Objective To study the influence of obesity on outcome of rehabilitation for the hemiplegic post stroke. Methods 118 hospitalized stroke patients were divided into the normal weight, overweight and obesity groups according to the Body Mass Index. All the patients received rehabilitation for 12 weeks. They were assessed with National Institute of Health Stroke Scale (NIHSS), Fugl-Meyer Assessment (FMA), Berg Balance Scale (BBS) and modified Barthel Index (MBI) before and after rehabilitation. Results The scores of NIHSS, FMA, BBS and MBI improved significantly after rehabilitation in all the groups (P<0.001), and improved the lest in the obesity group in the scores of NIHSS, BBS and MBI (P<0.05). There was no significant difference in FMA score among groups (P>0.05). Conclusion Obesity influences the outcome of rehabilitation, results in poor functioning.

HIV p24 core protein can induce both cellular and neutralizing antibody responses.HIV-1 CA-virus-like particles(VLPs)vaccines provide a promising approach for the development of an effective vaccination strategy against HIV infection.Rhizosecreion of the recombinant proteins provides a new manufacturing platform that can simplify the extraction and purification procedure.Lycium barbarum L.was transformed by Agrobacterium tumefaciens EHA105 harboring the plant expression vector pCAMBIA1305.2-MA4-CA with a GRP signal peptide and MA4-CA fusion gene.Transgenic hairy roots were induced and cultivated in hydroponic culture.Western blotting indicated that the recombinant CA proteins were present in two forms,a glycosylated monomer(37 kDa)and a dimer(50 kDa)in the roots and hydroponic medium.It appeared from the present immunohistochemical data that the recombinant CA proteins fused with GRP signal peptide were confined to the cytoplasm,cell wall and intercellular space,indicating targeting into the secretory pathway.It demonstrated for the first time the rhizosecretion of HIV-1 recombinant capsid protein in Lycium barbarum L.hairy roots,and may offer a novel method for expressing HIV-1 CA-VLPs vaccines in plants.

Artificial intelligence technology is being widely applied in drug screening. This paper introduces the characteristics of artificial intelligence, and summarizes the application and progress of artificial intelligence technology especially deep learning in drug screening, from ligand-based and receptor structure-based aspects. This paper also introduces how to apply artificial intelligence to drug design from these two aspects. Finally, we discuss the main limitations, challenges, and prospects of artificial intelligence technology in the field of drug screening.

Objective To analyze the genetic model of attention deficit hyperactivity disorder(ADHD).Methods The segregation analysis and polygenic multiple threshold model were used to prove the polygenic model and to estimate the heritability and recurrence risk of ADHD in each degree relatives.Results 1. The average heritability of ADHD was (102.47?9.78)%;2.The first-degree relatives of probands were in high risk for ADHD(23.0%)compared with colony prevalence rate(2.6%). The ADHD prevalence of each degree relatives rapidly decreased with the increased magnitude of consanguineous relationship of each degree relatives and ADHD probands. Conclusions The genetic model of ADHD is the most likely polygenic inheritance with major genes, which suggested that the genetic factor might play an important role in the liability variance of ADHD.Apart from the involvement of multiple genes,each gene contributes a small additive effect,and the major genes may be involved as well.

BACKGROUND:Previous studies have reported the cause and treatment of biliary complication. However, how to improve operative technique for preventing the complication is rarely reported.
OBJECTIVE:To explore the effect of operational skil s during liver transplantation on biliary complications.
METHODS:Biliary complications in 475 patients who underwent liver transplantation were retrospectively analyzed. The relationship between operational skil s and biliary complications after liver transplantation was observed. The potential risk factors about operative technique were summarized. Some preventive interventions for biliary complications were suggested.
RESULTS AND CONCLUSION:Biliary complication was diagnosed in 36 (7.6%) of 475 patients who underwent liver transplantation. They were nonanastomotic biliary stricture (n=19, 4.0%), anastomotic biliary stricture (n=7, 1.5%), biliary leakage (n=3, 0.6%), twisted common biliary duct (n=3, 0.6%), residual common duct stone (n=1, 0.2%), and neoformative common duct stone (n=3, 0.6%). There was no difference in the incidence of nonanastomotic biliary stricture among the three biliary anastomotic styles. The possibility of anastomotic biliary stricture in placing T-drainage tube group was lower than the other two groups according to clinical data. Nevertheless, there was no statistical difference between these three groups. Infusing UW into the liver from cranial mesenteric vein and douching the biliary duct immediately while taking the donor could decrease the incidence of biliary complication after liver transplantation (P=0.013 and P=0.018, OR=0.26 and OR=0.28), the later factor could also decrease the incidence of nonanastomotic biliary stricture (P=0.001, OR=0.09). Meanwhile, some operational skil s also decrease the incidence of biliary complications, such as protecting the artery around the biliary duct, and elevating the liver when suturing the common biliary duct.

