Objective To investigate the risk factors of hemorrhagic transformation (HT) after cerebral infarction. Methods The clinical and neuroimaging data of 100 patients (gender,age-matched)with cerebral infarction and hemorrhagic transformation from January 2005 to January 2010 were analyzed retrospectively. The following factors were listed for single factor analysis: the history of hypertension, diabetes mellitus,admission blood pressure,blood sugar,infarction size,alcohol,smoking,atrial fibrillation,hypercholesterolemia, combined anticoagulant and antiplatelet aggregation therapy. All the above factors were analyzed by chi-square test or t test, and Logistic regression analysis was used to screen out the related risk factors of HT from the potentially related factors. Results Atrial fibrillation (OR =5.483,95%CI:fibrillation,extensive cerebral infarction,blood sugar,high blood pressure at the beginning of the disease,combined anticoagulant and antiplatelet aggregation therapy are the major risk factors of HT. At the same time, the occurrence of HT is the result of the joint effect of multiple factors and multiple mechanisms.

Objective To investigate the predictive value of metabolic tumor volume (MTV) in angiogenesis and hematoge‐nous metastasis of patients with colorectal cancer .Methods Totally 108 patients with colorectal cancer from January 2011 to De‐cember 2015 were enrolled into the study and divided into metastasis group (n=42) and non‐metastasis group (n=66) according to whether combining with hematogenous metastasis .All patients received 18 F‐2‐fluoro‐D‐glucose positron emission tomography/com‐puted tomography (18F‐FDG PET/CT) before operation ,then used the PET VERA software to automatically calculate MTV ac‐cording to the 40% of standard uptake value max(SUVmax ) as the threshold .The blood vessels were identified with CD34+ immu‐nohistochemical staining ,then measured the microvessel density (MVD) .The clinical pathologic data ,SUVmax ,MTV and MVD were compared between metastasis group and non‐metastasis group .The area under the receiver‐operating characteristic curve (AUC) was performed to evaluate the predictive value of MTV on hematogenous metastasis .Results SUVmax ,MTV and MVD in metastasis group were significantly higher than that in non‐metastasis group (P<0 .05) .There were significant differences in MTV and MVD among patients with different T stage (P<0 .05) .Pearson correlation analysis results showed that MTV was positively correlated with MVD (r=0 .636 ,P<0 .001) ,and there was no significant relationship between MTV and SUVmax (r= 0 .161 ,P=0 .096>0 .05) ,MVD and SUVmax (r=0 .179 ,P=0 .064>0 .05) .AUC of MTV was 0 .736 ,and the best threshold value was 15 .016 cm3 ,whose sensitivity ,specificity ,positive predictive value ,negative predictive value and Youden index were 83 .3% ,63 .6% , 59 .3% ,85 .7% and 47 .0% respectively .Conclusion Compared with SUVmax ,MTV of colorectal cancer is associated with angio‐genesis and hematogenous metastasis ,so as to predict the prognosis of colorectal cancer ,which is worthy of clinical application .

Objective To investigate the epidemiological and clinical characteristics and prognosis of 31 children with hand foot and mouth disease(HFMD) complicated with acute flaccid paralysis(AFP).Methods Thirty-one HFMD children complicated with AFP served as study objective,who were admitted to Tangshan Maternity and Children Health Hospital from Jun 2011 to Dec 2014.The clinical manifestations and follow-up outcomes of 31 children with HFMD followed by AFP were retrospectively reviewed.Results Participants in this study consisted of 31 children(16 males,15 females,age from 3 months to 9 years) who met the criteria for HFMD with AFP.Among the 31 cases,27(87.1％)cases were less than 3 years old and 29(93.5％) cases were from countryside.Eleven cases (35.5％)were infected by enterovirus 71,1 case (3.2％) was infected with coxsackieviruses A16 and 19 cases(61.3％) were infected by other enteroviruses.AFP developed(7.1 ±2.9) days after the onset of fever and progressed to maximum severity within 1-2 days.All of the cases presented with fever and skin rash,38.7％ cases presented with limbs tremor and 87.1％ cases presented with startle and skip.Besides AFP of limbs, 100％ cases complicated with encephalitis.Thirty-one cases showed poliomyelitis-like syndrome(20 cases with one flaccid limb,5 cases with lower limbs,4 cases with upper limbs and 2 cases with left hemiplegia).In these cases, the muscle power varied from level 0 to level 4.The muscle strengthen and muscle tone in 21 patients were recovered within 2 weeks,and the other cases showed recovery 2 to 3 weeks later.After four weeks, the muscle strengthen in 19 cases recovered to 5 level(10 cases with single lower limb,5 cases with single upper limb,3 cases with two lower limbs and 1 case with two upper limbs).Conclusion HFMD complicated with AFP most commonly occurs in children aged less than 3 years old.The majority of cases were from countryside.Enterovirus 71 is still relatively common pathogen.All the 31 cases complicated with encephalitis.Cases clinically presented one flaccid limb, lower limbs, upper limbs and hemiplegia.AFP may be to some degree reversible in HFMD cases.In most cases described here, paralysis occurred in a single lower extremity and recovered more rapidly than those with two fimbs affected or with single upper extremity impairment.

