Objective To evaluate the effect of probucol combined with simvastatin on blood levels of oxidied low density lipoprotein (ox-LDL) and inflammatory factors in acute stage of cerebral infarction. Methods A total of 122 patients with acute stage of cerebral infarction were randomly divided into two groups:observation group ( n = 62),and control group( n = 60). After two weeks of follow-up ,the levels of high sensitivity C-reactive protein(hsCRP) ,oxLDL ,fibrinogen ( FIB ), interleukin 6 (IL-6) and blood lipids were detected. The side effect was recorded and the difference between two groups was analyzed. At 7 d and 14 d, curative effects were evaluated by standard scale of clinical neurological deficit. Results Compared with the control group, 2weeks after the medication, low-density lipoprotein cholesterol( LDL-C), apolipoprotein B ,ox-LDL, IL-6 and hsCRP were significantly decreased in the observation group (P <0.01 ). Conclusion The treafment of probucol combined with simvastatin could reduce the levels of ox-LDL and inflammatory factors in acute stage of cerebral infarction, and prevent hemorrhagic transformation and recurrence of cerebral in farction.

Objective: To investigate the preventive effect of alprostadil (prostaglandin E1) combining hydration therapy on contrast induced nephropathy (CIN) after percutaneous coronary intervention (PCI) in elder patients. Methods: A total of 175 patients with coronary artery disease (CAD) elder than 75 years received PCI in our hospital from 2011-03 to 2014-03 were retrospectively studied, those including 122/175 (69.71 %) with male gender. The patients were at the mean age of (74.7 ± 3.9) years and randomly allocated into 2 groups: Control group, based on routine treatment, the patients received regular hydration of intravenous normal saline 1 ml/(kg?h) at 6 hours prior and 12 hours after PCI,n=84 and Alprostadil+hydration group, based on routine treatment and regular hydration, the patients received intravenous alprostadil 10μg in 100ml normal saline twice a day at 1 day prior PCI and the 3rd day after PCI,n=91. The serum levels of creatinine (SCr) were examined prior PCI and 3 days continuously after PCI, creatinine clearance rates (Ccr) were calculated and the CIN occurrence rates were compared between 2 groups. Results: At the 3rd day after PCI, the mean SCr level in Alprostadil+hydration group (92.08 ± 21.65) μmol/L was lower than Control group (99.43 ± 22.77) μmol/L,P<0.05, the mean Ccr level in Alprostadil+hydration group (63.78 ± 20.58) ml/min was higher than Control group (57.09 ± 22.31) ml/min,P<0.05. The occurrence rate of CIN after PCI was higher in Control group (13.1%, 11/84 patients) than Alprostadil+hydration group (3.3%, 3/91 patients),P<0.05. Conclusion: Alprostadil combining hydration therapy may obviously protect renal function and reduce the incidence rate of CIN in elder CAD patients after PCI treatment.

Objective: To observe the protective effect of ischemic post-conditioning on myocardial reperfusion injury with the potential mechanism in experimental rabbits. Methods: A total of 36 healthy New Zealand rabbits were divided into 6 groups:①Sham group,②Ischemic reperfusion control (CON) group,③Myocardial ischemic post-conditioning (MpostC) group,④Remote ischemic post-conditioning (RPostC) group,⑤MPostC+5-HD group,⑥RPostC+5-HD group.n=6 in each group. The ischemic reperfusion injury model was established by left ventricular descending artery occlusion for 45 min followed by reperfusion for 120 min. Bilateral external iliac artery was occluded for 5 min to induce the short skeletal muscle ischemia. The indexes of cardiac function and plasma CK , LDH activities were measured at baseline, end of ischemia and 1, 2 h after reperfusion respectively, the sizes of myocardial infarction (MI) were examined and compared among different groups. Results: ①Compared with CON group, the indexes of cardiac function were improved in MPostC and RPostC groups at 1, 2 h after reperfusion,P<0.05, and compared with MPostC group and RPostC group, the indexes of cardiac function were improved in MPostC+5-HD and RPostC+5-HD groups,P<0.05.②Compared with CON group, plasma CK, LDH activities were decreased in MPostC and RPostC groups at 2 h after reperfusion,P<0.05, and compared with MPostC group and RPostC group, the CK, LDH activities were increased in MPostC+5-HD and RPostC+5-HD groups,P<0.05.③The ischemic ranges and areas were similar between CON group and the other 5 groupsP>0.05. The MI ranges and areas in MPostC and RPostC groups were much less than that in CON group,P<0.05, and compared with MPostC group and RPostC group, the MI ranges and areas increased in MPostC+5-HD and RPostC+5-HD groups,P<0.05. The MI ranges and areas were similar between CON group and MPostC+5-HD, RPostC+5-HD groups,P>0.05. Conclusion: Classical ischemic post-conditioning and remote organ ischemic post-conditioning both have protective effect on myocardial reperfusion injury in experimental rabbit, which might be related to the activation of mitochondrial ATP-sensitive potassium channels.

