Stroke is a type of neurological disease with high morbidity,disability,and mortality.It has become a global public health problem.At present,the stroke burden in countries around the world has shown an upward trend.This article reviews the extent of population health hazards caused by stroke,as well as the evaluation of economic burden of the disease.

Objective To investigate the effect of ketamine on hippocampal uncoupling protein 2 (UCP 2) expression after forebrain ischemia-reperfusion (I/R) in rats and the mechanism of protective effect of ketamine on brain. Method Forty-five male Wistar rats weighing 250～300 g were randomly divided into 3 groups, with 15 animals in each group. Forebrain I/R was estabhshed by occlusion of bilaleral carotid artery combined with hy-potemion,EFG in a sustained low rate of 7 Hz, 30～40 μVθ rhythm was the success signs of forebrain I/R. Con-trol group (C) :sham operation was performed; I/R group (Ⅰ): bilateral common carotid arteries were clamped for lOmin combined with hypotension [MAP:(40±5) mmHg] induced by exsanguinations, then saline (1 mg/kg) was injected into the lateral cerebral ventricle using microsyringe; ketamine group (K):ketamine (1 mg/kg) was injected into the lateral cerebral ventricle using microsyringe after I/R. The animals were decapitated, the brain was immediately removed,and the hippocampal tissues were dissociated at 6 h after reperfusion. The cerebral I/R injury was observed with light microscope, the levels of UCP 2 mRNA expression in hippocampus were detected by using semi-quantitative RT-PCR technique (n=7), coronal sections including hippocampal tissue were obtained for detection of UCP 2 protein expression by immuno-histochemistry (IH) method (n=8). The RT-PCRR and IH data were expressed as the mean±SD, the statistical signiticance was determined by one-way ANOVA. Results The UCP 2 mRNA expression was (1.06±0.02) in group Ⅰ and (1.18±0.06)in group K increased significantly compared with that in group C(0.91±0.02) (P<0.05), there were more UCP2 mRNA expression in group K increased than that in group Ⅰ(P<0.05). The expression of UCP 2 protein was (31.56±4.01) in group Ⅰ and (44.61±4.96) in group K, increased significantly compared with that in group C (17.91±5.49) (P<0.05),there were more UCP 2 protein expression in group K than that in group Ⅰ (P<0.05). Conclusions Ketamine can attenuate the cerebral I/R injury in rats, the underlying mechanism may be related to the up-regulartion of the expression of hippocampal UCP 2 mRNA and UCP 2 protein.

The lymphatic metastasis affects prognosis and survival of colorectal cancer seriously,and lymphangiogenesis plays an important role in the lymphatic metastasis. Many factors such as COX-2 and MMP-7 which are found in many researches recently can promote the expression of VEGF-C which can promote the lym-phangiogenesis by connecting with its receptor and activating the relevant signal pathway. At present,as these related factors of lymphangiogenesis are found in colorectal cancer,the process of lymphangiogenesis in colorec-tal cancer becomes more clear,but the exact mechanism of these factors needs to be researched in future.

Objective To investigate the effect of therapeutic hypercapnia on the inflammatory response in the rat lung transplantation. Methods Male pathogen free Wistar rats weighing 300-400 g were used in this study. The animals were anesthetized with 3% pentobarbital sodium 30 mg/kg, tracheostomized and mechanically ventilated (V_T 10 ml/kg, RR 50 bpm, FiO_2 50%). Carotid artery and femoral vein were cannulated for BP monitoring, blood sampling and fluid and drug administration. Left lung transplantation was performed using modified cuff technique. Forty-eight animals in which lung transplantation was successfully performed were randomized into 2 groups ( n = 24 each) : model group (M) and hypercapnia group (H) . In group H, PaCO_2 was maintained at 80-100 mm Hg by inhalation of CO_2.Arterial blood samples were obtained before lung transplantation (To , baseline) and at 1, 2, 4 h (T_(1-3)) of reperfusion for determination of blood TNF-α, IL-1 and IL-8 concentrations. The animals were then killed and the transplanted lungs were removed for microscopic examination and calculation of wet/dry lung weight ratio. Results The MAP and PaO_2 were significantly higher in group H than in group M. The blood IL-8 and TNF-α concentrations were significantly lower at T_(1-3) in group H than in group M, but there was no significant difference in blood IL-1 concentration between the 2 groups. The elastase content in the lung tissue was significantly lower at T_2 and T_3 in group H than in group M. Microscopic examination showed that the alveolar hemorrhage, the infiltration of the lung by macrophages and neutrophils and lung edema were significantly less in group H than in group M. Conclusion Therapeutic hypercapnia can obviously inhibit the inflammatory response in the rat lung transplantation.