Objective To investigate the effect of midazolam combined with fentanyl as adjuvant therapy on inflammatory factors and biochemical indexes in children with serious hand-foot-mouth disease with mechanical ventilation .Methods One hundred and thirty children with serious hand-foot-mouth disease treated with mechanical ventilation were selected at Maternal and Child Health Care Hospital from January 2010 to January 2014 . The patients were divided into two groups according to the treatment regimen :58 cases treated with midazolam for sedation and analgesia as control group and 72 cases treated with midazolam combined with fentanyl as observation group . Inflammatory factors (interleukin-6 , interferon-γ ,high-sensitivity C-reactive protein and tumor necrosis factor-α) and biochemical indices (albumin ,alanine transaminase [ALT] ,aspartate transaminase [AST] ,alkaline phosphatase ,glutamate transpeptidase [γ-GT] and fasting blood glucose) before drug exposure and on withdrawal were compared between two groups .Adverse reactions were analyzed in the two groups .Continuous variables were compared using two-sample t-test , while categorical variables were compared using chi-square test . Results Interleukin-6 ,interferon-γ, high sensitive C reactive protein and tumor necrosis factor-α on withdrawal decreased significantly in both groups than those before drug exposure (all P< 0 .05) .All observation indices on drug withdrawal in observation group were significantly lower than control group (all P< 0 .05) .Levels of albumin ,ALT ,AST ,alkaline phosphatase and γ-GT were not significantly different between two time points in both groups (all P>0 .05) .However ,in observation group ,fasting blood glucose level decreased significantly on drug withdrawal compared with that before drug exposure ([5 .17 ± 0 .28] vs [10 .31 ± 1 .39] mmol/L ,t=46 .237 ,P=0 .000) ,and that was also lower than control group ([5 .17 ± 0 .28] vs [5 .85 ± 0 .34] mmol/L ,t=4 .372 ,P=0 .000) .Incidence of adverse reactions in observation group was significantly lower than control group (15 .3% vs 32 .8% ,χ2=4 .707 ,P=0 .030) . Conclusions Midazolam combined with fentanyl as adjuvant therapy is helpful to improve blood glucose , stabilize biochemical indices and reduce inflammation factor secretions in children with serious hand-foot-mouth disease with mechanical ventilation .This therapy is safe and worthy of clinical use .

ObjectiveTo study the possibility of the liver histioid construction through co-culturing hepatocytes and sinusoidal vessel endothelial cells (SVECs) on hyaluronic acid(HA) scaffold.MethodsHepatocytes and SVECs of a mouse were isolated respectively, and then were cultured successively in HA scaffold. The scaffold-cell complexes formed later were implanted onto the surfaces of liver in the mouse. After 2 weeks, the implants were taken out for HE staining and compatibility evaluation.ResultsThe isolated hepatocytes and SVECs were vigorous. The implants inosculated well with liver tissue of the host with visible growth of blood vessels in the implants. The hepatocyte aggregation grown around the vessels, the liver-like tissue, were observed.ConclusionIt is feasible to construct liver histioid through co-culturing hepatocytes and sinusoidal vessel endothelial cells on hyaluronic acid scaffold.

Objective To investigate the problems during using, standard and quality management of the POCT glucose meters in hospital, to analyze the solutions, and to provide reference data for improving the test level of POCT in hospital.Methods The amount, brand and application of portable glucose meters in the hospital were obtained by 3 rounds of surveillance from May to July in 2013.All of those glucose meters were taken part in external quality assessment of Clinical Laboratory Center of National Health and Family Planning Commission.The test results of those glucose meters were compared with that of automatic biochemical analyzer, the comparison results were then analyzed.Results The POCT glucose meters possessed 5 brands in our hospital, and the amount and type of glucose meters in some clinical departments were often changed.When 4 brands which were detected as quality control samples by ministry of health, the accuracy of detection results of 3 concentration of brand Ⅲ were substandard, the CV% of two levels were 11.9%and 10.1%respectively, the remaining 3 brands were in line with the requirements.The qualified percentages of 3 times of comparison were 85.0%, 92.0%and 97.4%.Conclusions The hospital should select the brand of portable glucose meters reasonably, correct use of glucose meters, and it is very necessary to build indoor and interstitial quality evaluation system, at the same time, suggesting the hospital to establish the POCT quality management team, to carry out the instrument comparison periodically, so to guarantee the accurate, reliable results of POCT in hospital.

