Objective To investigate the effects of Yindan-Xinnaotong combined with aspirin on lipidemia levels and hemorrheology in patients with stroke. Methods A total of 62 patients with stroke were randomized into a treatment group (31 cases) and a control group (31 cases). The patients in the control group were treated with aspirin and those in the treatment group were treated with aspirin and Yindan-Xinnaotong capsule (4 capsules each time, 3 times/d) for 30 days. The lipidemia levels and hemorrheology were evaluated before and after the treatment. Results After the treatment, whole blood viscosity (4.15 ± 0.14 mPa?s vs. 5.25 ± 0.40 mPa?s;t=14.452, P<0.01), plasma viscosity (1.70 ± 0.30 mPa?s vs. 2.70 ± 0.25 mPa?s;t=14.258, P<0.01), fibrinogen (3.71 ± 0.51 g/L vs. 5.80 ± 0.41 g/L;t=17.783, P<0.01) and thrombosis index (0.75 ± 0.31 vs. 1.30 ± 0.21;t=8.178, P<0.01) in the treatment group were significantly lower than those in the control group. After the treatment, the serum levels of total cholesterol (3.31 ± 1.19 mmol/L vs. 5.04 ± 1.30 mmol/L;t=5.465, P<0.01), triacylglycerol (0.63 ± 0.31 mmol/L vs. 1.34 ± 0.05 mmol/L;t=12.589. P<0.01) in the treatment were significantly lower than those in the control group, the serum level of high-density lipoprotein cholesterol in the treatment group was significantly higher than that in the control group (1.83 ± 0.49 mmol/L vs. 1.28 ± 0.45 mmol/L;t=4.603, P<0.01), and there was no significant difference in the serum level of low-density lipoprotein cholesterol between the two groups (2.22 ± 0.61 mmol/L vs. 2.11 ± 0.95 mmol/L; t=0.543, P>0.05). Conclusion Yindan-Xinnaotong combined with aspirin can improve the lipidemia and hemorrheology in stroke patients.

The microRNAs is a kind of endogenous and non-coding small RNA ,which possesses biological function negatively regulating gene expression.Recent researches also found that artificial controlling some microRNAs ex-pressions can improve heart function via regulating skeletal myoblasts through multiple mechanisms,so may become a new breakthrough point in myocardial infarction treatment area.

Objective To understand the current situation of neurology nurses′self-efficacy and quality of nursing services in Lanzhou area, and explore the relationship between self-efficacy and the quality of nursing services. Methods Using the method of questionnaire, one hundred and the neurology nurses and hospitalized patients in 5 Grade 3 Level hospitals of Lanzhou city were investigated by using self-efficacy scales and Servqual scales. Results Neurology nurses′ self-efficacy in Lanzhou area was lower than the general population ( U=-9.875,P=0.042);the scores of quality of care from high to low were at reliability, tangibles, assurance, responsiveness, cost acceptability and empathy, which were-(0.12 ± 0.05) points,-(0.23 ± 0.03) points,-(0.24 ± 0.06) points,-(0.25 ± 0.02) points,-(0.26 ± 0.05) points,-(0.66 ± 0.03)points.Satisfaction arranged from high to low were assurance (89.98%), reliability (89.69%), responsiveness (89.12%), tangibles (87.66%), cost acceptability (87.08%), empathy (86.67%).There were positive correlations between satisfaction and expectations and perceived service quality, and the correlation between satisfaction and perceived qualities of service was higher. Moreover, there might exist positive correlation between self-efficacy score and quality of nursing services (reliability, assurance, responsiveness, empathy) (P values were 0.002, 0.001,0.012 and 0.005). Conclusions Neurology nurses in Lanzhou area have lower self-efficacy, and the perceived qualities of care from patients never exceed their expectations. As results, hospital managers should take measures to improve general self-efficacy of nurses, and thus enhance the quality of care.

