Objective To investigate the expression of zinc finger E-box-binding protein 2(ZEB2)and CC chemokine ligand 20(CCL20)in glioma tissue and their relationship with prognosis.Methods The tumor tissues of 156 patients with glioma were collected as tumor group and 52 normal brain tissues of the same period were collected as normal group.The expression of ZEB2 and CCL20 in tissues were detected by immunohistochemistry,and the relationship between the expression and survival was analyzed by Kaplan-Meier survival curve.Patients in the tumor group were followed up for three years and grouped into a poor prognosis group and a good prognosis group based on their survival status,and the prognostic factors were analyzed by COX regression.Results The positive expression rate of ZEB2 and CCL20 in the tumor group were higher than those in the normal group(P＜0.05).The 3-year survival rate of 156 glioma patients was 69.87%.The survival rate of patients with positive ZEB2 and CCL20 expression was lower than that of patients with negative expression(P＜0.001).Age,maximum tumor diameter,tumor pathological grade,and positive expression of ZEB2 and CCL20 were all risk factors for poor prog-nosis of patients with glioma(P＜0.05),and preoperative KPS,postoperative radiotherapy,and course of temo-zolomide treatment were all protective factors(P＜0.05).Conclusion The expression level of ZEB2 and CCL20 in tumor tissues of glioma patients is up-regulated,and related to the prognosis of patients.

Objective:To investigate the clinical efficacy of carbomer hemorrhoid gel in the treatment of second-degree internal hemorrhoid bleeding.Methods:A total of 160 anorectal outpatients with second-degree internal hemorrhoid bleeding who received treatment in Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine from January 2017 to January 2021 were included in this study. They were randomly divided into an observation group and a control group ( n = 80/group). In the observation group, carbomer hemorrhoid gel was used to plug the anus, while in the control group, a hemorrhoid suppository was used to plug the anus. All patients were treated for 7 days. Clinical efficacy was compared between the two groups. Results:After 4 days of treatment, the bleeding score in the observation group was lower than that in the control group [1(0) point vs. 2(1) points, Z = -6.70, P < 0.05). After 7 days of treatment, the bleeding score in the observation group was significantly lower than that in the control group [0(1) point vs. 1(1) point, Z = -4.73, P < 0.05]. After 4 days of treatment, there was no significant difference in the size score of the hemorrhoids between the two groups ( P > 0.05). After 4 days of treatment, the size score of hemorrhoids in the control group did not differ significantly compared with before treatment ( P > 0.05). After 4 days of treatment, the size score of hemorrhoids in the observation group differed significantly compared with before treatment ( Z = -3.16, P < 0.05). After 7 days of treatment, the size score of the hemorrhoids in the observation group was lower than that in the control group [1(1) point vs. 1(0) point, Z = -4.48, P < 0.05]. The total response rate in the observation group was significantly higher than that in the control group [97.5% (78/80) vs. 75% (60/80), Z = -4.50, P < 0.05]. Conclusion:Carbomer hemorrhoid gel is a new drug used to treat hemorrhoids. It has a new dosage form, has no stimulation to the rectum, and is safe to use. Carbomer hemorrhoid gel is highly effective on second-degree internal hemorrhoid bleeding and deserves clinical popularization.

Objective To make an exhaustive study of the evolution,status quo and future developments of wearable technologies for monitoring of exercise across the world via knowledge graphs in order to provide reference for related research in China's military.Methods Data on wearable technologies for monitoring of exercise collected from literature that was retrieved from Web of Science was used as the subject.Bibliometrix and other visual analysis softwares were used to construct knowledge graphs.The essential characteristics of developments of wearable technologies for monitoring of exercise were explored in terms of trends of publication,co-occurrence networks and co-occurrence of key words.Results The field of wearable technologies for monitoring of exercise was growing fast.Institutional cooperation was characterized by intraregional cooperation.The United States held an important position in the global innovation cooperation network.Conclusion As the leading author of co-occurrence network,Professor Zhonglin Wang has contributed greatly to the collaboration between research teams.Artificial intelligence,big data,cloud computing and other technologies have become hotspots in this field.The application and development of new materials has gone a long way towards making monitoring devices thin,skin-friendly and traceless.

