Objective To investigate the relationship between blood uric acid and ischemic stroke in the elderly with hypertension.Methods Totally 100 elderly patients with hypertension were divided into study group (blood uric acid≥417 μmol/L,n=49) and control group (blood uric acid＜417 μmol/L,n=51).The relationship between the level of uric acid and ischemic stroke were analyzed in two groups.Results There were not significant differences in age,body mass index (BMI),smoking and drinking,diabetes(P＞0.05)between the groups,but there were differences in uric acid levels,smoking history,and stroke incidence at admission into hospital(P＜0.05).In study group,uric acid and stroke severity score were significantly related in different times(P＜0.05).After adjusting the related risk factors,logistic multiple regression analysis showed that the odd ratio of ischemic stroke was greater in study group than in control group (β=1.059,OR =2.884,P=0.03).

DEFENCATH?(taurolidine/heparin)is the first hemodialysis central venous catheter lock solution approved by the FDA.Taurolidine has broad-spectrum antibacterial activity against Gram-negative and Gram-positive bacterium and fungal species and anti-endotoxin and anti-exotoxin activities.Moreover,microbial resistance has not been observed,and the safety is good.Low-dose heparin is effective in anticoagulation and has a low risk of bleeding,and the two complement each other,clinical studies have reported that the catheter lock solution(CLS)effectively reduces the incidence of catheter-related blood stream infection(CRBSI),with good safety and significant clinical value.It will bring benefits to renal failure patients undergoing maintenance hemodialysis.

AIM:This study investigates the apoptotic and autophagic effects of atractylodin on lung cancer cells,elucidating the underlying molecular mechanisms.METHODS:Non-small cell lung cancer(NSCLC)A549 and H460 cells,in addition to non-cancerous HBE cells,were cultured in vitro.The effects of atractylodin at various concen-trations on cell viability were assessed using CCK-8 assay.Apoptotic effects were evaluated through Hoechst staining and flow cytometry,while Western blot analysis was performed to detect changes in protein expressions associated with apopto-sis and autophagy,including P62,beclin-1,microtubule-associated protein 1 light chain 3(LC3),Kelch-like epichloro-hydrin(ECH)-associated protein-1(Keap-1),nuclear factor E2-related factor 2(Nrf2),heme oxygenase-1(HO-1),and NAD(P)H:quinone oxidoreductase 1(NQO1).Autophagic flux was further analyzed using acridine orange(AO)stain-ing,and immunofluorescence for LC3 and Nrf2.Additionally,autophagy inhibition experiments were conducted using chloroquine(CQ),followed by analyses of autophagy and apoptosis.Reactive oxygen species(ROS)levels were quanti-fied using DCFH-DA.RESULTS:Treatment with atractylodin significantly reduced the viability of A549 and H460 lung cancer cells,promoting apoptosis and inducing autophagy.This was evidenced by an increase in acidic autophagic vesi-cles,upregulation of LC3 and beclin-1,and downregulation of P62.Inhibition of autophagy by chloroquine reversed atrac-tylodin-induced apoptosis.Moreover,atractylodin heightened ROS production,inhibited Keap-1,and stimulated the ex-pression of Nrf2,HO-1 and NQO1.CONCLUSION:Atractylodin effectively inhibits the proliferation of lung cancer cells by inducing apoptosis and autophagy.These effects are mediated through the modulation of the ROS/Nrf2/HO-1 sig-naling pathway,underscoring its potential as a therapeutic agent in lung cancer treatment.

Objective To investigate the risk factors for hemorrhagic transformation(HT)of different subtypes of acute cerebral infarction in elderly patients.Methods A total of 415 elderly hospitalized patients aged ≥60 years with acute cerebral infarction were selected from a hospital in Changsha from January 2014 to December 2016 for the study.Among them,56 had hemorrhagic transformation(observation group)and 359 had no hemorrhage transformation(control group).The general demographic information,past medical history,physical examination and laboratory indicators,cranial CT/MRI examination,admission treatment and the National Institutes of Health Stroke Scale (NIHSS) score on admission were analyzed and compared between two different subtypes.Multivariate Logistic regression was used to analyze the influencing factors for HT of different subtypes of acute cerebral infarction in elderly patients.Results The incidence of HT was 26.61％(29/109)for largeartery atherothrombosis,47.50％ (19/40)for cardiac embolism and 3.12％ (8/257)for small-artery occlusion with a statistically significant differences among the three subtypes (x2 =77.923,P =0.000).The incidence of HT was 0％ (0/7)for unknown type,and 0％ (0/2)for other types.Multivariate logistic regression showed that female was the protective factor(OR =0.171,95％ CI:0.037-0.790),but high level of glycated haemoglobin A1c(HbA1c)and large infarct size were the risk factors(OR =5.949 and 20.619,95 ％CI:1.199-29.509 and 2.869-148.207)for HT due to largeartery atherothrombosis.A high score of NIHSS and high level of matrix metalloproteinase-9 (MMP-9)were the risk factors for HT due to cardioembolism(OR =20.254 and 91.200,95％CI:1.605-255.625 and 4.044-2056.710,respectively).A high level of homocysteine(Hcy) and large infarct size were the risk factors for HT due to small-artery occlusion(OR =10.231 and 15.251,95 ％ CI:1.202-87.108 and 3.371-68.995,respectively).Conclusions The incidence of HT due to cardioembolism is the highest.Influencing factors for HT due to different subtypes of acute cerebral infarction are different in the elderly.It is important for clinicians to know that gender,HbA1c levels and infarct size are associated with HT due to large-artery atherothrombosis,NIHSS score on admission and MMP-9 concentration associated with HT due to cardioembolism,and Hcy level and infarct size associated with HT due to small-artery occlusion.

