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ObjectiveTo observe the effects of electroacupuncture at Zhongwan （CV12） on gastric nociceptive response induced by gastric acid stimulation and explore the underlying mechanisms associated with nuclei of the medullary viscerosensory and visceral motor neurons. MethodsTwenty SD rats were given intragastric administration of 0.5 mol/L diluted hydrochloric acid （0.5 ml/100 g） to induce gastric nociceptive response induction. Eight rats were randomly selected to record the gastric slow wave （GSW） area under the curve， and extracellular discharge frequency of neurons in the nucleus of the solitary tract （NTS） and dorsal motor nucleus of the vagus nerve （DMV） before intragastric administration and at 1， 5， 10， 15， 20， 25， 30， 35， 40， 45， 50， 55， and 60 minutes after intragastric administration. The remaining 12 rats received electroacupuncture intervention at Zhongwan within 5 to 25 minutes after intragastric administration of diluted hydrochloric acid， with a duration of one minute. The GSW area under the curve and extracellular discharge frequency of NTS and DMV neurons were compared between the 1-minute intervals before and after electroacupuncture intervention. ResultsCompared to the baseline before intragastric administration， the area under the curve of GSW significantly increased at 1， 5， 10， 15， 20， and 25 minutes after intragastric administration， and the extracellular discharge frequency of excitatory neurons in the NTS （accounting for 90%， 57/63） significantly increased at 1， 5， 10， 15， 20， 25， 30， 35， and 40 minutes， both reaching peak values at 1 minute after intragastric administration （P＜0.01 or P＜0.05）. The extracellular discharge frequency of inhibitory neurons in the DMV （accounting for 91%， 20/22） showed a non-significant increase at 1 minute after intragastric administration （P＞0.05）， but significantly decreased at other timepoints （P＜0.05）. Compared to the baseline before electroacupuncture intervention， the GSW area under the curve and the extracellular discharge frequency of excitatory neurons in the NTS significantly decreased （P＜0.05）， while the extracellular discharge frequency of inhibitory neurons in the DMV showed no significant difference （P＞0.05）. ConclusionElectroacupuncture at Zhongwan can improve gastric nociceptive response induced by gastric acid stimulation， possibly by reducing the transmission of visceral sensation and decreasing the excitability of NTS neurons in the medulla.
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Reflux esophagitis is an inflammatory disease of esophageal mucosa damage caused by the reflux of gastric contents into the esophagus. Its incidence is on the rise， and it has become an important precancerous disease of esophageal cancer. Studies have shown that the continuous inflammatory response stimulates the esophageal mucosa， causing abnormal proliferation of esophageal epithelial cells and damage to esophageal mucosal tissue， which eventually leads to the occurrence of heterogeneous hyperplasia and even carcinogenesis. The nuclear transcription factor-kappa B （NF-κB） signaling pathway is one of the most classical inflammatory and cancer signaling pathways. It has been found that abnormal activation of the NF-κB signaling pathway is crucial to the development and prognosis of reflux esophagitis and esophageal cancer. It is widely involved in the proliferation， autophagy， apoptosis， and inflammatory response of esophageal epithelial cells and tumor cells， accelerating the transformation of reflux esophagitis to esophageal cancer and making it a potential target for the treatment of reflux esophagitis and esophageal cancer. Currently， there is no specific treatment for reflux esophagitis and esophageal cancer， and large side effects often appear. Therefore， finding a promising and safe drug remains a top priority. In recent years， traditional Chinese medicine scholars have conducted a lot of research on NF-κB signaling pathway， and the results indicate that NF-κB signaling pathway is an important potential target for traditional Chinese medicine to prevent and treat reflux esophagitis and esophageal cancer， but there is a lack of comprehensive and systematic elaboration. Therefore， this paper summarized the relevant studies in recent years， analyzed the relationship among NF-κB signaling pathway， reflux esophagitis， esophageal cancer， and transformation from inflammation to cancer， and reviewed the research literature on the regulation of the NF-κB signaling pathway in traditional Chinese medicine to prevent and treat reflux esophagitis and esophageal cancer， so as to provide new ideas for the prevention and treatment of reflux esophagitis and esophageal cancer.
