. (49.13±10.74) points, t=5.157, P=0.000] were all higher after three months (all P values<0.05). Three months after implementation, the level of systolic blood pressure, diastolic blood pressure, fasting plasma glucose and total cholesterol decreased respectively by (1.42±0.52) mmHg (1 mmHg=0.133 kPa), (0.98 ± 0.34) mmHg, (0.66 ± 0.16) mmol/L, (0.15 ± 0.56) mmol/L,the differences were statistically significant (tpaired values were 3.935, 2.030, 4.889, 4.899, all P values<0.05). Conclusion The diabetes self-management program based on Chinese local patients for Nanjing may improve patients' awareness rate of diabetes-related knowledge, self-management behavior, the quality of life, and health status. CDSMP could be applied effectively in Nanjing.

Objective To evaluate the effect of curcumin on the inflammatory responses in the hippocampus during global cerebral ischemia-reperfusion (I/R) injury in hypertensive rats.Methods Forty-eight SPF male Wistar-Kyoto rats,aged 8 weeks,weighing 180-200 g,were randomly divided into 2 groups (n =24 each) using a random number table:sham operation group (W-Sham group) and I/R group (W-I/R group).Seventy-two SPF male spontaneously hypertensive rats,aged 8 weeks,weighing 180-200 g,were randomly divided into 3 groups (n =24 each) using a random number table:sham operation group (S-Sham group),I/R group (S-I/R group),and curcumin group (S-Cur group).Global cerebral ischemia was induced by 4-vessel occlusion method (10 min of transient global ischemia followed by reperfusion).Curcumin 100 mg/kg was injected intraperitoneally at 30 min of reperfusion in S-Cur group,and corn oil 5 ml/kg was injected intraperitoneally at 30 min of reperfusion in the other groups.The ability of learning and memory was tested by step-down test at 7 days of reperfusion.Rats were sacrificed at 3 h and 1,3 and 7 days of reperfusion (T1-4) and the hippocampi were removed.The morphological changes of pyramidal cells in hippocampal CA1 area were observed by HE staining.The mean density of pyramidal cells in hippocampal CA1 area was quantified by Nissl staining.The contents of interleukin-lβ (IL-1β),tumor necrosis factor-alpha (TNF-α) and IL-10 in the hippocampus were determined by ELISA.Results Compared with W-Sham group,the ability of learning and memory was significantly decreased,the mean density of pyramidal cells in hippocampal CA1 area was decreased,the contents of IL-1β at T1-3,TNF-α at T1,and IL-10 at T2 were increased,and the contents of IL-10 were decreased at T1,3,4 in W-I/R group,and no significant changes were found in the parameters mentioned above in S-Sham group.Compared with W-I/R group,the ability of learning and memory was significantly decreased,the contents of IL-1β at T1,3 and IL-10 at T2 were decreased,the content of TNF-α was increased at T1,no significant change was found in the mean density of pyramidal cells in hippocampal CA1 area,and the damage to pyramidal cells in hippocampal CA1 area was severe in S-I/R group.Compared with S-I/R group,the ability of learning and memory was significantly increased,the mean density of pyramidal cells in hippocampal CA1 area was increased,the contents of IL-1β at T2,3 and TNF-α at T1-4 were increased,and the content of IL-10 was increased at T2,and the damage to pyramidal cells in hippocampal CA1 area was reduced in S-Cur group.Conclusion Inhibition of inflammatory responses in the hippocampus may be involved in the mechanism by which curcumin reduces global cerebral I/R injury in hypertensive rats.

Objective: To investigate the intake of liquid dairy products and identify its influencing factors among the fourth grade students in Nanjing City. Methods: The fourth grade students were selected as the study subjects in Nanjing City using a multi-stage random cluster sampling method in September 2020. Their general information, frequency of liquid dairy product intake one week prior to survey and mean intake amount per time were collected. According to the 2016 Dietary Guidelines for Chinese Residents, weekly intake of liquid dairy products of 2 100 g and greater was defined eligible. Factors affecting the frequency and amount of liquid dairy product intake were identified using multivariable logistic regression analysis. Results: A total of 2 268 questionnaires were allocated and 2 216 valid questionnaires were recovered, with an effective recovery rate of 97.71%. The respondents included 1 199 boys ( 54.11% ) and 1 017 girls ( 45.89% ). The frequency of liquid dairy product intake was (6.41±4.86) times per week, and the median intake amount was 1 250.00 g per week (interquartile range, 1 750.00 g per week). There were 607 students ( 27.39% ) consuming liquid dairy products of 2 100 g and greater a week, and 1 016 students ( 45.85% ) consumed liquid dairy products for 7 times and more a week. Multivariable logistic regression analysis showed that living in urban areas ( OR=1.204, 95%CI: 1.005-1.443 ), knowing nutrition labels ( OR=1.221, 95%CI: 1.021-1.460 ), periodical measurement of body weight (OR=1.486, 95%CI: 1.098-2.011) and restricted intake of sugar-containing drinks ( OR=1.264, 95%CI: 1.005-1.590 ) facilitated the intake of liquid dairy products for 7 times and more a week, and students with periodical measurement of body weight were more likely to consume liquid dairy products for 2 100 g and greater a week ( OR=1.821, 95%CI: 1.240-2.676 ). Conclusions Inadequate intake of liquid dairy products is found among the fourth grade students in Nanjing City. Residence, awareness of nutrition labels, periodical measurement of body weight, and parental restriction of sugar-containing drink intake affect the intake of liquid dairy products.

