Stroke is one of the main diseases endangering the health and life of the middle-aged and elderly,and in recent years it shows a younger trend.It has the characteristics of high incidence,mortality and disability rate.Atherosclerosis is the main intervention target for stroke prevention and treatment.CircRNA is highly expressed in the cerebrovascular system and plays an important regulatory role in the pathogenesis of ischemia-reperfusion and ischemic stroke.This paper reviews the mechanism of circRNA and miRNA molecular network in the pathophysiological process of atherosclerosis,ischemic stroke and ischemia-reperfusion injury,so as to provide theoretical support for the application of circRNA in gene diagnosis and drug treatment of atherosclerotic ischemic stroke.

Objective:To understand the occurrence of major adverse cardiac events (MACE) during the perioperative period of cervical spine surgery and analyze its risk factors.Methods:A retrospective analysis of 426 cervical spine surgery patients admitted to the from March 2017 to March 2021. The basic information of the patients, including gender, age, body mass index (BMI), underlying diseases, and the Charlson comorbidity index (CCI) was calculated based on the underlying diseases.The preoperative serum cardiac troponin I(cTnI) level and the operation-related indicators were collected,including the type of cervical spine surgery, surgical procedure, approach, duration of surgery, duration of anesthesia, intraoperative bleeding, postoperative pain visual analogue scale (VAS), and electrolyte disturbances. Count data were expressed as cases (%), and comparisons between groups were made using the χ 2 test; logistic regression models were applied to perform a multifactorial analysis of the factors influencing the perioperative occurrence of MACE in patients undergoing cervical spine surgery. Results:Among the 426 patients, 54 (12.68%) experienced MACE during the perioperative period, including 4 cases of unstable angina (7.41%), 4 cases of acute myocardial infarction (7.41%), 33 cases of severe arrhythmia (61.11%), and 13 cases of acute heart failure (24.07%). The results of multivariate logistic regression analysis showed that the older the age group (50-59 years old: odds ratio=1.34, 95% confidence interval: 1.14-1.78; 60-69 years old: odds ratio=1.48, 95% confidence interval: 1.20-1.86; 70-79 years old: odds ratio=1.71, 95% confidence interval: 1.34-2.57; 80-89 years old: odds ratio=1.95, 95% confidence interval: 1.46-2.85), as well as females, CCI scores>3, and preoperative cTnI>0.04 μg/L, postoperative VAS score>5, and electrolyte disorders are all influencing factors for the occurrence of MACE in cervical spine surgery patients during the perioperative period (odds ratios of 1.84, 2.12, 2.34, 2.57, 2.20, 95% confidence intervals of 1.34-2.68, 1.50-3.41, 1.63-3.72, 1.53-4.01, 1.43-3.69, all P<0.05). Conclusions:The incidence of MACE in the perioperative period of cervical spine surgery is relatively high. Elderly age, female, high CCI score, high preoperative serum cTnI, postoperative pain and electrolyte disturbance are independent risk factors for the perioperative period of cervical spine surgery.

