Cerebrovascular disease is a common cause of cognitive impairment or dementia.Vascular cognitive impairment (VCI) often occurs independently or coexists with Alzheimer's disease and other neurodegenerative diseases.Early intervention of vascular risk factors,such as hypertension,can prevent or delay the process of VCI.MRI can only reveal the parenchymal damage from structures,but can not early identify brain tissue dysfunction or the presence of VCI.The molecular imaging techniques,such as single-photon emission computed tomography and positron emission tomography have been gradually used to the field of neuroscience.They have important roles in the diagnosis,differential diagnosis,and related research of VCI.

Objective To evaluate a chemically-modified chitosan anti-adhesion film in the prevention of intestinal adhesion after abdominal surgery.Method In this study 240 patients at the Department of Surgery, Fudan University Zhongshan Hospital undergoing abdominal surgery from Jan 2006 to Dec 2006 were randomly divided into two groups.In the research group, chemically-modified chitosan antiadhesion film was put both at the area of operation and under the incision before closing the abdomen.The recovery procedures were recorded including the recovery of gut movement, the degree and the lasting time of abdominal pain, complication after surgery, the abdominal pain and ileus within 1 year.Result Postoperative incision pain was less significant in research group.The gut function recovered quicker and dietary began earlier.The ratio of early ileus after the surgery decreased significantly.The abdominal adhesion symptom in 1 year after surgery ameliorated significantly.There was no significant difference in other postoperative complications in the two groups.Conclusion The use of chemicallymodified chitosan anti-adhesion film helps to prevent the intestinal adhesion after the abdominal surgery.

Objective To study the changes of T lymphocyte subtype levels and serum levels of leukotriene B4 ( LTB4 )in children with acute leukemia (AL). Methods The activity of T lymphocyte subsets:CD3+ T cells,CD4+ T cells,CD8 + T cell levels and NK cell were detected in 40 cases of AL and 40 control by Flow Cytometry(FCM). The serum level of LTB4 was measured by ELISA in all subjects. ResultsCompared with normal control , the percentages of CD3 + T cells ( [ 49.51 ± 6.53 ] ％ vs [ 67.63 ± 5.23 ] ％ ), CD4 + T cells ([22.15±4.87]％ vs [34.43 ±5.07]％),CD8+ T cell ([23.41 ±3.96]％ vs [28. 17 ±4.61]％),NK cell ( [5.41 ± 4.25 ] ％ vs [ 13.10 ± 4.91 ] ％ ) were significantly lower in children AL patients, ( Ps ＜0.01 ). However,the serum levels of LTB4 increased significantly in AL patients compared with normal control ( [ 25.23 ± 6.24 ] ng/L vs [ 8.28 ± 2.53 ] ng/L, P ＜ 0.01 ). ConclusionT lymphocyte subtype and serum level of LTB4 showed significant changes in children AL patients compared with normal control, which revealed an important theoretical basis to AL pathogenesis.

Objective To investigate the safety of preoperative hepatic and regional arterial infusion chemotherapy in the prevention of liver metastasis and improving survival after curative colorectal cancer resection.Methods Patients admitted from 2001 to 2007 with Stage Ⅱ or Stage Ⅲ colorectal cancer were randomly assigned to receive preoperative hepatic and regional arterial infusion chemotherapy (PHRAIC group,n=256)or surgery alone(control group,n=253).Toxity of liver,hematology,immunology and post-operative complication of PHRAIC and the control were evaluated.Results Grade Ⅲ hepatic toxity,leukemia,anemia and platelet decrease in PHRAIC group was 3.1%(8/256),5.5% (14/256),7.4%(19/256)and 6.6%(17/256).There were no grade Ⅳ toxities,and all the patients in PHRAIC group received surgery.Morbidity rate in PHRAIC and the control group was 9.8%(25/256)vs 8.3%(21/253)(X2=1.86,P＞0.05).All patients were followed up,with mean follow up of 42±14 months until Oct 30.2007.For stage Ⅲ patients,5-year overall survival and liver metastasis rate were 81.0% in PHRAIc group vs.60.4% in control group(X2=5.15,P＜0.05)and 18.9%(28/148)vs 27.3%(41/150)(X2=5.41,P＜0.05),respectively.Conclusion Preoperative hepatic and regional arterial infusion chemotherapy 7 days before surgery was safe and could reduce liver metastasis and improve survival rate in patients with Stage Ⅲ colorectal cancer.

