MicroRNAs (miRNAs) are endogenous,small,non-coding,single-stranded RNA molecules,which can specifically bind to the 3'-terminal non-coding regions of mRNA chain to induce posttranscriptional gene silencing effect and regulate the expression of mRNA.Recent studies have shown that miRNAs have extensively involved in various pathophysiological processes,including atherosclerosis,cerebral ischemia and hypoxia tolerance,cerebral edema,neuronal cell death,suggesting miRNAs may be used as biological markers of the early diagnosis of ischemic stroke and the biological target of early treatment.This article reviews the biological characteristics of miRNAs,its relationship with ischemic stroke and mechanism of action in order to provide new evidence and ideas for miRNAs in the diagnosis and treatment of ischemic stroke.

Psychotherapy is a sort of arts based on science following the general principles of social science and natural science.Meanwhile,the content of psychotherapy,the process of the practice,and the relationship be-tween the help-seekers and the helpers reflect substantial humanistic connotation and are bound up with cultural and subcultural transmission and reality context.This paper is a commentary on the article written by an Indonesian fel-low T.Citraningtyas discussing the mother's role in the matriarchal society and its modern meanings.We discussed that the phenomenon of being cultural extinctionalso presents in China.Although the main stream in Chinese cul-ture is still patriarchic familism,the remainder of matriarchal society still exists in the basic emotional models of parent-child relationship.The deprivation and frustration related with filial piety and kinship may cause the conse-quence of cultural extinctionin the individual level.Referring the theory of Wen-Shing Tseng on the mechanisms of the cultural influence on psychopathology,from the perspective of understanding psychology,we emphasized the importance of cultural empathy and recommended the systemic clinical thinking way of empathic considering and contextualizing.Last but not least,we discussed the second case of the overseas migrant workers and their left-at-home childrenin this article within Chinese context.Moreover,besides the 61 million left-at-home children in rural areas,there are a large amount of substitute-raised children by their grandparents who might be also in the risk of being impaired physically and psychologically.This problematic phenomenon may relate to the living stress and the cultural encouragement as well.By providing a critique discussion with the related theories of correlation of the in-secure attachment with psychological disorders in childhood and adulthood,this commentary encouraged humble learning from our Indonesian fellows and appealed for greater appreciation of separate mothers and their children a-mong Chinese clinicians.

Objective To investigate clinical value of povidone -iodine disinfection for prevention of postpartum endometritis and abdominal incision infection in cesarean, to provide a reference for clinical treatment. Methods 160 cases of puerpera women were selected, all of them underwent uterine segment cesarean section. According to the digital table,they were divided into control group and observation group,80 cases in each group.In the observation group previous cesarean group remained untreated 30min before cesarean vaginal experiments 0.4%povidone-iodine for disinfection.The maternal postpartum endometritis incidence,abdominal incision infection rate, visual analogue scale,leukocyte index WBC,erythrocyte sedimentation rate index ( ESR) ,C-reactive protein ( CRP) were compared in the two groups.Results There were 32 cases of postoperative endometritis,12 cases (15.00%) occurred in the observation group, 20 cases ( 25.00%) occurred in the control group, the overall incidence of endometritis between the two groups had statistically significant difference (χ2 =5.945,P=0.025);endometritis 5cases (17.86%) premature rupture of membranes occurred in the observation group,the control group had 10 cases (31.25%),the difference was statistically significant (χ2 =6.565,P=0.009).Postpartum WBC,ESR,CRP in the observation group were significantly lower compared to the control group,the differences were statistically significant (t=5.045,P=0.007;t=7.945,P=0.001;t=8.676,P=0.000).In the observation group,postoperative abdominal incision infection rate was 3.75%,compared with the control group,there was no significant difference (χ2 =1.021, P=0.124).The VAS score of the observation group was (3.94 ±0.74),which was significantly lower than (6.25 ± 1.05) of the control group,the difference was statistically significant (t=6.331,P=0.010).Conclusion Previous cesarean vaginal povidone-iodine disinfection is effective in preventing postpartum endometritis,but can't help to low abdominal incision infection or improve wound healing.

