ObjectiveTo compare the differences in stroke subtype classification between ASCO and modified TOAST.MethodsAll 425 first-ever ischemic stroke patients were recruited and classified into different stroke subtypes according to the ASCO and modified TOAST criteria.Results Comparing ASCO grade 1 with modified TOAST,more patients were classified as atherosclerosis (60.2％ vs 57.9％ ; x2 =2.68,P=0.132) and fewer as small artery disease and cardiac disease subtype (13.4％ vs 14.8％ and 8.5％ vs 8.7％ ; x2 =1.30 and 0.00,P =0.238 and 1.000,respectively).ASCO grade 1 did not reduce the proportion of cause undetermined patients compared with modified TOAST ( 15.5％ vs 16.2％ ; x2 =0.09,P =0.795 ). Agreement was showed in every subtype categories between the two approaches.Agreement for atherosclerotic cause and small artery disease was very good ( all κ over 0.81 ),and for the cardiac disease subtype was good (κ: 0.61-0.80). Conclusion Agreement can be found in every subtype categories between ASCO and modified TOAST classification.ASCO grade 1 does not reduce the proportion of cause undetermined cases compared with modified TOAST,but the subtype categories characteristics of the two approaches should be considered in practice.

Objective To develop the physical model of male pelvic organ group and conduct corresponding prostate puncture experiments.Because sufficient research and plenty of surgical training is very important for improving the surgical treatment effect of prostate puncture surgery,in which the deformation of needle and tissue has significant influences on surgical precision.Methods Based on the magnetic resonance images,the 3D reconstruction of human pelvic organs group was performed,and then the monomer organ moulds were designed.The monomer organ models were made by a new type of polyvinyl alcohol (PVA) hydrogel which is a biomimetic material and can simulate biomechanical properties of different tissues by adjusting the proportion of components.The monomer organ models were assembled to simulate the internal environment of pelvic cavity based on the human anatomical structure,and the experiments of insertion force and deformation were conducted.Results The results of insertion force experiments indicated that the mechanical properties of the proposed model of pelvic organ group were coincident with the force variation in real surgury.During the insertion deformation experiments,the deformation of needle and organs could be clearly observed in the ultrasound images,which indicates that the pelvic organ group has good ultrasonography compatibility.Conclusions The proposed physical model of male pelvic organ group can meet the requirements of experiment research and surgical training of prostate puncture,which provides foundation for improving precision and popularization of puncture surgery.

OBJECTIVE:To systematically evaluate the efficacy and safety of simvastatin vs. pravastatin in the treatment of hy-perlipidemia,and provide evidence-based reference for the clinical treatment. METHODS:PubMed,Medline,EMBase,Cochrane Library and CJFD were retrieved to collect the randomized controlled trial(RCT)of efficacy and safety of simvastatin(test group) and pravastatin (control group) in the treatment of hyperlipidemia. The methodological quality of included studies was evaluated. The Rev Man 5.2 software was chosen for data analysis. RESULTS:14 RCT involving 1 019 patients were included. Meta-analysis showed that simvastatin had more significant effect in the decreasing of TC [MD=-0.34,95%CI(-0.52,-0.16),P<0.001] and LDL-C[MD=-0.31,95%CI(-0.45,-0.17),P<0.001] than pravastatin;and simvastatin and pravastatin had the similar effect in TG[MD=-0.06,95%CI(-0.18,0.05),P=0.28)] and HDL-C[MD=0.00,95%CI(-0.04,0.04),P=0.85]. Adverse drug reaction rate results showed they were similar[OR=0.70,95%CI(0.36,1.39),P=0.31]. CONCLUSIONS:Simvastatin is more effective in lipid-lowering than pravastatin with similar safety. Due to the limited number and low quality of included studies,it remains to be further verified with more reasonably designed,multi-center and large-sample studies.

Cardiopulmonary resuscitation board (CPR Board) is an essential tool in emergency care, which can keep the patient's airway open and support the patient in the administration of CPR. This paper introduces the structure, performances and clinical trials of a CPR board.

Objective To analyze the doctors' working enthusiasm and its influencing factors on county level hospitals.Methods 17 seminars were held in 8 counties of 3 provinces to investigate 1055 doctors with questionnaires, analyzing the three scales of working enthusiasm, working enthusiasm influencing factors, and changes since the 2009 new healthcare reform.Results Working enthusiasm comprises inner drive, working pleasure, work recognition and external recognition, and inner drive of which is found to play the most important part, with 20.55％ variance contribution.Among the six dimensions of the influencing factors, working conditions rank the highest with 19.46％ variance contribution.Conclusion Optimized measures in the healthcare reform, better working conditions and social environment can improve working enthusiasm of these doctors.

Combining theory and practice at home and abroad in recent years ,construction plan of the military infectious diseases syndromic surveillance system was discussed from aspects of data collection and transmission , data analysis and early warning , incident response based on the core business requirements of syndromic surveillance for infectious diseases . The study provides the demand traction for the system construction .

