Objective To study of characters of memory disfunction of the patients with transient ischemic attack(TIA) in internal carotid artery system(ICAs) and vertebra-basilar artery system(VBAs) when the clinical symptoms disappeared,and to explore correlation between memory disability and illness course,frequency and persistence time of TIA.Methods 42 patients with TIA in ICAs(ICAs group),36 patients with TIA in VBAs(VBAs group) were measured by clinical remembrance scale,MMSE and Zung self-rating depressive scale in 3～7 d after the final attack.the results were compared with 30 health volunteers(normal control group).Correlation analysis was made between memory disability and illness course,frequency and persistence time of TIA.Results(1)There was no significant difference in clinical remembrance scale scores between ICAs group and VBAs group.The equivalent scale scores of clinical remembrance but insignificant figure recognition item in both TIA groups were significantly lower than that in the normal control group(all P

Objective To explore the effect of early stage of comprehensive lung rehabilitation on cervical spinal cord injury in patients with mechanical ventilation.Methods The patients with cervical spinal cord injury admitted from January to December 2015 were selected as the control group which was treated with routine nursing measures.The patients with cervical spinal cord injury admitted from January to December 2016 were selected as the treatment group,which received early stage lung rehabilitation measures.We compared two groups of patients in the using time of breathing machine,the total length of hospital stay and pulmonary infection rate.Results The duration of mechanical ventilation and hospitalization days in the control group were(13.98±11.11),(25.10±16.98)d,which were higher than those in treatment group[(7.23±4.94),(16.26±6.41)d](P<0.05).The infection rates of control group and treatment group were 76.19％and 52.38％respectively,and the difference was significant(P<0.05).Conclusion In the early stages comprehensive pulmonary rehabilitation measures for mechanical ventilation in patients with cervical spinal injury can shorten the breathing machine use time and the total hospitalization days,and reduce pulmonary infection rate.

This paper firstly expounded the origin of the ritual-music culture.Then it explored the nature of the ritual-music culture which respects the laws of nature,bases on the position,sticks to the rules,exerts subjective initiative,fulfillseach duty,promotes harmony,unifies objectivity and subjectivity,complements each other and pursuits civilization.Analysis of the ritual-music culture provided inner value pursuit,conscientious code of conduct and healthy mental attitude for the construction of a harmonious doctor-patient relationship,which is of great theoretical and practical significance to handle the doctor-patient relationship properly.

Objective To study the influences of psycho-social factors in the treatment of the aged patients with hypertension. Methods Aged in-patients with hypertension were divided into two groups according to their improvement: 148 reached the standard and 62 did not reach the standard. Their psycho-social factors were assessed by self-rating depression scale(SDS), self-rating anxiety scale(SAS), life events scale (LES) and social support scale. Results (1)The percentages of depression (7.4% vs 32.2%, P

Objective: To compare the effectiveness before and after the adjustment of schistosomiasis control strategies in Nanjing City, so as to provide the evidence for improving schistosomiasis control interventions. Methods: The prevalence of Schistosomasis japonicum infections in humans, livestock, Oncomelania hupensis and sentinel mice was collected in Nanjing City from 1993 to 2018, and the prevalence of S. japonicum infections in humans, livestock, sentinel mice and O. hupensis, and the areas of snail habitats, areas of infected snail habitats and snail control areas were compared before (1993-2004) and after (2005-2018) the adjustment of schistosomiasis control strategies to evaluate the effectiveness. Results: The prevalence of S. japonicum infections in humans, livestock, O. hupensis and sentinel mice was 0.77% and 0.02% (χ2=6 430.634, P<0.001), 0.46% and 0.01% (χ2=344.401, P<0.001), 0.19% and 0.11% (χ2=239.685, P<0.001), and 34.35% and 1.56% (χ2=1 856.286, P<0.001) in Nanjing City before and after the adjustment of schistosomiasis control strategies, respectively. The median areas (interquartile range) of snail habitats, infected snail habitats and snail control were 4 175.37 (1 301.65) and 2 366.44 (885.27) hm2 (Z=-3.755, P<0.001), 870.49 (1 001.75) and 0 (158.89) hm2 (Z=-3.654, P<0.001) and 1 383.23 (793.57) and 5 031.94 (629.11) hm2 (Z=-4.320, P<0.001) in Nanjing City before and after the adjustment of schistosomiasis control strategies, respectively. Conclusions After the adjustment of schistosomiasis control strategies, remarkable effects on schistosomiasis control has achieved in Nanjing City, where the transmission of schistosomiasis was interrupted. Nevertheless, the strategy requires to be continued and improved to move towards elimination of schistosomiasis in Nanjing City.