Objective To review the research progress of functional magnetic resonance imaging in Self -referential Processing (SRP) of patients with Depression based on the papers published from 2004 to 2014 at abroad and domestic,with an attempted to explore the neuromechanism of depression and to provide reference for treatment of depression.Methods Major online database including PubMed,EBSCO,Ovid,Medline,Clinicalkey,Wan Fang,CNKI,Cqvip,and CBM date bases were searched in Octobor 2014.The key words we used are depressionor depressive disorder,Self-referential Processing or rumination orautobiographical memory or Self-face recognition, Functional Magnetic Resonance Inaging(tMRI)and so on.Results 28 studies were adopted in this study,findings from the study showed:①rumination,autobiographical memory (AM) retrieval,and self-face recognition(SFR) are SRP paradigms,the cortical midline structures (CMS)and default mode network (DMN) were involved in the SRP of depression.②Both medication and cognitive behavioral therapy could reduce the abnormal activation of CMS and DMN in patients with depression.Conclusioins ①Both CMS and DMN may be the neuromechanism of SRP of depression.②Both CMS and DMN may be used as objective indicators to evaluate the treatment response in patients with depression.

Psychotherapy is a kind of medical treatments based on interpersonal interaction that is highly context-dependent.While psychotherapy is an important treatment in clinical work and its effectness has been confirmed with wide practical application,its adverse effects has received little attention.This article will review the literaturesand discuss the possible side effects and relatedfactors of psychotherapy.

Object:To describe Chinese systemic family therapy process through analysis on the therapeutic experience of 4 Chinese systemic family therapists.Method:Four well-certificated systemic family therapists in China were selected as research sample.A semi-structure interview under the guidance of a self-compiled interview outline was made with every therapist.Transferred raw data was analyzed with deductive thematic analysis following 5 steps:coding,themes searching,themes reviewing,themes defining and naming,themes merging and revision.Results:(1)Respectively 102,93,97,and 95 codes were got from each piece of interview raw data,which generated 57,52,50,and 33 primary themes.Five main themes emerged from the merging of the primary themes.(2)Themes and sub-themes constructed the theoretical hypothesis on the change process of Chinese systemic family therapy.Conclusion:There is an experiential manipulating model in Chinese systemic family therapy process under the guidance of systemic therapeutic philosophy,which is integrated with some therapeutic technique from other psychotherapy models.This model can be studied with deductive thematic analysis.

OBJECTIVE: To discuss the function recovery and treatment effect of extended supraglottic orizontal-partial laryngectomy in the treatment of advanced laryngeal carcinoma and vallecula carcinoma. METHOD: Forty-four patients who received extended supraglottic orizontal partial laryngectomy were followed up on the survival, breath function, pronunciation and swallowing function. RESULT: The 2-year, 3-year survival rates of this group were 72.7% and 71.4%, respectively. There were no recurrence cases in this group. All cases of death were due to cervical lymph node metastasis or recurrent cervical lymph node metastasis after cervical lymph node dissection. The extractive rate of tracheostomy tube was 97.7%. Forty-two patients own good pronunciations. Two patients who received partial arytenoid cartilage resection own weaker pronunciations. After practising, all the patients can eat without the nasal feeding tube. CONCLUSION Extended supraglottic orizontalpartial laryngectomy give complete resection of the primary lesion. Patients who received extended supraglottic orizontalpartial laryngectomy have good breath, swallowing and pronunciation function.
Arytenoid Cartilage ; surgery ; Epiglottis ; pathology ; Humans ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; methods ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Neck Dissection ; Neoplasm Recurrence, Local ; Survival Rate ; Tracheostomy

[ Abstract] Vitamin D is a steroid derivative. It has the effect of regulating calcium -phosphorus metabolism. With the development of medicine, the effects of vitamin D in other respects, such as regulation of blood pressure, blood glucose, nerve protection, and immunity have received more and more attention. A lot of research show s that the level of vitamin D is closely associated w ith the onset and outcome of ischemic stroke. In addition, some researchers explored the relationship betw een vitamin D and stroke from the genetic perspective. How ever, the existing research results are not consistent. The link betw een vitamin D and ischemic stroke is not clear. This article review s the correlation studies of the relationship among vitamin D and vitamin D receptor gene polymorphism, the onset of ischemic stroke, outcomes and risk factors in recent years.