BACKGROUND: The Id2 gene is an endogenous negative regulator of basic helix-loop-helix factor, which is involved in the cell proliferation, differentiation and existence. Id2 also shows functional diversity in the progression and infiltration of different types of tumors OBJECTIVE: To observe the changes of proliferation and invasiveness of PC-3 human prostate cancer stem cells after shRNA-Id2 transfection. METHODS: PC-3 human prostate cancer stem cells in logarithmic growth phase were harvested to isolate tumor stem cell spheres by serum-free suspension culture. The expression of CD44+CD24-on the surface of tumor stem cells was detected by flow cytometry. The shRNA-Id2 expression vector was constructed and transfected into PC-3 human prostate cancer stem cells. Untransfected PC-3 human prostate cancer stem cells were used as control. At 48 hours after transfection, the expression of Id2 gene and protein in shRNA-Id2 transfected prostate cancer stem cells, NC-shRNA empty vector transfected prostate cancer stem cells and untransfected prostate cancer stem cells were detected by RT-PCR and western blot, respectively. The proliferation and invasion of shRNA-Id2 transfected prostate cancer stem cells and untransfected prostate cancer stem cells were detected by MTT assay and Transwell chamber, respectively. The expressions of E-cadherin, vimentin and Twist were detected by western blot and RT-PCR. RESULTS AND CONCLUSION: Tumor stem cell spheres were successfully isolated by the serum-free suspension culture. The expression rate of CD44+CD24-on the surface of the third-generation PC-3 human prostate cancer stem cells was (85.69±8.96) ％, indicating that the cultured tumor stem cell spheres overexpressed the phenotype of tumor stem cells. At 48 hours after transfection, the expression of Id2 gene and protein was significantly lower in the shRNA-Id2 transfection group than the non-transfection group (P < 0.05) , indicating that the expression of Id2 was successfully interfered with the expression of PC-3 prostate cancer stem cells. The invasive ability of the cells in the shRNA-Id2 transfection group was significantly lower than that in the non-transfection group (P < 0.05). Western blot and RT-PCR detection showed that the expression of E-cadherin, an epithelial marker of PC-3 prostate cancer stem cells, in the shRNA-Id2 transfection group was significantly higher than that in non-transfection group (P < 0.05) , while the expression of vimentin, a marker of mesenchymal stem cells, and Twist, a transcription factor regulating cell-mesenchymal transformation, in the shRNA-Id2 transfection group was significantly lower than that in the non-transfection group (P < 0.05). These findings indicate that RNA interference with Id2 gene can inhibit the proliferation and invasion of PC-3 prostate cancer stem cells by regulating the expression of E-cadherin, vimentin and Twist.

Objective: To investigate the prevalence and severity of cerebral microbleeds(CMBs) in patients with different stroke classifications of cerebral infarction. Methods: From October 2016 to December 2017, the clinical data of patients with acute cerebral infarction in the Second Affiliated Hospital of Xuzhou Medical University were collected through the prospective study.The SWI technique was used to screen the CMBs.According to the TOAST and OCSP classifications, the prevalence and severity of CMBs in patients with different stroke classifications of cerebral infarction were analyzed. Results: A total of 254 patients with cerebral infarction were enrolled, there were 136 patients(53.54%) in CMBs group and 118 patients(46.46%) in no CMBs group.The prevalence of CMBs in patients with different TOAST classifications was large artery atherosclerosis(54.29%), small-artery occlusion(64.15%), cardioembolism(40.43%), stroke of other determined etiology(33.33%), stroke of undetermined etiology(38.46%), and the difference was statistically significant(χ²=12.206, P=0.016). The prevalence of CMBs in patients with different OCSP classifications was total anterior circulation infarcts(43.75%), partial anterior circulation infarcts(51.19%), posterior circulation infarcts(49.18%), lacunar infarcts(67.53%), and the difference was statistically significant(χ²=8.944, P=0.030). The severity of CMBs in patients with different TOAST classifications was large artery atherosclerosis[mild(55.26%), moderate(26.32%), severe(15.79%)], small-artery occlusion[mild(25.00%), moderate(33.82%), severe(41.18%)], cardioembolism[mild(57.89%), moderate(26.32%), severe(15.79%)), stroke of other determined etiology[mild(50.00%), moderate(33.33%), severe(16.67%)], stroke of undetermined etiology[mild(60.00%), moderate(20.00%), severe(20.00%)], and the difference was statistically significant(Fisher exact test, P=0.025). The severity of CMBs in patients with different OCSP classifications was total anterior circulation infarcts[mild(57.14%), moderate(28.57%), severe(14.29%)], partial anterior circulation infarcts[mild(52.50%), moderate(32.50%), severe(15.00%)], posterior circulation infarcts[mild(50.00%), moderate(33.33%), severe(16.67%)], lacunar infarcts[mild(25.00%), moderate(32.69%), severe(42.31%)], and the difference was statistically significant(Fisher exact test, P=0.023). Conclusion The prevalence and severity of CMBs in patients with different stroke classifications of cerebral infarction are variable.The prevalence of CMBs in small-artery occlusion and lacunar infarcts are the highest and give first place to severe CMBs(number of lesions≥10). We should pay attention to these two stroke classifications by early recognition and taking targeted clinical strategies.

