Objective To investigate the application of statins in secondary prevention of ischemic stroke and transient ischemic attacks (TIA) in different risk groups,and to identify the factors influencing the compliance of statins. Methods Data were prospectively collected on consecutively encountered ischemic stroke or TIA patients admitted to the First Affiliated Hospital of Zhengzhou University from April 2009 to January 2010.All clinical characteristics and possible factors influencing the compliance of statins were collected; the application of statins was investigated at 3-month follow-up.The multivariate Logistic regression analysis was used for the analysis of influence factors of the compliance of statins.Results All 369 patients were collected,52.8％ of cases were prescribed statins for therapy during hospitalization.The application rate of statins in accordance with guidelines in high-risk group,extremely high-risk Ⅱ group and extremely high-risk Ⅰ group was 25.0％ (16/64),44.1％ (30/68) and 71.4％ (135/189),respectively. Logistic regression analysis showed that the statins application during hospitalization was associated with diabetes history ( P =0.032,OR =1.789,95％ CI 1.052-3.043 ) and the presence of carotid vulnerable plaques(P =0.000,OR =5.308,95％ CI 3.340-8.434).The general application rate of statins was 22.3％ (81/363),which was significantly lower than that during hospitalization. The application rate of statins in accordance with guidelines in high-risk group,extremely high-risk Ⅱ group and extremely high-risk Ⅰ group was 9.7％ ( 6/62 ),25.8％ (17/66) and 29.4％ (55/187) respectively.Logistic regression analysis showed that good compliance of statins was associated with discharge instructions on statins application ( P =0.000,OR =34.852,95％ CI 14.673-175.452 ). Conclusions The compliance of statins in secondary prevention of ischemic stroke and TIA is poor,and there is still a large gap between clinical practice and guidelines; Discharge instructions on statins application increase the compliance of statins.

Objective To investigate the predictive value of the modified National Institutes of Health Stroke Scale ( mNIHSS),measured within 9 days after stroke,for the outcome in terms of modified Rankin Scale (mRS) at 6 months after stroke.Methods AII 161 patients with acute anterior circulation ischemic stroke were recruited consecutively from July 2010 until November 2010.The mNIHSS score was assessed within 3 days,4 to 6 days and 7 to 9 days after stroke,and the mRS score at 6 months after stroke was assessed by a neurology resident.Spearman rank correlation and ROC curve were used for statistic analysis.Results One hundred and sixty-one patients were assessed within 3 days,at 4 to 6 days and 7 to 9 days after stroke.Significant Spearman rank correlation coefficients were found between mRS at 6 months and mNIHSS scores within 3 days (rs =0.592,P＜0.01 ),4 to 6 days (rs =0.597,P＜0.01 ) and 7 to 9days (rs =0.595,P＜0.01).At 6 months after stroke,the AUC ranged from 0.789 (95％ CI 0.708-0.856) for measurements within 3 days to 0.792 (95％ CI 0.712-0.857 ) and 0.799 ( 95％ CI 0.721-0.864) for 4 to 6 days and 7 to 9 days,respectively. There was no significant difference for the AUCbetween them.The optimal cut-off values for the prediction of prognosis at 6 months were 8,7 and 6 points of mNIHSS score within 3 days,4 to 6 days and 7 to 9 days,respectively.The negative predictive value gradually increased from 0.847 for assessment within 3 days to 0.867 ( 95％ CI 0.578-0.765 ) for 7 to 9 days,whereas positive predictive value declined from 0.601 for assessment within 3 days to 0.533 for 7 to 9 days.The overall accuracy of predtictions decreased from 0.753 for assessment within 3 days to 0.709 for 7 to 9 days.Conclusions When measured within 9 days,the mNIHSS has a good predictive value for final outcome in terms of mRS at 6 months after stroke.However,the optimal cut-off values for the prediction of prognosis at 6 months are different when early mNIHSS scores were assessed at different periods.

Objective To investigate the effect of the side of cerebral lesion on the outcome in patients with ischemic stroke.Methods A total of 407 consecutive anterior circulation ischemic stroke patients within 14 days after symptom onset were recruited prospectively.The basic data ofthe e,~ISes were collected,such as the National Institutes ofHealth Stroke Scale (NU-ISS)and the side ofcerebral lesion.The modified Rankin Scale(mRS)was used to evaluate the prognosis of the patients at 6 raomhs.Results Of the 407 patients recruited,230 patients (56.5%)Were left hemisphere stroke,177(43.5%)were fight hemisphere stroke.After multivariable logistic recession analysis,the age(odds ratio[OR]1.022,95% confidence interval[CI]1.001-1.043,P=0.040),the side of lesion(OR 1.999.95%CI1.179.3.389.P=0.010),the time from onset to admission(OR1.006,95%(7/1.002-1.010,P=0.007),the outcome of the anterior circulation ischcmic stroke at 6 months aftel"onset.The outcome of the right hemisphere stroke Was significantly worse than that of the left hemisphere stroke.The onset-admission time in patients with right hemisphere stroke(median 12 h,median 39.61 h)was significantly delayed compared to the patients with left hemisphere stroke(median 12 h,median 22.72 h;Z=-2.962,P=0.003).Condusions The outcome of the left hemisphere stroke at 6 months after onset is superior to the right hemisphere stroke,and it mau be associated with the delayed admission.

