Objective To clear the coping process of ischemic stroke patients and their families before the onset,explain its response rules and the influence factors,and provide scientific basis for the construction of comprehensive stroke pre-hospital intervention program.Methods A semi-structured interviews were conducted with 10 cases.Data were analyzed using the grounded theory.Results Ischemic stroke patients and their families at the onset process experienced recognition,reaction,alert and action stage.Conclusion Health education should be combined with the whole process of ischemic stroke patients and their families before hospital,building a comprehensive intervention program.

BACKGROUND:It has found that secretions of tumor necrosis factor α (TNF-α), interleukin 1β (IL-1β) and interleukin 6 (IL-6) are closely related to osteoporosis
OBJECTIVE:To further investigate the levels of TNF-α, IL-1β and IL-6 of bone tissue in ovariectomized rats and their relationship with osteoporosis.
METHODS: Sixty 3-month-old female Sprague-Dawley rats were randomly divided into control group and test group (n=30 per group). In the test group osteoporosis model was induced by ovariectomy folowed by intraperitoneal injection of aluminum nitride solution; while rats in the control group were given intraperitoneal injection of normal saline without ovariectomy. The experiment cycle was 12 weeks. One week after modeling, serum level of estradiol was tested, and the bone mineral density of rats measured with bone densitometry. In the meanwhile, the levels of TNF-α, IL-1β and IL-6 in bone tissue were detected to analyze the correlation between cytokines and bone mineral density.
RESULTS AND CONCLUSION: The level of serum estradiol in the test group was significantly lower than that in the control group (P=0.007); the bone mineral density of the lumbar spine and femur in the test group was significantly lower than that in the control group (P=0.006, 0.004). Compared with the control group, the percentages of trabecular bone and osteoblast area within the visual field in the test group were significantly lower, while the osteoclast area within the visual field was significantly higher (P=0.037, 0.029, 0.044). Compared with the control group, the levels of TNF-α, IL-1β and IL-6 in the test group significantly increased (P=0.032, 0.031, 0.025). And the bone mineral density of the lumbar spine and femur was negatively correlated with the levels of TNF-α, IL-1β and IL-6 in the test group (P < 0.05). In conclusion, the osteoclast activity is enhanced by elevating the levels of TNF-α, IL-1β and IL-6 of bone tissue of ovariectomized rats, and increasing the percentage of osteoclast area within the visual field. Moreover, the percentages of trabecular bone and osteoblast area within the visual field have a decline, which accelerates the process of bone resorption and leads to the formation of osteoporosis. Subject headings:Ovary; Cytokines; Osteoporosis; Tissue Engineering

Objective: To study the curative effects of Rupixiao Grains on mammary hyperplasia rats and provide the bisis for the wider use. Methods: The model of mammary hyperplasia were established with estrogen and progestogen, the changes of nipple appearance and pathological tissue of mammary gland on morphologic change were observed. The E2, P and PRL of serum were determined. Results: The treatment groups of high and middle dose of Rupixiao Grains can siginifi cantly reduce the diameter and height of nipple in rat mammary gland hyperplasia models(P

