OBJECTIVE: To assess the association of cytochrome P450 (CYP450) gene polymorphisms with the occurrence of ischemic stroke (IS). METHODS: From January 2020 to August 2022, 390 IS patients treated at the Zhengzhou Seventh People's Hospital were enrolled as the study group, and 410 healthy individuals undergoing physical examination during the same period were enrolled as the control group. Clinical data of all subjects were collected, which included age, sex, body mass index (BMI), smoking history and results of laboratory tests. Chi-square test and independent sample t test were used for comparing the clinical data. Multivariate logistic regression analysis was used to analyze the non-hereditary independent risk factors for IS. Fasting blood samples of the subjects were collected, and the genotypes of rs4244285, rs4986893, rs12248560 of the CYP2C19 gene and rs776746 of the CYP3A5 gene were determined by Sanger sequencing. The frequency of each genotype was calculated by using SNPStats online software. The association between the genotype and IS under the dominant, recessive and additive models was analyzed. RESULTS: The levels of total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL-C), apolipoprotein B (Apo-B) and homocysteine (Hcy) of the case group were significantly higher than those of the control group, whilst the levels of high density lipoprotein (HDL-C) and Apo-A1 (APO-A1) were significantly lower (P < 0.05). Multivariate Logistic regression analysis showed that TC (95%CI = 1.13-1.92, P = 0.02), LD-C (95%CI = 1.03-2.25, P = 0.03), Apo-A1 (95%CI = 1.05-2.08, P = 0.04), Apo-B (95%CI = 1.7-4.22, P < 0.01) and Hcy (95%CI = 1.12-1.83, P = 0.04) were non-genetic independent risk factors for the occurrence of IS. Analysis of the association between the genetic polymorphisms and the risk of IS showed that the AA genotype at rs4244285 of the CYP2C19 gene, the AG genotype and A allele at rs4986893 of the CYP2C19 gene, and the GG genotype and G allele at rs776746 of the CYP3A5 gene were significantly associated with IS. Under the recessive/additive model, dominant model and dominant/additive model, polymorphisms of the rs4244285, rs4986893 and rs776746 loci were also significantly associated with the IS. CONCLUSION TC, LDL-C, Apo-A1, Apo-B and Hcy can all affect the occurrence of IS, and CYP2C19 and CYP3A5 gene polymorphisms are closely associated with the IS. Above finding has confirmed that the CYP450 gene polymorphisms can increase the risk of IS, which may provide a reference for the clinical diagnosis.
Humans ; Cytochrome P-450 CYP3A/genetics* ; Cytochrome P-450 CYP2C19/genetics* ; Ischemic Stroke ; Cholesterol, LDL/genetics* ; Polymorphism, Single Nucleotide ; Genotype ; Apolipoproteins B/genetics* ; Gene Frequency

Objective:To analyze the risk factors for postoperative one-year mortality in elderly patients with femoral intertrochanteric fracture following multidisciplinary treatment (MDT) by intramedullary nailing.Methods:The clinical data were retrospectively analyzed of the 158 elderly patients with femoral intertrochanteric fracture who had undergone MDT by proximal femoral intramedullary nailing between January 2018 and August 2020 at Department of Orthopedics, Trauma Center, Zhongda Hospital Affiliated to Southeast University. There were 41 males and 117 females with an average age of 82.5 years (from 65 to 95 years). By the modified Evans classification, there were 15 cases of type Ⅰ, 16 cases of type Ⅱ, 35 cases of type Ⅲ, 81 cases of type Ⅳ, and 11 cases of type Ⅴ. The one-year mortality was documented in the patients after surgery. To screen for risk factors, univariate analysis was conducted of gender, age, body mass index (BMI), modified Evans classification of fractures, time from injury to operation, American Society of Anesthesiologists (ASA) classification, Charlson comorbidity index (CCI) and comorbidities, as well as preoperative hemoglobin (Hb), serum albumin (ALB) and total lymphocyte count (TLC). The factors with P<0.05 were included in the multivariate logistic regression model analysis to determine the risk factors. Results:A total of 13 patients died within one year after surgery, yielding a mortality of 8.2% (13/158). Univariate analysis showed significant differences in age, body mass index, modified Evans classification of fractures, CCI and Hb between the surviving and dead patients ( P<0.05). Multivariate logistic regression analysis showed that age >85 years ( OR=0.122, 95% CI: 0.018 to 0.834, P=0.032), BMI>23.9 kg/m 2 ( OR=0.083, 95% CI: 0.013 to 0.510, P=0.007), CCI≥3 points ( OR=0.051, 95% CI: 0.090 to 0.275, P=0.001) and preoperative Hb<90 g/L ( OR=4.733, 95% CI: 1.036 to 21.624, P=0.045) were the independent risk factors for postoperative one-year mortality in the elderly patients with intertrochanteric fracture following MDT by proximal femoral intramedullary nailing. Conclusions:After MDT by proximal femoral intramedullary nailing of femoral intertrochanteric fractures, the geriatric patients with an age >85 years, BMI>23.9 kg/m 2, CCI≥3 points and Hb<90 g/L are likely to die. Therefore, special care should be taken for them.

