Objective To explore the relationship between cerebral micro-bleeds (CMBs) and recurrent stroke after transient ischemic attack (TIA),and to guide early diagnosis of prognoses.Methods A total of 147 patients with TIA,admitted to our hospital from January 2015 to June 2017,were enrolled;29 patients (19.73％) were given anti-platelet therapy,double-antibody treatment was performed in 103 patients (70.07％),15 patients (10.20％) were given anticoagulation,and 108 patients (73.47％) took statins.Intracranial imaging was performed on these patients on admission and one week after different treatments.The general data and biochemical markers were collected;the recurrent stroke after TIA within 90 d was followed up.Univariate analysis and multivariate Logistic regression were used to screen the risk factors for stroke after TIA.Results CMBs were noted in 30 patients (20.41％) at first intracranial imaging;another 2 patients with CMBs were noted at one week after treatments,and there were no significant differences in newly-detected CMBs among different treatment methods (P＞0.05).Nine patients (6.12％) had stroke recurrence.Univariate analysis indicated that the percentages of patients with atrial fibrillation,symptomatic carotid artery stenosis≥ 50％,CMBs and white matter high signal (WMH) and high ABCD2 scores between TIA patients with/without stroke were significantly different (P＜0.05).Multivariate Logistic regression showed that CMBs were the independent risk factors of recurrent stroke after TIA (OR=4.126,P=0.003,95％CI:0.320-2.390).Conclusion CMBs canpredict the risk of stroke recurrence after TIA.

Total mesorectal excision(TME)and complete mesoclic excision (CME)concepts make people aware of membrane integrity;the effect of endoscopic magnification and the hemostatic effect of ultrasonic scalpel,surgical field of view clearly,to further understand the structure of the membrane,which proposed the surgical anatomy of the membrane.This article describes the surgical membrane anatomy from the colorectal membrane of the embryonic development and membrane anatomical features that guide laparoscopic colorectal surgery.

Objective To establish a solvent desorption inductively coupled plasma-mass spectrometry (ICP-MS) method for determination of iodine in workplace air. Methods Iodine in workplace air was collected with alkaline activated carbon tube and desorbed with 10.0 mL pure water or 20 mmol/L sodium bicarbonate solution. Rhenium-185 was used as an internal standard for quantification. The sample was determined in standard mode and kinetic energy discrimination collision (KED) mode by ICP-MS. Results In standard mode, iodine showed a good linear range in the concentration of 9.0 to 1 100.0 μg/L, with a correlation coefficient of 0.999 3 and a detection limit of 2.7 μg/L. In KED mode, iodine showed a good linear range in the concentration of 24.3 to 800.0 μg/L, with a correlation coefficient of 0.999 1 and a detection limit of 7.3 μg/L. The average desorption efficiency using pure water ranged from 99.1% to 106.7%, with within-run relative standard deviation (RSD) of 3.1% to 8.0% and between-run RSD of 4.9% to 9.3%. The average desorption efficiency using sodium bicarbonate solution ranged from 96.5% to 105.3%, with within-run RSD of 4.9% to 8.6% and between-run RSD of 2.5% to 9.9%. There were no statistical significant differences in the main effects of desorption solution, ICP-MS detection mode, their interaction on average desorption efficiency and within-run RSD (all P>0.05). Samples could be stored at room temperature for at least 7 days. Conclusion This method is highly sensitive, accurate, and suitable for the determination of iodine in workplace air. The sample pretreatment is simple and rapid.

