ObjectiveTo investigate the effects of hippocampal CA3 dopaminergic system in acquisition and consolidation of Pavlovian fear conditioning,and expression of GluR1 and NR2B in medial prefrontal cortex (mPFC),CA1 and basolateral amygdala (BLA) after fear conditioning training.MethodsBilateral injection 6-OHDA into hippocampal CA3 to lesion dopaminergic fibers 2 weeks before fear conditioning training.The change of GluR1 and NR2B were analyzed by western blot after training.ResultsCompared with the saline group ( (66.44 ± 16.58)％ ),there were significant decreases ( (39.24 ± 12.83)％,(31.15 ±6.51 )％ ) in the consolidation of short- and long- term fear memory (P ＜ 0.05 ) but not the acquisition ( ( 65.58 ± 5.33 ) ％,P ＞ 0.05).The expression of GluR1 protein was significantly increased in BLA (P＜0.01 ) but not the mPFC or hippocampal CA1 (P＞1.05 ),compared with the saline group.In addition,the expression of NR2B protein was significantly increased in the mPFC and decreased in BLA (P＜0.01) but not the hippocampal CA1 (P＞0.05),compared with the saline group.ConclusionDown-regulation of dopaminergic system in hippocampal CA3 may impair the consolidation but not the acquisition of fear memory,and also regulate the expression of GluR1,NR2B protein related to fear memory in other brain regions.

Objective To explore ways of enhancing the therapeutic level of the neurology department and reducing the economic burdens of patients. Methods Relevant materials were collected by means of evidence based medicine to optimize therapeutic schedules, with cerebral infarction being the pitching in point. Results Prior to the adoption of evidence based medicine, the average length of stay, the effective rate of treatment and the expenses for single entity diseases were respectively 17.83?13.44, 89.91% and 4 550.70 yuan, whereas after the adoption of evidence based medicine, they were respectively 15.38?11.37, 94.16% and 3 942.88 yuan. Conclusion Evidence based management is a means of scientific management. Its application in the department of neurology has produced a marked effect and it is worthy to be spread.

Hepatocellular carcinoma(HCC)is one of the most common malignancies worldwide.Due to the difficulty of diagnosis in the early stage of HCC, most HCCs are diagnosed in intermediate-advanced stage.Moreover, the high invasion, metastasis and recurrence rate of HCC result in the high mortality of HCC.MicroRNAs(miRNAs) are a class of highly conserved, endogenous, small, non-coding ,single stranded RNA with the length of 22 nucleotides.There are plentiful of miRNAs in liver.MiRNAs not only can regulate the growth and development of liver, but also are closely related to the formation of HCC.In the process of HCC formation, miRNAs could function as oncogenes or tumor suppressor genes to regulate multiple biological processes related to HCC, including cell differentiation,proliferation,tumorigenesis,angiogenesis,invasion,and metastasis.With the intensive study of molecular mechanisms of miRNAs in the process of HCC formation, increasingly studies have revealed that miRNAs could become sensitive biomarkers and effective therapeutic targets for HCC.

AIM To study the effects of Biejiajian Pills (Colla Carapacis Trionycis,Asini Corii Colla,Nidus Vespae,etc.) on NF-κB,p65,p50 and IκB in NF-κB signaling pathway and target gene expression in HSC-T6 cells of rats.METHODS HSC-T6 cells were cultured with Biejiajian Pills drug serum for 24 hours,the expressions of p65,p50,VEGF and TIMP-1 mRNA were determined by qPCR;the expression of p65 was measured by immunofluorescence;the expressions of IκBα,IκBβ and α-SMA were determined by Western blot.RESULTS The Biejiajian Pills middle-,high-dose and positive control groups showed significantly lower expressions of p65,VEGF and TIMP-1 mRNA as compared with the blank control group and negative control group,the expressions of p50 mRNA among various groups showed no significant differences.But immunofluorescence showed that the expression of p65 in cytoplasm was decreased.Meanwhile,Biejiajian Pills showed significantly higher IκBα protein expression and obvious down-regulation of α-SMA expression in a dose-dependent manner,but had no significant influence on the expression of IκBβ.CONCLUSION Biejiajian Pills' therapeutic effects on hepatic fibrosis may be related to influencing NF-κB signaling pathway and inhibiting the expression of down-stream target gene.

