Objective We determined the proportion of doctors in Haidian community participating in the training of secondary prevention of ischemic cerebrovascular diseases related knowledge and the knowledge level of doctors so as to make a new targeted training plan,and assessed the effect of the training.Methods We enrolled 80 doctors,who filled out the questionnaire on secondary prevention of ischemic cerebrovascular diseases related knowledge,from 22 Haidian community center from March to July in 2014 in Beijing.The primary outcome was the proportion of doctors with the training of secondary prevention of ischemic cerebrovascular diseases related knowledge and the improvement rate of new training.Results Seventy (87.5％) community doctors didn't accept ischemic stroke secondary prevention system training.The understanding of Chinese Ischemic Stroke Subclassification and three cornerstones of secondary prevention of ischemic stroke(anti-hypertention,anti-lipidemia,antithrombotic) after the training was significant improvement (20％ vs.82.5％,P ＜ 0.05;31.25％vs.90％,P ＜ 0.05),while according to different causes classification subtype the doctors could make corresponding strategies of secondary prevention of ischemic cerebrovascular diseases.The rates of all community risk factors identification,community health education,lifestyle intervention,antihypertension,aspirin use,statin use,hypoglycemic treatment were both above 60％ no matter before the training or after the trainig.Conclusion Our results suggest that the community doctors in Haidian District lack corresponding knowledge of ischemic stroke secondary prevention.Further training of ischemic stroke secondary prevention is needed.

OBJECTIVE: To assess the evaluation on auditory rehabilitation effect for 42 deaf children with GJB2 gene mutation after cochlear implantation to provide a reference for the cochlear implant effect evaluation of such patients. METHOD: To conduct the detection on common genetic deafness gene mutation hotspots of hearing impaired children with cochlear implantation. To conduct auditory rehabilitation effect evaluation on 42 cases of patients with GJB2 genetic deafness after 3 months, 6 months and 12 months of the operation respectively. The single factor repeated measure ANOVA was applied to analyze whether there were significant difference among the results of initial consonant of a Chinese syllable recognition at 3 different stages after the operation, the results of vowel of a Chinese syllable recognition at 3 different stages after the operation, and the results of two-syllable recognition at 3 different stages after the operation. RESULT: 235delC is the high-incidence mutational site in 42 cases of patients with GJB2 genetic deafness, the total detection rate is up to 90.48%. There were significant differences in the initial consonant of a Chinese syllable recognition rate, the vowel of a Chinese syllable recognition rate, the two-syllable recognition rate as well as the vowel of a Chinese syllable recognition rate after 3 months, 6 months and 12 months of the operation (P < 0.01). CONCLUSION Cochlear implantation is a safe and effective measure for auditory reconstruction, it can help patients with GJB2 hereditary severe sensorineural deafness to improve auditory speech recognition.
Asian Continental Ancestry Group ; Child ; Cochlear Implantation ; Connexin 26 ; Connexins ; genetics ; Deafness ; genetics ; rehabilitation ; Hearing Loss, Sensorineural ; genetics ; rehabilitation ; Humans ; Language ; Mutation

In this article we report the results on the synthesis and accumulation of PHAs by Rhodocista pekingensis (strain 3-p), a phototroph that was isolated from wastewater treatment plant. Our results showed that the optimal conditions for PHAs accumulation with strain 3-p were as following: 0.01% Yeast Extract, 0.01% NH 4Cl, Acetate 5 g/L, and medium pH of 7.0～7.2.Under optimized conditions, strain 3-p accumulated PHAs up to 60% of its cellular dry weight. Enzymatic activities of ?-ketothiolase, acetoacetyl-CoA reductase, and PHA polymerase were detected and their activities increased as PHA synthesis initialized. Based on these study, we proposed the metabolic pathway of this strain should be:Acetate (or other fatty acids) - Acetyl-CoA --- thiolase Acetoacetyl-CoA --- reductase D (-)-?-Hydroxybutyryl-CoA ----- PHA polymerase PHAs.

