BACKGROUND: High incidence rate in the morning and low incidence rate in the evening is the regularity of stroke; however, there are no clear reports on changes of concentration of plasma endothelins and its relationship with onset of cerebral thrombus.OBJECTIVE: To investigate dynamic regularity of plasma endothelins in patients with acute cerebral thrombus within 24 hours and its correlation with episode.DESIGN: Case-controlled study.SETTING: Center of Radio-immunology and Department of Laboratory of Affiliated Hospital of Medical College of Qingdao University.PARTICIPANTS: Totally 32 patients with cerebral thrombus were selected from Neurological Department of Affiliated Hospital of Medical College of Qingdao University from January 2002 to January 2003. There were 20males and 12 females with mean age of (61.5±4.1) years. Ten patients had history of diabetes mellitus combined with hypertension, 8 had history of hypertension, 1 had history of diabetes mellitus, and 13 did not have history of diabetes mellitus and hypertension. Another 30 healthy subjects were selected from the same hospital including 13 males and 17 females with the mean age of (58.1±6.25) years. Informed consent was obtained from all subjects.METHODS: Radio-immune analysis was used to determine the dynamic changes of plasma-endothelins level in 32 patients with cerebral thrombus and 20 healthy subjects at 2, 8, 14 and 20 o'clock.MAIN OUTCOME MEASURES: ① Plasma-endothelins level of patients in cerebral thrombus group and control group at the four time points within 24 hours; ② Plasma-endothelins level of patients with or without cerebral thrombus at the four time points within 24 hours.RESULTS: Totally 32 patients with cerebral thrombus and 30 subjects in control group entered the final analysis. ① Plasma-endothelins level in cerebral thrombus group day and night was higher than that in the control group (t=29.1-30.5, P ＜ 0.001). The level was the lowest [(69.96±3.92) ng/L] at 2 o'clock within 24 hours but the highest at 8 o'clock [(78.55±3.80) ng/L,(t=5.67, P ＜ 0.01)]. ② Levels of endothelins in patients with history of hypertension and cerebral thrombus were obviously higher than those in patients without history of hypertension and cerebral thrombus at 2, 8, 14 and 20 o 'clock within 24 hours [(73.28±7.89), (64.52±5.29) ng/L; (82.39±8.62),(75.81±5.14) ng/L; (81.39±8.62), (70.32±5.97) ng/L; (82.47±5.04),(65.27±5.14) ng/L, (t=2.11-5.17, P ＜ 0.05-0.01)].CONCLUSION: Plasma-endothelins level in patients with acute cerebral thrombus has rhythm changes within 24 hours. The changes are high in the morning and low in the evening, and this is accorded with high onset of cerebral thrombus in the morning.

Objective To investigate the changes of plasma cortisol and adrenocorticotrophic hormone(ACTH)levels in prema-ture neonates with the infectious diseases.Methods Ninety premature neonates in the neonatal department of our hospital were di-vided into the control group(30 cases),mild infection group(30 cases)and severe infection group(30 cases).The radioimmunoassay was adopted to detect the serum cortisol and ACTH levels on 1,3,7 d after birth in all subjects and the corresponding comparison was conducted.Results The cortisol levels on 1,3,7 d in the mild infection group were (193.04 ±39.48),(151.12 ±35.62 ), (128.37±27.47)ng/mL respectively,the level on 1 d was higher than that on 3,7 d (P <0.05),and the 3 d was higher than that on 7 d (P <0.05).The cortisol level on 1,3,7 d in the severe infection group were (99.43±50.17),(96.52 ±44.69),(131.13 ± 42.73)ng/mL respectively,and the level on 1,3 d was significantly lower than that on 7 d (P <0.05).Conclusion The relative ad-renocortical insufficiency exists in premature neonates with the early stage of severe infection and is manifested by the decline of plasma cortisol level,which could recover to the normal level on 7 d,but the plasma ACTH level has no relation with infection.