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Esophageal cancer （EC） is a common malignant tumor of the digestive system with an extremely poor prognosis. MicroRNA （miRNA） is an important regulator in tumor occurrence and development， and can participate in malignant biological behaviors such as tumor cell proliferation， invasion， metastasis and apoptosis. Traditional Chinese medicine has the characteristics of accurate curative effects， wide range of effects， and few side effects. The review uses miRNA as the entry point to systematically elaborate on the mechanism of traditional Chinese medicine-mediated miRNA intervening in EC. The results showed that active ingredients of traditional Chinese medicine （including curcumin， Tussilago farfara polysaccharides， Atractylodes macrocephala polysaccharides and ophiopogonin B） and Dougen guanshitong oral liquid could up-regulate the expressions of miRNAs such as miRNA-532-3p （miR-532-3p）， miR-551b-3p， miR-99a， miR-34a， miR-199a-3p and miR-377； and the active ingredients/parts of traditional Chinese medicine （including chrysin and Actinidia arguta extract）， and Chinese herbal formulas （including Chaihu shugan san combined with Xuanfu daizhe decoction and Modified jupi zhuru decoction） could down-regulate the expressions of miRNAs such as miR-199a-3p， miR-451 and miR-21， which could regulate the expressions of signaling pathways （phosphoinositide 3-kinase/protein kinase B， etc.） or their downstream protein（zinc-finger and homeobox protein 1， etc.） or enzymes（thymidine kinase-1， etc.）， inhibit the proliferation， invasion and metastasis of EC cells and induce apoptosis， thereby ultimately achieving the purpose of preventing the disease from aggravating.
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Pancreatic cancer is one of the most destructive malignant tumors； the pathogenesis of this disease is complex and is closely related to genetic susceptibility， chronic pancreatitis， and gene mutations in signaling pathways. The phosphoinositide 3- kinase （PI3K）/protein kinase B （Akt） signaling pathway is a classical cancer signaling pathway that is aberrantly activated in pancreatic cancer cells. In recent years， it has been found that traditional Chinese medicine （TCM） monomers show special activity in the treatment of pancreatic cancer and can be potential drug for the treatment of pancreatic cancer. Based on PI3K/Akt signaling pathway， this paper summarizes the mechanism of TCM monomer intervening in pancreatic cancer and finds that TCM monomer of alkaloids （sinomenine， dictamnine， dauricine， etc.）， terpenoids （saikosaponin A， linderalactone， isoalantolactone， etc.）， phenols （6-gingerol， curcumin， pterostilbene， etc.）， flavonoids （fisetin， kaempferol， quercetin， etc.） and quinones （β-hydroxyisovaleryl shikonin， rhein， lucidone， etc.） can inhibit the proliferation， invasion and migration of pancreatic cancer cells， regulate autophagy and apoptosis， and then inhibit the pathological process of pancreatic cancer by inhibiting PI3K/Akt signaling pathway.
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The clinical manifestations, biochemical parameters and imaging examination, genetic test results, and treatment of 3 cases of X-linked adrenoleukodystrophy(X-ALD) patients were reviewed and analyzed, and the structure of adrenoleukodystrophy protein(ALDP) was analyzed. All 3 patients were male. Patients 1 and 2 were childhood cerebral ALD(CCALD), patients 3 was adrenomyeloneuropathy(AMN), and all of them were misdiagnosed at early stage. Brain magnetic resonance imaging(MRI), and hematologic examinations showed the neurological demyelination of X-ALD, adrenocortical insufficiency, and accumulation of very long chain fatty acids(VLCFAs). Sequencing of ABCD1 gene revealed 3 new pathogenic mutations[c.910delins22(p.A304delins8), c. 887A>C(p.Y296S), and c. 1451_1481del(p.P484fs)], which affected the key structure of ALDP and led to the disease. Patients 1 and 2 received hematopoietic stem cell transplantation, and their condition continued to progress after surgery. Patient 3 was in stable condition. The misdiagnosis rate of X-ALD is high, clinicians should be vigilant. In this study, 3 new mutations were found, which expanded the ABCD1 gene mutation spectrum in patients with X-ALD. It is important to note that early identification and early diagnosis of X-ALD should be made to reduce misdiagnosis and mistreatment.