Objective To investigate the epidemiological features and antiviral response of patients with genotype 6 chronic hepatitis C (CHC) in Guangxi, China. Methods A total of 97 patients with genotype 6 CHC who were admitted to The First Affiliated Hospital of Guangxi Medical University from December 2012 to December 2020 were enrolled, among whom 62 patients were given antiviral therapy. The 62 patients receiving antiviral therapy were divided into interferon group with 22 patients and direct-acting antiviral agent (DAA) group with 40 patients. Related data were collected, including general demographic data, HCV RNA, liver function, routine blood test results, and renal function. The chi-square test was used for comparison of categorical data between groups. Results Among the 97 patients, there were 69 male patients (71.1%) and 28 female patients (28.9%), with a mean age of 41.97±10.12 years, and the patients aged 30-40 years accounted for 47.4% (46/97). Of all 97 patients, 95 (97.9%) had genotype 6a, 1 had genotype 6e, and 1 had genotype 6xa. Among the 65 patients with a definite route of infection, 41 (63.1%) had intravenous drug use, 14 had medical-related operations, 9 had blood transfusion, and 4 had sexual contact as the route of infection. For the interferon group, the rapid virologic response (RVR) rate at week 4 was 81.8% (18/22), the rate of undetectable virus at the time of drug withdrawal (Epoint) was 86.4% (19/22), the rate of sustained virologic response at 12 weeks after drug withdrawal (SVR12) was 81.8%, and the rate of sustained virological response at 24 weeks after drug withdrawal (SVR24) was 81.8%; 1 patient in this group experienced recurrence. All 40 patients in the DAA group were previously untreated patients (33 patients without liver cirrhosis and 7 patients with compensated liver cirrhosis), with an overall RVR rate of 87.5%(35/40), an Epoint rate of 100%, and an SVR12 rate of 100%, and there was no treatment failure or recurrence. Although different DAA regimens had different RVR rates, they all had a SVR12 rate of 100%. The patients with compensated liver cirrhosis and other diseases had a SVR12 rate of 100%. Conclusion Intravenous drug addiction is the main route of infection for patients with genotype 6 CHC in Guangxi, and CHC is more common in men, with genotype 6a as the main subtype. DAA treatment has a higher virologic response rate than interferon treatment, with an SVR12 rate of 100%. There is no significant difference in SVR12 rate between the patients with compensated liver cirrhosis and those without liver cirrhosis.

Objective:To investigate the biomechanical properties of cannulated screws fixation in a configuration of "axial compression and lateral buttress" in the treatment of Pauwels type Ⅱ femoral neck fractures.Methods:Ten specimens of Sawbones artificial femur were first made into models of type Ⅱ femoral neck fracture with a Pauwells angle of 50° and then randomized into 2 equal groups ( n=5). The specimens in the experimental group were subjected to fixation with cannulated screws in a configuration of "axial compression and lateral buttress" in which the axial screw was 8.5 mm in diameter and the lateral screw 6.5 mm in diameter. The specimens in the control group were subjected to conventional fixation with cannulated screws in a configuration of "inverted triangle and parallel compression" in which the 3 screws was 7.3 mm in diameter. Finally, the specimens were placed onto a biomechanical testing machine to determine the parameters of static axial stiffness, displacement under 60 to 600 N load for 5,000 cycles, ultimate load and ultimate stiffness in turn. The 2 groups were compared to find out their differences. Results:The static axial stiffness was (1,492.00 ± 87.86) N/mm, significantly higher than that in the control group [(1,200.22 ± 228.06) N/mm] ( P<0.05). There was no significant difference between the 2 groups in the cyclic load displacement [(0.44 ± 0.01) mm versus (0.57 ± 0.17) mm] ( P>0.05), but the experimental group showed a lower trend. The ultimate load and ultimate stiffness were (4,292.61 ± 804.29) N and (1,623.55 ± 180.94) N/mm in the experimental group and (4,383.64 ± 1,423.24) N and (1,433.77 ± 289.93) N/mm in the control group, showing no significant difference between the 2 groups ( P>0.05). Conclusion:In the treatment of Pauwels type Ⅱ femoral neck fractures, fixation with cannulated screws in a configuration of "axial compression and lateral buttress" may exhibit better biomechanical properties than that in a conventional configuration of "inverted triangle" .

Objective:To explore the effect of paradoxical intention training on the sleep quality, negative emotion and quality of life of elderly patients with obstructive sleep apnea syndrome (OSAS) .Methods:From March 2018 to February 2020, convenience sampling was used to enroll 130 elderly OSAS patients admitted to the First Affiliated Hospital of Zhengzhou University. Patients were randomly divided into control group and observation group, with 65 cases in each group. Control group implemented routine nursing, while observation group conducted paradoxical intention training based on routine nursing. Pittsburgh Sleep Quality Index (PSQI) , Hospital Anxiety and Depression Scale (HADS) , Calgary Sleep Apnea Quality of Life Index (SAQLI) were used before and after the intervention to compare the sleep quality, psychological status and quality of life between two groups.Results:After one week of intervention, the score of PSQI, anxiety subscale (HADS-A) , depression subscale (HADS-D) of observation group were (7.08±2.70) , (6.25±1.20) and (6.34±1.24) respectively, lower than those of control group, the differences were statistically significant ( t=4.871, 9.439, 8.754; P<0.01) . After the intervention, the total score of SAQLI in observation group was (4.87±0.35) and that in control group was (4.22±0.25) , the difference was statistically significant ( t=12.184, P<0.01) . Conclusions:Paradoxical intention training can help improve the sleep quality, psychological conditions and quality of life of elderly OSAS patients.

