Objective To investigate the early risk factors for stroke-associated pneumonia (SAP) in acute stroke patients with dysphagia.Methods The modified Mann assessment of swallowing ability (MMASA) was used to screen dysphagia in patients with acute stroke admitted to hospital within 24 hours after symptom onset.The patients with dysphagia were used as research subjects.They were divided into either a SAP group or a non-SAP group according to whether they had SAP or not within one week of symptom onset.Univariate and multivariate logistic recession analyses were used to analyze the data of demography,past history,clinical practice,and laboratory.The early risk factors for the occurrence of SAP in patients with dysphagia were identified.The independent risk factors were analyzed with receiver operating characteristic (ROC) curves in order to assess their predictive value for SAP.Results Of the 113 patients with acute stroke,55 had dysphagia,and 30 of them (54.54％ ) had SAP.Univariate analysis showed that the National Institutes of Health Stroke Scale (NIHSS) score (median,[ interquartile range] 16,[ 13 - 21 ] vs.3,[ 1 - 7 ] ; P =0.000),neut rophil counts ([ 8.22 ± 3.75 ] × 109/L vs.[ 5.39 ± 2.56 ] × 109/L; t =3.198; P =0.002),proportion of hemorrhagic stroke (96.00％ vs.4.00％ ;x2 =7.333; P =0.007),and proportion of mechanical ventilation (20.00％ vs. 0.00％;x2=5.612; P=0.018) in the SAP group (n=30) were significantly higher than those in the non-SAP group (n =25),while the MMASA score (median,[ interquartile range ] 53,[ 27 - 84 ] vs.88,[ 66 - 92 ] ; P =0.002),Glasgow Coma sCale (GCS) score (median,[ interquartile range] 10,[7-13] vs.15,[11-15];P=0.001),lymphocytecounts([1.17±0.54] ×109/L vs.[1.75±0.81 ] × 109/L; t =-3.563,P =0.001),CD3+ T lymphocyte counts ([0.73 ± 0.42] × 109/L vs.[ 1.14 ±0.85] × 109/L; t=-2.307; P=0.025),and CD4+ T lymphocyte counts ([0.38± 0.22] × 109/L vs.[ 0.69 ±0.57] × 109/L; t =-2.761; P =0.008) were significantly lower than those in the non-SAP group.Multivariate logistic regression analysis showed that the NIHSS score was higher at admission (odds ratio [ OR ],1.206,95％ confidence interval [ CI ] 1.076- 1.351; P=0.001) and the CD4+ T lymphocyte counts decreased ( OR,0.974,95％ CI 0.952 - 0.997; P =0.025) were the independent risk factors for SAP in stroke patients with dysphagia.The NIHSS score ≥ 10.5 had good predictive value for SAP,and its sensitivity and specificity were 86.7％ and 72.0％ respectively (P =0.000).Conclusions More than half of the acute stroke patients with dysphagia occurred SAP.The NIHSS score at admission,neutrophil counts,stroke types,mechanical ventilation,MMASA score,GCS score,lymphocyte counts,CD3+ T lymphocyte counts,CD4+ Tlymphocyte counts,and other factors were associated with occurrenee of SAP in patients with dysphagia,in which a higher NIHSS score and a decreased CD4+ T lymphocyte counts were independent risk factors for the occurrence of SAP in stroke patients with dysphagia.The NIHSS score ≥ 10.5 at admission had higher predictive value.

The incidence of dysphagia after stroke is high.It may affect the rehabilitation of patients and increase mortality.The assessment is of great significance for early objective examination of dysphagia,in which the bedside screening tests are the most common assessment methods in the routine clinical work.This article reviews the advances in research on the commonly used bedside screening tests of dysphagia.

Objective To analysis clinical effect of Diyu Shengbai tablets combined with granulocyte colony stimulating factor on cancer related fatigue syndrome.Methods II-VI primary cancer 60 patients from January 2011 to December 2013 were admitted to department of internal medicine, Fourth Hospital of Hebei Medical University,and randomly divided into two groups.Control goup(n=30)were treated with granulocyte colony stimulating factor(G-CSF).Experimental group(n=30)were treated with Diyu Shengbai tablets and G-CSF.Results After chemotherapy, ratio of patients in the experimental group appeared fatigue syndrome and changes in leukocyte was significantly lower than that of control group, the difference was statistically significant ( P <0.05 ) . Conclusion Diyu Shengbai tablets combined with G-CSF have better clinical efficacy for leukopenia caused by tumor chemotherapy, the symptom of fatigue also can improve significantly.