Objective To investigate the epididymal sperm ultrastructure after vasectomy. Methods During the operation of vasovasostomy (38 cases, test group) and vasectomy (13 cases,control group,group A) the proximal vas deferens fluids were collected.The epididymal sperm morphology in the proximal vas deferens fluids was observed using optical and electronic microscopes.Data were analyzed by SPSS program. Results The data from group A showed that there was no significant difference between left and right side in the percentage of normal sperm morphology.The results from both optical and electronic microscopes showed that there was a significant difference in the percentage of normal sperm morphology (a),abnormal sperm head (b),sperm with neck defect (c) and sperm with tail defect (d) between group A and group B(5 years after vasectomy). (electronic microscopes:(a):(40.28?11.53)% vs (16.80?7.93)%,(6.29? 4.57 )%,( 4.63? 5.06 )%; (b):(35.00?14.18)% vs (59.05?14.44)%,(63.43?15.23)%,(82.05? 16.71 )%;(c):(20.83? 6.40 )% vs (13.60?6.78)%,( 14.71? 6.82)%,(9.00?7.18)%;(d):(3.89?4.44)% vs (10.55?11.73)%,(15.57?9.81)%,(4.32?7.65)%. optical microscopes:(a):(49.12?20.55)% vs (19.95?15.42)%,(10.00?9.50)%,(5.84?9.63)%; (b):(35.00?14.55)% vs (22.55?16.24)%,(14.71?15.78)%,(10.68?18.65)%; (d):(15.80?9.55)% vs (57.50?24.74)%,(75.29?23.90)%,(78.21?30.33)%.There existed multi-cell organ and multi-form abnormalities in the inner structures of sperm heads,necks and tails. Conclusions The epididymal sperm defect (including head, neck and tail) after vasectomy was demonstrated in the inner cell organs.The longer after vasectomy, the higher percentage of sperm with abnormality was found.

Objective:To investigate the risk factors of non-obstructive gastric retention before endoscopic retrograde cholangiopancreatography (ERCP) in patients with biliopancreatic disease.Methods:The matched case-control study included 109 patients with non-obstructive gastric retention before ERCP as the case group, and 218 patients without gastric retention as the control group. The patients′ medical records including comorbidities, preoperative medication and laboratory indicators were compared between the two groups. Multivariate conditional logistic regression models were subsequently used to determine the risk factors for non-obstructive gastric retention before ERCP.Results:Logistic regression revealed that the jaundice ( OR=12.359, P<0.001), opiates use ( OR=3.009, P=0.001), somatostatin use ( OR=2.445, P=0.033), fasting hyperglycemia ( OR=1.513, P=0.045), hypokalemia ( OR=4.634, P=0.001) and hyponatremia ( OR=1.805, P=0.023) were independent risk factors for non-obstructive gastric retention before ERCP in patients with biliopancreatic disease. Conclusion:Except for gastrointestinal obstruction, jaundice, opiates use, somatostatin use, fasting hyperglycemia, hypokalemia and hyponatremia are all risk factors for gastric retention in patients with biliopancreatic disease. Comprehensive evaluation and early intervention for patients showing these risk factors are needed.

Objective:To investigate the association among presenteeism, emotional intelligence, and professional identity among higher vocational nursing interns and the mediating role of emotional intelligence between presenteeism and professional identity, and to provide a basis for clinical intervention.Methods:A questionnaire survey was conducted among 308 higher vocational nursing interns using the general information questionnaire, Wong Law emotional intelligence scale (WLEIS), the Stanford presenteeism scale-6 (SPS-6), and professional identity questionnaire for nurse students (PIQNS). SPSS 22.0 was used for related analyses including descriptive analysis and Pearson correlation analysis, and the mediating role of emotional intelligence was examined based on the Bootstrap method.Results:The higher vocational nursing interns had a total score of (80.57±15.52) for emotional intelligence, (15.91±4.40) for presenteeism, and (64.93±12.83) for professional identity. The Pearson correlation analysis showed that emotional intelligence was positively correlated with professional identity ( r=0.712, P<0.001), and there was a negative correlation between any two of presenteeism, emotional intelligence, and professional identity ( r=-0.282 to -0.256, all P<0.001). The analysis of mediating effect showed that emotional intelligence played a partial mediating role between presenteeism and professional identity and had a mediating effect of -0.512, accounting for 62.14% of the total effect. Conclusions:Emotional intelligence is a mediating factor between presenteeism and professional identity among higher vocational nursing interns, and emotional intelligence can improve their presenteeism and professional identity.