Objective To investigate the effect of exogenous hydrogen sulfide (H2S) on neuronal apoptosis during focal cerebral ischemia-reperfusion (I/R) in rats.Methods One hundred eight male Sprague-Dawley rats,aged 6-8 weeks,weighing 250-270 g,were randomly divided into 3 groups (n =36 each) using a random number table:control group (group C),I/R group and H2S group.Focal cerebral ischemia was induced by middle cerebral artery occlusion in anesthetized rats.A nylon thread with a rounded tip was inserted into the left internal carotid artery and advanced intracranially to block blood flow into the middle cerebral artery.Middle cerebral artery occlusion was maintained for 90 min followed by reperfusion.In group H2S,0.25％ NaSH (a donor of exogenous H2S) 10 mg/kg was injected intraperitoneally at the onset of reperfusion.The equal volume of normal saline was given in C and I/R groups.At 1,3 and 7 days of reperfusion,neurological deficit was scored,and corner test was performed.Brains were removed for determination of myocardial infarct size,Bax-,Bcl-2-and caspase-3-positive cells,and cell apoptosis.The percentage of myocardial infarct size,rate of Bax-,Bcl-2-and caspase-3-positive cells and apoptosis rate were calculated.Results Compared with group C,the neurological deficit score was significantly decreased,and the corner score,percentage of myocardial infarct size,rate of Bax-,Bcl-2-and caspase-3-positive cells and apoptosis rate were increased at each time point of reperfusion in I/R and H2S groups (P＜0.05).Compared with group I/R,the neurological deficit score and Bcl-2-positive cells were significantly increased,and the corner score,percentage of myocardial infarct size,rate of Bax-and caspase-3-positive cells and apoptosis rate were decreased at each time point of reperfusion in group H2S (P＜0.05).Conclusion The mechanism by which exogenous H2S attenuates focal cerebral I/R is related to inhibition of neuronal apoptosis in rats.

Objective To understand the present condition of preclinical dental undergraduate in-terns' AIDS-related knowledge. Methods The questionnaire was designed referring to domestic and foreign relevant questionnaires. The cluster sampling method was used to conduct the questionnaire survey among the undergraduates who started their clinical internship in July 2016 in three domestic colleges, using SPSS 14.0 statistical software to analyze it. Results In this survey, 144 questionnaires were distributed, and 144 ones were filled out and sent back. The survey results suggested that 97.22％ (140) of interns held a posi-tive attitude towards aiding HIV-infected patients despite that 96.53％ (139) of interns knew that dental medical staff was considered to be highly susceptible with HIV. In spite of the fact that most interns knew AIDS-related knowledge and protection measures, 40.28％ (58) of interns were not clear about incubation period of AIDS, and the average awareness of children's AIDS and methods to disinfect HIV-infected dental instruments was less than half in the interns. Meanwhile it was found that 86.81％ (125) of interns didn't perform well in terms of complying with the principles of confidentiality in AIDS prevention and treatment. Conclusion Dental clinical interns' attitudes towards AIDS-infected patients should be praised. Further-more, they should accept education about infection control to have a deeper understanding about AIDS-related clinical manifestations and legal knowledge in order to reduce the probability of nosocomial infec-tion of AIDS.

Objective:To investigate the safety and effect of complete mesocolie excision (CME) combined with arterial infusion chemotherapy (AIC) and intra-peritoneal interstitial sustained-release chemotherapy (IPISRC). Methods:A total of 104 patients were classified under the experimental group and underwent CME combined with AIC and IPISRC. The other 98 patients were classified un-der the control group and only received radical surgery. Pre-and post-operative blood routine examinations, as well as liver and kidney function tests, were conducted for both groups. Post-operative adverse reactions and incidence of complications were recorded. Cancer and para-neoplastic tissues were sampled in experimental group. The post-surgery 5-fluorouracil (5-FU) concentration in the drainage fluid as well as those in the peripheral blood , were determined. Three-year follow-ups were conducted, during which the local recur-rence rate, liver metastasis, progression-free survival rate, and total survival rate were recorded. Results: No significant differences were found in the white blood cell count, hemoglobin count, liver and renal functions of the patients before and after the surgery, and rate of adverse reaction and complications between the two groups after surgery (P>0.05). In experimental group , the 5-FU concentra-tion was significantly higher in the cancer tissues than in the para-neoplastic tissues . The 5-FU concentration in experimental group was also significantly higher in the intra-peritoneal drainage liquid and reached its peak in the peripheral blood on day 3 post-surgery . Local recurrence and liver metastasis rates were significantly lower in experimental group than those in control group, whereas the pro-gression-free and three-year overall survival rates were significantly higher in experimental group than in control group (P<0.05). Con-clusion:The tharepy of pations of experimental goup is safe and effective. This method significantly improves the progression-free and three-year survival rates of the patients as well as significantly reduces the local recurrence and liver metastasis rates of colon cancer.

