Objective To explore the risk factors of the recurrence of ischemic stroke and to supply theoretical basis for secondary prevention.Methods 612 patients with ischemic stroke were enrolled in the study and they were followed-up for 2 years to record the stroke recurrence.According to whether the recurrent stroke occurred,all the patients were divided into the recurrent group and the non-recurrent group.Logistic regression model was used to analyze the risk factors.Results Of 612 patients,90 patients suffered from recurrent stroke and the recurrence rate after 2 years was 14.7％.In the recurrent group,age,smoking,hypertension,diabetes,fibrillation atrial history and homocysteine level were significantly higher than those in non-recurrent group (P ＜ 0.05),compliance of anti-platelet drugs was significantly lower than that in non-recurrent group (P ＜ 0.01).Multivariate analysis suggested that age,smoking,hypertension,diabetes,atrial fibrillation history,homocysteine level and compliance of anti-platelet drugs were associated with recurrence of ischemic stroke (OR value =11.14,47.38,53.11,111.12,53.11,40.98,90.12,all P ＜ 0.05).Conclusion Age,smoking,hypertension,diabetes,atrial fibrillation history,homocysteine level and compliance of anti-platelet drugs are the independent risk factors of recurrent stroke.To enhance the interference of these risk factors are helpful for preventing the recurrence of stroke.

Fetal Blood ; Humans ; Infant, Newborn ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; blood ; congenital ; diagnosis

Background Refractive lens exchange is one of corrective surgeries for high myopic eyes and is concerned in clinic recently. Its clinical value is worthy of consideration. Objective This study was to investigate the efficacy and safety of refractive lens exchange for high myopic eyes. Methods Phacoemulsification and intraocular lens implantation was performed on 124 eyes of 65 patients with high myopia. The mean age of these patients was 51. 4±8. 57 years old,and the preoperative corrected visual acuity was 4. 11±0. 51. The mean spherical equivalent was ( -20. 17±5. 34) D. The mean axial length was (31. 33±2. 08) mm and intraocular lens power 2. 88 D. The follow-up time was 31 months. The uncorrective visual acuity, best corrective visual acuity, the spherical equivalent lens and complications were observed after operation. Written informed consent was obtained prior to the surgery. Results The uncorrective visual acuity improved after the operation in all the eyes. The uncorrective visual acuity was ≥0.5 in 15 eyes(12% ). The best corrected visual acuity improved in 114 eyes (92% ) following the surgery and that of 64 eyes (51. 6% ) was 2s 0. 5. The mean postoperative spherical equivalent was ( -2. 57 ± 1. 76 ) D in the entire follow-up duration. Posterior capsular opacification was found in 58 eyes (46. 7% ) and received laser capsulotomy. Retinal detachment occurred in 4 eyes throughout the follow-up period. Conclusion Refractive lens exchange is an effective and safe method for high myopic eyes. But preoperative fundus examination and long-term postoperative follow-up should be carried out to prevent the complications.

Objective To investigate the clinical characteristics and risk factors for healthcare-associated infection (HAI)in patients with severe chronic hepatitis B (CHB),and provide theoretical basis for preventing and controlling HAI.Methods Retrospective survey was used to investigate the occurrence of HAI in hospitalized patients with severe CHB in a hospital between January 2012 and January 2015,risk factors for HAI were analyzed. Results A total of 126 patients with severe CHB were investigated,49 patients developed 106 times of HAI, incidence of HAI was 38.89%.The main HAI site was respiratory tract (n=47,44.34%),the next was abdominal cavity (n=34,32.08%).A total of 76 isolates of pathogens were detected,gram-negative bacteria,gram-positive bacteria,and fungi accounted for 53.95%(n =41 ),43.42%(n =33),and 2.63%(n =2)respectively.Risk factors for HAI in patients with severe CHB were patients ’ age ≥ 60 years, length of hospital stay ≥ 30 days, complications,invasive operation,serum albumin < 35 g/L,and white blood cell count (WBC)< 4 × 109/L. Conclusion Incidence of HAI in patients with severe CHB is high,the majority are respiratory tract and abdominal cavity infection,risk factors are old age,long length of hospital stay,invasive operation,hypoalbuminemia,and low WBC count.

0.05).Immunohistochemical staining for intratumoral aromatase in endometrial cancer was positive,21(42 %)in stromal cells.The expression of P450 aromatase in stromal cells correlated positively with advanced surgical stage and histologic grade,indepedent on muscular invasion and lymph node metastasis.Conclusion Aromatase P450 play an important function in establishment and devel- opment of the endometrioid endometrial cancer.The expression of P450 aromatase in intratumoral stromal cells correlated positively with the development and prognosis of endometrioid endometrial cancer.

Carrier State ; virology ; Female ; Hepatitis B ; complications ; Humans ; Lymphoma, Large B-Cell, Diffuse ; virology ; Male ; Middle Aged

Patients with multiple myeloma (MM) have increased constantly in recent years, but treatment for patients with MM is currently unsatisfactory and it is necessary to develop new complementary therapies. Dendritic cells (DCs) are specialized antigen-presenting cells capable of initiating and regulating immune responses. Vaccination with tumor antigen-pulsed DCs has shown to be safe and possesses therapeutic effect against many tumors. In this review, the various types of MM-associated antigens and clinical trials on DC-based immunotherapy in MM are summarized, the development of DC immunotherapy for MM patients in future trials is discussed.
Cancer Vaccines ; immunology ; therapeutic use ; Dendritic Cells ; immunology ; Humans ; Immunotherapy ; Multiple Myeloma ; therapy