Female breast cancer has surpassed lung cancer as the most commonly diagnosed cancer in 2020. A large number of studies have proved that tumor infiltrating lymphocytes (TILs) are lethal to tumors and play an important role in identifying tumor antigens. Therefore, the application of TILs in clinical immunotherapy and prognosis assessment of breast cancer has attracted wide attention. In this review, the basic research progress and clinical application of TILs in different molecular types of breast cancer are reviewed, and the value of TILs in judging breast cancer prognosis and predicting the therapeutic effect of clinical immunotherapy is evaluated.

Objective:To investigate the joint associations of smoking and insufficient physical activity with hypertension, diabetes and dyslipidemia in male adults.Methods:Based on the data from the 2017 Nanjing Chronic Diseases Risk Factors Surveillance Program, 61 098 Nanjing residents aged 18 and older was randomly recruited from 12 districts, using the multi-stage stratified cluster sampling method. Information about smoking behaviors, physical activity and chronic disease-related indicators within the first 12 months before the survey was obtained through questionnaires.Results:Among the 29 848 valid male samples, the proportions of non-smokers, current smokers and ex-smokers were 59.6%, 37.2% and 3.2%, and the proportions of those who had physically active<600 MET-min/w (insufficient physically active) and ≥600 MET-min/w (adequate physically active) were 18.8% and 82.2%, respectively. In non-smokers, current smokers and ex-smokers, the prevalence of hypertension was 24.7%, 34.0% and 43.8%, and the prevalence of diabetes was 8.8%, 12.3% and 16.5%, and the prevalence of dyslipidemia was 26.8%, 36.1% and 41.9%, respectively. Multivariate logistic regression analysis showed that current smokers had a higher risk of hypertension ( OR=1.164, 95% CI: 1.086-1.248), diabetes ( OR=1.324, 95% CI: 1.207-1.452), and dyslipidemia ( OR=1.291, 95% CI: 1.216-1.371) than non-smokers in male adults. Compared with people who had adequate physical activity, someone with insufficient physical activity had higher hypertension ( OR=1.452, 95% CI: 1.331-1.583), diabetes ( OR=1.170, 95% CI: 1.041-1.315) and dyslipidemia ( OR=1.245, 95% CI: 1.158-1.338). And current smokers with insufficient physical activity had the highest risk of hypertension ( OR=1.749, 95% CI: 1.550-1.974), diabetes ( OR=1.363, 95% CI: 1.165-1.595), and dyslipidemia ( OR=1.614, 95% CI: 1.461-1.782) in male adults. Conclusions:Smoking and insufficient physical activity are risk factors for hypertension, diabetes, and dyslipidemia. People who is characterized by smoking together with insufficient physical activity presents with increased risk on developing hypertension, diabetes, and dyslipidemia.

Objective To evaluate the effect of a community-based self-management model and the quality of life in patients with hypertension in Nanjing.Methods From April to June 2014,multistage stratified random sampling was used to randomly select patients with hypertension from the standardized management of basic public health services among 11 districts in Nanjing.A baseline survey and a follow-up after 3 months were conducted by well-trained investigators through face-to-face interviews to estimate the effect of self-management on quality of life. Results There were 586 patients investigated in the baseline survey.Among them,575 patients finished group activities six times;the follow-up rate was 98.1%.After a self-management group intervention, the awareness of hypertension-related knowledge and six aspects of self-management behaviors were measured; the scores of all dimensions improved significantly, and SF-36 increased to 32.03 ± 17.33. Multi-factor analysis results showed that those who were single and had complications felt improvement in their blood pressure control, experienced improvement in their stress conditions,and their quality of life improved.The OR(95% CI)values were 1.93(1.06-3.52),1.96(1.21-3.19), 1.79 (1.11-2.89), and 2.51 (1.59-3.97). Conclusion Carrying out self-management group work with community patients with hypertension that is focused on prevention and control of physical, psychological, and social aspects of life can improve their quality of life.

