Objective To investigate the clinical rating scale appropriate to evaluate neurological impairment of ischemic stroke subtypes classified by Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria. Methods 289 cases of hospitalized patients with ischemic stroke in neurological wards of the first affiliated hospital of Dalian medical university from December 1,2007 to December 31, 2009 were analyzed prospectively. Results The component ratio of ischemic stroke subtypes on the basis of TOAST etiological classification were as follows: UND (36.6%) was the largest, SAO (29.8%) followed,OC (1.7%) was the lowest. In three-month mortality, CE (15.5%) was the most, LAA (11.8%) followed, SAO (1.2%) was the lowest. In three-month relapse rate, LAA (17.6%) was the most, CE (8.6%) followed, SAO (2.4%) was the lowest. The best validity of scale assessment about LAA, CE,UND, SAO subtypes were MESSS (-0.812), ESS (0.816), NIHSS (-0.807), NIHSS (-0.795) respectively, both reliability and operability were set as medium. Conclusion In ischemic stroke subtypes classified by TOAST criteria, UND had the highest incidence (SAO has the highest incidence in the specific etiology), CE mortality was the highest, LAA had the highest rate of recurrence, SAO mortality and relapse rate were the lowest. In ischemic stroke subtypes classified by TOAST criteria, MESSS was the most suitable scale for LAA, the most appropriate scale for CE was ESS, the most appropriate scale for UND, and the SAO was NIHSS.

Objective To investigate the regulation of blood-testis barrier by Rab13-PKA pathway in rats.Meth-od First, shRNA vector targeting at Rab13 was constructed and then the Rab13 shRNA was transfected into the rat testis by injection.Western blot was used to detect the knock-down effect of Rab13 and the expression of blood-testis barrier ( BTB) constituent proteins.PKA activity was detected by autoradiography and scintillation counting.Further, immunoflu-orescence analysis and phalloidin staining were applied to observe the distribution of occludin and F-actin, respectively. Results The expression level of Rab13 in the testis was reduced by approximately 70%after transfection of Rab13 shRNA as compared with the non-targeted control group ( P<0.01 ) , while the expression of BTB constituent proteins remained unchanged.PKA activity was significantly increased after Rab13 RNAi transfection (P<0.01).The distribution of occlu-din at BTB was remarkably increased after Rab13 RNAi silencing around stage VIII but not at other stages of the seminifer-ous epithelial cycle.The assembly of F-actin at BTB was also intensified in Rab13-silenced testis.Both the changes of dis-tribution of occludin and F-actin induced by Rab13 shRNA were found to be antagonized by the PKA specific inhibitor H89.Conclusions Rab13 can modulate the distribution of occludin and F-actin at the blood-testis barrier in rats by regu-lating PKA activity, which may participate in the regulation of BTB function.

After a description of the characteristics of novelty assessment of literature on information technology involving different subjects, multiple new technologies and deep knowledge, the strategies were elaborated for it.

Objective To observe the effect of E-LINK system on hand function of patients with stroke. Methods 30 stroke patients were divided into treatment group (n=16) and control group (n=14). All the patients accepted routine rehabilitation, while the treatment group was trained additionally with the E-LINK system for 12 weeks. Results The strength of grip and pinch, the scores of Barthel index and Fugl-Meyer assessment of upper limb, and the range of supination of forearm improved more in the treatment group than in the control group (P<0.05). Conclusion Training with E-LINK system can improve the motor function of upper limb and activities of daily living of stroke patients.

Objective To investigate the CT performances and causes of misdiagnosis of parovarian cyst,to improve its diagnostic accuracy.Methods CT data of 75 patients with surgically and pathologically confirmed parovarian cyst were analyzed retrospectively. Results Among the 75 patients,there were 79 cysts,in which 48 patients (51 cysts)originated from the epoophoron and 27 patients (28 cysts) from the mesosalpinx.77 were simple serous cysts and 2 serous cystadenomas.38 were located in the right ovarian adnexa,36 in the left ovarian adnexa,3 in the anterosuperior uterus,1 in the rectouterine pouch and 1 in the right iliac fossa.The size of the cysts ranged from 10 mm × 13 mm to 174 mm × 227 mm.75 were single cysts and 4 double cysts,34 presented as ovoid cysts,25 as irregular cysts, 17 as round cysts and 3 as gourd-shaped cysts.All the 79 cysts showed clear boundaries,thin walls,non-mural nodules,cystic fluid with a homogeneous densitywith CT value of 0-31 HU.Enhanced scanning revealed curved “obvious enhancement of the fallopian tube”at the edge of 68 cysts.In addition,the ipsilateral ovary could be detected in 76 cysts.“Holding ball”was found in 1 9 cysts.Conclusion Indication in ipsilateral ovary,curved “obvious enhancement of the fallopian tube”at the edge of cysts and “holding ball”are distinctive CT performances of parovarian cysts.CT has an important diagnostic value in parovarian cyst.

