AIM: The purpose of this study was to investigate the expression of myristoylated alanine-rich C kinase substrate (MARCKS) and p-MARCKS during cerebral ischemia. METHODS: The multi-cerebral infarction model was established by method of Kaneko. The stroke symptoms and signs scoring system were used to evaluate the animal model. Microscope and electronic microscope were used to watch the structure of rat brain. The expression of MARCKS and p-MARCKS was measured by Western blotting. The expression pattern of these proteins was further analyzed for their distribution at cellular level by immunohistochemistry staining of the tissues. RESULTS AND CONCLUSION: The expression of MARCKS and p-MARCKS protein in acute ischemic brain were elevated compared with the normal and control group (P

Objective To study the effect of mind mapping on cognitive ability in elderly with mild cognitive impairment(MCI).Methods A total of 60 elderly aged were randomly divided into training group (30 cases) and control group(30 cases).Elderly in control group received routine maintenance of living habits.The elderly in the training group received miud mapping training intensively for 30 minutes every day for 12 months.The training effects were evaluated by mini-mental state examination(MMSE) and abilities of daily living scale(ADL).Results After training,the score of MMSE in the training group( six months:25.55 ± 1.17;one year:26.30 ±1.64) were significantly higher than before intervention( P＜ 0.05 ) and higher than that of control group(24.90 ± 1.97) (P＜0.05).The score of ADL in the training group( 14.47 ±0.64) were significantly lower than before intervention( 14.47 ±0.64) and that of control group( 15.47 ± 1.19) ( P＜ 0.05).Conclusion Mind mapping training can improve the cognitive abilities of MCI older people.

AIM:To investigate whether Mycoplasma pneumoniae ( Mp)-induced interleukin-1β( IL-1β) pro-duction in RAW264.7 cells is through the activation of NLRP3 inflammasome via reactive oxygen species (ROS).ME-THODS:RAW264.7 cells were randomly divided into 3 groups.In normal group , RAW264.7 cells were treated without Mp.In model group, RAW264.7 cells were treated with 1∶10 multiplicity of infection ( MOI) of Mp.In NAC group, RAW264.7 cells were pretreated with N-acetylcysteine ( NAC) at a concentration of 5 mmol/L for 30 min before infection with Mp.The RAW264.7cells were infected with Mp (1∶10 MOI) for 4, 8, 16 and 24 h in model group and NAC group , respectively.The intracellular ROS level was analyzed by flow cytometry .The mRNA expressions of NLRP3, ASC and caspase-1 were detected by real-time PCR.The protein levels of NLRP3, ASC and caspase-1 p20 were determined by Western blot.The levels of pro-inflammatory cytokine IL-1βin the supernatant were measured by ELISA .RESULTS:Compared with normal group , the production of ROS were significantly increased at 4, 8, 16 and 24 h after infection, the mRNA expression of NLRP3, ASC and caspase-1 were increased at 8, 16 and 24 h after infection, the protein levels of NL-RP3, ASC and caspase-1 p20 were increased at 16 and 24 h after infection, and the releases of IL-1βwere increased at 24 h after infection in model group (P<0.01).Compared with the model group, the level of ROS in NAC group decreased, so as the expression of NLRP3, ASC and caspase-1 at mRNA and protein levels and the releases of IL-1βin the superna-tant at the corresponding time points .CONCLUSION:Mp may stimulate the ROS production to activate NLRP 3 inflam-masome in RAW264.7 cells.

Objective To evaluate the combination use of transcatheter arterial chemoembolization (TACE), portal vein embolization (PVE) and high intensity focused ultrasound (HIFU) in treating portal vein tumor thrombus(PVTT). Methods A total of 85 patients with primary hepatocellular carcinoma complicated by PVTT, who were encountered during the period from Jan. 2011 to Feb. 2012 at authors’ hospital, were enrolled in this study. The patients were divided into the study group (n=47) and the control group (n=38). TACE, PVE and HIFU were performed in the patients of the study group, while only TACE and PVE were carried out in the patients of the control group. The therapeutic process was as follows: PVE was carried out 2 weeks after TACE was performed, and for the patients of the study group additional HIFU was conducted about 10 days after PVE procedure. Results The short-term effective rate in the study group and the control group was 89.4% (42/47) and 39.5% (15/38) respectively, and the difference between the two groups was statistically significant (P< 0.05). The 6-month, one-year, and two-year survival rate in the study group were 87.2%(41/47), 66.0%(31/47) and 27.7%(13/47) respectively; the median survival time was 15.4 months. In the control group, the 6-month, one-year, and two-year survival rate were 55.3% (21/38), 39.5% (15/38) and 10.5%(4/38) respectively;the median survival time was 10.3 months. The differences between the two groups were statistically significant (P< 0.05). Conclusion For the treatment of primary hepatocellular carcinoma associated with portal vein tumor thrombus, transcatheter arterial chemoembolization, portal vein embolization together with high intensity focused ultrasound is an safe and effective therapy as it can significantly improve the therapeutic effect and prolong the survival time.

