Objective To explore the correlation between the recurrence rate of the elderly patients with lacunar infarction and the risk factors including blood pressure, blood glucose, total cholesterol, triglycerides,low density lipoprotein cholesterol values, high-density lipoprotein cholesterol and other. Methods 207 over 60 years old patients with lacunar infarction occurred the first time were included in the study. All patients were followed up two years to assess the relapse rate and the risk factors of the patients with lacunar infarction. Results 207 cases of elderly patients with lacunar infarction complicated with hypertension,type 2 diabetes and hyperlipidemia were 148 cases,22 cases,7 cases respectively, and the recurrence rates of three groups were 8.78%, 18.18%, 14.29% respectively;The patients complicated with hypertension and 2 type diabetes were 6 cases,and the recurrence rate was 34.62%;The patients without hypertension,type 2 diabetes and hyperlipidemia were 4 cases,and the recurrence rate was 0%. In two years,27 cases of lacunar infarction recurred,and the recurrence rate was 13.04%. Conclusion Hypertension,type 2 diabetes,hyperlipidemia could also be considered as the high-risk predictor factors for the recurrence rate of the elderly patients with lacunar infarction.

Autophagy occurs in all types of eukaryotic cells, which has a rigid connection with the normal or abnormal development of cells and is associated with many diseases. There're lots of molecular control elements and multiple signaling pathways involved in regulating autophagy. As a form of type Ⅱ programmed cell death, autophagy participates in maintaining cell homeostasis and pathogenesis of various of diseases through interacting with apoptotic pathway. Recent studies show that autophagy has effects on the occurrence and development of tumor cells through influencing on cell cycle, apoptosis-associated factors and angiogenesis.

Objective To explore more suitable calculation method of the insulin dosage in insulin hypoglycemia-growth hormone stimulation test(insulin tolerance test, ITT). Methods Fifty-six subjects suspected of growth hormone deficiency were divided into primary and secondary onset groups. All the patients took oral glucose tolerance test and ITT. Homeostasis model of assessment for insulin resistance index ( HOMA-IR) and insulin sensitivity index ( ISI), area under insulin curve ( AUCINS ) and the area under glucose curve ( AUCPG ) were calculated. The insulin dosages during ITT between two groups were compared and the main factors influencing the insulin dosage were analyzed. Results There was no difference in the insulin dosage during ITT between primary and secondary groups. The actual dosage of insulin in this cohort study revealed a significant difference from the initial insulin dosage recommended by the guideline. Multiple linear regression analysis found that AUCINS and body mass index were the independent factors affecting the insulin dosage. Then the optimized coefficient of ITT ( γ) were found. Conclusion The insulin dosage used in our study was inconsistent with the guidelines-recommended ones. In order to make ITT more efficient and safer, a more optimized calculation method to improve the successful rate of insulin-induced hypoglycemia in ITT is proposed.

Objective To study the periodontal status and risk factors for periodontitis in periodontitis patients at different ages in wuhan. Methods From January 2007 to March 2008, the cross-sectional survey on periodontal conditions of 493 physical examinees in Wuhan city was carried out with random cluster sampling method. 458 cases of them were in accordance with the inclusive criteria and were stratified into two groups: young and middle-aged adults (aged 30-59 years) and old adults (aged 60 years and over). A case-control study was carried out in the periodontitis cases group (n=280) and the control group (n=178). Database was created by SQSERVER2000 and SPSS11.0 was used for statistical analysis. The relationship of periodontitis with age, gender, nation, educational background, diabetes mellitus, smoking, drinking, mental pressure and oral hygiene habits were analyzed by univariate and multivariate logistic regression analysis. Results The prevalence of periodontitis was 61.1% (280/458). Univariate analysis revealed that age, educational background, diabetes mellitus, smoking and oral hygiene habits were related factors for periodontitis (OR:0.44, 2.27, 3.44, 1.75, 9.82, P<0.05 or P<0.01). Meanwhile, multivariate analysis showed that suffering from diabetes mellitu and low educational background were the independent risk factors for periodontitis (OR=2.66, 1.95, all P<0.05). After stratification by age, multivariate logistic regression analysis showed that there was no correlation between diabetes mellitus and periodontitis prevalence in young and middle-aged adults and diabetes mellitus was a risk factor for periodontitis in old adults(OR=6.91, 95%CI: 1.27～37.42). Conclusions There are many risk factors for periodontitis and diabetes plays a major role in the development of periodontitis in old adults.

