Objective To investigate the risk factors for cerebral microbleeds (CMBs) and its correlation with the 24 h microalbuminuria (mALB) in patients with small artery occlusion (SAO).Methods The patients with SAO were enrolled.CMBs were detected with susceptibility-weighted imaging.The demographic and clinical characteristics and 24 h mALB of the patients were compared.Multivariate logistic regression analysis was used to identify the independent risk factors for CMB in patients with SAO.Spearman correlation analysis was used to investigate the correlation between the 24 h mALB and the degree of CMBs.Results A total of 90 patients with SAO were enrolled and 35 patients (38.89％) had CMBs.CMBs mainly distributed in basal ganglia/thalamus and infratentorial (62％) regions.The Age (70.8 ± 5.4 vs.67.3 ± 8.1; t =2.461,P =0.016),proportion of hypertension (80.0％ vs.52.7％ ;x2 =6.851,P =0.009),and 24 h mALB levels (16.257 ± 6.031 mg/24 h vs.11.910 ±5.458 mg/24 h; t =3.536,P =0.001) in the CBM group were significantly higher than those in the non-CMB group.Spearman rank correlation analysis showed that the 24 h mALB and the severity of CMB in patients with SAO showed a significant positive correlation (rs =0.795,P =0.000).The higher the 24 h mALB level was,the more severe the CMB degree would be.Multivariate logistic regression analysis showed that only 24 h mALB was the only independent risk factor for CMBs in patients with SAO (odds ratio,1.100,95％ confidence interval 1.031-1.176; P =0.002).Conclusions The 24 h mALB is an independent risk factor for CMB in patients with SAO.The 24 h mALB level is positively correlated with the severity of CMB,and it may be used as a marker for small vascular injury.

Objective To study the extraction and purification of glycosaminoglycans from Rhoqilema esculenta Kishinouye,optimize the enzymolysis process,and its antihyperlipidemia effects were studied.Methods Extraction of glycosaminoglycans(GAG) from Rhopilema esculenta Kishinouye by hydrolyzation method with papain,subtilisin and trypsin neutral proteinase,ethanol precipitation.The rude product of glycosaminoglycans(GAG) was purified and fractionated by the methods of adsorption,dialysis,ethanol precipitation and CTAB precipitation.The experimental hyperlipidemia mice induced by high fat forage were studied.The total cholesterol(TC) and triglyceride(TG) levels were determined.Results Optimum enzymolysis process: papain neutral proteinase1.5%,subtilisin neutral proteinase1.5%,treated for 5h;The result showed that the levels of TC and TG decreased to 6.83?1.09 mmol?L-1(P

The animal models of hypoxic-ischemic brain injury have been established inmany animals, such as monkeys, dogs, rats, mice, rabbits, and pigs. These models have provideda great deal of important information for neonatal hypoxic-ischemic brain injury. Howerver, thedifferent species vary in their susceptibility to the various types of ischemic insults. This articlereviews the animal models of hypoxic-ischemic brain injury in different species.

Objective To evaluate the efficacy of pleth variability index (PVI) in guiding volume therapy in the patients undergoing thoracoscopic surgery.Methods Forty patients of both sexes, aged 18-64 yr, with body mass index＜35 kg/m2 , of American Society of Anesthesiologists physical status I or Ⅱ ,scheduled for elective thoracoscopic lobectomy, were randomized into 2 groups (n =20 each) : control group (group C) and PVI group.During induction of anesthesia, multiple electrolyte solution was infused rapidly as a bolus of 250 ml, followed by a 2-8 ml · kg-1 · h-1 infusion.In group C, 6％ hydroxyethyl starch 130/0.4 and sodium chloride injection 50 ml and metaraminol 0.5 mg were administered to maintain mean arterial pressure ≥ 65 mmHg.In group PVI, 6％ hydroxyethyl starch 130/0.4 and sodium chloride injection 50 ml and metaraminol 0.5 mg were administered to maintain PVI ≤ 13％ and mean arterial pressure ≥ 65 mmHg.Immediately after the beginning of one-lung ventilation (T1) , immediately after the termination of one-lung ventilation (T2) and at 1 h after surgery (T3) , arterial oxygen saturation were recorded, and arterial blood samples were collected for blood gas analysis, and for determination of lactic acid concentrations.The blood creatinine concentrations were measured at 24 h before and after surgery.The fulid balance was recorded.Results The amount of colloid solution infused, total volume of fluid infused and lactic acid concentrations at T3were significantly lower in group C than in group PVI.There were no significant differences in the amount of crystralloid solution infused, urine volume, blood loss, arterial oxygen saturation at each time point, and blood creatinine concentrations at 24 h before and after surgery between the two groups.Conclusion PVI-guided volume therapy can not only maintain adequate blood volume and tissue perfusion, but also reduce the amount of fluid infused, and is helpful in mitigating lung water overload when used for the patients undergoing thoracoscopic surgery.

