Objective To establish Cox proportional hazards regression model and individual prognosis index (PI) equation for the 3-year recurrence of ischemic stroke and to verify their external reality according to their propective application.Methods A total of 1058 first-ever ischemic stroke patients admitted to our hospital were followed up from 2013-01-01 to 2013-12-31,during which the recurrence of ischemic stroke was recorded.Cox proportional hazards regression model and PI equation for the 3-year recurrence of ischemic stroke were established.Six hundred and sixteen first-ever ischemic stroke patients admitted to our hospital were followed up from 2016-01-01 to 2016-12-31.The external reality of Cox proportional hazards regression model for the 3-year recurrence of ischemic stroke was verified according to the established PI equation.Results Of the patients who were followed up in 2013,ischemic stroke reoccurred in 184.Cox proportional hazards regression model analysis showed that age,heart disease,hypertension,diabetes mellitus and TC were the independent risk factors for the recurrence of ischemic stroke.Of the patients who were followed up in 2016,ischemic stroke reoccurred in 114.The sensitivity,specificity and accuracy of PI equation in predicting the recurrence of ischemic stroke were 71.9％,76.9％ and 80.0％ respectively.Conclusion Establishment of PI equation for the 3-year recurrence of ischemic stroke can predict the recurrence of ischemic stroke.

Objective To investigate the potential of inflammatory markers for short-term prognosis of acute cerebral infarction.Methods A total of 272 consecutive patients with acute cerebral infarction were divided into a high hs-CRP group (hs-CRP level ＞3 mg/L) and a low hs-CRP group (hs-CRP level ≤3 mg/L),and their general information and medical history were collected.The Trial of Org 10172 in Acute Stroke Treatment (TOAST) stroke subtype classification was conducted and scores of the National Institutes of Health Stroke Scale (NIHSS),the Barthel index (BI) and the modified Rankin scale (mRS) were collected after admission.White blood cell count,blood glucose,blood homocysteine (Hcy) and C-reactive protein were measured within 24 hours following admission.Multivariate Logistic regression analysis was performed to identify independent risk factors for short-term prognosis of acute cerebral infarction.Results Between the high hs-CRP group and the low hs-CRP group,there were significant differences in the incidences of atrial fibrillation history,cardiogenic embolism of TOAST,blood homocysteine,blood glucose,white blood cell count,NIHSS,BI and mRS score 1,7,14 days after admission (P＜0.05 for all).The hs-CRP level (OR=0.876,P＜0.001,95％ CI:0.817-0.917),white blood cell count (OR=1.137,P=0.029,95％ CI:1.013-1.275),lipid metabolism disorders (OR=2.863,P＜0.001,95％ CI:1.561-5.250),and BI score (OR=1.038,P=0.047,95％ CI:1.001-1.077) 1 day after stroke were independent risk factors for short-term prognosis of acute cerebral infarction.Conclusions Increased levels of the inflammatory marker hs-CRP and elevated white blood cell count may be independent risk factors for short-term prognosis of acute cerebral infarction.

Objective To establish the prediction model for ischemic stroke recurrence. Methods Consecutive patients with ischemic stroke from January 1st, 2008 to December 31st, 2009 were followed up until June 30th, 2010. The rate of recurrence were described with Kaplan-Meier curve, and the factors associated with recurrence were analyzed with monovariant and multivariate Cox's proportional hazard regression. Results There were 79 cases relapsed during the follow-up. The independent risk factors associated with recurrence were age(X),history of hypertension (X2), family stroke history (X3), total cholesterol (X4), disease progression (X5), total scores of Essen stroke risk score (X6). The personal prognosis index (PI) for predicting recurrence was as: PI=0.025X1+0.681X2+0.973X3+0.395X4+0.636X5+0.283X6. As the receiver operating characteristic (ROC) curve showed, when the cut-off point of PI was 2.289, the sensitivity of the model was 0.731 and specificity was 0.795. Conclusion The model for predicting recurrence of ischemic stroke was established.