Objective To find out parental locus of control and mental health affecting students test anxiety. Methods The samples were from 5 middle schools including 1000 students,and their parents. They were investigated with the general life scales, Sarason's test anxiety scale, Symptom checklist 90 (SCL-90)and Parenting Locus of Control Scale(PLOC). Results The ratio of test anxiety: the mild was 28.8%, moderate was 45.0%, severe was 26.2% ,and felt anxiety was 55.8%. Ratio of test anxiety was higher in the boy students (X2=9.284, P =0.010) ,and heavier(F:16.42±6.70; M:15.18 ±6.51, t=2.716, P=0.007). Student test anxiety was significantly positively correlated with their parental mental health (r fatherl～11=0.166～0.272, Pfather l～11= 0.000;r mother 1～11=0.182～0.242, P mother 1～11= 0.000); Student test anxiety positively correlated with the effectiveness cof parents education, father's belief on the fate, eontrol of fathers for their children, locus of control from fathers (r1～5=0.075～0.143; P1-5=0.000～0.030);felt anxiety positively correlated with self-expect ,pressure from their mothers,over take care attitude from their parents,self-pressure from their parents( r1～6=0.068～0.230; P1-6=0.000～0.050) ,and negatively correlated with respect attitude of parents for their child, Marital relations,Communication time between the students and their parents,attitude of mother for learning( r1-7=-0.074～-0.140;P1～7=0.000～0.034). Felting test anxiety was served as a dependent factor, some factors enter the regression equation,and they were somatization of father, psychotic mother, the pressure from parents, mother over expectations, self-expectations ,the child control from student's father by Logistic regression analysis ( OR1～16=0.675～3.029;P1-6=0.000～0.007). Conclusion Students test anxiety is a common problem in male and female students. Mental health and locus of control from students' parents show test anxiety has somatization of father, psychotic mother, the pressure from parents, mother' expectations,self-expectations, the control of father for the child 6 risk factors.

The aim of this study is to investigate the effects of electrical stimulation ES) on the induction of rat bone marrow mesenchymal stem cells (rBMSCs) to differentiate into cardiomyocyte-like cells in vitro. The third or fourth-generation of the rBMSCs was randomly divided into three groups, i. e. ES group, 5-Azacytidine (5-Aza) group, and control group. Those in the ES group with complete medium were exposed to 1,2,4 and 6V, 2Hz, 5ms ES for 2h everyday,lasting for 10d. Those in the 5-Aza group were induced by 10 micromol/L 5-Aza for 24h, then the medium was changed to complete medium without 5-Aza. Those in the control group were only cultured with complete medium. The growth status and morphological features of rBMSCs were observed by inverted phase microscope. The mRNA expressions of GATA4, a-actin, ACTN2 and TNNT2 were determined by Real-time fluorescent quantification PCR, and the protein expression of TNNT2 was detected with immunofluorescence staining. The results showed that the mRNA expression level of the GATA4, a-actin, ACTN2 and TNNT2 and the protein expression level of the TNNT2 were significantly higher in the ES group and 5-Aza group, compared to those in the control group(P<0. 05). It suggested that ES could induce rBMSCs differentiation into cardiomyocyte-like cells in vitro.
Animals ; Bone Marrow Cells ; cytology ; Cell Differentiation ; Cell Proliferation ; Cells, Cultured ; Electric Stimulation ; Female ; Male ; Mesenchymal Stromal Cells ; cytology ; Myocytes, Cardiac ; cytology ; Rats ; Rats, Sprague-Dawley