Objective:To explore the optimal postpartum nursing intervention method of elderly second-birth parturient based on the best evidence and evaluate its effect so as to improve the quality of clinical nursing.Methods:Based on the best evidence obtained from the previous study, the optimal nursing examination index of the elderly second parturient was established, and the evidence of best practice was obtained by using the evidence-based nursing method, and the 2017 revised version (the third edition of) Johns Hopkins evidence-based nursing practice model) was used to guide nurses to apply the evidence to clinical practice. During the period from March to May 2019, the baseline review was completed, including 82 pregnant women and 43 nurses. The evidence was incorporated into clinical practice in June 2019. From July to October 2019, the same indicators and inclusion and exclusion criteria were used to evaluate the effectiveness of evidence application in 43 nurses (including midwives) and 85 elderly second-child parturients in obstetric wards (including baby-friendly areas). The anxiety, depression, maternal satisfaction and nurses' correct implementation rate of the best evidence were compared before and after the application of evidence.Results:After the use of evidence-based intervention, the implementation rate of nurses was above 80%. The anxiety score of parturient decreased from 55.29±10.11 to 41.74±10.35, the difference was statistically significant ( t value was 8.55, P<0.001), and the depression score decreased from 57.77 ±8.32 to 47.86 ±9.33, the difference was statistically significant ( t value was 7.23, P<0.001). Maternal satisfaction increased from 92.68% (76/82) to 98.82% (84/85), the difference was statistically significant ( χ2 value was 3.92, P< 0.05). Conclusion:The result of practice shows that through evidence-based nursing intervention, we can further standardize the postpartum optimal nursing paradigm of elderly second-child parturients in China. Reduce postpartum anxiety and depression and improve maternal satisfaction. And quality review still needs to be continuously promoted and implemented in clinical practice in order to continuously improve the quality of nursing and ensure sustainability.

Acupuncture Therapy ; methods ; Adult ; Aged ; Cervical Vertebrae ; Female ; Humans ; Male ; Middle Aged ; Neck Pain ; therapy ; Spondylosis ; therapy

Objective To study the recovery of the peripheral lymphocyte subsets in patients underwent allogeneic peripheral blood stem cell transplantation (allo-PBSCT) and guide the prevention and treatment of infection. Methods Indirect immunofluorescence assay was used to detect the lymphocyte subsets, such as T cell subsets (CD3, CD4, CD8). B cell (CD19) and natural killer cell(CD56) at 1, 3, 6, 12, 18months post transplantation, in the meantime, lymphocyte subsets of 32 samples from healthy blood donors were tested as normal control values. Results CD+3, CD+4 and CD+8 ceils significantly decreased than that of normal control at 1 month post transplantation, the recovery of CD+3 T cells was within 3-12 months, CD+4 and CD+8 T cells recovered to normal at 6 months and 3 months post transplantation respectively, CD+4/CD+8 ratio were not significantly lower than that of normal control at different stages, CD+4/CD+8 ratio reversed only at 6 months post transplantation. CD+19 and CD +56 T cells recovered quickly and they were more than normal proportion at 3 months post transplantation. The CD+3, CD+8 T cells and CD+4/CD+8 ratio were statistically higher in HLA haploidentical allo-PBSCT patients than that in HLA identical allo-PBSCT at 3 months post transplantation. There were no difference between the two groups at 1, 6, 12, 18 months post transplantation.The patients with cGVHD had significantly higher CD+4 cells than those without cGVHD at 1 month after transplantation. There was no significant difference in all of the lymphocyte subsets at 3, 6, 12, 18 months after transplantation between them. Conclusion Allo-PBSCT has a hastened immune reconstitution, which was not delayed by the incompatibility of HLA and the development of cGVHD.