Objective To investigate the changes of bone mineral density (BMD) in human immunodeficiency virus (HIV)-infected patients in Changsha,and take intervention measures to prevent the occurrence of osteoporosis and fracture.Methods A total of 278 HIV-infected patients and 154 cases of healthy adults from March 2011 to May 2015 were selected.Dual energy X-ray absorptiometry (DXA) was used to detect BMD,T-score and Z-score of all the research objects,including the whole body,lumbar spine (L2～4),and left hip joint.The height and weight were measured at the same time.Results The HIV infection group had an average age of (31.53 ± 8.56) years old,and the healthy control group was (34.45 ± 8.22) years old.Height between two groups had no significant difference.The average weight of HIV infection group was 6.93 kg [95％ CI,-9.01,-4.97;P ＜0.001] lighter than that in the normal control group.BMD,T-score and Z-score of HIV infection group were significantly lower than those in norrmal control group (P ＜ 0.001).The occurrence rate of osteopenia (Z ≤-1.0)and osteoporosis (Z ≤-2.0)in HIV infection group were correspondingly 43.53％ ～ 54.68％ and 9.71％ ～23.74％,which is about 4 times of that in the healthy control group (14.28％ ～ 20.13％,0.65％ ～ 5.84％).Conclusions The average body weight of HIV-infected patients was significantly lower than that of normal control group,and the incidence of osteopenia and osteoporosis in HIV-infected group was significantly higher than that in normal control group.

BACKGROUND: What are the influencing factors of serum uric acid of inhabitants from coastal area? What is the critical concentration of serum uric acid to prevent and treat metabolic syndrome?OBJECTIVE: To probe into the relationship between serum uric acid and metabolic syndrome in female inhabitants aged more than 20 years from coastal area of Shandong province.DESIGN: A clusting stratified random sampling survey.SETTING: Department of Endocrinology, Affiliated Hospital of Medical College of Qingdao University.PARTICIPANTS: The survey was carried out in the female inhabitants of five cities from coastal area of Shandong province (Qingdao, Rizhao, Yantai, Weihai and Dongying) between May and October 2004. The inhabitants, aged 20 to 80 years, lived there for 5 or more than 5 years, and they were natural crowd taking family as unit.METHODS: Investigations in the manner of entering every family and being on the spot were combined. Questionnaires were filled in on the first day, and fasting blood was taken to perform serum uric acid examination on the morning of the second day. For those with serum uric acid higher than normal, they were given rechecking on the third day, and education about prevention and treatment of gout and hyperuricemia was conducted at the same time.MAIN OUTCOME MEASURES: ① Investigation on general condition:Including health status, diet, physical activity, labour intensity and economics. ② Investigation on nutrition: Consists of food intake frequency and dietary. ③ Body height, body mass, waistline, hip circum, blood pressure and body mass index. ④ Levels of fasting blood glucose(FBG), serum uric acid, total cholesterol (TC), triacylglycerol (TG), high-density lipoprotein cholesterol(HDL-C), urea nitrogen (UN) and creatinine(Cr).RESULTS: ① With the increase of concentration of serum uric acid, levels of systolic pressure (SP), diastolic pressure (DP), pulse pressure (PP),body mass index(BMI) , waistline, waist-to-hip ratio(WHR), UN, Cr, TG,TC were all gradually increased. Each index was significantly higher in the serum uric acid 280-319 μmol/L group, serum uric acid 320-349 μmol/L group and serum uric acid ＞ 350 μmol/L group (hyperuricemia group)than that in serum uric acid ＜ 280 μmol/L (P ＜ 0.05-0.01 ), While the concentration of HDL-C was decreased with the increase of concentration of serum uric acid (all P ＜ 0.01). ② The incidence of hypertension, lipid metabolic disorder, overweight and obesity, glycometabolism disorder as well as metabolic syndrome was increased with the increase of uric acid;Compared with serum uric acid ＜ 280 μmol/L group, OR value of metabolic syndrome was 2.29(95%CI: 1.81-2.89),4.15(95%CI:3.10-5.55),4.96 (95%CI:3.85-6.39) in the serum uric acid 280-319 μmol/L group,320-349 μmol/L group and hyperuricemia group , respectively. ③Noncondition Logistic multiple stepwise regression analysis showed that age,hypertension, shellfish intake volume, UN, Cr, TG and WHR and light physical activity were the independent risk factors for female patients with hyperuricemia and HDL-C was protective factor.CONCLUSION: The incidence of metabolic syndrome is increased with the increase of concentration of serum uric acid in female inhabitants from coastal area of Shandong province. 280 μmol/L should be as the critical concentration of serum uric acid to prevent and treat metabolic syndrome.Controlling metabolic syndrome and reducing intake of shellfish and other marine products which contain high level of purine is one of means to prevent hyperuricemia. Clinical physicians should paid more attention to the pathopoiesis of hyperuricemia.

