Objective To explore the change of copeptin in plasma and its significance in patients with intracerebral hemorrhage combined with stress ulcer.Methods Eighty patients with intracerebral hemorrhage were collected.Forty-nine patients of pure intracerebral hemorrhage and 31 patients of intracerebral hemorrhage combined with stress ulcer were included.Thirty healthy people were taken as controls.The level of copeptin in plasma was measured and compared in all subjects.Results The level of copeptin in plasma in patients with pure intracerebral hemorrhage and intracerebral hemorrhage combined with stress ulcer was significantly higher than that in controls:(303.684 ± 68.691),(527.034 ± 74.111) ng/L vs.(121.460 ± 53.364) ng/L,and the level of copeptin in plasma in patients with intracerebral hemorrhage combined with stress ulcer was significantly higher than that in patients with pure intracerebral hemorrhage.The differences were statistically significant (P ＜ 0.05).Conclusion The level of copeptin in plasma in patients with pure intracerebral hemorrhage increases significantly,and it is much higher in patients with intracerebral hemorrhage combined with stress ulcer.

Objective To study the changes of portal vein pressure before and after interventional embolization with α-cyanoacrylate alkyl and their clinical significance. Methods Thirty five patients with esophageal-gastric variceal bleeding were included. Esophageal-gastric fundal varices were embolized with e-cyanoacrylate alkyl in 35 patients, and 10 of them were treated with combination of partial splenic emblization. Portal pressure was measured directly before and after interventional embolization. The patients were followed up for 3-18 months. The changes of the liver functions and complications after the embolization were observed. Results All bleeding were controlled successfully. The main portal pressure in those who received variceal embolization only increased significantly from (32.54±5.23) cm H2O (1 cm H2O=0. 098 kPa) to (37.45±5. 11) cm H2O; superior mesenteric vein pressure increased from (31.46±4.35) cmH2O to (34.33±4.68)cm H2O; and the level of serum albumin raised from (30.45±5.78) g/L to (34.57±6.84) g/L 3 weeks after embolization. Whereas the main portal pressure in those who received both variceal and partial splenic embolizations, decreased significantly from (32. 68±4. 89) cm H2O to (28. 70±4. 58) cm H2O; superior mesenteric vein pressure decreased from (31.46±4.35) cm H2O to (28.03±4.12) cm H2O; and splenic vein pressure decreased from (32.89±4.79) cm H2O to (28.81±5. 12) cm H2O.Conclusions Esophageal-gastric variceal embolization is effective for varieeal bleeding. The increase of main portal pressure after embolization may be benefit for liver function, while the rise of superior mesenteric vein pressure may increase the risk of portal hypertensive gastrointestinal re-bleeding.Esophageal-gastric variceal embolization combined with partial splenic embolization may reduce the incidence of portal hypertension and gastrointestinal re-bleeding, but will increase the risk of ascites.

Objective To explore the clinical and imaging factors influencing the patients' prognosis after preoperative radiotherapy for local advanced rectal cancer.Methods We retrospectively analyzed 106 locally advanced rectal cancer patients from June 2004 to September 2015 in our institution.All patients underwent preoperative radiotherapy.According to the Mandard score,patients were divided into 5 groups (TRG1-5).All patients were divided into two groups according to the TRG,which including good responder (TRG1 + 2) and poor responder (TRG3 + 4 + 5) groups.All of the tumor ADC values of post-RT were measured by Diffusion-weighted MRI technology,and the relationship between tumor ADC values of post-RT and TRG was analyzed.Results In univariate analysis,age,chemotherapy,pT,pN,differentiation degree,vascular invasion and TRG were significantly associated with overall survival (x2 =3.945-8.110,P ＜ 0.05).Multivariate analysis indicated that differentiation degree and TRG were the independent prognostic factors for OS (x2 =5.221,6.563,P ＜ 0.05).No significant difference was found between long-course and short-course radiotherapy group (P ＞ 0.05) in OS.The good responder group had a favorable survival in 5-year OS compared to the poor responder group (x2 =8.110,P ＜ 0.05).Preoperative radiotherapy,preoperative chemotherapy,pathological type,differentiation degree and gross type,vascular tumor thrombus and tumor ADC values of post-RT were significantly associated with TRG (x2 =4.189-18.139,P ＜ 0.05).The best critical point of tumor ADC values of post-RT was 1.7 x 10-3 mm2/s by using ROC curve.The accuracy of tumor ADC values of post-RT in predicting TRG1 + 2 was 70％.Conclusions The TRG can predict the efficacy of preoperative radiotherapy in patients with locally advanced rectal cancer based on the Mandard score.There was no significant difference in OS between long-course radiotherapy group and short-course radiotherapy group.The tumor ADC values of post-RT might become a potential factor to predict TRG in patients with locally advanced rectal cancer after preoperative radiotherapy.