Objective: The random forest algorithm was used to construct a rapid screening diagnostic prediction model for children with autism spectrum disorder, to provide the references for early detection, early diagnosis of ASD children, and to reduce the pressure of ASD clinical diagnosis and assessment. Methods: The random forest algorithm of machine learning was applied to build the auxiliary diagnosis model. Totally 346 ASD children and 90 normal children were evaluated by Social Responsiveness Scale and Vineland Adaptive Behavior Scales. ROC curve, and accuracy was used to evaluate the models. Results: Among the models, the accuracy of 13 feature factors and 7 feature factors were above 0.9, the sensitivity was up to 0.927, the specificity was up to 0.936 and the AUC was up to 0.979. The accuracy, sensitivity, specificity and AUC of the model were 0.943,0.959,0.931 and 0.978 respectively. The fitting and generalization effects of the three models were all satisfactory. Conclusion A random forest model based on the SRS Scales and Vineland Adaptive Behavior Scales can be used to diagnose ASD accurately and provide scientific basis for the development of rapid screening and diagnosis tools.

AIM:To study the regulation of endoplasmic reticulum stress(ERS)using the glucose regulated protein 78(GRP78)/CCAAT/enhancer binding protein homologous protein(CHOP)pathway and explore the related mech-anism of Wenyang-Shengji ointment in facilitating the repair of diabetic refractory wounds.METHODS:To establish a rat model of diabetic refractory wound repair,Sprague-Dawley(SD)rats were fed a high-fat diet and intraperitoneally in-jected with streptozotocin.Subsequently,full-thickness skin defects were induced in the dorsal region of the rats.The ex-periment included 4 groups:normal,model(diabetic refractory wounds),Wenyang-Shengji ointment,and Beifuxin(re-combinant bovine basic fibroblast growth factor gel)groups.The normal and model groups were treated with normal saline after disinfection.In the Wenyang-Shengji ointment and Beifuxin groups,the wounds were topically treated with the re-spective ointments once daily.After 14 d of treatment,wound healing was assessed and quantified using the wound healing rate.Hematoxylin-eosin(HE)staining was employed to examine the micromorphology of the wound tissue.Western blot analysis was performed to measure GRP78,CHOP and caspase-12 levels in the wound tissue.Immunohistochemical analy-sis was used to detect the expression and distribution patterns of GRP78,CHOP and caspase-12 in the wounds.Transmis-sion electron microscopy was used to observe reticulum numbers and swelling.Enzyme-linked immunosorbent assay was used to determine interleukin-1β(IL-1β)level as a pro-inflammatory factor within the wound.RESULTS:Indexes of each group were assessed 14 d after the corresponding intervention.Compared with normal group,the rats in model group exhibited a significant decrease in the wound healing rate(P＜0.01),accompanied by increased inflammatory exudation and poor granulation tissue growth.Additionally,there were increases in the expression levels of GRP78,CHOP and cas-pase-12 proteins(P＜0.01),as well as a significant elevation in the content of inflammatory factor IL-1β(P＜0.01).In contrast,compared with model group,treatment with Wenyang-Shengji ointment resulted in a significant improvement in wound healing rate(P＜0.01),reduction in inflammatory exudation,and enhanced granulation tissue growth(P＜0.01).Furthermore,there was a notable decrease in the protein expression of GRP78/CHOP/caspase-12 within the wound tissue following treatment with Wenyang-Shengji ointment(P＜0.01).The levels of inflammatory factor IL-1β also showed a sig-nificant decrease(P＜0.01).CONCLUSION:Wenyang-Shengji promotes the healing of diabetic refractory wounds,which may be associated with the downregulation of the GRP78/CHOP pathway,inhibition of excessive ERS,and reduc-tion in the level of wound cell apoptosis.

