Objective To investigate the main risk factors influencing the pre-hospital delay of patients with acute ischemic stroke (AIS) for preventing methods.Methods A retrieval was done across the epidemiologic studies on pre-hospital delay of AIS patients during 2004 to 2015 using the key words of ischemic stroke,prehospital delay,treatment delay.According to the inclusion and exclusion criteria,the literature was collected and the literature quality was assessed.The data were extracted for meta-analysis by RevMan software.Results Sixteen epidemiologic studies were included.Totally,there were 2,966 cases of prehospital delay and 2,468 cases of non-delay.The pooled OR values and 95％ CI by multivariate analysis were as follows:the degree of awareness of stroke was 0.5 (0.3,0.82),emergency medical service (EMS) was 0.49 (0.29,0.85),National Institute of Health Stroke scale (NHISS) score 0.58 (0.36,0.95),outpatient visit as first visit 4.28 (1.44,12.74),distance 0.76 (0.61,0.95),medical history of ischemic stroke 0.37 (0.18,0.79) (with significant differences in OR value,P＜0.05).Conclusions The protective factors for pre-hospital delay of acute ischemic stroke patients include:strengthened awareness of stroke,effective EMS,high NHISS score,short distance,medical history of ischemic stroke.The main risk factor is that their outpatient visit is their first visit for medical treatment.Therefore,we need to enhance the health education to the patients and their families about awareness of stroke,improve the use of EMS and build complete and efficient green path for the stroke patient.

Objective:To improve the TLC identification method in the quality standard for Yangyin Qingfei granules by identifying paeoniflorin and radix scrophulariae on the same condition plate. Methods:The preparation method for paeoniflorin sample solution in the original standard of TLC identification was improved, the extraction method was water-saturated n-butanol extraction, and the reference crude herb solution of radix scrophulariae was prepared. Simultaneous TLC identification of paeoniflorin and radix scrophular-iae was carried out according to the method described in the original standard. Results:The improved TLC method could be used in the simultaneous identification of paeoniflorin and radix scrophulariae, the spots were clear, and the separation and reproducibility were promising without interference. Conclusion:The improved method is more useful in the quality control of the product with simplified operation.

Objective: To identify the changes of gene expression profiles and metastasis ability of rat hepatoma cell line McA-RH7777 after sublethal irradiation, and to explore the underlying molecular mechanism. Methods: Rat hepatoma McA-RH7777 cells were received single exposure of 6 Gy X-ray. Then, the remaining McA-RH7777 cells were continuously passaged and named as McARH7777- 6Gy. The gene expression profiles of McA-RH7777 and McA-RH7777-6Gy cells were detected by gene microarray and compared. Subsequent bioinformatic analysis of the genes with significant changes in expression levels were performed by DAVID software (including GO-analysis and KEGG-analysis). The mRNA expression levels of tissue inhibitor of metalloproteinase 2 (TIMP2), SMAD family member 2 (SMAD2) and MET proto-oncogene in McA-RH7777 and McA-RH7777-6Gy cells were detected by real-time fluorescent quantitative PCR to verify the difference in gene expression profiles of the two cells. The migration and invasion abilities of McA-RH7777 and McA-RH7777-6Gy cells were detected by scratch wound healing assay and Transwell chamber assay, respectively. Results: The gene microarray showed that the expressions of a series of tumor-related genes were changed in McA-RH7777-6Gy cells as compared with wild-type McA-RH7777 cells. Real-time fluorescent quantitative PCR showed that the relative expression levels of TIMP 2, SMAD 2 and MET in McA-RH7777-6Gy cells were raised by 13.000, 14.516 and 6.384 times as compared with McA-RH7777 cells, respectively. GO analysis showed that the remarkably changed genes mainly located in tumor metastasis-associated biological processes, such as Ras protein signal transduction, cell cycle arrest, cell migration, cell adhesion, negative regulation of apoptotic process, positive regulation of cell proliferation, positive regulation of epithelial to mesenchymal transition and positive regulation of MAP kinase activity. KEGG analysis showed these genes mainly involved in proteoglycans signaling pathway, phosphoinositide-3 kinase (PI3K)-protein kinase B (PKB, Akt) signaling pathway, viral carcinogenesis pathway, FoxO signaling pathway, Rap1 signaling pathway, Hippo signaling pathway, Ras signaling pathway, etc. The scratch healing and Transwell chamber tests showed that the migration and invasion abilities of McA-RH7777-6Gy cells were significantly enhanced as compared with McA-RH7777 cells (both P < 0.001). Conclusion: After sublethal radiation, the migration and invasion abilities of hepatoma cells are significantly enhanced, which may be related to the changes of gene expressions in metastasis-associated pathways.

