Objective To evaluate the effectiveness of using low-frequency repetitive transcranial magnetic stimulation (rTMS) along with donepezil in the rehabilitation of aphasia after cerebral infarction. Methods Fortythree aphasic patients with acute cerebral infarction were assigned into a treatment group or a control group.Both groups received standard basic treatment for acute cerebral infarction.From day 7 on,both groups received oral donepezil hydrochloride (5 mg/d) for 12 consecutive weeks.The treatment group received in addition 2 sessions of low frequency rTMS on the language center of the right hemisphere.The first session started at day 7 after onset,and each session consisted of rTMS on 10 consecutive days (once per day).There was a resting interval of 3 d between the two sessions.The rehabilitation of the aphasia was assessed prior to and after each session,and at the end of the entire 12 weeks of treatment using the western aphasia battery ( WAB ) scoring system and the aphasia quotient (AQ). Results There was no significant difference between the two groups after the first session in terms of the WAB or AQ results.However,the difference in improvement became statistically significant after the second session,as well as at the end of the entire 12 weeks.The average change in AQ was significantly greater in the treatment group. Conclusion Donepezil combined with rTMS early in the acute phase of cerebral infarction is helpful for the rehabilitation of aphasia.

Objective To investigate the expression of CD90,IGF1R in hepatocellular carcinoma.Methods CD90,IGF1R expression were detected by SP immunohistochemical staining in 36 cases of hepatocellular carcinoma,20 cases of normal liver tissue biopsied from patients of chronic cholecystitis undergoing cholecystectomy. Results The positive rate of CD90 (63.89％,23/36),IGF1R (52.78％,19/36) in hepatocellular carcinoma significantly increased (P ＜ 0.05 ); The positive rate of CD90 was higher in UICC Ⅲ - Ⅳ stage group (79.17％ ) than in UICC stage Ⅰ - Ⅱ group (33.33％,P ＜0.05) ;The positive rate of CD90 was higher in low differentiated group (76.92％ ) than in well-differentiated group (56.52％,P ＜0.05).The positive rate of IGF1R was higher in UICC Ⅲ - Ⅳ stage group (70.83％ ) than in UICC stage Ⅰ - Ⅱ group ( 16.67％,P ＜ 0.05 ). The positive rate of IGF1R was higher in low differentiated group (84.62％) than in well-differentiated group (37.38％,P ＜ 0.05 ).The expression of IGF1R was positively correlated with that of CD90 (P ＜ 0.05 ).The median survival of CD90+ patients (85 days) was shorter than CD90- patients ( 505 days ) ( P ＜ 0.05 ).The median survival of IGF1 R + patients (100 days) was shorter than IGF1 R- patients (408 days,P ＜ 0.05). Conclusions CD90 or IGF1R expression correlates positively with the progression of HCC.

Non-drug treatment of hypertension has become a research hotspot, which might overcome the heavy economic burden and side effects of drug treatment for the patients. Because of the good treatment effect and convenient operation, a new treatment based on slow breathing training is increasingly becoming a kind of physical therapy for hypertension. This paper explains the principle of hypertension treatment based on slow breathing training method, and introduces the overall structure of the portable blood pressure controlling instrument, including breathing detection circuit, the core control module, audio module, memory module and man-machine interaction module. We give a brief introduction to the instrument and the software in this paper. The prototype testing results showed that the treatment had a significant effect on controlling the blood pressure.
Biofeedback, Psychology ; methods ; Blood Pressure ; Humans ; Hypertension ; therapy ; Physical Therapy Modalities ; instrumentation

Objective:In the research, the traditional mercury sphygmomanometer was used to press the puncture point to evaluate the hemostatic effect.Methods:Eighty patients with acute cerebral infarction diagnosed clinically in Xuanwu Hospital of Capital Medical University from June 2018 to December 2019 were examined by magnetic resonance perfusion examination. The serial number of the patient was randomly divided into the group by random digital table, and the puncture point was pressed by mercury sphygmomanometer after needle extraction in the auxiliary pressing group, and the individual systolic blood pressure intensity was set as the pressing intensity, while the control group adopted independent vertical pressing technique. After examination, the puncture points of the two groups were qualitatively evaluated, such as secondary bleeding, hematoma, ecchymosis, normal and so on.Results:In the auxiliary compression group, there were 3 cases of secondary hemorrhage, 1 case of hematoma, 0 cases of ecchymosis and 36 cases of normal, while in the control group, there were 4 cases of bleeding, 2 case of hematoma, 1 case of ecchymosis and 33 cases of normal ( χ2value was 4.372-34.225, P<0.05). Conclusion:Traditional mercury sphygmomanometer-assisted pressing puncture point can make personalized nursing hemostasis plan for patients with acute cerebral infarction, reduce the phenomenon of puncture point bleeding, ecchymosis, and even subcutaneous hematoma caused by unstable pressing and unequal force, and practice high-quality nursing service.

