Objective:To establish and verify a diagnostic model for distinguishing multiple sclerosis (MS) from other neurological diseases with similar symptoms by usingcerebrospinal fluid oligoclonal band (CSF-OCB)combined with IgG intrathecal synthesis indicators and biochemical markers.Methods:Multiple sclerosis (MS) patients admitted to the Neurology Department of Beijing Tiantan Hospital affiliated with Capital Medical University from January 2014 to December 2022 were selected as the case group, while patients with similar neurological symptoms were selected as the control group. Using the case-control study design, a retrospective analysis was conducted on the detection of age, gender, oligoclonal bands in cerebrospinal fluid, IgG intrathecal synthesis indicators and biochemical indicators for all study subjects. The differential diagnosis model was determined by the multiple logistic regression analysis, and the receiver operating characteristic (ROC) curve was used to analyze the diagnostic efficiency of the differential diagnosis model for neurological diseases with similar symptoms to MS and other conditions.Results:This study included 167 patients in the case group and 335 patients in the control group, of which 128 patients in the case group and 265 patients in the control group were used to construct the model, and 39 patients in the case group and 70 patients in the control group were used for model validation. The differential diagnostic model constructed by a multivariate logistic regression model was Y=0.871×CSF-OCB-0.051×CSFprotein-0.231×CSFchloride+1.183×gender-0.036×LDH+35.770. The model showed that the area under the curve, sensitivity and specificity were respectively 0.916, 87.3% and 87.6%. The Delong test results showed that the diagnostic efficacy of the model was significantly different from OCB, IgG intrathecal synthesis indicators, and OCB combined with IgG intrathecal synthesis indicators ( P<0.05). The new model validation showed that the actual diagnostic consistency rate for the MS group was 84.6%, while the actual diagnostic consistency rate for the control group was 90.0%. Conclusion:This study combines OCB, IgG intrathecal synthesis indicators, and biochemical indicators to establish a diagnostic prediction model for neurological diseases with similar clinical symptoms in MS. This model may have good differential diagnostic value and can better assist clinical diagnosis in the early stages of disease progression in MS patients.

Objective:To establish and verify a diagnostic model for distinguishing multiple sclerosis (MS) from other neurological diseases with similar symptoms by usingcerebrospinal fluid oligoclonal band (CSF-OCB)combined with IgG intrathecal synthesis indicators and biochemical markers.Methods:Multiple sclerosis (MS) patients admitted to the Neurology Department of Beijing Tiantan Hospital affiliated with Capital Medical University from January 2014 to December 2022 were selected as the case group, while patients with similar neurological symptoms were selected as the control group. Using the case-control study design, a retrospective analysis was conducted on the detection of age, gender, oligoclonal bands in cerebrospinal fluid, IgG intrathecal synthesis indicators and biochemical indicators for all study subjects. The differential diagnosis model was determined by the multiple logistic regression analysis, and the receiver operating characteristic (ROC) curve was used to analyze the diagnostic efficiency of the differential diagnosis model for neurological diseases with similar symptoms to MS and other conditions.Results:This study included 167 patients in the case group and 335 patients in the control group, of which 128 patients in the case group and 265 patients in the control group were used to construct the model, and 39 patients in the case group and 70 patients in the control group were used for model validation. The differential diagnostic model constructed by a multivariate logistic regression model was Y=0.871×CSF-OCB-0.051×CSFprotein-0.231×CSFchloride+1.183×gender-0.036×LDH+35.770. The model showed that the area under the curve, sensitivity and specificity were respectively 0.916, 87.3% and 87.6%. The Delong test results showed that the diagnostic efficacy of the model was significantly different from OCB, IgG intrathecal synthesis indicators, and OCB combined with IgG intrathecal synthesis indicators ( P<0.05). The new model validation showed that the actual diagnostic consistency rate for the MS group was 84.6%, while the actual diagnostic consistency rate for the control group was 90.0%. Conclusion:This study combines OCB, IgG intrathecal synthesis indicators, and biochemical indicators to establish a diagnostic prediction model for neurological diseases with similar clinical symptoms in MS. This model may have good differential diagnostic value and can better assist clinical diagnosis in the early stages of disease progression in MS patients.

With rapid development of information technology,blended teaching model has gradually become mainstream teaching model in most colleges and universities.How to evaluate students'learning effect and analyze factors that affect students'per-formance is a key research direction of this teaching model.Taking blended teaching of Medical Immunology course in Xinxiang Medical University as an example,this paper introduces implementation process and evaluation system of blended teaching,analyzes main factors affecting students'performance and learning effect,and focuses on discussing influence of formative evaluation and"flipped classroom"on students'academic performance.