To report the first case of chronic disseminated paracoccidioidomycosis in China. A 49-year-old male patient presented with papules and nodules of the skin for 1 year, and papules and ulcers on the oral mucosa for 2 months. Skin examination showed the edema of the left foot, multiple crusting ulcers on the sole of the left foot, ulcers with a granular base in the interdigital regions between the third and fourth toes as well as fourth and fifth toes of the left foot, accompanied by punctate hemorrhage and exudation; there were multiple papules, nodules, and plaques on the dorsum and medial side of the left foot and the left knee, with ulcers and crusts in the center; 2 papules were observed on the left wrist, and 1 papule on the left upper lip with a crusted surface; red plaques with ulcers and punctate hemorrhage were observed on the gingival mucosa, buccal mucosa, labial mucosa, and palate, and the lesions mainly occurred on the left side. Ultrasonography of superficial lymph nodes showed bilateral cervical and supraclavicular lymph node enlargement, which was more obvious on the left side. Computed tomography of the chest and abdomen showed diffuse miliary nodular shadows, and cordlike, cloudy flocculent and nodular high-density shadows in both lungs, as well as obvious thickening of the left adrenal gland in the abdomen. Yeast cells were observed by immunofluorescent staining of biopsy tissues from the oral mucosa and left lower limb. Histopathological examination of biopsy tissues from the oral mucosa and left lower limb showed granulomatous inflammation, and refractive double-membrane yeast cells could be observed inside or outside the multinucleated giant cells, without or with a single bud or multiple buds; periodic acid-Schiff staining and hexamine silver staining of the above biopsy tissues were positive. Fungal culture of the left lower limb lesion in Sabouraud dextrose agar medium at 25℃ and 37℃ both yielded fungal hyphae. Metagenomics sequencing of the oral mucosal tissue and alveolar lavage fluid indicated the infection with Paracoccidioides brasiliensis. The diagnosis of chronic disseminated paracoccidioidomycosis was confirmed. After 1-month oral treatment with itraconazole capsules at a dose of 400 mg/d, the lesions on the skin and oral mucosa markedly improved, and computed tomography imaging of the lung and left adrenal gland also showed obvious improvement. The dose of itraconazole was reduced to 200 mg/d after 3 months. The patient′s condition further improved during a 10-month follow-up.

Objective:To investigate clinical and histopathological features and differential diagnostic considerations of mucoepidermoid carcinoma (MEC) .Methods:A retrospective study was carried out on clinical manifestations, histopathological and immunohistochemical features, treatment and prognosis of 8 patients with MEC, who were collected from Department of Pathology, Hospital of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College during 2018 - 2021.Results:Among the 8 patients, 5 were males and 3 were females, and their age at onset ranged from 19 to 67 years. Skin lesions were located on the lip mucosa in 5 cases, on the cheek in 2 cases, and on the nose in 1 case. Tumors were all located in the dermis and subcutaneous tissue, parts of which were connected to the epidermis; different proportions of mucous cells, epidermoid cells and intermediate cells were arranged in nests or clumps, and formed solid or cystic structures accompanied by varying degrees of formation of ducts and mucus lakes; all epidermoid cells and intermediate cells expressed cytokeratins AE1/AE3, CK5/6, P63, carcinoembryonic antigen and epithelial membrane antigen. According to the current Chinese grading system, 1 of the 8 patients was diagnosed with intermediate-grade MEC, and others were diagnosed with low-grade MEC. No abnormalities were found by systemic examination. All patients received surgical resections. After the follow-up of 12 - 36 months, no recurrence or distant metastasis was observed.Conclusion:MEC presents no characteristic clinical manifestations, its diagnosis mainly depends on histopathological features, and mucus in the cytoplasm of mucous cells as shown by alcian blue staining is specific for MEC.