Objective Objective TO investigate the potential association between matrix metalloproteinase-9 (MMP-9) gene polymorphisms and risk of ischemic stroke in Western Guangdong population.Methods This hospitalbased case-control study recruited 251 patients with ischemic stroke and 96 controls.Using Multiplex SNaPshot method was used to detect the genotype of MMP-9 gene rs3787268、rs3918241 and rs3918242 polymorphisms.The association between MMP-9 gene polymorphisms and risk of ischemic stroke was analyzed.Results ① There were significant differences in the genotype distribution of rs3787268 between ischemic stroke group and the controls (P=0.042).In the recessive model,the individual risk of A/A genotype was higher (OR=2.21,P=0.046) than that of the G/G+G/A genotype.② Compared with the controls,the genotype and allele distribution of rs3918242 in the ischemic stroke group were significantly different (P=0.007,P=0.038).In the dominant model,the risk of individuals carrying the T genotype was significantly elevated (OR=2.14,P=0.009) compared with individuals with the C/C genotype.③ The genotype distribution of rs3787268 polymorphisms in the LAA but not in no-LAA subgroup was significantly different from that in the controls (P =0.039).The genotype distribution and allele frequency of rs3918242 polymorphisms in the LAA subgroup were significantly different from that of the control group (P=0.009,P=0.047).There was no significant difference in the genotype distribution and allele frequency between no-LAA subtype and the control group.Conclusions The MMP-9 gene rs3918242 and rs3787268 polymorphisms may be the risk factors of ischemic stroke in Han population in the western part of Guangdong province,China.The MMP-9 gene rs3918242 and rs3787268 polymorphisms may be the risk factors of large-artery atherosclerotic stroke.

Objective To explore the effect of the health management service in patients with metabolic syndrome (MS) by family doctors. Methods A total of 417 patients with MS were screened during a health examination and divided into the intervention and control groups (206 and 211 cases, respectively), using a random digital table. Based on routine health follow-up, the intervention group received increased health management intervention by the family doctor, while the control group was only had followed-up with routine health check-ups.After 1 year,the changes in body mass index(BMI),blood pressure, triglyceride (TG) levels, fasting blood glucose (FBG) levels, and high-density lipoprotein cholesterol(HDL-C)in the two groups of patients were observed.The effect of intervention was analyzed using the paired design t-test and chi-square test.Results In the intervention group,the BMI(25.04±2.92)kg/m2, systolic blood pressure(121.5±15.6)mmHg(1 mmHg=0.133 kPa),TG levels(2.02±1.24)mmol/L,and FBGlevels (5.92±1.75)mmol/L after the intervention,were lower than those before the intervention(25.66±2.64)kg/m2, (128.4±16.5)mmHg,(2.43±1.06)mmol/L,(6.34±1.62)mmol/L;respectively,and these differenceswerestatistically significant(t=2.437,3.598,3.536,2.983,respectively;P<0.05).HDL-C levels after the intervention(1.32± 0.26) mmol/L were higher than thosebefore the intervention (1.26 ± 0.32) mmol/L, and the difference was statistically significant(t=-2.218,P<0.05).In the intervention group,blood pressure,BMI,FBGlevels,and HDL-C levels after the intervention were higher than the normal reference values.The proportion of patients with normal reference valuesafter the intervention were 62.6%, 75.2%, 14.6%, and 52.9%, respectively, which were lower than those before the intervention(92.7%, 85.4% 23.3%, and 63.6%, respectively);thesedifferenceswerestatistically significant (χ2=53.795, 6.777, 5.124, and 4.832, respectively;P<0.05). After 1 year,the control group had lower BMI(24.52±2.69)kg/m2than that before the intervention(25.79± 2.85) kg/m2; thisdifference was statistically significant (t=2.421, P<0.05).There were no significant differences in the systolic and diastolic blood pressure, TG levels, HDL-C levels, and FBG levels. Conclusion Health management byfamily doctors can effectively reduce weight, blood pressure, blood lipids,and blood sugar by interfering with the lifestyle of patients with MS.