AIM: To observe the dynamic alteration of myristoylated alanine-rich C kinase substrate(MARCKS) mRNA expression in rat hippocampus with acute multi-cerebral infarction,and discuss the relationship between the alteration of hippocampus MARCKS gene and ischemia damage.METHODS: The acute multi-cerebral infarction model was established by method of Kaneko.Neurological function deficits were evaluated in the behavior test.The consequences of cerebral ischemic damage were examined by histopathological analyses.The MARCKS mRNA expression was measured by semi-quantitative PCR.RESULTS: The rats in acute multi-cerebral infarction group showed different level changes of neurological function deficits.The hippocampus damage of histopathology became significant 24h after ischemia.At the same time,the MARCKS mRNA expression was upregulated at the area of rats hippocampus during ischemia,and its overexpression started 1h after ischemia,and reached maximum7d after ischemia.CONCLUSION: MARCKS mRNA of rat hippocampus overexpresses during acute cerebral ischemia.This MARCKS mRNA overexpression is related with hippocampus ischemia damage.

Objective To observe the value of dual-source CT energy spectral imaging in qualitative evaluation of metastatic lymph nodes in patients with gastric cancer.Methods Data of patients with pathologically diagnosed gastric cancer were collected,who underwent both dual-source CT abdomen plain scanning and energy spectrum double-phase enhanced scanning.The long diameter,short diameter,short length-diameter ratio,arterial phase and venous phase standardized iodine concentration of lymph nodes were measured and recorded.Energy spectrum attenuation curves were drawn,and the slopes were calculated.Parameters with statistical significant differences between metastatic and non-metastatic lymph nodes were used to plot ROC curves,and the thresholds for diagnosing metastatic lymph nodes of gastric cancer,and their diagnostic sensitivity and specificity were calculated.Results There were significant differences in short axis,short aspect ratio,normalized iodine concentration in arterial phase and venous phase between metastatic and non-metastatic lymph nodes in patients with gastric cancer (all P＜0.05),the area under the curve of ROC curve was 0.601 (P=0.006),0.881 (P＜0.001),0.865 (P＜0.001) and 0.834 (P＜0.001),respectively.When the short length to diameter ratio was 0.730,the sensitivity and specificity in diagnosis of metastatic lymph nodes of gastric cancer was 75.72％ and 93.64％.When standardized iodine concentration was 0.223 in arterial phase,the sensitivity and specificity in diagnosis of metastatic lymph nodes of gastric cancer was 69.81％ and 91.20％.When the standardized iodine concentration was 0.392 in the venous phase,the sensitivity and specificity in diagnosis of metastatic lymph nodes of gastric cancer was 78.33％ and 85.63％.Dual-phase energy spectrum curve of both gastric metastatic lymph nodes and non-lymph node decreased.Taken the arterial curve slope k=6.860 as the threshold,the sensitivity and specificity in diagnosis of metastatic lymph nodes was 83.24％ and 84.72％.When the threshold venous phase slope k was set at 6.660,the sensitivity and specificity in diagnosis of metastatic lymph nodes was 64.62％ and 97.70％,respectively.Combining arterial phase length-to-diameter ratio,arterial phase standardized iodine concentration and spectral curve slope,the sensitivity and specificity in diagnosing metastatic lymph nodes was 97.34 ％ and 87.83 ％,which was 80.13 ％ and 90.31％ when combining venous phase short length-diameter ratio,venous phase standardized iodine concentration and spectral curve slope.Conclusion The short-length-to-diameter ratio,arterial-venous phase standardized iodine concentration and arterial-venous phase slope of lymph nodes are the main parameters for evaluating metastatic lymph nodes in patients with gastric cancer.Combination of the above three parameters can obviously improve the sensitivity and specificity in diagnosis of metastatic lymph nodes in patients with gastric cancer.

Objective To explore the clinical applicability of diffusion kurtosis imaging (DKI)in children with spastic hemiplegic cerebral palsy.Methods 22 children with spastic hemiplegic cerebral palsy and age-matched 22 normal children were selected in this study,and were treated with routine brain MRI and DKI to test the white matter area of tractus corticospinalis on brainstem plane, anterior limb of internal capsule,posterior limb of inter capsule,genu of corpus callosum and the splenium of corpus callosum.The fractional alanisotropy(FA)value and mean kurtosis (MK)value of deep gray nuclei area in thalamus,lenticular nucleus and head of caudate nucleus were examined.Furthermore,gross motor function classification system (GMFCS)was performed for the children in research group.Two independent sample t test was applied in the comparison of groups.The correlation between DKI parameters and cerebral palsy gross motor function was analyzed by Spearman analysis.Results As for MK value,there were statistically significant differences in all different brain areas between the research group and the control group(P<0.05).And for FA value,there was statistically significant difference only in white matter area between the research group and the control group (P<0.05).However,there was no statistically significant difference in cerebral deep gray nuclei area (P>0.05).The GMFCS score was negatively correlated with the FA value,and was positively correlated with the MK value.Conclusion DKI can reflect the damaged situation of gray matter in children with cerebral palsy,and its parameter values can be used to monitor the children with cerebral palsy as evaluation indicators.

