Objective:To explore the protective effects of Zhenzhu Tongluo Pills on cerebral ischemia reperfusion injury in rats.Methods:Totally 15 healthy SD rats were randomly divided into sham-operation group, model group and TCM group according to random number table method, with 5 rats in each group. Except for the sham-operation group, cerebral ischemia models in the other two groups were induced by temporary middle cerebral artery occlusion. After the establishment of ischemia models, the TCM group was administered Zhenzhu Tongluo Pills solutions (1 ml/100 g) intragastrically at a dose of 0.5 g/(kg·d), and the sham-operation group and model group were treated with normal saline, for 14 consecutive days. Neurological deficit score was used to evaluate the degree of neurological deficit in cerebral ischemia rats. TTC staining were used for determining the infarct weights. The nerve cell damage was observed using HE staining method. Immunohistochemistry staining was used to observe the expression levels of GFAP, Nestin, and NeuN.Results:Compared with that at the 3 hours after reperfusion, the Bederson score in the TCM group decreased at the 30 minutes after the last administration ( P<0.05); compared with the model group, the infarction ratio of rats in the TCM group decreased ( P<0.05); the NeuN staining of neurons around the ischemic lesion in the model group rats was light, while Nestin and GFAP staining were deep; the Nestin and GFAP staining of neurons in the TCM group was light, while NeuN staining was deeper. Conclusion:Zhenzhu Tongluo Pills can improve the symptom of neurological deficits, reduce the volume of infarction, and protect neurons from injury in rats with cerebral ischemia.

Objective:To understand the status of sedation and analgesia treatment and management in pediatric intensive care unit(PICU) in Shandong Province, and to provide the basis for the improvement of sedation and analgesia treatment plan.Methods:This study was a multi-center retrospective study.The PICUs of 6 tertiary hospitals in Shandong Province participated in this study.The data of 1 340 children admitted to these 6 PICUs from January 2016 to December 2018 were collected.The age, gender, the pediatric risk of mortality score Ⅲ at 24 hours after admission, whether they received mechanical ventilation, whether they received sedation and(or) analgesia, whether they were monitored sedation and(or) analgesia, and in-hospital mortality were analyzed.The children were divided into the simple sedation group( n=798), the sedation + analgesia group( n=120) and the non-sedation analgesia group( n=422) according to whether they received sedation and(or) analgesia.The diseases, proportion of mechanical ventilation, incidence of hypotension, average length of stay in PICU and in-hospital mortality were compared among the three groups. Results:The median age of the 1 340 children was (13.3±6.4) months, including 786 males(58.7%). Sedation therapy had been carried out in 6 PICUs, of which 5 PICUs had routine sedation assessment; 4 PICUs had carried out analgesic therapy, of which only 2 had routine pain assessment.A total of 918 children(68.5%)received sedation and(or) analgesia, midazolam was the most commonly used sedative drug, followed by dexmedetomidine, and 526 children(57.3%)were monitored for sedation assessment, the most commonly used assessment method was the Richmond agitation sedation score.One hundred and twenty(9.0%)cases received sedation combined with analgesia, fentanyl was the most commonly used analgesic, and 38 children(31.7%) underwent routine pain assessment.There was no significant difference in age and sex among the three groups.The proportion of surgical diseases and patients received mechanical ventilation(100.0%, 120/120) were the highest in the sedation + analgesia group.The proportion of mechanically ventilated patients was the lowest in the non-sedation analgesia group(11.4%, 48/422). The mean duration of mechanical ventilation in the sedation + analgesia group was slightly shorter than that in the simple sedation group( P>0.05). The incidence of hypotension was highest in the sedation + analgesia group, and lowest in the non-sedation analgesia group[21.7%(26/120) vs.2.1%(9/422), P<0.01]. There was no significant difference in in-hospital mortality and mean PICU stay among three groups. Conclusion:Benzodiazepines are still the main sedative drugs used in PICUs in Shandong Province.In recent years, the usage of dexmedetomidine has gradually increased, but the proportion of analgesic use is very low.At present, analgesic and sedative therapy is mainly used for children after surgery and receiving mechanical ventilation.Although analgesic and sedative therapy does not increase the in-hospital mortality and average length of stay in PICU, it increases the incidence of hypotension.The sedative and analgesic treatment and assessment in the PICU of Shandong Province are still not standardized, mainly reflected in infrequently analgesic treatment and the assessment of sedation and pain, which need to be further improved.