Objective:To investigate the expression of platelet-specific alloantibody in the sera of primipara,pluripara,and recurrent spontaneous abortion (RSA) patients,and analyze the relationship between platelet-specific alloantibody and gravidity or RSA. Methods:A total of 100 primipara, 100 pluripara (gravidity≥2) and 100 RSA patients who received prenatal examination in department of aristogenesis, No. 202 Hospital of PLA from Apr 2015 to Dec 2015 were recruited. The blood samples were collected during 16-28 weeks of pregnancy, and the expression of platelet-specific alloantibody was detected by solid-phase red cell adherence assay. Results:There were 5 positive platelet-specific alloantibody in primipara group, 14 in red all pluripara group,and 26 in RSA group. Platelet-specific alloantibody was significantly associated with gravidity and the incidence of RSA (P<0.05) by chi-square analysis. Conclusion:Screening the expression of platelet-specific alloantibody during pregnancy can provide evidence for the diagnosis and treatment of RSA.

Objective To detect the levels of anti-measles antibody in a healthy population in Jin-shan District of Shanghai and to provide references for making a better immunization strategy against measles in this area. Methods Stratified sampling was used to collect 390 serum sample in 12 age groups with an equal number of males and females as well as resident and floating population. Indirect enzyme-linked immu-nosorbent assay (ELISA) was performed to detect the concentrations of IgG antibody against measles in dif-ferent groups. Results The overall positive rate and protective rate of anti-measles antibody were 78.21% and 41.28%, respectively. No significant difference in the positive rates of antibody was found between males and females, or resident and floating population (P>0.05). Antibody levels varied significantly among different age groups(χ2=191.214,P<0.01). More than 80.00% of the people aged≥1 year were positive for anti-measles antibody and the positive rates in children 3 to 6 years old and people aged ≥40 years reached 100% and over 90.00%,respectively. Infants under 8 months of age,having the lowest posi-tive rate of antibody(10.00%),were susceptible to measles. The highest protective rate was found in chil-dren aged 8 months to 9 years,followed by that in people≥40 years. Levels of anti-measles antibody in peo-ple aged 10 to 39 years mainly ranged from 200 mIU/ml to 800 mIU/ml. No significant difference in anti-body levels was found among people aged≥8 months who had different immunization histories(χ2=1.140,P>0.05). Conclusion The average level of anti-measles antibody was high in Jinshan District in 2015,in-dicating that the people in that area had a relatively high immunity to measles,but the positive rate of anti-body needed to be further improved. Infants under 8 months old and people 10 to 39 years old were the main susceptible groups. It is suggested that measles vaccination efforts should be focused on susceptible popula-tion and women of childbearing age to improve herd immunity.

Objective:To study the risk factors of adverse pregnancy outcomes for induced abortion of cesarean scar pregnancy in midtrimester.Methods:A national multicenter retrospective study was conducted. A total of 154 singletons pregnant women with cesarean scar pregnancy during the second trimester induced abortion by various reasons in 12 tertiary A hospitals were selected, their pregnant outcomes were observed and the risk factors of serious adverse outcomes were analyzed with univariate and multivariate logstic regression; the role of ultrasound and MRI in predicting placenta accreta and severe adverse outcomes was evaluated, the effectiveness of uterine artery embolization (UAE) in preventing hemorrhage in pregnant women with and without placenta accreta was compared.Results:Among 154 subjects, the rate of placenta accreta was 42.2% (65/154), the rate of postpartum hemorrhage≥1 000 ml was 39.0% (60/154), the rate of hysterectomy was 14.9% (23/154), the rate of uterine rupture was 0.6% (1/154). The risk factor of postpartum hemorrhage≥1 000 ml and hysterectomy was placenta accreta ( P<0.01). For each increase in the number of parity, the risk of placenta accreta increased 2.385 times (95% CI: 1.046-5.439; P=0.039); and the risk of placenta accreta decreased with increasing ultrasound measurement of scar myometrium thickness ( OR=0.033, 95% CI: 0.001-0.762; P=0.033). The amount of postpartum hemorrhage and hysterectomy rate in the group with placenta accreta diagnosed by ultrasound combined with MRI were not significantly different from those in the group with placenta accreta diagnosed by ultrasound only or MRI only (all P>0.05). For pregnant women with placenta accreta, there were no significant difference in the amount of bleeding and hysterectomy rate between the UAE group [median: 1 300 ml; 34% (16/47)] and the non-embolization group (all P>0.05); in pregnant women without placenta accreta, the amount of bleeding in the UAE group was lower than that in the non-embolization group (median: 100 vs 600 ml; P<0.01), but there was no significant difference in hysterectomy rate [2% (1/56) vs 9% (3/33); P>0.05]. Conclusions:(1) Placenta accreta is the only risk factor of postpartum hemorrhage≥1 000 ml with hysterectomy for induced abortion of cesarean scar pregnancy in midtrimester; multi-parity and ultrasound measurement of scar myometrium thickness are risk factors for placenta accreta. (2) The technique of using ultrasound and MRI in predicting placenta accreta of cesarean scar pregnancy needs to be improved. (3) It is necessary to discuss of UAE in preventing postpartum hemorrhage for induced abortion of cesarean scar pregnancy in midtrimester.

