Objective To investigate the relationship of serum uric acid level with carotid atherosclerosis and intracranial stenosis in patients with cerebral ischemic stroke.Methods 186 patients checked by Color Doppler Flow Imaging (CDFI) and Transcranial Doppler (TCD) were enrolled.According to the degree of carotid intima-media thickness (IMT), patients were divided into normal group, and intima thicken group, the plaque shaping group and the vascular stenosis group.According to the degree of intracranial stenosis, patients were divided into stenosis group and nonstenosis group.The serum levels of uric acid (UA), triglycerides (TG), total cholesterol (TC), highdensity lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) were detected.The relative factors for carotid atherosclerosis and intracranial stenosis were analyzed by multiple logistic regression analysis.Results Compared with normal group and intima thicken group, the percentage of patients with hypertension, coronary heart disease and serum TC level were increased in plaque shaping group and vascular stenosis group (P＜0.05 for all).With the increase of carotid IMT, serum UA level was also gradually increased (F=11.386, P =0.000).Logistic regression analysis showed that serum UA level was the independent risk factor for carotid atherosclerosis (OR=3.486, P=0.013).Among 186 patients, 43 cases (23.1％) had intracranial vascular stenosis.The UA level was higher in stenosis group than in non stenosis group (t=9.372, P=0.013).Logistic regression analysis showed that serum UA level were the independent risk factors for intracranial arterial stenosis (OR =1.914, P=0.022).Conclusions The occurrence of carotid atherosclerosis and intracranial stenosis are closely related with hyperuricemia in patients with cerebral ischemic stroke, which indicates serum uric acid level may reflect the degree of carotid artery atherosclerosis.

Objective To investigate the protective effect of IL-37 on hepatocyte injury against hypoxia/reoxygenation (H/R) by promoting polarization of M2-type macrophages and its molecular mechanisms.Methods Real-time fluorescent quantitative PCR (qRT-PCR) and Western blot were used to detect the levels of IL-37 mRNA and protein in human monocyte-macrophage THP-1 cells with different polarizations.The lentivirus with IL-37 gene was infected into THP-1 cells.The levels of CD206,CD86,ARG1 and iNOS mRNA was detected by qRT-PCR.The levels of CD163 and CD86 protein was detected by flow cytometric analysis.THP-1 cells and L02 cells were co-cultured by Transwell and treated with H/R.The survival rate and apoptotic rate of L02 cells were detected.The levels of alanine transaminase (ALT) and aspartate aminotransferase (AST) in culture medium were measured.The levels of STAT6 and its phosphorylation in THP-1 cells were detected by Western blot.Results The levels of IL-37 mRNA and protein were up-regulated in M2-type macrophages.IL-37 promoted the polarization of M2-type macropahges.M2-type macrophages induced by IL-37 were cocultured with L02 cells,the survival rate was significantly increased by H/R treatment (P =0.015),while the apoptotic rate,ALT level and AST level were significantly decreased (P＜0.001).The level of phosphorylated STAT6 in THP-1 cells overexpressing IL-37 was up-regulated (P ＜ 0.01).Conclusions IL-37 can induce polarization of M2-type macrophages and protect hepatocyte injury against H/R.Its mechanism may be related to STAT6 signal pathways.

Objective To observe high glucose induced expression of hepatocyte growth factor (HGF) and c met in human kidney fibroblast. Methods The effects of glucose concentrations on expression of HGF, c met and plasminogen activator inhibitor (PAI) 1 in cultured human kidney fibroblasts were observed by RT PCR. In the same system, the effect of exogenous HGF on the expression of PAI 1 was investigated. Results Human kidney fibroblasts cultured in high glucose concentration (25 mmol/L) showed higher HGF and c met expressions in the early stage and then manifested a gradient decrease of HGF and c met expressions, but PAI 1 expression was gradiently increased. Exogenous HGF resulted in inhibiting PAI 1 expression. Conclusion HGF is a potential anti fibrogenic factor and activates matrix degradation pathways in diabetic kidney by reducing PAI 1 expression.

