Objective:To investigate the application value of thromboelastography (TEG) in choosing antiplatelet drug for patients with cerebral arterial thrombosis.Methods: 100 new patients with cerebral arterial thrombosis, who received single antiplatelet therapy after received dual antiplatelet therapy (aspirin and clopidogrel) in acute stage (14d), were randomly divided into observation group (50cases)and control group (50cases). According to different method of choosing drug, patients of control group randomly were implemented different single antiplatelet drug, while patients of observation group received more sensitive antiplatelet drug based on TEG results. The follow-up observation about recurrent situation of cerebral arterial thrombosis for the two groups were carried out in further study.Results: In one year, the recurrence rate of cerebral arterial thrombosis of observation group (6%, 3/50) was significantly lower than that of control group (20%, 10/50) (x2=4.332,P<0.05). The differences of recurrence rate between different antiplatelet drug in intra-group were not statistically significant.Conclusion: TEG can efficiently evaluate the therapeutic effect of antiplatelet drug, and guide the selection for drug so as to reduce the recurrence rate of cerebral arterial thrombosis.

Objective To observe blood pressure variability (BPV) in elderly patients with primary hypertension and carotid artery intima-media thickness (IMT),and analyze the correlation between BPV and atherosclerosis.Methods One hundred and nine patients with primary hypertension were divided into non-carotid atherosclerosis group (IMT ＜ 1.0 mm,49 cases) and carotid atherosclerosis group (IMT ≥ 1.0mm,60 cases).24 h ambulatory blood pressure monitoring (ABPM) was used to measure the 24-hour mean systolic blood pressure (24 h SBP),24-hour mean diastolic pressure (24 h DBP) ; SBP of daytime (dSBP)and nighttime (nSBP) ; DBP of daytime (dDBP) and nighttime (nDBP).And their standard deviation and coetficient of variation (CV) was calculated.Results dSBP,24 h SBPCV,24 h DBPCV,dSBPCV,nSBPCV in carotid atherosclerosis group was higher than that in non-carotid atherosclerosis group [(132.3 ± 12.1)mm Hg(1 mm Hg =0.133 kPa) vs.(122.7 ± 10.8) mm Hg,0.118±0.011 vs.0.107 ± 0.023,0.142 ± 0.058vs.0.116 ±0.028,0.129 ±0.039 vs.0.105 ±0.017,0.119 ±0.060 vs.0.109 ±0.037],and there was significant difference (P ＜ 0.01 or ＜ 0.05).There was no significant difference in 24 h SBP,24 h DBP,dDBP,nSBP,nDBP,dSBPCV,nSBPCV between two groups (P ＞0.05).Conclusions BPV of carotid atherosclerosis is higher than that of non-carotid atherosclerosis.BPV and carotid artery IMT has a certain relevance.

Objective To obtain the normal value of blink reflex(BR) in the elderly. Methods With clinical electrophysiological diagnostic technique, the orbital nerve was stimulated with electric current to elicit blink reflex in an elderly group (30 subjects, 60 sides) and an adult group (29 subjects, 58 sides). Results For the early response R 1 of BR in the elderly, the latency and amplitude were (10 28?0 39) ms,162 88 ?V. For the late response R 2 and R 2',the latency was (32 86?2 81) ms and (33 33?2 90) ms respectively; the amplitude was 210 72 ?V and 156 32 ?V respectively The difference of the latency between the elderly and adult was statistically significant. Conclusions This study indicates that BR measurement is a simple and harmless technique. The latency of BR was prolonged in the aged.

Objective The purpose of this study was to explore the efficacy of low level laser treatment (LLLT) combined with initial periodontal therapy in treating chronic periodontits.Methods Eighteen patients with chronic periodontitis were randomly treated in a spit-mouth design with combination of laser (808 nm,80 mW) treatment with scaling and root planing (experimental) or with scaling and root planing alone (contol) after OHI and supragingival cleaning.Clinical parameters of sulcus bleeding index (SBI),periodontal probing depth (PD) and clinical attachment loss (CAL) of both sides were recorded and gingival crevicular fluid samples were collected at baseline and 1,4,12 weeks after the treatment.GCF samples were analyzed for b-FGF,IL-1β,IL-8 level using ELISA assay.Results For the change of SBI and PD,only SBI in the experimental group experienced significant reduction (P＜0.05) at 1 week compared with baseline (P＜0.05),and the reduction in both groups were statistically significant (P＜0.05) at 4 weeks.The same situation occurred while both experimental groups made more significant difference (P＜0.01) at 12 weeks.The reduction of SBI was obvious in both groups when the PD was more than 6 mm.For CAL,the experimental group showed signs of improvement (P＜0.05) at 4 weeks; both groups indicated improvement (P＜0.05),while the experimental was more significant (P＜0.01) at 12 weeks.For the levels of b-FGF,it showed steady rise after treatment in experimental group,while it went up to the baseline after falling in control group.At 12 weeks,there were statistical significance of differences between two groups (P＜0.05).The changes of IL-1β and IL-8,in the experimental group showed better results than that in control group,while the difference between two groups was not significant (P＞0.05).Conclusion LLLI can accelerate the healing of periodontal tissue by reducing the SBI,decreasing the PD,improving the CAL and increasing levels of b-FGF in the GCF of the patients.

Objective To develop the clinical practice guidelines for the management of medication adherence to highly active antiretroviral therapy (HAART) in China. Methods The development methods included qualitative interview of 31 stakeholders, questionnaire survey of 423 PLHIV, adaptation of 30 clinical practice guidelines related to AIDS care, and overviews of reviews of 44 systematic reviews/Meta-analysis. Results 10 clinical practice guidelines and 10 systematic reviews/Meta-analysis were included. The clinical practice guidelines for the management of HAART were formed. Conclusions The formed clinical practice guidelines showed better applicability and higher general quality. It is recommended to use the guidelines in AIDS care.

