BACKGROUND:Ischemic stroke is a highly prevalent disease associated with apoptosis.Neuronal death occurs after cerebral ischemia,including necrosis and apoptosis.The ischemic core region is dominated by necrosis,while delayed neuronal death in the penumbra is dominated by apoptosis.The penumbra has become a target for the treatment of ischemic stroke.This bibliometric analysis was used to identify the characteristics,hotspots,and frontiers of global scientific output related to apoptosis in ischemic stroke over the past 5 years. OBJECTIVE:To analyze the role of apoptosis and its mechanisms in the pathological process of ischemic stroke through a bibliometric approach. METHODS:A total of 927 relevant literature records from 2018 to 2022 were retrieved from Science Citation Index Expanded(SCI-Expanded)and Social Science Citation Index Expanded(SSCI-Expanded)of the Web of Science Core Collection.Research trends and hotspots of apoptosis in ischemic stroke were visualized using Citespace,VOSviewer and Bibliometrix. RESULTS AND CONCLUSION:From 2018 to 2020,the number of papers on the role of apoptosis in ischemic stroke showed an upward trend,but in 2020,the number of papers began to reduce.China had the largest number of publications,and the United States ranked the second.Capital Medical University and BRAIN RESEARCH BULLETIN were the institutions and journals with the most articles,respectively.In recent years,the two keywords"expression"and"oxidative stress"have appeared more frequently.The bibliometric study showed that in the past 5 years,most of the studies focused on basic research,in which research on the role of apoptosis in ischemic stroke has gradually decreased in the last 3 years,showing a downward trend.On the contrary,nerve regeneration has gradually become a research hotspot,especially the regulation of neurotrophic factors under the influence of different mechanisms,and the research on angiogenesis and glial cell repair is on the rise.At the same time,apoptosis in nerve regeneration is a potential point of discovery.

Intracerebral hemorrhage (ICH) is a hemorrhagic cerebrovascular disease with high incidence and mortality. Oxidative stress response plays an important role in the pathological and physiological processes of ICH, and is also a potential effective target for clinical treatment. In this paper, the pathogenesis of oxidative stress after ICH, mechanism of nerve and vascular injury in oxidative stress, and detection and treatment of oxidative stress are reviewed in order to provide references for basic research and clinical practice in ICH.

Blockchain technology has the advantages of decentralization, secure sharing and tamper resistance, and high privacy, which can solve the current problem of sharing electronic medical records in medical institutions in China. A tertiary hospital established an electronic medical record sharing services convenience service platform based on blockchain in collaboration with China mobile gansu company in September 2021. The hardware architecture of the platform consisted of a hospital data warehouse, a local front-end computer and a blockchain platform. The functional architecture included platform front-end services, the blockchain electronic medical record archiving and service platform. The technical architecture included the underlying blockchain, service layer, interface layer and application layer, which was embedded with asymmetric encryption technology, hash algorithm, smart contract and other technical means, ensuring data ownership and on-demand, controllable, real-time and secure sharing of data. Since the operation of the platform in September 2021, as of October 2022, a tertiary hospital had accumulated 21 545 patient medical records on the chain. The overall operation of the platform was smooth, achieving reliable storage and secure sharing of patient electronic medical records, providing reference for further promoting the interconnection trusted sharing of electronic medical records in medical institutions in China.

Animal model of hydrocephalus is an important object to study the mechanism, pathological characteristics, and treatment of hydrocephalus. A stable and controllable animal model in accordance with clinical development of hydrocephalus can help to develope hydrocephalus related basic research and clinical translational application. According to the study purpose and genetic and physiological characteristics of experimental animals, a variety of animals have been used to establish different types of hydrocephalus animal models. The methods for congenital hydrocephalus models include gene edition and metabolic induction, while secondary hydrocephalus models can be induced by blocking the circulation of cerebrospinal fluid and interfering cerebrospinal fluid absorption. The hydrocephalus models constructed by different methods are also different in progression, neurofunctional changes, and histopathological characteristics. This paper reviews the construction methods and pathological characteristics of various hydrocephalus models in order to provide references for selection of animal models for hydrocephalus-related research.