Objective:To observe the effect of sodium fluoride (NaF) on the expression of phosphatidylinositol-3-kinase/protein kinase B (PI3K/Akt) signal and apoptosis in human osteosarcoma Saos-2 cells.Methods:Saos-2 cells were divided into 0 (control), 5, 10, 20 and 40 mg/L fluoride groups ( n= 3) according to the dose of NaF. The cells were collected after 24 and 48 h of culture in vitro. Western blotting was used to detect the expressions of PI3K/Akt signal and Forkhead transcription factor (FoxO) 1, and the apoptosis level of Saos-2 cells was detected by flow cytometry. Results:There were no significants differences in the expressions of PI3K and Akt in Saos-2 cells at 24 and 48 h ( P > 0.05). At 24 h, the expressions of phosphorylated PI3K (p-PI3K) in 5, 10, 20 and 40 mg/L fluoride groups (0.40 ± 0.06, 0.45 ± 0.02, 0.37 ± 0.06, 0.32 ± 0.06) were higher than that in the control group (0.28 ± 0.04, P < 0.05); at 48 h, the expressions of p-PI3K in 5 and 10 mg/L fluoride groups (0.46 ± 0.06, 0.58 ± 0.03) were higher than that in the control group (0.29 ± 0.04, P < 0.05), and that in the 40 mg/L fluoride group (0.21 ± 0.03) was lower than that in the control group ( P < 0.05). At 24 h, the expressions of phosphorylated Akt (p-Akt) in 5, 10 and 20 mg/L fluoride groups (0.27 ± 0.01, 0.30 ± 0.03, 0.27 ± 0.03) were higher than that in the control group (0.20 ± 0.02, P < 0.05); at 48 h, the expressions of p-Akt in 5 and 10 mg/L fluoride groups (0.42 ± 0.04, 0.60 ± 0.02) were higher than that in the control group (0.27 ± 0.01, P < 0.05), and that in the 40 mg/L fluoride group (0.18 ± 0.02) was lower than that in the control group ( P < 0.05). The expressions of FoxO1 in 10, 20 and 40 mg/L fluoride groups at 24 h (0.38 ± 0.07, 0.41 ± 0.06, 0.47 ± 0.08) were higher than that in the control group (0.34 ± 0.04, P < 0.05). At 48 h, the expressions of FoxO1 in 5, 10, 20 and 40 mg/L fluoride groups (0.36 ± 0.08, 0.37 ± 0.10, 0.54 ± 0.04, 0.73 ± 0.04) were higher than that in the control group (0.28 ± 0.04, P < 0.05). At 24 and 48 h, the apoptosis rates of control group and 5, 10, 20 and 40 mg/L fluoride groups were (2.867 ± 0.583)%, (3.647 ± 0.035)%, (3.773 ± 0.095)%, (5.440 ± 0.325)%, (7.203 ± 0.476)%; (3.707 ± 0.286)%, (4.023 ± 0.241)%, (4.970 ± 0.368)%, (12.473 ± 0.949)%, (19.387 ± 1.892)%, respectively. The apoptosis level of 40 mg/L fluoride group was higher than that of control group at 24 h ( P < 0.05), and that of 20 and 40 mg/L fluoride groups were higher than that of control group at 48 h ( P < 0.05). Conclusion:Fluoride can directly activate the PI3K/Akt signaling pathway in osteoblasts, and then has anti-apoptotic effect.

Animals ; Brain-Derived Neurotrophic Factor ; metabolism ; Hypothalamus ; metabolism ; Male ; Physical Conditioning, Animal ; physiology ; Rats ; Rats, Sprague-Dawley

Objective To evaluate the predicting value of serum procaleitonin (PCT) in treatment of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) in elderly patients. Methods A total of 267 elderly patients requiring hospitalization for AECOPD were randomly assigned into 2 groups: standard therapy group (standard group, n= 135) and PCT-guided group(PCT group, n= 132). Standard group received antibiotics according to the guideline of attending physicians and PCT group were treated with antibiotics according to serum PCT levels.Length of hospitalization, clinical efficacy, costs of hospitalization and antibiotics, rate of antibiotics use, hospital mortality, rate of exacerbation and rehospitalization, frequency of exacerbation within 1 year were observed. Results Length of hospitalization, clinical efficacy, hospital mortality, rate of exacerbation and rehospitalization, frequency of exacerbation within 1 year were similar in 2 groups(all P＞0.05);costs of hospitalization and antibiotics, rate of antibiotics use of PCT group[10 882 (3808-16 651)yuan, 6934 (2390-10 660)yuan, 76.5%] were lower than those of standard group[13 637(4650-19 730)yuan, 8589(3144-12 117)yuan, 87.4%] (all P＜0.05). Conclusions PCT guidance offers an advantage over standard therapy in reducing antibiotic use and in lowering the costs of hospitalization in treatment of AECOPD in elderly patients.

