Vertebral artery hypoplasia is a congenital vessel variation. Its incidence is from 1. 9 to 26. 5% . In recent years, studies have shown that vertebral artery hypoplasia may be a potential risk factor for posterior circulation infarction, especialy when it coexists with other cerebrovascular risk factors. Vertebral artery hypoplasia may also cause regional hypoperfusion and complex neurovascular regulation, and it also has a certaln link with migralne.

Objective To investigate the treatment effect of atorvastatin in patients with soft carotid atherosclerotic plaques using contrast-enhanced ultrasound(CEUS).Methods Sixty patients with acute cerebral infarction and soft carotid atherosclerotic plaques were divided into two groups:high-dose atorvastatin treatment group(40 mg daily)and control group without atorvastatin treatment.The same soft carotid plaque in each patient was examined before and after 3-months'treatment respectively using CEUS.The parameters of CEUS were compared between pretherapy and post-treatment,including arrived time (AT),time to peak(TTP),peak intensity(PI),based intensity(BI)and enhanced intensity(EI,EI=PI-BI).Results EI of carotid plaques in treatment group was decreased significantly than that in control group after three months'treatment(P＜0.05).While the difference of EI in control group has no significance between pre-therapy and post-treatment(P＞0.05). Conclusions The neovascularization in soft carotid plaques was reduced after 3-months'treatment of a high dose atorvastatin.CEUS can be used to evaluate the effect of atorvastatin in treatment of soft carotid plaques.

Objective To investigate the status of self-care ability and cognition among disabled elderly,and to analyze the relationship between self-care ability and cognition,then analyze their influencing factors.Methods A total of 813 disabled elderly accepted long-term care at community or facility were recruited by stratified sampling method and investigated by socio-demographic questionnaire,activities of daily living and short portable mental status questionnaire.Results The total scores of self-care ability of the long-term care disabled was 32.01±11.59,and the total points of cognition was 3.77±3.24.Disabled elderly with severe disorders of self-care ability had a higher obstacle rate in every cognition ability than those with mild disabilities (P＜0.001).There were differences in orientation and memory function with different persistent disabled time (x2 =11.875,14.758,P＜0.01).Disabled elderly with cognition obstacles have a higher obstacle rate in every self-care aspect than those with normal cognition (P＜0.01).The multiple regression analysis showed that the educational level (β=-0.067),arital status (β=-0.071),disabled persistence time (β=0.121),orientation ability (β=0.403),the amount of cognition obstacles (β=0.443) were the influence factors of Basic Activities of Daily Living(BADL) among disabled elderly ; and disabled persistence time (β=0.116),orientation ability (β=0.417),recalled ability (β=0.275),memorial ability (β=0.189),calculative ability (β=0.257),the amount of cognition obstacles (β=0.358) were the important factors influence Instrumental Activities of Daily Living(IADL).Conclusion The self-care ability and cognition of the long-term care elderly were declining sharply,and influencing each other.It is advisable to offer them direct long-term care service combined with the laws and characteristics of cognition and self-care ability.

OBJECTIVE To investigate the proliferation effect of di(2-ethylhexyl) phthalate (DEHP) on prostate in aged rats at the environmental exposure dose and the possible mechanism.METHODS Thirty-two male Sprague-Dawley rats,aged 1.5 years,were randomly divided into 4 groups (8 rats per group) and treated with DEHP (30,90 and 270 μg· kg-1,ig) and vehicle once daily respectively for 4 weeks.All the animals were anesthetized with pentobarbital sodium and sacrificed on the day subsequent to the last treatment.① Abdominal aortic blood samples were collected,and serum estradiol (E2),testosterone (T) and prolactin (PRL) levels were assayed by ELISA.② The prostate tissues were dissected and categorized into different lobes,weighed and measured.The prostate relative mass was calculated.③ The morphological changes were detected by HE staining and prostate epithelial height was analyzed with microscopic image analysis software.RESULTS Compared with vehicle control group,the prostate relative mass,dorsolateral prostate mass,and dorsolateral prostate index in DEHP 270 μg· kg-1 group were significantly higher (P＜0.05).The height of the ventral prostate epithelium in DEHP 30,90 and 270 μg· kg-1 groups was increased significantly (P＜0.01),so was the height of dorsal prostate epithelium in DEHP 270 μg· kg-1 group (P＜0.01).There were no significant changes in levels of E2,PRL or T in DEHP 30,90 and 270 μg· kg-1 groups,but the ratios of E2/T in DEHP 30 and 270 μμg· kg-1 groups were increased significantly (P＜0.05).CONCLUSION Low-dose DEHP could promote the proliferation of prostatic hyperplasia in the aged rats,which might be associated with the relative levels of endogenous hormone.

