Objective To investigate the prevalance and risk factors of post-stroke depression(PSD)in patients with the first ever stroke during first year after stroke.Methods A total of 60 eligible stroke patients were followed up for 12 months after the first ever stroke and Hamilton Rating Scale for Depression,Activity of Daily Living Scale,Neurological Functional Deficit Scores,Social Support Scale and Eysenck Personality Questionnaire(EPQ)were used to investigate the incidence and risk factors of PSD in 2 weeks,3,4 and 12 months,respectively.Results The prevalence of PSD after the first ever streke was 18.18%(12/66),29.23%(19/65),38.09%(24/63),31.67%(19/60)in 2 weeks,3,4 and 12 months after the attack of stroke,respectively.Logistic regression analysis indicated that the major risk factors of PSD were female and introvert(b=-1.55,P=0.001;b=1.59,P=0.047)in 2 weeks,poor social support,low grade of neurological functional deficit score and female(b=-0.19,P=0.005;b=0.26,P=0.01;b=2.84,P=0.03)in 3 months.poor social support and low grade of neurological functional deficit score in 6 months and 12 months after stroke re-spectively(6 months:b=-0.24,P<0.001;b=0.35,P=0.004.12 months:b=-0.17,P=0.001;b=0.33,P=0.002).Conclusions The prevalence of PSD is considerable and the risk factors of PSD are different in different stage.

Objective To evaluate the role of endoscopic ultrasonography in the diagnosis and preoperative staging of rectum carcinoma. Methods Fifty-seven patients with rectum carcinoma were performed with preoperative endoscopy and endoscopic ultrasonography. And the staging results of endoscopic ultrasonography were compared to that of postoperative pathological assessment. Result Compared with the pathological staging, the endoscopic ultrasonography staging accuracy rate was 78.9% (45/57),and lymph node metastasis accuracy rate was 73.7% (42/57). Conclusion Endoscopic ultrasonography is effective in diagnosing and preoperative staging of rectum carcinoma.

700 mL/min).Conclusion The CLh-s could be correlated with operation complications,and be considered as an effective supplement to evaluate hepatic functional reserve when combined with ICGR15 and Child-Pugh classification. It could be used to evaluate liver functional reserve more effectively and reliably.

Objective:To investigate the effect of transurethral plasma enucleation of prostate with bladder neck and prostatic apex urethral mucosa preservation on the incidence of retrograde ejaculation after surgery.Methods:The clinical data of 77 patients with benign prostatic hyperplasia (BPH) admitted to Jinhua people's Hospital from January 2018 to June 2020 were retrospectively analyzed. The ages of the two groups [(62.06±2.01)years old and (62.36 ± 2.12)years old] were comparable. There were no significant differences between the groups( P>0.05) in term of the prostate volume (72.91±17.57) ml vs. (68.07±17.28)ml, Q max [(7.33±2.02)ml/s vs. (7.79±2.09)ml/s)], and IPSS (25.51±5.66) vs.(25.17±4.90). The conventional operation group was treated with " trefoil" enucleation of prostate. The modified operation group underwent the following three improved techniques. Firstly, the anterior mucosa of the verumontanum was cut 1.5 cm away from the medial surface of the verumontanum to prevent the external sphincter injury. Secondly, part of the prostate tissue was retained by exceeding the verumontanum when cutting off the bilateral lobes. Thirdly, the middle lobe of the prostate was bluntly stripped to the bladder neck with the sheath of the electroscope in order to protect the transverse muscle fibers as well as the integrity of the bladder neck. The outcome and the ejaculation function of the two groups were analyzed. Results:There was no significant difference in operation time [(66.74±9.29)min vs. (71.29±15.32) min], catheter indwelling duration [(5.31±0.76)d vs.(5.00±1.06)d], and hospital stay [(7.57±0.88) d vs. (7.17±1.45)d] between the two groups ( P>0.05) after more than 6 months of follow-up. According to IIEF score, mild erectile dysfunction occurred in both groups, with the incidence rate of 20.7%(6/29) and 13.5%(5/37) respectively, and there was no significant difference between the two groups ( P>0.05). The postoperative maximum urinary flow rate (Q max) [(23.51±4.25) ml/s vs.(24.05±3.81)ml/s] and IPSS score (6.46±2.72 vs. 6.55±2.99) was significantly different from that before the operation ( P<0.05). However, there was no significant difference between the two groups ( P>0.05). The incidence of retrograde ejaculation in conventional operation group and modified operation group was 23/35(65.7%) and 13/42(31.0%), and the difference was statistically significant ( P<0.05). Immediate urinary continence were 24/35(68.6%) and 36/42(85.7%) in the conventional operation group and the modified operation group respectively, and there was no significant difference between the two groups( P>0.05). After 6 months of follow-up, urinary continence in both groups was 100.0%. Conclusions:Transurethral plasmakinetic enucleation of the prostate with the preservation of bladder neck and urethral mucosa of prostate apex is the same effective as conventional operation in the treatment of benign prostatic hyperplasia, but the incidence of retrograde ejaculation after operation is significantly reduced, which is suitable for those patients who desire to retain their ejaculation function.