Objective To observe the clinical effect of multimodal analgesia for painless artificial abortion . Methods 150 cases of ASA Ⅰ-Ⅱ pregnancy received painless artificial abortion operation ,no contraindication for all patients,were randomly divided into the five groups ,30 cases in each group,the blank control group (group S):do not use any analgesia measure ,intravenous injection of 0.9% sodium chloride 2mL preoperation;the fentanyl group ( F group ) :intravenous injection of fentanyl 1μg/kg preoperation ;the parecoxib group ( group P ) :intravenous injection of parecoxib sodium 40mg preoperation.The patients were given painless artificial abortion after injection the above drugs.Nerve block group ( N group):the implementation of painless induced abortion operation after sleep in patients with the cervical nerve block ,injection of 1%lidocaine 2 mL.Multimodal analgesia group (group M):intra-venous injection of parecoxib sodium 40mg,fentanyl 1μg/kg,then the implementation method the same as N group . The operation time,anesthesia onset time,recovery time,time of accurate orientation and additional dosage of propo-fol;incidence rate of artificial abortion syndrome ,the incidence rate of uterine contraction pain ,10min,30min,1h,6h pain scores after operation; adverse reaction;satisfaction score of analgesic effect postoperative 24h were observed. Results The additional dosage of propofol in the group S ,group F,group P,group N and group M were (78.45 ± 20.36)mg,(15.55 ±12.33)mg,(16.75 ±13.13)mg,(14.55 ±10.25)mg,(9.35 ±8.27)mg.The incidence rates of uterine contraction pain in the group S ,group F,group P,group N and group M were 30%,10%,10%,10%,0. Compared with group M ,the additional dosage of propofol and incidence rate of uterine contraction pain in the other four groups were significantly increased (t=3.05,1.82,1.84,1.78,χ2 =72.1,68.2,68.2,68.2,all P<0.05). Pain scores after operation 10min,30min,1h,6h in the group S were (6.6 ±1.5)points,(5.6 ±1.4)points,(4.6 ± 1.1)points,(3.6 ±1.4)points.Those in group F were (5.1 ±1.5)points,(4.3 ±1.1)points,(3.1 ±0.9)points, (2.8 ±0.8).Pain scores after operation 10min,30min,1h,6h in the group P were (4.6 ±1.5) points,(4.2 ± 0.9)points,(2.9 ±0.8) points,(2.7 ±0.6) points.Those in the group N were (4.5 ±1.5) points,(4.1 ± 0.8)points,(2.9 ±0.8)points,(2.6 ±0.5).Pain scores after operation 10min,30min,1h,6h in the group M were (2.2 ±0.8)points,(1.9 ±0.7)points,(1.5 ±0.5)points,(1.2 ±0.3)points.Compared with the group M,pain scores after operation 10min,30min,1h,6h in the other four groups were significantly elevated ( t=2.03,1.96,1.86, 1.84,1.98,1.82,1.80,1.76,2.05,1.99,1.95,1.86,2.06,1.88,1.82,1.76,all P<0.05).Compared with S group,postoperative 24h satisfaction score of analgesia in the group M was improved significantly ( t =1.98,P<0.05).Compared with group M,the incidence rate of nausea in the other four groups was increased significantly (χ2 =72.2,68.9,68.1,68.1,all P<0.05).Conclusion Multimodal analgesia method can greatly reduce artificial abor-tion postoperative pain ,reduce the adverse reactions ,improve patients'satisfaction score ,ensure the safety of operation .

Objective To explore the value of echocardiography in the diagnosis of the parachute mitral valve(PMV).Methods The echocardiographic characteristics of 12 patients with PMV between 2005 and 2012 were reviewed retrospectively,including the morphology,movement and blood flow of mitral valve apparatus,and other associated cardiac abnormalities.Results Of the mitral valve leaflets in these 12 cases,all were thickened and opened restricted in diastole.Axial view showed that in all cases mitral valves opened eccentrically and in 2 cases they didn't close tightly.Each patient only had single papillary muscle in left ventricle,which received all chords of mitral valves.Of papillary muscles in these patients,4 were located at posteromedial wall,3 at anterolateral wall,2 at middle posterior wall,2 at apical wall,and 1 at posterolateral wall.Of the 12 patients,only one were simple PMV,11 had associated cardiovascular anomalies,2 had mild regurgitation in systolic period and 11 had increased trans-valve peak flow velocity.Conclusions Echocardiography is reliable in the diagnosis of PMV,which could provide a comprehensive evaluation of valvular lesions and other associated cardiovascular anomalies.