Objective To observe the inhibitory role of valproic acid (VPA) in hypertrophic cardiomycytes induced by angiotensin Ⅱ (Ang Ⅱ)in rats. Methods The cultured rat cardiomyocytes were divided randomly into control group, hypertrophic group and VPA group. They were treated with Ang Ⅱ to induce hypertrophy and then given with VPA. The morphologic changes of cardiomyocytes were observed under the contrast phase microscope and electron microscope. The mRNA levels ofβ-MHC were exmained by reverse transcriptase polymerase chain reaction (RT-PCR) method. The protein expression of C-FOS was exmanined by immunohistochemistry method. Results Stimulated by Ang Ⅱ, the cardiomyocytes were enlarged under the contrast phase microscope and the ultrastructure also changed. After stimulated by Ang Ⅱ, the mRNA level of β-MHC and the protein expression of C-FOS increased in the hypertrophic cardiocytes. Given by VPA, these data decreased accordingly. Conclusion VPA may inhibit the cardiomyocyte hypertrophy induced by angiotensin Ⅱ in some degree.

Objective To observe the inhibitory role of valproic acid(VPA) in hypertrophic cardiomycytes induced by angiotensin Ⅱ(AngⅡ)in rats.Methods The cultured rat cardiomyocytes were divided randomly into control group,hypertrophic group and VPA group.They were treated with AngⅡ to induce hypertrophy and then given with VPA.The morphologic changes of cardiomyocytes were observed under the contrast phase microscope and electron microscope.The mRNA levels of ?-MHC were exmained by reverse transcriptase polymerase chain reaction(RT-PCR) method.The protein expression of C-FOS was exmanined by immunohistochemistry method.ResultsStimulated by AngⅡ,the cardiomyocytes were enlarged under the contrast phase microscope and the ultrastructure also changed.After stimulated by AngⅡ,the mRNA level of ?-MHC and the protein expression of C-FOS increased in the hypertrophic cardiocytes.Given by VPA,these data decreased accordingly.Conclusion VPA may inhibit the cardiomyocyte hypertrophy induced by angiotensin Ⅱ in some degree.

Objective To evaluate the role of nuclear factor E2-related factor 2 (Nrf2)-antioxidant response element (ARE) signaling pathway in mitigation of anoxia/reoxygenation (A/R)-induced damage to rat cardiomyocytes by emulsified isoflurane postconditioning.Methods Primarily cultured cardiomyocytes obtained from Sprague-Dawley rats,aged 16-20 weeks,were seeded into the laminin pre-treated 6-well plates at a density of 104/cm2 and cultured for 20 h.The cells were randomly divided into 3 groups (n =12 each) using a random number table:control group (group C),group A/R,and emulsified isoflurane postconditioning group (group EI).The cells were cultured for 110 min without any treatment in group C.The cells were exposed to 45 min anoxia followed by 60 min reoxygenation in A/R and EI groups.After 45 min of hypoxia,the cells were cultured with emulsified isoflurane 1.68 mmol/L for 5 min before onset of reoxygenation in group EI.At the end of reoxygenation,transmission electron microscope was used to observe the ultrastructure of myocardial cells,and mitochondrial function was scored.The mRNA and protein expression of Nrf2,heme oxygenase-1 (HO-1),superoxide dismutase 1 (SOD1),and quinone oxidoreductase 1 (NQO1) was detected by real-time PCR and Western blot.Laser scanning confocal microscopy was used to detect Nrf2 nuclear translocation at the end of incubation,and Nrf2 activity was recorded in the nucleus of myocardial cells.Results Compared with group C,the mitochondrial function score was significantly increased,the mRNA and protein expression of Nrf2,HO-1,SOD1 and NQO1 was down-regulated,and Nrf2 activity in the nucleus was enhanced in A/R and EI groups.Compared with group A/R,the mitochondrial function score was significantly decreased,the mRNA and protein expression of Nrf2,HO-1,SOD1 and NQO1 was up-regulated,and Nrf2 activity in the nucleus was enhanced in group EI.Conclusion The mechanism by which emulsified isoflurane postconditioning mitigates A/R-induced damage to rat cardiomyocytes is related to induced nuclear translocation of Nrf2 and activated Nrf2-ARE signaling pathway.