Objective To explore the association of single nucleotide polymorphism ( SNP ) in TP53 Arg72Pro (rs1042522) locus with thyroid cancer risk in human. Methods Articles involved in the association between SNP in TP53 Arg72Pro ( rs1042522) locus and thyroid cancer risk were retrieved from PubMed, Embase, and Web of Science databases, and studies which met the inclusion criteria were included. The meta-analysis, sensitivity analysis, subgroup analysis, and the assessment of publication-bias were performed by Stata 14. 0 software. The odds ratio ( OR) and their corresponding 95％ Confidence Intervals ( CI) were used to determine the strength of association between SNP in TP53 Arg72Pro locus and thyroid cancer risk. Results Thirteen case-control studies were eligible for this meta-analysis, including 2112 thyroid cancer cases and 4000 control subjects. Overall, mutated homozygous genotype ( Pro/Pro) in TP53 Arg72Pro ( rs1042522) locus was associated with significantly increased thyroid cancer risk(Recessive model, OR=1.78, 95％CI 1.24-2.56, P=0.002), showing a significantly higher Pro mutation frequency among thyroid cancer patients ( Allelic model, OR=1. 35, 95％ CI 1. 12-1. 63, P=0.002). In the stratified analysis, mutated homozygous genotype (Pro/Pro) in TP53 Arg72Pro (rs1042522) locus was only asscociated with significantly increased thyroid cancer risk among Asians, but not among Europeans and South Americans;mutated homozygous genotype ( Pro/Pro) in TP53 Arg72Pro ( rs1042522) locus was asscociated with significantly increased risk of papillary thyroid carcinomas ( PTC) among total population, but not medullary thyroid carcinomas. Conclusion There is a significant association between TP53 Arg72Pro polymorphism in TP53 and thyroid cancer risk, and the mutated homozygous genotype ( Pro/Pro) in this locus of TP53 maybe a risk factor for thyroid carcinoma among Asians.

BACKGROUND:Thoracolumbar degenerative kyphosis could experience severe lumbar back pain due to sagittal plane imbalance, thereby affecting quality of life. Thus, it is very important to reconstruct spino-pelvic profile in these patients. OBJECTIVE:To explore the relationships between life quality and spino-pelvic parameters fol owing pedicle subtraction osteotomy for thoracolumbar degenerative kyphosis and the clinical significance. METHODS:Between May 2010 and October 2014, 59 patients with thoracolumbar degenerative kyphosis undergoing L2 pedicle subtraction osteotomy in Cangzhou Hospital of Integrated Traditional and Western Medicine were retrospectively reviewed. Anteroposterior and lateral X-ray films of al patients during standing were photographed before and after surgery. The pre-and post-operative thoracic kyphosis, lumbar lordosis, sagittal imbalance, T1 pelvic angle, pelvic incidence, sacral slope and pelvic tilt were measured in al patients. The patients’ quality of life was evaluated using SF-36 preoperatively and postoperatively. RESULTS AND CONCLUSION:(1) Significant differences were observed in the improvement of thoracic kyphosis, lumbar lordosis, pelvic tilt, sacral slope and sagittal imbalance (P<0.01). With respect to SF-36, postoperative SF-36 score was higher than preoperative postoperative SF-36 score (P<0.01). (2) The alteration of lumbar lordosis showed significant correlation with the change of pelvic tilt, sacral slope and sagittal imbalance. The change of pelvic tilt exhibited cardinal correlation with the change of sacral slope, body pain and general health. The improvement of sagittal imbalance significantly correlated with the improvement of lumbar lordosis, body pain and general health. The improvement of T1 pelvic angle significantly correlated with the improvement of lumbar lordosis, sagittal imbalance, body pain and general health. (3) Pedicle subtraction osteotomy can effectively restore spino-pelvic sagittal profile, improve the life quality and relieve pain for the patients with thoracolumbar degenerative kyphosis.

