With the changing disease spectrum, the incidence of tumors is increasing and tends to occur among the youth. The long-term survival rate of patients with cancer has increased significantly, and attention to their reproductive rights is growing. Surgery, chemotherapy, radiotherapy, immunotherapy, and molecular targeted therapy are the conventional treatment methods for cancer, with each exerting different effects on the fertility of patients. Common fertility preservation techniques currently include sperm cryopreservation, embryo and oocyte cryopreservation, ovarian tissue cryopreservation, uterine transplantation, and assisted reproductive technology. This article systematically summarizes the influence of different antitumor treatments on fertility, as well as the current status and prospects of fertility preservation in patients with cancer. This study aims to improve cooperation between clinical oncologists and reproductive medicine doctors to enhance fertility preservation for patients with cancer.

Objective:To investigate the application effect of WeChat combined with team-based learning (TBL) in the teaching of rehabilitation therapy.Methods:A total of 40 students majoring in rehabilitation therapy who studied in our department were selected and divided into control group and experimental group, with 20 students in each group. The students in the control group received lecture-based learning, and those in the experimental group received WeChat combined with TBL. At the end of training, department examination and satisfaction investigation were performed for all students. SPSS 26.0 was used to perform the t-test and the chi-square test. Results:Compared with the control group, the experimental group had a significantly better score of department examination (74.3±4.9 vs. 62.4±5.2, P<0.001), which was reflected in the three aspects of case analysis (18.3±2.1 vs. 15.2±1.9, P<0.001), clinical practice (19.3±2.1 vs. 14.8±2.4, P<0.001), and doctor-patient communication (17.8±2.4 vs. 14.1±2.4, P<0.001). Compared with the control group, the experimental group had a significantly better total score of satisfaction investigation (79.6±4.8 vs. 71.2±3.5, P<0.001). Conclusion:The teaching method of WeChat combined with TBL can improve the teaching effect of rehabilitation therapy and help to enhance the abilities for case analysis, clinical practice, and doctor-patient communication among students.

Objective To evaluate the teaching effects of applying clinical pathway in clinical practice teaching of neurology. Methods The undergraduate interns majoring in clinical medicine were randomly divided into clinical pathway teaching method group (n=34) and traditional teaching method group (n=34). Both groups were taught by senior physicians with the same teaching content and teaching material. A control study between the two groups in theoretical knowledge, operational skills and satisfaction degrees of teaching was carried out. Results The results of clinical pathway teaching method group in theoretical knowledge[(55.2±3.70) vs. (51.8±4.6)] and operational skills [(36.3±3.2) vs. (31.3±2.19)] were both sig-nificantly better than those of traditional teaching method group (P<0.05). The satisfaction degree of teach-ing of clinical pathway teaching method group is relatively higher . Conclusions The clinical pathway teaching method enhances the scientific property and systematic property of teaching contents, obtaining a favorable teaching effect.

Objective To investigate the influence of carotid artery stenting (CS)of asymptomatic critical internal carotid artery (ICA)stenosis patients on cognitive function .Methods One hundred and fifty‐six asymptomatic patients with internal carotid arter‐y stenosis(carotid stenosis severity≥70% )were enrolled ,in whom CS was attempted .Functional assessments including alzheimer disease assessment scale‐cognitive subtest (ADAS‐Cog) ,mini‐mental state examination (MMSE) ,and trail making test A(TMTa) and B(TMTb) were done prior to 1 weeks and 3 months after the procedure .Results Successful CS was achieved in all of patients (100% ) ,only 1 patient was lost to follow‐up .There were significant improvement in ADAS‐Cog score(pre 6 .60 ± 2 .04 vs .post 5 .16 ± 1 .63 ,P<0 .01) ,MMSE score (pre 26 .32 ± 1 .06 vs .post 27 .05 ± 1 .46 ,P< 0 .01) ,TMTa (pre 108 .94 ± 17 .42 vs .post 94 .70 ± 20 .27 ,P<0 .01) ,TMTb (pre 178 .65 ± 21 .77 vs .post 148 .92 ± 23 .65 ,P<0 .01) .There was new cerebral infarction dur‐ing 3 months after surgery .Conclusion Asymptomatic critical internal carotid artery (ICA)stenosis may be one reason of cognitive impairment ,and successful CS could improve cognitive function in asymptomatic ICA stenosis .

