With the acceleration of the aging process of the population, the number of patients suffering from dementia has increased year by year, which has become a prominent social public health problem and has brought a huge burden to the global economy. The effective intervention of controllable risk factors for dementia can reduce and delay the occurrence of dementia by 40%. Strengthening the intervention of the controllable risk factors of dementia, promoting the early diagnosis of dementia, improving the whole-process management of dementia treatment, and exploring new therapeutic targets are a huge systematic project that urgently needs the joint efforts of individuals and the public health system.

Aspirin can effectively prevent ischemic cerebrovascular disease. However, as the existence of "aspirin resistance" phenomenon, ischemic events still occur in some patients during the aspirin treatment. This article mainly reviews the mechanisms, screening methods and treatment measures of aspirin resistance.

Objective To explore the diagnostic value of bronchofiberscopic washing cytology (BWC) and bronchoalveolar lavage fluid (BALF) ThinPrep cytology test (TCT) in the diagnosis of lung cancer.Methods Three hundred and eighty-five lung cancer patients who completed the BWC and BALF TCT were selected.The sensitivity was compared between the conventional smear and the two TCT methods.The sensitivity and accuracy of BWC and BALF TCT in the diagnosis of lung cancer were analyzed.Results The sensitivity of TCT was 76.1％ (293/385) in the diagnosis of lung cancer,and conventional smear was 54.8％ (211/385).The sensitivity of TCT was significantly higher than that of conventional smear (P ＜ 0.05).In the diagnosis of central lung cancer,the sensitivity of BWC TCT and BALF TCT was 74.4％ (131/176) and 70.5％ (124/176),and there was no statistical difference (P ＞ 0.05).In the diagnosis of peripheral lung cancer,the sensitivity of BALF TCT and BWC TCT was 83.3％ (174/209) and 44.0％ (92/209),and there was statistical difference (P ＜ 0.05).In BWC TCT,the accuracy of TCT and histology in squamous cancer was 92.7％ (127/137),in adenocarcinoma was 92.6％ (151/163),in small cell cancer was 96.8％ (61/63),and total accuracy was 91.9％ (354/385).In BALF TCT,the accuracy of TCT and histology in squamous cancer was 92.0％ (126/137),in adenocarcinoma was 94.5％ (154/163),and in small cancer was 98.4％ (62/63),and total accuracy was 92.7％ (357/385).Conclusions TCT has more diagnostic value in lung cancer.BWC and BALF TCT show different sensitivity in the diagnosis of lung cancer of different kinds.BWC TCT combination with BALF TCT is helpful to improve the diagnosis of lung cancer.

Objective To evaluate the effect of sodium potassium magnesium calcium and glucose (SPMCG) injection on the internal environment and metabolism of glucose,fat and protein in the patients undergoing craniotomy.Methods Forty-four patients of both sexes,aged 18-64 yr,of American Society of Anesthesiology Anesthesiologists physical status Ⅰ-Ⅲ,with body mass index of 18-30 kg/m2,were divided into either lactated Ringer's solution group (group R) or SPMCG injection group (group S) using a random number table.Before anesthesia induction,6％ hydroxyethyl starch 130/0.4 was infused intravenously at 15 ml · kg-1 · h-1 for 30 min,followed by iv infusion of 6％ hydroxyethyl starch 130/0.4 and corresponding volume of crystalloid solution in a ratio of 1 ∶ 2 at a rate of 5-10 ml · kg-1 · h-1 until the end of surgery.Before fluid infusion (baseline),immediately after the beginning of surgery,at 2 and 4 h after the beginning of surgery,at the end of surgery and at 1 h after surgery,arterial blood samples were collected for blood gas analysis,the pH value and concentrations of base excess,Na +,K+,Ca2+,Mg 2+and lactic acid were recorded,and the blood glucose concentration was determined.Before fluid infusion (baseline) and at the end of surgery,venous blood samples were taken for determination of the concentrations of plasma insulin,β-hydroxybutyric acid and 3-methylhistidine (3-MH).Results No hyperglycemia was found in the two groups.Compared with group R,the Mg2+ concentration was significantly increased,the concentrations of lactic acid and plasma β-hydroxybutyric acid and 3-MH were decreased (P＜0.05),and no significant change was found in the other parameters in group S (P＞0.05).Compared with the baseline,the blood glucose concentration was significantly increased after fluid infusion in the two groups,the Mg2+concentration was significantly decreased,and the concentrations of lactic acid and plasma insulin,β-hydroxybutyric acid and 3-MH were increased after fluid infusion in group R (P＜0.05),and no significant change was found in the parameters mentioned above in group S (P＞0.05).Conclusion For the patients undergoing craniotomy,SPMCG injection can maintain homeostasis,and the component 1％ glucose can inhibit the decomposition of fat and protein without inducing hyperglycemia and glucose metabolic disorders.