Objective To study a possible correlation between the duration of reproductive period ( from puberty to menopause) and the prognosis of ischemic stroke. Methods Female in-patients with acute ischemic stroke confirmed by CT/MRI in the Neurology Department of the First Affiliated Hospital of Zhengzhou University from 09/03/2006 to 08/30/2008 were enrolled in this study. The probable risk factors of prognosis were analyzed and recovery was assessed by modified Rankin score (MRS) at 6 months followup. Multivariate Logistic regression was used for statistic analysis. Results 371 female patients were enrolled. The average age was (66. 2 ± 10. 0) years; average menopause age was (48. 5 ± 3.9 ) years and average duration of reproductive period was (33.3 ± 4. 3) years. There is a negative correlation between the duration and MRS (OR =0. 285, 95% CI: 0. 095-0. 850, P =0.024). There is no correlation between menopause age and prognosis of stroke. Conclusions Duration of reproductive period is a predictor for prognosis of ischemic stroke. Patients with longer reproductive period have better prognosis.

Objective To assess the influence of active movement of the affected upper limb on the prognosis for patients after acute cerebral infarction.Methods From 2007 to 2008, 171 consecutive patients with acute cerebral infarction were registered prospectively in this study. Active movement of the hemiplegic upper limb was assessed on the 14th day after stroke onset. Ability in the activities of daily living was assessed using the Barthel index one year later.Results Finger flexion and extension on the 14th day after stroke onset correlated positively with Barthel index scores 1 year later. NIHSS scores at admission, the time interval from onset to admission and stroke history were significant predictors of the prognosis 1 year later.Conclusion Assessing the active movement of the hemiplegic upper limb on the 14th day after stroke has good predictive power for the prognosis of acute cerebral infarction patients.

Objective To investigate the pathogenic spectrum and epidemiological characteristics of acute diarrhea patients in Tianjin.Methods A total of 1 536 stool samples of diarrhea patients were collected from hospitals between 2015 and 2017.Viral nucleic acids were detected by real-time polymerase chain reaction.Selective medium was used to culture bacteria.Drug susceptibility tests were performed by Kirby-Bauer disk diffusion method recommended by the Association for Standardization of Clinical Laboratories.x2 test was used for statistical analysis.Results In the stool samples of 1 536 cases of diarrhea,one enteric bacterium was detected in 109 samples with the positive rate of 7.10％,one enterovirus was detected in 171 samples with the positive rate of 11.13％,mixed infection was detected in 20 samples with positive rate of 1.30％,including 8 samples with enteric bacterium and enterovirus and 12 samples with double enterovirus.The total detection rate of diarrhea cases was 19.53％.Norovirus,vibrio parahaemolyticus,rotavirus,Salmonella,stellate virus and sapovirus ranked the top six in the detection rate.The total detection rate curve of bacteria showed a single peak,mainly in August,while the total detection rate curve of the virus showed a double peak,which was from May to June and from November to December.The positive rate of bacteria in patients aged over 30 years old was 9.82％ (75/764),while that in those aged less than 30 years old was 5.44％ (42/772).The difference was statistically significant (x2 =10.451,P ＜ 0.01).The positive rate of viral pathogen in patients aged no less than 25 years old was 10.02％ (91/908),while that in those aged less than 25 years old was 17.83％ (112/628).The difference was statistically significant (x2 =19.755,P ＜ 0.01).Salmonella,Shigella and vibrio parahaemolyticus were resistant to ampicillin in varying degrees.Conclusions The positive rate curves of bacteria and virus are obviously different,showing a trend of "bacterial single peak and viral double peak".Bacteria mainly infect people aged over 30 years old,while the virus mainly infects people under 25 years old.The main pathogens of diarrhea are norovirus,vibrio parahaemolyticus and rotavirus.

Induced sputum testing is a non-invasive test that reflects the nature and extent of airway inflammation and plays an important role in the diagnosis, treatment and prognosis of chronic airway diseases. This article outlines the development history of induced sputum technology, introduces the principle and operation of induced sputum technology, evaluates its safety, summarizes the three main test components, elaborates the role of this technology in various chronic airway diseases, such as reflecting the type of airway inflammation, predicting the efficacy of medication, and combining it with transcriptomics to study disease mechanisms, and briefly summarizes its innovations and makes a vision for the future.