Objective:To explore the psychological status of female patients with mandibular angle hypertrophy before and after receiving mandibular angle osteotomy (MAO) using psychological measurement methods.Methods:The study included 36 female patients (age ranged 18-35 years, with mean age of 23 years) who underwent bilateral mandibular angle osteotomy at the Department of Burns and Plastic Surgery, Naval Medical University. Symptom Checklist-90 (SCL-90), Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS) were used to assess the patients′ psychological status before and after surgery. SPSS 18.0 was used to compare the preoperative and postoperative data with the national norms.Results:According to the SCL-90 questionnaire, the scores of the six factors, including obsessive-compulsive symptoms (2.24±0.43 vs. 1.62±0.58, P<0.01), interpersonal sensitivity (1.85±0.46 vs. 1.65±0.61, P=0.02), depression (1.91±0.43 vs. 1.50±0.59, P<0.01), anxiety (1.75±0.42 vs. 1.39±0.43, P<0.01), hostility (1.86±0.45 vs. 1.46±0.55, P<0.01), and paranoia (2.18±0.46 vs. 1.43±0.57, P<0.01) of patients before surgery were significantly higher than the national norms. One month after surgery, there was a significant improvement in SAS and SDS scores compared to preoperative scores ( t=8.0, 10.4, P<0.01). The SAS score decreased from 43.0±9.8 to 37.5±6.8, and the SDS score decreased from 47.1±10.6 to 39.4±7.5. There was no statistically significant difference in the depression and anxiety indices of SCL-90 compared to the national norms ( P>0.05). Conclusions:Mandibular angle osteotomy significantly improves the psychological health of female patients with mandibular angle hypertrophy and can alleviate the symptoms of anxiety and depression.

Objective:To investigate the clinical application value of serum carcinoembryonic antigen (CEA) level in predicting lymph node metastasis of resectable medullary thyroid carcinoma (MTC) .Methods:140 patients of resectable MTC from Zhejiang Cancer Hospital and Hangzhou First People’s Hospital from Jan. 2009 to Feb. 2019 were included. The relationship of serum CEA and lymphatic metastasis was retrospectively analyzed in 140 patients of resectable MTC, and the clinical significance of serum CEA for predicting total lymph node, central lymph node, lateral lymph node and upper mediastinal lymph node metastasis was also evaluated.Results:The positive rate of serum CEA in resectable MTC was 77.14%. The expression level of serum CEA in resectable MTC with lymph node metastasis was significantly higher than those without lymph node metastasis ( P<0.001) . Spearman correlation analysis further indicated that the level of serum CEA expression was positively correlated with the number of lymph node metastases of resectable MTC patients ( P<0.001) . The area under curve of predicting lymphatic metastasis of total lymph node, central lymph node, lateral lymph node and upper mediastinum was 0.773, 0.768, 0.827 and 0.847. When the cut-off value of serum CEA was 6.58, 11.43, 15.74 and 30.45 ng/ml, respectively, the sensitivity of serum CEA to predict total, central, lateral neck and upper mediastinal lymph node metastasis was 88.46%, 81.43%, 85.00%, 95.00%, and the specificity was 56.45%, 60.00%, 71.25%, and 69.17%, respectively. Conclusion:Serum CEA has a high positive expression rate in resectable MTC, and its expression level has important clinical significance in evaluation of lymphatic metastasis.