Objective:To determine the pathogenic gene mutation in a family with incomplete congenital quiescent night blindness (CSNB) of Schubert-Bornschein type.Methods:A retrospective clinical study. In February 2021, one patient and his parents and elder brother from a Han Chinese incomplete CSNB of Schubert-Bornschein type family diagnosed by clinical and genetic examination at Henan Provincial People's Hospital were included in the study. The patient’s medical history, family history were inquired; best corrected visual acuity (BCVA), color vision, fundus color photography, full-field electroretinogram (ERG), and frequency domain optical coherence tomography (OCT) were examined in detail. Five ml of the subject’s peripheral venous blood was collected and the whole genome DNA was extracted. The genomic DNA of the subject was library constructed, and all-exon probes were polymerized for capture. The suspected pathogenic mutation site was verified by Sanger, and the pathogenicity of the gene mutation site was determined by parallel bioinformatics analysis.Results:The BCVA of both eyes of the proband (Ⅱ2) was 0.4; the color vision test could not recognize the red color. Fundus examination showed no obvious abnormalities. The retina thickness in the macular area of both eyes was slightly thinned. ERG examination of the whole field showed that the amplitude of ERG b wave was significantly reduced under the stimulation of binocular dark adaptation 3.0 and showed a negative waveform. The mother of the proband (Ⅰ2) had normal BCVA, color vision, fundus color photography, and frequency domain OCT examination. The full-field ERG examination showed that the amplitude of each eye reaction was slightly reduced, and the amplitude of the dark adaptation shock potential was significantly reduced. Genetic testing showed that the proband (Ⅱ2) had a c.1761dupC hemizygous mutation in exon 14 of the voltage-dependent calcium channel α1F subunit gene ( CACNA1F gene). The results of protein sequence homology analysis showed that the site was highly conserved in multiple species; the results of bioinformatics analysis showed that the CACNA1F gene c.1761dupC (pY588fs) subsequently had a frameshift mutation and became a stop at position 10. Codons appear translational termination in the conserved regions of the protein. According to the standards and guidelines of the American College of Medical Genetics and Genomics, the mutation was judged to be a possible pathogenic variant. The mother of the proband (Ⅰ2) was a carrier of this site mutation. The clinical and genetic test results of the father and elder brother of the proband were not abnormal. Conclusion:CACNA1F gene c.1761dupC is the pathogenic mutation site of the Schubert-Bornschein type incomplete CSNB family.

Objective:To explore the standard intraoperative nursing procedure in MAKO robot-assisted unicompartmental knee arthroplasty.Methods:We retrospectively analyzed the Operating Room nursing procedure and related data among 34 patients (a total of 39 cases of unicompartmental knee arthroplasty were performed) with MAKO robot-assisted unicompartmental knee arthroplasty in Department of Orthopedics, the First Medical Center, Chinese PLA General Hospital from September 2016 to December 2019. All patients were diagnosed with knee osteoarthritis before surgery, and all of them were operated with MAKO RIO robotic surgery system and RESTORIS MCK unicompartmental knee prosthesis. We summarized the main points of nursing management during unicompartmental knee arthroplasty assisted by MAKO robot.Results:We summarized the nursing procedures of 39 cases of MAKO robot-assisted unicompartmental knee replacement in our center, and formulated the standard nursing procedure in MAKO robot-assisted unicompartmental knee arthroplasty.Conclusions:This study has completed the formulation of details of standard procedures for nursing coordination during MAKO robot-assisted unicompartmental knee arthroplasty, which has a guiding significance for nursing management of MAKO robot-assisted unicompartmental knee arthroplasty in the future.

Objective: To systematic evaluate the real experience of patients after falling during hospitalization and qualitative research on the cognition and demand for fall prevention will provide theoretical basis for patients, their families, medical staff and medical institutions to better carry out fall prevention. Methods: English databases such as PsycINFO, Medline, Embase, CINAHL, Cochrane, PubMed, and Chinese databases such as Chinese biomedical literature database, CNKI, Wanang database were retrieved by computer. Included qualitative studies on the emotional experience of fall of inpatients and their cognition and needs for fall prevention. The retrieval time limit was until November 1, 2018.The literature was evaluated using the quality evaluation criteria for qualitative research (2016) of the JBI evidence-based health care center, and the results were integrated using a pooled integration method. Results: A total of 8 studies were included, and 33 clear research results were extracted. Similar results were summarized and combined to form 7 new categories, which were integrated into 4 results. Results 1: psychological experience of hospitalized patients after falling down. Integration results 2: the causes of falls from the perspective of inpatients. Integration results 3: hospital fall prevention measures and evaluation from the perspective of inpatients. Integration result 4: inpatients expected to receive care from their families and help from medical staff. Conclusion Fall events seriously affect the mental health of patients; Patients′ cognition of falling is affected and changed by many factors. Fall prevention should shift from clinical focus to patient-centered and attach importance to the participation of family members.