BACKGROUND: Recent studies have found that hyperuricemia and gout are closely correlated with the occurrence and development of diabetes, coronary heart disease, hypertension and cerebrovascular diseases. It is of significance to investigate their prevalence so as to find way of early interventions.OBJECTIVE: To determine the prevalence and risk factors of gout and hyperuricemia among residents above 20 years old in Shandong coastal area.DESIGN: A randomized, stratified cluster sampling survey.SETTING: Department of Endocrinology, Affiliated Hospital of Qingdao University Medical College.PARTICIPANTS: A random, stratified cluster sampling was conducted in Shandong coastal area including Qingdao,Yantai, Weihai, Rizhao and Dongying. Residents lived in these areas for 5 years or more, aged between 20 to 80 years, were selected, and they were surveyed by family as a unit.METHODS: A randomized, stratified cluster sampling survey was conducted. The prevalence of gout and hyperuricemia were investigated among about 5 000 residents in Qingdao, Yantai, Weihai, Rizhao and Dongying. The serum uric acid, lipids, glucose and creatinine were detected with Sysmex chemix-180 total automatic biochemical analyzer. Those with uric acid higher than reference level were reexamined by collecting fasting blood sample on the third day. The comparison between rates was taken with the Chi-square test, means between two groups with the t test, means between multiple groups with analysis of variance, correlation between dependent and independent variables with logistic regression analysis.MATN OUTCOME MEASURES: Prevalance of hyperuricemia; Level of serum uric acid; Prevalence of gout in patients with hyperuricemia; Influencing factor of hyperuricemia.RESULTS: This investigation planned to include 5 500 subjects while in fact 5 003 subjects were investigated and the response rate was 91%, in which males were 2 395 (47.87%) and females were 2 608 (52.13%). ① The prevalence of hyperuricemia was 13.19% with standardized rate of 13.27% according to the Shandong population in 2000; The pevalence was higher in males than in females (18.32%, 8.56%, x2=108.52, P＜ 0.01). The risk in males was 2.5 times higher than that in females (OR =2.5). The prevalence of gout was 1.14% with standardized rate of 1.10%; and the prevalence in males was higher than that in females (1.94%, 0.42%, x2=30.38, P ＜ 0.01). The risk in males was 5.3 times higher than that in females (OR =5.3). ②The average value of serum uric acid in normal males was higher than in normal females [(343.40±84.54), (258.90±70.90) μmol/L, t =48.03, P ＜ 0.01]. It was obviously higher in male patients with hyperuricemia than in female ones [(469.43±48.08), (399.73±104.91) μmol/L, t =11.70, P ＜ 0.01]. It was higher in male patients with gout than in female ones [(502.44±106.76), (403.48±52.72) μmol/L, t =2.07, P ＜ 0.05]. ③The prevalence of gout in patients with hyperuricemia was 8.34%. ④ The prevalence of hyperuricemia and gout were climbing up with age after 40 years old in females and those elder than 70 years old were of high risk; while in males,the prevalence of hyperuricemia and gout increased with age before 60 years old and those aged 50-59 years were of high risk, yet after 60 years, it climbed up with age again. Nevertheless, the mean ages of hyperuricemia and gout in females were older than male. The average episode ages of hyperuricemia and gout in females were later than in males respectively by 7.5 and 8.5 years. ⑤ Non-conditional Logistic regression analysis showed that drinking frequency,drinking quantity, the quantity and frequency of seashell intake, BUN, Cr, TG, TC, BMI and WHR were the independent risk factors of male patients with hyperuricemia [OR =1.016-30.217, 95%C/ (1.010-1.023)-(9.955-214.869)]; while HDL-C and heavy physical labour were the protective factors (OR =0.492, 95%C/ 0.339-0.713; OR =0.755, 95% CI 0.575-0.991).As for females, age, hypertension, the quantity of seashell food intake, BUN, Cr, TG, WHR and light physical labour were the independent risk factors of hyperuricemia [OR =1.022-27.34, 95%CI (1.006-1.040)-(9.955-214.869)]. Similarly, HDL-C was a protective factor (OR =0.428, 95%CI0.223-0.820).CONCLUSION: ① The prevalence of hyperuricemia and gout are different between genders: ② The risk factors of hyperuricemia and gout among residents in Shandong coastal area include the high intake of marine products such as seashell foods, less physical activity, abdominal obesity and kidney insufficiency, as well as the existence of metabolic syndrome. Drinking is also involved in the increased prevalence in males, and age in females. ③ Higher risk for hyperuricemia and gout are noticed in all age groups in males, whereas in females after 50 years old.

