Stroke is a prevalent acute cerebrovascular disease associated with significant morbidity and mortality,which highly demand effective prevention and treatment strategies.Glucagon-like peptide-1 receptor agonists(GLP-1RA)is a novel type of antidiabetic drug that exerts hypoglycemic and weight loss effects on GLP-1 receptors.Additionally,GLP-1RA possess the potential to reduce infarction size and promote nerve recovery by inhibiting inflammation,oxidative stress,apoptosis,and improving blood-brain barrier permeability and other pathologies.This paper provides a comprehensive summary of the role of GLP-1 in stroke occurrence while also explores the underlying mechanisms by which GLP-1RA influences stroke pathogenesis.Furthermore,it briefly reviews the therapeutic efficacy of GLP-RA in managing stroke.

Objective:To analyze the data of critical care related literatures published in Web of Science core set by knowledge map visualizing technology, and summarize the research status and hotspots of critical care.Methods:The core set database of Web of Science from January 2011 to December 2020 was searched, the extracted information was standardized and analyzed by knowledge map visualizing technology.Results:A total of 783 articles in the field of critical care were included, and the number of literatures increased year by year, among which the number of articles published in the American Journal of Critical Care(305) was the most. The United States (437) was the country with the most published literatures, and Australia was the country with the highest centrality (centrality=0.67). The number and centrality of articles published from China were at the lower middle level. There was cooperation among countries, but not close cooperation. The cooperation among authors was in the state of small aggregation and large dispersion. Cluster analysis and keyword emergence analysis showed that many aspects in the field of intensive care had been the research hotspots, among which "post intensive care syndrome" and "children′s intensive care" were the research hotspots in recent years.Conclusions:The research field of intensive care is still in the rising stage of development, and post intensive care syndrome and children's intensive care are the latest hotspots in intensive care research.

Objective:To explore the effect of case three-dimensional teaching method (CTTM) combined with multimedia teaching on the practice teaching of liver infectious diseases.Methods:Twenty-five interns of liver infectious diseases received by The Second Hospital of Nanjing from May 2019 to January 2020 were taken as the control group, and 25 interns of liver infectious diseases received from February 2020 to October 2020 were taken as the observation group. The control group was given the conventional teaching mode including the conventional case teaching and the conventional multimedia teaching, while the observation group was given CTTM integrated with multimedia teaching method, and both groups were taught for 4 weeks. After teaching, the examination results of liver infectious disease related theory and practice, the changes of core competence before and after teaching, and the recognition of teaching were compared between the two groups. SPSS 25.0 was used for t test and chi-square test. Results:After teaching, the examination results of liver infectious disease related theory [(92.45±7.23) vs. (81.21±7.11)] and practice [(93.27±6.68) vs. (81.23±6.26)] in the observation group were higher than those in the control group. There was no significant difference in the scores of core competence between the two groups before teaching; after teaching, the scores of autonomous learning, problem analysis and solving, doctor-patient communication and teamwork ability of the two groups were higher than those before teaching, and the scores of observation group were significantly higher than those of the control group ( P<0.05). The recognition rates of interns in the observation group were higher than those in the control group in the improvement of learning initiative, the consolidation of theoretical knowledge, the enhancement of practical ability and the improvement of learning efficiency ( P<0.05). Conclusion:In the teaching of liver infectious disease interns, CTTM integrated with multimedia teaching method can not only improve the examination results, and enhance the core competence, but also improve the recognition of interns on the teaching mode.

The transcription factor c-Myc regulates the proliferation, differentiation, metabolism and other key processes of normal cells extensively.The unleashed MYC oncogene frequently produces abundant c-Myc protein, which directly regulates the gene expression of key metabolic enzymes, or tumor-related metabolic pathways by inhibiting microRNA, leading to abnormal metabolism characterized by heightened nutrients uptake, enhanced glycolysis and glutaminolysis, and elevated fatty acid and nucleotide synthesis.This paper briefly summarizes how c-Myc regulated metabolism on glycolysis, glutamine metabolism, tricarboxylic acid cycle, lipid metabolism and nucleotide synthesis in cancer cell,which provides some theoretical reference for the development of antitumor targets and drugs involving c-Myc.