Objective To evaluate the value of serum B-cell activating factor (BAFF) level in predicting cardiovascular events in patients with ST segment elevation myocardial infarction (STEMI). Methods A total of 166 patients with coronary angiography for STEMI in the Nantong Third Hospital Affiliated to Nantong University from January 2020 to June 2022 were selected as research objects, and general materials, medical history, echocardiography and laboratory data were collected. Patients were followed up for 12 months to record the incidence condition of major adverse cardiac events (MACE). The predictive value of serum BAFF level for MACE was evaluated by Cox proportional hazard model; the receiver operating characteristic (ROC) curve of serum BAFF level for prediction of MACE was drawn, and the area under curve (AUC) was calculated. The optimal cut-off value for serum BAFF level was determined by the ROC curve, the patients were grouped based on this optimal cut-off, and the Log-rank test was used to draw the Kaplan-Meier curve for analyzing the incidence of MACE. Results Among the 166 patients, 26 cases had MACE within 12 months of follow-up, and the incidence rate of MACE was 15.7 %. In the MACE group, the age and levels of triglycerides, low-density lipoprotein, cardiac troponin Ⅰ, creatine kinase isoenzyme, and serum BAFF were significantly higher than those in the non-MACE group (P < 0.05). Cox proportional hazard model analysis revealed that there was a significant positive correlation between age and incidence of MACE (HR=1.267, 95 %CI, 1.126 to 1.426, P < 0.001) as well as a significant positive association between serum BAFF level and incidence of MACE (HR=1.020, 95 %CI, 1.003 to 1.038, P=0.024). The sensitivity of serum BAFF level in predicting MACE was 76.2 %, and the specificity was 82.9 %. ROC curve analysis identified the optimal cut-off value of serum BAFF was 1.07 ng/mL, patients were divided into a group with serum BAFF>1.07 ng/mL and another with serum BAFF ≤ 1.07 ng/mL, and the cumulative survival rate in the group with serum BAFF ≤ 1.07 ng/mL was significantly higher than that in the group with serum BAFF>1.07 ng/mL (P < 0.001). Conclusion The increase of serum BAFF level is significantly positively correlated with the increased incidence of MACE in STEMI patients, and serum BAFF level can be used as a predictor of cardiovascular events in STEMI patients.

ObjectiveTo investigate the intestinal absorption characteristics of multi-index components in Danggui Buxuetang with drug absorption simulating system （DASS） established by everted intestinal sac model. MethodThe intestinal absorption solution at different time points after administration of Danggui Buxuetang was collected and detected by high performance liquid chromatography （HPLC）， acetonitrile （A）-0.2% glacial acetic acid solution （B） was used as the mobile phase for gradient elution （0-16 min， 15%-23%A； 16-20 min， 23%-28%A； 20-25 min， 28%-30%A； 25-30 min， 30%A； 30-35 min， 30%-65%A； 35-45 min， 65%-95%A）， the detection wavelength was 302 nm. HPLC fingerprint of intestinal absorption solution was established and the common peak was calibrated， and the relative cumulative absorption rate of each index component was calculated. The relative cumulative absorption curves of components were fitted with various mathematical models by DDSolver 1.0 to explore the absorption law of different components. ResultThe absorption process of C2 （calycosin-7-glucoside） and C6 in Danggui Buxuetang was in line with zero-order equation， C9 was best fitted by Weibull equation， and the remaining 7 components were in line with Makoid-Banakar equation. C1 with C2， C3， C5， C7 and C10， C2 with C5 and C7， C3 with C4， C5， C7 and C10， C4 with C6 and C10， C5 with C7， C6 with C10， C7 with C10， C8 with C9 were absorbed simultaneously during the absorption process. With the prolongation of time， the overall cumulative absorption rate of Danggui Buxuetang increased. At 120 min， the overall cumulative absorption rate of Danggui Buxuetang exceeded 38%， and reached 49.14% at 180 min. ConclusionTen ingredients in Danggui Buxuetang are absorbed in the jejunum， but absorption law of various components is different， which shows that the intestinal absorption of compound preparations of traditional Chinese medicine （TCM） has multiple characteristics. Intestinal absorption study of TCM compound preparations with chemical composition as the index can reveal some of its absorption law， but it is not complete.

