Objective To evaluate the clinicophatholgic benefits and safty of antivirus therapy in patients with liver cirrhosis resulting from hepatitis B.Methods 80 patients with HBV-ralated liver cirrhosis were divided into three groups by the histopathology of liver:group of lamivudine treated with lamivudine 100 mg once daily;Adefovir group treated with Adefovir 10 mg once daily;control group treated with liver protective treatment only.Liver and renal function,PTA and HBV DNA were regularly measured.The Child push-Turotte sore and histopathology wag compared before and after treatment.All courses of treatment were 36 weeks.Results The scores of Child Pugh-Turotte sore in groups of lamivudine and Adefovir were lowered sinificantly (3.9 and 2.1 respectively),the load of HBV-DNA was decreased also[(4.1±0.9) copies/ml and(2.8±1.0) copies/ml],liver inflammmation decreased by more than 2 scores and liver fiber was improved by more than one score,with obviously significant difference(P<0.05) as compared with control group.Conclusion Patients with HBV-related cirrhosis treated with lamivudine and adefovir for antivims are improved and antivirus is important and safe to those during cirrhosis decompensation.

By referring to the domestic and foreign relevant regulatory guidelines, this paper analyzed and sum-marized the ethical point in the design phase in the perspective of relevant regulations of clinical waste sample man-agement and biological sample management. It also analyzed the focus problems including the difference in sample library and clinical laboratory remaining sample as well as the ownership of the sample, to provide theoretical basis for ethics committee to review this kind of protocols.

Objective To compare the effects of Baimai ointment and baclofen in stroke patients with spas-ticity.Methods 84 cases accompanied by limb spasticity in stroke patients by digital table were randomly divided into Baimai ointment group and baclofen group,42 cases in each group.The Baimai ointment group were treated with Baimai ointment on the spastic limbs,the baclofen group received oral baclofen tablets 30 -75mg/days for 2 weeks, 4 weeks,8 weeks.The curative effects of the two groups were compared before and after treatment.Results Before and after treatment in the two groups,the levels of spasticity,pain and activities of daily living (ADL)differences were statistically significant and Baimai ointment in the treatment of spasm.After 4 weeks and 8 weeks,the Ashworth score of the Baimai ointment group were (1.59 ±0.46)points,(0.89 ±0.56)points,and those of baclofen group were (1.75 ±0.64)points,(1.45 ±0.48)points,the differences were statistically significant(t values were 2.916, 3.367,all P <0.05).After 2 weeks,4 weeks and 8 weeks,the VAS score of the Baimai ointment group were (2.72 ± 0.54)points,(2.02 ±0.24)points,(1.24 ±0.12)points,and baclofen group were (3.56 ±0.44)points,(3.15 ± 0.48)points,(2.58 ±0.26)points,the differences were statistically significant(t values were 2.975,3.359,5.416, all P <0.05),activities of daily living (ADL)was higher than that of the baclofen group.After 8 weeks,the MBI score of the Baimai ointment group was (64.46 ±10.78)points,and baclofen group was (50.74 ±9.18)points,the difference was statistically significant between the two groups (t values was 3.562,P <0.05).Conclusion Baimai ointment has the better antispasmodic effect than baclofen in patients with stroke.

Objective To describe the hemodynamic characteristics of normal pancreas and pancreatic tumors by 64 slices helical CT perfusion imaging, to evaluate the role of CT perfusion in the diagnosis of pancreatic tumors. Methods Perfusion CT scan was performed in 149 patients, including 36 patients with normal pancreas, 105 patients with pancreatic tumors and 8 patients with duodenal papillary carcinoma. The parameters including blood flow (BF) ,blood volume (BV) and permeability surface area product (PS) were measured. Results The mean value of BF, BV and PS of normal pancreas were (135.24±48.36) ml· min-1·kg-1, (200.55±54.96)ml/kg and (49.75±24.27) ml·min-1·kg-1, respectively. Pancreatic carcinoma has a lower BF, BV and PS,whieh were 31.77±19.36 ml·min-1· kg-1, (66.84±39.49)ml/kg and (37.64±27.14) ml·min-1·kg-1, respectively. The aforementioned parameters in pancreatic cysts were close to zero. The parameters in pancreatic carcinoma were significantly lower than those in normal pancreas(P<0.05); the BF and BV in duodenal papillary carcinoma were significantly lower than those in normal pancreas(P<0.05), while the value of PS was not significantly different from that in normal pancreas; the aforementioned parameters in pancreatic cysts were significantly different from those in normal pancreas(P <0.01). Conclusions In perfu sion CT, normal pancreas was an organ with symmetrical BF,BV and PS. Pancreatic carcinoma was a tumor with low perfusion and decreased PS. Duodenal papillary carcinoma had decreased BF and BV with no significant change in PS. Pancreatic cyst had no blood perfusion. The 64 slice helical CT peffusion imaging was invaluable in differential diagnosis of pancreatic tumors.