AIM: To investigate the relationship between the intracellular expression of Th1 and Th2 type cytokines in placental lymphocytes and the pregnancy outcomes in NOD/SCID mice. METHODS: The resorption rate of embryos (RR) was compared between BALB/c and NOD/SCID mice. In addition, the expression rates of Th1 type (TNF-? and IL-2) and Th2 type (IL-10) cytokines were detected intracellularlly in placental lymphocytes by four-color flow cytometry. RESULTS: Although multiple-immunodeficiency was confirmed in the NOD/SCID, no significant difference was observed in RR between BALB/c and NOD/SCID mice. At the same time, a dramatically elevated level of CD8+IL-10+/CD8+ cell percentage was found at the feto-maternal interface in NOD/SCID?NOD/SCID, as compared with BALB/c?BALB/c mice, while no significant difference was observed for TNF-? and IL-2 expression in CD4+ and CD8+ cell subsets isolated from these mice. CONCLUSION: The spontaneous elevation of CD8+IL-10+/CD8+ cell percentage at the feto-maternal interface may be related to the roughly normal fertility in NOD/SCID mice.

Objective To develop MSNs loaded with ICG and investigate its diagnostic value and photodynamic therapeutic value in the experimental pancreatic cancer. Methods ICG was loaded into MSNs to prepare the ICG/MSNs probe. The probe toxicity was evaluated by MTT assays. Near?infrared stereo fluores?cence microscope ( NISFM) was applied to investigate whether the ICG/MSNs would be uptaken by the human pancreatic cancer cells. After incubated with PBS, ICG (10μg/ml), MSNs or ICG/MSNs (10μg/ml ICG) for 24 h and treated with photodynamic therapy (PDT, (780±25) nm laser, 500 mW/cm2), the human pancreatic cancer cells survival rate was determined by MTT method. The human pancreatic cancer cells were implanted into nude mice to prepare subcutaneous tumor models. The distribution of ICG/MSNs in sub?cutaneous tumor models was studied with in vivo imaging system ( IVIS ) . With reference to the injection dose of ICG(0.5 mg/kg), the mice in PBS group, ICG group, ICG/MSNs group (4 mice per group) were injected via tail vein with 150μl PBS, ICG solution and ICG/MSNs solution, respectively. After treated by PDT for 48 h, the mice were observed by IVIS for 2 weeks using BLI to evaluate the therapeutic effect of PDT. NISFM was used to observe the fluorescence in tumor region. One?way analysis of variance was used to analyze the data. Results The diameter of ICG/MSNs was about 100 nm and it could be uptaken by human pancreatic cancer cells. After treated by PDT, the survival rates of human pancreatic cancer cells were (24?5±5.0)%, (81.2±1.6)%, (90.7±2.0)% and (93.4±1.7)% in ICG/MSNs group, ICG group, MSNs group and PBS group, respectively(F=212.289, P<0.05). ICG/MSNs group showed better therapeutic effect than ICG group( P<0.05) . After 12 d treated by PDT, the tumor did not recur or grow in ICG/MSNs group, but grew obviously in ICG group and PBS group. The BLI of tumor area in PBS group, ICG group and ICG/MSNs group were (61.2±7.7)×108, (56.7±9.0)×108 and (2.4±1.5)×108, respectively(F=67?098, P<0.05) . And the difference between ICG/MSNs and ICG group was statistically significant ( P<0.05) . Meanwhile, the NISFM showed clearly the tumor location with ICG/MSNs. Conclusions ICG/MSNs have good biocompatibility, good PDT effect on pancreatic cancer cells and pancreatic cancer xeno?grafts. Near?infrared fluorescence imaging with ICG/MSNs could delineate the tumor location.

The electrocardiograph signal presents the sparseness. In this paper, a new method of extracting the Fetal Electrocardiograph (FECG) is proposed, which uses the Blind Source Separation(BSS) of Sparse Signal. Both the Wavelet Analysis method and a new scheme named Vanish Circle are also involved in order to avoid the influence on the signal separation, because the ECG signals are not completed sparse signals. Some experiments show that the new method is effective.
Adult ; Algorithms ; Electrocardiography ; methods ; Female ; Fetal Heart ; physiology ; Fetal Monitoring ; methods ; Humans ; Pattern Recognition, Automated ; methods ; Pregnancy ; Signal Processing, Computer-Assisted