Chromium is an essential mineral that is thought to be necessary for normal glucose homeostasis. Numerous studies give evidence that chromium picolinate can modulate blood glucose and insulin resistance. The main ingredient of Tianmai Xiaoke (TMXK) Tablet is chromium picolinate. In China, TMXK Tablet is used to treat type 2 diabetes. This study investigated the effect of TMXK on glucose metabolism in diabetic rats to explore possible underlying molecular mechanisms for its action.

Objective: To investigate the current status of job stress in locomotive attendants in a locomotive depot and related influencing factors. Methods: From 2012 to 2013, cluster sampling was used to select 1500 locomotive attendants in a locomotive depot in Zhengzhou Railway Bureau as respondents.The contents of the investigation included general data and occupational information.A job satisfaction questionnaire was used to investigate the degree of satisfaction, a depression scale was used to investigate the frequency of symptoms, and a daily stress scale was used to investigate the frequency of fatigue and stress. Results: There was a significant difference in depression score between locomotive attendants with different ages, working years, degrees of education, working situations of spouse, total monthly family incomes, numbers of times of attendanceat night, monthly numbers of times of attendance,ormonthly attendance times(P<0.05). There was a significant difference in job satisfaction score between locomotive attendants with different ages,working years, degrees of education, working situations of spouse, total monthly family incomes, numbers of times of attendance at night, monthly attendance times,or ways to work(P<0.05). There was a significant difference in daily stress score between locomotive attendants with different ages, working years, marital status,working situations of spouse, total monthly family incomes, types of work,numbers of times of attendance at night,monthly attendance times,attendance times at night,or ways to work(P<0.05). The multiple stepwise regression analysis showed that the type of locomotive was positively correlated with job satisfaction(β=1.546)and monthly number of times of attendance,working years,attendance time at night,and degree of education were negatively correlated with job satisfaction(β=-0.185,-0.097,-0.020,and -1.106); monthly number of times of attendance andcommute time were positively correlated with depression(β=0.243 and 0.029); attendance time at night,working situation of spouse,commute time,monthly number of times of attendance,degree of education,and working years were positively correlated with daily stress(β=0.006,0.473,0.010,0.043,0.585, and 0.028). Conclusion Number of times of attendance, attendance time,working years,and spouse are influencing factors for job stress in locomotive attendants. Improvement in work process and care for their personal life help to reduce the level of job stress.

Objective:To evaluate the value of preoperative serum miRNA-146a-5p expression in predicting postoperative delirium (POD) in the pediatric patients undergoing living donor liver transplantation.Methods:Eighty pediatric patients with congenital biliary atresia, aged 5-12 months, with body mass index of 4-10 kg, of American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ, undergoing elective living donor liver transplantation in our hospital, were selected. Venous blood samples were collected at 1 day before surgery, and serum miRNA-146a-5p expression was detected by quantitative real-time polymerase chain reaction. The children′s cognitive function was evaluated using the Mini-Mental State Examination and the Modified Montreal Cognitive Assessment at 1 day before operation and at 1, 3 and 7 days after operation. The pediatric patients were divided into POD group and non-POD group according to whether POD occurred within 7 days after surgery. Multiple logistic regression analysis was used to evaluate the relationship between serum miRNA-146a-5p expression and POD, Pearson′s correlation analysis was used to analyze the correlation between miRNA-146a-5p and POD, and the receiver operating characteristic curves were used to evaluate the accuracy of serum miRNA-146a-5p concentrations in predicting the occurrence of POD.Results:There were 30 cases in POD group and 50 cases in non-POD group, and the incidence of POD was 38%. The results of multiple logistic regression analysis showed that down-regulated serum miR-146a-5p expression was an independent risk factor for POD in pediatric patients undergoing living donor liver transplantation ( P<0.05). The incidence of POD was negatively correlated with serum miRNA-146a-5p expression ( r=-0.658, P<0.001). The area under the receiver operating characteristic curve of serum miRNA-146a-5p expression in predicting POD was 0.870 in pediatric patients undergoing living donor liver transplantation, with a sensitivity of 0.825 and a specificity of 0.875. Conclusions:Preoperative serum miRNA-146a-5p expression has a certain predictive value for POD in the pediatric patients undergoing living donor liver transplantation.

