ObjectiveTo investigate the clinical and imaging features of nonaneurysmal perimesencephalic subarachnoid hemorrhage (NAPSAH).MethodsThe patients with NAPSAH were retrospectively enrolled, and their clinical and imaging features were collected and analyzed.Results In 489 patients with subarachnoid hemorrhage treated over the same period, a total of 23 (4.7%) with NAPSAH were diagnosed with cranial CT and CT angiography.Subarachnoid blood centered in the prepontine cistern in 4 patients (17.39%), interpeduncular cistern in 8 (34.78%), ring pool in 7 (30.43%), and quadrigeminal cistern in 4 (17.39%).Two patients were transferred to other hospital for treatment, and the remaining 21 patients had a good outcome without complications and neurological deficits.Among them, the modified Rankin scale scores in 17 patient were 0, and 4 were 1.Their cardinal symptoms were forgetfulness, irritability, anxiety, and other subjective symptoms.They were improved after receiving psychological counseling and anti-anxiety treatment.ConclusionsThe incidence of NAPSAH is low.The clinical symptoms in patients with NAPSAH are mild, the outcomes are better without obvious complications.

Objective To investigate the efficacy of treatment with a single loading dose of rosuvastatin before percutaneous coronary intervention (PCI) for prevention of complications after surgery in elderly patients underwent PCI with coronary artery disease.Methods 216 elderly patients with coronary artery disease admitted to Department of Cardiology of Tianjin First Center Hospital were divided into two groups at random (108 patients per group). Within 24 hours before PCI, the patients of loading dose group received a loading dose of rosuvastatin 20 mg, while the patients of regular dose group received a regular dose of rosuvastatin 5 mg, and after surgery, both groups received rosuvastatin 5 mg/d orally. The serum creatinine (SCr), endogenous creatinine clearance rate (CCr), cardiac Troponin I (cTnI), creatine kinase-MB isoenzyme (CK-MB) and hypersensitive C-reactive protein (hs-CRP) before and after PCI were detected, and the incidences of contrast induced nephropathy (CIN) and myocardial infarction were calculated in both groups. The patients were followed up for 1 year after PCI, and the incidence of major adverse cardiac events (MACE) was observed.Results There were no statistically significant differences in the levels of SCr, CCr, cTnI, CK-MB or hs-CRP before PCI between two groups (allP > 0.05). While after PCI in two groups, the levels of SCr, cTnI, CK-MB and hs-CRP were higher than those before PCI, but CCr was lower than that before PCI, and the changes in regular dose group were more significant as compared with loading dose group [SCr (μmol/L): 89.52±21.79 vs. 83.45±19.17, cTnI (μg/L): 0.49±0.23 vs. 0.35±0.18, CK-MB (μg/L): 5.98±1.16 vs. 3.05±0.71, hs-CRP (mg/L): 8.31±0.06 vs. 2.46±0.02, CCr (mL/min): 62.61±19.54 vs. 73.48±20.14, allP < 0.05]. The incidence of CIN [7.41% (8/108) vs. 17.59 (19/108)] and myocardial infarction [1.85% (2/108) vs. 8.33% (9/108)] in loading dose group was evidently lower than that in regular dose group (bothP < 0.05). The incidence of MACE within 30 days after PCI in loading dose group was lower than that in regular dose group [5.56% (6/108) vs. 13.89% (15/108),P < 0.05], while within 1 year after PCI, the comparison of MACE incidence between loading dose group and regular dose group showed no statistically significant difference [19.44% (21/108) vs. 27.78% (30/108),P > 0.05].Conclusion A single loading dose of rosuvastatin given before PCI in elderly patients with coronary cardiac disease can protect renal function and myocardium, reduce the incidences of CIN, myocardial infarction and the occurrence of MACE at early stage after PCI.

Cancer stem cells comprise a sub-population with the capacity of self-renewal,self-differentiation and high tumorigenicity.Cancerogenesis,development,relapse and therapeutic resistance are closely related with these cells.The most important characteristics of these cells are the ability to self-renew.So insight into the regulating mechanism of self-renewal in cancer stem cells will be important for the development of novel molecular agents targeted the cancer stem cells.

Objective To investigate the safety and efficacy of hydroxychloroquine plus low-molecular-weight hep-arin and glucocorticoids in pregnant women with antiphospholipid syndrome (APS). Methods Clinical data of 12 pregnant women with APS were retrospectively analyzed. Eight patients were APS secondary to connective tissue disease while four were primary APS. Hydroxychloroquine plus low-molecular-weight heparin was employed for the treatment of all the pa-tients,among some of whom undergone combined glucocorticoids therapy. Results All patients underwent a successful de-livery with no abnormalities and are with normal Apgar scores of the babies. No compliations were developed during a follow up of 2-15 months. Conclusion Hydroxychloroquine plus low-molecular-weight heparin and glucocorticoids is safe and effective in treatment of pregnant women with APS, but its clinical value needs further investigate.