Objective To investigate the curative effect of ultra early enteral nutrition (EN) supplemented with probiotics in patients with severe acute pancreatitis (SAP).Methods Seventy-five SAP cases admitted in Second People's Hospital of Nantong from December 2014 to June 2018 were enrolled and assigned into 24 h group (who received EN & probiotics at 24 h,n =25),72 h group (who received EN & probiotics at 72 h,n =25) and the control group (who received EN & probiotics on day 7,n =25).After admission,the levels of PCT,hs-CRP and endotoxin on day 1,4 and 8 were detected.APACHE Ⅱ score on day 3 after admission,complication rate,infection rate,hospitalization duration and mortality were recorded.Results On day 1 after admission,serum PCT,hs-CRP and endotoxin concentrations among three groups were of no significant differences.On day 4 after admission,the serum concentrations of PCT and edotoxin in 24 h group were significantly lower than those in 72 h group and the control group [(3.12 ± 1.45) μg/L vs (5.26±1.52),(6.07 ± l.59) μg/L;(0.24 ± 0.02) EU/ml vs (0.35 ±0.03),(0.46±0.04) EU/ml].The serum hs-CRP in 24 h group was significantly lower than that of the control group [(20.71 ±4.89) μg/L vs (28.37 ± 4.64) μg/L],and the difference was statistically significant (P ＜ O.05).The serum concentrations of hs-CRP in 24 h group and 72 h group was of no significant difference.On day 7 after admission,the serum concentrations of PCT,hs-CRP and endotoxin in 24 h group were significantly lower than those in 72 h group and the control group (P ＜0.05);the serum concentrations of PCT,hs-CRP and endotoxin in 72 h group were significantly lower than those of the control group,and all the differences were statistically significant (all P ＜ 0.05).The score of APACHE Ⅱ (day 3 after admission) [(15.1 ± 1.8)],complication rate (52％),infection rate (8％),length of stay [(19.7 ± 5.3) d] in 24 h group were all significantly lower than those of 72h group [(17.0 ± 2.0),72％,32％,(25.4 ± 6.8) d] and control group [(18.3 ±2.6),84％,44％,(38.7 ± 12.6) d],and all the differences were statistically significant (all P ＜0.05).Conclusions Ultra EN supplemented with probiotics in treating the patients with SAP could significantly reduce the level of serum PCT,hs-CRP and endotoxin,decrease complication rate and mortality,and shorten the time of hospitalization.

Objective To analyze the characteristics and correlated factors of attempted suicide among psychological aid hotline callers,and provide a reference for suicide prevention and intervention to the domestic psychological aid hotlines.Methods From September,2010 to August,2015,1 299 callers who had the database of attempted suicide among hotline callers were collected.During the calling,the callers were interviewed on their attempted suicides,depression and 10 correlated factors associated with caller's suicidal behaviors.Results Among 1 299 callers who received assessment of suicidal behavior relates factors,361 (27.8％) had evaluated of current suicidal ideation or behavior,223 (17.2％) had history of prior suicidal attempts.There was no significant difference in the incidence of suicide attempts among different gender,age and occupation.1 024 (78.8％) had symptoms of mental illness,794 (61.1％) had symptoms of anxiety,708 (54.5％) had symptoms of depression,864(66.5％) had concomitant two or more symptoms.Compared the caller's occurrence rate of suicidal attempter between single depression and concomitant other symptoms,the results found single depression and concomitant anxiety,concomitant obsession,concomitant panic and concomitant fear were statistically significant.Multiple logistic regression analysis showed that high depression emotion (β=O.389,OR=1.48,95％CI=1.08-2.02),the history of prior attempted suicide (3=0.487,OR=1.63,95％CI=1.19-2.22) and high hopelessness (β=0.618,OR=1.86,95％CI=1.32-2.60) were associated with the caller of ever attempted suicide behaviors.Conclusion Among the callers with attempted suicide,in order to improve the effectiveness of hotline prevention and invention,the psychological consultant should focus on the evaluation of concomitant mental symptoms,high depression emotion,history of prior attempted suicide and hopelessness.