Recently, herbal medicine including traditional Chinese medicine (TCM) has gained huge attention in the world. In 2015, the global trades of herbal medicine reached 93.15 billion US dollars. And, the latest statistics from the Ministry of Industry and Information Technology of People's Republic of China showed that total sales of Chinese patent medicine and raw herbs reached 120 billion US dollars in 2014. Therefore, the aim of this study was to analyze the situation of international marketing on herbal medicine and how much TCM shared in it. The PubMed database, search engines and government websites and research reports were searched for analyses. The results showed that total trades of TCM products in both domestic and foreign markets, were about 135 billion US dollars, including Chinese patent medicine, raw herbs, herbal extracts, herbal health care products, whose proportion of the global marketing was 80%.

Objective To investigate students' experiences of learning achieved through the flipped classroom based on Massive Open Online Course(MOOC). Methods Qualitative study in which data were gathered from semi-structured and in-depth interviews conducted with 8 key students from the flipped classroom. The interviews were analyzed using Nancy′s phenomenology 7-step analysis method. Results Four themes emerged from the interviews: personalized learning, active learning, cooperative learning, and the critical role of teacher. Conclusions Overall, our research highlights the efficacy of MOOC-based flipped classroom. The implementation of the flipped classroom in this study improved personalized, active, and cooperative learning, and promoted the positive teacher-student relationship. Further research is needed to continue the investigation into maintaining students′ learning initiatives, controlling teach-learning progression,and strengthening formative evaluation.

Objective: To evaluate the effects of dietary behaviors on the risk of hypertension, diabetes and cardiovascular diseases. Methods: A total of 12 208 subjects aged 18-60 years old were investigated by questionnaires to collect demographic data, dietary behaviors and lifestyle information, when they did health examination in a tertiary hospital in Beijing from 2014 to 2019. During the observation period of five year, the incidence of hypertension, diabetes and cardiovascular diseases were collected through health examination files every year. The multivariate logistic regression model was employed to analyze the associations of dietary behaviors with hypertension, diabetes and cardiovascular diseases. Results: The study included 6 218 ( 50.93% ) males and 5 990 ( 49.07% ) females. The cumulative incidence rates of hypertension, diabetes and cardiovascular diseases were 7.75%, 2.72% and 3.49%, respectively. The multivariate logistic regression analysis indicated that the high-sodium diet ( OR=1.422, 95%CI: 1.191-1.697 ) , eating fast ( OR=1.457, 95%CI: 1.102-1.974 ), eating more refined grain ( OR=1.251, 95%CI: 1.050-1.490 ) and drinking milk less than once a week ( OR=1.316, 95%CI: 1.022-1.697 ) were risk factors for hypertension. The high-sodium diet ( OR=1.344, 95%CI: 1.048-1.725 ), eating fast ( OR=1.733, 95%CI: 1.046-2.871 ), eating more meat ( OR=1.651,95%CI: 1.263-2.158 ) were risk factors for diabetes. High-sodium diet ( OR=1.501, 95%CI: 1.192-1.889 ) was risk factors for cardiovascular disease. Conclusion The diet with high sodium, more meat and refined grain as well as eating fast can increase the risk of hypertension, diabetes and cardiovascular diseases.

INTRODUCTIONIn order to commit to their mission and placement requirements, medical education policy-makers are required to understand the background and character of students in order to admit, cultivate and support them efficiently and effectively.

MATERIALS AND METHODSThis study sample consisted of 408 homogeneous medical students with the same level of education, occupation, school and societal environment. They differed mainly in their family background. Therefore, this study used part of a multidimensional "student portfolio system" database to assess the correlation between family status (indexed by parental education and occupation) and medical students' mental health status and characters. The controls were a group of 181 non-medical students in another university.

RESULTSThe parents of the medical students were from a higher socioeconomic status (SES) than the parents of those in the control group. This showed the heritability of genetic and environment conditions as well as the socioeconomic forces at play in medical education. Students' personal and professional development were associated with their parents' SES. The mother's SES was associated with the student's selfreported stress, mental disturbances, attitude towards life, personality, health, discipline, internationalisation and professionalism. The fathers' SES did not show a statistically significant association with the above stress, physical and mental health factors, but showed an association with some of the personality factors. The greater the educational difference between both parents, the more stress, hopelessness and pessimism the student manifested.

