Objective To detect the alteration of circulating CD34 + cell level in patients with the In'st-ever nonlacunar stroke and to investigate the prognostic value of CD34 +cell level. Methods 1he level of the circulating CD34+ cells were examined using flow eytometry in 119 patients with nonlacunar infarction. 1he patients were divided into group A (higher than average) and group B (lower than average) according to the detected values, The National Institutes of Health Stroke Scale (NIHSS) scores on admission and the modified Rankin Scale (mRS) scores at 3 months after the onset in the two groups wre compared. Results The level of CD34 + cells in group A was significantly higher than that in group B (0. 048 ± 0. 001 versus 0. 032 ± 0. 002, P < 0. 05 ), however, there was no significantly difference in NIHSS sores between the two groups. One week after admission, the increased level of CD34 + cells in group A was significantly higher than that in group B (0. 001 ±0. 003 versus - 0. 005 ± 0. 000, P < 0. 05 ). Three months after the onset of symptoms, the average mRS score in group A was significantly superior to that in group B (2. 98 ± 1.14 versus 3.25 ± 1.39, P <0. 05). 1he level of circulating CD34 + cells at the initial onset of symptom was negatively correlated with the mRS score at 3 months after stroke (r = -0. 48, P <0. 05). Conclusions The higher level of circulating CD34+ cells had better prognosis in patients with cerebral infarction. The level of circulating CD34+ ceils may be used as a prognostic indicator in patients with cerebral infarction.

Objective To evaluate the clinical effects of percutaneous vertebroplasty (PVP) with high-viscosity bone cement in treatment of severe osteoporotic vertebral compression fracture (OVCF).Methods This study involved 176 patients with severe OVCF treated by PVP with high-viscosity bone cement between January 2013 and January 2015.There were 61 male and 115 female patients,aged 58-78 years (mean,67.7 years).Ninety-four patients were injured in a fall,31 patients in a bumping condition,and 61 patients with no obvious causes.A total of 204 vertebrae were involved,including 23 T10,22 T11,49 T12,43 L1 and 29 L2.Thirty patients suffered vertebral posterior wall damage.All the vertebral bodies were compressed more than 2/3.Vertebral height,kyphotic Cobb angle,visual analogue scale (VAS) and Oswestry disability index (ODI) were recorded.Bone cement filling and leakage were detected.Results Bone cement leakage was detected in 64 patients,with a leakage rate of 36.3％.Seven patients were found with cement leakage in paravertebral veins,38 patients in intervertebral spaces,and 19 patients in prevertebral soft tissues.Five patients with back pain got partial remission.Four patients experienced burning sensation in the lower extremity 5 minutes after bone cement filling and were relieved 10 minutes later.No severe adverse events were observed,including spinal cord compression,epidural hematoma,pulmonary infection,pulmonary embolism,bedsores,and cerebrovascular accident.After operation,improvements were observed in ODI [(31.73 ± 7.98) ％ vs.(75.40 ± 8.17) ％] and VAS [(2.33 ±0.91)points vs.(7.23 ±0.88) points] (P＜0.05).Conclusion PVP with highviscosity bone cement can significantly relieve pain and improve motor function and hence is effective in the treatment of patients with severe OVCF.

Objective:To investigate the current status and related factors of psychological distress in tele-phone operators.Methods:Totally 575 telephone operators from sample of a convenient survey in a certain telecom-munication company of Shandong Province were selected.They were assessed with Kessler Psychological Distress Scale (K10),Connor-Davidson Resilience Scale (CD-RISC-10),Perceived Social Support Scale (PSSS)and Sim-plified Coping Style Questionnaire (SCSQ)for the evaluation of psychological distress,resilience,perceived social support and the coping style respectively.Ordinal logistic regression was used to identify the related factors of psy-chological distress.Results:The mean score of K10 was (24.7 ±6.7),91.8% (528 /575)of telephone operators had psychological distress.Specifically,24.5%(141 /575)had mild psychological distress,45.4% (261 /575)had moderate psychological distress,21.9% (126 /575)had severe psychological distress.Ordinal logistic regression a-nalysis indicated that the ones with good economic conditions (OR =1.74,95%CI:1.15 -2.63),higher level of re-silience (OR =1.13,95%CI:1.10 -1.17)and other social support (OR =1.07,95%CI:1.02 -1.12)had milder psychological distress;while with negative coping style (OR =0.29,95%CI:0.20 -0.41)had more severe psycho-logical distress.Conclusion:It suggested that the prevalence rate of psychological distress among telephone opera-tors is high.Poor economic conditions,lower level of resilience and social support,and negative coping style might be the related factors of psychological distress.