Objective To study the risk factors for children with acute central nervous system(CNS)viral in-fection,so that pediatrician may identify children with poor prognosis at early stages of the disease,and provide them with a theoretical basis for clinical treatment. Methods The clinical data of a cohort patients of acute CNS viral infec-tion who were hospitalized at the First Affiliated Hospital of Fujian Medical University between January 2010 and June 2013 were retrospectively collected and analyzed. According to Glasgow outcome scale on discharge,children were di-vided into good prognosis group and poor prognosis group. Clinical data and outcomes were analyzed by using univariate analysis and binary Logistic regression multivariate analysis. Results Three hundred and one cases were enrolled,278 (92. 36% )patients were assigned to the good prognosis group,and 23(7. 64% )patients were assigned to the poor prognosis group. By univariate analysis,the patients in the poor prognosis group had longer duration of sickness before admission,longer time of fever,lower white blood cell count in cerebrospinal fluid,a relatively lower calcium level,con-scious disturbance at the early stage,multiple seizures,convulsive status epilepticus,meningeal irritation sign,muscle weakness,severe changes in electroencephalogram(EEG),and abnormal neuroimaging findings(computed tomography or magnetic resonance imaging,or both)had significant differences between the good prognosis group and the poor short - term outcome groups(all P < 0. 05). By binary Logistic regression multivariate analysis,factors indicating a poor prognosis during the early stage were conscious disturbance at the early stage(0R = 4. 885,95% CI:1. 523 - 15. 670, P = 0. 008),multiple seizures(0R = 6. 352,95% CI:1. 905 - 21. 178,P = 0. 003),severe changes in EEG( 0R =4. 269,95% CI:1. 708 - 10. 666,P = 0. 002),and abnormal neuroimaging findings( 0R = 9. 740,95% CI:2. 360 -40. 192,P = 0. 002). Conclusions Conscious disturbance at the early stage,multiple seizures,severe changes in EEG and abnormal neuroimaging findings are risk factors for acute viral infection of CNS in children.

Objective To discuss the role of DNA-dependent protein kinase catalytic subunit (DNA-DPKCS) in human lung adenocarcinoma cell line (A549) by using small interfering RNA (siRNA) to specifically knockdown DNA-DPKCS expression and its effects on cell proliferation, cell cycle and radio-sensitivity. Methods The DNA-DPKCS-siRNA expression vector was constructed and transfected into A549 cell line. The transformed clones were randomly selected and isolated. The cell cycle distribution and apop-tesis were analyzed by flowcytometry analysis. Cell survival was detected by using clonogenic formation as-say. Results With specific inhibition of DNA-DPKCS expression, stable transfected cell line 549pRNA-DNA-DPKCS was constructed by RNA interference technique. The 549pRNA-C and 549pSUPER cell lines were the control cell lines tansfected with control and blank plasmids, respectively. Compared with A549 cells, the expression levels of DNA-DPKCS mRNA (0.110: 1. 000), protein (0. 870: 2.967) and activity of DNA-DPKCS (0.004: 0.266) in 549pRNA-DNA-DPKCS cells were significantly lower (F = 80.55 ,P < 0.01;F=63.96, P<0.01;F=51.62,P<0.01, respectively). The analysis of SF_2(0.25:0.76), D_0 (1.42:1.62) and D_q (0.06: 1. 00) showed significant difference between 549pRNA-DNA-DPKCS and A549 cells (F = 996.86, P < 0.01 ; F = 17.41, P < 0.05 ; F = 68.92, P < 0.01). The number of 549pRNA-DNA-DPKCS cells in S (24.5%: 35.5%) and G_2 (10.7%: 11.0%) phases was significantly decreased (F = 4.83, P<0.05 and F=32.04, P <0.01, respectively). Conclusions In A549 cells, inhibit of DNA-DPKCS gene expression can enhance the radiosensitivity and affect cell cycle distribution.

Objective To evaluate the outcomes and prognostic factors of image-guided 125I seed implantation for locally recurrent soft tissue sarcoma(RSTS).Methods A total of 60 patients with RSTS who received image-guided 125I seed implantation in Peking University Third Hospital,from September 2002 to December 2015,were retrospectively analyzed.The enrollment criteria: KPS ＞60 points,refused or could not tolerate surgery or radiotherapy,the expecting survival time ＞3 months,relapsed after multiple treatment of soft tissue sarcoma,and underwent CT or ultrasound guided 125 I seed implantation treatment.In all,the median activity of seeds was 25.9×106Bq(range,11.1×106-29.6×106Bq),median number of implanted seeds was 58(range,3-133),and the median D90was 120 Gy(range,36.50-460.97 Gy).The local progression-free survival(LPFS)and overall survival(OS)were calculated using the Kaplan-Meier method.The log-rank test and Cox regression model were used for the univariate and multivariate analyses.Results The median follow-up was 18.75 months(range,1-146).The median OS was 18.5 months(95％CI 13.1-23.9).The 1-,3-and 5-year OS rate were 63.3％,33.0％and 29.5％,respectively.The 1-,3-and 5-year LPFS rate were 72.5％,63.7％and 59.7％,respectively.The general rate of pain relieving was 100％(6/6).8.3％(5/60)presented grade Ⅳskin toxicity.No fatal complications ocurred.The univariate analysis suggested that tumor size,tumor volume,KPS score,D90were prognostic factors of OS and LPFS.The multivariate analysis demonstrated that previous chemotherapy history and distant metastases were independent prognostic factors of survival.Conclusions Image-guided 125I seed implantation for recurrent soft tissue sarcoma is a safe treatment option with high efficacy and low morbidity.Tumor size and D90were the prognostic factors of OS and LPFS.