Objective:To investigate the effects of total flavonoids from Cycas Revolute on expression of vascular endothelial growth factor (VEGF),basic fibroblast growth factor (bFGF),Hypoxia inducible factor-1α (HIF-1α) and nuclear factor-κB(NF-κB) in model mice of Lewis lung cancer.Methods: The expressions of VEGF,bFGF,HIF-1α and NF-κB in tumor tissues were detected by immunohistochemistry and Western blot.The expression of VEGF,VEGF and NF-κB in tumor tissues were detected by fluorescent quantitative PCR.BFGF,HIF-1α and NF-κB mRNA were detected by immunohistochemistry.Results: The results of immunohis-tochemistry,Western blot and Real-time PCR showed that the results were basically the same,compared with model group,the expression of VEGF,bFGF,HIF-1α,NF-κB mRNA and the expression of VEGF,bFGF,HIF-1α and NF-κB were decreased,the difference was highly significant (P<0.05).Conclusion: The mechanism of total flavonoids from Cycas Revolute in the treatment of lung cancer may be through inhibition of the expression of VEGF,bFGF,HIF-1α,NF-κB in invasion and metastasis,and further inhibit the expression of VEGF,bFGF,HIF-1α and NF-κB in invasion and metastasis-related proteins,thus play a role of anti-lung cancer invasion and metastasis.

Objective To investigate the association between the HLA-DRB1 gene polymorphisms and susceptibility of pulmonary tuberculosis (TB) in patients with type 2 diabetes mellitus in North China. Methods A 1∶1 matched case-control study was adopted. Polymerase chain reaction-sequence-specific primers techniques (PCR-SSP) and restriction fragment length polymorphism (RFLP) was used to type polymorphisms (DR15, DR16, DR1, DR11). Information on environmental-related risk factors and pathological changes of tuberculosis was collected using a pre-tested standard questionnaire. Variance analysis, Chi-square, univariate and multivariate conditional Logistic analysis were conducted with SPSS 12.0 for Window. Results A sample of 124 pairs of cases and controls was studied. Univariate analysis demonstrated that DR15 mutant increased the risk of susceptibility of pulmonary tuberculosis (OR＝2.461, 95%CI: 1.363~4.444, P=0.002),and it would further increased if DR16 mutant occurred together (OR=4.904, 95%CI: 1.554~15.476). In multivariate analysis, DR15 mutant also associated with susceptibility of pulmonary tuberculosis (OR=2.996, 95%CI: 1.51~5.945). Conclusion Polymorphism of DR15 genotype might be a susceptible genotype of TB patients with type 2 diabetes mellitus in North China.

Objective To investigate the risk factors and establish the Cox's regression model and the personal prognosis index for the recurrence of ischemic stroke in 3-year follow-up.methods 1058 patients were retrospectively reviewed consecutively diagnosed with ischemic stroke admitted to the Neurology Department of the Hebei united University Affiliated Hospital from January 1,2013 to December 31,2013.Cases were followed up since the onset of ischemic stroke.The follow-up was finished in January 1,2016.Kaplan-Meier methods were used for recurrence rate description.Monovariant and multivariate Cox's proportional hazard regression model were used to analyze risk factors associated with recurrence.Thus,a recurrence model was set up.Result sDuring the period of follow-up,184 cases relapsed.The 1-year recurrence rate was 29.9 person-year,2-year recurrence rate was 46.6 person-year,3-year recurrence rate was 52.7 person-year.Monovariant and multivariant Cox's proportional hazard regression model showed that the independent risk factors associated with recurrence were age(X1)(RR=1.303;95%CI:1.019~1.666)history of heart disease(X2)(RR=1.788;95%CI:1.127~2.836),hypertension(X3)(RR=1.897;95%CI:1.097~3.280),diabetes(X4)(RR=1.674;95%CI:1.015~2.760),total cholesterol(X5)(RR=2.136;95%CI:1.396~3.266).The personal prognosis index(PI)of recurrence model was as the following: PI=0.265X1+0.581X2+0.640X3+0.515X4+0.759X5.Conclusion sAge,history of heart disease,hypertension,disease progression,and total cholesterol are the independent risk factors associated with recurrence of ischemic stroke.The recurrence model and the personal prognosis index equation are successful constructed.