BACKGROUND: Ischemic postconditioning protects the myocardium from ischemia/recursion injury via maintaining 3-minute acidosis initially. But its effect on the skeletal muscle remains unclear. OBJECTIVE: To dynamically measure the pH values in rat skeletal muscle after ischemia, and then to simulate acidic perfusate infusion to investigate the effect of ischemic postconditioning on ischemia/reperfusion injury. METHODS: Based on the ischemia/reperfusion injury model and ischemic postconditioning protocol in previous study, dynamic measurement of pH values in rat skeletal muscle was conducted using pH instrument at the global ischemia, ischemic postconditioning (30/30 seconds) and reperfusion period, and then the acidic perfusate equivalent to pH in ischemic postconditioning period was prepared with lactic acid and normal saline. Twenty-five healthy adult male Sprague-Dawley rats were randomly divided into sham, ischemia/reperfusion, ischemic postconditioning, lactic acid, and normal saline groups (n=5 per group). Blood samples were collected to detect lactate dehydrogenase level. The samples from gastrocnemius were harvested to calculate the wet/dry ratio, level of myeloperoxidase, and infarct size through triphenyltetrazolium chloride staining. The samples from the right tibialis anterior muscle were taken to detect the expression level of Erk1/2 in the MAPK signaling pathway by western blot assay. RESULTS AND CONCLUSION: A prolonged acidic platform was detected in the early reperfusion during ischemic postconditioning, on which the pH value was 6.81±0.133, and the duration was 2 minutes and 40 seconds. The levels of lactate dehydrogenase and myeloperoxidase as well as the wet/dry ratio in the ischemic postconditioning and lactic acid groups were significantly lower than those in the ischemia/reperfusion group (P < 0.05). Western blot assay results showed that the expression level of p-Erk in the ischemic postconditioning, lactic acid and normal saline groups was significantly higher than that in the ischemia/reperfusion group (P < 0.05). Triphenyltetrazolium chloride staining results showed that compared with the ischemia/reperfusion group, the infarct area was significantly reduced in the postconditioning and lactic acid groups (P < 0.05). These findings suggest the existence of a short acidosis during ischemic postconditioning in the early reperfusion, and acidic perfusate can simulate the ischemic postconditioning and effectively attenuate ischemia/reperfusion injury in the rat skeletal muscle via activating Erk1/2 in RISK signaling pathway.

Sleep-disorderedbreathingarecloselyassociatedwithischemicstroke.Sleep-disordered breathing includes obstructive sleep apnea and central sleep apnea. Studies have show n that obstructive sleep apnea is an independent risk factor for stroke, w hile stroke can also increase the incidence of sleep-disordered breathing. This article review s the latest research progress of sleep-disordered breathing and stroke.

Considering that the patients would bear the annoyance of fixed posture for long time when they are examined with gastrointestinal wireless endoscopy, even though portable devices have been developed, the treatments still depend on PC so much, we proposed an embedded solution based on ARM + FPGA. It used embedded ARM9 S3C2440 as processor core, collected images from digestive tract through capsule endoscopy which can be swallowed down there, and wirelessly transferred these images to the receiving system, then used video decoder chip SAA7114H for analog of NTSC video image decode. And under FPGA's logic controlling, effective digital video signal was transferred to S3C2440 for further treatment. Finally within the embedded Linux environment, we programmed the visual user interfaces using the QT/Embedded, realizing the offline record of the real-time video images of digestive tract portable and preferences. It can make patients move more freely and even without PC when examining. In addition, the method greatly improves the efficiency of the doctor, and is more intelligent and with more humane nature.
Capsule Endoscopy ; instrumentation ; methods ; Equipment Design ; methods ; Humans ; Signal Processing, Computer-Assisted ; instrumentation ; Software ; Video Recording