OBJECTIVE: To analyze the clinical phenotype and genetic basis for a male neonate featuring hypoparathyroidism, sensorineural hearing loss, and renal dysplasia (HDR) syndrome. METHODS: The child was subjected to genome-wide copy number variation (CNVs) analysis and whole exome sequencing (WES). Clinical data of the patient was analyzed. A literature review was also carried out. RESULTS: The patient, a male neonate, had presented with peculiar facial appearance, simian crease and sacrococcygeal mass. Blood test revealed hypocalcemia, hypoparathyroidism. Hearing test suggested bilateral sensorineural deafness. Doppler ultrasound showed absence of right kidney. Copy number variation sequencing revealed a 12.71 Mb deletion at 10p15.3-p13 (chr10: 105 001_12 815 001) region. WES confirmed haploinsufficiency of the GATA3 gene. With supplement of calcium and vitamin D, the condition of the child has improved. CONCLUSION The deletion of 10p15.3p13 probably underlay the HDR syndrome in this patient.
DNA Copy Number Variations ; Hearing Loss, Sensorineural/genetics* ; Humans ; Hypoparathyroidism/genetics* ; Infant, Newborn ; Kidney/abnormalities* ; Male ; Syndrome ; Urogenital Abnormalities/genetics*

Objective:To analyze the effect of role standardized progressive nursing model on delivery fear and delivery outcome of primiparas.Methods:Using the convenient sampling method, a total of 200 primiparas who were admitted to Ruian Maternal and Child Health Hospital of Zhejiang Province from January to December 2020 were selected as the research objects. According to the random number table method, they were divided into the control group and the observation group, with 100 cases in each group. Patients in the control group were given routine nursing intervention, while patients in the observation group were given role standardization progressive nursing mode on the basis of the control group. Childbirth Attitude Questionnaire (CAQ) and Childbirth Self-Efficacy Inventory-32 (CBSEI-32) were used to investigate, and the outcomes of delivery in the two groups were counted.Results:Before intervention, there was no statistically significant difference in CAQ and CBSEI-32 scores between two groups ( P>0.05) . After intervention, the scores and total scores of all dimensions of CAQ in the observation group were lower than those in the control group, and the outcome expectation, delivery self-efficacy expectation score in CBSEI-32 were higher than those in the control group, and the differences were all statistically significant ( P<0.05) . There was no statistically significant difference in the incidence of postpartum hemorrhage, lateral perineal resection and premature rupture of membranes in the observation group ( P>0.05) . The cesarean section rate in the observation group was lower than that in the control group, and the difference was statistically significant ( P<0.05) . Conclusions:The role standardized progressive nursing model can alleviate the fear of delivery, improve the sense of self-efficacy during delivery and improve the outcome of delivery, which is worthy of clinical application.

Psoriasis and atherosclerosis are both complex and refractory.Genetic susceptibility,inflammatory response and the role of adipokines may be the main mechanisms of their comorbidity.TCM believes that heat,toxicity,phlegm,and blood stasis are the basic pathological factors of the comorbidity,which intertwine and lead to a longer course of disease.TCM,starting from the holistic concept,has a certain efficacy in the treatment of psoriasis and atherosclerosis,and has received widespread attention.This article reviewed the pathogenesis of psoriasis and atherosclerosis comorbidity from the aspects of heredity,inflammatory response,and the role of adipokines,and combed the current situation of the research on the mechanism of the treatment of psoriasis and atherosclerosis comorbidity with TCM monomer and compounds,providing references for related mechanisms and clinical research.