Objective:To evaluate the effect of combined teaching of optical laryngoscope and general laryngoscope on anesthesia undergraduate practice.Methods:A total of 40 anesthesia undergraduate students were randomly divided into group A (using the optical laryngocope only in the first month and the general laryngoscope only in the second month, n=20), and group B (using the general laryngocope only in the first month and the optical laryngoscope only in the second month, n=20). The teaching effect was evaluated through the first month and the second month of tracheal intubation assessment and questionnaire survey results. SPSS 23.0 was used for t test and chi-square test. Results:In the first month, the success rate was 90% in group A and 60% in group B, which showed that the success rate of group B was lower, with significant differences ( P < 0.05). The time for tracheal intubation in group A was (61.8±5.0) s, and that in the group B was (83.0±4.9) s, showing that the time of group B was longer, with significant differences ( P < 0.05). The complications in group A was 5%, and that in group B was 14%, showing that the group B had more cases of implications, with significant differences ( P < 0.05). In the second month, there was no significant difference in the one-time success rate, the time for tracheal intubation, and complications between the two groups ( P > 0.05). There was no significant difference in one-time success rate and complications between groups. Both groups showed that the time for general laryngoscope intubation was longer, with significant differences ( P < 0.05). All of the students believed that applying optical laryngoscope teaching was beneficial and could enhance the interest of learning, and the combination of the two methods was better. Conclusion:Using the optical laryngoscope first and then the general laryngoscope teaching is more beneficial for students to master the two methods of tracheal intubation, improve the success rate, reduce complications, and cultivates their self-confidence.

Objective To understand the relationship between MTHFR 677C/T polymorphism and general status of pregnant women and offspring congenital heart disease (CHD).Methods A case-control study was conducted among the biological mothers of 100 infants with CHD and 100 healthy controls to collect the information about their demographic characteristics,general status during pregnancy and awareness of eugenics.Their MTHFR 677C/T polymorphism and serum homocysteine (HCY),folic acid,vitamin B12 levels were detected.Results The differences in MTHFR genotype and allele frequency between the two groups were not statistical significant (x2=1.08,P=0.582;x2=0.53,P=0.468),but the difference in serum HCY between two groups were statistical significant (t=-8.14,P=0.000).Univariate analysis showed that 14 factors had statistical significances (P＜0.05).Multivariate logistic regression analysis indicated that mother's educational level(OR=3.386,95％ CI:1.279-8.961),annual household income (OR =8.699,95％ CI:2.177-34.765),chronic disease prevalence (OR=0.343,95％ CI:0.134-0.881),awareness of eugenics (OR=0.906,95％ CI:0.836-0.981),serum HCY level(OR=1.734,95％CI:1.458-1.986) and abnormal reproductive history(OR=3.710,95％ CI:1.217-11.308) were correlated with offspring CHD.Conclusion There was no correlation between MTHFR 677C/T polymorphism of pregnant women and offspring CHD,but low educational level,low annual household income,abnormal reproductive history,low awareness of eugenics and high serum HCY levels of pregnant women might increase the risk of offspring CHD.