Objective:To establish the determination method for four lurasidone hydrochloride enantiomers by HPLC. Methods:Lurasidone hydrochloride enantiomers were separated on a CHIRALPAK AD-H column (250 mm × 4. 6 mm, 5μm). The mobile phase consisted of hexane-ethanol-diethylamine ( 90∶10∶0. 1) at a flow rate of 1. 0 ml·min-1 and the column temperature was at 40℃. The detection wavelength was 230nm. Results:The resolution of lurasidone hydrochloride enantiomers was above 2. 0. The linear calibra-tion curves were obtained over the range of 5-120 μg· ml-1 for all the enantiomers (r=0. 999 9). The recovery was above 99. 0%with RSD below 0. 5%. The detection limits were 5ng. Conclusion:The method is simple, accurate and rapid, and suitable for the de-termination and quality control.

BACKGROUND:The homing ability of mesenchymal stem cells is closely associated with the effects of celltransplantation. Clarifying the mechanism of chemotaxis and migration wil contribute to enhance the clinical application of mesenchymal stem cells. OBJECTIVE:To investigate the effect of Cdc42 in the homing of human umbilical cord mesenchymal stem cells. METHODS:First, mesenchymal stem cells were isolated from human umbilical cord, and co-cultured with tumor necrosis factorα, interleukin-1β, and transforming growth factorβ. Western blot assay was used to test the level of Cdc42. Besides, Cdc42 siRNA was synthesized by chemical method to transfect the cells, and cellmigration and adhesion were measured by Transwel and Matrigel separately. Meanwhile, the activity of signal molecule, extracellular regulated protein kinase 1/2, was evaluated by western blot. RESULTS AND CONCLUSION:The results indicated that the inflammation factors induced the highly expression of Cdc42 in human umbilical cord mesenchymal stem cells, almost double level to controls. siRNA notably inhibited the migration and adhesion of human umbilical cord mesenchymal stem cells through Cdc42 down-regulation, and the extracellular regulated protein kinase 1/2 and phosphorylation form were also decreased simultaneously. In a word, we speculate Cdc42 plays a role in the chemotaxis of human umbilical cord mesenchymal stem cells in vitro.

This study was aimed to establish the method of identifying bupleurum cultivated germplasm using simple sequence repeat (SSR) molecular markers and to initially establish dataset of characteristic SSR bands to the bred cultivars or strains. From the bupleurum SSR primer pairs which were designed in previous work, 50 primer pairs were selected. Two bred strains and 4 other bupleurum cultivated germplasms were used as test materials. Primers pairs were screened with effective PCR amplification and high polymorphism. Meanwhile, conditions for PCR amplification and electrophoresis were optimized. Then, obtained SSR bands were analyzed and a clustering tree on the basis of genetic distance was constructed. The results showed that 9 SSR primer pairs can be used for identification. The suitable assay conditions were established and characteristic SSR bands were obtained for tested materials. The tested samples can be divided into 4 categories in the genetic similarity coefficient of 0.73. TheB. scorzonerifolium cultivated inHeilongjiang andChuanhongchaiNo. 1 strains were clustered as one category. ChuanbeichaiNo. 1 strain andZhongchai No. 1 cultivar clustered as another category. Cultivated germplasms fromSichuan Fengshunand Rongxian clustered as a unique category. It was concluded that the primer pairs and assay method established in the present study can be used as reference in identification of bupleurum cultivars or cultivated germplasms.

OBJECTIVETo investigate the transcriptional activity of P53 in gastric cancer.

METHODSThe activity of p53 in gastric cancer was investigated by dual-luciferase reporter assay. The coding sequence of the p53 was amplified by reverse transcription-polymerase chain reaction (RT-PCR) and sequenced. The expression of P21WAF1/Cip1, Gadd45alpha and Mdm2 was detected by immunohistochemistry in 76 samples of gastric carcinoma, and their adjacent tissues were analyzed as control.

RESULTSThe p53 activity was higher in human normal cell lines than that of gastric cancer. Furthermore, the transcriptional activity of P53 was lowest in MKN28 cells in which p53 was mutated. The expression level of P21WAF1/Cip1, Gadd45alpha and Mdm2 in the adjacent tissues was higher than that of cancer tissues (P<0.05), and there was a tendency of decline in the positive ratio with the poor differentiation of the carcinoma (P<0.05). In addition, a strong linear correlation was observed between P21WAF1/Cip1, Gadd45alpha and Mdm2 (P<0.05).

