Objective To observe the correlation between degrees ofextracranial cerebral artery stenosis and pressure ratio across stenosis.Methods The patients with ≥ 50％ stenosis,admitted to our hospital and conformed by DSA from September 2015 to February 2017,were collected in this study.Collateral circulation compensation was assessed by DSA.The distal stenosis pressure (Pd) and stenosis pressure (Pa) were measured by pressure wire system;the pressure ratio across stenosis was recorded.Correlations of pressure ratio with stenosis rate and collateral circulation compensation were analyzed by Spearman correlation.Results Thirty one stenotic extracranial cerebral arteries (9 of carotid stenosis,12 of vertebral artery stenosis and 10 of subclavian artery stenosis) in 28 patients were collected.There were no perioperative complications or adverse events.The vascular stenosis rate showed negative correlation with pressure ratio (r=-0.615,P=0.000).In the subgroups,pressure gradient was negatively correlated with carotid artery stenosis rate (r=-0.948,P=-0.000),vertebral artery stenosis rate (r=-0.757,P=0.004) and subclavian artery stenosis (r=-0.759,P=0.011).Pressure ratio and collateral circulation compensation showed negative correlated relation (r=-0.475,P=0.007).Conclusion The pressure ratio across stenosis gets worse impairment with increase of severity of stenosis,and the collateral circulation influences the pressure ratio.

Objective To investigate the association between occupational stress and activity of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in patients with metabolic syndrome.Methods A case-control study was performed.According to inclusion and exclusion criteria,among the staff members of enterprises and public institutions aged 20～60 years who underwent physical examination in The Affiliated Hospital of Ningxia Medical University and The People's Hospital of Wuzhong from October 2011 to October 2012,622 patients with metabolic syndrome who did not have a blood relationship with each other were enrolled as case group,and 600 healthy staff members who also did not have a blood relationshipwith each otherwere enrolled as control group.Questionnaire investigation,chronic occupational stress investigation,physical examination,and laboratory tests were performed for all subjects.Results Compared with the control group,the case group had significantly higher serum levels and abnormal rates of AST and ALT (t=-4.338 and-5.485,x2=11.168 and 34.302,all P＜0.05).There were no significantdifferences in the serum level and abnormal rate of AST between the subgroups with different occupational stresses in both groups (F=2.192 and 2.567,x2=2.694 and 5.402,all P＞0.05),but there were significant differencesbetween the subgroups in all subjects (F=5.005,x2=6.398,all P＜0.05).There were no significant differences in the serum level and abnormal rate of ALT between thesubgroups with different occupational stresses in the case group,the control group,and all subjects (F=0.845,0.450,and 1.416,x2=2.564,1.344,and 3.147,all P＞0.05).The partial correlation analysis showed that the total score of occupational stress was positively correlated withthe serum level of AST (r=0.071,P＜0.05) and was not correlatcd with the serum level of ALT(r=-0.044,P＞0.05),and that the serum level of AST was positively correlated with that of ALT (r=0.736,P＜0.05).After the adjustment for age,sex,nationality,smoking,drinking,marital status,and degree of education,the total score of occupational stress was positively correlated with the serum level of AST (r=0.069,P＜0.05) and was not correlated with the serum level of ALT (r=-0.042,P＞0.05),and the serum level of AST was positively correlated with that of ALT(r=0.730,P＜0.05).The multiple linear regression analysis showed that the serum level of AST increased with the increasing occupational stress (b=0.131,P=0.013).Conclusion Occupational stress is associated with increased serum level of AST,and the serum level of AST increases with the increasing occupational stress.Increased risk of metabolic syndrome caused by occupational stress may be associated with the increased activity of AST caused by occupational stress.