Objective To explore the difference of gene expression profiling between normal basilar arteries and basilar arteries of cerebral vasospasm (CVS) after subarachnoid hemorrhage (SAH) in rabbits. Methods cDNA chip of normal basilar arteries and basilar arteries of CVS after SAH in rabbits were downloaded from GEO database. The chip was analyzed and screened by Bioconductor software, and function enrichment and pathway analysis of the differentially expressed genes were analyzed by Cytoscape software. Then 6 adult male Japanese rabbits were used, and randomly divided into normal control group (n=3) and SAH model group (n=3). Rabbit SAH models were established by cisterna secondary-blood-injection method. RNA data of normal basilar artery specimens on the 0 day and basilar artery specimens after SAH on the 5-day were used to validate the parts of differentially expressed genes by qRT-PCR. Results A total of 4356 differentially expressed genes were found in normal basilar arteries and basilar arteries of CVS after SAH in rabbits. Among them, 920 genes were considered to be significant with P-value<0.05, such as GRIK1, MYH13, ZNF45, SAA3, RLN1, MSR1 and others. Function enrichment analysis indicated that the differentially expressed genes were involved in regulation of Ca2+transmembrane transporter activity, negative regulation of ion transmembrane transport, regulation of potassium ion transport, positive regulation of JAK-STAT signaling cascades and other biological processes. Pathway analysis showed that calcium signaling pathway, cGMP-PKG signaling pathway, HIF-1 signaling pathway, PI3K-Akt signaling pathway and other signaling pathways maybe related with the differentially expressed genes. qRT-PCR verification showed that the expression of MSR1 in SAH model group was consistent with that of the chip result. Conclusion The gene expressions of basilar arteries of CVS after SAH in rabbits are significantly different, and MSR1 gene can be used as a potential target for studying the pathological mechanism of CVS.

Objective To observe the incidence and the influencing factors of kidney insufficiency in acute cerebral infarction patients with non-valvular atrial fibrillation. Methods From January 2013 to January 2015,266 consecutive acute cerebral infarction patients with non-valvular atrial fibrillation admitted to the Department of Neurology,Xuanwu Hospital,Capital Medical University were enrolled retrospectively. Renal function was assessed by the estimated glomerular filtration rate (eGFR),eGFR <60ml/(min·1.73 m2 ) was defined as renal insufficiency,and were divided into a renal insufficiency group (n = 36)and a non-renal insufficiency group (n = 230). The incidence of kidney insufficiency and its influencing factors in acute cerebral infarction patients with non-valvular atrial fibrillation were observed. Results (1)In 266 acute cerebral infarction patients with non-valvular atrial fibrillation,the prevalence of renal insufficiency was 13. 5% (n = 36). The proportion of age (≥65 years)of the renal insufficiency group was higher than that of the non-renal insufficiency group. There was significant difference (94. 4%[34 / 36]vs. 70. 0%[161 / 230];P = 0. 002). There were no significantly differences in general information of others (all P >0. 05). (2)Multiple Logistic regression analysis showed that the age (≥65 years)was an independent risk factor for the occurrence of renal insufficiency in acute cerebral infarction patients with atrial fibrillation (OR,1. 147,95% CI 1. 087 -1. 209;P < 0. 01),and the histories of hypertension (OR,0. 870,95% CI 0. 362-2. 089;P = 0. 755),diabetes mellitus (OR,1. 078,95% CI 0. 403 -2. 883;P = 0. 882 ), and hyperlipidemia (OR,1. 666,95% CI 0. 645 - 4. 302;P = 0. 292 )were not associated with renal insufficiency in cerebral infarction patients with atrial fibrillation. Conclusions The incidence of renal insufficiency in cerebral infarction patients with atrial fibrillation is higher. Age (≥65 years)is an independent risk factor for renal insufficiency in this type of patients.

OBJECTIVETo analyze the clinicopathological characteristics of patients with anaplastic lymphoma kinase (ALK) rearrangements in lung adenocarcinoma, and the clinical therapy and prognosis of the patients.

METHODSClinicopathological data of 34 cases of ALK-positive patients treated in the Beijing Chest Hospital from 2005 to 2014 were reviewed. The expression of ALK proteins in the resected tumors was detected by immunohistochemistry, and EGFR mutations were examined by polymerase chain reaction and a direct DNA sequencing method.

RESULTSAmong the 34 patients, 20 were male and 14 were female, the median age was 49, and 11 were smokers and 23 were never smokers. The clinical stages of the patients were stage IA in 5 patients, IB in one patient, IIA in two patients, IIIA in 16 patients, IIIB in 5 patients, IV in 4 patients, and one patient of unknown stage. ALK-positive tumors showed strong granular staining in cell cytoplasm by immunohistochemistry. Forteen patients were solid predominant subtype with mucin production, 10 of acinar predominant subtype, 6 of papillary predominant subtype, 3 of micropapillary predominant subtype, and one was of colloid variant. There were 18 cases with mucin production, 6 cases had signet-ring cell morphology, and 10 cases showed cribriform pattern. Only one patient had coexistence of ALK rearrangement and EGFR mutation (L858R at exon 21). Of the 34 patients, 24 patients were followed up. The median follow up of the 24 patients was 11.0 months (1.7-48.7 months).