Objective To investigate the correlation between post-stroke depression(PSD) and cerebral microbleeds(CMBs)in elderly patients with ischemic stroke.Methods In the prospective study,220 elderly patients with ischemic stroke were enrolled and followed up to one month after onset.Finally a total of 214 elderly patients performed a follow-up.According to DSM-Ⅳ Diagnostic and Statistical Manual of Mental Disorders,patients were divided into the PSD group and non-PSD group.The degree of depression was evaluated by17-item Hamilton Depression Scale(HAMD-17)score,and patients were divided into mild depression,moderate depression and severe depression group.The loci number,distribution and location of CMBs lesions were assessed by SWI.Patients were divided into brain lobe type,deep lobe type and mixed type according to the CMBs lesion location.The influence of CMBs or not,loci number and location of CMBs lesions on PSD were compared.Results A total of 214 elderly patients with ischemic stroke were enrolled,in whom 84(84/214,39.3％)had PSD with 29(34.5％)males and 55(65.5％)females.According to the HAMD scale,there were 51 patients (60.7 ％) with mild depression,25 (29.8 ％) with moderate depression,and 8 (9.5 ％) with severe depression.The prevalence rate of CMBs was 62.5 ％ (32/51) in mild depression group,71.0 ％ (22/25) in moderate depression group,81.8 ％ (6/8)in severe depression group and 45.4 ％ (49/108)in non PSD group(all P=0.008).The number of CMBs lesions were(4.5±1.2)in mild depression group,(7.8± 2.0)in moderate depression group,(12.6±2.7)in severe depression group and(1.8±0.5)in non-PSD group,with the statistically significant differences between groups (F =2.79,P =0.041).The proportions of CMBs lesions location(brain lobe type,deep lobe type and mixed type)were 40.6 ％ (13/32),34.4％(11/32) and 25.0％ (8/32) in mild depression group,36.4％(8/22),40.9％(9/22) and 22.7％(5/22) in moderate depression group,33.3％ (2/6),50.0％ (3/6) and 16.7％ (1/6) in severe depression group,40.8％ (20/49),12.2％ (6/49) and 46.9％ (23/49) in non-PSD group,respectively (Fisher exact test,P =0.043).The proportions of CMBs lesions distribution(left side,right side and double side)were 37.5％(12/32),43.8％(14/32) and 18.8％(6/32) in mild depression group,36.4％ (8/22),40.9％ (9/22) and 22.7％ (5/22) in moderate depression group,50.0％ (3/6),33.3％ (2/6)and 16.7％(1/6) in severe depression group,36.7％(18/49),40.8％(20/49) and 22.5％(11/49) in non-PSD group,and the difference was not statistically significant (Fisher exact test,P =0.998).Conclusions The prevalence rate of CMBs,number of CMBs lesions and deep lobe type of CMBs are closely related to the degree of post-stroke depression in the elderly.The distribution of CMBs lesions has no relevance with the degree of post stroke depression in the elderly.Elderly patients with ischemic stroke at high risk of post-stroke depression can be identified by evaluating CMBs for early intervention,which is worthy of promotion in clinical work.