Objective To investigate the effect of the reduced nicotinamide adenine dinucleotide phosphate (NADPH) oxidase on Toll-like receptor 4 (TLR4)-mediated proinflammatory phenotype of cultured vascular smooth muscle cells (VSMCs) in mice.Methods NADPH oxidase agonist platelet-derived growth factorBB (PDGF-BB) and inhibitor apocynin were used respectively to treat cultured VSMCs from C57BL/6J and TLR4-/-mice.The fluorescent probe 2',7'-dichlorodihydrofluorescein diacetate was used to detect the reactive oxygen species (ROS) level in VSMCs.An enzyme-linked immunosorbent assay was used to detect the expressions of interleukin (IL)-6,IL-1β,and tumor necrosis factor-α (TNF-α) in VSMCs.Tetrazolium blue staining and Boyden chamber assay were used to detect the proliferation and migration of VSMC.Results The ROS levels were increased in VSMCs both from C57BL/6J and TLR4-/-mice after PDGF-BB treatment,and this could be inhibited by apocynin.PDGF-BB pretreatment significantly upregulated the expressions of IL-6 (52.69 ±3.49 ng/ml vs.35.04 ±2.74 ng/ml; P =0.001),IL-1β (79.68 ±2.33 ng/ml vs.62.38 ±0.54 ng/ml;P=0.000),and TNF-α (218.35± 5.42 ng/mlvs.124.74± 4.59 ng/ml; P=0.000) in VSMCs from C57BL/6J mice,and the abilities of proliferation (1.69 ± 0.53 vs.1.04 ± 0.40; P =0.000) and migration (42.11 ±4.05 vs.1.69 ± 0.53; P =0.000) were increased significantly; apocynin pretreatment significantly inhibit the expressions of IL-6 (42.11 ± 4.05 ng/ml vs.52.69 ± 3.49 ng/ml; P =0.010),IL-1β (67.57 ± 1.36 ng/ml vs.79.68 ±2.33 ng/ml; P =0.000) and TNF-α (156.18 ± 6.98 ng/ml vs.218.35 ± 5.42 ng/ml;P =0.000),as well as proliferation (1.23 ±0.42 vs.1.69 ±0.53; P =0.000) and migration (42.11 ±4.05 vs.52.69 ± 3.49; P =0.000).While there were no significant changes in the expressions of IL-6,IL-1β,and TNF-α in VSMCs from TLR4-/-mice after PDGF-BB and apocynin pretreatment.Conclusions NADPH oxidase-derived ROS involved in the TLR4-mediated VSMC inflammatory phenotype as well as proliferation and migration,which may be the important mechanisms of its influencing on the occurrence and development of atherosclerosis.

Objective To investigate the efficacy of intra-arterial thrombolysis with stenting for acute cerebral infarction. Methods Using a prospective case-control design, 24 patients with acute cerebral infarction who remained angiostegnosis ( ＞ 50%) after intra-arterial thrombolysis were randomly divided into stent treatment group and drug treatment group. They were treated with stenting + drug treatment and conventional drug treatment. The rates of vascular complete revascularization and residual stenosis, and the modified Rankin scale scores at 3 months in both groups were evaluated. Results The rate of complete revascularization in the stent treatment group was significantly higher than that in the drug treatment group (54. 5% vs.0%,χ2 =6.382, P ＜0. 001), and the rate of residual stenosis was significantly lower than that in the drug treatment group ([4.5 ±5.2]% vs. [82. 5 ±10. 5]%, t =7.464, P＜0.001). The rate of favorable clinical outcome in the stent treatment group was significantly higher than that in the drug treatment group (100% vs. 76. 9%,χ2 = 14. 263, P = 0.038). Conclusion The efficacy of intra-arterial thrombolysis with stenting in the treatment of acute cerebral infarction is superior to that in the drug treatment group, and it is safer.

Objective To observe the dynamic changes of serum inflammatory factors after vertebral artery stenting and to investigate its clinical significance. Methods A total of 48 patients treated with vertebral artery stenting were included, and 48 patients only received cerebral angiography were used as a control group. The levels of soluble intercellular adhesion molecule-1 (sICAM-1), high-sensitivity C-reactive protein (hs-CRP) and tumor-necrosis factor-α (TNF-α) were detected before procedure (angiography), at 24 h, 48 h, 3 d, and 1 and 3 weeks after procedure (angiography). Results The serum levels of hs-CRP (4. 85 ± 0. 53 mg/L vs. 2. 57 ±0. 36 mg/L,P＜0. 05), TNF-α (2.42 ±0. 34 μg/L vs. 1. 08 ±0. 37 μg/L,P ＜0. 05) and sICAM-1 (449.43 ± 47. 16 μg/L vs. 269. 15 ± 37. 46 μg/L, P ＜ 0. 05) at 24 hours after procedure in the stenting group were significantly elevated compared with those before procedure. The Hs-CRP level (6.24 ± 0.59 mg/L) reached the peak at 48 hours after procedure. At week 3 (2. 51 ±0.29 mg/L), it returned to the level before procedure (2. 57 ±0. 36 mg/L); TNF-α level reached the peak at day 3 (2.30 ± 0.25 μg/L), and it remained higher level at week 3 (1. 89 ±0. 13 μg/L); the sICAM-1 level continued to rise at week 3 (296. 95 ± 59. 72 μg/L). The serum hs-CRP, TNF-α and sICAM-1 levels at 24 hours after procedure in the stenting group were significantly higher than those (3. 25 ±0.40 mg/L、J. 18 ±0. 19 μg/L and 336. 57 ± 50. 18μg/L) in the control group (all P＜0.05). Conclusions The serum hs-CRP, TNF-α, sICAM-1 levels were significantly elevated after vertebral artery stenting. It was suggested that the stenting caused a longer duration of inflammatory response.