Objective To investigate the antitumour effects of transfected gut-enriched Krüppellike factor(GKLF) on human gastric carcinoma cell line SGC-7901 in vitro and in vivo. Methods The expression of GKLF mRNA and protein in human gastric carcinoma cell line SGC-7901 were detected before and after transfection by real-time fluorescence quantitative PCR and Western blot,respectively. Proliferation and invasion in SGC-7901 were measured respectively by MTT assay, flow cytometry, colony formation assay and cell invasion assay after transfected with GKLF. The growth of xenograft was observed, the microvessel density(MVD) of xenograft tissue was determined by immunohistochemistry. Results The GKLF mRNA and protein in SGC-7901 were overexpressed after transfected with GKLF(P＜0.05). The proliferative speed of SGC7901-pcDNA3.1-GKLF group was markedly lower than that of SGC-7901 and SGC7901-pcDNA3.1 groups (P＜0.05). Transfected with GKLF caused part of the G0/G1 arrest, decreased clone formation rate and the invasion ability (P＜0.05). The growth speed of xenograft in SGC7901-pcDNA3.1-GKLF group was lower, the weight and MVD of xenograft tissue in SGC7901-pcDNA3. 1-GKLF group were less (P＜ 0. 05).Conclusion Transfected with GKLF maysuppress proliferation and invasion in human gastric carcinoma cell line SGC-7901, inhibit the growth and the angiogenesis of xenograft in nude mice.

Objective To identify and analyze the plasmid (pR_ ST98 ) encoding multi-resistance to anti-microbial agents in S.typhi presenting the Salmonella plasmid virulence gene (spv).Methods Plasmid pR_ ST98 ,which could mediate virulence to its host bacteria, was used as the templete. The spv-specific PCR and Southern blot were employed to identify the spv virulence gene on this plasmid. The amplified spv fragments (spvR and spvB) were cloned into pGEM-T EASY.Then the DNA sequences were analysed. Results The date of PCR and Southern blot showed that spv,which had been found in other pathogenetic Salmonella spp. except S. typhi was also presented on pR_ ST98 . The ORF of spvR and spvB of pR_ ST98 were 894bp and 1 776bp respectively. They had more than 99% homologus with that of spvR and spvB on virulence plasmid in S.typhmurium.Conclusion From the results of PCR,Southern blot and nuclei acid sequencing, we concluded that this is the first report of revealing a mosaic-like plasmid carrying genes encoding not only drug resistance but also virulence in S.typhi.

Objective:To compare the clinical effects of restrictive blood transfusion combined with hyperbaric oxygen preconditioning (HBOPC) and restrictive blood transfusion in the treatment of hip,knee arthroplasty (THA,THA).Methods:40 patients in the period of epidural anesthesia,femoral nerve hysteresis hip and knee arthroplasty were selected and randomly divided into two groups:restrictive transfusion group (maintain 80 g/L≤ Hb ＜100 g/L,n=20) and restrictive blood transfusion combined with HBOPC (HBOPC+maintain 80 g/L =Hb ＜100 g/L,n=20).The red blood cell transfusion,red blood cell transfusion rate,perioperative Hb,blood oxygen saturation (SO2),the incidence of hypotension during operation,hospitalization time and postoperative cerebral infarction,acute pulmonary embolism,pneumonia,myocardial infarction,wound infection rate and 90 days mortality rate were compared between two groups.Results:Compared with the restrictive transfusion group,the postoperative Hb,blood oxygen saturation (SO2) of restrictive blood transfusion combined with HBOPC group were significantly increased(P ＜ 0.05);the red blood cell transfusion,red blood cell transfusion rate,incidence of pneumonia,wound infection rate were significantly decreased (P＜0.05).Conclusion:Restrictive blood transfusion combined with hyperbaric oxygen preconditioning could improve the anoxic state of the hip,knee arthroplasty patients,which could effectively reduce red blood cell transfusion,reduce postoperative complications,has good clinical curative effect.

Objective: To investigate the resistance of Mycobacterium tuberculosis to first-line anti-tuberculosis drugs in Jiaxing City, Zhejiang Province from 2017 to 2019, so as to provide insights into improvements of the therapeutic effect of pulmonary tuberculosis. Methods: Data pertaining to pulmonary tuberculosis in Jiaxing City from 2017 to 2019 were collected from the Tuberculosis Surveillance System of Chinese Disease Prevention and Control Information System, including demographics, treatment classification, sputum culture and drug resistance. The spectrum, types and prevalence of drug resistance in M. tuberculosis to four first-line tuberculosis drugs, including isoniazid (INH), rifampicin (RFP), streptomycin (SM) and ethambutol (EMB), was analyzed using a descriptive epidemiological method. Results: A total of 1 310 M. tuberculosis isolates were cultured from pulmonary tuberculosis patients in Jiaxing City from 2017 to 2019, and there were 259 M. tuberculosis isolates that were resistant to anti-tuberculosis drugs, with an overall drug resistance rate of 19.77%. The prevalence rates of drug resistance to INH, SM, RFP and EMB were 13.36%, 11.83%, 5.50% and 3.59%, respectively. The prevalence of drug resistance was lower in M. tuberculosis isolates from treatment-naïve patients than from retreated patients (18.45% vs. 34.58%, P<0.05). M. tuberculosis isolates presented high resistance to SM (4.50%) and INH alone (4.35%), the highest resistance to INH-SM combinations (3.28%), and the highest resistance to INH+RFP+SM combinations (1.83%). Sixteen isolates were resistant to all the four drugs, with a drug resistance rate of 1.22%. The proportions of resistance to a single drug, RFP resistance, multidrug resistance and resistance to two and more drugs were 10.31%, 5.50%, 4.73% and 4.73%, respectively. In addition, the prevalence of RFP resistance among all patients and treatment-naïve patients both showed a tendency towards a rise from 2017 to 2019 (P<0.05). The prevalence of RFP resistance (7.01% vs. 3.76%) and resistance to two and more drugs (6.01% vs. 3.25%) was both higher among interprovincial mobile tuberculosis patients than among local non-mobile patients (P<0.05). Conclusions The overall prevalence of drug resistance was lower in M. tuberculosis isolates in Jiaxing City from 2017 to 2019 than in Zhejiang Province, with INH and RFP resistance as predominant types.

