Objective To investigate the relationship between the education level of staff members and the risk factors for stroke in a university in China.Methods From January 2014 to May 2014,a total of 659 staff members in a university in China were collected with a cluster sampling method.The basic information and the relevant data of the risk factors for stroke of the subjects were collected and recorded completely.The subjects were divided into 3 groups according to their education levels from low to high.The relationship between their education levels and the risk factors for stroke were analyzed.Results A total of 633 staff members were enrolled,including 426 men (67.3％) and 207 women (32.7％).The low,middle and high education level groups were 188 (29.7％),193 (30.5％),and 252 (39.8％),respectively.With the increase of the education level,the prevalence of hypertension,dyslipidemia,and stroke decreased,and the awareness rates of hypertension and dyslipidemia and the treatment rate increased.The proportion of drink-ing increased in the male group and that decreased in the female group.The proportion of regular exercise increased in the female group.Multivariate logistic regression analysis showed that after adjusting for age,per capita income,employment,drinking,smoking,regular exercise and other factors,compared with the high education level group,the risk of hypertension increased 2.55 times in the low education level group in males (odds ratio [OR] 2.55,95％ confidence interval [CI] 1.42-4.58;P =0.002);the prevalence risk of dyslipidemia increased 2.25 (OR 2.25,95％ CI 1.31-3.86;P =0.003) and 2.02 times in the low and middle education level groups (OR 2.02,95％ CI 1.23-3.33;P =0.006) respectively;the risk of smoking decreased 42％ in the middle education level group (OR 0.58,95％ CI 0.36-0.93;P =0.024);the risk of hypertension increased 6.27 times in the low level education group in women (OR 6.27,95％ CI 1.59-24.74;P =0.009);the risk of dyslipidemia increased 3.91 times in the middle education level group (OR 3.91,95％ CI 1.70-8.98;P =0.001);the risk of drinking increased 3.49 times in the low level education group (OR 3.49,95％ CI 1.12-10.92;P =0.032),and the weekly regular exercise decreased 65％ in the low level education group (OR0.35,95％ CI0.15-0.82;P =0.016).Conclusion The incidence of the risk factors for stroke in the low education level group was higher than the popuhtions of high or middle education level.

Objective To explore the clinical value of microsurgery in the treatment of lateral ventricle tumors. Methods Microsurgery was conducted in 14 cases of lateral ventricle trmors in this department from May 1996 to August 2002. According to the location of tumors, we selected the approach close to the focus, protected the surrounding nerve tissue and the deep venous system, and resected the tumor in fractions. Results Among the 14 cases, 13 (92.9%) received total resection and 1 (7.1%) subtotal resection. A total of 11 cases of complications occurred postoperatively, including 3 cases of intracranial infection, 2 cases of hemiparalysis, 1 case of hydrocephalus, 3 cases of frontal lobe mental symptoms, 1 case of intraventricular hematoma and 1 case of nominal aphasia. Except for 1 case of hemiparalysis who were not able to resume the ability to take care of his own basic needs, the remaining 10 cases obtained full recovery. Follow-up in 9 cases for 6～60 months (mean, 29 months) showed 2 cases of recurrence of astrocytoma. Conclusions Microsurgery offers good visualization, minimal invasion and a high total resection rate for tumor.