Objectives:To discuss and analyse the causes of local recurrence after Dixon operation.　Methods:Retrospective analysis was made on 72 cases after resection of rectal cancer by Dixon operation in our department from 1995 to 1999.　Results:The local recurrence rate after Dixon operation was 12.5%(9 cases),the recurrence time was 3～26 months,and 16.2 months in an average after the operation.Seven cases of recurrence were within 2 years.The recurrence location occurred at the anastomotic stoma (6 cases),pelvic cavity (2 cases) and the perinum (1 cases) respectively.Based on Dukes classification, it showed one case of phase A, three cases of phase B and five cases of phase C.According to pathological classification, there were one case of papillary adenocarcinoma,five cases of rubiformadenocarcinoma and three cases of mucoid adenocarcinoma.A length from the lower margin of the tumors to the distal resection site,seven cases were within 3 cm,and two cases were beyond 3 cm.　Conclusions:The causes for local recurrence after operation were related to Duke classification,pathological types,length from the lower margin of the tumors to the distal resection site,lymphadenectomy and operation on the tumor itself.

Abstract: Objective To investigate the molecular characteristics of the H9N2 avian influenza virus (AIV) causing human infection in Yunnan Province in 2019, and to provide the scientific basis for the prevention and control of avian influenza in Yunnan Province. Methods Influenza virus typing was performed by real-time RT-PCR in two influenza-like illness samples, and the Illumina Miseq high-throughput sequencer was used to determine the viral genome sequence. HA and NA gene sequence alignment and phylogenetic tree construction were performed using Mega7.0 software. Results Real-time RT-PCR results showed that two influenza-like illness samples were positive for H9N2 subtype. The full length of HA and NA were obtained by genomic sequencing. Sequence system evolution analysis showed that the HA and NA of the two AIVs in Yunnan Province were in the same evolutionary clade as A/Chicken/Zhejiang/HJ/2007 and belonged to the G57 type. The HA nucleotide and amino acid homology of the two AIVs were 93.92% and 95.00%, respectively, and the NA nucleotide and amino acid homology was 93.31% and 82.03%, respectively. The nucleotide (amino acid) homology of HA was 92.29%-96.94% (93.77%-98.43%) and 92.84%-94.92% (94.18%-96.23%), respectively, and NA nucleotide homology (amino acid) were 91.81%-97.60% (77.82%-94.83%), 94.38%-97.22% (85.47%-94.55%), respectively, compared with that of human infected H9N2 epidemic strains obtained in China from 2015 to 2020. Both AIVs HA protein cleavage site sequences were PSRSSR↓GLF, which was in line with the characteristics of low pathogenic influenza. The analysis of HA protein receptor binding site showed that amino acids at positions 109, 161, 163, 191, 202, 203 and 234 were consistent with the reference strains, while amino acids at position 198 were mutated to T. N166D and 168N mutations were also found in HA protein, and both AIVs had 7 potential glycosylation sites. Analysis of the erythrocyte binding site of NA gene found that there were amino acid mutations at positions 369, 402, 403, and 432, and amino acid deletion at positions 63-65 was found in the NA genes. There were 4 and 5 potential glycosylation sites in the two AIVs, respectively, and no drug resistance site mutations were found. Conclusions　The receptor binding sites, erythrocyte binding sites and glycosylation sites of HA and NA genes of H9N2 AIV in Yunnan Province have different degrees of variation, and monitoring and prevention and control should be strengthened.

Objective To explore the effects on image quality and dose reduction to the lens when using bismuth shielding in head and neck MSCT.Methods The standard phantom and the cadaveric head with none,1,2 and 3 layers of bismuth shielding were scanned with protocols of brain,temporal bone and paranasal sinuses using a 16-MDCT scanner.The organ dose to the lens in each scanning was measured with thermoluminescence dosimeters(TLD).The above scanning with sinus protocol was repeated with a sponge with thickness of 5,10,15 and 20 mm placed between the shielding and phantom/head.The CT attenuation of phantom with the distance of 2,4,6 and 8 cm to shielding were measured.The image quality was subjectively evaluated by 2 physicians.Results The organ doses of the lens with protocols of brain,temporal bone and sinuses were 24.31,27.60 and 20.01 mGy,respectively.The doses were decreased significantly when using bismuth shielding.With the increase of the shield gap,the degree of dose reduction was reduced,but the increasing degree of CT attenuation significantly reduced.Using 2-layer and 3-layer bismuth shield in brain and temporal bone CT scan,the radiation doses were reduced by 47.1％ and 59.1％,respectively while maintaining the diagnostic image quality.Using 1-layer shield without gap and 2-layer shield with 1.5 cm gap in sinus CT,the radiation doses were reduced by 31.5％ and 34.5％,respectively.Conclusions Reasonable usage of bismuth shielding can effectively reduce the radiation dose to the lens of eye in head and neck MSCT.

