Objective To investigate the influencing factors of disease progression and prognosis in patients with large artery atherosclerotic(LAA)cerebral infarction and analyze the value of plasma cyclin-dependent kinase 9(CDK9)level in the diagnosis and treatment of LAA cerebral infarction.Methods Patients with acute cerebral infarction admitted to the Department of Neurology of the Affili-ated Hospital of Yangzhou University between March 1,2022,and November 20,2023,were select-ed.According to the diagnostic criteria,98 patients with acute LAA(LAA group)and 33 patients with acute small artery occlusion(SAO)cerebral infarction(SAO group)were selected.Additionally,40 healthy individuals matched for age and gender from the Health Examination Center were included as control group.Based on whether the condition of LAA cerebral infarction patients progressing,they were divided into progressive cerebral infarction(PCI)group(39 patients)and the non-pro-gressive cerebral infarction(NPCI)group(59 patients).During the 3-month follow-up period,6 patients from the 98 LAA cerebral infarction patients were lost.According to the modified Rankin Scale(mRS)score at 90 days of follow-up,patients were divided into good prognosis group(mRS score≤2,59 patients)and poor prognosis group(mRS score＞2,33 patients).Fasting lipid in-dices[total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),glucose(GLU),glycated hemoglobin(HbA1c),and homocysteine(Hey)]were collected on the second day after admission.The National Institutes of Health Stroke Scale(NIHSS)was used to assess the degree of neurological impairment in cerebral infarction patients.Enzyme-linked immunosorbent assay(ELISA)was used to measure plasma CDK9 levels in different groups;factors influencing disease progression in patients with acute LAA cerebral infarction were explored;and receiver operating characteristic curves were plotted to evalu-ate the predictive value of CDK9 in patients with acute LAA cerebral infarction.Results Compared with the control group,the LAA group had lower HDL-C level and higher CDK9 level(P＜0.05).The LAA group had a higher proportion of diabetes history,larger infarction volume,higher NIHSS score at admission,and higher CDK9 level compared with the SAO group(P＜0.05).Binary Logistic regression analysis showed that diabetes history and plasma CDK9 levels were influencing factors for LAA cerebral infarction.There were statistically significant differences in the proportion of diabetes history,HbA1c,random GLU,and CDK9 levels between the NPCI and PCI groups(P＜0.05).Diabetes history and plasma CDK9 levels were influencing factors for disease progression in patients with acute LAA cerebral infarction.The area under the ROC curve for CDK9 in predicting acute LAA cerebral infarction was 0.854 5(95％CI,0.794 1 to 0.9148).When the CDK9 level was 602.1 ng/L,the Youden index was maximum(0.604),with a corresponding sensitivity of 0.849 and specificity of 0.755.The NIHSS score,infarction volume,and plasma CDK9 level were higher in the poor prognosis group compared with the good prognosis group(P＜0.01).Correlation analysis showed a positive correlation between mRS scores and CDK9 levels(r=0.485,P＜0.01).Conclusion Plasma CDK9 levels are significantly elevated,and is an influencing factor.It is positively correlated with disease progression and poor prognosis in acute cerebral infarction and has certain predictive value for the progression of LAA cerebral infarction.

BACKGROUND:Nanocomposite hydrogel has great research prospects and application potential in the treatment of osteoarthritis. OBJECTIVE:To review the research progress of nanocomposite hydrogel in osteoarthritis and cartilage repair. METHODS:Databases such as CNKI and PubMed were searched.The English key words were"nanocomposite hydrogel,nanogel,osteoarthritis,cartage,physical encapsulation,electrostatic interaction,covalent crosslinking",and the Chinese key words were"nanocomposite hydrogel,nanogel,osteoarthritis,cartage,physical encapsulation,physical encapsulation,electrostatic effect,covalent cross-linking".After an initial screening of all articles based on inclusion and exclusion criteria,71 articles with high correlation were retained for review. RESULTS AND CONCLUSION:In cell or animal experiments,nanocomposite hydrogel has the effect of improving osteoarthritis.Nanocomposite hydrogel can promote cartilage repair,improve the internal environment of osteoarthritis,and achieve the therapeutic purpose of osteoarthritis by improving the mechanical environment between joints,carrying targeted drugs,and promoting the chondrogenesis of seed cells.At present,the research of nanocomposite hydrogel in osteoarthritis disease still has a huge space to play.It is expected to open up a new way for the clinical treatment of osteoarthritis by continuing to deepen the research of material preparation and actively carrying out cell and animal experiments.

Objective To analyze the value of sentinel lymph node biopsy (SLNB)in predicting axillary lymph node status by injection of fluorescence agent and methylene blue.Methods 156 breast cancer patients receiving surgery from Oct.2013 to Jun.2014 were studied and they were randomly divided into the experimental group(n =78) and the control group(n =78).The fluorescent agent combined with methylene blue and methylene blue were used respectively as tracers for SLNB.Axillary lymph nodes dissection was made during surgery and combined with pathology the status of sentinel lymph node(SLN) metastasis was distinguished between true negative,false negative,true positive,and false positive.Results A total of 164 SLNs were detected by the method of fluorescent agent combined with methylene blue with the detection rate of 97.44％.An average of 2.10 SLNs were detected for each patient.The accuracy rate was 97.44％,the sensitivity was 97.44％,the false negative rate and the false positive rate was 0％ and 0％.A total of 139 SLNs were detected by the method of methylene blue with the detection rate of 89.74％.An average of 1.78 SLNs were detected for each patient.The accuracy rate was 89.74％,the sensitivity was 89.74％,the false negative rate and the false positive rate was 10.26％ and 3.85％.There was statistical difference between the two groups in the average detection number and the false negative rate (P ＜ 0.05)while no statistical difference was found in the detection rate,accuracy,or sensitivity between the two groups (P ＞ 0.05).Conclusion Fluorescent agent combined with methylene blue as tracer for lymph nodes has the advantages of higher detection rate and less trauma,which is worth of clinical application.

Objective To probe into the characteristics of men who have sex with men living in small-medium sized cities and provide scientific foundation for the formulation of strategy for AIDS prevention and control.Methods A qualitative survey was carried out by convenience sampling for thirty one selected MSM.Results Interviewees had a large age gap,widely different occupations and various degrees of education;they depended mainly on internet and friends' contacts to find their sex partners;their knowledge about HIV/STDs was poor and they were indifferent to the risk of AIDs,but were faced with enormous psychological pressure.Multiple sex partners,unprotected anal intercourse were their main high risk behaviors,and they hoped to have access to free condoms,free HIV detection and hot line consultation.Conclusion To implement prevention in an effective manner,close attention should be paid to the role of key persons within the MSM group,to increasing knowledge of the target population,to protecting their mental health and to creating a friendly social environment for their existence and effective use of internet.