A case of methamphetamine-related cerebral infarction was reported and the relevant databases of CBMdisc and Medline were searched.Among 14 cases of ischemic stroke , the ratio of male:female was 9∶5 and the age range 19-45 years.There were anterior circulation lesions ( n=13,92.8%) and 10 of them (71.3%) had cerebral vascular occlusion or stenosis.And the predominant manifestation was hemiplegia (85.7%);among 34 cases of hemorrhagic stroke ,the ratio of male: female was 12∶5 and the age range 16-60 years.And 28 cases (82%) were≤45 years.Cerebral hemorrhage was the most common (85%).The major manifestations were headache ( n =26, 76%) and disturbance of consciousness (n=21,62%).The methamphetamine-related stroke occurs frequently in young males.And ischemic stroke tends to involve anterior circulation and cause hemiplegia.Yet hemorrhagic stroke has extensive attack sites and headache and disturbance of consciousness are quite common.

Objective To observe the influence of rational emotional therapy on breast cancer patients preoperation. Methods 50 cases of breast cancer patients were randomly divided into the experimental group and the control group with 25 cases in each group. The control group was provided routine therapy and nursing, health education and general psychological nursing, based upon these routine measures, the experimental group adopted systematic and standardized rational emotional therapy. Zung self rating depression scale(SDS), Zung self rating anxiety scale(SAS), Pittsburgh Sleep Quality Index scale(PSQI)were used to evaluate the effect between two groups. Results No significant differ-ence existed in anxiety, depression and sleep quality between the two groups at admission, but significant difference was seen one day preoperation, also there was statistical significance between at admission and one day preoperation in the experimental group. Conclusions Rational emotional therapy of breast can-cer patients who underwent surgical operation played a significant role on their preoperative short-term e-motions(including anxiety,depression, sleep quality), and worthy of clinical application.

Objective To investigate the correlation between T cell subsets and HCV viralload in HCV infection. Methods Flow cytometry was used to detect peripheral T cell subsets count of 69 patients with hepatitis C and 20 cases of normal health human, and fluorescent quantitative PCR was used to detect viral load in patients with hepa-titis C. Results ① The study showed that the percentage ratio of CD4 +T cells (42.87 ±6.11) and of CD4 +/CD8 +(1.34±0.25) in patients patients was significantly lower than those of normal health group,it was 49.55±6.68 and 1.82±0.11 (P<0.01);but the percentage ratio of CD8 +T cells (32.78±5.48) was higher than that of the normal health human ( 27.35 ±4.32 ) ( P<0.01 ) . There were no significant differences between the two groups in the percentage ratio of CD3 + T cells. ② The viral load gradually increased as the percentage ratio of CD8 +T cells increased, while the percentage ratio of CD4 +T cells and the percentage ratio of CD4 +T cells and CD4 +/ CD8 + were decreased gradually. Conclusion It may be one of the important reasons as the chronic infec-tion of hepatitis C virus by change of T cell subsets, and may be an important cause leading to the decrease of T lymphocyte response ability as the expression level of HCV RNA increases.

Objective To investigate the detection of human bocavirus (HBoV) in children with acute respiratory infection and to explore the relationship between viral load and clinical characteristics of acute respiratory infection in children.Methods A total of 4 501 nasopharyngeal secretion samples were collected from hospitalized children with acute respiratory infection from January 2013 to June 2013.HBoV-positive children were divided into simple infection group and mixed infection group.Children with HBoV DNA≥1 × 104 copy/mL were categorized into high viral load group,while those with HBoV DNA ＜1 × 104 copy/mL were categorized into low viral load group.HBoV was determined by fluorescence quantitative polymerase chain reaction (PCR).Respiratory syncytial virus (RSV),influenza virus (Inf)-A,Inf-B,parainfluenza virus (Pinf)-Ⅰ 、Pinf-Ⅱ 、Pinf-Ⅲ and adeno virus antigen were detected by direct antigen-specific immunofluorescence assays.Mycoplasm Pnuemonia was detected by real-time fluorescence quantitative PCR.Serum mycoplasma antibodies were detected by enzyme-linked immunosorbent assay (ELISA).Bacteria was detected by sputum culture.Over the same period,23 children undergoing elective inguinal hernia operation with no respiratory infection or fever were considered as control group.The percentage of peripheral blood T lymphocyte subsets were tested by flow cytometry.Inter-group differences were compared using Chi-square test or Fisher exact test.Viral loads were compared using Mann-Whitney test.Results Two hundred and twenty-two HBoV-positive cases were detected with a positive rate of 5.41％ (222/4 105),33.33％ (74/222) of which were with high viral load and 66.67％ (148/222) were with low viral load.There was a high incidence in the age group of 1-2 years.The simple HBoV infection accounted for 24.32％,including 26 cases with high viral load and 28 cases with low viral load.Wheezing was more common in patients with high viral load than those with low viral load,and the difference was statistically significant (88.46 ％ vs 42.86 ％,x2 =12.295,P=0.001).Among the 222 HBoV-positive cases,the median viral load of HBoV in simple infection group was 3.86 × 103 copy/mL,and 1.0× 103 copy/mL in mixed infection group.The difference of the viral load between these two groups was statistically significant (Z =2.906,P =0.004).Mycoplasma and Streptococcus pneumonia were most commonly detected in the 168 patients with mixed infection.Percentages of CD3+ and CD3+/CD8+ subsets were significantly lower in HBoV simple infection group and mixed infection group,compared to control group (both P＜0.05).However,percentages of CD3 /CD19+,CD19+/ CD23+ subsets were significantly higher in HBoV simple infection group and mixed infection group,compared to control group (both P＜0.05).Conclusions HBoV is one of the pathogens causing acute respiratory tract infection in children,which lead to cellular immunity dysfunction in children.Moreover,children with higher HBoV load are more likely to develop wheezing.Co-infection with other pathogens should be considered in children with low HBoV load.

