Objective To investigate the correlation between fatigue and cognitive impairment and depression after lacunar stroke.Methods A total of 103 patients with lacunar infarction admitted from September 2009 to November 2010 were enrolled.Post-stroke fatigue was evaluated with the Fatigue Scale (FS-14) and the Fatigue Severity Scale (FSS-9); cognitive function was evaluated with the mini-mental state examination (MMSE) and the Montreal cognitive assessment (MoCA); and depression was evaluated with the self-rating depression scale (SDS) and the Hamilton Depression Rating Scale (HAMD).Results There were 34 patients (33.01％) (FSS-9) and 45 patients (43.69％) (FS-14) had fatigue.Of the 34 fatigue patients determined with FSS-9 scores,20 had cognitive impairment,26 had depression,and 16 had both cognitive impairment and depression.The Pearson correlation analysis showed that the FS-14 scores were siguificantly negatively correlated with the scores of MMSE (r =-0.307,P =0.002) and MoCA (r =-0.457,P=0.000),and significantly positively correlated with the scores of SDS (r =0.368,P =0.000) and HAMD (r =0.526,P =0.000); the FSS-9 scores were significantly negatively correlated with the scores of MMSE (r =-0.292,P=0.003) and MoCA (r=-0.340,P=0.000),and significantly positively correlated with the scores of SDS (r =0.403,P =0.000) and HAMD (r =0.564,P =0.000).Conclusions The incidence of fatigue,cognitive impairment and depression was higher.There was a certain correlation between fatigue and cognitive impairment and depression.

Objective To investigate the method and efficiency of supracondylar dome osteotomy of femur combined with arthroscopy for the treatment of the adult valgus deformity of knees. Methods From September 2008 to May 2012, 32 patients (35 knees) with valgus deformity of knees were treated with supracondylar dome osteotomy of femur combined with arthroscopy. The study group included 7 male and 25 female (average age: 43 years). The pre-operative HSS knee score was an average of 60.46. The weight-bearing knee joint AP & LAT and the full-length AP view of the lower extremity were examined before and after operation. At the same time , the femoral angle and femoral-tibial angle were measured and evaluated. The internal fixation was taken out in an average in 12 months. All the patients were followed-up and the change of the correction angles , the function of the knee and the condition of bone healing was recorded. Result The follow-up time was an average of 24 months. All the patients got a satisfied correction of the deformity, good bone union and obvious improvement of joint function. The postoperative HSS knee score was an average of 85.40. Conclusion The supracondylar dome osteotomy of femur combined with arthroscopy is a safe, reliable and effective strategy for the treatment of the adult valgus deformity of knees.

Background and purpose:Metabolism change is one of the main characteristics of the tumor de-velopment. Many studies have conifrmed that cytosolic acetyl-CoA synthetase 2 (ACSS2) plays a critical role in hydro-carbon metabolism of cancer cells. This study aimed to explore the effect of ACSS2 on cellular proliferation, apoptosis and migration of A549 cells by RNA interference.Methods:The ACSS2 interference fragment ACSS2-siRNA and neg-ative control were designed and synthesized for RNA interference followed by the transient transfection in non-small cell lung cancer (NSCLC) cell line A549. Real-time lfuorescence quantitative polymerase chain reaction (RTFQ-PCR) was used to detect ACSS2 mRNA expression. Methyl thiazolyl tetrazolium (MTT), lfow cytometry and wound healing assay were used to detect cell proliferation, apoptosis rate and migration.Results:The expression of ACSS2 mRNA was signiifcantly decreased after transfection with the interference fragment ACSS2-siRNA in NSCLC cell line A549. The proliferation and migration activity of ACSS2-siRNA treated cells were decreased significantly compared with the control group. The apoptosis rate, especially the early apoptosis, was increased..Conclusion:Knockdown of the ACSS2 expression in NSCLC cell line A549 can signiifcantly inhibit the cell proliferation, migration ability and pro-mote the apoptosis rate, especially early apoptosis. This study indicates that ACSS2 may contribute to the progression of human lung adenocarcinoma and may have the potential to serve as a novel therapeutic target.