Objective: To evaluate the protective effect of influenza vaccine among people aged 70 years and older in Jiaxing City, Zhejiang Province, so as to provide a basis for formulating immunization strategies. Methods: The influenza-like illness (ILI) cases aged 70 years and older treated in influenza surveillance sentinel hospital in Jiaxing City from November 2022 to May 2023 were selected. The medical information and influenza vaccination information were collected by a questionnaire survey, and influenza virus was detected using the quantitative fluorescent real-time PCR assay. The test-negative design case-control study was used to analyze the influencing factors of influenza virus positive and evaluate vaccine effect (VE). Results: Totally 1 084 ILI cases were enrolled, including 535 males (49.35%) and 549 females (50.64%). There were 732 cases (67.53%) aged 70 to 79 years, and 352 cases (32.47%) aged 80 years and older. There were 689 cases with underlying diseases, accounting for 63.56%. A total of 224 influenza virus positive samples were detected, with a positive rate of 20.66%. Multivariable logistic regression analysis showed that a lower possibility of influenza virus positive was seen in ILI cases aged 80 years and older, with underlying diseases and with influenza vaccination in the current season (all P<0.05). A total of 345 cases were vaccinated against influenza in the current season, with a vaccination rate of 31.83%. The VE of influenza vaccine was 37.40% (95%CI: 12.40%-55.40%), of which the VE to A (H1N1) was 36.00% (95%CI: 7.50%-55.70%) and to A (H3N2) was 40.90% (95%CI: -26.00%-72.30%). The VE for ILI cases aged 70 to 79 years was 41.00% (95%CI: 13.90%-59.60%), and for ILI cases aged 80 years and older was 20.60% (95%CI: -64.60%-61.70%). Conclusions Influenza vaccine has a certain protective effect on cases aged 70 years and older. Free influenza vaccination for the elderly should be continuously promoted and the vaccination coverage should be increased.

Objective To evaluate the effect of astragaloside Ⅳ on postoperative cognitive function in aged rats.Methods Sixty healthy male Sprague-Dawley rats,aged 22 months,weighing 360-480 g,were divided into 4 groups(n=15 each)using a random number table:control group(group C),surgery group(group S),low-dose astragaloside Ⅳ group(group L-AGS)and high-dose astragaloside IV group(group H-AGS).At 3 days prior to surgery,astragaloside Ⅳ 20 and 40 mg/kg were injected intraperitoneally once a day in L-AGS and H-AGS groups,respectively.The equal volume of normal saline was given instead in C and S groups.The animals underwent splenectomy under anesthesia with 1.8% isoflurane in S,L-AGS and H-AGS groups.Five rats in each group were randomly sacrificed at 1 day after operation,the hippocampi were removed for determination of interleukin-1beta(IL-1β),tumor necrosis factor-alpha(TNF-α)and IL-6 contents(by enzyme-linked immunosorbent assay)and expression of activated caspase-3,Bax and Bcl-2(by Western blot).The left animals underwent Morris water maze test at 15 days after operation.Results Compared with group C,the escape latency was significantly prolonged,the frequency of crossing the original platform was reduced,the space exploration time was shortened,the expression of activated caspase-3 and Bax was up-regulated,the expression of Bcl-2 was down-regulated,and the IL-1β,TNF-α and IL-6 contents were increased after operation in group S(P<0.05).Compared with group S,the escape latency was significantly shortened,the frequency of crossing the original platform was increased,the space exploration time was prolonged,the expression of activated caspase-3 and Bax was down-regulated,the expression of Bcl-2 was up-regulated,and the IL-1β,TNF-α and IL-6 contents were decreased after operation in L-AGS and H-AGS groups(P<0.05).Compared with L-AGS,the escape latency was significantly shortened,the frequency of crossing the original platform was increased,the space exploration time was prolonged,and the TNF-α contents were decreased after operation in group H-AGS(P<0.05).Conclusion Astragaloside Ⅳ can improve the postoperative cognitive function in a dose-dependent manner in aged rats.