Many studies have shown that the incidence of type 1 diabetes mellitus (T1DM) is increasing with an annual of 2％ to 5％.As the same with type 2 diabetes mellitus,T1DM is also a risk factor for stroke.Although some T1DM studies have taken stroke as a component of the composite endpoint of cardiovascular events,a few studies have focused on the risk of stroke in patients with T1DM.Recent studies have shown that the risk of stroke in patients with T1DM is significantly higher than those without diabetes mellitus,especially in the population under the age of 50.In addition,the T1DM patients died of the risk of stroke are 3 to 4 times higher than the general population.This article reviews the relationship between T1DM and stroke.

Effective prevention is the best approach for reducing the burden of stroke.The reduction of low-density lipoprotein cholesterol with statins may decrease the risks of patients with the first ever stroke and ischemic stroke or recurrent stroke in patients with transient ischemic attack.In stroke prevention,the treatment of statins has become the most important advance following aspirin and antihypertensive treatment.This article reviews the roles of statins in the prevention of stroke.

Objective Women with gestational diabetes mellitus (GDM) are at risk to develop Type 2 diabetes mellitus ( DM2).The aim of this study is to compare the effect of three diagnostic criteria on the prevalence of GDM.Methods 2864 pregnant women receiving obstetric care at 24 to 28 weeks of gestation at Peking University First Hospital,underwent the 75 g oral glucose tolerance test for routine GDM screening.The pregnancies were evaluated bythe American Diabetes Association (ADA 2004) Cuideline,the new criteria which was proposed by the International Association of Diabetes and Pregnancy Study Groups (IADPSG 2010) based on the HAPO study,not by the criteria of American College of Obstetricians and Chinese Obstetrics and Gynecology (6th edition 2005).Venous plasma glucose was measured by the IDMS-traceable glucose oxidase method.Results The mean age of the women was 30 years.590 women were diagnosed with GDM using the IADPSG criteria.According to the IADPSG standard,GDM diagnostic rate reached 20.6％.The diagnostic rate of new criteria was increased by 307％ and 199％ compared with the Chinese Obstetrics and Gynaecology (6th edition) and the old ADA standard,respectively.If increasing the number of abnormal glucose values in the IADPS standard to 2 or more,the number of positive cases dropped to 227 people.The diagnostic rate of GDM plummeted to 7.93％,similar with that of the old ADA diagnostic criteria (6.8％).Conclusions The diagnosis rate of GDM was significantly higher using the IADPSG criteria,due to more stringent glucose abnormality recommended by the IADPSG.

Objective To investigate the expressions of Livin and vascular endothelial growth factor (VEGF)in pancreatic carcinoma and their cilinical significances.Methods The expressions of Livin and VEGF proteins were tested by immunohistochemistry in 68 cases of pancreatic carcinomas and 44 cases of adja-cent paracancerous tissues.Results The positive rates of Livin in pancreatic carcinomas and adjacent paracan-cerous tissues were 73.5% and 4.5% respectively,and the difference was statistically significant (χ2 =48.137,P<0.001).The positive rates of VEGF in pancreatic carcinomas and adjacent paracancerous tissues were 69.1% and 13.6% respectively,and the difference was statistically significant (χ2 =29.147,P <0.001).The expressions of Livin and VEGF were related with tumor differentiation (χ2 =6.061,P=0.014;χ2 =6.592,P=0.010),TNMstage (χ2 =4.175,P=0.041;χ2 =9.992,P=0.002),lymph node metasta-sis (χ2 =11.731,P=0.001;χ2 =12.002,P=0.001)and neural invasion (χ2 =9.950,P=0.002;χ2 =7.433,P=0.006).Significantly positive correlation was found between the expressions of Livin and VEGF by using Spearman correlation analysis (r=0.320,P=0.008).Survival analysis showed that the expressions of Livin and VEGF were independent prognostic factors in pancreatic carcinoma.Conclusion Livin and VEGF involve in the development,migration and metastasis of pancreatic carcinoma.Livin may upregulate the expres-sion of VEGF,which may lead to the angiogenesis and migration in pancreatic carcinoma.