OBJECTIVE：To s ystematically review the economics of osimertinib for advanced non-small cell lung cancer （NSCLC），and to provide the reference for clinical application and healthcare decision makers. METHODS ：Retrieved from PubMed，Embase，the Cochrane L ibrary，Health Technology Assessment ，CNKI，Wanfang database ，VIP，CBM，etc.， pharmacoeconomic studies on osimertinib in the treatment of advanced NSCLC were collected from the inception to Apr. 2020. After screening and extracting relevant data ，the quality of the included studies was evaluated by using the Quality of Health Economics Studies （QHES），and the economic research results of the included literatures were systematically evaluated by using descriptive analysis method. RESULTS & CONCLUSIONS ：A total of 10 studies from 7 different countries were included ；QHES scores of the included literatures were 73-93，with an average of 86.8，and the quality of the researches was generally high. All the 10 studies were cost-effectiveness analysis ，including 6 first-line treatment ，4 second-line treatment. Six studies reported the cost discount rate ；only one study used the cost of osimertinib after price reduction for evaluation and analysis. Compared with other epidermal growth factor receptor-tyrosine kinase inhibitors （EGFR-TKI），six studies from different countries showed that osimertinib as the first-line treatment drug had no cost-effectiveness advantage ；cost-effectiveness of second-line treatment of osimertinib was controversial ，compared to chemotherapy. For advanced NSCLC patients ，the second-line treatment of osimertinib after the national centralized negotiation of price reduction has a more cost-effectiveness advantage in China ’s medical service system，while the first-line treatment of osimertinib before price reduction does not have this advantage compared with other EGFR-TKI drugs.

Objective To investigate the clinical and epidemiological characteristics of 135 confirmed cases of COVID-19 in Tianjin. Methods The clinical and epidemiological data of 135 cases of COVID-19 in Tianjin were collected, and the data were analyzed with descriptive method. The factors influencing the severity of the illness were analyzed. Results Among the 135 COVID-19 cases, 72 were males and 63 were females, the age of the cases was (48.62±16.83) years, and the case fatality rate was 2.22%. Local transmission caused 74.81% of the cases. A total of 33 clusters occurred, involving 85.92% of all COVID-19 cases. The median of the incubation period of COVID-19 was 6.50 days, the average generation interval was 5 days, and the household secondary transmission rate was 20.46%. Fever was the main symptom (78.63%), followed by cough (56.48%). Multivariate regression analysis indicated that age ( OR =1.038, 95% CI : 1.010-1.167) and the number of chronic underlying diseases ( OR =1.709, 95% CI : 1.052-2.777) were the risk factors of severe illness. Conclusions Fever was the main symptom at the early phase of COVID-19 in Tianjin, and the local cluster cases accounted for high proportion in confirmed COVID-19 cases reported in Tianjin. Severe illness was prone to occur in people with old age and multi underlying diseases. Strict isolation of close contacts and intensive care of high-risk groups are the main measures to reduce the morbidity and case fatality of COVID-19.

AIM: To observe the effect of fudosteine on induced sputum cell components and lung function in patients with stable neutrophil-dominated COPD. METHODS: From October 2019 to October 2022, 53 patients with stable COPD were selected and divided into fudosteine group and placebo group. The placebo group was treated with routine treatment, and the fudosteine group was treated with fudosteine on the basis of routine treatment. The two groups were treated for 6 months. The clinical symptoms [Saint George's Respiratory Questionnaire (SGRQ), COPD Assessment Test (CAT) and Modified British Medical Research Council Dyspnea scale (MMRC), Breathlessness, Cough, and Sputum Scale (BCSS)], lung function index, induced sputum cytology analysis and other related examination results were recorded in detail before and after treatment. RESULTS: (1) Compared with the baseline, the forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and the ratio of FEV1 to FVC (FEV1/FVC) of the two groups were improved after treatment, and the differences were statistically significant (P<0.05). However, after treatment, there was no significant difference in pulmonary function between the two groups except for the percentage of carbon monoxide diffusion in the predicted value (DLCO%pre) (DLCO%pre in the fudosteine group was higher than that in the placebo group). (2) After treatment, the total number of induced sputum cells and neutrophil counts in the fudosteine group were lower than those in the placebo group. Compared with the number of cells in each component at baseline, the total number of induced sputum cells and neutrophil count in the fudosteine group were significantly lower (P< 0.05). CONCLUSION: Fudosteine treatment in patients with stable neutrophil-dominated COPD can improve lung function, reduce the total number of induced sputum cells and the total number of neutrophils, thereby improving airway inflammation.