Objective:To analyze the nursing effect of central venous catheter (CVC) infusion combined with empathy nursing on AIDS patients.Methods:A total of 129 AIDS patients who were hospitalized for infusion at Beijing You'an Hospital, Capital Medical University from June 2014 to June 2016 were selected as the control group. Another 129 AIDS patients from August 2016 to August 2018 were selected as the observation group. The control group was given ordinary infusion needle infusion and conventional psychological nursing, and the observation group was given CVC infusion combined with empathic nursing. The clinical nursing effect of the two groups of patients was analyzed.Results:The infusion fluency rate, vascular damage rate, nurse puncture rate, and occupational exposure rate in the observation group were 91.47% (118/129), 10.85% (14/129), 0, 0, and the control group was 82.94% (107/129), 20.93% (27/129), 6.20% (8/129), 6.20% (8/129), the difference between the two groups was statistically significant ( χ 2 values were 4.188-8.224, P <0.05 or 0.01). After 3 months of intervention, the anxiety and depression (Self-rating Anxiely Scale/Self-rating Depression Scale) scores of the observation group were 47.87 ± 5.43 and 45.02 ± 5.61, which were significantly lower than the control group, which were 51.15 ±6.97 and 49.11 ± 6.48. The difference was statistically significant ( t values were 3.320, 4.268, P <0.01). After 3 months of intervention, the treatment compliance rate in the observation group was 92.24% (119/129), which was significantly higher than 83.72% (108/129) in the control group, and the difference was statistically significant ( t value was 4.419, P <0.05). After 3 months of intervention, the CD 4+ T lymph count and HIV viral load in the observation group were (378.25 ± 49.04)/μl, (2.86 ± 0.53) igIU/ml, and the control group were (342.17 ± 43.47)/μl, (3.13 ± 0.66) igIU/ml, the improvement effect of the observation group was significantly better than that of the control group ( t values were 3.559, 2.853, P <0.01). Conclusion:CVC infusion combined with empathic nursing can significantly improve the anxiety and depression of AIDS patients, improve treatment compliance and infusion fluency, reduce vascular damage rate, related infection rate, nurse puncture rate and occupational exposure rate, and good nursing effect.

Objective:To analyze the molecular characteristics of Echovirus 11 (Echo11) strains isolated in Xiangyang, Hubei Province from 2016 to 2017 based on the sequences of VP1 gene.Methods:Rectal and throat swab specimens were collected from children with hand, foot and mouth disease (HFMD) in Xiangyang from 2016 to 2017. Echo11 strains were detected by real-time reverse transcriptase PCR (RT-PCR) and isolated after cultured in human rhabdosarcoma (RD) cells. The VP1 regions of Echo11 strains isolated from RD cells and the whole genomes of three representative Echo11 strains were amplified by conventional RT-PCR and the sequences were analyzed. DNAStar7.0 (MegAlign) and MEGA6.0 (Data) were used to analyze the homology and mutation sites in nucleotide and amino acid sequences. Neighbor-joining method was used to construct phylogenetic trees. Recombination analysis was performed with SimPlot software (BootScanning).Results:A total of 11 Echo11 strains were isolated from 3 494 HFMD cases, accounting for 0.31%. They were highly homologous in the VP1 gene. These strains shared 98.4%-100.0% homology in nucleotide sequences and 98.3%-100.0% homology in amino acid sequences. The homology between the 11 Echo11 strains and the prototype strain (Echo11/Gregory, X80059) was 73.9%-74.8% in nucleotide sequences and 87.7%-88.7% in amino acid sequences. All of the Echo11 strains circulating in Xiangyang were classified into lineage D, having a similarity to the strains circulating in some regions of mainland China since 2013. In multiple regions of the genome, the Echo11 strains isolated in Xiangyang were highly similar to the Henan Echo1 strains in 2010 and the Hubei Echo6 strains in 2015, suggesting there was recombination within the genome of Echo11 strains in Xiangyang.Conclusions:The Echo11 strains circulating in Xiangyang from 2016 to 2017 belonged to lineage D and were recombinant strains.