Objective To investigate the incidence and its related factors of apathy in patients with acute ischemic stroke. Methods A total of 100 consecutive cases of ischemic stroke patients and 50 health controls were recruited in the present study. Apathy was assessed using modified apathy evaluation scale (MAES). According to the MAES score, acute ischemic stroke patients were divided into apathy group (MAES was more than 14 points) and non-apathy group. The differences of general information, clinical data, national institutes of health stroke scale (NIHSS), Montreal cognitive assessment (MoCA), Hamilton depression scale (HAMD), modified rankin scale (mRS) and the lesion location were compared between the two groups. Differences that showed statistical significance (P<0.05) went into the multi-factor analysis. The Logistic regression analysis was used to estimate the influence factors of apathy. Results There were 34 cases of apathy in patient group (34.00%), which was significantly higher than those of control group (3 cases of apathy, 6.00%, P<0.001). The age, incidence of diabetes, NIHSS score, HAMD score, lesions in brain stem and multiple lesions were significantly higher in apathy group than that of non-apathy group, while educational level, MoCA score were significantly lower ( P<0.05). The Logistic regression analysis showed that the higher MoCA score was a protective factor for apathy, while higher NIHSS score, lesions in brain stem and multiple lesions were risk factors for the incidence apathy. Conclusion The cognitive impairment, severity of neurological deficits, brainstem lesions and multiple lesions may be the risk factors of apathy after the occurrence of acute ischemic stroke.

Objective To evaluate the efficacy and adverse effects of docetaxel combined with 5-fluorouracil in treating patients with advanced gastrice cancer.Methods 130 patients with advanced gastric cancer were randomly divided into observation group and control group,observation group treated with docetaxel combined with 5-fluorouracil,the control group treated with 5-fluorouracil and cisplatin,the clinical efficacy after the treatment was observed.Results The clinical efficiency rate of the observation group was significantly higher than that of the control group,the rate of leukopenia,thrombocytopenia and gastrointestinal reactions of the observation group was significantly lower than the control group,the quality of life scores of the two groups after treatment were all improved,but that of the observation group was significantly higher than the control group,the difference was statistically significant(P ＜ 0.05).Conclusion Docetaxel combined with 5-fluorouracil was effective in treating advanced gastric cancer.It worth further clinical research and application.

Lactic acid bacteria (LAB) are traditional dairy strains which have a long history of safe use. They are a kind of food-grade microorganisms that can be used in industry to produce lots of food and drink, such as yoghourt. In the last two decades the physiology and genetics of these bacteria have been thoroughly studied. Because of their genetic accessibility and easy to handle, LAB, in addition to their traditional applications, have been extensively developed and used for the expression of heterologous genes. So they have an important foreground in agricultural, medical and many other fields. People have developed a series of food-grade gene expression systems of LAB. LAB, especially their model strain Lactococcus lactis and their most useful food-grade induced expression system--nisin controlled gene expression system NICE and its food-grade inducer nisin, food-grade host, expressing vectors and applications in expressing heterologous proteins of NICE will be introduced.

Objective To elucidate the effect of human leukocyte antigen(HLA)cross-reactive groups(CREGs)matching on the patient/graft survival rate of renal transplant recipients positive for penal-reactive antibody(PRA).Methods The PRA level and the HLA antibody specificity of renal transplant candidates were assayed using the LAT1240,LM720R,and SSP2LB kits.The appropriate donors were selected according to the CREGs matching standard.Results 112 recipients included 43 positive cases of HLA classⅠantibody,39 positive cases of HLA classⅡantibody,and 30 positive cases of bothⅠandⅡ.The HLA mismatching cases of 0,1,2,3,4 and 5 allele(s)were 6,39,38, 21,7 and 1,respectively.Hyper-acute rejection(2 cases),acute rejection(18 cases),chronic rejec- tion(5 cases),delayed graft function(4 cases),graft excision(one case)due to rejection and deaths (13 cases,5 with a functioning graft)occurred after transplant.Ninety-nine recipients and 96 grafts survived.The 1-,3-,and 5-year graft survival rate was 91.96%,86.96%,and 86.21%,respec- tively.Conclusion The HLA matching rate of patient/graft was elevated significantly and the effect of high PRA level was decreased according to the principle of CREGs,which increased the patient/graft survival rate remarkably in sensitized recipients.