Background/Aims: Existing hepatocellular carcinoma (HCC) prediction models are derived mainly from pretreatment or early on-treatment parameters. We reassessed the dynamic changes in the performance of 17 HCC models in patients with chronic hepatitis B (CHB) during long-term antiviral therapy (AVT). Methods: Among 987 CHB patients administered long-term entecavir therapy, 660 patients had 8 years of follow-up data. Model scores were calculated using on-treatment values at 2.5, 3, 3.5, 4, 4.5, and 5 years of AVT to predict threeyear HCC occurrence. Model performance was assessed with the area under the receiver operating curve (AUROC). The original model cutoffs to distinguish different levels of HCC risk were evaluated by the log-rank test. Results: The AUROCs of the 17 HCC models varied from 0.51 to 0.78 when using on-treatment scores from years 2.5 to 5. Models with a cirrhosis variable showed numerically higher AUROCs (pooled at 0.65–0.73 for treated, untreated, or mixed treatment models) than models without (treated or mixed models: 0.61–0.68; untreated models: 0.51–0.59). Stratification into low, intermediate, and high-risk levels using the original cutoff values could no longer reflect the true HCC incidence using scores after 3.5 years of AVT for models without cirrhosis and after 4 years of AVT for models with cirrhosis. Conclusions The performance of existing HCC prediction models, especially models without the cirrhosis variable, decreased in CHB patients on long-term AVT. The optimization of existing models or the development of novel models for better HCC prediction during long-term AVT is warranted.

Objective: To investigate the methods for qualitative pathological assessment of dynamic changes in liver fibrosis/cirrhosis after antiviral therapy in patients with chronic hepatitis B (CHB), since antiviral therapy can partially reverse liver fibrosis and cirrhosis caused by hepatitis B and semi-quantitative, rather than qualitative, pathological assessment is often used for the research on liver fibrosis regression. Methods: Previously untreated CHB patients with liver fibrosis and cirrhosis were enrolled, and liver biopsy was performed before treatment and at 78 weeks after the antiviral therapy based on entecavir. The follow-up assessment was performed once every half a year. Based on the proportion of different types of fibrous septum, we put forward the new qualitative criteria called P-I-R classification (predominantly progressive, predominantly regressive, and indeterminate) for evaluating dynamic changes in liver fibrosis. This classification or Ishak fibrosis stage was used to evaluate the change in liver fibrosis after treatment and Ishak liver inflammation score was used to evaluate the change in liver inflammation after treatment. Results: A total of 112 CHB patients who underwent liver biopsy before and after treatment were enrolled, and among these patients, 71 with an Ishak stage of ≥3 and qualified results of live biopsy were included in the final analysis. Based on the P-I-R classification, 58% (41/71) were classified as predominantly progressive, 29% (21/71) were classified as indeterminate, and 13% (9/71) were classified as predominantly regressive; there were no significant differences between the three groups in alanine aminotransferase, aspartate aminotransferase, albumin, HBeAg positive rate, HBV DNA, and liver stiffness (P < 0.05). After treatment, the proportion of predominantly progressive, indeterminate, or predominantly regressive patients changed to 11% (8/71), 11% (8/71), and 78% (55/71), respectively. Among the 35 patients who had no change in Ishak stage after treatment, 72% (25/35) were classified as predominantly regressive and had certain reductions in the Laennec score, percentage of collagen area, and liver stiffness. Conclusion This new P-I-R classification can be used to assess the dynamic changes in liver fibrosis after antiviral therapy in CHB patients.