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To investigate the clinical role of T-cell transcription factor (TBX21) and adenylate cyclase 9 antibody (ADCY9) gene polymorphisms in the development of childhood asthma. METHODS: Two hundred Han Chinese wheezing children aged 5 years and younger in Henan region from July 2016 to January 2017 were selected as the study group, and another 100 Han Chinese healthy children aged 5 years and younger in the same period were selected as the control group. Oral mucosal exfoliated cells were collected from both groups, and the genotypes of TBX21 gene rs2240017 polymorphic locus and ADCY9 gene rs2230739 polymorphic locus were detected by real-time fluorescence quantitative polymerase chain reaction (PCR) technique, and the risk level of asthma was assessed based on the test results. The children in the low-risk and high-risk groups were compared in terms of serum immunoglobulin E (IgE) levels, API positivity rate and allergic disease incidence, and the correlation between the risk level of asthma-related genetic polymorphisms and serum IgE levels, API and allergic disease incidence was analyzed. All children were followed up until 6 years of age to confirm the diagnosis of asthma, and the incidence of asthma was compared between the low-risk and high-risk groups. Children with asthma were treated with inhaled glucocorticoids and leukotriene receptor antagonists for 3 months, and the control of asthma and the impairment of lung function were compared between the low-risk and high-risk groups. RESULTS: The genotype detection results of rs2240017 polymorphic locus of TBX21 gene and rs2230739 polymorphic locus of ADCY9 gene in the study group compared with those in the control group were statistically significant (P<0.001). The percentages of CC, CT, and TT genotypes of rs2240017 polymorphic locus of TBX21 gene were 19.50%, 56.00%, and 24.50%, respectively, and the percentages of CC, CG, and GG genotypes of rs2230739 polymorphic locus of ADCY9 gene were 86.00%, 10.00%, and 4.00%, respectively, in 200 children with wheezing; serum IgE level, API positivity rate and allergic disease incidence were higher in the high-risk group than in the low-risk group (P< 0.001, <0.001, 0.021, respectively). The degree of risk of asthma-related gene polymorphisms in children with wheezing was positively correlated with serum IgE levels, API positivity, and the incidence of allergic diseases (P<0.001); the incidence of asthma (81.48%) and impaired lung function (74.07%) were higher in the high-risk group than in the low-risk group (4.90%, 3.50%) (P<0.001). There was no statistically significant difference between the asthma control rate of children with asthma in the high-risk group (79.55%) compared with the asthma control rate of children with asthma in the low-risk group (100.00%) (P=0.433). CONCLUSION: Gene polymorphisms at rs2240017 locus of TBX21 gene and rs2230739 locus of ADCY9 gene are closely associated with asthma development and impaired lung function in children with wheezing.