Objective:To understand the smoking cessation behaviors in chronic obstructive pulmonary disease (COPD) patients aged 40 years or older in China and provide evidence for COPD control and prevention.Methods:COPD patients with post-bronchodilator FEV 1/FVC<70% were selected from COPD surveillance (2014-2015) of China, in which 5 791 current or former smokers defined by questionnaire survey were included in the study. The smoking cessation rate/ratio and the successful smoking cessation rate in COPD patients, the successful smoking cessation rate in COPD patients who ever smoked daily and the rate of attempting to quit smoking in current smokers with COPD were estimated using data adjusted by complicated sampling method. Results:The smoking cessation rate was 25.0% and the successful smoking cessation rate was 19.1% in COPD patients aged 40 years or older who ever smoked. The smoking cessation ratio was 23.1% and the successful smoking cessation ratio was 17.6% in COPD patients who ever smoked daily. The rate and ratio were higher in urban area than rural area ( P<0.05) and increased with age ( P<0.05). Patients who were aware of smoking being a risk factor for COPD had higher rate and ratio than patients who were not aware ( P<0.05). Patients with more severe airflow limitation and patients smoking less had higher rate and ratio ( P<0.05). Conclusions:The smoking cessation rate and ratio were low in COPD patients in China. More health education for COPD patients about smoking cessation needs to be strengthened. It is suggested for healthcare workers to actively advise smoking cessation and suggest smoking cessation ways for patients who smoke in their routine clinical service to increase the successful smoking cessation rate/ratio in COPD patients.

Objective:To understand the awareness of chronic obstructive pulmonary disease (COPD) status and awareness of COPD-related knowledge and its influencing factors in COPD patients aged ≥40 years in China in 2014-2015.Methods:The study subjects were selected through multi-stage stratified cluster sampling from 125 COPD surveillance points in 31 provinces (autonomous regions, municipalities) in China. The number of the subjects was 75 107. The relevant variables about COPD diagnosis and COPD-related knowledge awareness were collected by electronic questionnaire in face to face interviews. A total of 9 134 participates with post-bronchodilator FEV 1/FVC<70% were diagnosed with COPD. Based on the complex sampling design, the awareness rate of COPD status and related knowledge were estimated, and the influencing factors were analyzed. Results:A total of 9 132 COPD patients were included in the analysis. Among COPD patients aged ≥40 years in China, 0.9% were aware of their COPD status (95 %CI: 0.6%-1.1%), and 5.7% were aware of COPD related knowledge (95 %CI: 4.8%-6.6%), and 3.4% were aware of pulmonary function test (95 %CI: 2.8%-4.0%). The COPD status awareness rate was 3.9% in the patients with history of chronic respiratory disease (95 %CI: 2.9%-4.8%), 2.4% in the patients with respiratory symptoms (95 %CI: 1.7%-3.1%), and 7.1% in the patients with COPD related knowledge awareness (95 %CI: 4.5%-9.8%) respectively. The results of multivariate logistic regression analysis showed that chronic respiratory disease history, respiratory symptoms, occupational dust and/or harmful gas exposure and COPD related knowledge awareness had influences on the awareness rate of COPD status. Educational level and chronic respiratory disease history had influences on the awareness rate of COPD related knowledge. And ethnic groups, educational level and history of chronic respiratory diseases had influences on the awareness rate of pulmonary function test. Conclusions:The awareness rates of COPD status, COPD-related knowledge and pulmonary function test in COPD patients in China were low. The comprehensive intervention of COPD should be carried out to improve the level of diagnosis and the awareness COPD status of COPD patients.

Objective:To understand the pneumococcal vaccination rate in chronic obstructive pulmonary disease (COPD) patients aged 40 years or older in China and provide evidence for COPD control and prevention.Methods:COPD patients with post-bronchodilator FEV 1/FVC<70% in COPD surveillance (2014-2015) of China were used as study subjects, in which 9 067 patients with definite pneumococcal vaccination status were included. The pneumococcal vaccination rate and its 95 %CI in COPD patients were estimated using data adjusted by complicated sampling method. The factors in association with the vaccination rate were also identified. Results:The pneumococcal vaccination rate was 0.8% in the past five years in COPD patients aged 40 years or older in China (95 %CI: 0.3%-1.4%). The vaccination rate was 0.3% in the patients aged 40 to 59 years (95 %CI: 0.2%-0.5%) and 1.2% in the patients aged 60 years or older (95 %CI: 0.3%-2.1%) ( P<0.05). The rate was higher in the patients living in urban area (1.5%) than in those living in rural area (0.4%) ( P<0.05). The vaccination rate increased with the severity of airflow limitation ( P<0.05). The patients with comorbidities of other chronic lung diseases or diabetes had higher vaccination rate (1.7% and 2.1%) compared with those without comorbidities ( P<0.05). The vaccination rate was 1.4% in former smokers and 0.6% in current smokers. The pneumococcal vaccination rate in COPD patients was associated with age, education level, occupation, the severity of airflow limitation and the history of influenza vaccination. Conclusions:The pneumococcal vaccination rate was extremely low in COPD patients aged 40 years or older in China. It is necessary to strengthen the health education and recommendation for pneumococcal vaccination in COPD patients through different measures.

