Objective To systematically evaluate the effectiveness of using gargle solution Chlorhexidine Gluconate for patients with mechanical ventilation in ICU.Methods The randomized controlled trials (RCTs) on the application of gargle solution Chlorhexidine Gluconate for patients with mechanical ventilation in ICU were collected through the databases such as the China National Knowledge Infrastructure (CNKI),China Scientific Journal Database by VIP (VIP) and Wanfang Database.The quality of studies was critically appraised and data were extracted by two reviewers independently.Meta-analysis was conducted for the included studies.Results Eleven RCTs involving 1 337 patients were included.Meta-analysis showed that the application of gargle solution Chlorhexidine Gluconate for patients with mechanical ventilation in ICU could reduce ventilator-associated pneumonia (VAP) incidence rate[RR=0.54,95％CI(0.44-0.65),P ＜ 0.01],shorten the duration of mechanical ventilation [mean differences(MD)=-2.38,95％CI(-2.69--2.07),P ＜ 0.01] and length of ICU [MD=-3.66,95％CI (-5.45--1.87),P ＜ 0.01],but the mortality rate was not statistically significant [RR=0.37,95％CI (0.11-1.26),P ＞ 0.05].Conclusions The application of gargle solution Chlorhexidine Gluconate for patients with mechanical ventilation in ICU is safe and effective.

Alzheimer′s disease(AD)is one of the neurodegenerative diseases.Now it seriously threatens the life of the elderly.The pathogenesis of AD is not clear,thus there is no cure for this disease.The current treatment can′t reverse the pathological change of the disease or prevent the development of the disease,and the symptoms of the AD patients can only be partly improved.In recent years,the application of RNAi technology to the inhibition of the expression of the AD-related genes provides a new method for the treatment of AD.This article mainly introduces the application of the RNAi technology to AD.

Objective To describe the health literacy level and to explore the effect of health literacy level on education retention of patients with stroke.Methods Totally 100 stroke survivors were selected as the subject by convenience sampling.They were evaluated by Short Test of Functional Health Literacy in Adults on admission,and they accepted 60-90 minutes education intervention during hospitalization.Evaluation retention were measured before discharge.Results The score of the overall health literacy was (15.60±1.36) points,among of them,low level was 37 cases,general level was 24 cases,high level was 39 cases.Age,education level and Mini-Mental Status Exam score had a significant effect on the health literacy of patients with stroke (x2/F=14.248,12.082,11.329,P＜ 0.05).After education intervention,the score of education retention was (6.69±2.00)points,and the score of education retention in low,general,high level health literacy were (5.08±2.06),(7.46±1.61),(7.51± 1.76) points,and there were significant differences(F=14.223,P ＜ 0.05).Heahh literacy had a effect on education(P ＜ 0.01).Conclusions The level of health literacy of stroke patients has the effect of improving the education retention.Improving and maintaining the health literacy of stroke patients should be the development direction of the prevention and treatment of stroke diseases.

As an important neurotransmitter, adenosine displays its functions by acting on the adenosine receptors. Recent studies have shown that the distribution, expression and balance among subtypes of adenosine receptors are closely related with cognitive activities, and changes of adenosine receptors play key roles in neurodegenerative disorders including Alzheimer's disease. It has been pointed out that prolonged activation of adenosine receptors by high level adenosine may lead to the disturbance of balance among adenosine receptor subtypes. This imbalance mainly performed as increased expression of A2a receptor and decreased expression of A1 receptor, and enhancement of the excitatory signals mediated by A2a receptor and weakened inhibitory signals mediated by A1 receptor. Changes of these two subtypes of adenosine receptors may lead to a lot of disorders of neurological activities which developed into dysfunction of cognition to the end. These findings imply that the potential of maintaining the balance among adenosine receptors on the treatment of AD would facilitate both the revealing of the mechanism and the cure of AD.