Objective To investigate the value of KIM-1 and NGAL in predicting the early diabetes nephropathy(DN).Meth-ods 132 cases of type 1 and type 2 diabetic patients were recruited in this study,patients were divided into four groups based on the urine albumin/creatinine and serum creatinine levels,as follows:normal albuminuria group (45 cases),mi-croalbuminuria group (36 cases),clinical albuminuria group (30 cases),renal failure group (21 cases),65 healthy subjects were recruited as control group.Urinary KIM-1 and NGAL levels were measured by enzyme linked immunosorbent assay (ELISA).Results With the progress of DN,urinary KIM-1 and NGAL levels gradually increased (P<0.05),the urinary KIM-1/Ucr level was positively correlated with ACR (r=0.822,P<0.01),and the urinary NGAL/Ucr was positively cor-related with ACR (r=0.842,P<0.01).Conclusion The urinary KIM-1 and NGAL level can predict the occurrence of ear-ly DN,and also monitor the progression of DN.

Objective To observe the clinical efficacy and safety of local injection of botulinum toxin A ( BTX-A ) combined with infrared polarized light for patients with chronic migraine ( CM ). Methods Ninety-one patients with CM were randomly divided into 4 groups.Group A served as the control group in which Nimodipine was used to treat CM ( n =22 ) ; in group B infrared polarized light was used to irradiate the area of the CM for 50 to 60 d ( n =22 ) ; in group C subcutaneous injections of BTX-A were used ( n =24 ) ; and in group D infrared polarized light irradiation of the affected area was combined with subcutaneous injections of BTX-A ( n =23 ).The onset of headaches,their severity,quality of life,as well as side effects were recorded using the migraine disability assessment scale (MIDAS) and the short form of the medical outcomes study form (MOS-SF).The results obtained before and after 6 months of treatment were compared. Results Both of MIDAS and MOS-SF assessment showed significant differences before treatment and after 1,3 and 6 months of treatment in all groups.After 1,3 and 6 months of treatment,the MIDSA and MOS-SF results revealed statistically significant differences between groups A and D,as well as between groups B and C. Conclusion BTX-A injection combined with infrared polarized light exerts significant therapeutic effects on CM with few side effects.

Objective Radiation can cause multiple damages to tissues and organs.This study aimed to explore the protec-tive effect of Ganoderma lucidum polysaccharides ( GLPs) against the 60 Co-γray radiation injury in mice and provide an experimental basis for the clinical use of GLPs. Methods One hundred mice were randomly divided into five groups of equal number: normal control, gavage control, radiation control, high-dose GLPs, and low-dose GLPs.Models of radiation injury were made in the mice by whole-body exposure to 60 Co-γrays.Three days before and after mod-eling, the animals in the high-dose and low-dose GLPs groups were given GLPs intragastrically at the dose of 100 and 50 mg/kg respec-tively, once daily for 14 days.Then the 30 day survival rate and sur-vival time of the model mice were recorded and the changes in the pe-ripheral blood index, spleen index, and serum superoxide dismutase( SOD) activity were observed. Results GLPs significantly increased the 30-day survival rate and the mean survival time of the mouse models (P<0.05), decreased the reduction of WBC count in the peripheral blood, and shortened the time of WBC restoration ( P<0.05 ) .Furthermore, GLPs obviously improved the spleen index and SOD activity of the Co-γray irradiated animals. Conclusion GLPs, with a significant anti-radiation effect, can effectively raise the survival rate of the mice exposed to a lethal dose of 60 Co-γrays, reduce radiation injury to WBC and platelets, and increase the activity of SOD in irradiated mice.