Objective:The authors introduced the change point analysis of normal distribution based on the likelihood ratio principle, analyzed the number of outpatients in a hospital of Luohu District, Shenzhen, to provide scientific basis for rational allocation of health resources.Methods:The authors collected totally 636 number of outpatients' data from 8: 00 to 12: 00 a.m. at 48 time windows at 5 minutes intervals in a hospital of Luohu District, Shenzhen, and analyzed it with single change point analysis of simultaneous change of mean and variance, and discussed when the change point occurred.Results:The average number of outpatient was 13.250 0 for every time window, the change point occurred at 8: 50, the probability was 0.000 025, the average number of outpatient per 5 minutes from 8: 00 to 8: 50 was 7.000 0, the average number of outpatient per 5 minutes from 8: 50 to 12: 00 was 14.897 4, and the ratio of number of outpatients before and after the change point occurred was 1∶2.Conclusion:In the case of no need to determine the base period or compare the data, the change point analysis of normal distribution based on the principle of likelihood ratio provides a new way of statistical analysis and statistical monitoring for the rational allocation of health resources based on the number of patients.

Objective To discuss the clinical features,pathogenesis,diagnosis,treatment and therapeutic outcome of neonatal cardiac arrhythmia.Method The clinical data of newborns with arrhythmia admitted from May 2013 to May 2018 were analyzed retrospectively.All cases were grouped into benign and non-benign arrhythmia groups according to the severity of clinical manifestations.The clinical features,pathogenesis,diagnosis,treatment and therapeutic outcome of them were compared.Result There were 128 cases including 89 (69.5％) males,39 (30.5％) females;106 (82.8％) full-term infants,22 (17.2％) premature infants;39 (30.5％) atrial premature contraction,5 (3.9％) atrial tachycardia,10 (7.8％) atrial flutter,36 (28.1％) paroxysmal supraventricular tachycardia,26 (20.3％) ventricular premature contraction,12(9.4％) atrioventricular block;65 cases (50.8％) were benign arrhythmia and 63 cases (49.2％) were non-benign.52 cases (40.6％) showed noncardiac symptoms (including 10 cases of shortness of breath,9 cases of pallor or cyanosis,5 cases of refusal to suck,3 cases of grunting,25 cases with two or more than two kinds of clinical symptoms),and 76 cases (59.4％) were asymptomatic;31 cases (24.2％) were cardiac insufficiency.The three common causes of neonatal cardiac arrhythmia were:32 (25％) cases by infection,20 (15.6％) cases by perinatal asphyxia,19 (14.8％) cases were congenital heart disease;87 (68.0％) cases were mainly treated with primary diseases.41 cases (32.0％) were treated with antiarrhythmic drugs or cardioversion.There was significant difference in gender,noncardiac symptoms,cardiac insufficiency,age of onset,days of hospitalization,cardiac troponin Ⅰ and creatine kinase isoenzyme between the two groups (P ＜ 0.05).Conclusion Neonatal cardiac arrhythmias should be considered and evaluated with shortness of breath,cyanosis or pallor and rejection refusal of milk.High risk factors of neonatal cardiac arrhythmias included infection,perinatal asphyxia and congenital heart disease.Benign and non-benign arrhythmia should be identified.

Objective To evaluate the effectiveness and safety of acupuncture in patients with Major Depressive Disorders.Methods Search the database for relevant literature published before April 15,2023.Select randomized controlled trial that meeting the enrollment criteria,evaluate the quality of the literature and classify before meta-analysis systematic evaluation.Results 15 RCTs are included in this study,with a total of 1077 patients.The results showed that acupuncture treatment,compared with antidepressants alone,The score of Hamilton Depression Scale(HAMD)in patients with liver-qi depression disorder[MD=-0.73,95%CI(-1.22,-0.24),P<0.05],the score of TCM Syndrome Scale[MD=-1.89,95%CI(-2.35,-1.44),P<0.001],effective rate[RR=1.09,95%CI(1.03,1.153),P=0.001]and TESS score[MD=-2.76,95%CI(-3.68,-1.85),P<0.001]were statistically significant.Compared with fluoxetine hydrochloride,the effective rate of HAMD scale score was statistically significant[RR=1.07,95%CI(1.01,1.14),P<0.05].Conclusion Compared with antidepressants alone,acupuncture therapy has the advantages for the improvement of HAMD score in patients,the improvement of Traditional Chinese medicine symptoms,and significantly less adverse effects than those in the control group.Through this study,it is considered that acupuncture can be a safe and effective treatment modality.However,due to the quantity and quality of the included literature,the above conclusions still need to be verified by more high-quality clinical trials.