Objective Study on the best drug compatibility for the double-lumen endobronchial intubation anesthesia. Methods Eighty ASA Ⅰ - Ⅱ patients undergoing selective thoracis surgery requiring intubation with double-lumen tubes were randomly divided into A and B group, with 40 cases in each group.The systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), were recorded before induction (T0) , after drug injection (T1), during intubation (T2), and at 1 min (T3), 3 min (T4)and 5 min (T5) after intubation. Results There was no significant difference in SBP, DBP and HR between the two groups at T0[(124. 9 ± 16. 0) mmHg vs (125.8 ±6. 4) mmHg, (73. 1 ±9. 9)mmHg vs (74. 3± 10. 4) mmHg, (81.8 ± 6. 6) times/min vs (82. 4 ± 8. 1) times/min] (P ＞ 0. 05). Compared with parameter at T0, SBP, DBP and HR, parameters in two groups in T1 were all significantly decreased after anesthesia [(94. 8 ± 10. 03) mmHg vs (96. 9 ± 10. 1) mmHg, (57. 3 ± 7. 66) mmHg vs (55.4 ± 7. 03) mmHg,(69. 6 ± 7. 43) times/min vs (66. 3 ± 7. 03) times/min] (P ＜ 0. 05). The cardiovascular parameters at T0,T2, T3, T4 were all comparable with those in group B [SBP: (130 ± 11.6) mmHg, (125.6 ± 10. 43) mmHg,(120. 1 ± 12. 3)mmHg,(116. 8± 11.4)mmHg;DBP:(75.6 ±9. 12)mmHg,(76. 2 ±9. 8)mmHg,(73. 1 ±9. 2) mmHg, (71.6 ± 8.46) mmHg; HR: (88 ± 9. 12) times/min, (82. 9 ± 7.5) times/min, (81.9 ± 8.2)times/min, (79. 9 ± 7. 8) times/min] (P ＞ 0. 05) , which were significantly higher than those in group A [SBP: (146. 3 ± 14. 2) mmHg, (141.2 ± 10. 63) mmHg, (137. 2 ± 13.23) mmHg, (122. 9 ± 11.6) mmHg;DBP: (94. 9 ± 10. 6) mmHg, (84 ± 9.63) mmHg, (79. 9 ± 9) mmHg, (75.8 ± 8. 3) mmHg; HR: (102 ±10. 63) times/min, (97.6 ± 9. 23) times/min, (87. 7 ± 8. 2) times/min, (82. 1 ± 7.32) times/min] (P ＜0. 05). The parameters at T2, T3, T4 in group A were obviously higher than those group B (P ＜ 0. 05).Conclusions Cardiovascular response with double-lumen endobronchial intubation by sufentanil-induced was stronger than fentaty, sufentanil had more stable hemodynamic parameters and it worth to be usd in clinic.

The concentration of serum adiponectin [(2.51±1.42)mg/L] was lower in the group of patients with type 2 diabetes mellitus as compared with that in normal controlgroup [(5.26±0.78)mg/L ,P＜0.01]. The concentration of serum adiponectin was lower in the diabetics with macrovascular complications (MVC) [(1.38±0.77)mg/L] as compared with those without macrovascular complication [(3.66±0.91)mg/L]. The concentration of serum resistin was higher in the diabetic group as compared with that in control group[(7.07±1.11 vs 6.09±0.47)μg/L, P＜0.01]. It was also higher in patients with MVC [(7.96±0.65)μg/L] compared with those without MVC [(6.10±0.43)μgL, P＜0.01].

Objective To investigate the expression of ionic channels of the rat bone marrow mesenchymal stem cells(BMSCs) and provide the basis for the change of ionic channels in the process of differentiation of stem cells.Methods The full marrow from Wistar rats was isolated by Percoll centrifugation and passaged repeatedly.The membrane currents of BMSCs were recorded with the whole-cell patch-clamp technique.The current amplitude of pathway,peal value and time course of activation and deactivation,selectivity of ions pathway,I-V curve were recorded.The currents were identified and analyzed by using various channel blockers.Results The cells began to stick in 24 h and arranged in whirlpool shape after passenger culture.They were positive for CD71,CD44,and negative for CD34,CD45 by flow cytometry,which improved that the cultured cells were BMSCs.The functional ion channels were characterized in cultured rat BMSCs with whole-cell patch clamp and reverse transcription polymerase chain reaction(RT-PCR) techniques.Three types of outward currents were found in BMSCs,including a delayed rectifier K+ current(IKDR),in addition,tetrodotoxin-sensitive sodium current(INa.TTX) and nifedipine-sensitive L-type Ca2+ current(ICa.L) were detected in 24% and 25% BMSCs.Moreover,RT-PCR result revealed the molecular evidence of mRNA for the functional ionic currents,including SCN5A,Kv4.3 and CACNA1C.Conclusion The currents are consistent with the characteristics of excitable cell membrane.