Objective:To explore best drug treatment regimen through the participation of clinical pharmacists in the drug treat-ment of one patient with multidrug-resistant Acinetobacter baumannii meningitis intracranial infection. Methods: Clinical pharmacists joined in the treatment team and designed the treatment plan. The individualized dosage regimen was made out through the choices of drugs, dose and administration route, and taking the ADR of drugs into consideration. Results: The intracranial multidrug-resistant Acinetobacter baumannii infection was controlled by the sensitive antibiotics. Cefoperazone sulbactam and minocycline were both effec-tive in the treatment of Acinetobacter baumannii intracranial infection. Conclusion:Clinical pharmacists should provide clinical consul-tation for physicians to ensure the safety, effectiveness and economic of patients’ medication.

Objective By studying the different blood volume blood donors machine adopt platelet product aggregation,platelet content,the machine adopt circulating volume,etc,analysis of different blood volume machine adopt donors on appropriate conditions.Methods The base material of randomly selected 307 blood donors,through blood related index in the study of circulating volume,blood volume,gender,platelets,Hct,Pct count before collection,machine adopt of platelet aggregation and the relationship between the acquisition time;different blood volume,blood platelet count grouping machine adopt the different of platelet aggregation rate,different amount of platelets collect blood volume group,the comparison of blood circulation.The use of statistical software SPSS 17.0,data analysis,analysis including multiple regression analysis,chi-square test,t test,etc.Results 1)The lower count of platelets,Hct,Pct count before collection,the longer the acquisition time,and gender and Pct has nothing to do with the acquisition time the longer the acquisition time,the higher the machine adopt the possibility of platelet aggregation.2)Low blood volume and low platelet count group,machine mining platelet aggregation rate is higher.3)Machine adopt donors of blood volume is higher,the machine adopt the platelet collection amount,the more and the less blood circulation.Conclusion According to the different blood volume blood donors check-up indicators,further carries on the reasonable analysis,optimized machine mining scheme,especially to reasonable arrangement of low blood volume blood donors,so as to improve the quality of platelet collection.

Objective To evaluate the relationship between smoking and p53 gene mutation in the lung cancer patients with Meta-analysis.Methods PubMed,Web of Science,ProQest and Medline were used to search all the relevant studies about the association between smoking and p53 gene mutation in the patients with lung cancer. Based on reviewing full text,the studies were selected and evaluated and the data was extracted.Statistical analysis was performed with Stata 1 2.0 software including the heterogeneity inspection, publication bias assessment, sensitivity analysis,effect consolidating and cumulative Meta-analysis.Results Totally 15 articles with 1 770 lung cancer patients were identified. 69.6% of the patients were smokers,30.4% were non-smokers.Overall,the smokers with lung cancer had a 2.70-fold higher risk for p53 gene mutation than the non-smokers with lung cancer (OR=2.70,95%CI=2.04-3.59).Conclusion p53 gene mutation is associated with smoking in the patients with lung cancer.The smokers with lung cancer have higher risk for p53 mutation than non-smokers.