CONCLUSIONChanges of P53 transcriptional activity play an important role in the development of gastric cancer. p53 mutation could affect its transcriptional activity. P21WAF1/Cip1, Gadd45alpha and Mdm2 are a group of effecters that could reflect P53 transcriptional activity when detected together in cancer tissues.

Adult ; Aged ; Carcinoma ; genetics ; metabolism ; pathology ; Cell Cycle Proteins ; Cell Line ; Cyclin-Dependent Kinase Inhibitor p21 ; genetics ; metabolism ; Female ; Humans ; Male ; Middle Aged ; Nuclear Proteins ; Proto-Oncogene Proteins c-mdm2 ; genetics ; metabolism ; Stomach Neoplasms ; genetics ; metabolism ; pathology ; Transcriptional Activation ; Tumor Suppressor Protein p53 ; genetics ; metabolism ; Young Adult

Objective:This study aimed to translate the development of a delirium knowledge test for intensive care nurses (DKT-ICN) and test its reliability and validity.Methods:The DKT-ICN was translated and adapted according to Chinese culture following the translation, back translation and culture adaptation of DKT-ICN using Brislin′s translation model. The Chinese version of DKT-ICN was tested among 316 nurses conveniently sampled in the First Affiliated Hospital of Zhengzhou University from September to December 2021, the reliability and validity of the scale were evaluated by cross-sectional survey method.Results:The scale-content validity index was 0.98, and the item-content validity index ranged from 0.83 to 1.00, the Cronbach′s α for the total scale was 0.884, and the Cronbach′s α for five dimensions ranged from 0.608 to 0.679. The test-retest reliability was 0.753 for the overall scale, and 0.880-0.978 for each domain.Conclusion:The Chinese version of DKT-ICN has acceptable reliability and validity. The DKT-ICN is a valid and reliable instrument for evaluating the knowledge level of ICU nurses in China.

Objective To investigate the characteristics of symptom burden and extract symptom clusters in lung cancer patients at the end of thoracic radiotherapy.Methods Lung cancer patients receiving Thoracic Radiotherapy were collected from 20 tertiary hospitals in China,including Guang'anmen Hospital of the Chinese Academy of Traditional Chinese Medicine,during November 2014—September 2017,and the MDASI-TCM scale assessed patient symptoms at the end of radiotherapy,and descriptive statistics and exploratory factor analysis explored symptom burden and the distribution of TCM symptom clusters.Results At the end of radiotherapy,45.1%of patients reported two or more moderate to severe symptoms,with fatigue being the most prevalent and severe symptom.Fatigue(31.4%),cough(30.9%),expectoration(24.1%),distress(23.2%)and shortness of breath(20.9%)were the top five symptoms from the highest to the lowest in the incidence of moderate to severe symptoms.The enjoyment of life(36.4%)had the highest incidence of interference with moderate to severe symptoms.Exploratory Factor analysis extracted three symptom clusters,namely the excessive heat and damaged yin-Spleen and stomach disorders related symptom cluster,the heart and spleen-deficient related symptom cluster,and the lung qi-unfriendly related symptom cluster,with a cumulative variance contribution of 70.1%.Conclusion Lung cancer patients undergoing thoracic radiotherapy have a certain symptom burden at the end of radiotherapy.The identification of symptom burden and symptom group characteristics is conducive to promoting standardization of TCM syndrome differentiation and laying a preliminary foundation for formulating reasonable and effective TCM intervention measures in the future.

Objective To observe the efficacy of oropharyngeal muscle exercise for relieving obstructive sleep apnea (OSAS) among stroke survivors.Methods Fifty stroke survivors with moderate OSAS were randomly divided into an observation group and a control group,each of 25.Both groups were given routine drugs and rehabilitation,while the observation group was additionally provided with oropharyngeal muscle exercises during the daytime for 20 minutes twice a day for6 weeks.The control group received deep breathing therapy.Before and after the 6 weeks of treatment,both groups were evaluated using polysomnography.Their sleep quality and daytime sleepiness were measured using the Pittsburgh sleep quality index and the Stanford sleepiness scale.Any changes in the patients' pharyngeal morphology after exercise were evaluated using MRI.Results After the oropharyngeal muscle exercises,the apnea hypoventilation index and minimum SaO2 ％,the snore index and sleep quality improved significantly.Daytime sleepiness was significantly relieved.Some structural remodeling of the pharyngeal airvay was observed by MRI,including significantly larger retropalatal distance and shorter length of the soft palate.The retropalatal distance was positively and correlated with the duration of exercise while the length of soft palate correlated negatively.Conclusion Exercising the oropharyngeal muscles is a promising alternative treatment for stroke survivors with moderate OSAS.It improves the morphology of the oropharynx to relieve obstruction during sleeping.