Objective To evaluate the efficacy of different interventions to the extra cranial lesions in acute ischemic stroke(AIS)due to anterior tandem lesions(TL)on reperfusion.Methods As a multi-center,cross-sectional study,AIS due to anterior TL receiving mechanical thrombectomy(MT)were retrospectively collected.Interventions to the extra-cranial stenosis were recorded.Post-procedural reperfusion was assessed using the modified thrombolysis in cerebral infarction(mTICI)score.Complete revascularization was defined as mTICI 3 and good revascularization was defined as mTICI 2b/3.The relationship between different extra-cranial intervention regi-mens and rate of re-vascularization was compared.Results Totally 117 patients were included with 92.3% reaching good recanalization and 63.2% reaching complete re-canalization.There was no significant difference in good re-canalization rates among various extra-cranial intervention regimens.The rate of complete re-canalization was significantly higher in patients receiving endovascular therapy(P＜0.05)and there was significant difference among various endovascular treatment regimens(P＜0.01):acute balloon angioplasty only group presented the highest rate of complete re-canalization(100.0% ),followed by acute stenting only group(80% ),acute stenting+balloon angioplasty group(73.7% )and conservative treatment group(54.3% ).Conclusions Endovascular inter-vention to extra-cranial stenosis contributes to complete re-canalization in AIS due to anterior TL receiving MT,and acute balloon angioplasty seems to be quite effective than acute stenting.

Objective: To investigate the prevalence and influencing factors of electronic cigarette (e-cigarette) use among adolescents in Haidian District, Beijing, so as to provide insights into tobacco control among adolescents. Methods: The students in junior high school, high school and vocational high school were recruited from Haidian District using the stratified cluster random sampling method in October of 2019, and subjects' demographic features and use of e-cigarettes were collected using the Questionnaire for Survey on Tobacco Prevalence among Adolescents in China in 2019. The factors affecting e-cigarette use were identified among adolescents using the multivariable logistic regression analysis. Results: A total of 658 adolescents were investigated, including 315 junior high school students ( 47.87% ), 221 high school students ( 33.59% ), and 122 vocational high school students ( 18.54% ), and there were 261 boys ( 39.66% ), and 397 girls ( 60.34% ). There were 605 students that had heard of electronic cigarettes ( 91.95% ), 63 students that had used e-cigarettes (9.57%), and 23 students with current use of e-cigarettes ( 3.50% ), and there were 39 students that had never used electronic cigarettes but had a tendency of use in the future ( 6.55% ). Multivariable logistic regression analysis identified parental smoking ( OR=2.408, 95%CI: 1.179-4.916 ), close friends' smoking ( OR=3.597, 95%CI: 1.715-7.544 ) and cigarette smoking ( OR=23.029, 95%CI: 11.092-47.812 ) as factors affecting e-cigarette use among adolescents. Conclusions The prevalence of electronic cigarette uses is 9.57% among adolescents in Haidian District, Beijing. Parental smoking, peer smoking and use of cigarettes may facilitate the use of e-cigarettes among adolescents.

Pathophysiology is a comprehensive subject, which is very important to cultivate the clinical comprehensive thinking of medical students. Pathophysiology involves a wide range of subjects and contents, and is one of the major and difficult courses in basic medicine. Based on many years of research and practice, we have developed main-line-problem-based learning (ML-PBL). ML-PBL is a diversified teaching mode, including the main line teaching method, clinical case discussion method, and the main line synopsis explaining method. The analysis of application results shows that ML-PBL teaching improves the student performance. Furthermore, ML-PBL is more conducive to cultivating the comprehensive clinical thinking ability, improving the independent learning ability, and fully mobilizing the learning initiative.

At present, general practitioners in China lack both specialist knowledge and ability, which calls for close cooperation between general practitioners and specialists to better guarantee medical quality and patient safety. The authors reviewed the connotation, research status, development trend, problems and suggestions of general practitioners-specialists joint consultation service. Based on such, they pointed out that such a general practitioner-specialist joint clinic is quite new in the country, but numerous literature has confirmed that it can not only make up for services fragmentation, but also reduce referral rate.Furthermore, it can improve the quality of people′s lives, improve the general practitioner′s professional knowledge and skills, standardize general practitioner′s rational drug use. All these prove the reform an effective measure and deserves further promotion and greater supervision.