Objective:To study the variation of recent bladder function of the patients who received radical hysterectomy and evaluate its significance. Methods:Sixty-three patients with cervical carcinoma in International Federation of Gynecology and Obstetrics(FIGO) stage IB1 to ⅡA received urodynamic examination before and after operation. The urodynamic parameters included filling cystometry, pressure-flow rate, and electromyography of sphinctienter. Results:Radical hysterectomy induced significant increase in the first sensation (P<0.01)and post voiding residual of bladder (P<0.01) ;whereas caused significant decrease in the maximum volume(P<0.01), compliance(P<0.01),maximum flow rate(P<0.01) and the pressure at the maximum flow rate(P<0.01), respectively, compared with the corresponding values before the operation. Short-term bladder dysfunctions were observed in 34 patients (54.0%) including bladder detrusor dysfunction, low compliance bladder, bladder outlet obstruction, dyssynergia of urethral external sphincter and detrusor overactivity. The incidences of low compliance bladder and bladder detrusor dysfunction increased significantly after operation (P<0.01). Urinary retention was found in 28.6%(18/63) patients. The incidences of bladder detrusor dysfunction (66.7% vs 20.0%) and detrusor overactivity (33.3% vs 4.4%) in the group with urinary retention were significantly higher than those of corresponding group without urinary retention. Conclusion:The bladder function had obvious short-term changes following radical hysterectomy. In the many types of bladder dysfunction the main dysfunctions were low compliance bladder and bladder detrusor dysfunction. The bladder detrusor dysfunction might be the major cause of the urinary retention following the surgery. Urodynamic test was important for post-operative analysis and treatment of bladder dysfunction.

Objective To evaluate the efficacy and security of splenic artery ligation for severe hypersplenism during liver transplantation.Method Thirty-two liver transplant patients with preoperative hypersplenism were selected,including 17 cases (ligation group) treated by splenic artery ligation during liver transplantation,and rest 15 patients as non-ligation group.The fluctuation of white blood cells,platelets and volume of spleen were compared between these two groups.At the same time,splenic infarction,postoperative infection,recurrent gastrointestinal bleeding,splenic artery steal syndrome and other complications were observed in these two groups.Result All recipients were followed up for over 6 months.One recipient in ligation group died of multiple organ dysfunction caused by delayed recovery of liver donor with the survival rate being 94.1％ (16/17).The survival rate in non-ligation group was 93.3 ％ (14/15) (one recipient died of respiratory failure caused by pulmonary infection).There was no statistically significant difference in survival rate between these two groups (P＞0.05).Splenic necrosis wasn't detected in the ligation group.The splenic volume in ligation group was significantly less than that in non-ligation group (P＜0.01).The products of splenic maximum length and wide diameter shrunk 33.17-± 8.26 cm2 and 22.47 ± 7.25 cm2 in ligation group and non-ligation group,respectively.The platelet counts of ligation group were significantly greater than those of non-ligation group in all the observation points within 6 postoperative months (P＜0.01).The white blood cell counts of ligation group were greater than those of non-ligation group at the first week postoperatively (P＜0.01),whereas,there was no statistically significant difference between these two groups from then on (P＞0.05).The infection incidence of ligation group was lower than that of non-ligation group within 6 postoperative months (P ＜0.05).Statistically significant differences in recurrent gastrointestinal bleeding and splenic artery steal syndrome weren't found between these two groups (P＞0.05).Conclusion Splenic artery ligation in liver transplantation is safe and effective.It can rapidly increase the counts of platelet and white blood cell in the earlier postoperative time,which is beneficial to patient's recovery.Besides,it adds no correlative complication.

