Objective To investigate the value of early hematocrit (Hct) level in predicting early neurological deterioration (END) in patients with acute ischemic stroke. Methods The patients with acute ischemic stroke within 24 h of onset were enrolled prospectively. They were divided into low Hct, normal Hct, and high Hct according to the quantile of the measured Hct. END was defined as an increase of ≥2 of the National Institute of Health Stroke Scale (NIHSS) score or ≥1 of the motor item score within 5 d after admission compared with the baseline. The vascular risk factors, clinical features, baseline NIHSS score, infarct size, and laboratory test variables were compared between the END group and the non -END group. Multivariate logistic regression analysis was used to identify the independent risk factors for END. Results A total of 216 patients with acute ischemic stroke were enrolled, including 128 males (59.26%). Their mean age was 67.40 ±14.12 years. Sixty-two patients (28.70%) experienced END. The normal ranges of Hct in male and female were 40.12%-46.35% and 38.32%-44.17%, respectively. Univariate analysis indicated that there were significantly differences in baseline NIHSS score ( P =0.001), fasting glucose (P =0.030), C reactive protein (CRP) (P =0.041), and the proportions of different Hct levels between the END group and the non-END group (P =0.023). The END incidences in patients with high -level Hct (40.0%) and low –level Hct (35.2%) were significantly higher than that in the normal Hct patients (20 .4%), but there was no significant difference between the high-level and low -level Hct patients ( P = 0.690). Multivariate logistic regression analysis showed that theigh-level Hct (odds ratio 2.460, 95% confidence interval 1.146-5.283; P =0.021) and the baseline NIHSS score (odds ratio 1.070, 95% confidence interval 1.014-1.129; P = 0.013) were the independent risk factors for END. Conclusion The elevated Hct in patients with acute ischemic stroke are susceptible to END.

Humans ; Nose ; anatomy & histology ; surgery ; Petrous Bone ; anatomy & histology ; surgery

Urine provides an alternative to blood plasma as a potential source of disease biomarkers. Exosomes was separated by ultracentrifuge at 200000 g in normal persons and non-small cell lung cancer (NSCLC) patients′ urine. For proteomic analysis of urinary exosome, 1D sodium dodecylsulfonate-polyacrylate gel electrophoresis(SDS-PAGE) was carries out and cut the gel 31 kDa-20 kDa bands in normal group and disease group′s. These gel blocks were subjected to in-gel trypsinization, and the extracted peptides were analyzed HPLC-CHIP-MS/MS. Approximately 24 unique proteins were identified in the UniProtKB/SWISS-PORT. The difference expression proteins were found in urinary exosome from NSCLC patients, including three fragment of the immunoglobulin kappa, two kinds of Ras related proteins, glutathione S-transferase A2, serum amyloid P-component precursor and phosphatidylethanolamine-binding protein 1.

Endoscopy ; education ; Humans ; Skull Base ; surgery

Three-dimensional virtual surgery experiment is the application of virtual reality technology in the medical field.Doctors use the information in the virtual environment to develop surgical planning,surgical drills.surgical teaching,surgical skills training,to lead the surgical technique and postoperative rehabilitation,and the information is available for surgery every sur-gical member to share.Virtual Surgery experiments combined with the real operation together constitute complete experimental teaching system,making telemedicine experimental teaching methods and teaching content rich and varied.

Objective To explore the inhibitory effect of mycophenolic acid (MPA) on the proliferation and monocyte chemoattractant protein-1 (MCP-1) secretion in mice glomerular mesangial cells (GMCs).Methods MPA with different concentrations ( 0.1 , 1, 5 and 10 ?mol/L ) was added into the cultured mice GMC line in vitro for 24 h. The GMCs proliferation level was detected by the 3-(4,5-Dimethylthiazol-2-yl)2,5-diphenyltetrazolium bromide (MTT) incorporation. The absorbance for counting the GMCs survival was read at 570 nm by using an automated microplate ELISA reader. The cells treated with MPA (0, 0.5 and 2.5 ?mol/L ) were stimulated by TNF-? (20 ng/ml), IL-1? (2 ng/ml), IFN-? (10 ng/ml). Four h later, the MCP-1 concentration in supernatant was determined by ELISA. At the same time, the lymphocyte migration was examined.Results MPA has a concentration -dependent antiproliferative effect on cultured GMCs. The secretion of MCP-1 of cultured GMCs stimulated by TNF-?, IL-1?, IFN-? was significantly increased. Addition of MPA could signi -ficantly inhibit the secretion of MCP-1 ( P

Objective To investigate the effect of sodium nitroprusside sustained release on cognitive function, S-100βprotein and VILIP-1 in pituitary tumor surgery patients.Methods 156 cases of pituitary tumor patients were selected and divided into two groups according to random number table method,78 patients in each group.All patients underwent general anesthesia induction,the experimental group treated with 0.5~6 μg ( kg· min) infusion of sodium nitroprusside induced hypotension by micro pump at the beginning of operation.MMSE was used to determine the cognitive function of 2 groups of patients 1 day before operation and 2 days after operation,S-100βand VILIP-1 content were determined by ELISA before anesthesia,after surgery,and 0,12,24,48 h after operation.Results There was no statistical significance between the 2 groups in the incidence of postoperative cognitive dysfunction.Compared with control group, the operation time, bleeding volume and the recovery time of the experiment group were lower(P<0.05).S-100βprotein and VILIP-1 showed increased at first and then decreased at the peak of 24h;compared with the normal group, the levels of S-100βprotein and VILIP-1 of the cognitive impairment were higher ( P <0.05 ).Compared with the control group, the levels of S-100βprotein and VILIP-1 of the experiment group were lower(P <0.05).Conclusion Sodium nitroprusside sustained release controlled hypotension can reduce the level of cognitive disorder, patients of S-100βprotein and visinin-like protein 1 and has certain directive significance to the clinical.