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Colorectal cancer （CRC） is one of the leading causes of cancer-related deaths worldwide， with increasing incidence and mortality rates. The disease often develops covertly and lacks specific symptoms in its early stages， leading to late-stage diagnoses in most patients. It has become a prominent research topic in the field of digestive system tumors. The exact mechanisms underlying CRC are not yet clear and involve factors such as genetics， gene mutations， inflammatory responses， and aberrant activation of tumor-related signaling pathways. Nuclear factor-kappa B （NF-κB） is a crucial transcription factor that participates in various biological processes， including inflammatory responses， immune responses， cell proliferation， and apoptosis. Research suggests that NF-κB， serving as a molecular link between inflammation and cancer， is highly expressed in CRC. It promotes the occurrence and development of CRC by regulating the activity of target genes such as cell pro-inflammatory factors， chemokines， angiogenic factors， metastasis factors， and anti-apoptotic proteins. Currently， common treatments for CRC include surgery， radiation therapy， and chemotherapy drugs like 5-fluorouracil. However， these treatments have limitations such as significant adverse reactions， high metastasis rates， and the development of drug resistance. Therefore， the search for effective， low-adverse-reaction drugs to replace or supplement current treatments is essential. In recent years， traditional Chinese medicine （TCM） has shown some effectiveness in preventing and treating CRC. TCM has been found to inhibit the growth of CRC cells by modulating the NF-κB signaling pathway， playing a positive role in the occurrence and progression of CRC. Based on the asthenia in origin and sthenia in superficiality and deficiency-excess in complexity in CRC， this article summarized and analyzed the mechanisms and effects of TCM interventions targeting the NF-κB signaling pathway in CRC， and reviewed advances of 10 Chinese medicinal compound formulas and 37 Chinese medicinal monomer components of different types， including flavonoids， phenols， alkaloids， glycosides， and terpenoids with the effects of dispelling pathogenic factors， reinforcing healthy qi， and removing toxins in the prevention and treatment of CRC by targeting the NF-κB pathway. It is found that Chinese medicine can inhibit CRC cell proliferation， invasion， metastasis， angiogenesis， and inflammation by modulating the NF-κB signaling pathway， induce cell apoptosis， restore drug and radiation sensitivity， and counteract CRC. This article is expected to provide insights and references for the in-depth exploration and treatment of CRC mechanisms.
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Colorectal cancer （CRC）， a malignant tumor of the digestive system， originates from the colorectal mucosa epithelium and is usually asymptomatic until it progresses to an advanced stage. With high incidence around the globe and the increasingly younger patients， this disease poses a serious threat to the health and lives of the patients. Although the pathogenesis of this disease is not fully understood， it is generally believed that it is associated with autophagy， apoptosis， and inflammation. Autophagy and apoptosis as two types of programmed cell death are subject to complex interactive regulation， and the imbalance between them is closely related to the occurrence， development， and prognosis of a variety of diseases. Studies have shown that autophagy-apoptosis balance plays a key role in CRC. On the one hand， autophagy and apoptosis coordinate with each other to inhibit CRC cell growth. On the other hand， autophagy can antagonize apoptosis to promote CRC cell growth. In clinical practice， surgery is often combined with radiotherapy and chemotherapy to treat CRC， which can control the progression of CRC to a certain extent but has serious adverse effects and poor long-term results. In recent years， traditional Chinese medicine （TCM） has been proved to be effective in the treatment of CRC. Studies have shown that numerous herbal active components can promote CRC cell death by regulating the autophagy-apoptosis balance， thereby blocking the progression of this disease. The process of autophagy-apoptosis balance in regulating cell activities has similar theoretical connotations with the Yin and Yang theory of TCM. Applying TCM in regulating autophagy-apoptosis balance at various stages of CRC has become a frontier， while the comprehensive elaboration remains to be conducted. By reviewing the relevant studies in recent years， this paper introduces the correlation between the Yin and Yang theory and the autophagy-apoptosis balance， the role of autophagy-apoptosis balance in CRC， and the research progress in the application of 27 Chinese herbal active components such as flavonoids， terpenoids， glycosides， and phenols capable of regulating autophagy-apoptosis balance in the treatment of CRC. The active components in Chinese medicines can recover the autophagy-apoptosis balance in CRC by acting on microtuble-associated protein 1 light chain 3（LC3）， Beclin-1， and B-cell lymphoma-2（Bcl-2）to regulate multiple signaling pathways such as protein kinase B（Akt）/mammalian target of rapamycin（mTOR）and reavtive oxygen species（ROS）/ c-Jun N-terminal kinase（JNK）， thus balancing Yin and Yang. This review aims to provide a reference for the treatment of CRC and the development of new drugs.
