ObjectiveTo study the effect and clinical meaning and pathogenic of extinction on cerebral cortex lesion. MethodsTactile extinction to classical extinction test(simple stimuli)and modified Quality extinction test(QET)were used. ResultsThe positive rate of ex-tinction using modified QET was higher than that of simple stimuli; left cortex lesion could result in extinction both in the contralateral side andthe ipsilateral side;left frontal sites lesion caused ipsilateral extinction. Conclusion: The modified QET was more sensitive than simplestimuli; modified QET showed extinction has competiting and restricting effect at 2 different levels, the mechanism of extinction is correlatedto competition and adventage restraint of diplo-hand cerebral hemisphere and liaise correliation fiber of diplo-hand cerebral hemisphere; thehighesttthe positive rate of extinction was observed in left parietal lesions.

Vascular cognitive impairment in patients with severe stroke has attracted wide attention of clinicians in recent years,and the cognitive impairments of transient ischemic attack (TIA) and minor stroke are often overlooked because of their mild symptoms and short duration.This article reviews the advances in research on cognitive impairment in patients with TIA and minor stroke in recent years in order to increase the degree of attention of clinicians and improve the overall prognosis of patients.

Objective To explore the accuracy and practicability of the three-dimensional ultrasound in real-time intellectual positioning navigation.Methods The phantom was applied in the real-time intellectual positioning guided biopsy of three dimensional ultrasound,free-hand ultrasound-guided biopsy and bracket-guided biopsy with different depths(5 cm,10 cm) and different sizes of the targets (6 mm and 15 mm).The time spent,the length of the sample and the success rate of biopsy were compared among three groups,and statistical analysis was done.Results ①The different sizes of targets with different depths were shown in three kinds of biopsy that the real-time intellectual positioning guided biopsy of three-dimensional ultrasound spent more time than bracket-guided biopsy,less than free hand ultrasound-guided biopsy.The difference was significant (P ＜0.05).The aquired red-dyed sample was longer in the real-time intellectual positioning guided biopsy of three-dimensional ultrasound compared to free-hand ultrasound-guide biopsy and bracket-guided biopsy,the difference was significant (P ＜0.001).②For real-time IP-guided biopsy of three-dimensional ultrasound with same depth,larger size of targets(15 mm) spent less time than smaller saize of targets (6 mm),the difference was significant (P ＜ 0.05).However,compared to smaller saize of targets(6 mm),success rate of biopsy in larger size of targets(15 mm) had no significant difference (P =0.238 at depth of 5 cm,P =0.479 at depth of 10 cm).③For real-time intellectual positioning guided biopsy of three-dimensional ultrasound with same size,time spent was less in the targets at the depth of 5 cm than in the targets at the depth of 10 cm,the difference was significant (P＜0.05).The aquired red-dyed sample was longer in the targets at the depth of 5 cm than in the targets at the depth of 10 cm,and success rate of biopsy in the targets at the depth of 5 cm was higher too (P ＜0.05).Conclusions The real-time intellectual positioning guided biopsy of three dimensional ultrasound spend less time with high accuracy and success rate of biopsy,especially for smaller and deeper targets,can be clinically applied with accuracy and practicability.

OBJECTIVE:To observe the efficacy and safety of moxifloxacin combined with Jiehe pill in the treatment of muilt drug-resistant tuberculosis(MDR-TB). METHODS:116 patients with MDR-TB were randomly divided into control group and ob-servation group. Control group was given Moxifloxacin hyohochloride tablet 0.4 g once a day,observation group was additionally given Jiehe pill 9 g,twice a day,and 2 groups were given rifapentine,albendazole isoniazid,amikacin,pasiniazide,pyrazin-amide,p-amino salicylic acid and other conventional treatment. The treatment course for both groups was 18 months. The clinical efficacy,and T cell subsets (CD3+,CD4+,CD4+/CD8+),interferon(INF)γ,interleukin(IL)4 levels before and after 6,12 and 18 months,and incidence of adverse reactions in 2 groups were recorded. RESULTS:The total effective rate in observation group was significantly higher than control group,the difference was statistically significant(P<0.05). After treatment,CD3+,CD4+,CD4/CD8 and INF-γ level in 2 groups were significantly higher than before and gradually increased by time,and observation group was high-er than control group;IL-4 level was significantly lower than before and graually decreased by time,and observation group was lower than control group,the differences were statistically significant(P<0.05). There was no significant difference in the inci-dence of adverse reactions(P>0.05). CONCLUSIONS:Based on the coventional treatment,moxifloxacin combined with Jiehe pill has better efficacy than moxifloxacin in the treatment of MDR-TB,with similar safety.