Objective To understand the psychological health status of the middle and primary school students,and to provide some advice of their mental health care.Methods In 11 611 middle and primary school students in 18 schools in Maojian area of Shiyan city,the students,teachers and parents at 5 schods were investigated a randomely,targets were examined by Achenbach Child Behavior Checklist(CBCL),Pupil Rating Scale Revised Screening for Learning(PRS),Conner's Parent Symptom Questionnaire(PSQ)and Conner's Teacher Rating Scale(TRS)and self-established questionnaires for general information.Results The investigation demonstrated:89.29% of students possessed very promising dreams and sublime pursuits,and had correct outlook on life and values;10.71% of students had comparatively severe psychological problems.The major problems appeared to be indefinite purpose of study,shorted of mental endurance and severe impulsivetrend.Moreover,an-xiety,emotion instability and solitary trend caused indifference,sheepish ness and difficulty in their communication.Conclusion Schools,families and society pay close attention to students,mental health and help the youngsters develop in a healthily psychdogical way.

To investigate and analyze the epidemiology of serious corneal ulcer.
● METHODS: A total of 133 serious corneal ulcercases from June 2010 to December 2013 in Xiangya Hospital Affiliated to Central South University were retrospectively reviewed for risk factors, demographic characteristics and diagnosis.
●RESULTS: There were 91 male patients (68. 4%) in the 133 patients. A peak incidence age was from 41 to 60 years old (82 cases, 44. 4%). Most of patients were peasant (77 cases, 57. 9%) and the percentage of the low schooling patients was 85. 0% (113 cases). The number of patients who had been sick was 73 before hospitalization (54. 9%) in all cases. The peak incidence season was January (34. 6%). Average length of stay was 9. 84d. The number of emergency cases was 44 (33. 1%). Most of patient were not only corneal ulcer cases but the hypopyon (92 cases, 69. 2%). The figure of inpatients who received operations was 102 cases ( 76. 7%). And the most of operations was amniotic membrane transplantation (31 cases, 39. 2%). Additionally, this data was classified regard to gender differences.
● CONCLUSlON: The peasant of the middle age and elderly represents a distinct clinical group in the serious corneal ulcer in hospital. Severity, ocular trauma in agriculture and health awareness are the major predisposing factors.

Abstract: Objective　To analyze the nucleic acid detection results of severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) by droplet digital PCR (ddPCR) and compare with the detection results of real-time fluorescence quantitative RT-PCR (qRT-PCR), so as to evaluate the advantages and disadvantages of detection, and to provide data support for optimizing the nucleic acid detection scheme of SARS-CoV-2. Methods　According to the SARS-CoV-2 specific primer probe published by the China Center for Disease Control and Prevention, a ddPCR detection method for SARS-CoV-2 was designed. One sample was selected for sensitivity test after gradient dilution; six respiratory virus nucleic acid positive samples including seasonal H3N2 influenza virus and SARS-CoV-2 positive samples were selected for specificity test; five SARS-CoV-2 positive samples were selected for repeatability test; in addition, 30 positive and 20 negative SARS-CoV-2 samples were selected for multiple clinical samples testing, and the results were analyzed and compared with those of qRT-PCR. Results　The ddPCR method can specifically detect SARS-CoV-2, and directly obtain the original copy number of the sample target gene to achieve accurate quantification; the sensitivity test of gradient dilution positive samples showed that qRT-PCR detected target genes in part of the 10-5 dilution of samples, and no target genes were detected in 10-6 dilution, while ddPCR detected all target genes in both 10-5 and 10-6 dilution of samples. The detection limit of ddPCR was two orders of magnitude higher than that of qRT-PCR, and the sensitivity was higher than that of qRT-PCR; in the comparison of the repeatability test results of the two methods, the coefficient of variation of ddPCR was 1.266%-11.814%, lower than 1.729%-26.174% of qRT PCR, and the repeatability was higher than qRT-PCR; among 50 clinical samples, 30 positive samples of confirmed cases of Coronavirus Disease 2019 (COVID-19) were detected by both methods, SARS-CoV-2 was successfully detected by both methods, and 20 negative samples of COVID-19 were detected by both methods, and the results were negative, with a coincidence rate of 100.00% (50/50). Conclusion　The ddPCR method can accurately quantify SARS-CoV-2 with strong specificity, and its sensitivity and repeatability are higher than those of qRT-PCR, but it also has certain detection limitations and is more suitable for the detection of low load samples. In the actual detection, the two methods can be reasonably combined to improve the detection accuracy.