CONCLUSIONSALK-positive tumors as a molecular subtype of lung adenocarcinoma have distinct clinicopathological features. The histological findings of ALK-positive tumors are characterized by solid predominant subtype with mucin production, acinar predominant subtype, signet-ring cells and cribriform structures. They were rarely co-mutated with EGFR mutation.

Adenocarcinoma ; enzymology ; pathology ; therapy ; Exons ; Female ; Gene Rearrangement ; Genes, erbB-1 ; Humans ; Immunohistochemistry ; Lung Neoplasms ; enzymology ; pathology ; therapy ; Male ; Middle Aged ; Mucins ; biosynthesis ; Mutation ; Neoplasm Proteins ; genetics ; Polymerase Chain Reaction ; Prognosis ; Receptor Protein-Tyrosine Kinases ; genetics ; Sequence Analysis, DNA

BACKGROUND:MicroRNAs (miRNAs) play an important role in many diseases. To analyze the miRNA expression profile in degenerative scoliosis patients is helpful for classifying its pathogenesis. OBJECTIVE: To compare miRNAs expression profile in the intervertebral disc tissue between degenerative scoliosis patients and healthy controls, and to investigate its role in the pathogenesis of degenerative scoliosis. METHODS:Degenerative nucleus pulposus tissues from 48 patients with degenerative scoliosis (male 36, female 12; 58-69 years old) and normal nucleus pulposus tissues from 36 patients with lumbar fractures were harvested to isolate, culture and identify nucleus pulposus cels folowed by total RNA extract. Differentialy expressed miRNAs were screened by microRNA microarray analysis and validated by real-Time qPCR. Target genes of highly expressed microRNAs were predicted by analyzing information from MicroCosm v5, TargetScan 5.1 and microRNA.org databases. Biological signal pathways associated with the target genes were analyzed, and qPCR was used to validate the screening results. RESULTS AND CONCLUSION:Nineteen differentialy expressed miRNAs were identified. The miR-98 was highly expressed in degenerative nucleus pulposus tissue, and the fold change was 6.368. Predicted miR-98 target gene was interleukin-10, which was involved in JAK-STAT signaling pathway and located in upstream of this pathway. In degenerative nucleus pulposus cels of degenerative scoliosis patients, miR-98 was highly expressed, and the corresponding target gene was interleukin-10. These results indicate that JAK-STAT signaling pathway may play an important role in the pathogenesis of degenerative scoliosis.

Objective To analyze related behaviors of individual preparedness and influencing factors on violent terrorist attacks among undergraduates.Methods A total of 1 800 undergraduates from 5 colleges or universities in Guangzhou were selected,using the stratified cluster method.A questionnaire involving the response to violent terrorist attack behavior was used to assess the individual preparedness behaviors among undergraduates.A self-made questionnaire was applied to collect information on demographic factors,cognitive and preparedness behaviors.Results The mean score of individual preparedness behavior among undergraduates was 13.49 ± 5.02 while information on seeking behavior was 4.27 ± 1.64,avoidance behavior was 5.97± 2.16 and violent terrorist attack response behaviors was 23.73 ± 7.21,with 30.0 percent of undergraduates behaved properly.Significant differences were found in the scores of behaviors on the response to violent terrorist attack with different gender,major they pursue or religious belief (P＜0.05),among undergraduates involved in this study.Results from the logistic regression analysis revealed that persons being girls (OR=1.46,95％ CI:1.06-2.01),with bigger perceived probability (OR=1.60,95％ CI:1.12-2.30),with higher alertness (OR=3.77,95％ CI:2.15-6.61),with stronger coping confidence (OR=0.34,95％ CI:0.24-0.48) and bigger affective response (OR1=3.42,95％ CI:2.40-4.86; OR2 =0.23,95 ％ CI:0.1 3-0.41),would present more prominent behavior responses when facing the violent terrorist attack.Conclusion Individual response behaviors to violent terrorist attacks among undergraduates were relatively ideal.Perceived probability,alertness,coping confidence and affective response appeared to be independent influencing factors related to response behaviors against violent terrorist attack.In colleges and universities,awareness on violent terrorist attacks should be strengthened among undergraduates.Focus should target on psychological education dealing with disaster,knowledge and skills needed for emergency response,so as to respond to the emergency on campus.