Background Individuals may experience significant alterations in sleep hygiene during the major public health emergencies,consequently impacting their sleep quality.Objective To explore the relationship between sleep quality and sleep hygiene among adult residents during the major public health emergencies,so as to provide references for improving the sleep quality of residents during such a period.Methods A sample of 1 364 adult residents were enrolled as the research subjects from February 20 to 29,2020.All participants were asked to complete self-administered questionnaire to obtain basic-demographic information and sleep hygiene.Pittsburgh Sleep Quality Index(PSQI)was applied to assess sleep quality.Residents were classified into poor sleepers with PSQI score≥8 and good sleepers defined as PSQI score<8.Binary Logistic regression analysis was conducted to identify factors associated with sleep quality.Radar chart was used to visualize and compare the sleep hygiene between poor sleepers and good sleepers.Results According to PSQI score,891(65.32%)residents were good sleepers,while 473(34.68%)residents were poor sleepers.Comparison revealed that age(χ2=3.887),past medical history(χ2=27.938),awareness rate of importance of sleeping before major public health emergencies(χ2=4.337),impact of sleep quality on quality of life during the major public health emergencies(χ2=178.138),frequency of staying up late during the major public health emergencies(χ2=139.390),compensatory sleep behaviors(χ2=39.257),impact of sleep problems on daytime functioning(χ2=285.879),change of bedtime(χ2=63.031),sleep latency(χ2=168.672),wake-up time(χ2=59.221),changes in sleep duration(χ2=172.332),time spent in the bedroom(χ2=23.071),and sum of money spent on improving sleep environment(χ2=58.584)yielded statistical difference between poor sleepers and good sleepers(P<0.05 or 0.01).Logistic regression analysis denoted that past medical history(OR=1.680,95%CI:1.185～2.382),negative impact of sleep quality on quality life(OR=4.181,95%CI:2.722～6.422),staying up late 3 to 4 times per week(OR=3.145,95%CI:1.497～6.605),staying up late almost every day(OR=4.271,95%CI:1.970～9.260),negative impact of sleep problems on daytime functioning(OR=7.169,95%CI:5.188～9.907),prolonged sleep latency(OR=2.836,95%CI:2.019～3.982)and shortened sleep duration(OR=3.518,95%CI:2.144～5.772)were risk factors of poor sleep quality.The sum of money spent on improving sleep environment following the major public health emergencies≤500 RMB(OR=0.334,95%CI:0.134～0.830)was related to the incidence rate of poor sleep quality.Radar chart showed that poor sleepers were characterized by extravagant concerns,excessive cleanliness and poor sleep hygiene practices during the major public health emergencies,and poor sleepers were more likely to stay up late due to stress and emotional issues.Conclusion Some residents are facing poor sleep quality during the major public health emergencies,and poor sleep hygiene practice also contributes to poor sleep quality.

Objective To analyse the clinical features and treatment strategies of papillary thyroid carcinoma(PTC) coexistent with lymphocytic thyroiditis (LT).Methods A total of 292 patients including 25 males and 267 females with LT and thyroid nodules treated in the department of head and neck surgery between Sep 2011 and Sep 2014 was analysed retrospectively and divided into two groups according to pathological results,of them 262 patients,with a median age of 47 years old,were LT with PTC and 30 patients,with a median age of 54 years old,were LT with benign nodules.Among 262 patients having LT with PTC,259 were diagnosed as having malignant or suspicious malignant nodules and 3 having benign nodules with ultrasound before surgery,98 cases were considered multifocal malignant nodules by preoperative ultrasound,and 112 cases were positive in cervical lymph nodes,including bilateral positive in 37 cases.Of 30 patients having LT with benign nodules,14 were diagnosed malignant or suspicious malignant nodules and 16 benign nodules.Results The mean age in 262 patients with PTC was less significantly than that in 30 patients with benign nodules (P ＜ 0.05).Ultrasound showed a high proportion of calcification and microcalcification in patients with PTC (34％) compared to patients with benign nodules (13 ％) (P ＜ O.05).There were not significant differences in the mean levels of serum thyroid stimulating hormone(TSH) (2.80 vs 2.99 mU/L,P =0.233),thyroglobulin(TG) (27.14 vs 18.60 μg/L,P =0.747),and anti-thyroglobulin antibodies (ATG) (417.3 vs 378.7 U/ml,P =0.834) between patients with PTC and those with benign nodules.In patients with PTC,multifocal tumor accounted for 42％.The central and lateral lymph node metastasis rates were respectively 50％ and 24％,and the occult metastasis rate of lateral neck lymph node was 16％.Univariate analysis showed that age less than 45 years old,multifocal tumor,tumor diameter more than or equal to 2cm and extrathyroidal extension were associated with central lymph node metastasis (P ＜ 0.05),but not with lateral neck metastasis.Multivariate analysis showed a closed correlation only between the lymph node metastases in central and lateral neck levels (P ＜ 0.05).Conclusions Calcification and microcalcification have the same importance in the ultrasonic diagnosis for PTC in patients with LT.Total thyroidectomy and prophylactic central lymph node should be a choice for LT with PTC.Lymph node metastasis in level Ⅵ indicates the possibility of lateral cervical lymph node metastasis in the patients having LT with PTC.

