Objective To investigate the correlation between serum miR-320b and carotid atherosclerosis in patients with acute ischemic stroke.Methods From January 2017 to December 2017,patients with acute ischemic stroke visited the Department of Neurology,the Affiliated Hospital of Yangzhou University were enrolled.According to the findings of carotid artery ultrasonography,they were divided into plaque group and plaque-free group.The baseline clinical data such as demographic data,vascular risk factors,and blood biochemical indicators were collected.Reverse transcription quantitative polymerase chain reaction was used to detect the expression level of serum miR-320b.Multivariatelogistic regression analysis was used to determine the independent risk factors for carotid atherosclerosis.Results A total of 135 patients with acute ischemic stroke were enrolled in this study,including 58 females and 77 males,aged 58.4 ± 10.6 years.There were 85 patients in the plaque group and 50 in the plaque-free group.The total cholesterol (t =5.523,P =0.023) and low-density lipoprotein cholesterol (t =4.415,P =0.044) in the plaque group were significantly higher than those in the plaque-free group,while high-density lipoprotein cholesterol (t =5.849,P=0.017) and serum miR-320b (t =4.331,P=0.039) were significantly lower than those in the plaque-free group.Multivariate logistic regression analysis showed that referring to the highest quartile group,the low serum miR-320b level might be an independent risk factor for carotid atherosclerosis (the first quartile group:odds ratio 2.701,95％ confidence interval 1.154-6.321,P =0.022;the second quartile group:odds ratio 2.521,95％ confidence interval 1.249-5.091,P =0.010;and the third quartile group:odds ratio 1.849,95％ confidence interval 1.041-3.283,P=0.036).Conclusion The low serum miR-320b level might be an independent risk factor for carotid atherosclerosis in patients with acute ischemic stroke.

Homoharringtonine (HHT), a plant alkaloid from Cephalotaxus harringtonia, exhibits a unique anticancer mechanism and has been widely used in China to treat patients with acute myeloid leukemia (AML) since the 1970s. Trial SCMC-AML-2009 presented herein was a randomized clinical study designed based on our previous findings that pediatric AML patients younger than two years old may benefit from HHT-containing chemotherapy regimens. Patients randomized to arm A were treated with a standard chemotherapy regimen comprising mainly of anthracyclines and cytarabine (Ara-C), whereas patients in arm B were treated with HHT-containing regimens in which anthracyclines in all but the initial induction therapy were replaced by HHT. From February 2009 to November 2015, 59 patients less than 2 years old with de novo AML (other than acute promyelocytic leukemia) were recruited. A total of 42 patients achieved a morphologic complete remission (CR) after the first course, with similar rates in both arms (70.6% vs.72.0%). At the end of the follow-up period, 40 patients remained in CR and 5 patients underwent hematopoietic stem cell transplantation in CR, which could not be considered as events but censors. The 5-year event-free survival (EFS) was 60.2%±9.6% for arm A and 88.0%±6.5% for arm B (P= 0.024). Patients in arm B experienced shorter durations of leukopenia, neutropenia, and thrombocytopenia and had a lower risk of infection during consolidation chemotherapy with high-dosage Ara-C. Consequently, the homoharringtonine-based regimen achieved excellent EFS and alleviated hematologic toxicity for children aged younger than 2 years with de novo AML compared with the anthracycline-based regimen.

Objective To investigate the clinical and electrophysiological features of patients with non-inflammatory myopathy with neurogenic lesions. Method The clinical and electromyography data was retrospectively collected from 110 patients who were diagnosed with myopathy and completed routine electromyography examination from 2015 to 2017. A retrospective analysis of clinical and electrophysiological features was conducted on 4 patients with non-inflammatory myopathy with neurogenic lesions. Result Of the 110 patients, 10 patients with neurogenic lesions and 4 of them were diagnosed to have non-inflammatory myopathy. These 4 patients had limb and trunk weakness with muscle atrophy and the electromyography showed neurogenic lesion with or without peripheral nerve lesion. Conclusion This study has revealed neurogenic lesions in a small number of non-inflammatory myopathy on the electromyography, suggesting that the electromyography alone may not be sufficient for diagnosis of myopathy.