To explore the incidence and risk factors for spontaneous hemorrhagic transformation (HT) of cardioembolism (CE,n =150) and large artery atherosclerotic infarction (LAA,n =370).The incidence of HT was 29.3％ in CE.And it was significantly higher than 9.7％ (P ＜0.05).Infarct size,low-density lipoprotein-cholesterol (LDL-C) and admission National Institutes of Health Stroke Scale (NIHSS) score were independent predictors of spontaneous hemorrhagic transformation in LAA.OR values were 3.92,2.96 and 1.45 respectively.Infarct size,admission NIHSS score and random blood glucose level were independent predictors of spontaneous hemorrhagic transformation in CE.OR values were 4.86,2.42 and 1.42 respectively.As compared with LAA,CE was more prone to HT.LAA and CE-related factors of hemorrhagic transformation are not completely identical.

Objective To evaluate the effects of sufentanil and morphine on cisplatin-induced acute kidney injury in rats.Methods Thirty-two healthy Sprague-Dawley rats, aged 8-10 weeks, weighing 220-280 g, were randomly divided into 4 groups (n =8 each) using a random number table: control group (group C);cisplatin group (group Cis);sufentanil group (group S);morphine group (group M).Cisplatin 16 mg/kg was injected intraperitoneally in group Cis.In group S, cisplatin 16 mg/kg was injected intraperitoneally, followed by injection of sufentanil 2 μg/kg over 5 min via the caudal vein for 3 consecutive days.In group M, cisplatin 16 mg/kg was injected intraperitoneally, followed by injection of morphine 2 μg/kg over 5 min via the caudal vein for 3 consecutive days.The equal volume of normal saline was given in group C.After the end of administration on 3rd day, blood samples were collected from the orbital venous plexus for measurement of serum blood urea nitrogen (BUN) and creatinine (Cr) concentrations.The animals were then sacrificed, and the left kidney specimens were obtained for examination of the pathological changes (under the light microscope) and for determination of the tumor necrosis factor-alpha (TNF-α) , interleukin-1 beta (IL-1β) and interleukin-6 (IL-6) concentrations (by enzyme-linked immunosorbent assay) , and expression of X-linked inhibitor of apoptosis protein (XIAP) , suvivin and caspase-3 (by Western blot).Periodic acid-Schiff's staining was used to evaluate the pathological changes of the renal tubule.Results Compared with group C, the serum BUN, Cr concentrations and renal tubule injury score were significantly increased, the contents of TNF-α, IL-1β and IL-6 were increased, the expression of XIAP and suvivin was down-regulated, and the expression of caspase-3 was up-regulated in Cis,S and M groups (P＜0.05).Compared with group Cis, the serum BUN and Cr concentrations and renal tubule injury score were significantly decreased, the contents of TNF-α, IL-1β and IL-6 were decreased, the expression of XIAP and suvivin was up-regulated, and the expression of caspase-3 was down-regulated in S and M groups (P＜0.05).There were no significant differences in the indexes mentioned above between group S and group M (P＞0.05).Conclusion Both sufentanil and morphine can reduce cisplatin-induced acute kidney injury in rats with similar efficacy, and the mechanism may be related to the inhibition of the inflammatory responses and cell apoptosis.