Objective: To observe any curative effect on dysphagia of freehand respiratory training applied to hemiplegic stroke survivors. Methods: Forty-eight hospitalized, hemiplegic stroke survivors were randomly divided into an observation group and a control group, each of 24. Both groups received routine stroke rehabilitation, including motor function training, exercise training, physical therapy and swallowing training. The observation group was additionally provided with barehanded breathing function training, mainly consisting of cough glottis exercise, lip constriction aspiration exercise, chest movement exercise, abdominal muscle contraction and relaxation exercise, as well as abdominal aspiration training. The intervention lasted for 6 weeks for both groups. Before and after the intervention the maximum breathing time, first and second forced volume (FEV₁), forced vital capacity (FVC), maximum inspiratory pressure (PImax), standardized swallowing assessment (SSA), Kubota drinking water test (KDWT) and functional dysphagia scale (FDS) scoring were quantified for both groups. Results: There was no significant difference between the two groups′ averages on any of the measurements before the intervention. Afterward, however, the average maximal breathing time, FEV₁, FVC, and PImax of the observation group were all significantly higher than before the intervention and significantly higher than those of the control group. After treatment, the observation group′s average KDWT efficiency was not, however, significantly better than that of the control group. Moreover, after the treatment the average SSA and FDS of the observation group were significantly lower than those of the control group, as well as significantly better than before the treatment. Conclusion Barehanded breathing function training can supplement routine rehabilitation to significantly improve the breathing of stroke survivors.

Objective To investigate the impact of eotaxin-3 gene polymorphisms on the clinical effect of inhaled corticosteroids (ICS) to provide clinical basis for eotaxin-3 as the target spot for treating bronchial asthma.Methods One hundred and ninety-six cases of asthma and 196 cases as controls were selected from the outpatients and inpatients in our hospital.Peripheral blood samples were collected from the asthma patients and normal controls.PCR-RFLP was adopted to detect the genotypes of eotaxin-3 +2497T＞G and-+-77C＞T.The response of ICS treatment and the change situation of ACT scores were compared among asthmatic patients with various genotypes.Results Peripheral blood eosinophil(EOS) counts,EOS proportion and total IgE in the patients with TG genotype at+2497 locus were significantly decreased compared with those in the patients with TT genotype,the difference was statistically significant(P＜0.05).The level of PD20 in asthmatic patients with TG genotype was significantly higher than that in the patients with TT genotype,the difference was statistically significant[(0.07-±-0.03)mg vs.(0.03 ± 0.01)mg,t=2.45,P=0.048];whereas the above indicators had no statistical difference among 3 kinds of +-77 genotypes.During ICS treatment process in the patients with TT genotype at +-2497 locus,the FEV1％,PD20 value and ACT scores were significantly improved compared with those in the patients with TG genotype,the difference was statistically significant(P＜0.01).Conclusion The asthmatic patients with TT genotype at +-2497 locus were more sensitive to ICS treatment,regular ICS treatment can significantly improve the lung function and clinical symptom score in these patients.

Objective To explore the effect of journal club in cultivating the scientific research ability of oncology specialized nurses.Methods By cluster sampling method,a total of 45 oncology specialized nurses attending specialty training in Chinese PLA General Hospital in October 2014 and May 2015 were selected as the control group. A total of 48 oncology specialized nurses attending specialty training in October 2015 and May 2016 were selected as the experimental group. For two groups,training courses such as lecture, group discussion,and written assignment were given to them. The training lasted for a month. Furthermore, the experimental group conducted journal club for 5 times in 3 weeks,and it lasted 2 hours each time. After training,the score of a review completed by all nurses was compared between two groups,and the nurses′ opinions on journal club were investigated in the experimental group.Results The score of review in the experimental group(88.19±3.04)was higher than that(84.45±3.45)in the control group(t=-5.48,P<0.05). In the experimental group,95.83% of nurses believed that journal club training can increase innovative consciousness,93.75% of them thought that journal club training can improve the scientific research ability,and 91.67% of them thought that journal club training can raise self-learning ability.Conclusions The journal club training method can significantly improve the document retrieval ability,learning consciousness and innovation ability. It can promote comprehensive scientific research ability of oncology specialized nurses.