Objective Observed the characteristics and influence factors of blood pressure circadian rhythm in continuous ambulatory peritoneal dialysis patients.To investigate the effect of residual renal function and cardiac function.Methods Prospectively collected 120 cases of continuous ambulatory peritoneal dialysis from June 2016 to March 2017 in Tangshan renal medicine dialysis centers,who combined with hypertension were treated with peritoneal dialysis for more than 3 months.According to the dynamic monitoring blood pressure circadian rhythm of blood pressure,120 cases were divided into the normal rhythm of blood pressure and the abnormal blood pressure rhythm group.Collected medical history;Tested related test index respectively;Cardiac ultrasound.According to the formula to calculate residual renal function,left ventricular mass index,Eingabe/Ausgabe,Ejection Fraction.Univariate and multivariate unconditional logistic regression analysis was used to analyze the risk factors of circadian rhythm of blood pressure.Stepwise multiple linear regression analysis was used to analyze the risk factors of residual renal function and cardiac function.Results CAPD patients with normal blood pressure rhythm in 14 cases(11.7％),abnormal blood pressure rhythm in 106 cases(88.3％),Among them,non dipper blood pressure accounted for 75 cases(62.5％).Single factor and multiple factors unconditioned logistic regression analysis revealed that after the comparison of gender and age,Risk factors for abnormal circadian rhythm of blood pressure were:UA(OR=1.197,95％CI:1.099-1.441),CRP(OR=1.170,95％CI:1.061-1.331),RRF(OR=1.389,95％CI:1.160-1.779).Using stepwise multiple linear regression analysis of dangerous factors affecting residual renal function and cardiac function,we found:Residual renal function negatively correlated with left ventricular myocardial mass index,systolic blood pressure drops at night rate,and ultrafiltration volume;LVMI (cardiac function) Positively correlated with 24 h average systolic blood pressure,and negatively correlated with systolic blood pressure drop ratio and residual renal function at night.Abnormal circadian rhythm of blood pressure may lead to the decline of residual renal function and cardiac function.Conclusions UA,CRP and RRF may affect the CAPD patients blood pressure circadian rhythm.At the same time,abnormal circadian rhythm of blood pressure may lead to the decline of residual renal function and cardiac function.Therefore,pay attention to the monitoring and control of ABPM,can better protect the residual renal function and improve cardiac function,so as to prolong and improve the survival time and quality of life of patients with CAPD.

Objective:To elucidate the effects of andrographolide (AG) against acute pancreatitis (AP)-associated kidney injury and explore the potential mechanism.Methods:Thirty-two C57BL/6 mice were divided into control group, AP group, AG treatment group and AG control group. In AP group, AP model was established by intraperitoneal injection of L-arginine and LPS. AG treatment group was intravenously injected with AG 8 h before the model establishment. The control group was intraperitoneally injected with an equal volume of normal saline. The AG control group was intravenously injected with AG 8 h before the intraperitoneal administration of normal saline. Venous blood of inner canthus in mice was collected, and the levels of amylase, creatinine (Scr) and urea nitrogen (BUN) in serum were detected. Pancreatic and double kidney tissues were also collected. Pancreatic myeloperoxidase (MPO) activity was detected by colorimetry. Histopathological changes of pancreas and kidneys were observed under light microscope and pathological score was evaluated. Ultra-high-performance liquid chromatography coupled with quadrupole-time-of-flight mass spectrometry was used to analyze metabonomics in renal tissue.Results:Compared to the control group, the levels of amylase, Scr and BUN in serum and pancreatic MPO activity in the AP group were obviously increased [(13.78±6.01)U/L to (0.23±0.04)U/L, (79.81±24.03)μmol/L to (9.02±2.87)μmol/L, (34.76±14.53)mmol/L to (8.52±2.55)mmol/L, (16.55±4.23)U/g pro to (2.32±0.55)U/g pro]; histopathologic scores of pancreas and kidney in the AP group were also increased (2.70±0.26 to 0.20±0.12, 3.00±0.35 to 0.30±0.12), and the differences were statistically significant (all P<0.05). The levels of amylase, Scr and BUN in serum and pancreatic MPO activity in the AG treatment group were decreased than the AP group [(8.26±3.87)U/L to (13.78±6.01)U/L, (55.42±17.25)μmol/L to (79.81±24.03)μmol/L, (20.66±10.30)mmol/L to (34.76±14.53)mmol/L, (11.51±3.29)U/g pro to (16.55±4.23)U/g pro]; histopathologic scores of pancreas and kidney were also decreased in the AG treatment group than those in the AP group (1.40±0.19 to 2.70±0.26、1.70±0.26 to 3.00±0.35), and the differences were statistically significant (all P<0.05). Metabonomics analysis detected a total of 31 metabolites. Most of metabolites were involved in amino acid and fatty acid metabolism, and a few of them were also involved in glucose, nucleotide, vitamin and bile acid metabolism. Conclusions:AG exerts protective effects on AP-associated kidney injury by altering the levels of multiple metabolites.