Objective:To study the risk factors of adverse pregnancy outcomes for the diagnosis and treatment of pregnancy after cesarean section complicated with placenta previa.Methods:A national multicenter retrospective study was conducted to select a total of 747 pregnant women with the third trimester singleton pregnancy after cesarean section complicated with placenta previa from 12 tertiary hospitals in January 1st to December 31st, 2018. The risk factors of severe adverse outcomes [hysterectomy, intraoperative blood loss ≥1 000 ml, intraoperative diagnosis of placenta accreta spectrum disorders (PAS)] in pregnant women with second pregnancy complicated with placenta previa after cesarean section were investigated by logistic regression analysis. The roles of prenatal ultrasonography and magnetic resonance imaging (MRI) in the prediction of PAS and severe adverse outcomes were observed. According to whether vascular intervention was performed (uterine artery embolization or abdominal aortic balloon occlusion), the pregnant women were divided into the blocked group and the unblocked group, and the maternal and infant perinatal outcomes between the two groups were compared.Results:(1) General information: the hysterectomy rate of 747 pregnant women with second pregnancy complicated with placenta previa after cesarean section was 10.4% (78/747), the intraoperative blood loss ≥1 000 ml in 55.8% (417/747), and PAS was confirmed in 47.5% (355/747). The incidence of uterine rupture was 0.8% (6/747). (2) Analysis of risk factors for severe adverse outcomes: based on binary unconditioned logistic regression univariate and multivariate analysis, the risk factors for hysterectomy were the mode of vascular embolization and intraoperative blood loss. The probability of hysterectomy with uterine artery embolization was 5.319 times higher than that with abdominal aortic balloon occlusion (95% CI: 1.346-21.018). The risk factors of intraoperative blood loss ≥1 000 ml were the number of cesarean section delivery, ultrasonography indicated PAS and suspected PAS, intraoperative PAS and complete placenta previa. The risk factors for intraoperative PAS were uterine scar thickness, ultrasonography indicated PAS and suspected PAS, MRI indicated PAS and suspected PAS, and complete placenta previa. (3) The roles of ultrasonography and MRI in predicting PAS: the sensitivity and specificity of ultrasonography in predicting PAS were 47.5% and 88.4%; the kappa value was 0.279 ( P<0.001), with fair agreement. The sensitivity and specificity of MRI to predict PAS were 79.2% and 97.8%, respectively. The kappa value was 0.702 ( P<0.001), indicating a good agreement. The intraoperative blood loss and hysterectomy rate of pregnant women with PAS indicated by ultrasonography and MRI were significantly higher than those with PAS only by ultrasonography or MRI. (4) Influence of vascular occlusion on pregnancy outcome: there were no significant differences in intraoperative blood loss and incidence of intraoperative bleeding ≥1 000 ml between the blocked group and the unblocked group (all P>0.05). There was no significant difference in intraoperative blood loss between the pregnant women with abdominal aortic balloon occlusion, uterine artery embolization and those without occlusion ( P=0.409). The hysterectomy rate of pregnant women with uterine artery embolization was significantly higher than those with abdominal aortic balloon occlusion [39.3% (22/56) vs 10.0% (5/50), P=0.001]. Conclusions:In the third trimester of pregnancy with placenta previa after cesarean section, MRI examination has better consistency in predicting PAS than ultrasonography examination. Ultrasonography examination combined with MRI examination could effectively predict the hysterectomy rate and intraoperative blood loss. Vascular occlusion could not reduce the amount of intraoperative blood loss. The hysterectomy rate of pregnant women with uterine artery embolization is higher than those with abdominal aortic balloon occlusion.