Objective To analyze changes in quality of life(QOL)of diabetic patients before and after self-management group activities and potential factors influencing the changes.Methods From April to June 2014, volunteer patients with medical records confirming diagnosis of diabetes were recruited through telephone notification,poster announcements,and letter invitation.At baseline and six months later, interviews were conducted to analyze changes in QOL.A total of 633 participants were recruited who agreed to enter aself-management group. Paired t-tests were used to compare QOL before and after the self-management group activities, andbinary logistic regression analysis was used to analyze the potential influencing factors. Results Six hundred and three participants completed the 6-session activities with a response rate of 95.2%. Compared to baseline, the QOL scores in eight domains were all higher after six months.Single factor analysis showed that QOL of those with high income(χ2=6.72,P=0.035),the fruit and vegetable intake improvement group (χ2=5.11, P=0.024), the moderate-intensity physical activity improvement group (χ2=16.29, P=0.000), the eating habits improvement group (χ2=7.34, P=0.007), the self-confidence to manage diabetes improvement group(χ2=20.48,P=0.000),the glycemic control group(χ2=5.10,P=0.024),and the body-mass index improvement group(χ2=4.80,P=0.028)were higher than for other groups. Multi-factor analysis results showed that moderate physical activity improvement (OR=1.711, P=0.020) and self-confidence to manage diabetes improvement (OR=2.935, P=0.000) were factors related to improvement of QOL.Conclusion Self-management group activities were important ways to improve QOL.

Objective: To explore the knowledge and consumption of sugar sweetened beverage(SSB) and its influencing factors among third grade primary students, to provide basis for take targeted intervention measures. Methods: In September 2019, 1 686 primary school students of grade 3 were randomly selected from 2 primary schools in 1 urban area and 1 outer suburb area of 12 districts in Nanjing by using a multistage cluster sampling method，and a self administered questionnaire were offered to them to collect the knowledge about sugar sweetened beverage and its intake. Results: Totally 753 students (44.7%) answered 6 or more SSB knowledge questions correctly, and the rate of 389 students (50.2%) in urban areas was higher than that of 364 students (40.0%) in suburban areas. There were 780 (46.3%) students who knew that dairy containing beverage could not replace milk, the rate of 403 (52.0%) students in urban area was higher than that of 377 (41.4%) students in suburban area (χ 2=17.76, 18.99, P<0.05). Logistic regression analysis showed that compared with the frequency of consumption of SSB <1 time per week, the behavioral risk factors of primary school students who drink SSB ≥4 times per week were:urban area (OR=1.55), low parents educational level (OR=2.44), and frequent storage of SSB at home (OR=1.62). The protective factors were as follows:duration of extracurricular physical activity <120 min/week (OR=0.68), video time <120 min/day (OR=0.50), awareness rate of SSB ≥60% (OR=0.75), and restriction of high sugar snacks by parents (OR=0.60). Conclusion The knowledge associated with SSB among third grade students in Nanjing is relatively low. Consumption of SSB has been influenced by areas, parents educational level, knowledge about SSB and family factors. SSB consumption among primary students should be interfered at the school and family level. The health food education need to carry out based on the school and family, so as to create a supportive atmosphere integrating the school family to drink less sugar beverages.

Objective To investigate the expression,function and prognostic value of Ras-related C3 botulinum toxin substrate 2(RAC2)in breast cancer.Methods The expression profile of RAC2 mRNA was investigated in the TCGA-BRCA cohort,the prognostic value was analyzed using the Kaplan-Meier algorithm,the potential molecular function was investigated by gene set enrichment analysis,the relationship between RAC2 and immune infiltration was analyzed by Estimate and Cibersort algorithms,and the association between Rac2 and mutation spectrum was evaluated by maftools software package.The RNA-seq software package"pRRophetic"was used to predict the effect of chemotherapy drugs.In the validation cohort,Immunohistochemistry(IHC)staining was performed on tumor pathological sections of patients.Kaplan-Meier survival analysis and cox regression analysis were used to analyze the relationship between RAC2 and the prognosis of breast cancer.Results Bioinformatics analysis showed that the expression of RAC2 was up-regulated in estrogen receptor(ER)positive BC.In the Pam50 molecular subtype of BC,its expression decreased in the order of normal-like group,triple negative group,HER2 overexpression group,Luminal A group and Luminal B group.BC patients with high RAC2 expression had better overall survival(OS)and recurrence-free survival(RFS).The results of the validation cohort confirmed that RAC2 can be used as an independent predictor of BC prognosis.RAC2 was involved in the process of immune infiltration of tumor cells,and its high expression was mainly related to the mutations of CCDC168,VPS13C and AHNAK genes.Its up-regulation increased the drug sensitivity of doxorubicin,cisplatin,paclitaxel and gemcitabine.In terms of metabolism,it was negatively correlated with glycolysis and pentose phosphate pathway(PPP),and positively correlated with fatty acid oxidation(FAO)and glutamine metabolism.Conclusion High expression of RAC2 is associated with a good prognosis of BC and plays a role in the metabolism and immune infiltration.Further study on the molecular mechanism of RAC2 may provide new strategies for the prognosis and treatment of BC.