Objective To evaluate the predictive value of eight scoring systems (Acute Physiology and Chronic Health Evaluation Ⅱ [APACHE Ⅱ] and APACHE Ⅲ,Improved Edinburgh-Scandinavian Scale [CSS],U.S.National Institutes of Health Stroke Scale [NIHSS],Activity of Daily Living [ADL] scale,Glasgow Coma Scale [GCS],Previous History of Disease Scale and Concomitant Disease Scale) in severity and outcomes of patients with acute ischemic stroke by using discriminant analysis,and to establish their mathematical models to predict the status of early death of stroke patients.Methods Three hundred and ninety-nine patients with acute ischemic stroke,admitted to our hospital from January 2008 to December 2012,were chosen in our study; these patients were tested with APACHE Ⅱ,APACHE Ⅲ,CSS,NIHSS,ADL,GCS,Previous History of Disease Scale and Concomitant Disease Scale within 24 h of admission.All of them were divided into two groups according to groups of survival (n=278) or death (n=121) one month after disease onset.Discriminant analysis was performed on all the data and the predictive values of these eight scales in the prognosis were analyzed.Results Patients from group of death had significantly higher scores of APACHE Ⅱ,APACHE Ⅲ,CSS,NIHSS and Concomitant Disease Scale,and statistically lower scores of ADL and GCS scores than those from group of survival (P＜0.05).Cluster analysis showed that CSS and NIHSS,and APACHE Ⅱ and APACHE Ⅲ,respectively,belong to clusters,which enjoyed higher predictive values than other scales.The areas under receiver operator characteristic (ROC) curves were 0.808,0.818,0.796 and 0.794 of APACHE Ⅱ,APACHE Ⅲ,CSS and NIHSS scores,respectively,enjoying good definition; Discriminant analysis was used to analyze the eight scoring systems and mathematical models were established to predict the outcomes of stroke patients,enjoying more than 80％ of coincidence rate.Conclusion APACHE Ⅱ,APACHE Ⅲ,CSS and NIHSS are superior to the other four score systems in evaluating severity of stroke patients,whose mathematical models,having more than 80％ of accuracy rate.

Objective To explore the influence of cucurbitacin E (CuE) on autophagy in human bladder cancer cell line T24 and further study its impacts on cell proliferation. Methods MTT assay was used to determine the proliferation inhibition capacity of CuE on T24 and western blot to check the impacts of CuE treatment on the expression of classic autophagy markers LC3A/B and p62. LC3 turnover assay and GFP-RFP-LC3 fluorescent assay were performed to determine autophagy flux. Western-blot was used to check the autophagy inhibition ability of 3-MA on CuE treatment and MTT assay and cell counting assay were used to check the influence of CuE-induced autophagy on cell proliferation with/without autophagy inhibition. Results CuE inhibited the proliferation of T24 and the IC50 in 24 h was about 0.75 μmol/L. CuE treatment increased the expression of LC3A/B Ⅱ and LC3A/B Ⅱ/Ⅰ ratio (P < 0.05) , but decreased the expression of p62 (P < 0.05) , indicating the induction of autophagy. Autophagy flux was induced because of positive LC3 turnover assay and the increase of yellow and red dots in GFP-RFP-LC3 fluorescent assay (P < 0.05). CuE-induced autophagy was inhibited by 3-MA (P < 0.05). With autophagy inhibition, CuE's proliferation suppression ability on T24 was attenuated (P <0.05). Conclusion CuE induces autophagy in bladder cancer cell line T24 and the induced autophagy positively contributes to the inhibitation of cell proliferation.