Objective To evaluate the feasibility of T2 *mapping T2 *value combined with DWI ADC value in quantitative assessment of the activity of sacroiliitis.Methods 30 patients diagnosed with ankylosing spondylitis (AS)were divided into 2 groups as acute group (n=17)and chronic group (n=13)according to the BASDAI scores of the clinical severity of disease.And 20 healthy adults were recruited as control group.All groups were examined by MR with traditional sequence,T2 *mapping and DWI in the sacroiliac joint.The T2 *value and ADC value of the bone marrow edema region and normal region were measured.Furthermore,the imaging data and the clinical scores were statistical analysis and compared among three groups.Results T2 *values and ADC values in acute group of AS patients were higher than chronic group (P<0.05),as well as compared with healthy volunteers (P<0.05).There was no statistically significant difference between the chronic group of AS patients and control group (P>0.05).Positive correlation between ADC value and BASDAI was observed in patients group.Conclusion T2 *mapping combined with DWI imaging in AS is beneficial for early diagnosis and quantitative analysis of the activity of sacroiliitis.

Objective To understand the correlations between HIV-1 subtypes and changes in CD4+T cell count over time in patients with different subtypes of HIV-1 infection.Methods A total of 94 patients who were diagnosed with HIV-1 infection in Nanjing and received at least twice CD4+T cell counting test before antiretroviral therapy (ART) were recruited in this study.Descriptive analysis was used to present the rates of CD4+T cell decline for different HIV-1 subtypes.Logistic regression analysis and nonparametric test were conducted to investigate the factors responsible for CD4+T cell decline and to analyze the correlations between the rates of CD4+T cell decline and HIV-1 subtypes.Results The median monthly rate of CD4+T cell decline was-2.20 [interquartile range (IQR):-11.36-2.13] cell/μl.Of all patients,25.5% (24/94) had a significant decline (≥30%) in CD4+T cell count.Compared with the patients infected with CRF01_AE,those infected with CRF07_BC (OR=0.28,95%CI: 1.7-6.5) or other subtypes (OR=0.16,95%CI: 1.0-2.9) had a lower risk of significant decline in CD4+T cell count.In addition,results of the nonparametric test showed that the patients infected with CRF01_AE (M=-21.54,IQR:-30.97——11.92 cell/μl) had a faster CD4+T cell loss than those infected with CRF07_BC (M=-11.26,IQR:-14.06——5.63 cell/μl) (P=0.033).Conclusion HIV-1 subtype is associated with the rate of CD4+T cell decline.It is important to monitor the changes in CD4+T cell count in patients infected with CRF01_AE and to carry out timely ART.