Objective:To investigate the correlations of SOX17 gene polymorphisms at the rs1072737, rs9298506 and rs10958409 loci with sporadic intracranial aneurysm (IA) in patients from Anhui province. Methods:A case-control study was performed on 162 patients with sporadic ruptured IA admitted to our hospital from January 2017 to December 2020 and 182 age-matched controls from Inpatient or physical examination center at the same time-period. The genotype and allele frequencies of SOX17 gene at the rs1072737, rs9298506 and rs10958409 loci between the 2 groups were analyzed and compared to determine the influence of different genotypes and alleles in IA. According to gender, the subjects were divided into male and female subgroups; according to rupture of IA, the subjects were divided into ruptured and un-ruptured subgroups; the risk factors and protective factors for IA in these subgroups were verified. Results:There was no significant difference in genotype distributions at rs10958409 locus between the two groups ( P>0.05). The results of multivariate Logistic regression analysis indicated that GG+GT genotype ( OR=0.913, 95%CI: 0.845-0.990, P=0.031) and allele G ( OR=0.805, 95%CI: 0.718-0.932, P=0.029) at rs1072737 locus were independent protective factors for IA, and GG+AG genotype ( OR=1.043, 95%CI: 1.008-1.084, P=0.011) and allele G ( OR=1.003, 95%CI: 1.001-1.007, P=0.023) at rs9298506 locus were independent risk factors for IA. GG+GT genotype and G allele at rs1072737 locus were still risk factors for IA in both males and females ( P<0.05), while GG+AG genotype and G allele at rs9298506 locus were still protective factors for IA in both males and females ( P<0.05). There was no significant difference in in genotype distributions at rs1072737 and rs9298506 loci between ruptured subgroup and un-ruptured subgroup ( P>0.05). Conclusions:In Anhui province, GG+GT genotype (allele G) carriers in SOX17 gene at rs1072737 locus have a relatively low risk of IA, while GG+AG genotype (allele G) carriers in SOX17 gene at rs9298506 locus have a relatively high risk of IA. There is no correlation of SOX17 gene polymorphisms at rs1072737 and RS9298506 loci with rupture of IA.

ObjectiveTo investigate the expression of Midkine （MDK） in cholangiocarcinoma （CCA） and its value in predicting the prognosis of CCA， as well as the potential mechanism of the effect of MDK on the progression of CCA. MethodsThe data of CCA samples were obtained from TCGA database to analyze the difference in the expression of MDK between cancer tissue and paracancerous tissue and its association with clinical features， and the data collected from GEO database and 11 CCA patients who underwent surgical resection in The Fifth Medical Center of Chinese PLA General Hospital from June 2018 to September 2021 were used for validation. STRING and Cytoscape were used to construct a protein-protein interaction network， and gene ontology （GO） and Kyoto Encyclopedia of Genes and Genomes （KEGG） enrichment analyses were used to investigate the biological functions and tumor-related pathways involving MDK-related genes. In addition， TIMER and TISIDB databases were used to analyze the correlation between MDK expression and immune cell infiltration in CCA tissue. The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups， and the Fisher’s exact test was used for comparison of categorical data between two groups. The Kaplan-Meier method was used to plot survival curves， and the Log-rank test was used for comparison between groups. The Spearman correlation analysis was used to investigate the correlation between two variables. ResultsThe expression level of MDK in cancer tissue and paracancerous tissue of CCA patients was compared based on TCGA database， and the results of the non-paired and paired analyses showed that the expression level of MDK in CCA tumor tissue was significantly higher than that in paracancerous tissue （P<0.001）. Transcriptome sequencing was performed for the tumor tissue and its corresponding paracancerous tissue from 11 CCA patients， and the results showed that the expression level of MDK in CCA tumor tissue was significantly higher than that in corresponding paracancerous tissue （P<0.01）. High expression of MDK was associated with lymph node metastasis （P=0.045） and vascular invasion （P=0.044）. Survival analysis showed that compared with the CCA patients with low MDK expression， the CCA patients with high MDK expression had significantly shorter overall survival time （χ²=5.30， P=0.028） and disease-specific survival time （χ²=6.25， P=0.019）. The GO and KEGG enrichment analyses showed that the 30 MDK-related genes were closely associated with ubiquitin-mediated proteolysis and affected the prognosis of CCA patients. The TIMER analysis showed that the expression level of MDK was positively correlated with the infiltration of B cells （r=0.356， P=0.035 6） and dendritic cells （r=0.409， P=0.014 7） in tumor microenvironment of CCA； the TISIDB analysis showed that the expression level of MDK was positively correlated with CXCL16 （r=0.465， P=0.004 67） and was negatively correlated with CXCL12 （r=-0.389， P=0.019 7） and CXCR5 （r=-0.393， P=0.018 5）， and it was also negatively correlated with the immune checkpoint regulators VTCN1 （r=-0.393， P=0.018 3）， LTA （r=-0.380， P=0.022 7）， and PVR （r=-0.350， P=0.037 3）. ConclusionHigh expression of MDK is associated with poor prognosis in CCA patients， and MDK has the potential of being used as a molecular marker for predicting the prognosis of CCA. MDK may promote the development and progression of CCA by regulating ubiquitin-mediated proteolysis and the infiltration of B cells and dendritic cells.