Objective To investigate the risk factors of prehypertension among postmenopausal women.Methods2 592[(43±12)years old] health women were collected as the research object in Saihan District of Hohhot in Inner Mongolia Autonomous Region in April 2015,including 697[(58±6)years old] postmenopausal subjects and 1 895[(37±8)years old] premenopausal subjects.T test was used to compare means of blood pressure, fasting blood glucose (FBG), blood lipid, and body massive index (BMI) between postmenopausal group and premenopausal group and to compare prevalence of prehypertension, hyperglycemias, dyslipidemias, overweight, and obesity between two groups.Logistic Regression was implemented to analyze the relationship between different risk factors and prehypertension among postmenopausal women.Results Compared with premenopausal women, the systolic pressure, diastolicpressure, BMI, FBG, triacylglycerol (TG), low density lipoprotein (LDL) in postmenopausal women were significantly higher(P<0.05).Prevalence of prehypertension, impaired fasting glucose (IFG), diabetes, TG abnormalities, LDL abnormalities, overweight, and obesity in postmenopausal women were significantly higher than in premenopausal women(P<0.05).Age 55 to 59, 60 to 64 and above 65 years overweight, obesity, IFG and diabetes were independent risk factors of prehypertension among postmenopausalwomen.Conclusions Age 55 yearsand above, overweight, obesity, IFG and diabetes are the independent risk factors of prehypertension among postmenopausal women.

Objective To evaluate the effect of high-level spinal cord injury (SCI) on the myocardial energy metabolism in rats.Methods Sixty healthy male Sprague-Dawley rats,weighing 250-300 g,were randomly divided into 2 groups (n=30 each) using a random number table:sham operation (group S) and SCI group.SCI was induced in anesthetized rats by dropping a 10 g weight onto C7 spinal cord from 5 cm height falling freely inside a vertical hollow glass tube.At 6,12,24,48 and 72 h after SCI,6 rats in each group were chosen and arterial blood samples were taken for measurement of serum creatine kinase (CK) and creatine kinase isoenzyme-MB (CK-MB) activities.The rats were then sacrificed and myocardial specimens were obtained for examination of myocardial ultrastructure and for determination of ATP weight ratio,levels of Na+-K+-ATPase,Ca2+-Mg2+-ATPase,non-esterified fatty acids (NEFA) and lactic acid (LD),and expression of peroxisome proliferator-activated receptor alpha (PPARα) mRNA and protein (using fluorescent quantitative PCR and Western blot).Results Compared with group S,the serum CK and CK-MB activities were significantly increased,the ATP weight ratio,activities of Na+-K+-ATPase and Ca2+-Mg2+-ATPase and levels of NEFA and LD were decreased,and the expression of PPAR-α mRNA and protein was down-regulated in SCI group.No pathological changes of myocardium were found in group S,and the pathological changes of myocardium were obvious in SCI group.Conclusion High-level SCI can lead to decrease in the myocardial energy metabolism in rats,and down-regulated expression of PPARα is involved in the mechanism.

Objective To evaluate the effect of high-level spinal cord injury(SCI)on the expression of mitochondrial voltage-dependent anion channel 2(VDAC2)in rat cardiomyocytes.Methods Forty-eight pathogen-free healthy adult male Sprague-Dawley rats,weighing 200-250 g,were divided into 2 groups(n=24 each)using a random number table:sham operation group(group S)and high-level SCI group(group H).The animals were anesthetized with intraperitoneal chloral hydrate and subjected to SCI using the modified Allen weight-drop method in group H.The spinal cord was only exposed in group S.At 6,12,24 and 48 h after SCI(T1-4),6 rats in each group were randomly selected and sacrificed,and myocardial specimens were collected from the cardiac apex for microscopic examination of the cell morphology(with a transmission electron microscope) and for determination of cell apoptosis(by TUNEL assay),expression of Bax,Bcl-2 and VDAC2 protein and mRNA in cardiomyocytes(by Western blot and real-time polymerase chain reaction,respectively).The apoptosis rate and ratios of Bax/Bcl-2 protein and mRNA were calculated.Results Compared with group S,the apoptosis rate and ratios of Bax/Bcl-2 protein and mRNA were significantly increased at T1-4,the expression of VDAC2 protein and mRNA was significantly down-regulated at T2-4(P<0.05 or 0.01),and the pathologic changes of cardiomyocytes were aggravated in group H.Conclusion The mechanism of myocardial damage is related to down-regulation of mitochondrial VDAC2 expression in cardiomyocytes and promotion of cell apoptosis in rats with high-level SCI.

Objective To investigate the correlation between CpG island methylation levels of human placental genes and spontaneous abortion in pregnant women. Methods A total of 55 pregnant women who underwent routine prenatal examination were selected as the study subjects, including 25 cases of spontaneous abortion (abortion group) and 30 cases of normal delivery (control group). Clinical data and human placental tissue samples were collected from the enrolled pregnant women. Clinical general data of the two groups were compared. The predictive value of methylation levels of related placental genes on the outcome of spontaneous abortion in pregnant women was analyzed. Logistic regression analysis was used to analyze the influencing factors of spontaneous abortion in pregnant women. Results There were statistically significant differences in maternal age, birth weight of aborted fetuses/neonates, days of pregnancy, and gender of aborted fetuses/neonates between the two groups (P < 0.05). Methylation of MECP2-1, MECP2-4, HSD11B2, MECP2-3 and MECP2-2 genes was associated with spontaneous abortion. The methylation rates of MECP2-1, MECP2-4, HSD11B2 and MECP2-3 genes in the abortion group were higher than those in the control group, with statistically significant differences (P < 0.05). The area under the curve (AUC) of MECP2-1, MECP2-4, HSD11B2, MECP2-3 and MECP2-2 was 0.773, 0.737, 0.700, 0.663, and 0.627, respectively. Logistic regression analysis showed that MECP2-1 was an independent influencing factor for miscarriage in pregnant women (P < 0.05). Conclusion The methylation levels of MECP2-1, MECP2-4, HSD11B2, MECP2-3 and MECP2-2 genes are related to the outcome of spontaneous abortion in pregnant women. The MECP2-1 gene is an independent influencing factor for spontaneous abortion.