Objectives To investigate the significance of electronic bronchoscopy and bronchoalveolar lavage in diagno-sis and treatment in children with pulmonary mass lesion. Methods A total of 74 hospitalized children from January 2011 to June 2012 whose imaging examinations showed massive patchy shadow were examined and treated by electronic bronchoscopy and bronchoalveolar lavage. Their clinical data were retrospectively analyzed. Results The major cause for the massive shadow was infection according to electronic bronchoscopy examination (68/74, 91.89%), 65 cases of them were lobar pneumonia, 3 cas-es were pulmonary tuberculosis followed by 5 cases of foreign body (6.76%) and one case of pneumorrhagia (1.35%).The lower left lung was the most frequently seen site of infection, followed by lower right lung. The agreement between infection sites and imaging examination was 97.30%. Bronchoalveolar lavage fluid showed that the primary pathogen of lobar pneumonia infection is Mycoplasma pneumoniae (MP) (42/65, 64.62%). The highest detection rate of MP was found in preschool group and the detec-tion rate between different age groups indicated statistically significant difference (P<0.01). The imaging examination showed pulmonary lesions in 61.54%children with lobar pneumonia improved significantly in one week. The improvement rate of pul-monary lesions was higher in infected children with short duration (1-2 weeks, 90.91%) between disease onset and electronic bronchoscopy inspection than those with longer duration (2-3 weeks, 51.72% and >3 weeks, 35.71%) (P<0.05). Conclusions Electronic bronchoscopy and bronchoalveolar lavage play dual roles in etiological diagnosis and therapy in children with pulmo-nary mass lesion.

Objective: To investigate the impact of clinicopathological features, gene rearrangements and protein expression of bcl-6, bcl-2, C-MYC and chemotherapy regime on the prognosis of patients with primary central nervous system diffuse large B-cell lymphoma (PCNS-DLBCL). Methods: Thirty-three cases of PCNS-DLBCL diagnosed from January 2006 to December 2016 at Zhejiang Cancer Hospital were collected. The expression of CD10, bcl-6, bcl-2, MUM1 and MYC were detected by immunohistochemical staining (IHC). The presence of EB virus was detected by in situ hybridization(EBER). Copy number variation (ICN) and translocation status of bcl-6, bcl-2 and C-MYC genes were detected by fluorescence in situ hybridization (FISH). The relationship between the above indexes and the prognosis was analyzed by univariate, bivariate survival analysis and multiple Cox hazard regression analysis. Results: The study included 33 patients of PCNS-DLBCL, without evidence of primary or secondary immunodeficient disease. Male to female ratio was 1.36∶1.00, and the average age was 56 years. Twenty cases had single lesion while 13 had multiple lesions. Deep brain involvement was seen in 12 cases. All patients underwent partial or total tumor resection. Five patients received whole brain post-surgery radiotherapy, nine patients received high-dose methotrexate (HD-MTX) based chemotherapy, and 12 patients received whole-brain radiotherapy combined with HD-MTX based chemotherapy. Severn patients received no further treatment and rituximab was used in 8 patients. According to the Hans model, 27 cases were classified as non-GCB subtypes (81.8%). Bcl-2 was positive in 25 cases (75.8%, 25/33) and highly expressed in 8 (24.2%). MYC was positive in 12 cases (36.4%) and double expression of bcl-2 and MYC was seen in 6 cases. EBER positive rate was 10.0%(3/30), all of which had multiple lesions. Two bcl-6 gene translocations and 3 amplifications were found in 28 patients. Two translocations, 3 ICN or with both bcl-2 gene translocation and ICN were found in 30 patients. Four ICNs of C-MYC gene were found in 28 patients. Elevated protein in cerebrospinal fluid (CSF) was found in 13 patients. LDH increased in 10 cases. Follow-up period was 2-90 months with the average survival time of (23.0±3.7) months and two-year survival rate of 39.0%. Univariate survival analysis showed that overexpression of bcl-2 protein (≥70%) and MYC protein (≥40%), bcl-2 gene abnormality (including copy number increase and translocation), C-MYC gene copy number increased were adverse factors for survival. C-MYC/ bcl-2 gene double hit was seen in 2 cases. Bivariate survival analysis found that of bcl-2/MYC protein double expression and bcl-2 and C-MYC genes double aberration were significantly associated with adverse outcomes. Cox multivariate risk regression analysis found that gender, cerebrospinal fluid protein increasing, and ICN of C-MYC gene were independent poor prognostic factors. DH-MTX based comprehensive chemotherapy was associated with better prognosis. Conclusions Double hit at genomic level (copy number variations and gene rearrangements) and double protein expression of bcl-2 and C-MYC in PCNS-DLBCL are significantly associated with an adverse outcome. DH-MTX based comprehensive treatment may prolong the patient survival.