Objective To explore the relationship between the obstetric factors defined by Robson Ten-Group Classification System (RTGCS) and cesarean section rate (CSR),and to evaluate the validity of predictive models established based on the RTGCS for cesarean section.Methods Clinical data of 41 295 cases delivered in Shanghai First Maternity and Infant Hospital from January 1,2012 to September 30,2014 were retrospectively collected.CSR of different groups categorized by the RTGCS was analyzed by descriptive epidemiological methods by three models.Model 1 was obstetrics factors (parity,history of cesarean section,number of fetus,mode of labor,fetal presentation and gestational age);model 2 was obstetrics factors (model 1) + demographic characteristics and severity (maternal age and with/without treatment in intensive care unit);model 3 was defined as model 2+ complications (placenta previa,placental abruption,chronic or gestational hypertension,preeclampsia,renal disease,or human immunodeficiency virus infection).The relationship between obstetrics factors classified by the RTGCS and CSR was analyzed by the logistic regression model (the potential confounders were controlled).The validity of predictive models was evaluated by analyzing the area under the receiver operative characteristic (ROC) curve.Results (1) There were statistical differences in total CSR and CSR before labor among those cases respectively grouped by age,medical insurance,parity,signal/multiple pregnancy,fetal presentation and gestational age (all P＜0.05).(2) The recruited cases were categorized into ten groups according to the RTGCS and among them,the second group (single,cephalic presentation,nulliparous,≥ 37 gestational weeks,induced labor or cesarean section before labor) accounted for most of the cesarean section cases (61.2％,11 217/18 322),followed by the fourth group (single,cephalic presentation,multiparous,no previous cesarean section,≥ 37 gestational weeks,induced labor or cesarean section before labor),which were 11.2％ (2 061/18 322).(3) Obstetrical parameters,including parity,number of fetus,mode of delivery,history of cesarean section,fetal presentation and gestational weeks at delivery were related to CSR,even after adjustment for maternal age and medical insurance,or obstetrical complications,or both above factors (all P＜0.05).(4) Areas under the ROC curves and the 95％ confidence intervals of model 1,2 and 3 were 0.867 (0.863-0.870),0.875 (0.872-0.878) and 0.881 (0.878-0.885),respectively (all P＜0.01).Conclusion Related variables of RTGCS highly correlate with CSR and could be used as promising indicators for prediction of cesarean section.The RTGCS is of great application value to those research subjects.

Objective To compare the differences of clinical characteristics between genotype B and C chronic hepatitis B(CHB)patients and to summarize clinical factors related to genotype C hepa- titis B virus(HBV)infection.Methods Seventy eight CHB patients who were diagnosed with genotype B or C infection by liver puncture biopsy and genotyping were enrolled.Their serum HBV DNA levels were detected.Severe hepatitis,liver cirrhosis,hepatocellular carcinoma and HBeAg positive rate were analyzed to determine the pathologic inflammation and fibrosis degree of liver tissue.Chi square test and Logistic multiple regression analysis were employed for the statistical analysis.Results The serum albumin and pre-protein were lower in genotype C CHB patients than that in genotype B.The alanine aminotrans- ferase,total bilirubin and prothrombin time were higher in genotype C CHB patients than that in genotype B.The rates of genotype C patients increased significantly with the grade of liver necroin- flammation progressing from GO to G4(1.8%,11.1%,20.4%,33.3%,33.3%) and the stage of liver fibrosis progressing from SO to S4(5.6%,5.6%,14.8%,33.3%,40.7%),but the rates of genotype B patients did not change significantly with the grade of liver necroinflammation(16.7%, 25.0%,25.0%,20.8%,12.5%)and stage of liver fibrosis progressing(16.7%,29.2%%,20.8%, 16.7%,16.7%).There was statistical significance in grades of liver necroinflammation(X~2= 11.49,P=0.022)and stages of liver fibrosis(X~2=13.56,P=0.006)between genotype B and gen- otype C patients.The rates of genotype C CHB patients were higher than,similar with and lower than the rates of genotype B patients of HBV DNA level above 1.0?10~6 copy/mL,between 5.0?10~2-1.0?10~6 copy/mL and under 5.0?10~2 copy/mL,respectively(51.8% vs 12.5%,35.2% vs 45.8% and 13.0% vs 41.7%).There was statistical significance of HBV loads between genotype B and genotype C patients(X~2=13.25,P=0.001).HBeAg positive rate in genotype C patients was significantly higher than that in genotype B patients(61.1% vs 25.0%,X~2=8.67,P=0.003).The rates of decompensated cirrhosis,compensated cirrhosis and no-cirrhosis in genotype C patients were higher than,similiar with and lower than the rates in genotype B patients,respectively(40.7% vs 4.2%,22.2% vs 20.8% and 37.0% vs 75.0%).There was statistical significance of the rate of cirrhosis between genotype B and genotype C patients (X~2=12.47,P=0.002).Conclusions The degree of liver necroinflammation and fibrosis,the HBeAg positive rate and the incidence of cirrhosis are all related with genotype C HBV infection.