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From a time-based to a competency-based medical education, the evolution of residency training began nearly 30 years ago, the development of valid and reproducible assessment tools faces challenges.Medical educators across specialties remain motivated to develop a relevant, generalizable, and measurable system.The Accreditation Council for Graduate Medical Education (ACGME) in the United States commits to the responsibility by assuring that the process and outcome of graduate medical education (GME) in the national residency programs produce competent, safe, and compassionate doctors.The Milestones Project is the ACGME′s evolution to a competency-based system, which allows each specialty to develop its own subcompetencies and 5-level progression of Milestones, along a continuum of novice to expert.Milestones 1.0 provided important foundational information and insights for the education community, that has had nearly 5 years of experience for residency training in Anesthesiology, needs to be improved.Milestones 1.0 highlighted challenges with assessment and evaluation of residents, some mismatch between subcompetencies and current and future clinical practices in Anesthesiology, and the need for faculty development tools.The ACGME assembled representatives from stakeholder groups using an iterative process within the Anesthesiology community to develop the second generation of Milestones in 2021.This article describes Milestones 2.0 for residency training in Anesthesiology in the United States, emphasizing the rationality and practicability, to provide evidence for residency training in Anesthesiology in China.There is a lack of systematic, cooperative and continuous research on medical education in Anesthesiology in China, and a lack of competency-based and milestone-based residency training in Anesthesiology.It is urgent to narrow the gap between developed countries and China to improve medical education and training in Anesthesiology.
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The etiology of 46, XY disorders of sex development is complex and the clinical manifestations are various. Patients with a female phenotype often present with primary amenorrhea during adolescence, which is difficult to find. We analyze the clinical features of 3 cases of female phenotype diagnosed by gene sequencing. The pathogenesis, clinical manifestations, diagnosis, and treatment were reviewed.
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Objective To explore the effect of right median nerve stimulation ( RMNS) on brain function in healthy subjects . Methods Twenty-eight healthy volunteers were selected as the study′s subjects. RMNS was admin-istered as a task stimulation in a wake-up therapy mode. The subjects were given 30 seconds of stimulation followed by 30 seconds of rest, repeated for 6 times as the block experiment designed, and functional magnetic resonance imaging (fMRI) was performed simultaneously with the task stimulation . The brain activation was analyzed using SPM 12 soft-ware. Results The fMRI showed that RMNS activated primarily the left M1, the premotor cortex (PMC), the bilater-al primary and secondary somatosensory cortexes (S1 and S2), and the left insular lobe. Compared with the resting state, the intensity of BOLD signal in the above activated brain areas changed significantly in RMNS wake-up stimula-tion mode. Conclusion Stimulation of the right median nerve can stimulate the local cerebral cortex and produce a certain wake-up effect by activating the right brain areas related to the motor and sensory functioning of the hand.
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Objective To explore the mechanism of HSP70 on cell cycle regulation in hepatic IR (ischemia-reperfusion) injury.Methods SD rats were randomly divided into HSP70 inhibitor group (H-/P+),heat shock group (H+/P+),PARP-1 inhibitory group (H +/P-),IR group (PC) and negative control group (NC),respectively.After the IR model was induced,the liver specimen underwent IHC staining to observe the changes of the PARP-1 expression;Co-immunoprecipitation was used to detect the binding of HSPT0 with PARP-1.Results H +/P-was significantly different from H +/P +,H-/P +,PC,NC (P ＜ 0.01);Immunoprecipitation suggested that HSP70 entered into the nucleus to bind PARP-1,and immunofluorescence imaging analysis demonstrated both HSP70 and CyclinD1 expressed at the same timeline.Conclusion Under reversible hepatic ischemia-reperfusion injury,HSP70 enters the nucleus and binds to PARP-1,negatively regulates G2/M phase,blocks cells for DNA replication and recombination,blocks its entry into mitosis,repairs damaged DNA chain;Liver ischemia-reperfusion positively regulates the G1/S phase,promoting hepatocyte regeneration and liver function compensation.