Objective To investigate the clinical application value of stathmin, p16 and Ki-67 in the cervical intractable cases. Methods Immunohistochemical method was used to detect the expressions of stathmin, p16 and Ki-67 in surgical specimens of 288 cervical intractable cases, including 30 cases of cervical benign changes, 70 cases of cervical intraepithelial neoplasia (CIN)Ⅰ, 78 cases of CINⅡ, 85 cases of CINⅢand 25 cases of squamous cell carcinoma (SCC, as control group). The application value of stathmin, p16 and Ki-67 in the cervical cases were analyzed. Results The positive expression rates of Ki-67 of cervical benign changes and CINⅠwere 20.0 % (6/30) and 54.3 % (38/70) (χ2 = 3.29, P> 0.05). The expression rates of Ki-67 in CINⅡ, CINⅢ and SCC were all 100.0 %, and compared with the cervix benign changes, the differences were statistically significant (χ2= 112, P< 0.05). The expression rates of p16 in cervical benign changes and CINⅠwere 6.7 % (2/30) and 91.4 % (64/70), and there was significantly statistical difference (χ2=50.64, P<0.05). However, the expression rates of p16 in CINⅡ, CINⅢand SCC were all 100.0%, and compared with the cervix benign changes, the differences were statistically significant (χ2= 7.18, P< 0.01). The expression rates of stathmin in cervical benign changes, CINⅠ, CIN Ⅱ, CINⅢ and SCC were 3.3 %(1/30), 5.7 % (4/70), 23.1 % (18/78), 77.0 % (67/87) and 100.0 % (25/25), respectively, and there was no statistic difference in cervical benign changes, CINⅠand CINⅡ (χ2=0.68, P>0.05), but the expression rates in CINⅢ and SCC were higher than those in cervical benign change, CINⅠand CIN Ⅱ(P< 0.01). The positive expressions of stathmin, p16 and Ki-67 in each group of CIN were positively correlated (r= 0.412, P< 0.05). Conclusions Combined detection of p16 and Ki-67 can assist in the differential diagnosis of cervical intractable cases, and provide objective indicators for the classification and accurate diagnosis of CIN. Combined detection of p16 and stathmin may help to identify high-grade, low-grade CIN and cervix benign changes for the reduction of over-treatment.

Objective To investigate the clinical features of VAE and to assess the predictive value of VAE cough. Methods We retrospectively reviewed the medical records of 461 consecutive patients who underwent DBS surgery at Beijing Tiantan Hospital. Patients with VAE manifestation were enrolled in this study. The clinical features, operative courses, post-operative conditions and treatment of these patients were analyzed. The correlation between intraoperative tremor intensity , cough duration and prognosis was also investigated. Results Among 461 patients,10 (2.2%) were found with evidence of VAE, including cough, dyspnea, decreased O2 saturation (SO2). Statistical analyses revealed that severe cough was associated with greater age , a longer coughing time, more intensive tremor, greater influence, and a longer length of stay (P < 0.05, rspectively). Conclusions Early recognition and prompt management of VAE are essential to prevent unfavorable consequences. Cough intensity might be a useful tool for evaluating VAE and its prognosis , which is helpful for neurosurgeons to decide on the subsequent maneuvers.

Objective To investigate the association between electrode fusion error and improve-ment of depression during subthalamic nucleus-deep brain stimulation(STN-DBS)surgery for Parkinson's disease(PD).Methods A prospective trial was conducted on 240 PD patients under-going STN-DBS treatment in our hospital from January 2020 to December 2022.According to their clinical outcomes,they were divided into effective group(211 cases)and ineffective group(29 cases).The electrode fusion error was compared among the patients with different efficacy,psychological status,and cognitive status to analyze the correlation of electrode fusion error dur-ing STN-DBS surgery with improvement of depression and cognition.Results There were no sig-nificant differences between the effective group and ineffective group in terms of gender,age,body mass index,hypertension,diabetes,hyperlipidemia,disease duration,or preoperative MMSE and PDQ-39 scores(P＞0.05).STN-DBS treatment resulted in obviously improved clinical symptoms such as tremor,rigidity and bradykinesia,and higher UPDRSⅢ score when compared with the re-sults of preoperative impact test(P＜0.01).Before treatment,no statistical differences were ob-served in the scores of SAS,SDS,MoCA,MMSE,Alzheimer's disease assessment scale cognitive subscale(ADAS-Cog)or Chinese medicine syndrome change overall impression scale(CGIC-S)between the effective and ineffective groups(P＞0.05).After treatment,the scores of SAS,SDS,CGIC-S and ADAS-Cog were declined(P＜0.01),and these four scores was notably lower in the effective than the ineffective groups(P＜0.01).The scores of MoCA and MMSE were significant-ly elevated in both groups after surgery(P＜0.01),and the scores were higher in the effective group than the ineffective group(P＜0.01).The target coordinate deviation on the left and right was significantly higher in the patients with SDS≥53 and SAS≥50 than those of SDS＜53 and SAS＜50(P＜0.01).The target coordinate deviation on the left and right of the patients with MoCA＜26,MMSE＜27,ADAS-Cog≥36 and CGIC-S＞1 was statistically higher than that of the patients with MoCA≥ 26,MMSE≥27,ADAS-Cog＜36 and CGIC-S≤1(P＜0.01).Correlation analysis displayed that the bilateral fusion error of patients was negatively correlated with MoCA and MMSE scores(r=-0.678,P＜0.01;r=-0.653,P＜0.01;r=-0.448,P＜0.01;r=-0.704,P＜0.01),and positively with ADAS-Cog,CGIC-S,SDS and SAS scores(r=0.586,P＜0.01;r=0.501,P＜0.01;r=0.572,P＜0.01;r=0.601,P＜0.01;r=0.742,P＜0.01;r=0.667,P＜0.01;r=0.463,P＜0.01;r=0.381,P＜0.01).Conclusion In PD treatment,electrode fusion error during STN-DBS is significantly correlated with improvement of depression and cognitive score,which can be used as one of the important evidence for predicting clinical effectiveness.In the future,according to the intraoperative error,auxiliary treatment can be carried out timely and effectively to guide further clinical treatment.