ABSTARCT AIM: To investigate the effect of Ginkgo biloba extract (GBE) on kidney injury in rats with chronic renal failure (CRF) and its potential molecular mechanism. METHODS: SD rats were given 5/6 nephrectomy to construct CRF models and divided into model group, GBE group (100 mg /kg), GBE+ Agomir-NC group, and GBE+Agomir-145 group, 12 per group; another 12 were selected as the sham group, with only the kidney exposed and no nephrectomy. Rats in the GBE group were given GBE 100 mg/kg gavage daily, once a day, for 4 consecutive weeks; rats in the GBE+Agomir-NC group and GBE+Agomir-145 group were given GBE 100 mg/kg gavage daily, and then Agomir-NC and Agomir-145 were injected via the tail vein every 3 days for 4 weeks; the sham group and the model group were given the same amount of normal saline by gavage and injection through the tail vein respectively. The general state of the rat was observed, and the renal function indicators [24 h urine microalbumin (24 h UAlb), blood urea nitrogen (BUN), blood creatinine (SCr)] and oxidative stress indicators [malonaldehyde (MDA), Superoxide dismutase (SOD), glutathione peroxidase (GSH-Px)] were detected, Masson staining was used to observe the fibrosis of kidney tissue, real-time fluorescent quantitative PCR (RT-qPCR) was used to detect the mRNA expression levels of microRNA-145 (miR-145), transforming growth factor - β1 (TGF - β1) and forkhead box O1 (FOXO1) in renal tissue, Western blot was used to detect the protein levels of TGF - β1 and FOXO1 in kidney tissue. RESULTS: The general state of CRF rats improved significantly after GBE intervention, the body weight, renal tissue SOD and GSH-Px activities, and FOXO1 mRNA and protein levels were significantly higher than those in the model group (P<0.05); the 24 h UAlb, serum BUN, SCr and renal tissue MDA levels, the relative area of renal interstitial fibrosis, and renal tissue miR-145, TGF - β1 mRNA and protein levels were significantly lower than those in the model group (P<0.05); and on the basis of GBE intervention, up-regulating the expression of miR-145 could significantly weaken the protective effect of GBE on renal injury in CRF rats (P<0.05). CONCLUSION: GBE can alleviate kidney damage in CRF rats, and its mechanism of action may be related to down-regulation of miR-145, up-regulation of FOXO1 expression, and inhibition of renal fibrosis.

Objective To investigate the effects of nonylphenol (NP) exposure on the activity of SOD and GSH-Px and the content of MDA in gastric tissue of SD rats. Methods Twenty-four clean SD rats were randomly divided into four groups, 6 in each group. The negative control group was given corn oil, and the exposure groups included low, medium and high doses of NP treatment groups. NP was prepared in corn oil and administrated intragastrically. The concentration of NP was 25, 50 and 100 mg/kg, respectively, given once a day. After 42 days of continuous intragastric administration, the animals were sacrificed under anesthesia and gastric tissues were collected. The pathological changes of gastric tissues were observed by HE staining. The activity of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and level of malondialdehyde (MDA) in gastric tissues were respectively detected by chemical colorimetry. Results No bleeding or necrosis was found in the gastric mucosa of all groups by naked eye view. Pinhole-sized pigmentation was found in the stomach wall fold and bulge of NP medium dose group, and the number of pigmentation spots was increased significantly in NP high dose group. HE staining showed that the epithelial cells and glands of gastric mucosa of rats in normal group were arranged neatly and intact, and no any defect or abnormality in mucosal myometrium was observed. In the low dose group, hyperemia and edema, and vasodilation in the mucosal glands were observed, while in the medium and high dose groups, the epithelial cells of the gastric mucosa were damaged and exfoliated, the glandular ducts were swollen and congested, and lymphocyte infiltration was observed in the mucosa and interstitium. Compared with the control group, SOD activity in the high dose group was significantly decreased (P<0.05), while there was no significant difference between the low/medium dose groups and the control group (P>0.05). SOD activity decreased gradually with the increase of the dose. Compared with the control group, there was no significant difference in GSH-Px content among the NP exposure groups. Compared with the control group, the MDA content in the low dose group was significantly increased (P<0.05), while there was no significant difference in the medium and high dose groups. Conclusion Short-term exposure to 25mg/kg nonylphenol caused oxidative damage to gastric mucosa.