Objective:To analyze the clinical characteristics of patients suffering from acute ischemic stroke (AIS) complicated with obstructive sleep apnea-hypopnea syndrome (OSAHS).Methods:Data of patients with AIS who visited the Second Affiliated Hospital of Soochow University from January 2015 to June 2020 and underwent polysomnography monitoring (PSG) in the sleep center were collected retrospectively. Patients were divided into OSAHS group and AIS only group. Demographic information of patients, general clinical data, hematological indicators of glucose and lipid metabolism and inflammatory markers, PSG parameters and neurological function scores were collected, including the National Institutes of Health Stroke Scale (NIHSS) on admission and the modified Rankin Scale (mRS) on discharge. We compared the differences between the two groups. In addition, OSAHS group were divided into good prognosis and poor prognosis subgroups according to mRS score. The differences between the two subgroups were compared.Results:A total of 112 AIS patients combined with OSAHS and 89 AIS only patients were included. The proportion of non-rapid eye movement stages 1+2 [(N1+N2) %], arousal index, the oxygen desaturation index (ODI), percentage of total sleep time with oxygen saturation<90% (TS90) in the OSAHS group were higher than those in the AIS only group, while N3%, lowest nocturnal oxygen saturation (LSaO 2) were lower (all P<0.05). There was no statistical difference in the distribution of cerebral apoplexy lesions (cortex, subcortical, brainstem, cerebellum) between the two groups, but the proportion of patients with multifocal cerebral apoplexy in the OSAHS group was higher ( P=0.032). There was no statistical difference in NIHSS score on admission between the two groups, but the neutrophil/lymphocyte ratio (NLR) score ( P=0.004) and mRS score on discharge ( P=0.010) of the OSAHS group were significantly higher than those in the AIS only group. There were 74 patients in the good prognosis group and 38 in the poor prognosis group. The analysis showed that the NIHSS and NLR scores of the poor prognosis group were higher than the good prognosis group, admission NIHSS score was a risk factor for poor prognosis, all P<0.01. Conclusions:AIS patients complicated with OSAHS are characterized by disordered sleep structure, more severe nocturnal hypoxia, higher risk of developing multiple lesions, poor neurological function recovery at discharge, and high inflammatory index of NLR. Among them, patients with poor prognosis have poorer sleep efficiency, and high admission NIHSS score is a risk factor for poor prognosis.

OBJECTIVETo investigate the role of nuclear factor-κB (NF-κB) activation in bilirubin-induced apoptosis of rat hippocampal neurons and the effect of TAT-NBD intervention on bilirubin neurotoxicity.

METHODSPrimary-cultured rat hippocampal neurons were treated with TAT-NBD in the initial 6 or 24 h or in the latter 6 h during a 24-h bilirubin exposure of the cells (early, continuous and late intervention groups, respectively). Immunocytochemistry was performed to detect NF-κB p65 protein expression, and the cell survival and apoptosis were assessed with a modified MTT assay, Annexin V-FITC/PI and TUNEL assay. IL-1β concentration in the supernatant was determined with ELISA.

RESULTSCompared with the control cells, bilirubin-treated cells showed a significantly increased NF-κB p65 protein expression (P<0.01), which reached the peak level at 6 and 24 h (P<0.01). The cell survival rate in early TAT-NBD intervention group was (80.784∓9.767)%, significantly lower than that of the control group (P<0.01) but higher than that of bilirubin group (P<0.01); the apoptotic rate in early TAT-NBD intervention group was significantly higher than that of control group (P<0.01) but lower than that of bilirubin group (P<0.01). IL-1β concentration was significantly lower in early TAT-NBD intervention group (15.348∓0.812 pg/ml) than in bilirubin group (P<0.05). The continuous and late TAT-NBD intervention groups showed comparable cell survival rate, apoptotic rate and IL-1β concentration with bilirubin group (P>0.05).

CONCLUSIONNF-κB bidirectionally regulates bilirubin-induced apoptosis of rat hippocampal neurons. Selective inhibition of the early peak of NF-κB by TAT-NBD offers neuroprotective effect. TAT-NBD can be potentially used for prophylaxis of bilirubin-induced brain injury.

Animals ; Apoptosis ; drug effects ; Bilirubin ; toxicity ; Cell Survival ; Cells, Cultured ; Female ; Hippocampus ; cytology ; Interleukin-1beta ; metabolism ; Male ; Neurons ; cytology ; drug effects ; metabolism ; Neuroprotective Agents ; pharmacology ; Peptides ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Transcription Factor RelA ; metabolism

Objective:To understand the current status and existing problems of medical students' cognition of new medical ethics view, and to provide reference for the innovation of medical ethics education mode. Methods:A self-designed questionnaire was used to investigate the medical students in a university in Changsha. A total of 450 questionnaires were distributed and 440 questionnaires were collected. Results:Medical students generally had a better understanding of the new medical ethics view and could establish a"patient centered" service concept. But the medical ethics cognition of some medical students was not consistent with the medical ethics behavior, and the medical value orientation was not clear. Conclusion:In order to improve the medical ethics cognition level of medical students, it needs to establish a new medical ethics education mode with the integration of school, society and family, make medical ethics education integrate with clinical practice effectively, strengthen medical students' legal education meanwhile, and effectively carry out the new medical ethics view for medical students.