Objective To explore and analyze the clinical characteristics and treatment strategy of severe complications caused by childrenˊs foreign bodies in esophagus.Methods The clinical data of 71 ca-ses of esophageal foreign bodies in children with ENT admitted to our hospital were analyzed retrospectively from Jan 2009 to Dec 2014.Results Esophageal foreign bodies in children with 71 cases,of whom 42 males and 29 females;aged from 2 months to 14 years old,highest incidence of 1 to 3 years old.Foreign bodies in esophagus lasted 2 h to 15 d.Ingestion of metallic foreign bodies in 43 cases,12 cases of plant-based foreign body,9 cases of animal foreign bodies,7 cases of chemical foreign bodies.Foreign bodies located in the upper esophageal was 51 cases,9 cases of the middle and 7 cases of the under section,3 cases of esophageal en-trance,1 case of falling into the stomach.In children with 71 cases,9 cases had complications,69 cases were cured,improved in two cases,and the cure rate was 97.2%,the average healing time was 4 d.Conclusion Early diagnosis and treatment,avoid esophageal perforation are the key to avoid the emergence of the compli-cations in children with esophageal foreign bodies,timely and accurate treatment of esophageal perforation and other complications are the effective measures to improve the cure rate.

Objective To observe spinal cord neurotoxicity injury induced by mixture of bupiv-acaine-lidocaine compared with mixture of ropivacaine-lidocaine.Methods Forty-eight SD rats,weig-hing 250-300 g,were randomly allocated into 6 groups (n =8):NS group (group N),1.065% bupi-vacaine group (group B),1.5% ropivacaine group (group R),5% lidocaine group (group L),mix-ture group of 5% lidocaine and 1.065% bupivacaine (group LB)or mixture group of 5% lidocaine and 1.5% ropivacaine (group LR).The rats were given intrathecal cathetering after anesthesia.Tail-flick test (TFL)and the mechanical withdrawal threshold (MWT)of rats in each group were meas-ured 1 d before operation (the baseline values)and 1 d,2 d,3 d and 4 d after intrathecal administra-tion.The movement of rat double hind legs were observed at 10 min,30 min,1 h,2 h,3 h and 4 h and 1 d,2 d,3 d and 4 d after intrathecal administration,and the changes of recovery time of lower limbs were recorded.The rats were sacrificed 4 days postoperatively followed by observation on the indexes mentioned above,and spinal cord and cauda equine were taken for staining.Then the patho-logical changes of spinal cord were observed under light and electron microscope,and caudal nerve was rated for pathological injury.Results TFLs of group LR were obviously longer than those of group N,L,B,R,LB 1-4 d after intrathecal administration (P <0.05);Compared with the group N,there was no statistical difference of TFL in the group L,B,R,LB;there was no statistically sig-nificant difference of rat MWT in comparison among the six groups at each time point.There was no statistically significant difference among six groups in recovery time of movement after intrathecal ad-ministration;and the pathological injury scores were obviously higher in group LR than that of group N,L,B,R,LB (P <0.05),respectively.Compared with the group N,there was no statistical difference of the pathological injury scores in the group L,B,R and LB,respectively.Under light microscopy observa-tion:the structure of spinal cord was normal in group N,B and R.In group L and LB,there was focal ede-ma of neurofibers.In group LR,there was edema of neurofibers or demyelination,accompanied with white mass edema in posterior horn of spinal cord.Under electron microscope,only slight edema of medullated fi-bers and unmyelinated nerve fiber was seen in group B and group R;part of the medullated fibers appeared sparse focal lamellar structure in group L and group LB;swelling and degeneration of neuraxon,separation of neuraxon from myelin sheath and disappearance of unmyelinated nerve fiber were seen in group LR. Conclusion The mixture of 5% lidocaine with 1.5% ropivacaine is more neurotoxic to spinal cord than the single administration of lidocaine or ropivacaine,moreover it is not obviously changed compared with the mixture of lidocaine with equipotent bupivacaine.