ObjectiveTo explore the regulatory effect and mechanism of Danggui Shaoyaosan combined with Yinchenhaotang on lipid metabolism in the mouse model of type 2 diabetes mellitus （T2DM） complicated with metabolic dysfunction-associated steatotic liver disease （MASLD） based on network pharmacology and animal experiments. MethodsTwenty-four MKR transgenic diabetic mice were randomly allocated into 4 groups： Model， low-dose （12.6 g·kg^-1） Chinese medicine （concentrated decoction of Danggui Shaoyaosan combined with Yinchenhaotang）， high-dose （25.2 g·kg^-1） Chinese medicine， and Western medicine （metformin， 0.065 g·kg^-1）. Six FVB mice were used as the normal group. All groups were treated for 6 consecutive weeks. The mice in the drug treatment groups were administrated with corresponding agents by gavage， and those in the normal group and model group received the same volume of distilled water. Fasting blood glucose， body weight， liver weight， glucose tolerance， liver function indicators， blood lipid levels， and pathological changes in the liver were evaluated for each group. Network pharmacology was employed to analyze the targets and pathways of Danggui Shaoyaosan combined with Yinchenhaotang in the treatment of T2DM complicated with MASLD. Molecular biological techniques were used to verify the enriched key targets. ResultsCompared with the model group， each treatment group showed reduced fasting blood glucose， body weight， aspartate aminotransferase （AST）， alanine aminotransferase （ALT）， and liver weight （P<0.01）. The high-dose Chinese medicine group was superior to the low-dose group in reducing low-density lipoprotein （LDL）， increasing high-density lipoprotein （HDL）， and recovering glucose tolerance （AUC） and ALT （P<0.05）， with the effect similar to that of the Western medicine group. Morphologically， Chinese medicine groups showed reduced lipid accumulation and alleviated pathological damage in the liver tissue， with the high-dose group demonstrating more significant changes. Network pharmacology results showed that Danggui Shaoyaosan combined with Yinchenhaotang may exert therapeutic effects through multiple targets such as fatty acid synthase （FAS）， acetyl-CoA carboxylase （ACC）， B-cell lymphoma-2 （Bcl-2）， MYC oncogene （MYC）， and interleukin-1β （IL-1β）. Western blot showed that compared with the model group， the treatment groups demonstrated down-regulated protein levels of FAS and ACC （P<0.01） and up-regulated protein levels of peroxisome proliferator-activated receptor γ coactivator-1α （PGC-1α） and UCP1 （P<0.01）. Compared with the low-dose Chinese medicine group， the high-dose Chinese medicine group exhibited down-regulated protein levels of FAS and ACC and up-regulated protein levels of PGC-1α and UCP1 （P<0.05）. ConclusionDanggui Shaoyaosan combined with Yinchenhaotang has the effect of ameliorating T2DM complicated with MASLD and can improve the liver lipid metabolism by up-regulating the protein levels of Fas and ACC and down-regulating the protein levels of PGC-1α and UCP1.