Objective To observe the severity of cerebral edema after mechanical thrombectomy in the patients with acute ischemic stroke caused by large vessel occlusion,and to statistically analyze the related fac-tors affecting the prognosis quality of the patients,so as to guide the patients to conduct scientific interven-tion.Methods Ninety-one patients with acute ischemic stroke due to anterior circulation large vessel occlusion treated with mechanical thrombectomy in this hospital from October 2021 to October 2022 served as the ana-lytic subjects.According to the severity of brain edema,they were divided into the group Ⅰ(mild),group Ⅱ(moderate),and group Ⅲ(severe);after 12-week treatment,the improved Rankin scale was used to evaluate the prognosis.The patients with good prognosis were included in the excellent group,and the patients with poor prognosis were included in the poor group.Single factor and multifactor logistic analysis was used to ana-lyze the influencing factors and prognostic related factors of different degrees of brain edema.Results The univariate analysis showed that the percentage of patients with NIHSS score at admission ≥15,time from on-set to thrombolysis ≥6 h,history of hypertension,successful vascular recanalization and good collateral circu-lation were significantly different among the groups Ⅰ,Ⅱ and Ⅲ(P＜0.05);the multivariate logistic regres-sion analysis results showed that the NIHSS score at admission ≥15,time from onset to thrombolysis ≥6 h,and hypertension history were the risk factors leading to severe cerebral edema,while successful recanalization of blood vessels was a protective factor for cerebral edema(P＜0.05).The univariate analysis showed that in the good prognosis group the percentage of patients had good circulation of lateral branches,successful reca-nalization of blood vessels,severe cerebral edema,hypertension,time from onset to thrombolysis ≥6 h,and NIHSS score ≥15 at admission were significantly different from those in the poor prognosis group(P＜0.05).The multivariate logistic regression analysis results showed that severe cerebral edema,time from onset to thrombolysis ≥6 h and NIHSS score ≥15 at admission were the risk factors for poor prognosis,while good collateral circulation and successful recanalization of blood vessels were the positive factors for good prognosis(P＜0.05).Conclusion Mechanical thrombectomy patients with hypertension and time from onset to throm-bolysis ≥6 h and NIHSS score at admission ≥15 have more severe brain edema after treatment;severe brain edema,time from onset to thrombolysis ≥6 h,NIHSS score at admission ≥15 were the adverse factors affect-ing the prognosis of the patients with mechanical thrombectomy.

Objective To observe the abnormal brain activity in patients with migraine without aura(MwoA)with MRI.Methods Fifty MwoA patients(MwoA group)and 46 healthy volunteers(control group)were prospectively enrolled.Functional MRI(fMRI)was performed to observe the dynamic regional homogeneity(dReHo)of brain regions,then brain regions with differences of dReHo value between groups were extracted,and correlations with clinical scales were analyzed.Results Compared with control group,dReHo values of surrounding cortex of bilateral calcarine fissure and right middle occipital gyrus increased,of right middle temporal gyrus,right middle frontal gyrus and left cuneus decreased in MwoA group(GRF correction,voxel level all P＜0.005,cluster level all P＜0.05).The weight analysis showed that brain regions with top 3 absolute weight values were surrounding cortex of right calcarine fissure,left cuneus and right middle occipital gyrus.dReHo value of surrounding cortex of left calcarine fissure in MwoA patients was negative correlated with self-rating depression scale(SDS)(r=-0.28,P=0.04).Conclusion Abnormalities in the upward transmission pathway of visual information existed in MwoA patient,especially in surrounding cortex of right calcarine fissure,left cuneus and right middle occipital gyrus.

Objective: To assess the food and nutrition literacy level of school-age children and its related factors, and to provide targets for further nutrition health education and nutrition improvement action. Methods: A total of 4 359 school-age children, from third to eighth grade in 2 middle schools and 3 primary schools of Baoding city of Hebei Province, were selected as subjects using convenient sampling method. For all participants’ food and nutrition literacy evaluation, social demographic characteristics and family food environment were investigated. Results: The average score of food and nutrition literacy of valid respondents was (61.91±9.22), and the scores of functional, interactive and critical literacy increased successively. The score of food and nutrition knowledge was higher than that of skill, and the score of "food intake" skill was the lowest(60.45±11.00). Children’s food and nutrition literacy increased with age and grade during primary school period, but the literacy of junior school students was lower than that of high-level graders in primary school(P<0.05). Children who were female, the only children, non-resident in school, urban registered permanent residence, in a more affluent family, cared by their parents/grandparents with a higher education level, and had nutrition education experience in school, had significantly higher food and nutrition literacy(P<0.05). But the interactive literacy of only children, non-resident in school and urban registered children was significantly lower(P<0.05). The family food environment was significantly correlated with children’s food and nutrition literacy. The total score of food nutrition literacy was higher for the children who often had fruits at home, rarely ate out, eating without screen, and communicated food and nutrition information with families frequently(P<0.05). Conclusion The food and nutrition literacy of school-age children is not high, which is related with individual and family’s demographic characteristic, nutrition education experience in school and family food environment. Children in rural areas and younger age, with a large number of family children and poor family economic status and food environment, should be the main target population of nutrition education and nutrition improvement.