With computer and manual search of literatures on the comparison of concurrent with sequential adjuvant radio-chemotherapy after mastectomy for breast cancer, 4 eligible randomized controlled trials were found; the RevMan 5.0 software was used for Meta-analysis. The results showed that concurrent radio-chemotherapy reduced local recurrence more prominently than sequential radio-chemotherapy in patients with positive axillary lymph nodes( P = 0. 003 ). However, differences in 5-year overall survival,5-year disease-free survival and metastasis-free survival between two groups were not significant (P =0. 670,P =0. 200, P =0. 350).

Objective To investigate physiological changes in peri extracorporeal circulation period of patients who underwent cardiac valve replacement surgeries with crystalloid solution mixed with colloidal solutions and pure crystal solution as extracorporeal circulation priming solution, and explore the clinical value and practicability of crystalloid solution as the sole extracorporeal circulation priming solution.Methods A retrospective analysis was performed in 130 patients who underwent cardiac valve replacement surgeries.Pure lactated Ringer's solution liquid and Lactated Ringer's solution mixed with Voluven as the extracorporeal circulation priming solution were used.We respectively compared hematocrit at different time points, postoperative blood routine, liver and kidney function, blood coagulation index, duration of intensive care and trachea cannula in two groups.Results There were no significant differences in ages, preoperative blood routine, kidney function, blood coagulation function, duration of operation, clamping time, bypass time, intensive care, postoperative blood routine, kidney function, blood coagulation function and hematocrit at different time points in two groups (P ＞0.05).However, the hospital day of group which used crystalloid solution as extracorporeal circulation priming solution was significant shorter compared to group which used lactated Ringer's solution mixed with Voluven (P ＜ 0.05).Alanine aminotransferase of group which used crystalloid solution as extracorporeal circulation priming solution was significant higher compared to group which used lactated Ringer's solution mixed with Voluven (P ＜0.01).Conclusions Crystalloid solution as extracorporeal circulation priming solution is safe and economy in cardiopulmonary bypass.Pure crystalloid solution as the sole extracorporeal circulation priming solution can be safely used on patients (New York Heart Association class Ⅱ-Ⅲ) who have normal liver and kidney function before the operation of adult heart valve replacement with cardiopulmonary bypass.

Objective To observe the expression of discs large hom olog 4 (DLG4) protein in hippocam-pus, am ygdala and frontal cortex of rats and evaluate postsynaptic density in heroin dependence. Meth-ods The rat heroin dependent m odel was established by increasing intraperitoneal injection of heroin. DLG4 proteins in hippocam pus, am ygdala and frontal cortex of heroin dependent 9, 18, 36 days rats w ere detected with im munohistochem ical staining and com pared with that in the control group. Results DLG4 proteins in hippocam pus, am ygdala and frontal cortex w ere gradually reduced with extension of heroin dependent tim e. Conclusion Heroin dependence can affect postsynaptic density of hippocam pus, am ygdala and frontal cortex. The changes becom e m ore apparent with extension of heroin dependence tim e.

A liquid chromatography-quadrupole-time-of-flight mass spectrometer(LC-Q/TOF-MS) based urinary metabolomic approach was employed to assess the toxicity-alleviation effect of Huangqi oral solution(HOs) on cisplatin-exposed rats and explore its possible mechanisms. Rat toxicity model was developed by multiple intraperitoneal injection of low-dose cisplatin, while HOs was orally administrated to rats simultaneously for 16 consecutive days to attenuate or reduce the cisplatin-induced toxicity. 24-hour urine samples on day 18 were collected and analyzed using LC-Q/TOF-MS to obtain the dataset of urinary metabolites. Principal component analysis(PCA) and orthogonal partial least squares-discriminant analysis(OPLS-DA) were employed to assess the quality of the dataset and screen the potential toxicity-alleviation biomarkers. The serum level of rat creatinine and urea nitrogen on day 20 was determined, and the results showed that successive administration of HOs significantly reduced the cisplatin-induced increase of creatinine and urea nitrogen. PCA cluster analysis clearly demonstrated that HOs could partly improve the CDDP-induced abnormality of metabolic profiling. 35 urinary metabolites were finally screened as the potential biomarkers associated with the toxicity-attenuation effect of HOs, according to the combination of the analysis results of OPLS-DA, t-test and fold change analysis. Further metabolic pathway analysis revealed that HOs could restore the metabolic disorders of amino acid, energy and nucleotide, thereby exerted its toxicity-alleviation effect.