Objective To prepare paraoxonase 1 (PON1) liposomes, and investigate pharmacokinetics of common PON1 liposomes (L-PON1) and polyethylene glycol-modified PON1 long circulating liposomes (PEG-PON1-LCL) in rats after intravenous administration. Methods L-PON1 and PEG-PON1-LCL were prepared by film dispersion method. The entrapment efficiency, mean diameter and Zeta potential of the liposomes were measured, and the stability was evaluated. Thirty-six Wistar rats were divided into three groups according to random number table, with 12 rats in each group. The rats were intravenously administrated with PON1, L-PON1 or PEG-PON1-LCL 700 U/kg, respectively. The activity of PON1 in serum was determined by phenyl acetate method, the activity of PON1 at different time points after drug administration was compared with that before drug administration, and the difference value was considered as the activity of exogenous PON1, and PON1 activity-time curve was plotted. The pharmacokinetic parameters were calculated and analyzed by DAS 2.0 pharmacokinetic program and SPSS 17.0. Results The entrapment efficiencies of L-PON1 and PEG-PON1-LCL were above 85%, the mean diameter was about 126 nm, and Zeta potential was -14.35 mV. After 2 weeks of preservation, the above parameters showed no obvious change, indicating that liposomes had good stability and the properties of preparations were basically stable. Compared with purified PON1 administration, after L-PON1 and PEG-PON1-LCL administration, the activity of PON1 was increased, the half-life of PON1 activity in rats was significantly prolonged [the half-life of distribution (T1/2α, hours): 0.142±0.018, 0.147±0.021 vs. 0.126±0.022; the half-life of clearance (T1/2β, hours): 3.877±1.010, 4.520±1.117 vs. 1.226±0.422], the area under PON1 activity-time curve (AUC) was significantly increased [AUC from 0 hour to 24 hours (AUC0-24, U·h-1·L-1): 499.305±64.710, 563.576±70.450 vs. 18.053±2.190; AUC from the immediate injection to the disappearance of PON1 activity (AUC0-∞, U·h-1·L-1): 516.256±60.940, 587.801±76.210 vs. 21.044±3.250], the apparent volume of distribution (Vd) and clearance (CL) were significantly decreased [Vd (L): 0.140±0.065, 0.144±0.064 vs. 0.493±0.032, CL (L/h):0.039±0.008, 0.034±0.006 vs. 0.952±0.082, all P < 0.05]. There was no significant difference in pharmacokinetics between L-PON1 and PEG-PON1-LCL. Conclusions The film dispersion method prepared PON1 liposomes have high entrapment efficiency and small particle size with a good stability. Both liposomes can raise PON1 activity in vivo, change the pharmacokinetics of PON1 in vivo, prolong the resident time of PON1 in the blood circulating system, and compensate for the short half-life of PON1 in vivo.

Objective: To explore the association of arsenic with unexplained recurrent spontaneous abortion (URSA). Methods: A case-control study was conducted to select URSA patients who were admitted to the Beijing Maternal and Child Health Care Hospital affiliated to Capital Medical University from April to October 2018 as a case group. Women who had a normal pregnancy in the Family Planning Department of the hospital but volunteered to have an abortion were selected as a control group. The case and control group were paired in a 1: 1 ratio. The inclusion criteria of the case group were patients with newly diagnosed recurrent spontaneous abortion who had clinically confirmed more than 2 spontaneous abortions and had 20 weeks prior to pregnancy, excluding patients with recurrent spontaneous abortion caused by abnormal blood coagulation (anti-phospholipid antibody positive), abnormal physiological anatomy (B-ultrasound), abnormal immune factors (anti-nuclear antibody positive, anti-cardiolipin antibody, etc.), genetic chromosomal abnormalities (karyotype analysis) and pathogenic microbial infection. The control group was matched according to the age of the case group (±3 years old) and the gestational age (±2 weeks) to exclude adverse pregnancy outcomes such as stillbirth, congenital malformation, premature delivery and low birth weight infants. A total of 192 subjects were included. Questionnaires were used to collect information of all subjects, and 12 ml of peripheral venous blood was collected to detect blood arsenic levels. Blood arsenic levels were divided into low concentration group (<1.00 μg/L), medium concentration group (1.00-1.50 μg/L) and high concentration group (>1.50 μg/L). The multivariate conditional logistic regression was performed to analyze the relationship between blood arsenic exposure and URSA and explore the influencing factors of blood Arsenic. Results: The geometric mean values of blood arsenic level in the cases group and control group were 1.68 (1.50-1.86) μg/L and 1.26 (1.17-1.37) μg/L, respectively. The blood arsenic level in the case group was significantly higher than that in the control group (P<0.05). The results of multivariate conditional logistic regression analysis showed that after adjusting for tobacco exposure during pregnancy, pre-pregnancy body mass index and the effects of residential decoration in past five years, the risk of URSA was higher in the high-concentration group compared with the low-concentration group (OR=2.56, 95%CI:1.06-6.24). Conclusion Blood arsenic may increase the risk of URSA in women of childbearing age.