Objective:To analyze the correlation of glycosylated hemoglobin (HbA 1c) level in the late pregnancy gestational diabetes mellitus (GDM) patients and fetal weights, neonatal Apgar scores, maternal and infant adverse outcomes. Methods:One hundred and eighty-seven pregnant women who were diagnosed with GDM from January 2015 to July 2019 and delivered in Yixing People′s Hospital after standard diagnosis and treatment were divided into four groups (A group: HbA 1c<6.0%, 65 cases; B group: HbA 1c: 6.0% - 6.5%, 49 cases; C group: HbA 1c 6.6%-7.0%, 39 cases; D group: HbA 1c>7.0%, 34 cases) according to the HbA 1c examination results at 28 to 32 weeks of gestation. General data, fetal weights, neonatal Apgar scores and maternal and infant adverse outcomes were compared among the four groups. The correlation between GDM HbA 1c and fetal weights, neonatal Apgar scores and maternal and infant adverse outcomes were analyzed by unconditional Logistic regression. Results:In general data of GDM pregnant women with different HbA 1c levels, only oral glucose tolerance test (OGTT) fasting blood glucose: (4.68 ± 0.60), (4.89 ± 0.69), (5.23 ± 0.90), (6.48 ± 2.17) mmol/L; postprandial 1 h blood glucose: (9.84 ± 1.56), (10.09 ± 1.84), (10.6 ± 2.01), (12.74 ± 4.12) mmol/L; postprandial 2 h blood glucose: (8.65 ± 1.49), (8.86 ± 1.76), (9.28 ± 2.15), (11.56 ± 4.93) mmol/L, showed statistically significant differences ( P<0.05). Among the newborns of GDM pregnant women with different HbA 1c levels, there were statistically significant differences in the macrosomic infant rates: 1.54%(1/65), 10.20%(5/49), 12.82%(5/39), 17.65%(6/34); rates of neonatal Apgar scores<7 points:13.85%(9/65), 16.33%(8/49), 25.64%(10/39), 44.12%(15/34); the proportion of maternal and infant adverse outcomes: 24.62%(16/65), 24.49%(12/49), 28.21%(11/39), 50.00%(17/34), showed statistically significant differences ( P<0.05). After adjusting OGTT by unconditional Logistic regression analysis, HbA 1c (6.6%-7.0% and>7.0%) was independent risk factor for macrosomic infants: OR = 1.430, 95% CI = 1.035-1.977, P = 0.030; OR = 2.042, 95% CI = 1.311-3.180, P = 0.001; maternal and infant adverse outcomes: OR = 1.774, 95% CI = 1.130-2.874, P = 0.010; OR = 3.387, 95% CI = 1.608-7.133, P = 0.001. HbA 1c>7.0% was independent risk factors for neonatal Apgar scores<7 points: OR = 1.848 95% CI = 1.086-3.143, P = 0.023. Conclusions:There was a significant correlation between HbA 1c in GDM pregnant women in the late pregnancy and macrosomic infants, neonatal Apgar scores, and maternal and infant adverse outcomes. In particular, GDM pregnant women with HbA 1c>7.0% should be alert to the risk of macrosomic infants, neonatal Apgar score<7 points, and maternal and infant adverse outcomes.

Objective To evaluate the role of chemokine CXC-ligand 16 (CXCL16) in renal fibrosis following renal ischemia-reperfusion (I/R) injury in mice.Methods Twenty-four healthy male C57BL/6 mice,aged 8-10 weeks,weighing 20-30 g,were divided into 4 groups (n =6 each) using a random number table method:sham operation group (group S),sham operation plus anti-CXCL16 antibody group (group S+A),group I/R,and I/R plus anti-CXCL16 antibody group (group I/R+A).Renal ischemia was induced by occlusion of the left renal artery for 30 min followed by 72-h reperfusion,and the fight kidney was removed on 5th day in anesthetized mice.CXCL16 antibody 5 mg/kg and the equal volume of normal saline were intraperitoneally injected at 72 h after reperfusion twice a week for 2 consecutive weeks in I/R+A and I/R groups,respectively.Sham operation was performed,and the equal volume of CXCL16 antibody 5 mg/kg and normal saline were intraperitoneally injected at 72 h after reperfusion twice a week for 2 consecutive weeks in S+A and S groups,respectively.Orbital venous blood samples were collected at day 14 after reperfusion for determination of serum blood urea nitrogen (BUN) and creatinine (Cr) concentrations.Animals were then sacrificed and the left kidney was removed for measurement of the renal fibrosis size (using Sirius red staining),expression of t-smooth muscle actin (α-SMA),fibronectin (FN) and type Ⅰ collagen (Col-Ⅰ) in renal tissues by Western blot.Results Compared with group S,the serum BUN and Cr concentrations and renal fibrosis size were significantly increased,and the expression of α-SMA,FN and Col-Ⅰ was up-regulated in group I/R (P＜0.05).Compared with group I/R,the serum BUN and Cr concentrations and renal fibrosis size were significantly decreased,and the expression of α-SMA,FN and Col-Ⅰ was down-regulated in group I/R+A (P＜0.05).Conclusion CXCL16 is involved in the process of renal fibrosis following renal I/R injury in mice.