Objective:To investigate the effects of pregnancy and lactation nonylphenol (NP) exposure on the balance of Treg/Th17 cells in the brain of offspring mice and the related mechanisms.Methods:Thirty pregnant C57BL/6 mice were randomly divided into three groups: control group (drinking distilled water), and NP-treated groups (drinking 0.2 μg/ml or 2.0 μg/ml NP water solution). ELISA kit was used to analyze the levels of TNF-α, IFN-γ and IL-17, flow cytometry was used to analyze the frequency of Treg and Th17 cells in spleen, quantitative RT-PCR was used to analyze the RORγt, Foxp3 mRNA, Western blot was used to analyze the protein expression of RORγt, Foxp3 and PI3K/Akt/mTOR signal pathway, and immunofluorescence was used to analyze the expression of Iba1 in the brain tissue of offspring mice.Results:Compared with the control group, NP exposure increased the serum levels of IL-17 and TNF-α in male offspring mice ( P<0.05), and decreased the levels of IFN-γ( P<0.05). Flow cytometry analysis showed that the percentage of Th17 cells in the spleen of male offspring mice exposed to NP (0.2 μg/ml or 2.0 μg/ml) was significantly higher than that of the control group, while the percentage of Tregs cells was lower. Compared with the control group, the expression levels of Foxp3 proteins in the brain tissue of male offspring mice exposed to NP (0.2 μg/ml or 2.0 μg/ml) was significantly lower, accompanied by a dramatic increase in RORγt protein levels ( P<0.05). Similar mRNA expression was also observed in qRT-PCR analysis. The protein expression levels of mTOR (p-mTOR) and its upstream related regulators[PI3K, p-Akt (Ser473), p-Akt (Thr308)] in the brain of male offspring mice increased gradually during the period of exposure to NP( P<0.05). Immunofluorescence analysis showed that compared with the control group, the number of Iba1 positive cells in brain tissue of male offspring mice exposed to NP (0.2 μg/ml or 2.0 μg/ml) increased significantly ( P<0.05). Conclusions:Maternal exposure to NP during pregnancy and lactation may affect the development/function of neurons in offspring through neuroimmune axis, and increase the risk of neurodevelopmental disorders in offspring.

To propose an equipment and technology package for oxygen preparation and supply under hypoxia conditions in order to meet the requirements of populations on the plateau .Different populations were analyzed in terms of their oxygen supply requirements, and the modes, schemes and equipment for oxygen supply were explored accordingly and then applied.Efforts in the past 20 years have resulted in the advances in the equipment for centralized, mobile and portable oxygen preparation and supply, though the equipment for individual use hads to be improved and the diffused oxygen supply scheme also needs to be further evaluated .

OBJECTIVE:To systematically review the effect of CYP2C19 genetic polymorphism on lansoprazole pharmacoki-netics,and provide evidence-based reference for clinical individualized medication of lansoprazole. METHODS:Retrieved from PubMed,EMBase,Web of science,Cochrane Library and CJFD,retrospective studies about the effect of CYP2C19 genetic poly-morphism on lansoprazole pharmacokinetics were collected,Meta-analysis was performed by Rev Man 5.2 software after data ex-tract and quality evaluation. RESULTS:Totally 11 retrospective studies were included,involving 200 patients. The gene type in-cluded homozygote express metabolizers (EM),heterozygous express metabolizers (HEM) and slow metabolizers (PM). Results of Meta-analysis showed CYP2C19 polymorphism significantly affected cmax,AUC,t1/2,tmax and CL/F. The cmax and AUC in group PM were higher than group HEM and group EM;CL/F in group EM was higher than group HEM and group PM;t1/2 in group PM was higher than group HEM and group EM,while there was no significant difference in the t1/2 between group HEM and group EM;tmax in HEM and group PM were higher than group EM,while there was no significant difference in the tmax between group PM and group HEM. CONCLUSIONS:CYP2C19 genetic polymorphism shows obvious effect on lansoprazole pharmacokinetics, which is the key factor for causing efficacy of lansoprazole and individual differences among adverse reactions,and clinic should take into account individualized dose regimen of lansoprazole.

Objective To observe the effect of Triclosan( TCS) exposure on Caenorhabditis elegans( c. ele-gans) F1 generation of locomotory behavior, brood size, and generation time. Methods The trial included a control group and 4 TCS treatment groups with different doses (100 nmol/L,1 μmol/L,10μmol/L,20μmol/L),the exposure time being 24 hours,the effect of c. elegans′head thrashes,body bending frequency,the brood size and generation time was observed. Results (1) The control group exposed to 100 nmol/L,1 μmol/L,10 μmol/L,20 μmol/L TCS,their head thrash frequency of c. elegans F1 was(109. 40±8. 61) times/min,(84. 70±7. 82) times/min,(76. 35±7. 44) times/min,(74. 74±5. 93)times/min,(71. 95±4. 19)times/min,respectively,the head thrash ability of c. elegans was significantly inhibited(F=62. 245,P<0. 01). (2) When the control group was exposed to 100 nmol/L,1 μmol/L,10μmol/L,20 μmol/LTCS,the frequency of c.elegans F1 body bent was (19.94±2.46)times/20 s,(15.13±1.99) times/20 s,(14.63±2.31)times/20 s,(14.69±1.96)times/20 s,(12.00±1.86)times/20 s,respectively,and the comparative differences between groups were statistically significant(F=25. 636,P<0. 01). (3) When the control group was exposed to 0,100 nmol/L,1 μmol/L,10 μmol/L,20 μmol/L TCS,the body sizes of the c. elegans F1 generation was (286.83±6.01)articles,(273.33±6.41)articles,(214.17±7.25)articles,(173.67±9.20)articles, (118. 50 ± 6. 98 ) articles, respectively, the brood size of the C. elegans F1 generation exposed to 100 nmol/L, 1μmol/L,10 μmol/L,20 μmol/L TCS levels,were reduced by 4. 71%,25. 60%,39. 45%,58. 67%,the ge-neration time of the c. elegans′F1 generation was shortened by 2. 14%-5. 38% in the TCS treatment groups compared with the control group(F=27. 520,P<0. 01). Conclusions After c. elegans exposure to TCS,locomotory behavior can be severe-ly affected,reproductive damage causes a decline in the number of brood size,and the speeding-up of the breeding rate is related to the concentration of TCS concentration-response.