Objective To explore the synthesis of photographic developer 2-18 F-fluoropropionic acid(18 F-FPA) and its imaging value in prostate cancer-bearing nude mice.Methods 18F-FPA was automatically synthesized by using the CFN-multi-200 multifunctional drug synthesis module,then the quality control were performed.The PC3 prostate cancer-bearing nude mice models(16 cases) and 22RV1 prostate cancer-bearing nude mice models(4 cases) were constructed.Then 18F-FPA imaging was conducted in these models,which were compared with those by 2-deoxy-2-18 F fluoro-D-glueose(18 F-FDG) and 11C-choline for evaluating the imaging value of 18F-FPA in prostate cancer.The mice bearing PC3 prostate cancer were randomly divided into 4 group for conducting the biodistribution measurement.The percentage rate of injection dose per gram tissue(％ID/g) and tumor/non-tumor tissue ratio was calculated.Results The synthetic process of 18 F-FPA was about 40 min,the yield rate was (38 ± 2) ％ (without time correction),the radiochemical purity was more than 97 ％,with good in vitro stability.After 18F-FPA injection,the tumor image in two kinds of tumor-bearing nude micecould was developed clearly,while a slight uptake was detected in developed tumor with 18 F-FDG and n C-choline imaging.The biodistributions of tumor in PC3 prostate cancer bearing nude mice were (6.91 ± 0.72),(6.99 ±0.55),(7.17 ± 0.25),(6.49 ± 0.74) ％ ID/g at 0.5,1.0,2.0 and 4.0 h after 18 F-FPA injection,respectively,the difference was not statistically significant(P＞0.05).Conclusion 18 F-FPA is simply synthesized,has better imaging effect for the nude mice bearing prostate cancer and is expected to be used for clinical detection of prostate cancer.

Objective To observe what changes the brown adipose tissue (BAT) of T2DM rat models would have,including morphology,function and specially expressed uncoupling protein (UCP1) after the gastric bypass (Roux-en-Y,RYGB) and to explore the effects of RYGB on BAT of T2DM rat models and its related mechanism in order to provide a theoretical and experimental basis for treatment of T2DM patients with RYGB.Methods SD rats were given a high-fat and high-sugar diet for two weeks,by injecting streptozotocin (STZ) 30 mg/kg intraperitoneally to build models.Blood glucose was measured after 72 h and 1 week by the fast blood glucose meter.The models were built successfully if blood glucose at both times were ≥ 16.7 mmol/L.Feeding environment:individually caged,standard rat feed,natural circadian cycle,indoor temperature (18±2)℃,indoor humidity (50±2)％.50 rats were randomly selected and dividing into four groups according to intervention methods:diabetes operation group (group A,n=10),undergoing RYGB surgery with the whole stomach kept;diabetes sham operation group (group B,n=10),the same anesthesia and incision as the previous RYGB group.The operation mode was anterior gastric wall incision and suture,jejunum transection in corresponding position and in situ anastomosis with the same suture method as group A;diabetes control group (group C,n=10),normally feeding after building models;and the last one was the healthy control group (group D,n=10):no special treatment,adequate water feeding ensured.The rest of rats remained to be used.The body mass (BM),fasting blood glucose (FBG),fasting serum insulin(Fins)before and at the 1st,2nd,4th and 8th week after surgery were measured.The number of transversal ceils was calculated by IPP6.0 image software and the average radius of fat cells was calculated.UCP1 expression was tested with western blot.Results ① The fasting blood glucose,fasting serum insulin level and the body weight of dia betic rats were higher than those of the control group,but the insulin sensitivity index was significantly lower.② HE Staining showed:diabetes operation group (group A) rats,compared with diabetes control group and diabetes sham operation group(group B),had obviously higher brown fat cell counts transversally and average radius,and the difference was statistically significant (P＜0.01).Diabetes operation group (group A) rats had no significant difference from the healthy control group(group D) rats,and the diabetes control group (group C) rats had no significant difference from sham operation group (group B) rats as well.③ Western blot showed that after the gastric bypass surgery,compared with the diabetes sham operation group (group B) and the diabetes control group (group C),UCP1 expression of brown adipose tissue of the diabetes operation group (group A) increased significantly (P＜0.05).The diabetes sham operation group (group B) had no significant difference from the diabetes control group (group C),and the diabetes operation group(Group A) had no significant difference from the healthy control group (Group D) as well (P＞0.05).Conclusion RYGB can reduce the body mass and insulin resistance (IR) of diabetic rats and,at the same time,promote the expression of UCP1 of brown adipose tissue.RYGB might increase the activity of brown adipose tissue by regulating the UCP1 signaling pathway to improve body's insulin resistance.