OBJECTIVE:To provide reference for the formulation of clinical therapy plan for elderly patients with vaginal in-fection. METHODS:From Jun. 2014 to Oct. 2016,200 elderly patients with vaginal infection were selected from Wuhan Wuchang Hospital (called our hospital for short). Leucorrhea routine examination,bacterial culture,identification and drug sensitivity test were all performed for the secretions of vaginal side wall. The occurrence of vaginal infection was compared among different age groups. The distribution of bacteria,distribution of cleanliness and drug resistance were observed. RESULTS:The types of vaginal infectious diseases in 200 patients included Candida vaginitis,Trichomonas vaginitis,bacterial vaginitis,nonspecific vaginitis. The incidence of vaginal infection in 66-70 age group was significantly higher than 60-65 age group and 71-80 age group,the incidence of vaginal infection in 60-65 age group was significantly higher than 71-80 age group,with statistical significance(P<0.05). A to-tal of 205 strains of bacteria were detected,most of which were Gram-positive bacteria,except for Escherichia coli. Streptococcus was the most common pathogen,with a total of 76 strains(37.07％),followed by Staphylococci(48 strains,23.41％). The vagi-nal secretion cleanliness was grade Ⅰ,Ⅱ,Ⅲ and Ⅳ respectively in 10,70,90,30 cases. The amount of bacteria increased with the increase of vaginal secretion cleanliness,and Streptococcus and Staphylococcus infection were the most common in patients with Ⅲ to Ⅳ degree. Resistance rate of bacteria to penicillin,gentamicin and erythromycin were relatively higher while most of them to teicoplanin and linezolid were relatively lower;they were all sensitive to vancomycin (resistance rate of 0). CONCLU-SIONS:There are many types of vaginal infectious diseases in our hospital,and most of them are 66-70 years old. The majority of bacteria were Gram-positive bacteria,most of them were Streptococcus. The drugs which are sensitive to pathogen include vancomy-cin,teicoplanin and linezolid. Antibiotics should be rationally selected according to drug sensitivity test.

ObjectiveTo investigate the clinical significance of highly sensitive nucleic acid detection in precise antiviral therapy for patients with liver cirrhosis and its association with aminotransferase level. MethodsA total of 377 patients with hepatitis B cirrhosis who were hospitalized or attended the outpatient service from May 2013 to April 2019 were enrolled and tested by both domestic HBV DNA detection and highly sensitive Cobas HBV DNA detection. All patients underwent biochemical examination, four blood coagulation tests, routine blood test, and upper abdominal computed tomography or ultrasound. Sensitivity of different HBV DNA detection reagents was compared in liver cirrhosis patients with a low viral load, and the correlation between alanine aminotransferase (ALT) level and viral load was analyzed. The paired t-test was used for comparison of continuous data before and after treatment. The receiver operating characteristic (ROC) curve was used to screen out the optimal predictive values of ALT at different cut-off values of HBV DNA. ResultsAmong the 377 patients with hepatitis B cirrhosis, 215 tested positive and 162 tested negative by domestic HBV DNA, and among these 162 patients, 104 (64.2%) tested positive by Cobas HBV DNA detection, with a mean level of 267.5±42.3 IU/ml. After 24 weeks of antiviral therapy, the 104 patients with hepatitis B cirrhosis had significant improvements in viral replication level, ALT, and Child-Pugh score for liver function; HBV DNA decreased from 267.5±32.2 IU/ml before treatment to 59.6±7.7 IU/ml after treatment (t=3.486, P=0.002), ALT decreased from 871±10.8 U/L before treatment to 36.5±7.6 U/L after treatment (t=3.235, P=0.020), and the Child-Pugh score decreased from 6.5±0.7 before treatment to 5.7±0.5 after treatment (t=2.928, P=0.041). The ROC curve analysis of ALT in predicting HBV DNA decision point showed that an ALT level of 29 IU/L was the most sensitive cut-off value for predicting HBV DNA ＜20 IU/ml, with an area under the ROC curve of 0.904, a sensitivity of 1.0, and a specificity of 0.237. ConclusionPrecise detection helps to guarantee the precise clinical treatment of patients with hepatitis B cirrhosis and improve their treatment outcome and prognosis. An ALT level of 29 IU/L is a sensitive indicator for predicting patients with negative Cobas HBV DNA, so as to achieve individualized precise screening and treatment.