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Objective To investigate the correction between the levels of vascular endothelial growth factor (VEGF), serum amyloid A (SAA), hypersensitive C-reactive protein (hs-CRP) and acute cerebral infarction (ACI), and to provide the basis for the diagnosis and treatment of ACI.Methods A total of 76patients with ACI in the hospital from August to October 2017were selected as ACI group.In addition, 32healthy subjects underwent physical examination in the same period in this hospital were selected as negative control group (NC group).The levels of SAA and hs-CRP were detected by nephelometry, while the level of VEGF was measured by enzyme-linked immunosorbent assay (ELISA).The differences of detection indexes between two groups were compared, and the diagnostic value of each index and the combined test were evaluated with the Youden index.Results The levels of SAA, hs-CRP and VEGF in ACI group, were significantly higher than those of NC group (P＜0.01).The levels of VEGF was positively correlated with SAA and hs-CRP (r=0.434and0.631, P=0.000and 0.000).The optimal diagnostic critical points of VEGF, SAA and hs-CRP in the diagnosis of ACI were 161.93pg/mL, 3.81mg/L and 4.63mg/L, and the sensitivities were 93.55％, 65.91％and64.44％, the specificities were 60.00％, 93.75％and 90.32％, respectively.Combined detection with hs-CRP and VEGF was superior to single index detection and other joint detection.The sensitivity, specificity and Youden index of combined detection with hs-CRP and VEGF were 96.67％, 95.65％and 0.92respectively.Conclusion The levels of VEGF, SAA and hs-CRP increase in patients with ACI, and they play important roles in the diagnosis of ACI.VEGF are positively related to SAA and hs-CRP, and there may be an synergistic effect exist.VEGF may be involved in the pathological process of cerebral infarction.The combined detection of hs-CRP and VEGF is of high clinical value in the diagnosis of cerebral infarction.
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OBJECTIVE： To investigate how pharmacists provide through individualized pharmaceutical care for patients medication therapy management（MTM） combined with medicine gene detection， and to promote rational drug use in clinic.METHODS： A case of elderly comorbidity with acute upper gastrointestinal hemorrhage caused by Warfarin sodium tablets was taken as an example. The patient had a history of type 2 diabetes mellitus and hypertension. Coronary artery bypass grafting was performed two months before admission， and urinary tract infection occurred half a month ago. Medication therapy course was analyzed retrospectively before and after hospitalization； based on gene typing detection of CYP2C9*3 and VKORC1-1639， the individualized dose of Warfarin sodium tablets was evaluated. MTM was perfomed for acute upper gastrointestinal hemorrhage and all medication of patient to formulate individualized medication scheme. RESULTS： The genotyping of warfarin CYP2C9*3 and VKORC1-1639 indicated that the patients were of super slow metabolic type. The recommended dosage of warfarin should be 0.86-1.86 mg/d. Based on MTM analysis of acute upper gastrointestinal hemorrhage， the main causes of acute upper gastrointestinal hemorrhage were Warfarin sodium tablets 3.0 mg/d， poor drug compliance， disease status and co-morbidity and multi-drug combination. Clinical gastrointestinal hemorrhage of the patients were improved after drug withdrawal， anticoagulant drugs was changed into Rivaroxaban tablet，10 mg/d. Through MTM for all drug use in the patient， results of medication reorganization showed that Diltiazem hydrochloride tablet， Amoxicillin/clavulanate potassium dispersible tablet， Compound vitamin tablet were stopped； hypoglycemic drug Glimepiride tablet was changed into Gliquidone tablet； Metoprolol tartrate tablet was changed into Bisoprolol tablet after coronary artery bypass graft； proton pump inhibitor Esomeprazole enteric-coated tablet was changed into Pantoprazole sodium enteric-coated capsule. CONCLUSIONS： The pharmaceutical care mode of MTM combined with medicine gene detection can guide rational drug use in clinic， realize individualized pharmaceutical care， improve patient compliance and prevent problems related to adverse drug reactions.