Background Drug resistance is the main cause of failure after chemotherapy of retinoblastoma (RB),and how to improve the sensitivity of RB cells to chemotherapic drug become an urgent issue.All trans retinoic acid (ATRA) can inhibit the growth of tumor cells.However,whether ATRA increases the sensitivity of RB cells to chemotherapic drug is unclear.Objective This study aimed to investigate the inhibitory effect of ATRA with vincristine on the proliferation of SO-RB50 cells.Methods SO-RB50 cells were cultured routinely.Different concentrations of ATRA or vincristine were added into the medium for 48 hours for the determination of IC50 by cell counting kit-8 (CCK-8) method.Cultured cells were divided into normal control group,ATRA group,vincristine group and combined drug group.The cells were treated by ATRA or vincristine with the dose of IC50,and the proliferation of the cells was detected every day at the 24-hour interval for 6 consecutive days.The percentage of the cells in different cell cycles was analyzed 72 hours after treatment using flow cytometry.Cell apoptosis rate was detected and calculated 48 hours after treatment by annexin V/propidium iodide (PI) method.Results The IC50 of ATRA was approximately 12.84 μ mol/L,and that of vincristine was 0.11 μg/ml.The growth curve of SO-RB50 cells was gradually raised as the lapse of time,but the curves were relatively low in the ATRA group,vincristine group and combined drug group,with the lowest curve in the combined drug group.The proliferation values of the cells (A450)were 1.078±0.022,0.611 ±0.038,0.596 ±0.031 and 0.483 ±0.030 in 48 hours after treatment,and those in 72 hours were 1.380± 0.021,0.799 ± 0.016,0.668 ± 0.041 and 0.532 ± 0.033 in normal control group,ATRA group,vincristine group and combined drug group,showing significant differences among the groups and various time points (Fgroup =1115.207,P =0.000;Ftime =257.781,P =0.000).The A450 values of the ATRA group,vincristine group and combined drug group were significantly lower than those of normal control group (all at P＜0.05).The percentage of the cells in different cell cycles was changed after 72 hours' treatment and the differences were statistically significant (FG0/G1 =130.565,Fs =57.435;FG2/M =114.290,P＜0.05).Compared with the normal control group,the percentage of G0/G1 phase cells was increased and S phase cells was decreased significantly in ATRA group,the percentage of G0/G1 phase cells was decreased and G2/M phase cells was increased significantly in vincristine group(P＜0.05).The apoptotic rate of the cells was (7.17±0.18) ％,(27.34±1.36) ％,(27.49±2.45) ％ and (34.50±1.84) ％ in normal control group,ATRA group,vincristine group and combined drug group,with a significant difference among the groups (F=147.555,P＜0.05),and the apoptotic rate in the combined drug group was remarkedly lower than that of normal control group,ATRA group and vincristine group (all at P=0.000).Conclusions ATRA can improve the sensitivity of SO-RB50 cells to chemotherapeutic drug.The combined application of ATRA and vincristine enhance the inhibitory effect on the cells probably by regulating cell cycle and inducing apoptosis.

Objective To analyze the correlation between CT characteristics and epidermal growth factor receptor (EGFR)mutations in pulmonary adenocarcinoma.Methods 82 patients (87 lesions)with pulmonary adenocarcinoma were retrospectively collected.All patients were underwent CT examination before operation,and EGFR gene were determined after operation.Results EGFR mutations were found in 44 of 87 lesions (50.57%).The EGFR mutations rate was 50.00% in females and 47.50% in males,there was no statistical difference between genders (P=0.821).The EGFR mutations rate was 46.55% in the right lung and 58.62% in the left lung,while no statistically significant difference was found (P=0.289).Among all the CT characteristics,the mutations rate was 63.89% in spiculated lesions and 60.71% in lesions with pleural indentation,the differences was statistically significant (P<0.05).The mutations rate was 59.25% in lesions containing solid component and 36.36% in pure ground glass opacity lesions,the difference was statistically significant (P=0.011). There were no statistically differences in lobulation,cavitation and lymphadenectasis (P>0.05).The pleural indentation was the highest in sensitivity (77.27%)and negative predictive value (67.74%).The spiculation was the highest in specificity (69.77%)and positive predictive value (63.89%).Conclusion Among all the CT characteristics,pleural indentation,spiculation and the lesion containing solid component are prone to EGFR mutations.

Objective:To explore the effect of mini-clinical evaluation exercise (Mini-CEX) combined with simulation teaching + case-based learning (CBL) in pediatric clinical teaching.Methods:A total of 60 medical students who practiced in Department of Pediatrics, Affiliated Hospital of Jining Medical College from August 2019 to August 2020 were selected as the research objects. According to different teaching methods, they were divided into control group ( n=30) and observation group ( n=30). The control group received traditional teaching, and the observation group received Mini-CEX combined with simulated teaching + CBL. The assessment results, comprehensive ability of medical interview, critical thinking ability and teaching satisfaction of the two groups were compared. SPSS 20.0 was performed for t-test and Chi-square test. Results:The test scores and total scores of the observation group were significantly higher than those of the control group ( P<0.05). After teaching, the Mini-CEX scores, the CTDI-CV (critical thinking disposition inventory Chinese version) scores and the total scores of the two groups increased significantly, and the above scores were significantly higher in the observation group than the control group ( P<0.05). The scores of the teaching program satisfaction questionnaire in the observation group were significantly higher than those in the control group ( P<0.05). Conclusion:The application of Mini-CEX combined with simulation teaching + CBL in pediatric clinical teaching can help to cultivate the medical interview ability, clinical practice ability and critical thinking ability of interns, improve the examination results, and improve the teaching satisfaction.