Abstrsct:Objective To analyze the correlation of hyponatremia with chronic heart failure (CHF) and the prognostic analysis of CHF. Methods Patients with CHF (n=507) and healthy adult (n=212) were included in this study. The general data of the two groups were analysed. The index which was statistically significant was indicated as independent variables. Multivariate logistic analysis was used to analysis the correlation between serum sodium and CHF. The relationship between serum sodium and the prognosis of CHF include mortality and rate of readmission were included in follow-up study. The prognostic correlation of serum sodium with BNP (brain natriuretic peptide), heart failure with preserved ejection fraction (HFpEF, LVEF≥0.45) and heart failure with reduced ejection fraction (HFrEF, LVEF<0.45) were all analyzed. Results In?dicators such as sex, smoking history showed no statistical significance between two groups (P>0.05) while other indicators like age, hemoglobin, serum sodium presents statistical significance (P < 0.05). Serum sodium is the protective factor for CHF. Brain natriuretic peptide (BNP) concentration in hyponatremia group is significantly higher than that in normal serum sodium group (P<0.05). HFpEF and HFrEF were of no significant difference in these two groups. For patients with CHF, the mortality in hyponatremia group is significantly higher than that in normal serum sodium group (P<0.05), but readmission rates were not significantly different (P>0.05);While for patients with HFpEF, the mortality and the readmission rates were both significantly different (P<0.05). Conclusion Serum sodium is the protective factor in CHF, the patients with hypona?tremia have higher readmission rate and death rate in HFpEF background.

It is very common that the number of neurons in the brain is progressively decreasing in the neurodegen-erative diseases such as Alzheimer’s disease, Parkinson’s disease and Huntington’s disease, etc.Moreover, it is much more important that there is a decline in the neurogenesis of adult brain in such neurodegenerative diseases. In treating neurodegenerative diseases, it is a potential therapeutic modality to promote endogenous neurogenesis in the brain.

Objective To analyze the differences in clinical characteristics and risk factors in patients with diastolic heart failure and systolic heart failure. Methods A total of 2 088 patients with heart failure were divided into two groups, diastolic heart failure group (EF≥0.45,n=1 356) and systolic heart failure group (EF<0.45,n=732), according to ejection fraction (EF). The clinical features and related factors affecting the two types of heart failure were compared between two groups. Results There were higher age, higher proportion of women and higher proportion of hypertensive patients in dia?stolic heart failure group than those of systolic heart failure group, but lower rates of hypoalbuminemia, anemia, renal insuffi?ciency and hyperuricimia. There was higher incidence of functional class I and II in diastolic heart failure group. And com?pared with systolic heart failure group, there were higher levels of systolic blood pressure, albumin, prealbumin, cholesterol, sodium and serum chloride in diastolic heart failure group, but lower levels of heart rates, creatinine, blood uric acid, potassi?um and brain natriuretic peptide. Compared with systolic heart failure group, there were lower left ventricular end diastolic volume (LVEDV) and left ventricular end systolic volume (LVESV) in diastolic heart failure group. And there were lower RAS blocker andβ-blocker usage, higher statin usage in diastolic heart failure group. Logistic regression analysis showed that gender and hypertension were significantly correlated with diastolic heart failure, and hypoalbuminemia and hyper?uricimia were significantly correlated with systolic heart failure. Conclusion Our results show that there are differences in clinical features and risk factors in patients with diastolic heart failure and systolic heart failure. We should take the differ?ent treatment and prevention programs for the two kinds of heart failures.

Objective To analyze the age difference of gram negative isolates(GNB)from blood culture and antibiotic resistance profile between children and adults. Methods Age difference of pathogen distribution of GNB isolated from blood culture during 2015-2017 were retrospectively analyzed. WHONET 5.6 and Graphpad Prism 6 were used to perform Chi-square test on the pathogen proportion and antibiotic resistance rate. Results A total of 20 145 bacterial strains were isolated in Chongqing from 2015 to 2017. The top three strains of GNB were E. coli(56.7％, 6 688/11 799), K. pneumoniae(19.6％, 2 308/11 799), and P. aeruginosa(4.4％, 522/11 799). The resistant rate of E. coli to carbapenems was less than 1％. The resistant rate of K. pneumoniae to carbapenems was about 5％, while the resistant rate of S. marcescens was approximately 9％, similar to E. cloacae. The overall resistance rates of E. coli from adult patients to most antiobiotic agents were significantly higher than those of children, but the overall resistance rate of K. pneumoniae from children was higher than those of adults. The drug resistance rate of A. baumannii was higher than P. aeruginosa. A. baumannii isolates from adult patients were highly resistant to all drugs tested and more resistant than those from pediatric patients. Conclusions Majority of GNB strains isolated from blood culture were E. coli and K. pneumoniae, for which carbapenems are still active. More attention should be paid to carbapenem-resistant K. pneumoniae from children and A. baumannii from adults. National surveillance of nosocomial bloodstream infection should be highly evaluated.