Objective To investigate the changes in brain MRI scan in neuromyelitis optica (NMO).Methods MRI images in 27 cases with NMO were examined in a retrospective study.Results Twenty-two of 27 patients (81.5%) had abnormal brain MRI findings,which were classified as nonspecific (7 cases),atypical (1 case),multiple sclerosis-like (3 cases) and ventricle-aqueduct-syringocoele lesions (11 cases).The lust type is the most common (40.7%).Furthermore,the analysis showed that the number of brain lesions positively correlated with lag time from the onset to the last MRI scan (r=0.475,P=0.025).Conclusions Brain lesions in NMO are diverse,which might result from different pathogenesis.However,ventricle-aqueduct-syringocoele is the most common lesion.Early brain MRI examination of suspected cases is essential.

AimThe aim of this study was to establish a rodent model with similar characters of human metabolic syndrome(MS).Methods Three species mice and Wistar rats were fed with high energy chows(HEC)for 6 to 23 weeks.Animals were weighted every week.Fasting blood glucose(FBG)together with total cholesterol(TC)and low density lipoprotein-cholesterol(LDL-C)were investigated by oxidase test every two week.And fasting blood insulin(FINS)was determined by radioimmunoassay.Homeostasis model assessment of insulin resistance(HOMA-IR)was calculated as FBG×FINS/22.5.At the end of the experiment,oral glucose tolerance test(OGTT)was performed.Then animals were decapitated,and coel-fat and orchio-fat were collected and weighted to calculate the visceral fat coefficient(VFC).Results FBG,serum TC and LDL-C significantly increased(P<0.01)after 6 weeks feed of HEC in KM mice.The mice also formed abdominal obesity and insulin resistant together with impairment of glucose tolerance(P<0.05 or P<0.01).Though similar to the KM mice,C57BL/6 and BALB/c mice couldn't form abdominal obesity while the latter had increased body weight(P<0.05 or P<0.01).Wistar rats formed hyperlipidemia from 1 to 10 week and hyperglycemia from 10 to 23 week together with insulin resistance and impaired glucose tolerance(P<0.05 or P<0.01).Conclusion KM mice feed with HEC for 6 weeks could successfully establish metabolic syndrome mice model which might be suitable for drug-screening,the major characters includes the formation of abdominal obesity(increase of VFC),the increase of serum TC,LDL-C,FBG and HOMA-IR,and the decrease of OGTT.

Objective To study the clinical value of air-and hone-conduction auditory brainstem responses(ABRs) in children with congenital aural atresia.Methods Air-and bone-conduction clickevoked ABRs in 38 children with congenital external auditory canal atresia were compared to those in 34 normal-hearing children.Results ABR threshold were (65.0 ± 8.7) dBnHL for air conduction and (10.6 ±7.0) dBnHL for bone conduction in children with congenital external auditory canal atresia;and (25.6 ± 1.7) dBnHL and (9.7 ± 6.7) dBnHL respectively in normal hearing children.There was statistically difference between the two groups in air-conduction ABR threshold(t' =21.59,P ＜ 0.01).There was no significance between the two groups in bone-conduction ABR (P ＞ 0.05).While the air-bone ABR threshold gap was greater in children with external auditory canal atresia than in normal hearing children (t' =13.78,P ＜ 0.01),bone-conduction ABR wave latencies were not statistically different between the two groups(all P ＞ 0.05).Conclusion Bone conduction ABR is valuable in assessing fuuction of cochlea,auditory nerve and brainstem in individuals with congenital external auditory canal atresia.It has important clinical value in objective differential diagnosis of conductive deafness with combined application of air-and bone-conduction ABRs.

Alzheimer′s disease(AD)is a degenerative metabolic disease,whose exact pathological mechanism still remains unknown. Currently,studies have found that patients in AD accompany with insulin signaling pathway impairment and cerebral glu?cose metabolism dysfunction. As insulin signaling pathway and cerebral glucose metabolism homeostasis play a key role in AD ,some researches consider AD as“typeⅢdiabetes”. This review aims to discuss the alteration of cerebral insulin signaling pathway and glu?cose metabolism in AD,as well as their relationship with AD. We will also elaborate the advance in anti-AD drugs based on cerebral insulin signaling pathway.