BACKGROUND: Embryonic stem cells fESCs) develop from early blastular inner cell mass.Under proper condition,ESCs can maintain undifferentiated state in vitro,normal diploid nuclear type,and proliferative potential.In addition,ESCs possess multi-directional differentiation capacity and can differentiate into all sorts of cells of three germ layers. OBJECTIVE: To investigate the feasibility of directed differentiation of ESCs towards thyroid cells in vitro as well as related molecular expression. DESIGN,TIME AND SETTING: A cell-based observational experiment was performed at the Bank of Cord Blood,Second Hospital Affiliated to Sun Yat-sen University between January 2004 and December 2006.MATERIALS: Balb/c pregnant mice at pregnancy 12.5-14.5 days were used for preparation of embryonic fibroblast feeder layer.E14 mouse embryonic stem cell (ESC) strains were gifted by professor Xu from Harvard University.METHODS: Murine El4 ESCs were cultured in methylcellulose semisolid medium to form embryoid bodies (Ebs).These Ebs were transferred for further inductive culture with the stepwise addition of growth factors- thyrotropin (TSH),insulin and kalium iodidum (KI).The cultured thyroid cells of adult Kunming mice were taken as positive control.MAIN OUTCOME MEASURES: ①Cellular morphological change in the process of differentiation.② Detection of expression levels of TSHR,PAX8,TTF-2,and TIF-1 by immunofluorescence assay.③ Detection of expression levels of TSHR,PAX8,NIS,TPO,and Tg by reverse transcription-polymerase chain reaction (RT-PCR).RESULTS: The differentiated cells had clear boundary,exhibiting round,oval,shuttle-shaped,or polygon adhesive growth.On day 6 of inductive ifferentiation,the differentiated cells showed the expression of PAX8,NIS,TPO,Tg,and TSHR,the specific gene of thyroid ceils.On day 8 of inductive differentiation,the expression of TSHR,TIF-1,PAX8,and TIF-2 was detectable in the differentiated cells with morphous similar to thyroid cells.CONCLUSION: ESCs can differentiate towards thyroid cells under given inductive conditions.

Objective To describe the evolution of oculomotor nerve paresis (ONP) after endovascular packing of posterior communicating artery aneurysms (PcomA) to prospectively evaluate the effect of mecobalamine treatment on ONP prospective recovery.Methods A total of 56 patients with ONP attributable to PcomA,treated with coils in our hospital from July 2007 to January 2013,were enrolled in a randomized,controlled open study,and 55 of them got follow up;embolization+mecobalamine treatment was performed in 28 and embolization treatment was in 27.The degrees of ONP were recorded one year after treatment.Results All patients succeeded in one year follow-up; 31 patients (56.4％) achieved complete resolution of ONP,19 (34.5％) partial improvement and 5 (9.1％) no changes.The complete recovery rate in the embolization+mecobalamine treatment group was 71.4％ (20/28) and that in the embolization treatment group was 40.7％ (11/27),with statistically significant differences (P＜0.05).Conclusion Endovascular treatment is highly efficacious in treating ONP-inducing PcomA and mecobalamine treatment can promote the recovery of oculomotor nerve palsy after embolism.

Objective To investigate the clinical characteristics of posterior communicating artery (PcomA) aneurysm-induced oculomotor nerve paresis (ONP) before and after endovascular coiling,and provide a reference for diagnosis,treatment and prognosis of PcomA aneurysm-induced ONP.Methods A total of 55 patients with ONP attributable to PcomA,admitted to our hospital from July 2007 to January 2013,were chosen in our study;their clinical data and postoperative recovery were retrospectively analyzed to investigate clinical characteristics of ONP attributable to PcomA.Results The average preoperative paralysis time was 12.24±5.33 days in patients with complete preoperative paralysis and 8.90±3.51 days in patients with incomplete preoperative paralysis with significant difference (P=0.014).Of the 55 patients,31 (56.36％) had complete recovery ofoculomotor nerve function,19 incomplete recovery (34.55％),and 5 (9.09％) remained unchanged after endovascular treatment.Most patients (41/50) began to improve in 3 months after endovascular treatment.The complete recovery ratio between patients encountered improvement of ONP within 30 days and over 30 days had statistical differences (P=0.032).Of 31 patients received complete resolution of ONP at the end of the follow-up,25 (80.65％) fully recovered 6 months after endovascular treatment.Thirty patients (96.77％) fully recovered within one year of endovascular treatment.One (3.23％) received complete resolution of ONP over one year of operation.Within 31 patients encountered complete resolution of ONP,there were 24 patients (77.42％) whose duration of recovery was less than 3 months and 7 patients (22.58％) more than 3 months.Functional recovery was noted firstly in the levator palpebrae muscle,followed by the medial rectus muscle,superior rectus muscle,constrictor muscles of the iris,and ciliary muscle.Patients with incomplete recovery often had residual diplopia in upward gaze and pupillary dysfunction.Conclusions The degrees of oculomotor nerve palsy before endovascular coiling are significantly associated with the paralysis time.Endovascular treatment can promote the recovery of PcomA-induced ONP.The earlier the ONP starting improvement,the better the ONP recoverary after endovascular treatment.The muscles which functional damage occurs early will encounter improvement lately.