Objective To investigate the ATP binding cassette transporter A1 (ABCA1) expression in perihematomal tissue of mouse cerebral hemorrhage model induced by collagenase. Methods Stereotactic injection of type Ⅳ collagenase was used to induce a model of caudate putamen intracerebral hemorrhage in mice. The behavioral scores were use to assess neurological deficits at 24 h, 48 h and 72 h after model making. Neisserian staining was used to detect the morphology of neurons around hematomas.Immunohistochemical staining and Western blot analysis were used to detect the expression of ABCA1 around hematomas. Results Nissl bodies reduction, atrophy, necrosis of perihematomal neurons were observed and aggravated over time. Immunohistochemical staining and Western blot analysis showed that the expression level of ABCA1 in the perihematomal tissue was significantly higher than that in the sham operation group (all P < 0. 05), and the expression level increased significantly with time (all P < 0. 05 ).Conclusion ABCA1 was up-regulated after cerebral hemorrhage, suggesting that it might be involved in the pathological process of cerebral hemorrhage.

Objective To investigate the loss of motor unit and it's influencing factors in the lower motor neurons after middle cerebral artery infarction. Method Forty patients with first onset and unilateral middle cerebral artery infarction were divided into cortical-basal ganglia(26)and basal ganglia(14)groups and 10 healthy controls were served as control group.All included patients were scored by National Institute of Health stroke scale(NIHSS),modified Rankin scale (mRS), Fugl-Meyer Assessment (FMA) at 48 hours of admission. Nerve conduction study on the limb and motor unit number estimation (MUNE) on abductor pollicis brevis were performed at 2-4 weeks after onset, and the data of single motor action potential (SMUAP) were collected. SPSS 20.0 software was used to statistical analysis. Result The MUNE on were significantly lower and the amplitude and area of SMUAP were significantly increased in ipsilateral than contralateral sides (cortical-basal ganglia group:95.85±26.82 vs. 143.65±38.86, P<0.001; basal ganglia group: 126.71± 44.13 vs. 157.36±56.72, P=0.001). The affected MUNE was significantly decreased in the cortex-basal ganglia than in basal ganglia groups (95.85±26.82 vs.161.40±48.90,P=0.027). The MUNE was negatively correlated with NIHSS score (r=-0.362,P=0.022)and mRS score(r=-0.339,P=0.032).NIHSS score(β=-1.603,P=0.032,95%CI:-3.064~-0.142)and mRS score(OR=2.885,P=0.025,95%CI:1.139~7.158)on admission could predict the loss of MUNE on the affected side. Conclusion This study reveals the loss of motor unit and the compensation of remained motor unit on the affected side after middle cerebral artery infarction,NIHSS score and mRS score on admission may predict the loss of MUNE after stroke.

Objective:To clarify the significance of the fractional anisotropy(FA) value and apparent diffusion coefficient(ADC) value of diffusion tensor imaging(DTI) applied in the glioma grading with Meta-analysis, and to provide a reference for selecting the treatment program and judging the prognosis of glioma.Methods:Computer search was performed in PubMed database, EMBASE database,CBM, CNKI, Wanfang database, and VIP database.The relevant neurosurgery magazines and neuroimaging magazines, the proceedings of academic meeting were retrieved by hand and the references of related reviews were retrospectively retrieved.Then the case-series studies according to inclusion and exclusion criteria were screened,and the qualities of included studies were evaluated.Meta-analysis was carried out by Review Manager 5.2 software.Results:Nine studies were included.The FA value of low-grade glioma(LGG) in tumor centre was lower than that of high-grade glioma(HGG) (χ2=11.94,df=8,P=0.15;I2=33%,Z=2.78,P=0.005;WMDFA=-0.02,95%CI:-0.03--0.01),and the ADC value of LGG in tumor centre was higher than that of HGG (χ2=5.26,df=4,P=0.26;I2=24%,Z=2.19,P=0.03;WMDADC=0.15,95%CI:0.02-0.28).Conclusion:When the FA value in tumor centre of the glioma is increasd,the ADC value is decreased,and the grade of glioma is increasd.The FA value and ADC value of DTI can help determine the grade of gliomas.