Objective Mitral valve regurgitation often leads to cardiac insufficiency or even heart failure .Methods We tried a mitral valve annuloplasty with a ring to improve the effect of mitral valvuloplasty , 5 males and 6 females; aged(8.0 ± 4.5)years;weight(26.1 ±13.9)kg.From February 2015 to December 2017, 11 children underwent mitral valve annuloplasty with an mitral valve ring in our hospital.Immediately after surgery, the degree of mitral valve regurgitation was significant im-proved from moderate-severe to mild-moderate(P<0.05).Results 1 case of early death, 1 case had a mitral valve replace-ment because of early hemolysis.The rest of the children were discharged smoothly.The follow-up of 3 months of mitral valve regurgitation was not aggravated comparing with that immediately after surgery(P>0.05).There was no worsening of cardiac function at follow-up(P>0.05), and no other adverse events.Therefore, artificial mitral annuloplasty with a ring is effective in treating mitral regurgitation in children .The annulus had potential growth characteristics and did not require lifelong oral an-ticoagulant.Conclusion For some patients with difficulty, this method of mitral valvuloplasty can enlarge the surgical indica-tion and improve the quality of life of children.The treatment effect is good.

Objective:To detect the level of long non-coding RNA LINP1 (lncRNA-LINP1) in endometrial carcinoma and to explore the prognostic value of the expression leve.Methods:From January 2015 to December 2016, the tissue samples of 82 patients with endometrial carcinoma in North China University of Science and Technology Affiliated Hospital were used as endometrial carcinoma group, and the normal adjacent tissues were selected as the paracancerous control group.The expression of LINP1 mRNA was measured by real-time fluorescence quantitative PCR (qRT-PCR). The clinicopathological data of the patients were collected, and the relationship between the expression of LINP1 mRNA and clinicopathological parameters was analyzed.Kaplan-Meier method was used to analyze the relationship between the expression of LINP1 mRNA and the survival rate of endometrial patients; and COX multivariate analysis was used to identify the risk factors of death in patients with endometrial cancer.Results:The expression of LINP1 mRNA in endometrial carcinoma group and paracancerous control group were (2.38±0.43) and (1.00±0.24). There was significant difference between the two groups ( t=25.376, P<0.001). The results of clinicopathological parameters showed that the expression of LINP1 mRNA was not related to the age and histological type of endometrial carcinoma (all P>0.05). It was related to lymph node metastasis, FIGO stage, tumor differentiation and vascular invasion (all P<0.05). the three-year total survival rate of the group with high expression of LINP1 mRNA (48.78%) was lower than that of the group with low expression of LINP1 mRNA (80.49%), and the differences were statistically significant (χ 2=6.306, P<0.05). COX Regression analysis showed that, high expression of LINP1 mRNA and FIGO Stage III, IV and lymph node metastasis were the risk factors for death in endometrial cancer patients (HR(95% CI) were 2.898(2.031-4.136), 1.831(1.448-2.316), 1.708(1.364-2.138), P values were 0.002, 0.004 and 0.008, respectively. Conclusion:The high expression of LINP1 mRNA in endometrial carcinoma is closely related to lymph node metastasis, FIGO stage, tumor differentiation, vascular invasion and prognosis.It is a risk factor for the death of patients with endometrial cancer and may be used as an index to evaluate the prognosis of patients with endometrial cancer.

Objective Leukoaraiosis (LA) is a set of magnetic changes with white matter diffuse abormality,and it can be caused by brain small vessel disease.Recent studies showed that collagen type Ⅳ alpha 1 (COL4A 1) gene mutation as a single-gene disorder could cause cerebral small vessel disease.We aims to analyze the role of COL4A 1 gene mutations in Chinese patients with LA by targeted gene capture and high throughout sequencing technique.Methods Eleven patients with LA,conformed by imaging in our hospital from March 2012 to September 2014,were chosen in our study;COL4A 1 gene mutations were screened using targeted genomic capture and high throughout sequencing strategy.Missense mutation of SNP loci were verified by Sanger method.Biological information of mutation loci were studied by means of fumtional biology methods.Results A total of 1691 mutation sites were found,including two missense mutations (rs3742207 and rs9515185) and six synonymous mutations.By functional analysis,these two missense mutations showed no effect on protein structure or function.Conclusion COL4A 1 gene may be irrelevant with incidents of LA in Chinese patients.

Objective    To explore the early results of Ozaki operation in children with aortic regurgitation. Methods    We retrospectively analyzed the clinical data of 15 patients with aortic regurgitation who received the Ozaki operation in our hospital from April 2017 to July 2019. There were 11 males and 4 females with an average operation age of 10.7±3.7 years. Besides preoperative evaluation, aortic regurgitation and cardiac function were evaluated on 1 day, 1 week, 1 month, 3 months, and 6-12 months after surgery. Results    In 14 (93.3%) patients , the aortic valve leaflets functioned well on 1 day, 1 month, 3 months, and 6-12 months, and the regurgitation grade was Ⅰ-Ⅱ, which was improved than before (P=0.001). The cardiac function of children recovered quickly after operation. There was no statistical difference in ejection fraction on 1 day, 1 month, 3 months, and 6-12 months after operation (P>0.05). No children died, and no other clinical event was found. Conclusion    The Ozaki technique of reconstructing a tricuspid aortic valve leaflet for the treatment of severe aortic regurgitation in children is effective in short term, and the persistence of its valve function remains to be determined in the long-term follow-up.