OBJECTIVE:To observe clinical efficacy and safety of escitalopram combined with ozagrel sodium for elderly pa-tients with acute cerebral infarction complicated with anxiety and depression. METHODS:140 elderly patients with acute cerebral infarction complicating with anxiety and depression were divided into control group and observation group according to random number table method,with 70 cases in each group. Control group received routine treatment and Sodium ozagrel for injection 40-80 mg added into 0.9% Sodium chloride injection 500 ml,ivgtt,bid. Observation group was additionally given Escitalopram tablet 10 mg,qd. Both groups received treatment for 8 weeks. HAMA,HAMD,NIHSS and BI were compared between 2 groups before and after treatment,and clinical efficacy and the occurrence of ADR were observed. RESULTS:There was no statistical sig-nificance in HAMA,HAMD,NIHSS,BI before treatment and NIHSS,BI 1 week of after treatment between 2 groups(P>0.05). HAMA and HAMD of observation group 1,4,8 weeks after treatment,and NIHSS and BI of it 4,8 weeks after treatment were improved significantly;above indexes of control group were improved significantly 4,8 weeks after treatment,and the observation group was better than the control group,with statistical significance (P<0.05). The total effective rate of observation group was 87.14%,which was significantly higher than 74.29% of control group,with statistical significance(P<0.05). There was no statis-tical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Escitalopram combined with ozagrel so-dium is significantly effective for elderly patients with acute cerebral infarction complicated with anxiety and depression,and can significantly improve anxiety,depression and neurological function with good safety.

Objective To investigate the correlation of plasma lysophosphatidic acid (LPA) and matrix metalloproteinase-9 (MMP-9) with carotid atheromatous plaque stability in patients with cerebral infarction. Methods The duplex uhrasonography and transcranial Doppler-detected microemboli were performed in the carotid arteries of all the 87 patients with cerebral infarction located in arteriae carotis interna system. The patients were divided into the intima thickening group (n=16),unstable plaque group (n=41), stable plaque group (n=21) and non-plaque group (n=9). And there were 27 patients with positive microembolic signal and 60 patients with negative microembolic signal.The plasma levels of LPA and MMP-9 were determined by quantitative determination of inorganic phosphorus and enzyme-linked immunosorbent assay. Results The levels of LPA and MMP-9 were significantly higher in unstable plaque group than in the other three groups (F=49.98 and 106.49,both P<0.01), MMP-9 in intima thickening group and stable plaque group were both higher than in non-plaque group (q=7.04 and 7.51, both P=0. 00). LPA was higher in intima thickening group than in stable plaque group (q=7.37, P=0. 00), and higher in the above two groups than in non-plaque group (both P<0.05). The levels of LPA and MMP-9 were higher in microembolic signal-positive patients than in signal-negative patients (t=42.57 and 16.61, both P=0.00). LPA level was positively correlated with MMP-9 (r=0.22, P<0.05). Conclusions LPA and MMP-9 may serve as a potential risk signal to hint the formation and rupture of unstable carotid atheromatous plaque which may cause ischemic cerebrovascular disease.

Objective:To explore the role of parental origin verification in chromosomal microarray analysis (CMA) on the determination of the clinical significance of copy number variations (CNVs).Methods:This retrospective study collected clinical information from 73 core families who underwent prenatal diagnosis at Peking University First Hospital from November 2017 to December 2019. Indications for prenatal diagnosis included ultrasound abnormality in 54 cases (including 12 with thickened nuchal translucency (≥2.5 mm), four with fetal growth restriction, seven with abnormal pregnancy history, and 31 with isolated ultrasound abnormality), NIPT indicated high-risk in four cases, advanced age in nine cases, abnormal pregnancy history alone in three cases, intrauterine death in two cases and one with maternal mental retardation. Genomic DNA of amniotic fluid sample, chorionic villi, cord blood, fetal tissues, and fetal heart blood were extracted using genomic DNA extraction kit. The CNVs of prenatal samples in 73 subjects were analyzed using array-based comparative genomic hybridization (array-CGH) analysis and single nucleotide polymorphism array (SNP-array). Peripheral blood DNA of the couples, and relevant families if necessary, were collected and analyzed in the same way. The results of parental origin detection in CMA were summarized.Results:A total of 76 CNVs were detected in these 73 samples, out of which nine were pathogenic and parental origin detection revealed that six were de novo, two were maternally, and one was paternally inherited; six CNVs were likely pathogenic, including three de novo, two maternally inherited and one paternally inherited; 20 CNVs were variants of uncertain significance, including five paternally inherited, three maternally inherited and 12 de novo; 41 CNVs were likely benign, among which 38 were inherited from parents with normal phenotype. Conclusions:Parental origin verification plays an important role in explaining the clinical significance of detected fetal CNVs and thereby can help to analyze its clinical effect and reproductive risk.

Objective:To retrieve, evaluate and summarize the relevant evidence of subcutaneous injection in patients to reduce pain at the injection site, so as to provide reference for clinical practice.Methods:According to the evidence pyramid "6S" model, all evidence on subcutaneous injection and injection site pain, including guidelines, expert consensus, summary of evidence, clinical decision, systematic review, etc were retrieved from domestic and international guideline networks and databases. The search period was from database establishment to October 2, 2022. The literature quality evaluation and evidence grading system of Joanna Briggs Institute (JBI) Evidence-based Health Care Center was used to evaluate the literature quality and classify the evidence level.Results:A total of 12 articles were included, including 2 expert consensus, 6 systematic reviews, 2 best evidence summaries and 2 clinical guidelines. A total of 21 pieces of best evidence were summarized from 8 aspects, including pre-subcutaneous injection assessment, injection site, injection needle, injection position, injection method, precautions, personnel training and health education.Conclusions:This study summarized a comprehensive and practical subcutaneous injection method. Clinical practitioners can use evidence to administer subcutaneous injection to patients, reduce pain and improve patients ′ comfort.