Acute ischemic stroke has ischemic penumbra and actual infarct core, and when there is a bigger difference in the volume of the two, it is called " mismatch". It is not only manifested as a mismatch between the clinical manifestations and the infarct core, but also as a mismatch between the infarct core and the perfusion area. The advancement of neuroimaging technology enables this " mismatch" phenomenon to be manifested through different imaging methods or different sequences of the same imaging method, thereby providing more guidance for the further diagnosis and treatment process.

Hydatid worms, hosted by humans and animals, impose serious human health risk and cause significant livestock production loss. To better understand the disease infection status in Xinjiang, China, we investigated the disease epidemics in 4 livestock animals, i.e., cattle, sheep (both sheep and goat), camels, and horses, slaughtered at the abattoirs in Urumqi, Yining, Tacheng, and Altay areas. The results showed that the animals were infected at different rates, in the order of sheep (9.8%), cattle (8.4%), camels (6.8%), and horses (4.3%). The infection rates were found to be different between the abattoirs in various regions even for the same animals. For sheep, the rates increased significantly as the animals grew older. It was 1.9% before 1 year of age and increased to 8.2% in the age of 1-2 years, and further increased to 12.3% when the animals were 3-4 years old, and reached 17.2% when they were 5-6 year old. Sheep older than 6 years had an infection rate of 19.5%. This study demonstrates that the 4 livestock animals in the pastoral areas in Xinjiang were infected by the parasites to various extend. This study is the first systematic investigation of the hydatid worms in various livestock animals in Xinjiang, China, which provides epidemiological information about the infection of hydatid worms in livestock, and is valuable in developing strategies for prevention and control of the hydatid disease.
Age Factors ; Animals ; China/epidemiology ; Echinococcosis/epidemiology/*veterinary ; *Livestock ; Prevalence

Activating humoral and cellular immunity in lymph nodes (LNs) of nanoparticle-based vaccines is critical to controlling tumors. However, how the physical properties of nanovaccine carriers orchestrate antigen capture, lymphatic delivery, antigen presentation and immune response in LNs is largely unclear. Here, we manufactured gold nanoparticles (AuNPs) with the same size but different shapes (cages, rods, and stars), and loaded tumor antigen as nanovaccines to explore their disparate characters on above four areas. Results revealed that star-shaped AuNPs captured and retained more repetitive antigen epitopes. On lymphatic delivery, both rods and star-shaped nanovaccines mainly drain into the LN follicles region while cage-shaped showed stronger paracortex retention. A surprising finding is that the star-shaped nanovaccines elicited potent humoral immunity, which is mediated by CD4⁺ T helper cell and follicle B cell cooperation significantly preventing tumor growth in the prophylactic study. Interestingly, cage-shaped nanovaccines preferentially presented peptide-MHC I complexes to evoke robust CD8⁺ T cell immunity and showed the strongest therapeutic efficacy when combined with the PD-1 checkpoint inhibitor in established tumor study. These results highlight the importance of nanoparticle shape on antigen delivery and presentation for immune response in LNs, and our findings support the notion that different design strategies are required for prophylactic and therapeutic vaccines.

The continuing challenges that limit effectiveness of tumor therapeutic vaccines were high heterogeneity of tumor immunogenicity, low bioactivity of antigens, as well as insufficient lymph nodes (LNs) drainage of antigens and adjuvants. Transportation of in situ neoantigens and adjuvants to LNs may be an effective approach to solve the abovementioned problems. Therefore, an FA-TSL/AuNCs/SV nanoplatform was constructed by integrating simvastatin (SV) adjuvant loaded Au nanocages (AuNCs) as cores (AuNCs/SV) and folic acid modified thermal-sensitive liposomes (FA-TSL) as shells to enhance de novo antitumor immunity. After accumulation in tumor guided by FA, AuNCs mediated photothermal therapy (PTT) induced the release of tumor-derived protein antigens (TDPAs) and the shedding of FA-TSL. Exposed AuNCs/SV soon captured TDPAs to form in situ recombinant vaccine (AuNCs/SV/TDPAs). Subsequently, AuNCs/SV/TDPAs could efficiently transport to draining LNs owing to the hyperthermia induced vasodilation effect and small particle size, achieving co-delivery of antigens and adjuvant for initiation of specific T cell response. In melanoma bearing mice, FA-TSL/AuNCs/SV and laser irradiation effectively ablated primary tumor, against metastatic tumors and induced immunological memory. This approach served a hyperthermia enhanced platform drainage to enable robust personalized cancer vaccination.