Objective This study was to assess the three-dimensional gross tumor volume(GTV)motion of lung cancer caused by respiration using four-dimensional computed tomography(4DCT),and to analyze the influenee factors.Methotis Four-DCT scans of 22 lung focuses in 21 patients with lung cancer were analyzed.The gross tumor volume was contoured in all 10 respiration phases of 4DCT scans.The changes in volume of GTV,the 3D motion of the centroid,boundary of GTV and the 3D spatial motion vectors were calculated and the irdluenee factors were analyzed.Results The average change in volume of GTV was+14.3%(0.2%.42.5%)/-8.4%(0.4%-38.6%),the average movement amplitude of GTV centroid and GTV boundary were(0.18±0.12)cm,(0.20±0.16)cm,(0.53±0.59)cm and(0.42±0.23)cm,(0.41±0.22)cm,(0.57±0.70)cm in medio-lateral,vertro-dorsal,cranio-caudal(CC) direction,respectively.The CC movement was larger than other directions(Z=-2.12,P=0.034;Z:-2.10,P=0.035),and no significant difference was observed in 3D motion of GTV boundary(Z=-0.81.P=0.417;Z=-0.86,0.391).The CC motion of GTV eentroid in lower lobe was larger than that in upper lobe[(0.87±0.64)and(0.35±0.49)cm,(t=-2.12,P=0.047)],and no significant difference was found in other directions[(0.23±0.10)and(0.19±0.18)em(t=-0.49,P=0.629),(0.21±0.13)and(0.17±0.11)cm(t=0.76,P=0.460)].There was no correlation of the 3D movement and 3D spatial motion vector of GTV to the volume of GTV(r=-0.306,-0.062,-0.279,-0.300;P=0.189,0.796.0.234,0.199).Conclusions GTV motion of patients with lung cancer is individual,the CC movement is the moat obvious,using 4DCT to assess is comparatively accurate.The motion amplitude of lower lobe focuses is larger.No significant correlation of the GTV motion to the volume was observed.Larger sample study is needed to analyze the influence of adjacency to the GTV motion.

Objective To study image-guided hypofractionated radiotherapy for thoracic and abdominal tumors,and to determine the margins extended from internal target volume(ITV) to planning target volume(PTV). Methods Twenty-four patients who received image-guided hypofractionated radiotherapy for thoracic and abdominal tumors were included in this study. X-ray cone beam CT was regularly performed before the treatment. The shift and Rotation in right-left ( R-L), superior-inferior(S-I) and anterior-posterior (A-P) directions were recorded and analyzed. The shift margin from ITV to PTV was calculated with the equation,margin =2'mean+0.7'standard deviation. Results Before online correction,the shift errors in R-L,S-I and A-P directions were [2.1±2.0] mm, [3.9±3.2] mm and [2.9±2.8] mm,and the corresponding margins were 5.6 mm, 10.2 mm and 7.7 mm. After the correction the shift errors were [0.8±0.7] mm, [0.9±0.7] mm and [0.9±0.7] mm, and the margins were 2.1 mm,2.3 mm and 2.3 mm. The set-up error was markedly decreased after the correction. There was no change in rotation after the correction. Conclusions The positioning error decreases after the correction in IGRT,and the precision of radiotherapy is improved. Measuring set-up error in radiotherapy can provide institution-specific margins for PTV designing.

Objective E0703 is derived from estradiol and has anti-radiation effects on irradiated mice, the effects of E0703 on cell viability,cell cycle and the related mechanism in irradiated AHH-1 cells were investigated in this study.Methods Cell viability,cell apoptosis and cell cycle were determined by Cell Counting Kit-8.Annexin V-FITC double staining kit and Flow Cytometry,respectively.Level of mRNA and protein were detected by RT-PCR and Western blot,respectively.Results 3.0 Gy 60 Co γ-rays induced significant cell cycle arrest,necrosis,apoptosis and reduction of viability.Pretreatment with E0703 for 12 h before irradiation could increase cell viability and regulate cell cycle.but had no obvious effect on cell necrosis and apoptosis.The expression of cell cycle arrest related molecules Rb and MDM2 were increased after 3.0 Gy irradiation,but decreased significantly with pretreatment of E0703.Moreover.the phosphorylation of Rb was also increased.Conclusions The radioprotective function of E0703 might be exerted through influencing on cell cycle and promoting cell proliferation instead of apoptosis or necrosis.

Objective To screen a human single-chain variable fragments(scFv)against antiGBM antibody.Methods Using phage display technique,the phage antibody library was panned by antiglomerular basement membrane(GBM)antibody which was coated in a micro-titer plate,one clone was found to have high affinity to anti-GBM antibody.The DNA sequence of the positive clone was determined.Results Along with the increase of rounds anti-GBM antibody specific phage antibody was highly enriched and screening efficiency was increased 137 folds than the firest round.ELISA and competition inhibition assay showed that the scFv had a specific combination character with anti-GBM antibody.DNA sequencing confirmed that the whole gene of scFv was 750 bp,and in accordance with humanized single-chain variable region antibody sequence structure.Conclusion The results suggested that the scFv fragment to anti-GBM antibody could be successfully selected by recombinant phage antibody technique,which will laid an experimental foundation for further research of the therapy of Goodpasture syndrome.