Objective To investigate the relationship between early progression in elderly patients with minor stroke and abnormal circadian rhythm of blood pressure.Methods From June 2013 to December 2016,180 patients with mild stroke (age >65 years,the National Institutes of Health Stroke Scale Score ≤3) at the Department of Neurology,Beijing Zhongguancun Hospital were recruited retrospectively.They were divided into either a progress group (n=48;the National Institute of Health Stroke Scale score increased≥2) or a non-progress group (n=132) according to whether they developed an early neurological deterioration (within 5 days after onset).The baseline data,risk factors for cerebrovascular disease (hypertension,diabetes mellitus,stroke,chronic smoking,alcohol consumption,hyperlipidemia,and homocysteine) in patients of both groups were compared.The normal (dipper-type blood pressure)/abnormal circadian rhythm of blood pressure (non-dipper-type blood pressure,super dipper-type blood pressure,and inverse dipper-type blood pressure) were monitored by ambulatory blood pressure monitoring.The guilty arteries were divided into severe stenosis or occlusion,non-severe stenosis or without stenosis.Multivariate logistic regression analysis and multi-class dummy variable analysis were further performed.Results The proportions of past diabetes history,stroke history,abnormal circadian rhythm of blood pressure,severe stenosis and occlusion of guilty artery in the patients of the progress group were higher than those of the non-progress group (70.8% [n=34] vs.49.2% [n=65],64.6% [n=31] vs.47.7% [n=63],89.6% [n=43] vs.26.5% [n=35],and 77.1% [n=37] vs.39.4% [n=52] respectively).The differences were statistically significant (all P<0.05).The factors of having statistical differences were substituted into multivariate logistic regression analysis,which showed that abnormal circadian rhythm of blood pressure (OR,7.072,95%CI 3.004-16.431;P<0.01) and severe stenosis or occlusion of guilty arteries (OR,6.217,95%CI 2.034-14.212,P=0.003) were the independent risk factors for early progression of minor stroke in the elderly.The dummy variable analysis of abnormal circadian rhythm of blood pressure showed that the super dipper-type blood pressure (OR,13.429,95%CI 4.175-111.668;P<0.01) in abnormal circadian rhythm of blood pressure was an independent risk factor for early progression of minor stroke in the elderly.Conclusion The abnormal circadian rhythm of blood pressure,especially super dipper-type blood pressure,may be the independent risk factor for early progression of minor stroke in the elderly,which needs to pay close attention to early intervention.

Background The effect of chronic stress on cognitive functions has been one of the hot topic in neuroscience. But there has been much controversy over its mechanism. Such single stressor applied in the past could not simulate complicated living circumstances that people confronted with. The aim of this study was to investigate the effects of chronic multiple-stress on learning and memory as well as on the levels of calcium/calmodulin-dependent protein kinase II (CaMKII), calmodulin (CaM) mRNA, and cAMP-response element binding protein (CREB) mRNA in the hippocampus of rats. Methods The rats were divided randomly into stressed and control groups. The stressed group was given chronic multiple-stress for 6 weeks to set up a chronic multiple-stressed model. The rats' performance of spatial learning and memory was tested using Morris Water Maze (MWM) and Y-maze. Meanwhile, the expressions of CaMKII, CaM mRNA and CREB mRNA of rats' hippocampus were detected by immunohistochemistry, Western blot and reverse transcription-polymerase chain reaction (RT-PCR), respectively. In addition, the width of synaptic cleft and the thickness of post-synaptic densities (PSD) were observed in the hippocampal CA3 region of rats by electron microscopy. Results After exposure to chronic multiple-stress for 6 weeks, the ability of learning and memory of the stressed group was higher than that of the control group (P<0.05, P<0.01). The width of synaptic cleft was smaller and the thickness of PSD was larger in the hippocampal CA3 region of the stressed group than in that of the control group (P<0.01). The CaMKII immunostaining of the stressed group was stronger than that of the control group in the stratum radiatum and oriens of the hippocampal CA1 and CA3, especially in the stratum oriens. Quantitative analysis indicated that the expression of CaMKII, CaM mRNA, and CREB mRNA in the hippocampus of the stressed group was higher than that of the control group (P<0.05, P<0.01). Conclusions The capacity of learning and memory can be enhanced after chronic multiple-stress. The increased levels of CaMKII, CaM mRNA, and CREB mRNA may contribute to the enhancing effect of chronic multiple-stress on learning and memory.

OBJECTIVETo explore the expression of p-p38 MAPK protein and the number of astrocytes expressing p-p38 MAPK in CA1 hippocampus in rats during the induction of brain ischemic tolerance induced by intermittent hypobaric hypoxia (IH) preconditioning.