Objective:To explore the value of the quantitative fecal immunochemical test (FIT) for primary colorectal cancer screening in health check-up population.Methods:A total of 468 health check-up participants who underwent quantitative FIT and colonoscopy at the First Affiliated Hospital of Soochow University from January 2018 to December 2019 were enrolled into this study. The participants were divided into two groups-the negative group(FIT<100 μg/L)and the positive group(FIT≥100 μg/L) according to the results of the quantitative FIT. We compared the detection rate of colorectal polyps and colorectal advanced cancer between the two groups, and analyzed the sensitivity and specificity of the quantitative FIT for advanced colorectal cancer and the risk factors of colorectal polyps.Results:The positive rate of quantitative FIT in the healthy population was about 4.6% (95% CI: 4.27%-4.93%). The detection rate of colorectal polyps in the positive group was significantly higher than that of the negative group (51.53%, 95% CI: 45.81%-57.25%) vs (34.28%, 95% CI: 27.25%-41.31%, P<0.001). The sensitivity and specificity of the quantitative FIT for advanced colorectal cancer was 98.55% and 56.77%, respectively. The positive predictive value of the quantitative FIT for advanced colorectal cancer was 50.37%, while the negative predictive value was 98.88%. With the increase of FIT value, the detection rate of advanced cancer was increased (χ2 =20.08, P<0.001). The multivariate logistic regression of colorectal cancer suggested that the risk of colorectal polyps in patients with a history of diabetes was significantly higher ( OR=3.28, 95% CI: 1.45-7.41, P=0.004); the risk of colorectal polyps in men was also significantly higher ( OR=3.05, 95% CI: 1.40-6.65, P=0.005). Conclusions:Quantitative FIT is an ideal non-invasive examination for primary colorectal cancer screening for a health check-up population. Patients with negative FIT are less likely to develop colorectal cancer. Diabetes history, male, and age are independent risk factors for colorectal cancer.

Objective To study the expression and clinical significance of Survivin and PTEN in cervical carcinoma. Methods The expression of Survivin and PTEN in 60 cases of cervical carcinoma, 15 cases of CIN Ⅰ , 15 cases of CIN Ⅱ, 15 cases of CIN Ⅲ and 15 cases of normal cervical tissues were detected by immunohistochemical staining. Results The expression positive rates of Survivin were 86.67 %, 80.00 %,33.33 %, 20.00 % and 0, respectively, and those of PTEN were 21.67 %, 40.00 %, 80.00 %, 86.67 % and 100.00 % in cervical carcinoma, CIN Ⅲ, CIN Ⅱ, CIN Ⅰ and normal cervical tissues, respectively. The expression positive rates of Survivin were increased along with normal cervical epithelium, CIN Ⅰ, CIN Ⅱ,CIN Ⅲ and invasive carcinoma of cervix;while those of PTEN were inverse order.Compared with the expression positive rates of Survivin and PTEN protein in the CIN Ⅱ group, those in the CIN Ⅲ group had significant differences (P <0.01 and P <0.05, respectively). Expressions of Survivin and PTEN were correlated to the size of focus(P <0.05), the depth of tumor and pelvic lymphnode metastasis (P <0.05), but not to clinical staging, pathological types, pathological grading and age(P >0.05). There was a negative correlation between the expression of PTEN and Survivin in cervical carcinoma. Conclusion The expressions of Survivin and PTEN are correlated with invasion and metastasis of cervical carcinoma, and be related to clinical pathotology.Survivin and PTEN may play a important role in the formation, proliferation, differentuation and metastasis of cervical carcinoma. They may be used as markers of early diagnose, efficacy and prognosis evaluation.