Objective In order to study the difference of depression-like behaviours among three widelyused stress models in rats.Methods The new-born Spragne-Dawley rats were randomly divided into maternal deprivation(MD) group(n=27),chronic mild stress(CMS) group (n=29),dual stress(DS) group ( n=31 ) and control (C) group ( n =30) on postnatal day 1.MD rats only received maternal deprivation.CMS rats only received chronic mild stress when 10 weeks old.DS rats received both maternal deprivation and chronic mild stress.Control rats received no experimental handling.Behavior tests including forced swimming test and sucrose consumption which were carried out to evaluate rats' depression-like behaviors in the thirteenth weeks.The extend time of floating and sucrose preference ratio should be recorded in the forced swimming test and sucrose consumption test respectively to reflect the behavior of helplessness and anhedonia of rats.Results In the forced swimming test,the extend floating time of MD group( 119.30 ± 65.56) s,CMS group ( 145.00 ± 80.24) s and DS group ( 170.03 ±61.75 )s were longer than the control group(81.14 ± 52.40)s (F =11.53,P ＜ 0.01 ).In the sucrose consumption test,the MD group(0.32 ± 0.22) had a low sucrose consumption.The comparison of the MD group and CMS group (0.43 ± 0.28 ) to the control group (0.54 ± 0.28 ) had significant differences (F =4.33,P ＜ 0.01 ).In these four groups,no sexual difference was found in the forced swimming test and sucrose consumption test ( all P ＞ 0.05 ).Conclusion The results suggest that MD,CMS and DS may induce some kind of depression-like behaviors in rodents such as anhedonia or the behavior of helplessness and the depression-like behaviors induced by different stresses are similar in male and female individuals.

Objective To study the effect of dual stress on the behaviors and the expression of hippocampal let-7a and serotonin receptor 4(HTR4) in rats.Methods Newborn SD rats were randomly divided into dual stress group (DS,n=6) and control group (C,n=6).The DS rats were deprived of the mother care 6 hours per day from postnatal day 1 to 14 and then were exposed to chronic mild stress for 21 days from 10 weeks old,while the rats from C group received no experimental handle but husbandry care.Open field test,forced swimmiug test and sucrose consumption test were conducted to evaluate rats' depression-like behaviors at the age of thirteen weeks.The let-7a level in hippocampus was detected by real-time Polymerase Chain Reaction and the HTR4 protein level was measured by Western Blotting.Results In the open filed test,the rearing times of DS rats was shorter than that of C group((7.50±2.35) vs (19.00±5.73),P＜0.05).In the forced swimming test,the floating time of DS rats was longer than that of C group ((110.17 ± 1.72)s vs (70.33± 1.16)s,P＜ 0.05).In the sucrose c onsumption test,DS rats consumed less sucrose than rats from C group did((0.80±0.73) vs (0.52±0.26),P＜ 0.05).The protein level of hippocampal HTR-4 in DS group was lower than that of C group((1.44±0.38) vs (0.46±0.29),P＜0.01).The let-7a level in DS group was higher than that of C group((0.04±0.01) vs (1.58±0.27),P＜0.01).The Pearson correlation analysis revealed that the sucrose preference rate of rats were negatively and positively correlated with hippocampal let-7a and HTR4 level respectively(r=-0.653,P＜0.05; r=0.774,P＜0.01),and hippocampal let-7a level showed negative association with HTR4 protein level (r=-0.803,P＜0.01).Conclusion Dual stress can induce the depressive behaviors of rats and affect the expression of let-7a and HTR4 in hippocampus.Hippocampal HTR4 and let-7a might be involved in determining individual ability to experience pleasure in rats;and hippocampal let-7a may be involved in the regulation of HTR4 gene expression in rats.

Objective To investigate the correlation between dose volume histogram(DVH)of tumor targets and organs at risk(OAR)at CT-image based 192Ir brachytherapy and effects and complications for patients with locally advanced cervical cancer. Methods Ten patients with FIGO stage ⅢB cervical cancer received CT image-based 192Ir intracavitary brachytherapy after 54 Gy of three-dimentional four-field pelvic external beam radiotherapy and concurrent weekly cisplatin chemotherapy. Before each brachytherapy,CT images were acquired with applicators in place. Gross tumor volume(GTV), clinical target volume (CTV)and OAR were contoured and inverse treatment planning was designed and optimized by using PLATO treatment planning system. Conventional two-dimensional plans were also designed for comparison.The total intracavitary brachytherapy dose was 30 -42 Gy in 5 -7 fractions. The patients were followed, and the local control and complications were analyzed. The biologically equivalent dose(BED)and biologically equivalent dose in 2 Gy fractions(BED2)for GTV, CTV and OAR were calculated. The minimum dose in the most irradiated tissue volume 2 cm3(D2 cm3)adjacent to the applicator of the sigmoid colon, rectum,bladder and small bowel was determined from the DVH. Results The 1-year local pelvic control rate was 90% and grade 1-2 late complication of sigmoid colon and rectum was 50%. No grade 3 or more complications developed. On CT-image based planning, the BED and BED2 to 90% of the CTV(D90)were 95.50 Gy ± 7. 81 Gy and 79. 73 Gy ± 6. 57 Gy. The BED and BED2 to 90% of the GTV(D90)were 101.86 Gy ± 7.27 Gy and 84. 95 Gy ± 6. 1 Gy. The volume enclosed by 90% of prescribed dose(V90)for GTV and CTV were 92% ±4% and 87% ±7% respectively. The D2cm3 for rectum and sigmoid colon were 74. 97 Gy ±1.64 Gy and 67. 93 Gy ± 4. 30 Gy(EQD2, α/β = 3). Comparing with 2D brachytherapy plans , CT - image based planning has improved D90 and V90 for GTV and CTV with similar dose at point A and rectum reference point. Conclusions Computer tomography-image based 192Ir brachytherapy has resulted in the better dose distribution to the tumor targets with excellent tumor control and acceptable toxicity.