ancer prevention encompasses a broad spectrum of strategies designed to lower the chance of developing cancer and reduce the morbidity of established cancer. There are three levels of cancer prevention. Eliminating or mitigating cancer risk factors by adopting healthy behaviors and lifestyles, such as avoiding tobacco and alcohol use, exercising, eating a healthy diet, and applying sunscreen to protect against UV exposure, belongs to primary prevention and is the easiest and most effective way of preventing cancer for the general public. Secondary prevention includes screening to identify precancerous lesions and taking intervention measures to prevent disease progression to malignancy. Tertiary prevention refers to reducing or controlling the symptoms and morbidity of established cancer or the morbidity caused by cancer therapy. For high-risk populations, chemopreventive agents, such as selective estrogen receptor modulators (including tamoxifan and raloxifene) in breast cancer prevention and non-steroidal anti-inflammatory drugs (aspirin) in colorectal cancer prevention, and immunoprevention using human papillomavirus and hepatitis B virus vaccines in infection-related cancers have shown clear clinical benefits of reducing cancer incidences. In this review, we will summarize the current status of cancer prevention, focusing on the major agents that are clinically used for chemoprevention and immunoprevention.

Objective To analyze the perioperative conditions and long-term survival of patients with non-small cell lung cancer (NSCLC) after thoracoscopic lobectomy. Methods 119 patients with NSCLC underwent thoracoscopic lobectomy from January 2006 to December 2012 were enrolled in the study, then collecting and analyzing their perioperative indicators, pathological results and follow-up data. Results 9 patients converted to thoracotomy with a conversion rate of 7.0 %. The median operation time, the median intraoperative blood loss and off-bed activity time were 170 min (65~440 min), 90 ml (15~3 000 ml) and (32.9 ± 16.3) h after operation respectively. The time and amount of postoperative drainage, the length of hospital stay were (6.7 ± 3.2) d, (1 690.0 ± 410.5) ml, (9.2 ± 4.0) d respectively. The incidence of perioperative mortality and postoperative complications were 0.8 %, 13.4 % respectively. For postoperative pathological type, 96 cases of adenocarcinoma, 19 cases of squamous carcinoma, 2 cases of adenosquamous carcinoma and 2 cases of large cell carcinoma. For discharge patients, the median follow-up time was 34.5 months (0 ~ 102 months). The incidence of local recurrence and distant metastasis in observation group were 5.0 % and 17.6 % respectively. 1-year overall survival (OS) and disease free survival (DFS) were 85.3 % and 79.5 %, 3-year OS and DFS were 69.8 % and 64.8 %, 5-year OS and DFS were 60.8 %and 58.6 % respectively. There was no significant difference in 1-year, 3-year and 5-year OS and DFS between adenocarcinoma and squamous carcinoma (P > 0.05) while there were significant difference in local recurrence and distant metastasis among different stages (P < 0.05). In addition to slightly low OS, DFS of Ⅲ a , Ⅲ b and Ⅳ DFS and OS, the overall living conditions among all stage were similar. Conclusions The long-term survival condition of thoracoscopic lobectomy for NSCLC is ideal, and it’s a safe and effective operation, worthy of clinical promoting.

Objective To explore the effect of neural stem cells (NSCs) transplantation on neurogenesis in an alzheimer' disease mouse model and its related mechanism.Methods A total of 16 12-month old aPP/PS1 double transgenic aD mice were randomly divided into two groups:NSC group (receiving NSCs transplantation in the bilateral hippocampi,n=8) and PBS group as the negative control group (receiving an equal quantity of 0.01M/L phosphate buffer saline,n=8).another 8 wild type mice without any treatment were selected as the positive control group (Wt group).at five weeks after transplantation,the expressions of doublecortin (DCX) and nestin in the hippocampal dentate gyrus (DG) and subgranular zone (SGZ) were analyzed by immunofluorescence staining,the number of positive cells in these regions were counted by confocal microscopy,and Morris water maze (MWM) test was used to assess cognitive function in all mice.Results NSC group showed the enhanced spatial learning and memory ability in Morris water maze (MWM) as compared to PBS group,but it was still lower than that in Wt mice (both P＜0.05).Immunofluorescence staining showed NSCs induced the increased positive cells expressing DCX and nestin in the NSC group as compared with PBS group (F＝85.400 and 55.687,both P＜0.001).However,the number of DCX positive cells was still lower in NSC group than in Wt group (P＜0.05).There was no significant difference in the number of Nestin-positive cells between the NSC group and the Wt group (P＞ 0.05).Conclusions NSCs transplantation can promote endogenous neurogenesis via the increased expression of DCX-and Nestin positive cells in the hippocampal DG/SGZ in aD mice,which improves the cognitive abilities in aD mice in some extent.