Objective To investegate the effect of ginsenoside Rg1 on the apoptosis related protein FLICE-inhibitory protein(FLIP),Fas-associated death domain protein (FADD)and Caspase-3 in the subatania nigra(SN)of 1-methyl-4-phenyl-1,2,3,6-tetrahyd-ropyridine (MPTP)-induced mouse models of Parkinson’s disease(PD), and to investigate the role of FADD and FLIP in the pathogenesis of PD and the protective effect of ginsenosides Rg1 on dopaminergic neurons.Methods 45 C57BL/6N mice were randomly divided into control group,model group and ginsenoside Rg1 group (n=15).The mice in model group were injected with MPTP by intraperitoneal,the mice in Rg1 group were injected with ginsenoside Rg1 before injecting MPTP,and the mice in control group were injected with normal saline by intraperitoneal. The behavioral changes of the mice in various groups were observed, and immunohistochemistry and Western blotting methods were used to observe the expressions of tyrosine hydroxylase (TH),FADD,FLIP and Caspase-3 in substantia nigra of the mice.Results Compared with control group,the mice in model group presented with typical symptoms of PD, the TH-positive neurons in the subatania nigra was significantly reduced (P<0.01 ), the number of FADD, FLIP and Caspase-3 positive cells was significantly increased(P<0.01),and the cytoplasm was deeply stained;the protein expression levels of FADD,FLIP and Caspase-3 were significantly increased (P<0.01).Compared with model group,the PD symptoms of the mice in ginsenoside Rg1 group reduced, the number of TH-positive neurons was significantly increased, the number of positive cells of FLIP,FADD and Caspase-3 were significantly reduced(P<0.01),and the cytoplasm was lightly stained;the protein expression levels of FADD, FLIP and Caspase-3 were significantly reduced (P<0.01 ). Nonlinear correlation analysis found that there was a positive relationship between the number of FADD and Caspase-3 positive cells (r=0.791,P<0.05).Conclusion Ginsenoside Rg1 may play a neural protective effect dopaminergic on neurons by modulating the FADD and FLIP expressions in SN of PD model mice.

Objective: To investigate the breakthrough points and methods of pharmaceutical care performed by clinical pharmacists for chemotherapy-induced Ⅳ degree myelosuppression.Methods: One advanced lung adenocarcinoma patient suffering from chemotherapy-induced Ⅳ degree myolosuppression was selected as the example, clinical pharmacists provided suggestions on the chemotherapy regimen, assisted physicians in making reasonable treatment plan and implemented comprehensive pharmaceutical care for the patient.Results: Clinical pharmacists played a positive role in the clinical treatment through the comprehensive pharmaceutical care in oncology department.Conclusion: With the professional knowledge of pharmacy, clinical pharmacists can improve the level of clinical rational drug use.

Hemangioendothelioma, Epithelioid ; pathology ; Humans

Objective To evaluate the clinical efficacy of arthroscopic treatment with anchor fixation for Segond fractures.Methods A total of 29 patients with Segond fractures treated with arthroscopic evaluation and anchor fixation technique between January 2011 and December 2015 were included in this retrospective case series study.There were 17 males and 12 females,with an average age of 41 years (range,27-62 years).Among the patients with Segond fractures,there were 20 patients combined with anterior cruciate ligament (ACL) rupture,three with posterior cruciate ligament (PCL) rupture,seven with medial collateral ligament (MCL) lesion,six with lateral collateral ligament (LCL) rupture,12 with meniscus lesion,and two with tibial plateau fracture.The time duration from injury to operation was 5-14 days (mean,7 days).The operation time and intraoperative blood loss volume were recorded.The postoperative pain,complications,knee joint stability,and fracture healing were observed.The pain was evaluated using numerical rating scale (NRS).Drawer test,Lachman test,lateral stress test,and Lysholm scores were performed to assess the knee function before and after operation.Results The operation time was 40-125 minutes (mean,85 minutes),and intraoperative blood loss was 10-30 ml (mean,15 ml).All patients were followed up for 12-18 months (mean,14 months).Two weeks after operation,the pain was not obvious,with NRS of 0-1.One patient had deep venous thrombosis one week after operation,and recovered after vascular intervention therapy.Other patients had no infection,deep vein thrombosis or other postoperative complications.The results of drawer test,Lachman test,and lateral stress test were negative in all patients,which indicated good knee joint stability.All patients were seen bone union,with the healing rate of 100％.The preoperative Lysholm scores were 35-62 points [(52.0 ± 4.2) points],and the scores one year after operation were 86-95 points [(91.9 ± 1.4) points] (P ＜ 0.05).Conclusion Arthroscopic treatment with anchor fixation has advantages of minor trauma,little hemorrhage,high fracture healing rate and good function recovery,and hence is an effective surgical treatment for Segond fractures.