Objective:To investigate the signaling pathway of inhibiting macrophage phagocytosis of TIR domain-containing protein encoded by Escherichia coli (TcpC) N-terminal ubiquitin ligase active fragments of uropathogenic Escherichia coli. Methods:Bioinformatics software was used to analyze the amino acid sequences and the function of TcpC N-terminal ubiquitin ligase active fragments as well as the functional sites. PCR was performed to amplify tcpc-330, tcpc-450 and tcpc-510 genes and a prokaryotic expression system was constructed to express the target proteins. The recombinant proteins rTcpC-N110, rTcpC-N150 and rTcpC-N170 were purified by Ni-NTA affinity chromatography. LPS in the recombinant proteins was removed by Detoxi-gel chromatography. The expression of MyD88 at protein and mRNA levels in macrophages incubated with rTcpC-N110, rTcpC-N150, rTcpC-N170 or rTcpC-TIR was detected by Western blot and qRT-PCR. The activation of NF-κB signal pathway and the levels of proinflammatory factors in macrophages incubated with the above TcpC protein fragments were measured by Western blot and ELISA, respectively. Results:Cys12, Trp104 and Trp106 in the N-terminal fragment of TcpC were crucial amino acids in maintaining its ubiquitin ligase activity. The target recombinant proteins rTcpC-N110, rTcpC-N150 and rTcpC-N170 were successfully expressed and purified. After Detoxi-gel chromatography, rTcpC-N110, rTcpC-N150 and rTcpC-N170 extracts were undetectable for LPS. TcpC ubiquitin ligase fragments inhibited the expression of MyD88 at protein level, but not affect its expression at mRNA level in macrophages. LPS-induced phosphorylation of NF-κB signaling pathway-related proteins p50 and p65 was significantly inhibited in macrophages treated with TcpC ubiquitin ligase fragments. Moreover, LPS-induced production of pro-inflammatory factors was also significantly inhibited.Conclusions:The recombinant proteins rTcpC-N110, rTcpC-N150 and rTcpC-N170 could inhibit the expression of MyD88 at protein level and suppress the activation of NF-κB signaling pathway, suggesting that they were closely related to the inhibition of innate immune activity of macrophages.

Objective:To investigate the role of TcpC in uropathogenic Escherichia coli (UPEC)-induced cystitis in mice and to preliminarily analyze the pathogenic mechanism. Methods:C57BL/6 mice were injected with 10 9 CFU wild-type UPEC CFT073 (CFT073 wt) or tcpc gene-deleted mutant (CFT073 Δ tcpc) from urethra into bladder to construct the mouse model of cystitis. The mice were sacrificed 3 d after infection and the bladders were taken to observe the gross pathological changes. Histopathological changes in bladder tissues were observed after HE staining. Immunohistochemistry was used to detect TcpC in bladder tissues. Bacterial loads in urine samples of UPEC-infected mice were counted by tenfold dilution method, and the presence of tcpc gene in the genomic DNA of bacteria from the bladder and urine samples of CFT073 wt-infected mice was measured by PCR. Real-time quantitative RT-PCR (qRT-PCR) and Western blot were performed to detect the expression of TcpC at mRNA and protein levels in macrophages after CFT073 wt infection. The influence of UPEC strains on the activation of NF-κB signaling pathway in macrophages were determined by Western blot. The levels of proinflammatory factors and the bacterial and cell activity after infecting macrophages with UPEC strains were detected by ELISA, laser confocal microscope and fluorescence microscope, respectively. Results:Compared with the mice with CFT073 Δ tcpc infection, CFT073 wt-infected mice had significantly enlarged bladder and severe neutrophil infiltration and abundant TcpC in bladder tissues. The number of bacteria in the urine of CFT073 wt-infected mice was significantly greater than that of the CFT073 Δ tcpc group. PCR results showed that the bacteria in bladder or urine were CFT073 wt. The expression of TcpC at both mRNA and protein levels in macrophages increased significantly after CFT073 wt infection. Moreover, in CFT073 wt-infected macrophages, the expression of IκBα was promoted and the phosphorylation of p65 and the production of proinflammatory factors were suppressed. TcpC was instrumental in the survival and invasion of CFT073 wt in macrophages. Conclusions:TcpC expression increased significantly in mice with CFT073 wt-induced cystitis. TcpC inhibited the activation of NF-κB signaling pathway and the production of proinflammatory factors in macrophages to improve the survival rate of CFT073 wt, which was closely related to the pathogenesis and immune evasion of UPEC.

Objective:To explore the application effect of "blended learning + flipped classroom" in public elective courses for medical students, and provide reference for the blended construction of related courses.Methods:Totally 229 medical students were selected as research participants, who were taught by "blended learning + flipped classroom". After the courses, the curriculum evaluation questionnaires and focus group interview were used to collect students' evaluation of this course. SPSS 22.0 statistical software was used to make descriptive statistics on the questionnaire data.Results:Totally 98.5% students preferred "blended learning + flipped classroom" teaching mode, and more than 93% students thought this teaching method could improve their learning interest, empathy, understanding and application of knowledge. The results of the qualitative survey extracted two themes, namely "improving learning autonomy" and "expanding comprehensive quality".Conclusion:Perfecting the "blended learning + flipped classroom" teaching mode of the medical public elective courses plays a positive role in improving the learning autonomy and comprehensive quality of medical students and optimizing the learning effect.