Objective To explore pathogenesis and influencing factors of poor outcome in patients with wake-up stroke.Methods In this prospective study,patients with acute ischemic stroke who were hospitalized in the Department of Neurology of the Second Affiliated Hospital of Xuzhou Medical University from October 2016 to December 2017 were continuously collected.All patients were divided into wake-up stroke group and non-wake-up stroke group according to the onset time.The clinical data of demographics,vascular risk factors,imaging examination,laboratory examination of the two groups were collected to identify the pathogenesis of wake-up stroke.Followed up to six months of onset,the patients were divided into poor outcome (modified Rankin Scale (mRS) score ＞2) and good outcome (mRS score 0-2) subgroups according to mRS score.Multivariate Logistic regression analysis was used to determine the influencing factors of poor outcome in patients with wake-up stroke.Results A total of 178 patients with acute ischemic stroke were enrolled in the study,including 42 patients (23.60％) in the wake-up stroke group and 136 patients (76.40％) in the non-wake-up stroke group.Followed up to six months of onset,11 patients lost,and 167 patients were followed up finally.There were 40 patients (23.95％) in the wake-up stroke group,including 17 patients (42.50％) with poor outcome and 23 patients (57.50％) with good outcome.There were 127 patients (45.64％) in the non-wake-up stroke group,including 32 patients (25.20％) with poor outcome and 95 patients (74.80％) with good outcome.The difference of poor outcome between the two groups was statistically significant (x2=4.393,P=0.036).Comparison of the demographic and baseline data of the wake-up stroke group and the non-wake-up stroke group showed that the differences between variables such as atrial fibrillation and double-dose hypertension were statistically significant.Univariate analysis showed that there were statistically significant differences in vascular risk factors,Trial of Org 10172 in Acute Stroke Treatment etiology,stroke severity,number of stroke lesions,treatment patterns,and number of cerebral microbleeds between the poor and good outcome subgroups.Multivariate Logistic regression analysis showed that the moderate to severe stroke (odds ratio (OR)=3.838,95％ confidence interval (Co 2.162-5.890,P=0.018),the number of lesions in cerebral microbleeds (OR=2.113,95％CI 1.291-2.868,P=0.049) were independent risk factors for poor outcome of wake-up stroke.Intravenous thrombolysis (OR=0.427,95％CI 0.242-0.615,P=0.036) was an independent protective factor for poor outcome of wake-up stroke.Conclusions The onset of wake-up stroke is closely related to atrial fibrillation and reverse scoop hypertension with higher incidence of poor outcome.Early adequate imaging screening and stroke severity assessment have important reference to guide clinical treatment and predict outcome.

Objective To investigate the influencing factors and outcomes of patients with acute ischemic stroke having negative results in diffusion weighted imaging (DWI).Methods In prospective study, the patients with acute ischemic stroke, admitted to our hospital from October 2016 to January 2018, were selected as research subjects. The demographic and baseline characteristics, imaging data and laboratory examination data were collected. According to the signals of first DWI, the patients were divided into positive DWI group and negative DWI group. The influencing factors of negative results in DWI were clearly defined by univariate and multivariate Logistic regression analyses. The patients from negative DWI group were rechecked for DWI one week after first DWI. All patients were followed up for 90 d, and the outcomes were evaluated by modified Rankin scale (mRS).Results A total of 312 patients with acute ischemic stroke were enrolled finally. The negative rate of DWI was 12.82％ (40/312). Multivariate Logistic regression analysis showed that mild stroke (odds ratio [OR]= 2.533, 95％ confidence interval[CI]: 1.436-3.984,P=0.038), lacunar infarction (OR=4.668, 95％CI: 2.203-6.543,P=0. 005), arteriole occlusion (OR=4.236, 95％CI: 2.448-6.348,P=0.009), brainstem lesion (OR=1.629, 95％CI: 1.035-2.693,P=0.049) and time of onset within hyper-acute period (OR=4.074, 95％CI: 2.683-6.576, P=0.013) were influencing factors for negative results in DWI. The negative rate of DWI in the negative DWI group was reduced to 7.05％ (22/312) one week after first DWI. Totally, 302 patients finished the 90 d of follow up; 40 patients were into the negative DWI group, with poor outcome rate of 27.50％ (11/40); 262 patients were into the positive DWI group, with poor outcome rate of 30.15％ (79/262); the difference of poor outcome rates between the two groups was not statistically significant (P>0.05).Conclusion s The negative results in DWI in patients with acute ischemic stroke are closely related to severity of stroke, TOAST etiological types, locations of the lesions, sizes of the lesions and time of onset. Review of DWI can reduce negative rate of DWI. The outcomes of patients with acute ischemic stroke having negative results in DWI are not better than those with positive results in DWI. The patients with acute ischemic stroke having negative results in DWI and having onset within hyper-acute period should not be excluded from intravenous thrombolytic treatment.