Objective To discuss the clinical value of magnetic resonance imaging in the diagnosis of inner ear lesion.Methods 94 patients who took magnetic resonance imaging water imaging were selected as study subjects from February 2014 to October 2016 in Heilongjiang Province Hospital.All the patients had surgical data,CT,MRI water imaging data.Based on the standard data of surgery gold,analyzed the sensitivity,specificity,accuracy,positive predictive value and negative predictive value of CT and MRI in the diagnosis of inner ear lesions,compared the statistical differences between the two methods of examination.Results The sensitivity,specificity,positive predictive value and negative predictive value of MRI water imaging in diagnosis of inner ear werehigher than CT,but the differences were no statistically significant (all P ＞ 0.05).In the case of abnormal vestibular aqueduct (x2 =7.265,P =0.015),cochlear deformity (x2 =5.042,P =0.028),diagnostic accuracy of cochlear fibrosis (x2 =5.492,P =0.027),the differences were statistically significant(all P ＜ O.05).Conclusion MRI water imaging can effectively provide the information of ear canal,eudometrial and other internal organs,can provide a favorable clinical diagnosis,it is worth to promote the application in the clinical work.

Objective To analyze impact of diversity care on mental state of self-management ability of patients with gastric cancer.Methods A total of 85 patients with gastric cancer in our hospital were divided into two groups according to the random principle.The control group was taken routine care and the observation group accepted diversity nursing on the basis of traditional way.Psychological state,self-management skills,and satisfaction were observed and analyzed.Results The scores of depression,fear,and anxiety were significantly lower than the control group (P ＜ 0.05).Before nursing,no significant difference was seen in self-management ability in the observation group compared with the control group (P ＞ 0.05),while after treatment it was significantly higher than the control group (P ＜ 0.05).The satisfaction in the observation group was significantly higher than that in the control group,the difference was statistically significant (P ＜ 0.05).Conclusion Compared to traditional care measures,the diversity care can effectively improve emotions and quality of life of patients with gastric cancer,and enhance the patient's self-management skills,so it is worthy of widely clinical practice.

Objective To analyze impact of diversity care on mental state of self-management ability of patients with gastric cancer.Methods A total of 85 patients with gastric cancer in our hospital were divided into two groups according to the random principle.The control group was taken routine care and the observation group accepted diversity nursing on the basis of traditional way.Psychological state,self-management skills,and satisfaction were observed and analyzed.Results The scores of depression,fear,and anxiety were significantly lower than the control group (P ＜ 0.05).Before nursing,no significant difference was seen in self-management ability in the observation group compared with the control group (P ＞ 0.05),while after treatment it was significantly higher than the control group (P ＜ 0.05).The satisfaction in the observation group was significantly higher than that in the control group,the difference was statistically significant (P ＜ 0.05).Conclusion Compared to traditional care measures,the diversity care can effectively improve emotions and quality of life of patients with gastric cancer,and enhance the patient's self-management skills,so it is worthy of widely clinical practice.

Objective To investigate the effect of an ACE inhibitor ,perindopril ,on the expression of SR‐A in renal tubuloint‐erstitium of diabetic rats .Methods Diabetes was induced in male Sprague‐Dawley rats by injection with streptozotocin .The rats were then randomly divided into 3 groups:normal control group;untreated diabetes mellitus group and diabetes mellitus group trea‐ted with perindopril .After a 24‐week treatment ,tubulointerstitial injury index was assessed with Masson′s trichrome sections .The expression of SR‐A mRNA was detected by RT‐PCR and the expression of SR‐A protein in renal tubulointerstitium was detected by immunohistochemistry .Results The tubulointerstitial injury index ,the expression of SR‐A mRNA were significantly higher in the diabetes group than those in normal control group .Perindopril treatment not only attenuated the tubulointerstitial injury ,but also reduced the overexpression of SR‐A mRNA in diabetic rats .The expression of SR‐A protein was most obvious in renal tubulointer‐stitium in diabetic rats ,which was obviously attenuated by perindopril treatment(P<0 .05) .Conclusion The findings of the this study indicate that perindopril may have renoprotective effects on diabetic nephropathy via inhibiting the expression of SR‐A in re‐nal tubulointerstitium .

This paper reviews the etiology , pathogenesis ,prediction and evaluation and other related aspects of motion sickness in order to contribute to further research on motion sickness and to proride the theorotic basis for prevention .