Objective To evaluate the effect of emulsified isoflurane postconditioning on nuclear factor?E2 related factor 2 ( Nrf2 )?antioxidant response element ( ARE ) signaling pathway during myocardial ischemia?reperfusion ( I∕R ) in rats in vitro. Methods Healthy male Sprague?Dawley rats, aged 4-5 months, weighing 250-300 g, were heparinized and anesthetized with intraperitoneal 1% amobarbital sodium 40 mg∕kg. Their hearts were excised and perfused in a Langendorff apparatus with K?H solution. Thirty?two isolated rat hearts were randomly divided into 4 groups ( n=8 each ) using a random number table: control group (group C), group I∕R, emulsified isoflurane postconditioning group (EIP group) and fat emulsion group ( group F) . After 20 min of equilibration, group C was continuously perfused with K?H solusion for 100 min. Group I∕R underwent 40 min of ischemia at 32 ℃, followed by reperfusion for 60 min. In EIP and F groups, after undergoing 40 min of global ischemia, the isolated hearts were perfused for 2 min with K?H solution containing 1.68 mmol∕L emulsified isoflurane and 712 mg∕L intralipid, respectively, starting from the onset of reperfusion, and then were continuously perfused with K?H solution containing oxygen at 37 ℃ for 58 min. Heart rate (HR), left ventricular developed pressure (LVDP), left ventricular end?diastolic pressure ( LVEDP ) , and positive maximal pressure of left ventricular increase (+dp∕dtmax ) were recorded at the end of equilibration and reperfusion. At the end of reperfusion, myocardial specimens were obtained from the left ventricle for examination of the ultrastructure of myocardial cells and for determination of Nrf2, heme oxygenase?1 ( HO?1) , quinone oxidoreductase 1 ( NQO1) , and superoxide dismutase 1 ( SOD1) and mRNA expression using Western blot and real?time PCR. Results Compared with group C, HR, +dp∕dtmax and LVDP were significantly decreased, and LVEDP was increased at the end of reperfusion in I∕R and F groups, LVDP was significantly decreased, LVEDP was increased, and no significant changes were found in HR and +dp∕dtmax at the end of reperfusion in EIP group, and Nrf2, HO?1, NQO1 and SOD1 and mRNA expression was down?regulated at the end of reperfusion in I∕R, EIP and F groups. Compared with group I∕R, HR, +dp∕dtmax and LVDP were significantly increased, and LVEDP was decreased at the end of reperfusion in EIP and F groups, Nrf2, HO?1, NQO1 and SOD1 and mRNA expression was significantly up?regulated at the end of reperfusion in EIP group, and Nrf2, HO?1, NQO1 and SOD1 mRNA expression was significantly up?regulated, Nrf2 and HO?1 expression was up?regulated, and no significant changes were found in NQO1 and SOD1 expression at the end of reperfusion in group F. Compared with group EIP, HR, +dp∕dtmax and LVDP were significantly decreased, LVEDP was increased, and Nrf2, HO?1, NQO1 and SOD1 and mRNA expression was down?regulated in group F. Conclusion Emulsified isoflurane postconditioning attenuates myocardial I∕R injury probably by activating Nrf2?ARE signaling pathway in isolated rat hearts.

Objective:To explore the feasibility of artificial intelligence ultrasound to diagnose of biliary atresia (BA) based on deep learning.Methods:A total of 531 gallbladder ultrasound images in 177 cases of BA patients (BA group) and 585 gallbladder ultrasound images in 195 cases of Non-BA patients (Non-BA group) were collected in Hunan Children′s Hospital from September 2018 to October 2020. For the BA and Non-BA groups, all images were divided into training set and test set according to the ratio of 2∶1. The Mask R-CNN model was trained by training samples, and then the model was tested, according to patient and image as a unit respectively, to evaluate the gallbladder organ detection rate and the diagnostic accuracy of BA. In addition, the images of the test set were randomly numbered.Four sonographers were invited to interpret the images to calculate the diagnostic accuracy individually. Last, the diagnostic accuracy of the Mask R-CNN model was compared with that of sonographers.Results:In terms of the automatic detection of gallbladder organs, the detection rate in both BA and Non-BA group reached 100%, but there were 17 false alarms in 372 test images, with a false alarm rate of 4.57%. In terms of the diagnostic rate of gallbladders, when taking patient as a unit, the total diagnostic accuracy of the model in the test set was 95.97%, which was higher than that of the sonographers in other hospitals and the sonographer with intermediate professional title in our hospital, and the difference was statistically significant ( P<0.005). It was slightly higher than that of sonographer with senior professional title in our hospital (91.94%), but the difference was not statistically significant ( P=0.183). When taking picture as a unit, the total diagnostic accuracy of the model was 97.04%, which was higher than that of the sonographers in other hospitals and the sonographer with intermediate professional title in our hospital, and the difference was statistically significant ( P<0.001). It was slightly higher than that of sonographer with senior professional title in our hospital (94.09%), but the difference was not statistically significant ( P=0.05). Conclusions:The artificial intelligence technology based on Mask R-CNN can automatically and accurately detect gallbladder organs and diagnose BA, which is worthy of further study.