Objective To investigate the variations in the pol region of HIV-1 strain in treatment failed patients in Yunnan province's Dehong prefecture and Kunming. Methods Blood samples were collected from 139 patients who experienced treatment failure ( HAART treatment ＞ 1 years and HIV-1 RNA Viral load ＞ 1 000 copies/ml). HIV-1 RNA was extracted from plasma, and nested-PCR was performed for amplification of PR and RT genes on the HIV-1 pol region. The PCR products were then sequenced and submitted to Stanford HIV Drug Resistance Database for comparison. The evolution tree was built up with MEGA 4. 1 system, combined with patients' demographics. Results The most prevalent mutation in Kunming patients were T215F/N/Y/I, M41L/M, and T69G/N/I/S/A/D, the mutation rates were 39%(24/62), 27% (17/62) and 27% (17/62) , respectively, which were higher than the corresponding mutations in the Dehong prefecture [16% ( 11/69), 13% (9/69) and 9% (6/69)]. The rate differences were statistically significant ( x2 = 8.646, 4.242 and 7. 909, all P ＜ 0.05 ). The most common HIV-1 pol region subtype in the Dehong patients were CRF01_AE subtype (32%, 22/69), followed by C subtype (25% ,17/69), and B subtype ( 19%, 13/69). Major subtypes in Kunming patients were 08_BC (60%,37/62 ), CRF01_AE subtype(21% , 13/62 ) and 07_BC ( 15% ,9/62). Conclusions Partial differences of the point mutations of the HIV-1 strain pol region and frequency of their occurrences exist among Dehong and Kunming patients, HIV-1 strains in Dehong prefecture for the NNRTIs mutations at the T215 Y/N/T, M41L and T69G/N/I/S/A/D are significantly higher than those in Kunming. Six isoforms are found respectively:CRF01_AE, B, C, BC, 08_BC and 07_BC from the epidemic strains of HIV-1 pol region subtype in Dehong and Kunming areas.

Objective To explore the clinicopathological features and prognostic significance of human epidermal growth factor receptor 2 (HER2) in gastric carcinoma. Methods Pathological data of 127 patients with gastric carcinoma were retrospectively analyzed. HER2 expressions of all patients were detected by immunohistochemistry (IHC). 119 (93.7 %) patients were undergone R0 dissection and 123 (96.9 %) cases received D2 lymph nodes dissection. 51 (40.2 %) patients received adjuvant chemotherapy. The proportional differences of clinicopathological features for patients between HER2-positive and HER2-negative were compared, including the patients' survival. Results HER2 overexpression rate was 8.7 % (11/127) in gastric carcinoma patients. For the patients with HER2-positive and HER-negative, the lymph node metastasis rates were 100.0 % (11/11) and 81.9 % (95/116), respectively (P= 0.041). The 3-year overall survival (OS) rates for HER2-positive and HER2- negative patients with gastric carcinoma were 32.7 % and 42.9 % (P=0.413), and the 5-year progression free survival (PFS) rates were 27.3 % and 42.2 % (P = 0.354), respectively. Among patients with HER2-negative, 3-year OS rate for patients with surgery plus adjuvant chemotherapy was 55.3%, compared with 35.4%for patients with surgery alone (P=0.015), and the 3-year PFS rates were 53.3 % and 35.3 % (P= 0.038), respectively. Among patients with HER2-positive patients, 3-year OS rate for patients with surgery plus adjuvant chemotherapy was 0, compared with 75.0%for patients with surgery alone (P=0.002), and the 3-year PFS rates were 0 and 60.0% (P=0.004). Conclusions HER2 is expressed in gastric carcinoma tissue, related to lymph node metastasis. HER2 status are not correlated with the prognosis for gastric carcinoma patients, however, it is likely to be a predictive marker for adjuvant treatment after surgery for patients with gastric carcinoma.

A novel white-rot fungus AH28-2,which was isolated from 224 fungi samples,ability to produce effectively laccase by induction.Several factors influencing laccase production were investigated.The optimum conditions were as follows:the 300mL Erlenmeyer flask containing 150mL of liquid medium was inoculated with 7.5mL of mycelial fragments and the medium was supplied with lignin at a concentration of 0.1%(initial pH8.5).The cultures was incubated at 28℃ on rotary shaker(150r/min) for 4～5 days.The maximum enzyme activity was 20184IU/L.