Objective To explore the effect of behavior training on abilities of learning and memory in young SD rats received low doses of X-ray and their relevant mechanism.Methods A total of 48 SD rats aged 35 d were randomly divided into irradiated group,training group and control group (n=16);rats in the irradiated group and training group received X-ray once daily for seven d;rats in the training group also received behavior training.Abilities of learning and memory were detected by Morris water maze test;changes of N-acetyl aspartate/creatine (NAA/Cr) in the hippocampus were observed;the protein expression levels of cytochrome c oxidase Ⅳ (COXⅣ) in hippocampal regions were observed by immunofluorescence staining and Western blotting.Morphology of neurons in hippocampal CA1 region was detected by HE staining,and mitochondrial morphology was observed via transmission electron microscopy.Results (1) As compared with that incontrol group (1.873±0.032),the ratio of NAA/Cr in the irradiated group (1.611±0.013) was significantly decreased,while that in the training group (1.870± 0.018) was significantly higher than that in the irradiated group (P＜0.05).(2) The escape latency,times crossing the platform and duration of staying in the platform in rats of the irradiated group were significantly longer/fewer than those in the control group,while no significant differences were noted between the training group and control group (P＞0.05).(3) Immunofluorescence indicated decreased COXⅣ protein expression in the CA1 area of irradiated group and increased COXⅣ protein expression in the CA1 area of training group;Western blotting showed that the COXⅣ protein expression in the hippocampal regions of irradiated group (0.298±0.049) was significantly decreased as compared with that in the control group (0.998±0.056,P＜0.05),while no significant differences were noted between the training group (0.987±0.053) and control group (P＞0.05).(4) Karyopyknosis and more damaged mitochondria were found in the irradiated group,while more normal neurons were observed in hippocampal CA1 area of the control and training groups by HE staining.Conclusion Learning and memory abilities of SD rats received low doses of X-ray could be recovered by behavior training,which could be related to the increment of COXⅣ protein expression and mitochondria improvement by behavior training,and neuron damage in the hippocampus would be reversible in an extent.

Objective To retrospectively analyze computerized tomography (CT) imaging features of colorectal cancer with chronic schistosomiasis in order to improve the diagnostic accuracy.Methods Eighty patients whose diagnosis was pathologically confirmed as colorectal cancer with schistosomiasis were collected from Tongji Hospital and Kunshan Chinese Medicine Hospital from January 2007 to December 2012.All the patients underwent abdominal plain CT and contrast-enhanced CT scan.The lesion location,morphology,size,calcification features,enhancement patterns and cancer metastasis were evaluated and compared by two radiologists who were blind to the diagnosis.Twenty colorectal cancer cases without schistosomiasis from the same area were also collected as controls.Results CT imaging showed that the tumors all occurred in the colon and rectum in 80 patients,mainly in colon descendens,colon sigmoideum and rectum.The lesion was characterized by irregular bowel wall thickening with soft tissue masses,and the average length of impaired intestine was (21.35 ± 4.50) cm.The lesions were solitary in 68 cases (85.0％) and were multifocal in 12 cases (15.0％).Linear,spotty and small patchy calcifications were seen in all the patients,with margins unclear in 59 patients (73.8％) and margins clear in 21 patients (26.2％).Early phase enhancement was seen in 68 cases (85.0％),of which 45 cases (56.2％) had homogenous enhancement and 23 cases (28.8％) had heterogeneous enhancement.Late phase enhancement was seen in 73 cases (91.2％) and necrosis was hardly seen.Only two cases (2.5％) had liver metastasis without lymphatic metastasis.All the 20 colorectal cancer cases without schistosomiasis presented with single lesion,which was characterized by irregular bowel wall thickening and local ulcer.The average length of impaired intestine was (6.90±3.40) cm.No calcification was seen in these lesions.All cases had early phase lesion with remarkable heterogeneous enhancement with low density necrotic area.The late phase enhancement was decreased.Four cases (20.0％) had liver metastasis.Compared to cases without schistosomiasis,cases with schistosomiasis tended to have multifocal (x2=100,P=0.000) and longer lesion (t=45.506,P=0.000),and more calcification (x2=100,P=0.000).The early phase heterogeneous enhancement was less frequent (x2 =88,P=0.000) and late phase enhancement was more frequent (x2=100,P=0.000).The liver metastasis rate was significantly lower (x2 =8.688,P =0.014).Conclusions The CT imaging of colorectal cancer with schistosomiasis is characterized by calcifications inside the tumor with obscured margins and multiple intestinal segments involvement.Hematogenous metastasis and lymphatic metastasis are rarely seen.