METHODSThirty healthy adult male Wistar rats were randomly divided into 6 groups (n = 5 in each group): sham 0 min group, IH + sham 0 min group, sham 7 d group, IH + sham 7 d group, Ischemia (Is) 7 d group, and IH + Is 7 d group. Neuropathological evaluation was performed by thionine staining in CA1 hippocampus in rats. The expression of p-p38 MAPK in CA1 hippocampus was observed by immunohistochemical staining. And the number of astrocytes expressing p-p38 MAPK was observed by immunofluorescent double labeling.

RESULTSThe results showed that IH preconditioning induced brain ischemic tolerance successfully. At the same time, IH preconditioning obviously up-regulated the expression of p-p38 MAPK protein in CA1 hippocampus, and also increased the number of astrocytes expressing p-p38 MAPK.

CONCLUSIONIt might be concluded that IH preconditioning induced brain ischemic tolerance by up-regulating the expression of p-p38 MAPK protein in pyramidal neurones and astrocytes.

Animals ; Astrocytes ; enzymology ; pathology ; Brain Ischemia ; enzymology ; pathology ; Disease Models, Animal ; Hippocampus ; enzymology ; Hypoxia ; Ischemic Preconditioning ; methods ; Male ; Phosphorylation ; Pressure ; Rats ; Rats, Wistar ; p38 Mitogen-Activated Protein Kinases ; metabolism

Objective To conclude and compare the technical characteristics and clinical efficacy of retroperitoneal and transperitoneal approach for robotic partial nephrectomy.Methods 418 patients received robotic partial nephrectomy conducted by one surgeon in the urology department of PLA General Hospital from 2013, December to 2015, October, including 157 cases in retroperitoneal approach and 261 cases in transperitoneal approach.There were no significant difference between the transperitoeal and retroperitoneal approach in patient age(51 years, 51 years, P=0.593), BMI(25.5 kg/m2,25.6 kg/m2, P=0.331), gender(male/female:111/46,186/75,P=0.184), location(left/right,80/77,123/138,P=0.575), tumor size(3.1cm,3.5cm,P =0.356), comorbidities, proportion of solitary kidney(11.5%, 9.6%,P=0.253) or bilateral tumors(1.3%,3.4%,P=0.179), RENAL score(6(5-8),6(5-8),P=0.083), ASA score(2 vs.2)(P=0.310) and preoperative serum creatinine(74.7 μmol/L,76.7 μmol/L, P=0.736).Patients in the retroperitoeal approach group were more likely to have abdomen surgery history (21.7%,14.2%,P=0.049).there was significant difference between two approaches in tumor location in the kidney ( anterior/posterior/others: 9/140/8, 212/36/13, P <0.001 ) Results The operation time (105min, 115min, P =0.041 ) and warm ischemia time ( 15min, 20min, P <0.001 ) were shorter and estimated blood loss(50ml,75ml,P<0.001) was less in the retroperitoneal group.No significant difference was observed in postoperative 24h blood loss(45ml,50ml,P =0.093), intraoperative transfusion rate (2.5%,6.5%,P=0.072) and collective system injury(24.8%,27.6%,P =0.539) between the two groups.Peritoneum break occurred in 25 cases in retroperitoneal group, which were repaired by Hem-o-lock.One intestinal injury occurred in transperitoneal group and was repaired intraoperatively.Three and nine cases in the retroperitoneal and transperitoneal group were converted to radical nephrectomy.One case in the transperitoneal group was found positive margin and received laparoscopic radical nephrectomy.Two liver injury and five spleen injury occurred in the transperitoneal group.For postoperative food intake(1 day, 2 days, P <0.001 ) , the length of indwelling drainage ( 3 days, 4 days, P <0.001 ) and the length of postoperative stay ( 5 days, 6 days, P =0.001 ) , the retroperitoneal group had one day shorter than the transperitoneal group.With the median following-up time of both group, 11 months (IQR:6-16) in RPRPN group and 12 months ( IQR: 7-19 ) , no subject with a tumor recovery or metastasis.Conclusions Retroperitoneal robotic partial nephrectomy is feasible and effective, which is similar to transperitoneal approach.The retroperitoneal approach is superior to transperitoneal approach for posterior, lateral and superior renal tumors.