Objective To evaluate the effect of vertebral artery kinking on cerebral hemodynamics. Methods The patients with vertebral artery kinking on digital subtraction angiograph (DSA) were selected from 223 patients with vertebral-basilar artery transient ischemic attack, then the changes of vertebral artery hemodynamics were evaluated using transcranial color Doppler (TCD). Results There were 84 patients with vertebral artery kinking among 223 patients with vertebral-basilar artery transient ischemic attack. Patients with vertebral artery kinking were older and had more vascular risk factors than patients without vertebral artery kinking. Compared with the control group, patients showed decreased blood flow rate such as peak velocity (Vp) and mean velocity (Vm), increased pulsatility index (PI) and resistant index (RI) in vertebral artery kinking group. Conclusions Vertebral artery kinking is common abnormal artery among patients with vertebral-basilar artery transient ischemic attack, it leads to hemodynamic changes. Age and vascular risk factors are potential causes of vertebral artery kinking.

Objective To observe the effects of sleep deprivation(SD)on learning and memory and phos-phorylated cyclic AMP responsive element binding protein(pCREB) expression in hippocampus of mice,and to explore the mechanism of cognitive change after SD. Methods Twenty female C57BL/6J mice were randomly divided into sleep deprivation group(SD, n = 10) and normal cage control group (CC,n = 10). Touch method was used to establish the sleep deprivation model. 30 days after SD,all the animals were subjected for Morris Water Maze (MWM) to test mean escape latency and percentage of time spent in the target quadrant. pCREB level in hippocampus was tested with Western blot. Results The mean escape latency in SD group in the second and third day of MWM was (29.31 ±4.93) s and (25.33 ±5.06)s, respectively, and was longer than that in CC group ((26.05 ±5.96)s and (19.35 ±7. 85)s,respectively). Mice in SD group spent less time in the target quadrant than that in CC group((23.61 ±9.86)% and (37.46 ±7. 51)%,.respectively, P<0.05). Results of Western blot for pCREB revealed that the pCREB level in hippocampus in sleep deprivation group was significantly lower than that in control group(0.71 ±0.03 and 0.82 ±0.06, respectively, P<0.01) . Conclusion The impairment of spatial learning and memory ability in sleep deprivation animals may be associated with the reduction of pCREB in hippocampus.

BACKGROUND: Activation of leucocyte and endothelial cell in ischemic area of brain and the expression of adhesive molecule on the surface can cause aggregation and infiltration of leucocyte which deteriorated cerebral injury due to cytotoxicity. Ligustrazine can inhibit thrombosis and improve microcirculation.OBJECTIVE: To observe the effect of ligustrazine on adhesion of leucocyte and endothelial cell in focal area after cerebral ischemia-reperfusion injury.DESIGN: Randomized controlled animal study.SETTING: Second Division of Brain, Department of Neurology, Daping Hospital of the Third Military Medical University of Chinese PLA; Department of Psychiatry, the Second People's Hospital of Yuxi, Yunnan Province.MATERIALS: The experiment was carried out at the Second Cerebral Laboratory of Neurological Department of Daping Hospital Affiliated to the Third Military Medical University of Chinese PLA. A total of 32 male Wistar rats weighing 250-300 g were randomly divided into normal control group (n=8), cerebral ischemia-reperfusion group (n=12) and cerebral ischemia-reperfusion + ligustrazine group (n=12).METHODS: Rats in ligustrazine group were venously injected with 15 g/kg ligustrazine phosphoric acid, and rats in normal control group and cerebral ischemia-reperfusion group were venously injected with the same volume of saline. Cerebral ischemia-reperfusion injury and adhesive changes of leucocyte in focal area after administration of ligustrazine were observed with immunofluorescent labeling technique and micro-ultra-speed imaging system.MAIN OUTCOME MEASURES: ① Adhesive density index of leucocyte of arteriole in focal area after cerebral ischemia-reperfusion injury; ② Adhesive changes of leucocyte in focal area after administration of ligustrazine.RESULTS: All experimental animals were involved in the finalanalysis.① As compared with those in control group, adhesive density index of leucocyte of arteriole in focal area in cerebral ischemia-reperfusion group was increased, broken stress between leucocyte and endothelial cell was decreased remarkably, adhesion was increased obviously, and there was significant difference (P ＜ 0.01). ② As compared with those in cerebral ischemia-reperfusion group, adhesive density index and adhesion of leucocyte in ligustrazine group were decreased and reached the lowest values after 24 hours. Broken stress was increased and maintained at a higher level. There was no significant difference from that in normal control group till 24 hours.CONCLUSION: Ligustrazine can relieve adhesion between endothelial cell and leucocyte after cerebral ischemia-reperfusion injury.