Objective To investigate the correlation between cerebral microbleeds (CMBs) and early neurological deterioration (END) in patients with acute ischemic stroke. Methods Consecutive patients with acute ischemic stroke were enrolled prospectively. The clinical data, imaging data, and laboratory data were collected. END was defined as the National Institutes of Health Stroke Scale (NIHSS) score increased ≥2 within 7 d compared with the baseline. Susceptibility-weighted imaging was used to detecte CMBs. Multivariate logistic regression analysis was used to identify the independent correlation between CMBs and END. Results A total of 246 patients with acute acute ischemic stroke were enrolled. The incidence of END was 38. 21％ (94/246), 72. 34％ (68/94) occurred within 72 h and 21. 28％ (20/94) occurred from 72 h to 7 d. The detection rate of CMBs in the END group was 72. 34％ (68/94) and that of CMBs in the non-END group was 43. 42％ (66/152). There was significant difference between the two groups (χ2 = 19. 587, P < 0. 001). Multivariate logistic regression analysis showed that previous stroke or transient ischemic attack (odds ratio [ OR ] 1. 883, 95％ confidence interval [ CI ] 1. 284- 2. 277; P = 0. 033 ), large artery atherosclerosis (OR 4. 119, 95％ CI 2. 564-5. 771; P = 0. 003), baseline NIHSS score (OR 1. 682, 95％ CI 1. 320-1. 876; P = 0. 042), severe stroke (OR 4. 228, 95％ CI 2. 634-5. 917; P = 0. 003), onset to admission time (OR 2. 070, 95％ CI 1. 454-2. 582; P = 0. 029), and number of CMB ≥10 (OR 2. 728, 95％ CI 1. 834- 3. 217; P = 0. 016) were the independent risk factors for END. Conclusions END is common in patients with acute ischemic stroke, most of them occurred within 72 h. It is closely associated with the number of CMB, but it is not associated with the location of CMB lesions.

Objective To investigate the screening of elderly patients with post?stroke depression (PSD) and to analyze risk factors. Methods In this prospective study, 220 elderly patients with ischemic stroke were enrolled. At one month after onset, 214 aged patients completed follow?up. According to the DSM?IV diagnosis standard, the patients were divided into PSD and non?PSD groups. Seventeen items of the Hamilton Depression Scale (HAMD) was used to evaluate the degree of depression, and the patients were divided into mild, moderate, and severe depression groups. The demographic and baseline clinical characteristics were compared. Multivariate logistic regression analysis was used to identify the risk factors of PSD in individuals. Results (1) Of the 214 aged patients with ischemic stroke who completed follow?up, 84 had PSD including 29 (34.52%) men and 55 (65.48%) women. The detection rate of PSD was 39.25%. According to the HAMD, 51 (60.72%) aged patients were diagnosed with mild depression, 25 (29.76%) with moderate depression, and 8 (9.52%) with serious depression. (2) Multivariate logistic regression analysis showed that advanced age (>75 years old), female sex, joblessness, being divorced or widowed, having cerebral microbleeds, experiencing social and family environment tension, having low cultural exposure, having moderate and severe neurologic deficits, and having a left?side lesion were the independent risk factors of PSD in elderly patients. Conclusion PSD is common in elderly patients. Evaluation of these risk factors can help identify aged patients at high risk for PSD to allow early intervention, which is worth promoting in clinical work.