Objective To identify the dose-volumetric parameters associated with acute bone marrow suppression in concurrent chemoradiotherapy for cervical cancer,and provide the reference standard for the radiotherapy planning.Methods In total,155 patients concurrently receiving chemoradiotherapy for cervical cancer were enrolled in this study.The pelvis was contoured for each patient in radiotherapy treatment planning system and divided into three subsites:lumbosacral spine,ilium,and lower pelvis.The pelvic dose volume parameters were analyzed using univariate analysis (Chi-Square and t test),and multivariate analysis (Logistic regression model).Dose volume parameters include V5,V10,V15,V20,V25,V30,V35,V40,V45,V50 and the average dose (D).Results The percentage of patients that developed acute bone marrow suppression (≥ grade 2) was 87.7％ (136/155).The univariate analysis revealed that pelvic V5,V10,V15,V,0,ilium V15,lower pelvis V15 of patients with acute bone marrow suppression (≥ grade 2) were significantly higher than those of ＜ grade 2 patients (t =-2.277,-2.142,-3.475,-2.018,-2.963,-2.741,P ＜0.05).Multiple regression analysis indicated that pelvic V15 was associated with acute bone marrow suppression (OR =1.728.P ＜ 0.05).The threshold of pelvic V15 was 88％ as determined by receiver operating curve (ROC).Conclusions The results show that Pelvic V15 is associated with acute bone marrow suppression in concurrent chemoradiotherapy for cervical cancer and is thus an independent risk factor.To better predict and control acute bone marrow suppression,pelvic V15 should be carefully controlled below 88％ in treatment planning to reduce the incidence of acute bone marrow suppression.

Objective To investigate the possible role of oxidative stress in the protection of hydrogen sulfide during renal ischemia reperfusion.Methods Male Wistar rats were randomly divided into 3 groups: sham operation (Sham) group, renal ischemia reperfusion (IR) group subject to occlusion of left renal pedicle for 45 min then reperfusion for 24 h, and sodium hydrosulfide (NaHS) preconditioning group with continuous infusion of NaHS (450 nmol/min) by left renal artery for 10 min before ischemia reperfusion.Renal injuries were evaluated by PAS staining.The protein levels of NADPH oxidase (NOX) 4, NOX2 were analyzed by Western blotting.The reactive oxygen species (ROS) level of renal tissue was determined by dihydroethidium (DHE) staining assay.Renal superoxide dismutase (SOD), malonic dialdehyde (MDA) and Scr, BUN were evaluated by chromatometry assay.Cell apoptosis were evaluated by TdT-mediated dUTP nick end labeling (TUNEL) staining.Results Compared with Sham group, in IR group the renal NOX4 and NOX2 protein expressions, the existence of acute tubular necrosis and ROS expression were up-regulated (all P ＜ 0.01);MDA, Scr, and BUN were increased and SOD was decreased significantly in IR-treated kidney (all P ＜ 0.01);Moreover, more apoptotic cells presented in the risk zone of IR-treated kindey (P ＜ 0.01).The effects induced by IR were inhibited by NaHS.Compared to that in IR group, NaHS precondition reversed IR-induced damages of renal function and renal tissue, increased SOD activity and decreased MDA expression (all P ＜ 0.05), as well as reduced the expression of NOX4, NOX2 and ROS (all P ＜ 0.05).Moreover, NaHS precondition reduced apoptosis after IR (P ＜ 0.05).Conclusions NaHS alleviates renal ischemia reperfusion injury through inhibiting oxidative stress.Hydrogen sulfide can decrease ROS by inhibiting the activation of NOX, further inhibit the activation of NOD-like receptor, and alleviate kidney damage.