Objective To investigate the association between occupational stress and activity of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in patients with metabolic syndrome.Methods A case-control study was performed.According to inclusion and exclusion criteria,among the staff members of enterprises and public institutions aged 20～60 years who underwent physical examination in The Affiliated Hospital of Ningxia Medical University and The People's Hospital of Wuzhong from October 2011 to October 2012,622 patients with metabolic syndrome who did not have a blood relationship with each other were enrolled as case group,and 600 healthy staff members who also did not have a blood relationshipwith each otherwere enrolled as control group.Questionnaire investigation,chronic occupational stress investigation,physical examination,and laboratory tests were performed for all subjects.Results Compared with the control group,the case group had significantly higher serum levels and abnormal rates of AST and ALT (t=-4.338 and-5.485,x2=11.168 and 34.302,all P＜0.05).There were no significantdifferences in the serum level and abnormal rate of AST between the subgroups with different occupational stresses in both groups (F=2.192 and 2.567,x2=2.694 and 5.402,all P＞0.05),but there were significant differencesbetween the subgroups in all subjects (F=5.005,x2=6.398,all P＜0.05).There were no significant differences in the serum level and abnormal rate of ALT between thesubgroups with different occupational stresses in the case group,the control group,and all subjects (F=0.845,0.450,and 1.416,x2=2.564,1.344,and 3.147,all P＞0.05).The partial correlation analysis showed that the total score of occupational stress was positively correlated withthe serum level of AST (r=0.071,P＜0.05) and was not correlatcd with the serum level of ALT(r=-0.044,P＞0.05),and that the serum level of AST was positively correlated with that of ALT (r=0.736,P＜0.05).After the adjustment for age,sex,nationality,smoking,drinking,marital status,and degree of education,the total score of occupational stress was positively correlated with the serum level of AST (r=0.069,P＜0.05) and was not correlated with the serum level of ALT (r=-0.042,P＞0.05),and the serum level of AST was positively correlated with that of ALT(r=0.730,P＜0.05).The multiple linear regression analysis showed that the serum level of AST increased with the increasing occupational stress (b=0.131,P=0.013).Conclusion Occupational stress is associated with increased serum level of AST,and the serum level of AST increases with the increasing occupational stress.Increased risk of metabolic syndrome caused by occupational stress may be associated with the increased activity of AST caused by occupational stress.

Objective:To systematically evaluate the efficacy and safety of obinutuzumab-based regimen versus rituximab-based regimen in treatment of B-cell non-Hodgkin lymphoma (B-NHL).Methods:The Cochrane clinical controlled trials database, PubMed, Embase, American Society of Hematology meeting proceedings, American Society of Clinical Oncology annual meeting proceedings and ClinicalTrails database were searched for studies on the use of regimens containing obinutuzumab or rituximab for the treatment of B-NHL. Patients were divided into obinutuzumab group and rituximab group according to their medication status. Review Manager 5.3 software was used to compare the efficacy and safety of the two groups.Results:A total of 7 randomized controlled trials were selected, including 4 235 patients (1 430 cases of follicular lymphoma, 2 102 cases of diffuse large B-cell lymphoma, and 703 cases of other B-NHL); 2 121 cases were in the obinutuzumab group and 2 114 cases were in the rituximab group. Among 4 162 patients who could be evaluated, the objective response rate (ORR) in the obinutuzumab group was higher than that in the rituximab group [75.1% (1 565/2 083) vs. 72.7% (1 512/2 079); OR = 1.19, 95% CI 1.01-1.41, P = 0.03]. Progression-free survival (PFS) in the obinutuzumab group was better than that in the rituximab group ( HR = 0.86, 95% CI 0.75-0.99, P = 0.03). Among 3 542 patients who could be evaluated for adverse reactions, the incidence of grade 3-4 adverse reactions in the otuzumab group was higher than that in the rituximab group [61.8% (1 098/ 1 776) vs. 54.2% (958/1 766); OR = 1.50, 95% CI 1.29-1.74, P < 0.001], the incidence of grade 3-4 infusive-related adverse reactions [7.5% (158/1 776) vs. 3.1% (65/1 766); OR = 2.56, 95% CI 1.91-3.45, P < 0.001] and neutropenia [34.1% (597/1 749) vs. 29.4% (511/1 738); OR = 1.27, 95% CI 1.09-1.47, P = 0.002] in the obinutuzumab group were higher than those in the rituximab group. Conclusions:The ORR and PFS of B-NHL patients treated with obinutuzumab-based regimen are better than those treated with rituximab-based regimen, but the influence of adverse reactions should be considered when selecting the regimen.