Objective To observe the therapeutic effect of the new plan of concurrent capecitabine (CAP) and radiation therapy for hu-man cervical adenocarcinoma in nude mice. Methods The nude mice were injected with CAC-1 cells for the modelization of cervical ade-nocarcinoma. Before treatment,all mice with tumors were randomly divided into control group,CAP group,5-FU group,radiation group,CAP+ radiation group,5-FU+radiation group. According to the tumor size,mice were furtherly divided into large-size and small-size groups in the control group,CAP group,radiation group, CAP+radiation group. The change of tumor size,tumor growth percentage and the delay time of tu-mor growth were evaluated. Results The therapeutic effect of combining 2/3MTD CAP with 6 Gy radiation or fractionation 2 Gy × 8 times radiation was better than that of the control group,chemotherapy group and the radiation group. The difference was significant (P < 0.05). The restraint effect of the combining 2/3MTD CAP with 6 Gy radiotherapy was better than that of the combining 2/3MTD 5-FU with 6 Gy radiotherapy. Combining 2/3MTD CAP with fractionation 2 Gyx8 times radiation therapy was more efficient than Combining 2/3MTD CAP with fractionation 6 Gy radiation therapy. In combining therapy groups,the response of large-size tumors was more significant than that of the small-size tumors (P < 0.05),which had almost no obvious response. Conclusion Concurrent CAP and radiation therapy has obvious restraint effect on CAC-1 cervix adenocarcinoma in nude mice. The CAP and radiation therapy can promote the therapeutic effect to each oth-er. The therapeautic effect of the concurrent CAP and radiation therapy is affected by the radiation dose, radiation method and the tumor size.

AIM:To establish a screening model based on muscarinic receptor type 1(M1) for drugs against Alzheimer's disease (AD). METHOD: Human M1 receptor was expressed in HEK293 (human embryonic kidney) cells, and its activation was measured by the intracellular cAMP (cyclic AMP) level. Exogeneous 3H-cAMP was used to compete the intracellular cAMP binding sites. Acetylcholine chloride was used as a positive drug to ensure the sensitivity of this model. RESULT: HEK293 cell expressing system of human M1 receptor was established. Different concentrations of acetylcholine chloride (10-9～10-4 mol/L) activation of M1 receptor leads to an increase of intracellular cAMP 10.343×10-4～33.754×10-4 pmol/μl. CONCLUTION:This screening model has positive response to M1 receptor agonist and can be used for drug screening.

Aim To investigate the mechanism of the melanoma B16 F10 cells proliferation induced by Lico-chalcone A in vitro. Methods The proliferation of B16 F10 cells induced by Licochalcone A was deter-mined by SRB method. The morphological changes were observed using Giemsa staining under the phase contrast microscope equipped with a digital camera. The melanin level was assessed by colorimetric meth-od. The apoptotic rate was determined by Annexin V-FITC/PI assay. Cell cycle distribution was determined by flow cytometry. The mRNA expression levels of B cell lymphoma/lewkmia-2 ( Bcl-2 ) , Bcl-2 associated X protein ( Bax) , the cell cycle protein CyclinE2 and cyclin-dependent kinase-2 ( CDK2 ) CDK2 were detec-ted using Q-PCR analysis. Results The proliferation of B16 F10 cells treated with Licochalcone A was effec-tively inhibited in a concentration and time-dependent manner. A clear morphological change was observed with the increasing concentration of Licochalcone A in B16F10 cells, the dendrite-like projections changed to the narrowing ball shape, which was associated with the increasing melanin level. The low concentration of Licochalcone A could induce B16F10 differentiation, and the high concentration of Licochalcone A could in-duce B16F10 apoptosis, which was accompanied with the increasing G1 phase in cell cycle. The mRNA ex-pression levels of Bcl-2 /Bax, CyclinE2 and CDK2 were markedly reduced. Conclusion Licochalcone A can effectively inhibit the proliferation of B16 F10 cells, induced cell cycle arrest at G1 phase, and fur-ther induced differentiation and apoptosis.