Plasmablastic myeloma is a rare pathological classification of multiple myeloma. This condition must be differentially diag-nosed because of lack of a distinctive phenotype. Involvement of the central nervous system is a rare complication of multiple myelo-ma. The choice of treatment is important for plasmablastic myeloma. Thus, this article presents a rare case of plasmablastic myeloma with multiple cranial nerve involvement. We clarify the diagnosis through the multidisciplinary team and select the optimal therapy for the patient.

Objective:To investigate the reversing effect of phosphatidylinositol 3-kinase (PI3K) inhibitors, LY294002(LY) and wortmannin (Wort), on the drug resistance of mitoxantrone (MIT)-resistant human breast cancer MCF-7/MIT cells. Methods:Drug-resistant MCF-7/MIT cells were treated with LY or Wort combined with MIT. Cell viability and proliferation were measured using the MTT assay and morphological changes were recorded by microscopy. Intracellular accumulation of MIT in MCF-7/MIT cells was detected by flow cytometry. Mitochondrial membrane potential was determined by rhodamine 123 staining. Cell cycle was examined by propidium iodide staining. Results:LY significantly enhanced the cytotoxicity of MIT to MCF-7/MIT cells. In LY and MIT cotreated cells, the percentage of cells arrested at S and G2/M phases and the mitochondrial membrane potential decreased significantly compared with single LY- or MIT-treated cells. The mechanism was related with increased accumulation of MIT in MCF-7/MIT cells induced by LY. While Wort, another PI3K inhibitor, did not significantly enhance the cytotoxic effects of MIT.Conclusion: The PI3K inhibitor significantly enhances the sensitivity of MCF-7/MIT cells to MIT.

Objective To explore the outcome of body-weight-supported treadmill training on the kinetic data of lower limb in early stage of stroke.Methods Twenty-seven hemiplegic stroke patients at early stage were recruited and randomized to an experimental group(n =15) and a control group (n =12).Both groups were administered with routine neurological interventions.In addition,the control group was treated with conventional physiotherapy and over-ground walking training,while the experimental group was treated with body-weight-supported treadmill training.The speed of the treadmill walking was started at 0.22 m/s and increased to 0.60 ～ 0.80 m/s gradually.The percentage of the body-weight being supported was not more than 30％,the training time was 5 min per session at the beginning and was increased gradually to 20 ～ 40 min.Kinetic parameters were measured by using two force plates (AMT) and six cameras capture svstem (Vicon Nexus),and motor function was evaluated using Fugl-Meyer Assessment (FMA) at baseline and after three-week's therapy.Peak moment of lower limb joints,ground reaction force and motor function were analyzed.Results FMA scores were significantly improved (P ＜ 0.05) in both groups after treatment,but there was no significant differences (P ＜ 0.05) between the two group.Ground reaction force was significantly increased (P ＜ 0.05) after treatment in the experiment group,but not in control group (P ＞ 0.05).It showed that the hip extension moment at the affected side was significantly lower (P ＜ 0.05) in experiment group than in the control group,the ankle joint flexion and extension moment peak were improved to a significantly larger extend in the experimental group (P ＜ 0.05) than in the control group.In addition,the peak flexion and extension moment of the hip-knee joint and peak flexion and extension moment of the knee-ankle joint were also significantly different from those of the control group (P ＜ 0.05).Conclusion Body-weight-supported treadmill training can facilitate motor recovery of paretic extremity by increasing ground reaction force and load support of the affected lower limb,and help normalize the abnormal gait pattern of lower extremity of stroke patients.