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Objective To investigate the association of COL4A2 gene polymorphism rs9521733 with lacunar stroke in Xinjiang Han populations.Methods A total of 406 Han lacunar stroke patients and 425 controls enrolled from the First Hospital of Xinjiang Medical University and the 7th Division Hospital of Xinjiang Production and Construction Corps between March 2016 and September 2017 were recruited in the study.Clinical data were collected from all subjects.The improved multiple ligase detection reaction method was used to analyze the genotypes of rs9521733 in the COL4A2 gene.SPSS 17.0 was used for data analysis.Results There was no statistically significant difference in genotype and allele frequency of rs9521733 between case group and control group.Stratification analyses showed that the CC genotype of rs9521733 was associated with a significant increase in risk of lacunar stroke in the group of age ≥≥60 years (adjusted OR =1.950,95％ CI 1.222-3.112,P =0.005).Conclusion The rs9521733 of the COL4A2 gene might be associated with a higher risk of lacunar stroke in the group of age ≥60 years.
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Objective To evaluate the association between short-term outcomes and collateral circulation status in patients with acute ischemic stroke receiving thrombolysis therapy.Methods Full-text articles published from January 2000 to November 2016 in Cochrane Library,Medline,Embase and Web of Science electronic database were retrieved and their quality was assessed.The association between short-term outcomes and collateral circulation status were analyzed by random-effects models.Results Twenty three studies involving 2 849 patients were included in quantitative synthesis.The results showed that good collateral circulations had a beneficial effect on favorable outcomes at 3 or 6 months (RR =2.26,95％ CI:1.85-2.77,P =0.00),and were also associated with a lower rate of symptomatic intracranial hemorrhage (RR =0.56,95％ CI:0.47-0.67,P ＜ 0.01) and a lower rate of mortality (RR =0.30,95％ CI:0.22-0.40,P ＜ 0.01).Conclusion The baseline collateral cimulation status is associated with the short-term outcomes in patients with acute ischemic stroke receiving thrombolysis therapy.
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Objective To investigate the association of apolipoprotein E (ApoE) gene polymorphism in patients with mild cognitive impairment.Methods The patients aged 60-85 years were randomly selected from the outpatient,hospital or community age of Xinjiang Medical University Affiliated Hospital of traditional Chinese medicine in January 2015-June 2016,and cognitive function assessment for the patients.A total of 100 cases of mild cognitive impairment (MCI) patients were selected as case group,and 139 cases with normal cognitive function were the control group.The polymorphism of ApoE gene was analyzed in all patients.The final data were analyzed by Pearson chi square test.Results Compared to the control group,the proportion of genotype T/T in the genotype distribution of rs429358 loci was lower than that of the control group,T/C and C/C were higher than those in the control group,Allele C was a risk factor for MCI disease (OR value =2.100).The epsilon 4 allele was significantly higher than that of the control group,and the epsilon 3 allele was significantly higher than that of the control group (P ＜ 0.05).Conclusions The polymorphism of the ApoE gene is associated with the pathogenesis of MCI,in which the ApoE-E4 allele may be a risk gene for MCI.This suggests that the detection of ApoE gene polymorphism may provide useful information for the early diagnosis of MCI.