Objective To improve the quality of the management of the elderly patients with cancer in Sichuan province,and to understand the attitudes and perspectives of elderly surgeons and oncologists for the management and treatment of elderly patients with cancer.Methods A face-toface questionnaire interview was conducted with oncologists (n 64) and geriatricians (n =64).128 physicians were involved in this study.Results The cancer management and therapeutics were deemed appropriate at present by 9.38％ (6/64)of the geriatricians and 25.00％ (16/64)of the oncologists.The 39.06％ (25/64) of geriatricians used to notice geriatric syndromes,while 81.25％ (52/64)of oncologists never concerned about the geriatric syndrome(P=0.011).As for the causes of the therapy-associated toxicity,oncologist versus geriatrician payed an attention to malnutrition (100.00％ vs.100.00％ in both groups),to mobility disorders(65.63％ vs.65.63％,84/128 in both groups),to cognitive impairment/mood disorder (89.06％ in geriatrician group vs.75.00％ in oncologist group,P=0.038).For the factors affecting treatment decisions,a physical ability attention (oncologists vs geriatricians:70.31％ vs.92.19％;P =0.002),and comorbidity (oncologists vs geriatricians:62.50％ vs.79.69％,P =0.032) had statistically significant difference.In addition,lack of geriatrics knowledge was also reported by more oncologists.However,one hundred percent of participants wanted very much to cooperate with each other in their clinical work.When responding to the clinical scenario,the 10.94％ (7/64)of geriatricians and 32.81％ (21/64)of oncologists chose modified treatment for 65-74 years old patient with cancer(P =0.003).When the age of the patients was 75-84 years old,only 12.50 ％ (8/64) of geriatricians prefer end-of-life care,while 31.25 ％ (20/64) of oncologists chose it (P =0.010).Conclusions Selection of treatment decisions in the elderly patients with cancer affect by ageing.Both oncologists and geriatricians are concerned with the elderly patients with cancer,ageing syndrome,total sickness and functional status.And these doctors support an establishment of a multi disciplinary team cooperation for the elderly patients with cancer.Therefore,the establishment of mutual cooperation between the two professionals is necessary and feasible.

Objective:To investigate the clinical value of the long non-coding RNA HOXA terminal transcript antisense RNA (HOTTIP) for diagnosing pancreatic cancer (PC).Methods:PC tissue and adjacent normal tissue (>1 cm distant from cancer tissue) from 18 PC patients confirmed by pathology after surgery were collected from June 2017 to December 2018 in Xuzhou Central Hospital. Plasma samples from 78 PC patients clinically confirmed were collected, those from 78 healthy individuals were designed as healthy controls and those from 50 patients of liver cancer, 50 patients of colorectal cancer and 50 patients of gastric cancer were also collected as disease controls. HOTTIP expression in PC tissue and plasma of PC patients, disease controls and healthy controls was tested by real time quantitative polymerase chain reaction; the plasma CA19-9 level was tested by CLIA. The correlation between plasma HOTTIP, cancer tissue HOTTIP and plasma CA19-9 were analyzed, and the relationship between plasma HOTTIP and clinicopathological features was analyzed. The survival curves of patients with high and low expression of HOTTIP were drawn, and the difference of survival rates between the two groups was compared by log-rank test. Receiver operating characteristic (ROC) curves were drawn to calculate area under the ROC curve (AUC), and the diagnostic performance of plasma HOTTIP for PC was evaluated.Results:Compared to normal pancreatic tissue, the level of HOTTIP expression was significantly up-regulated in pancreatic cancer tissue (2.24±0.25 vs 0.62±0.11, P<0.001), the relative expression of plasma HOTTIP of PC, liver cancer, colorectal cancer, gastric cancer patients and healthy controls were 1.33±0.32, 0.57±0.17, 0.51±0.10, 0.41±0.09 and 0.54±0.05; HOTTIP level of PC patients was higher than that of liver cancer, colorectal cancer, gastric cancer patients and healthy controls (all P<0.05), but the difference on HOTTIP level between liver cancer, colorectal cancer, gastric cancer patients and healthy controls was not statistically significant. The plasma HOTTIP of PC patients had a strong positive correlation with plasma CA19-9 and also had a positive correlation with HOTTIP level in cancer tissue (all P<0.05); meanwhile the plasma level of HOTTIP was significantly correlated with TNM stage ( P=0.029), but not with sex, age, lymph node metastasis and tumor size. The median survival time of patients with high HOTTIP level was obviously lower than that of those with low HOTTIP level (15.9 months vs 30.6 months, P<0.05). The AUC of plasma HOTTIP for diagnosing PC was 0.81(95% CI 0.74-0.87). At the optimal cutoff value of 1.14, the diagnostic sensitivity, specificity and accuracy were 62%, 94% and 74%. By combining plasma HOTTIP with CA19-9, the diagnostic sensitivity, specificity and accuracy can be increased to 81%, 97% and 84%, respectively. Conclusions:Plasma HOTTIP level has a significant value in the diagnosis of PC.