Objective:To investigate the clinical significance of LncRNA anti-differetiation non-coding RNA (ANCR) expression in tumor tissues of gastric cancer patients and its biological effects on cells.Methods:72 cases of gastric cancer tissues and corresponding adjacent tissues were collected from Sep. 2016 to Jun. 2018 in our Hospital. Gastric cancer cell HGC-27 was cultured, lentiviral transfected ANCR cDNA full-length vector was used as a Test group in HGC-27 cells, and transfected blank vector as a control group. Real-time quantitative PCR (qPCR) was used to detect the expression of ANCR, transcription factor Oct4 and Sox2 mRNA in tissues or cells, Western blot was used to detect the expression levels of Oct4 and Sox2 in cells, CCK-8 assay was employed for detecting cell proliferation in both groups, and Transwell invasion and migration assay was used to detect the transfer ability of cells in the two groups.Results:The expressions of ANCR in gastric cancer and corresponding adjacent tissues were respectively 0.013 (0.006, 0.025) and 0.041 (0.011, 0.136) , and the expression of ANCR in gastric cancer tissues was significantly higher than that in adjacent tissues ( P<0.01) , and patients with high expression of ANCR had higher TNM stage and lower cell differentiation ( χ2=7.414 and 8.236, P<0.05) . The expressions of ANCR mRNA in control group and test group were respectively 1.000±0.064 and 6.250±0.889, Oct4 mRNA were respectively 1.000±0.208 and 2.815±0.349, Sox2 mRNA were respectively 1.000±0.173 and 2.526±0.390, Oct4 protein were respectively 1.000±0.148 and 3.396±0.105, Sox2 protein were respectively 1.000±0.119 and 2.916±0.130, and the expressions of ANCR, Oct4 and Sox2 mRNA in the test group were significantly higher than those in the control group ( P<0.01) ; the expression levels of Oct4 and Sox2 protein in the test group were significantly higher than those in the control group. The proliferation abilities of control group and test group were 7.164±0.426 and 9.627±0.605 in 72h, and 13.750±1.089 and 19.166±1.649 in 96h. The proliferation of cells in the Test group at 72 and 96 hours was significantly higher than that in the control group ( P<0.01) . The average number of invasive cells per visual field in control group and test group were 17.26±5.48 and 39.43±5.21, and number of migration cells were 30.49±7.74 and 62.20±7.51, and the number of migration and invasion cells in the Test group was significantly larger than that in the control group ( P<0.01) . Conclusions:The expression of LncRNA ANCR in tumor tissues of gastric cancer patients is significantly increased, and it is closely related to the progression of the disease of patients and the degree of cell malignancy. It can promote the expression of gastric cancer stem cell markers in vitro and enhance the ability of cell proliferation and metastasis.

Aim To explore the inhibitory effect of li-gustrazine combined with paeonol on rat liver fibrosis induced by CCl4 and its mechanisms,so as to provide new treatment strategies for liver fibrosis in clinical. Methods Cleaning laboratory male SD rats were ran-domly divided into blank control group,model group (CCl4 ),ligustrazine group,paeonol group and combi-nation group (ligustrazine+paeonol).HE staining was used to observe the pathological change.Masson stai-ning and Sirius red staining was used to observe the collagen deposition.The levels of serum ALT,AST, ALP and hydroxyproline were detected by automatic bi-ochemistry analyzer.Western blot detected the markers of liver fibrosis.HSC-T6 cell was divided into model group,ligustrazine group,paeonol group and combina-tion group.The protein and gene expression of inflam-mation and apoptosis pathway was analyzed by Western blot and real time-PCR.Results Ligustrazine com-bined with paeonol could significantly improve liver tis-sue pathology changes caused by CCl4 .It could reduce serum ALT, AST, ALP and hydroxyproline levels. Moreover,it could also inhibit liver fibrosis marker protein expression,and thus reduce the deposition of collagen fibers.The effect was better than that in sin-gle intervention group.Combination group could inhib-it the inflammatory pathways related protein expression in HSC cells and promote the apoptosis of HSC cells. Conclusion Ligustrazine in combination with paeonol has significant anti-fibrosis effect,and the effect is bet-ter than both single intervention.The effect may be due to the interference with TNF-α/NF-κB pathway in the HSC cells,which promotes its apoptosis and inhib-its the generation of extracellular matrix.

OBJECTIVE:To provide reference for rational use of antibiotics in the clinic. METHODS:From 2012 to 2014,5 medical records were selected randomly from 17 clinical departments each month,1 005 cases in 2012,1 020 cases each year in 2013 and 2014,a total of 3 045 cases. Rationality of antibiotics use was analyzed to summarize and analyze irrational drug use. RE-SULTS:The rate of antibiotics use from 2012 to 2014 were 39.90%,36.27% and 32.84%;the rational rate of antibiotics medical orders were 40.90%,68.11% and 82.67%. Irrational drug use manifested as irrational medication time,unreasonable drug selec-tion,inappropriate indications,inappropriate drug selection,inappropriate usage and dosage,inappropriate drug combination, off-label use etc. CONCLUSIONS:By clinical pharmacistsadvance interventionandadministrative intervention,the use of an-tibiotics in wards of our hospital tend to be more reasonable. But it still necds to strengthen awareness arnd management to effective-ly protect the rational drug use.