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<p><b>OBJECTIVE</b>To judge whether algesia sensitization of some acupoints is existed and whether the acupoint algesia sensitization area is expanded in the patients of intestinal cancer.</p><p><b>METHODS</b>Totally, 30 patients of intestinal cancer and 30 healthy subjects were included. The electronic Von Fray was used to determine the pressure-pain thresholds at 13 acupoints relevant with gastrointestinal disorders and the reference points at the sites 1and 2lateral to those points as well as the sites at the corresponding nerve segments. Compared with the pressure-pain thresholds at the reference points of the different segments, the relative value was calculated. The changes were analyzed in the pressure-pain thresholds at the relevant acupoints on the body surface in the patients of intestinal cancer as compared with the relative pressure-pain thresholds in the healthy volunteers.</p><p><b>RESULTS</b>The pressure-pain thresholds at Zusanli (ST 36), Shangjuxu (ST 37), Xiajuxu (ST 39), Quchi (LI 11) and Dachangshu (BL 25) in the patients of intestinal cancer were all significantly reduced as compared with those of the healthy subjects (<0.05,<0.01,<0.001). At the non-acupoint sites 1and 2lateral to those acupoints as well as at the sites of the same segments, the pressure-pain thresholds were reduced significantly as compared with the control group (<0.05,<0.01,<0.001). Particularly, the sensitization zone of Yinlingquan (SP 9) focused on the acupoint, the site 1lateral to it as well as the non-acupoint sites of the same segments (<0.01,<0.001).</p><p><b>CONCLUSION</b>The acupoint sensitization is displayed at Zusanli (ST 36), Shangjuxu (ST 37), Xiajuxu (ST 39), Quchi (LI 11), Dachangshu (BL 25) and Yinlingquan (SP 9) and the sensitization area is expended in the patients of intestinal cancer.</p>
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Objective To construct the assessment index system for general nursing goals management based on the performance structure theory. Methods Expert interviews and Delphi expert enquiry were used to complete the construction of index system, and SPSS17.0 was used to do data statistics and reliability analysis. Results The assessment index system for general nursing goals management was constructed which contained 6 level-Ⅰindicators such as nursing quality, nursing safety, nursing service, teaching and training, the contribution of department and the communication skills and 22 level- Ⅱ indicators. The department monthly examination scores calculation method and feedback mechanism were also established. The expert positive coefficients were 97.6%and 98.8%respectively, the authority coefficients were 0.85 and 0.86, the importance and feasibility mean scores of every index were 3.86-4.98 and 3.98-4.88, and coefficients of variation were 0.03-0.27 and 0.05-0.25 in 2 rounds of enquiry. The importance of level-Ⅰor level-Ⅱ indicators and operability coordination coefficients were 0.10-0.36, the significance test showed P<0.05. Conclusions The design of each dimension of the index system gives full consideration to 3 dimensions of performance: task-adaptive-relationship. Representative of key indicators is strong. The Delphi method used in building is scientific and the results are reliable. The maneuverability of calculate Method is strong, easy to quantify. The feedback mechanism has a strong incentive by combining the assessment results closely with the individual interests. The establishment of the index system can provide scientific and objective basis for the full implementation of the general nursing goals management.
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Objective To investigate the risk factors of creatine kinase (CK) elevation in chronic hepatitis B (CHB) patients and treatment outcomes for better management of such patients. Methods The CHB patients complicated with CK elevation who were treated during the period from June 2013 to June 2015 were reviewed retrospectively with their clinical data. CK elevation was examined in terms of antiretroviral regimens, and glycyrrhizin therapies. The clinical outcome was evaluated in terms of grade 3/4 CK elevation. Results A total of 364 CHB patients with CK elevation were included in this analysis. CK elevation was primarily associated with telbivudine monotherapy and combination therapy, followed by entecavir treatment. Grade 3/4 CK elevation was identified in 30 patients, which was mainly associated with telbivudine monotherapy and combination therapy. Good outcome was observed in most of these?patients?(76.7?%,?23/30).?Myopathy?was?confirmed?in?one?patient?by?muscle?biopsy.?Glycyrrhizin?was?not?associated?significantly?with CK elevation in CHB patients. Conclusions Creatine kinase elevation usually occurs in the CHB patients receiving telbivudine-containing therapies. CHB patients should be monitored for CK level during antiviral therapy. Concomitant glycyrrhizin treatment is not associated with CK elevation.