Objective:To analyze the clinical and physical tactors associated with acute bone marrow suppression in concurrent chemo-radiotherapy for rectal cancer and to provide a reference standard for the best clinical treatment plan. Methods:Retrospective analy-sis was performed on 62 patients with rectal cancer who received concurrent radiotherapy and chemotherapy in our department. The pelvis was contoured for each patient in the radiotherapy treatment planning system and divided into three subsites: lumbosacral spine, ilium, and lower pelvis. Prognostic clinical and physical factors were analyzed by univariate and multivariate analyses. Evaluated prognostic clinical factors included sex, age, clinical stage, original hemoglobin levels, and chemotherapy, operation, and radiation modes;physical factors included V5, V10, V15, V20, V25, V30, V35, V40, V45, V50, Dmax, and Dmean of lumbosacral spine, ilium, low-er pelvis, and pelvis. Results:The percentage of patients who developed acute bone marrow suppression (≥2 grade) was 61.3%(38/62).Univariate analysis of related factors revealed statistically significant differences were sex, chemotherapy, lumbosacral spine V45, il-ium V20, and ilium V30. Multivariate logistic regression analysis indicated that chemotherapy and ilium V30 are the risk factors for acute bone marrow suppression. The receiver operating curve showed that the threshold of ilium V30 was 44%. Conclusion:Acute bone marrow suppression is influenced by more than one factor;local control rate of the tumor and acute bone marrow suppression are tradeoffs in rectal cancer treatment. An appropriate chemotherapy method should be selected, and ilium V30 must be maintained below 44%to prevent bone marrow suppression in rectal cancer patients.

OBJECTIVETo investigate the effect of laparoscopic Roux-en-Y gastric bypass on the short-term immune function of type 2 diabetic patients and to explore the correlation between the immune regulatory effect and blood glucose control.

METHODSClinical data of 28 patients with type 2 diabetes mellitus who underwent laparoscopic Roux-en-Y gastric bypass surgery in our hospital during January 2014 to January 2015 were retrospectively collected. Fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), immunoglobulin (IgG, IgA, IgM), T lymphocytes CD3(+), killer T cells CD3(+)CD8(+), helper T cells CD3(+)CD4(+), natural killer(NK) cell subsets CD16(+),CD56(+) and B cell subsets CD19(+),CD45(+) levels were detected and compared between before and after surgery. Correlation of immunoglobulin and immune cell subsets with the level of FBG and HbA1c were examined.

RESULTSAfter operation, FBG and HbA1c decreased significantly from (5.78±1.15) mmol/L to (14.21±1.89) mmol/L, and (9.96±0.97)% to (6.87±0.69)%, respectively (all P<0.05), and immunoglobulin (IgG, IgA, IgM) increased significantly [IgG: from(9.41±1.23) g/L to (12.74±1.61) g/L, IgM: from (1.71±0.22) g/L to (2.43±0.39) g/L, IgA: from (1.25±0.26) g/L to (1.97±0.23) g/L, all P<0.05]. Besides, T lymphocytes CD3(+), killer T cells CD3(+)CD8(+) and B cell subsets CD19(+)CD45(+) elevated significantly as well [T lymphocytes CD3(+): from (55.3±3.8)% to (67.6±4.6)%, killer T cells CD3(+)CD8(+): from (15.6±5.3)% to (28.7±4.2)%, B cell subsets CD19(+)CD45(+): from (8.4±3.7)% to (18.1±4.1)%, respectively, all P <0.05]. There was no significant difference in the expression of helper T cells CD3(+)CD4(+) and natural killer cell subsets CD16(+)CD56(+) between pre-operation and post-operation(all P>0.05). Levels of immunoglobulin (IgG, IgA, IgM), CD4(+)/CD8(+) ratio and B cell subsets were negatively correlated with HbA1c and FBG levels (IgG with FBG: r=-0.865, IgA with FBG: r=-0.887, IgM with FBG: r=-0.902, CD4(+)/CD8(+) with FBG: r=-0.956, CD19(+)CD45(+) with FBG: r=-0.834; IgG with HbA1C: r=-0.859, IgA with HbA1C: r=-0.957, IgM with HbA1C: r=-0.843, CD4(+)/CD8(+) with HbA1C: r=-0.912, CD19(+)CD45(+) and HbA1C: r=-0.885, all P<0.05), but the proportion of NK cells was not significantly correlated with HbA1c and FBG (P>0.05).

CONCLUSIONSLaparoscopic Roux-en-Y gastric bypass has good effect on the immune function of patients with type 2 diabetes mellitus. Improvement of immune function is correlated with the control of FBG and HbA1c.

Blood Glucose ; analysis ; Diabetes Mellitus, Type 2 ; immunology ; surgery ; Gastric Bypass ; Glycated Hemoglobin A ; analysis ; Humans ; Immunoglobulins ; blood ; Laparoscopy ; Lymphocyte Subsets ; immunology ; Postoperative Period ; Retrospective Studies