Objective:To develop a novel posterior circulation score (PCS) based on pretreatment diffusion-weighted imaging (DWI) for predicting futile recanalization (FR) of acute basilar artery occlusion (BAO) after endovascular therapy (EVT).Methods:A prospectively registered consecutive cohort of BAO patients treated with EVT in Beijing Tiantan Hospital, Capital Medical University during a six-year period was reviewed. This novel DWI-based PCS (DWI-PCS) was calculated according to the characteristics of acute infarction at four sites (pons, midbrain, thalamus and cerebellum), with a normal score of 0 point and a full score of 16 points. FR was defined as the occurrence of poor outcome (modified Rankin Scale score>3) at 90 days despite successful recanalization (modified Thrombolysis In Cerebral Infarction ≥ 2b) at final angiogram after EVT. The independent association of DWI-PCS with FR was evaluated by multivariable Logistic regression, and the predictive discrimination of DWI-PCS was measured by the area under the receiver operating characteristic (ROC) curve. Additionally, the effects of DWI-PCS on FR in different subgroups stratified by age, time window, stroke severity and etiology were explored.Results:Of 109 patients in this study, 48 (44.0%) suffered from FR. The multivariable Logistic analysis showed that DWI-PCS was significantly associated with FR (adjusted OR=1.31, 95% CI 1.07-1.62, P=0.01). The ROC curve analysis demonstrated that the area under the curve of DWI-PCS for predicting FR was 0.74 (95% CI 0.65-0.83), and the optimal cut-off value was ≥ 3 points (sensitivity 0.75, specificity 0.66, accuracy 0.70). Finally, the effects of DWI-PCS on FR were not found to be different across all subgroups ( P>0.10 for all interactions). Conclusions:The novel DWI-PCS may be a valid and reliable predictor of FR in BAO patients treated with EVT. Nevertheless, external validation with blinded outcome is still needed to confirm its performance before clinical application.

Nephroptosis,a rare condition in urology,often results from inadequate support of the kidney's perinephric fat structures,leading to excessive renal mobility.It typically occurs in lean,tall,young females.Some cases manifest with abdominal pain and renal dysfunction.Open nephropexy,laparoscopic nephropexy and percutaneous nephropexy are all effective methods in the treatment of nephroptosis,among which percutaneous nephropexy is associated with less trauma and lower costs.Modifications to percutaneous nephropexy by the authors'team are also introduced mentioned in this article.

Objective:To evaluate the effects of different doses of ulinastatin on lung function in patients undergoing total aortic arch replacement.Methods:One hundred and thirty five patients with acute Stanford type A aortic dissection of both sexes, aged 20-70 yr, with body mass index of 16.2-33.3 kg/m 2, of American Society of Anesthesiologist physical status Ⅳ, were divided into 3 groups ( n=45 each) using a random number table method: high-dose ulinastatin group (group H with total dose of 30 000 U/kg), low-dose ulinastatin group (group L with total dose of 20 000 U/kg) and control group (group C). In group H and group L, half of the total dose of ulinastatin was given after induction of anesthesia, the rest of the total dose was primed after being added to cardiopulmonary bypass (CPB) circuit, while normal saline 100 ml was given at the same time point in group C. After induction of anesthesia (T 0), and at 3, 6, 12, 24 and 48 h after the beginning of CPB (T 1-5), blood samples from the central vein were collected for determination of plasma concentrations of tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6). The oxygenation index (OI) and alveolar-arterial partial pressure of oxygen difference (P A-aO 2) at T 0 and T 2-T 5, intraoperative blood loss and blood transfusion, postoperative mechanical ventilation time, length of intensive care unit (ICU) stay and the incidence of complications within 30 days after surgery were collected. Results:Compared with group C, the plasma concentrations of TNF-α and IL-6 were significantly at T 1-T 5, OI was increased, and P A-aO 2 was decreased at T 2, 3 in H and L groups ( P<0.05). There was no significant difference in the mechanical ventilation time, length of ICU stay and incidence of complications within 30 days after surgery among the 3 groups ( P>0.05). Conclusion:Ulinastatin can inhibit inflammatory responses and improve lung function in patients undergoing total aortic arch replacement, but it has no value for clinical outcomes.