Objective To investigate the effect of expanded deltopectoral perforator flap as a free skin flap for distant transfer to aesthetically repair large facial scars via microsurgical technique.Methods 20 cases of large facial scars were treated with free expanded deltopectoral skin flaps via microsurgical technique.At the first stage,24 large volume expanders were inserted into the subcutaneous pockets in the deltopectoral zone.4 to 6 months later,the second stage operation was performed when the flaps were expanded fully and facial scars removed;deltopectoral perforator flaps harvested choosing the second or the third thoracic artery perforating branches as the pedicle;the surface of the wound was covered with the flaps.Results All of the 24 flaps survived completely and the wounds healed well after transplantation.The 6 months to 2 years' follow-up results showed that the color and texture of the flaps matched the recipient place well without swelling.The superficial and deep sensation recovered very fast.Conclusions It is safe,practical and effective that the delto-pectoral perforator flaps are used to repair large facial scars avoiding the shortcomings of traditional pedicle transfer such as more procedures,longer fixed time,or more wasted expanded skin.Free transfer of expanded delto-pectoral perforator flaps can achieve ideal function and aesthetic effects.

Objective To explore the feasibility and value of dynamic contrast-enhanced (DCE-MRI) parameters in assessing early effects of anti-angiogenesis medicine in targeted therapy for tumors.Methods Twenty BALB/C-nu nude mice were injected subcutaneously with human colon cancer cells HT-29 to the right hind leg.The nude mice were evenly divided into the experimental group and control group with 10 mice in each group.The mice of experimental group were intraperitoneally injected with bevacizumab,and the control group were injected with the same volume of saline.DCE-MRI was performed before medication and one hour,24 h and 48 h after medication.The Ktrans,Kep,Ve and initial area under enhancement curve (iAUC) of DCE-MRI were analyzed.The animals were sacrificed 48 hours after medication.Microvessel density (MVD) of the tumors was detected by immunohistochemistry.One way analysis of variance was performed to analyze parameters of DCE-MRI.The Pearson correlation coefficient was used to analyze the correlation between parameters of DCE-MRI and MVD.Results Under DCE-MRI,the edge of subcutaneous colon cancer xenografts was obviously gradually enhanced,pseudo color indicated high perfusion,the strength degree of the central region was low and which meant low perfusion.The differences in Kep of different time point of experimental group were statistically significant (F=3.752,P=0.016) ; there as no significant difference in other parameters of DCE MRI (all P＞0.05).There was no significant difference in Ktrans and Kep before medication and one hour after medication (all P＞0.05).There were significant difference in Ktrans and Kep 24 hour and 48 hour after medication between experimental group (24 hour∶ (0.095 ± 0.039) min-1 and (0.297 ± 0.141) min-1,48 hour∶ (0.090±0.033) min 1 and (0.314±0.148) min-1) and control group (24 hour∶ (0.150±0.074) nin-1 and (0.494±0.126) min-1,48 hour∶ (0.171±0.045) min-1 and (0.441± 0.092) min-1) (F24h =4.824 and 11.386,F48h =22.605 and 5.455,all P＜0.05).There was no significant difference in Ve and iAUC between two groups at different time points (all P＜0.05).MVD of experimental group was lower than that of control group.Ktrans and Kep were positively correlated with MVD (r=0.745 and 0.400,both P＜0.05).Conclusion Ktrans and Kep parameters of DCE-MRI may be used in monitoring the earlier effects of anti-angiogenesis medicine in targeted therapy for colon cancer.

Objective To investigate the effects of IL-13 on fibrosis in hepatic stellate cells and its molecular mechanism .Methods The effects of IL-13 on the proliferation of hepatic stellate cell line LX-2 were measured by MTT assay .The transcription level of collagen typeⅠ( COLⅠ) in LX-2 cells was detec-ted by RT-PCR.The secretion of COLⅠin LX-2 cells was measured by ELISA assay and hydroxyproline as-say.Western blot assay was used to analyze the effects of IL-13 on the phosphorylation of signal transducer and activator of transcription(STAT6).Results Compared with control group, IL-13 (10 ng/ml, 20 ng/ml and 50 ng/ml ) significantly stimulated the proliferation of LX-2 cells in a dose-dependent manner ( P<0.05).The expression of collagen typeⅠin LX-2 cells at mRNA and protein levels were significantly up-regulated by IL-13 at a concentration of 50 ng/ml (P<0.05), but not affected by IL-13 at low concentra-tions (5 ng/ml, 10 ng/ml, and 20 ng/ml) (P>0.05).The expression of phosphorylated STAT6 protein in LX-2 cells was significantly enhanced upon the stimulation with 50 ng/ml of IL-13 ( P<0.05 ) for60 min or 120 min.C onclusion IL-13 promoted the proliferation of human hepatic stellate cells and up-regulated the expression of COLⅠat mRNA and protein levels .IL-13 might promote the fibrosis in human hepatic stellate cells through activating STAT 6 phosphorylation .