Objective:To construct a fall risk prediction model for patients with hematologic malignancies and to provide a reference for the risk assessment and accurate management of falls.Methods:The prospective study design was adopted to facilitate the selection of 510 patients with hematologic malignant in Qilu Hospital of Shandong University for investigation, and relevant data such as patient demographic characteristics, disease treatment and drugs were collected. The LASSO-Logistic regression was used to screen the risk factors of falls in patients with hematologic malignancies, to construct a nomogram risk prediction model. The receiver operating characteristic curve (ROC) and calibration curve were used to evaluate the predictive performance of the model. Bootstrap resampling were used to validate internal validation of the model.Results:Among 510 patients with hematological malignancies, there were 273 males and 237 females, aged 53.0 (41.0, 63.0) years old. A total of 6 risk factors were included in the fall risk prediction model for patients with hematological malignancies, which were disease type ( OR = 0.185, 95% CI 0.061 - 0.562), body temperature ≥38 ℃ ( OR = 2.239, 95% CI 1.128 - 4.445), pain ( OR = 15.581, 95% CI 6.592 - 36.829), anemia ( OR = 4.097, 95% CI 1.536 - 10.927), days of bone marrow suppression ( OR = 3.341, 95% CI 1.619 - 6.893), and assessment of daily self-care ability ( OR = 3.160, 95% CI 1.051 - 9.506)(all P<0.05). The ROC curve of the fall risk prediction model was 0.884 (95% CI 0.841-0.927). The optimal threshold, sensitivity, and specificity of the risk prediction model were 0.248, 87.4% and 75.6%. The internal validation C statistic was 0.873. The Calibration curve was almost coincides with the ideal curve, and the model Brier score was 0.080. Conclusions:The constructed fall risk prediction model has good predictive performance, which can efficiently and objectively quantify the risk of falls, and provide a reference for the early assessment and effective prevention of falls in patients with hematological malignancies.

Objective:To evaluate clinical efficacy and safety of topical compound oleum lithospermi in the treatment of mild to moderate diaper dermatitis.Methods:A multicenter, randomized, positive-drug parallel-controlled clinical trial was conducted in 19 hospitals from July 2019 to August 2020. Children aged 0 - 12 months with mild to moderate diaper dermatitis were enrolled and randomly divided into 2 groups using a random number table: test group topically treated with compound oleum lithospermi, and control group topically treated with zinc oxide cream. The treatment was carried out 6 - 8 times a day for 7 days. Visits were scheduled on days 0 and 7, and total response rate and clinical healing time were evaluated. Changes in the dermatitis family impact (DFI) score were compared between the test group and control group, and adverse events were recorded. Statistical analysis was carried out by using independent-sample t test for normally distributed continuous data, Wilcoxon rank sum test for non-normally distributed continuous data, and chi-square test or Fisher′s exact test for unordered categorical data; survival curves were drawn, and log-rank test was used for comparisons between two groups. Results:A total of 343 children with diaper dermatitis were enrolled in this study. Among them, 31 children violated the protocol, so 312 were included in the per protocol set, including 157 in the test group and 155 in the control group, and all completed the visits on days 0 and 7. The total response rate was significantly higher in the test group (87.26%, 137/157) than in the control group (78.71%, 122/155; χ2 = 4.04, P = 0.044) . The clinical healing time was significantly shorter in the test group (5.33 days) than in the control group (6.13 days; χ2 = 4.67, P = 0.025) . After 7-day treatment, the DFI score significantly decreased in both the 2 groups compared with that before the treatment, but there was no significant difference in the DFI score between the 2 groups (test group: 4.02 ± 6.96, control group: 3.58 ± 5.90, Z = -0.39, P = 0.686) . The incidence of adverse events was 2.92% (5/171) and 5.45% (9/165) in the test group and control group respectively, and there was no significant difference between the 2 groups ( χ2 = 0.03, P = 0.865) . Conclusion:Compound oleum lithospermi can markedly reduce the clinical severity of diaper dermatitis, improve the total response rate, shorten the clinical treatment period, and improve the quality of life of children′s families with a favorable safety profile.