Objective To explore the correlations between self-management and quality of life in elderly patients with chronic heart failure (CHF) in Xinjiang Uygur Autonomous Region, so as to provide effective measures to improve quality of life of them. Methods A total of 750 elderly patients with CHF were selected as the research subjects by convenience sampling method from 5 regions of Xinjiang Uygur Autonomous Region from February to August 2015. General Data Questionnaire, Heart Failure Self-Management Scale and Minnesota Living with Heart Failure Questionnaire (MLHFQ) were applied in the investigation to analyze the correlation between self-management and quality of life. Results A total of 750 questionnaires were distributed and 704 valid questionnaires were collected, with an effective recovery rate of 94.1%. The total score of self-management and MLHFQ in the 704 CHF patients was (47.6±11.1) and (57.1±18.5) respectively. Pearson correlation analysis showed that patients' self-management was positively correlated with quality of life (r=0.114, P＜ 0.05). Conclusions The overall level of self-management and quality of life in elderly patients with chronic heart failure in Xinjiang Region is mid-to-low. Nursing intervention can give full play to the initiative of self-management behavior in accordance with patients' cultural background, so as to improve their quality of life.

Objective:To evaluate the impact of the Japanese encephalitis vaccine included in an expanded immunization program on the reported incidence rate of Japanese encephalitis in Gansu province.Methods:Information on the reported incidence rate of Japanese encephalitis in Gansu province from 1987 to 2019 was collected through the National Population Health Science Data Center and the China Disease Prevention and Control Information System. In addition, the trend of Japanese encephalitis reported incidence rate in Gansu province before and after the inclusion of the Japanese encephalitis vaccine in the expanded immunization program was analyzed using an interrupted time-series design.Results:The annual reported incidence rate of Japanese encephalitis in Gansu province from 1987 to 2019 was 0.448/per 100 000. However, after the inclusion of the Japanese encephalitis vaccine in the expanded immunization program in Gansu province in 2008, the amount of change in the level of Japanese encephalitis reported incidence rate was -2.223/per 100 000 ( t=-2.90, P=0.007), the amount of change in the slope of Japanese encephalitis reported incidence rate was 0.082 ( t=2.87, P=0.008) with the slope of Japanese encephalitis reported incidence rate as 0.071 ( β1+ β3=0.071). Conclusions:The Japanese encephalitis vaccine has achieved good prevention and control effects in Gansu province in the short term after its inclusion in the expanded immunization program, but outbreaks of Japanese encephalitis have still occurred. Therefore, in the future, Gansu province should promptly adjust the immunization strategy of the Japanese encephalitis vaccine, and strengthen the vaccination of the adult population, especially the rural adult population in the southeastern region of Gansu province, based on the continued focus on the works on Japanese encephalitis vaccination for children and adolescents.

Objective    To explore the key points and difficulties of intraoperative frozen section diagnosis of pulmonary diseases. Methods    The intraoperative frozen section and postoperative paraffin section results of pulmonary nodule patients in Beijing Chaoyang Hospital, Capital Medical University from January 2021 to January 2022 were collected. The main causes of misdiagnosis in frozen section diagnosis were analyzed, and the main points of diagnosis and differential diagnosis were summarized. Results    According to the inclusion criteria, a total of 1 263 frozen section diagnosis results of 1 178 patients were included in the study, including 475 males and 703 females, with an average age of 58.7 (23-86) years. In 1 263 frozen section diagnosis results, the correct diagnosis rate was 95.65%, and the misdiagnosis rate was 4.35%. There were 55 misdiagnoses, including 18 (3.44%) invasive adenocarcinoma, 17 (5.82%) adenocarcinoma in situ, 7 (35.00%) mucinous adenocarcinoma, 4 (2.09%) minimally invasive adenocarcinoma, 3 (100.00%) IgG4 related diseases, 2 (66.67%) mucinous adenocarcinoma in situ, 1 (16.67%) atypical adenomatous hyperplasia, 1 (14.29%) sclerosing pulmonary cell tumor, 1 (33.33%) bronchiolar adenoma, and 1 (100.00%) papillary adenoma. Conclusion    Intraoperative frozen section diagnosis still has its limitations. Clinicians need to make a comprehensive judgment based on imaging examination and clinical experience.