OBJECTIVETo study the diagnostic value of SATB2, together with CK7 and CK20, in colorectal cancer.

METHODSImmunohistochemical study for SATB2, CK7 and CK20 was carried out in 210 cases of colorectal cancer tissue, 100 cases of non-colorectal cancer tissue, 90 cases of lymph node metastases and 50 cases of normal colorectal mucosa.

RESULTSThe sensitivity and specificity of CK20+/CK7- immunophenotype for diagnosis of colorectal adenocarcinoma were 78.1% and 92.0%, respectively. When triple markers were used, the immunophenotype CK20+/CK7-/SATB2+ had a sensitivity of 57.1% and a specificity of 98.0%. When combining the immunophenotype of SATB2+/CK7- or CK20+/CK7-, the sensitivity was 85.7% and specificity was 90.0%.

CONCLUSIONSA panel of immunohistochemical markers SATB2, CK7 and CK20 could increase the specificity for diagnosis of colorectal adenocarcinoma significantly. SATB2 is considered as a useful adjunct in this respect.

Adenocarcinoma ; diagnosis ; metabolism ; Biomarkers, Tumor ; metabolism ; Colorectal Neoplasms ; diagnosis ; metabolism ; Humans ; Immunophenotyping ; Keratin-20 ; metabolism ; Keratin-7 ; metabolism ; Lymphatic Metastasis ; Matrix Attachment Region Binding Proteins ; metabolism ; Sensitivity and Specificity ; Transcription Factors ; metabolism

Objective:To explore the expression of Bcl related anti-apoptotic protein 3 (BAG3 protein)in colon cancer and its clinical significance,and to clarify the relationship between its expression and the occurrence and development of colon cancer.Methods:A total of 90 cases of colon cancer tissue and paracancerous tissue were selected, the expressions of BAG3 protein in different tissues were detected by tissue microarray and immunohistochemical SP method;Kaplan-Meier method,univariate analysis and multivariate analysis were used to investigate the relationship between the clinicopathological parameters and the prognosis of the patients with colon cancer.Results:The expression of BAG3 protein in the colon cancer tissue was high,and the positive expression rates of BAG3 protein in the colon cancer tissue and paracancerous tissue were 37.8% and 0.01%,respectively, and the difference was significant (P < 0.05).The expression of BAG3 protein was associated with gender and tumor size (P <0.05),but there was no correlation between the expression of BAG3 protein in the colon cancer tissue and age,pathologic grade,TNM stage,and lymph node metastasis (P >0.05).The Kaplan-Meier results showed that the expression of BAG3 protein in the colon cancer tissue was not related with the prognosis of the patients and the survival rates of the younger patients and the higher TNM staging patients were high. Conclusion:The expression of BAG3 protein in the colon cancer tissue is high,and its expression is associated with the tumor size;BAG3 protein may act as a tumor marker and therapeutic target for colon cancer.

Objective To investigate the distribution of chronic disease and geriatric syndrome in hospitalized elderly patients with multimorbidity by chronic disease investigation and comprehensive geriatric assessment.Methods A total of 176 patients aged ≥60 years admitted into the geriatric department in our hospital were selected,and demographic factors were collected.Their chronic diseases and geriatric syndrome were recorded.The comprehensive geriatric assessment was consummated,and the biochemical indicators for chronic disease and geriatric syndrome were detected.Results All patients suffered from two or more kinds of chronic diseases.The top three most common diseases were hypertension (112 cases),diabetes (94 cases),and respiratory diseases (73cases).The sum of chronic diseases kinds were ≥3 in 137 patients,≥4 in 78 patients,≥5 in 40 patients.The amount of chronic diseases showed an increased tendency along with ageing.Totally 175 patients had more than one geriatric syndrome,the top three most common types were frailty and prefrailty(133 cases),visual impairment (117 cases),impaired daily activities (107 cases).There were significant differences in the number of geriatric syndrome among different age groups(x2 =16.989,P ＜ 0.001).Spearman analysis showed that the number of patients with geriatric syndrome were positively correlated with age(r =0.307,P＜0.001).Conclusions The prevalence of chronic disease and geriatric syndrome is high in hospitalized elderly patients with multimorbidity,which is increased with aging.We should pay attention to the screening of chronic disease and geriatric syndrome in multimorbid elderly patients