Objective:To understand the situation of respiratory rehabilitation and oxygen inhalation therapy in chronic obstructive pulmonary disease (COPD) patients aged 40 years or older in China, and provide basic information for the development of pulmonary rehabilitation.Methods:The data were from 2014-2015 COPD surveillance in China. Chinese residents aged 40 years or older were recruited through a complex multi-stage stratified cluster sampling from 125 COPD surveillance points in 31 provinces (autonomous regions, municipalities). Standardized face to face electronic questionnaires were used to collect information about respiratory rehabilitation and oxygen inhalation therapy of the patients. Spirometry was performed on all participants, and patients with post- bronchodilator FEV 1/FVC<70% were diagnosed with COPD. The number of defined COPD patients was 9 134. Based on the complex sampling design, the respiratory rehabilitation treatment rate and oxygen inhalation therapy rate of COPD patients aged 40 years old or older in China were estimated, and the influencing factors were analyzed. Results:A total of 9 118 COPD patients aged 40 years or older were included in the analysis. The rate of respiratory rehabilitation was 0.8% (95 CI: 0.6%-1.0%), and the rate of oxygen inhalation therapy was 2.5% (95 %CI: 2.0%-2.9%). Among patients with severe symptoms or high risk of acute exacerbation (combined COPD assessment groups B, C, D), the rate of respiratory rehabilitation was 1.4% (95 %CI: 0.9%-1.9%), and the rate of oxygen inhalation therapy was 5.4% (95 %CI: 4.4%-6.4%). Multivariate logistic regression analysis showed that urban or rural residences, geographic area, awareness of COPD, history of acute exacerbation and severity of airflow restriction had influences on the respiratory rehabilitation rate in the COPD patients. Gender, geographic area, awareness of COPD, history of acute exacerbation, mMRC scores and severity of airflow restriction had influences on the patients’ oxygen inhalation therapy rate. Conclusions:The rate of respiratory rehabilitation and oxygen inhalation therapy in COPD patients aged 40 years or older was relatively low in China. It is necessary to explore an effective model of pulmonary rehabilitation and COPD management, so that more COPD patients may have access to scientific pulmonary rehabilitation treatment.

Objective The objective of this study was to investigate the effect of salinomycin on proliferation and autophagic flux of human melanoma M21 cells. Methods The cell survival rate was determined by MTS assay and IC50values( half inhibitory concentration)were calculated. The morphological changes of cells after salinomycin administration were observed under optical micro-scope. Flow cytometry was used to examine the apoptosis rate of M21 cells. Western blot was used to detect the expression of autophag-ic-related protein LC3B and p62 in M21 cells. The presence of autophagosomes in M21 cells after salinomycin administration was ob-served under transmission electron microscope. Western blot and immunofluorescence were used to detect the level of p62 protein and localizing changes in M21 cells. Results Salinomycin significantly inhibited proliferation of M21 cells, and the IC50values were (1. 38 ± 0. 18)μM. After salinomycin administration,the proliferation rate of M21 cells was slowed down,and obvious vacuoles ap-peared in the cells. Salinomycin could not only induce cell apoptosis,but it also increased the ratio of LC3B-Ⅱ/LC3B-Ⅰ in M21 cells. The increase and accumulation of autophagosomes were directly observed under transmission electron microscope. The level of p62 protein was slightly elevated after salinomycin treatment and gradually aggregated into the cytoplasm,indicating that autophagic flux was inhibited. Conclusion Salinomycin can inhibit the proliferation of human malignant melanoma M21 cells,and its mechanism may be related to the accumulation autophagosomes granules and inhibition of autophagic flux.

Professor 's experience of acupuncture combined with medication for epilepsy is summarized, which is explained from epilepsy's etiology and pathogenesis, diagnosis and treatment of acupuncture and medication, respectively. Besides, the theoretical foundation and use instruction of acupuncture technique "-" for epilepsy are introduced. Professor highly values the adherence to etiology and pathogenesis, pays attention to syndrome differentiation and searches for the primary disease cause. He proposes the wind, phlegm, stasis and deficiency are the pathogenesis of epilepsy, and points out acupuncture could be applied during attack stage and remittent stage, but electroacupuncture should be used with caution. Regulating spirit is the key for treating epilepsy. The combination of acupuncture and medication could regulate the governor vessel and guide to the origin, which have significant curative effect.
Acupuncture Therapy ; Combined Modality Therapy ; Electroacupuncture ; Epilepsy ; therapy ; Humans