CONCLUSIONSMedical educators need to be aware that socioeconomic factors have meaningful patterns of association with students' mental and physical health, and their characters relating to personal and professional development. Low maternal SES negatively influences medical students' personal and professional development, suggesting that medical education policy-makers need to initiate support mechanisms for those with latent vulnerability.

Education, Medical ; methods ; Family Relations ; Female ; Humans ; Interpersonal Relations ; Male ; Mental Health ; Retrospective Studies ; Social Class ; Students, Medical ; psychology ; Taiwan

OBJECTIVETo apply echocardiography in diagnosis of isolated noncompaction of ventricular myocardium (INVM) in adults.

METHODSSix patients with INVM underwent echocardiographic examination using HP5500 ultrasound system with the frequency of 2 approximately equals 4 MHz, and the observation was focused on ventricularmyocardium and endocardium at one-third of the apex.

RESULTSAll 6 patients showed typical echocardiographic images characterized by an altered structure of the ventricular myocardium with extremely thickened, hypokinetic segments consisting of two layers: a thin, compacted epicardium and an extremely thickened endocardium, resulting in an extremely thickened ventricular wall.

CONCLUSIONEchocardiography should be the first choice to be applied in diagnosis of INVM, which is a distinct entity of specific cardiomyopathy in adults.

Adult ; Cardiomyopathies ; congenital ; diagnostic imaging ; pathology ; Echocardiography, Doppler, Color ; Female ; Heart Ventricles ; diagnostic imaging ; pathology ; Humans ; Male ; Middle Aged ; Myocardium ; pathology

OBJECTIVETo explore the effects of hyperbaric oxygen preconditioning (HBOP) on human stress responses during acute exposure to high altitude and the possible mechanism.

METHODSEight male subjects were treated with HBOP for 3, 5, and 7 days, followed by acute exposure to hypoxia simulating an altitude of 4,000 m. Subjects at rest were divided into sea-level control group, simulated high-altitude group, and 5-day HBOP intervention group, while subjects after physical load were divided into sea-level control group, simulated high-altitude group, 3-day HBOP intervention group, and 7-day HBOP intervention group. The physical load test was performed for each subject before and after HBOP, and the plasma levels of dopamine (DA), epinephrine (E), norepinephrine (NE), and adrenocorticotropic hormone (ACTH) were determined before and after exercise. The physical load test was performed by stepping up on to a 30 cm-high stepping stool at a rate of 25/min for 5 minutes, which was a type of moderate physical exercise. The stepping rate and timing were controlled by a metronome.

RESULTSThe levels of DA, E, NE, and ACTH at rest and after physical load were significantly higher in subjects acutely exposed to high altitude than in the sea-level control groups (all P<0.05). Moreover, the levels of DA, E, NE, and ACTH at rest were significantly higher after acute exposure to high altitude in the 5-day HBOP intervention group than in the simulated high-altitude group (all P<0.01). Except for the ACTH level in the 3-day HBOP intervention group, the levels of DA, E, NE, and ACTH after physical load were significantly higher after acute exposure to high altitude in the 3-day and 7-day HBOP intervention groups than in the simulated high-altitude group (all P<0.01).

CONCLUSIONHBOP can elevate the plasma expression of DA, E, NE, and ACTH, and then speed up the establishment of a new balance of homeostasis to adapt to the acute hypoxia at high altitude.

Adrenocorticotropic Hormone ; blood ; Altitude ; Dopamine ; blood ; Epinephrine ; blood ; Exercise ; Homeostasis ; Humans ; Hyperbaric Oxygenation ; Hypoxia ; blood ; Male ; Norepinephrine ; blood ; Rest ; Stress, Physiological

Adolescent ; Adult ; Constriction, Pathologic ; diagnostic imaging ; surgery ; Female ; Humans ; Male ; Peripheral Vascular Diseases ; diagnostic imaging ; surgery ; Renal Veins ; diagnostic imaging ; pathology ; Stents ; Ultrasonography