Objective To evaluate whether S-100β protein could be a serum marker for traumatic spinal cord injury (SCI). Methods From June, 2013 to October, 2014, 24 patients with complete SCI were measured the serum S-100β protein concentrations with en-zyme-linked immunosorbent assay, one week, three and six months after SCI. Serum from ten healthy persons was as normal control. Re-sults The serum S-100βprotein concentrations increased one week and 3 months after SCI (Z>4.273, P<0.001). Conclusion The increase of serum S-100βprotein may help assessing early impairment after complete SCI.

Objective:To investigate the changes in adaptive phenotypes of Yersinia pestis ( Yp) during successive passages in macrophages. Methods:A Yp strain of 201-MI was induced by 50 successive passages of Yp 201 strain in Raw264.7 cells. Phenotypic characteristics of 201 and 201-MI strains were compared by analyzing their survival rates in macrophages, growth curves, biofilm formation abilities, acid and hydrogen peroxide-stress tolerance, and virulence to mammal cells (Raw264.7 and HeLa cells) and mice. Results:Comparing with 201 strain, 201-MI strain showed various phenotypic changes, including higher survival rate in Raw264.7 cells, faster growth in iron-deficient medium, higher tolerance to acid and hydrogen peroxide, decreased biofilm formation ability, and less damages to Raw264.7 and HeLa cells. More-over, 201-MI strain showed decreased virulence to mice in both subcutaneous and intraperitoneal challenges. Preliminary comparative genomics analysis revealed some indel and nonsense mutations in 201-MI strain, which might account for its phenotype changes.Conclusions:After successive passages in macrophages, Yp showed some phenotypic changes, which might reflect its adaptive evolution under the pressure of macrophages. Detailed multi-omics analysis would be of great help to understand the underlying genetic mechanisms of these changes, and the related Yp-macrophage interaction processes as well.

【Objective】 To compare the efficacy and safety between partial tubeless and standard percutaneous nephrolithotomy in the treatment of upper urinary tract calculi. 【Methods】 The clinical data of 802 patients with upper urinary tract calculi treated at our hospital during Jun.2018 and Dec.2021 were retrospectively analyzed. The patients were divided into the partial tubeless group and standard group, and 60 cases in either group were selected by a simple random method. Clinical data, complications and stone-free rate were compared between the two groups. 【Results】 All 120 patients completed the operation successfully. The postoperative hospital stay, pain score and postoperative recovery of the partial tubeless group were significantly superior to those of the standard group (P<0.05). There were no significant differences in operation time, blood loss, complications and stone clearance rate between the two groups (P>0.05). 【Conclusion】 In the treatment of upper urinary tract calculi, partial tubeless percutaneous nephrolithotomy can achieve satisfactory surgical results, and has obvious advantages in postoperative recovery and patients’ experience. It is worthy of clinical application.

OBJECTIVETo analyze the prevalence and characteristics of childhood adverse experiences among adults aged 18-59 years and understand the association between childhood adverse experiences and risk of chronic diseases in adulthood.

METHODSA cross-sectional study was conducted with a questionnaire among adults aged 18-59 years selected through cluster random sampling from 3 communities in Macheng, Hubei province. Uinivariate and multivariate logistic regression analyses were conducted to evaluate the association between adverse experiences in childhood and the risk of chronic diseases in adulthood.

RESULTSA total of 1 767 adults aged 18-59 years were surveyed and 1 501 valid questionnaires were returned. The average age was (36.32± 10.20) years for males and (35.72±9.08) years for females. The prevalence rate of childhood adverse experiences was 66.22%. The risk of chronic disease in adults increased with the increase of the score indicating childhood adverse experiences (Z=-5.902 1, P<0.000 1). Multivariate logistic regression analysis showed that being physically abused (OR=1.93, 95% CI: 1.41-2.64), substance abuse in family (OR=2.82, 95% CI: 1.16-6.80), being bullied (OR=2.59, 95% CI: 1.39-4.80) and parents separation/divorce (OR=1.51, 95% CI: 1.09-2.09) were significantly associated with risk of chronic diseases in adulthood.

CONCLUSIONThe prevalence of adverse childhood experiences was high in adults aged 18-59 years, which was significantly associated with the risk of chronic diseases in adulthood. Early prevention of chronic diseases should be conducted in childhood.