Objective: To investigate the effect of UCHL5 on proliferation and apoptosis of breast cancer cells. Methods: SW527 cells were infected with lentiviral vector carrying short hairpin RNA to delete the expression of UCHL5. 3-(4, 5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium (MTS) assay was used to examine cell proliferation, and subcutaneous transplantation experiments were performed to detect tumor growth. Cell apoptosis was detected using Annexin V/ Propidium iodide (PI) double staining. The correlation between UCHL5 expression and the expressions of proliferation and apoptosis associated genes was analyzed using TCGA breast invasive carcinoma data set. The relationship between UCHL5 expression and breast cancer patients′survival was analyzed using Kaplan-Meier Plotter online tool. Results: After knockdown of UCHL5, A values of SW527 cells on day 2 and day 4 were 0.822±0.017 and 1.045±0.023, respectively, which were significantly lower than 0.976±0.016 and 1.284±0.025 of control cells on day 2 and day 4 (P<0.001). In vivo xenografted mouse model, the volume in UCHL5-suppressed group was (166.90±75.05) mm^3, significantly smaller than (329.80±35.84) mm³ in control group (P=0.029). Flow cytometry analysis showed the apoptotic rate of SW527 cells was (8.60±1.13)% after knockdown of UCHL5, significantly higher than (2.95±0.07)% of control group (P=0.020). TCGA database analysis showed that the expression of UCHL5 was positively correlated with the expressions of genes related to cell proliferation, in paralled with the increased expression of UCHL5, the expression of the pro-apoptosis associated genes was decreased. Kaplan-Meier Plotter analysis demonstrated that the overall survival and relapse-free survival of breast cancer patients with high expression of UCHL5 were much shorter (all P<0.001). Conclusions Down-regulation of UCHL5 inhibits the proliferation and tumor formation and promotes apoptosis of SW527 cells. High expression of UCHL5 may predict poor prognosis of breast cancer patients.

Objective To assess the long-term efficacy and adverse effects of three-dimensional radiotherapy (3-DCRT) for elderly patients with esophageal cancer,to investigate the effects of diabetes and hypertension on radiation esophagitis and pneumonitis and to analyze the prognostic factors.Methods A total of 233 patients aged 70 or over with esophageal squamous cell carcinoma were treated with 3-DCRT,and 27 of the patients had type-2 diabetes and 63 had hypertension.Radiation esophagitis and pneumonitis were monitored in patients with or without diabetes and in patients with or without hypertension.Potential prognostic factors were analyzed by Logrank single factor analysis and Cox multivariate analysis.Results The incidences of radiation esophagitis and pneumonitis in grade 3 or over were significantly higher in patients with diabetes than in those without diabetes (Z =-3.762,-2.972;P ＜0.001,0.003).The incidences of radiation esophagitis and pneumonitis in grade 3 or over in patients with hypertension were significantly higher than in those without hypertension (Z =-2.610,-2.209;P =0.009,0.027).The 1-,3 and 5-year overall survival (OS) rates were 70.6％,35.8％ and 23.9％,respectively.The median OS was 23.0 months (95％CI:18.6-27.5).Univariate analysis showed that age (x2 =4.274,P =0.039),T stage (x2=9.376,P 0.025),N-stage (x2=8.504,P=0.014),TNM stage (x2=7.806,P=0.020),gross tumor volume (GTV) (x2 =5.209,P =0.022) and short-term therapeutic efficacy (x2 =25.276,P＜0.001) had influenced OS.Multivariate analysis showed that T-stage (P =0.001),N-stage (P =0.007),TNM stage (P =0.002) and short term therapeutic efficacy (P ＜ 0.001) were independent prognostic factors for OS.Conclusions 3-DCRT achieves favorable long-term efficacy in elderly patients with esophageal cancer.Diabetes and hypertension are potential risk factors for radiation esophagitis and pneumonitis.T-stage,N-stage,TNM stage,and short term therapeutic efficacy are independent prognostic factors.