Objective To investigate the geographical distribution of plague host animals in residential areas and the association between plague and its distribution pattern in Yunnan Province.Methods A systematic investigation on fauna and community ecology of rodents was carried out in residential areas of 17 counties(cities) of Yunnan Province,southwestern China with different longitude,latitude and elevation from May 2007 to November 2012.The characteristics of the spatial distribution of flea communities along environmental gradients were analyzed using community structure indexes.Results A total of 390 small mammals were trapped in seventeen counties (cities),and the mammals were classified into 11 species and 7 genus in 4 families.Among all small host mammals,Rattus tanezumi,Rattus nitidus and Rattus norvegicus were dominant species of host animals in residential areas,accounting for 33.85％ (132/390),20.77％ (81/390) and 16.92％ (66/390),respectively.The horizontal distribution of rodents showed that Rattus tanezumi was the widest species in residential areas,which was found at the longitude 98°-105°,followed by Rattus norvegicus,Rattus yunnanensis and Mus musculus.The vertical and latitudinal distributions of rodents were similar in residential areas.Rattus tanezumi was also the widest distributed species,which was observed at the latitude 21°-＜ 28°N and at the altitude 500-＜ 3 500 m; the constituent of Rattus tanezumi showed similar trends of leaning peak curves,first gradually increasing and then decreasing with the increase of latitude and elevation; Rattus tanezumi gradually changed into Rattus nitidus and Apodemus chevrieri,et al.The richness spatial distribution patterns of host animals showed similar trends of leaning peak curves which gradually increased and then decreased with increasing of longitude and latitude; the highest richness was observed at the longitude 98°-＜ 101°E and at the latitude 23°-＜ 28°N.While,the richness spatial d istribution patterns of host animals were relatively poor in the low or the high altitude range.The highest richness was observed at the altitude between 1 000-＜ 1 500 m and 2 000-＜ 2 500 m.Conclusions All spatial patterns of indoor host animals have shown an aggregated spatial distribution in Yunnan Province.Moreover,important environmental factors such as longitude,latitude,and altitude play a substantial role on the distribution patterns of indoor host animals among various focus,therefore directly impact on the modes of prevalence and transmission of plague.

ObjectiveTo investigate the effect of patient-controlled epidural analgesia(PCEA) with opioids on serous myelin basic protein(MBP) and somatosensory evoked potential(SEP) of lower limbs in puerperants.MethodsA total of 120 puerperants,after receiving cesarean section,were divided into four groups by random number table method as group B,BR,MR and R randomly,and each group included 30 cases.After surgery,each case received PCEA:group B received 0.008％ butrophanol;group BR received 0.008％ butrophanol + 0.2％ ropivacaine;group MR received 0.004％ morphine +0.2％ ropivacaine and group R received 0.2％ ropivacaine only.VAS score,OAA/S score,adverse effect occurrence,concentration changes of serous MBP,SEP of both lower limbs and neurological function were observed at 2h(T1 ),4h(T2),8 h(T3),12h(T4),24 h(T5) and 48h (T6) after surgery.ResultsVASscoresofgroupBR(1.64±0.38,1.86±0.62,1.93±0.67) and MR( 1.74 ±0.39,1.91±0.58,1.98 ±0.63) at T3,T4,T5 were lower than those of group B(4.6 ±0.5,4.6 ±0.3,4.7 ±0.3)and R(2.64 ±0.41,2.83 ±0.91,3.37 ±0.87) (P＜0.05).There was no significance in four groups in OAA/S score at each point (P ＞ 0.05 ).Incidence of nausea ( 6 cases),vomiting ( 2 cases) and abdominal distention ( 5cases) of group M was higher than that of other three groups(P＜0.05).There was no significant difference in concentrations of serous MBP,SEP and neurological function in all four groups between preoperative time and 48h after operation(P＞0.05).ConclusionLower-dose and lower- concentration opioids used for PCEA have no influence on serum MBP and SEP.

BACKGROUND:There are many ways for surgical treatment of distal radius fractures. Both volar locking plates and Kirschner wires are common methods. Doctors have considerable flexibility in the choice of the ways of fixation, but both at home and abroad there is no comparison between the effects of the two operations for treating distal radius fractures. OBJECTIVE:To systematicaly review the differences in effectiveness and safety of volar locking plates versusKirschner wires for distal radial fracture. METHODS:Databases such as CBM, CNKI, VIP, PubMed and Cochrane Library were electronicaly searched.Chinese Journal of Orthopaedics,Chinese Journal of Orthopaedic Trauma,Chinese Journal of Trauma andJournal of Practical Orthopaedics were searched by hand. In strict accordance with inclusion and exclusion criteria, articles were screened. Methodological quality of included studies was evaluated according to Cochrane Handbook. Data were extracted, and then analyzed with RevMan 5.2 software. RESULTS AND CONCLUSION:Nine randomized controled trials were included. Meta-analysis results demonstrated that upper limb function scores were better in the volar locking plate group than in the Kirschner wire group [MD=-4.55(-7.89,-1.21),P=0.008] at 3 months of folow-up and [MD=-3.13(-6.08,-0.18),P=0.004] at 12 months. The incidence of infection was lower in the volar locking plate group than in the Kirschner wire group [OR= 0.42(0.23, 0.79),P=0.007]. No significant difference in incidence of complex regional pain syndrome [OR=0.28(0.05, 1.38),P=0.12], incidence of carpal tunnel syndrome [OR=0.75(0.20, 2.76),P=0.66] and tendon injury [OR= 1.66(0.51, 5.41),P=0.64] was detected between the volar locking plate group and Kirschner wire group. These results indicated that compared with the Kirschner wire, volar locking plate fixation for the repair of distal radial fracture is safe and effective. In the permission of economic circumstances, it is suggested that elder osteoporosis patients with distal radial fracture should receive plate fixation.