Objective To study the effect and safety of compound Biejiaruangan tablets combined with entecavir on the treatment of viral hepatitis B cirrhosis.Methods100 cases with hepatitis B cirrhosis in Zhejiang Taizhou hospital from June 2014 to December 2016 were selected as the research object in this study which were randomly divided into the control group and the experimental group 50 cases in each group.The control group were given entecavir, the experimental group were given compound Biejiaruangan tablets combined with entecavir.The clinical effect and the adverse reaction in the two groups were compared.ResultsThe effective rate was 90.0% in the experimental group, which was significantly higher than 72.0% in the control group(P<0.05).There were 2 patients vomiting in the experimental group, the adverse reaction rate was 4.0%.There were 9 cases of vomiting and headache in the control group, the adverse reaction rate was 18.0%.T,he adverse reaction rate(in the experimental group was significantly lower than that in the control group(P<0.05).ConclusionThe clinical effect of compound Biejiaruangan tablets combined with entecavir on the treatment of viral hepatitis B cirrhosis is better, which can reduce the rate of adverse reactions in a certain extent, is high safety, and worth popularizing.

Objective To analyze the status quo and influencing factors of patient safety culture among medical staffs in the hospitals of Shenzhen City to provided reference for its improvement and conduct the patient safety culture research by other medical institutions.Methods The Patient Safety Culture Questionnaire of Medical Institutions(PSCHO) was adopted to investigate on 1000 medical persons from February to May 2016.Results The total score of patient safety culture in medical staffs was (3.53±0.40) and,the difference among different categories of medical persons had no statistical significance (P＞ 0.05).The differences among the medical staffs with different working ages,communication frequency with patients,training times,concern frequency had statistical difference(P＜0.05).Conclusion The patient safety culture level in Shenzhen City is higher.However,the sense of blame and shame is one of the important factors impeding the promotion of the patient safety culture in hospitnl.Hospital should conduct the targeted improvement to the related factors affecting the patient safety culture from the aspects of organism,department and individual level.

Objective To compare the effect of oxycodone or sufentanil in preventing post-operative hyperalgesia induced by remifentanil.Methods One hundred and twenty patients scheduled for radical operation for carcinoma of stomach undergoing general anesthesia, 62 males and 58 females, aged 18-65 years, ASA physical status Ⅰ or Ⅱ, were randomly divided into 3 groups.Thirty minutes before the end of operation, oxycodone hydrochloride 10 mg was administered intravenously in oxycodone hydrochloride group (group O, n=42) while sufentanil 10 μg was injected in group S (group S, n=40) and equal normal saline was injected in control group (group C, n=38).The VAS score after waking up was recorded.VAS score>3 was defined as hyperalgesia, and sufentanil was injected when VAS score≥6.The BCS scores were recorded immediately after extubation (T1), 30 min (T1), 1 h (T3), 2 h (T4) and 4 h (T5) after extubation.Awakening time and extubation time and the incidence of nausea and vomiting 4 h after extubation were compared.Results At T1-T5, the BCS scores in group O were significantly higher than those in groups S and C (P<0.05).Group S has a higher adverse reaction (P<0.05).There was no significant differences of awakening time and extubation time in 3 groups.Conclusion Prophylactic injection of oxycodone 10 mg can reduce incidence rate of post-operative hyperalgesia, and increase BCS score with little side effects.

Objective To investigate the incidence of the ETV6/RUNX1 fusion gene among Chinese pediatric patients with B-ALL and its effect on the prognosis. Methods A total of 723 patients with B-ALL from January 1, 2007 to December 31, 2014 were enrolled in this study. All patients were detected ETV6/RUNX1 fusion gene by FISH. Clinical data and ETV6/RUNX1 were combined to analyze the clinical prognosis. Results Among the 723 patients, 151 were with ETV6/RUNX1 positive B-ALL, accounting for approximately 20.89%(151/723) of B-precursor cases;91 patients were with recurrence, including 10 patients with ETV6/RUNX1 positive B-ALL, and the recurrence rate of ETV6/RUNX1 positive B-ALL was 10.99%(10/91). Among 10 recurrent patients with ETV6/RUNX1 positive B-ALL, 9 patients relapsed more than 300 days later after diagnosis, while the recurrence times among the patients with ETV6/RUNX1 negative was very different. Although the recurrence times between the two groups showed no signiifcant difference (P?=?0.09), the recurrence times of ETV6/RUNX1 positive patients were mainly found at the end of clinical chemotherapy, while the recurrence time of ETV6/RUNX1 negative patients were mainly at maintaining chemotherapy period, there was a signiifcant difference between the distribution of recurrence time (P?