Observation on the efficacy of conbercept combined with subthreshold micropulsed laser photocoagulation in the treatment of diabetic macular edema / 中华眼底病杂志

Objective:To observe the efficacy of intravitreal injection of conbercept (IVC) combined with subthreshold micropulse laser photocoagulation (SMLP) in the treatment of diabetic macular edema (DME).Methods:A randomized controlled trial. From December 2020 to January 2022, 100 patients (100 eyes) with DME diagnosed by examination in Shanxi Aier Eye Hospital were included in the study. The patients were randomly divided into IVC group (50 eyes) and IVC+SMLP group (50 eyes). All the eyes were treated with IVC once a month for 3 times, and the eyes in IVC+SMLP group were treated with SMLP within 2 weeks after IVC. All affected eyes were examined by best corrected visual acuity (BCVA), which was statistically converted to logarithm of the minimum angle of resolution (logMAR) visual acuity. The central macular thickness (CMT) was measured by optical coherence tomography. Before the treatment, the logMAR BCVA of patients in IVC group and IVC+SMLP group were 0.56±0.04 and 0.55±0.03, respectively. The CMT were (437.36±11.35) μm and (434.58±10.88) μm, respectively. There was no significant difference in logMAR BCVA and CMT between the two groups ( t= 0.476, 1.027; P>0.05). The patients were followed up for 12 months after treatment. The times of IVC and the changes of BCVA and CMT were compared between the two groups. Independent sample t-test was used to compare the logMAR BCVA, CMT and times of IVC between groups. Results:After 12 months treatment, the logMAR BCVA of IVC group and IVC+SMLP group were (241.63±29.79) μm and (240.47±30.46) μm, respectively. Compared with those before treatment, 12 months after treatment, the BCVA of the two groups increased significantly ( t=7.014, 5.608; P<0.001), while CMT decreased significantly ( t=8.126, 6.013; P<0.001). There was no significant difference in BCVA and CMT between the two groups ( t=0.835, 0.764; P>0.05). The number of IVC in IVC group and IVC+SMLP group were (8.15±2.04) times and (5.91±1.80) times, respectively, and the difference was statistically significant ( t=5.210, P<0.001). Conclusions:Both IVC+SMLP and IVC alone can effectively reduce CMT and increase BCVA in patients with DME. Combination therapy can reduce the number of IVC.

Risk factors of bronchopulmonary dysplasia in very preterm infants: a national multicenter study / 中国小儿急救医学

Objective:To analyze the risk factors of bronchopulmonary dysplasia(BPD)in very preterm infants(VPI), and to provide scientific basis for the prevention and treatment of BPD in VPI.Methods:A prospective multicenter study was designed to collect the clinical data of VPI in department of neonatology of 28 hospitals in 7 regions from September 2019 to December 2020.According to the continuous oxygen dependence at 28 days after birth, VPI were divided into non BPD group and BPD group, and the risk factors of BPD in VPI were analyzed.Results:A total of 2 514 cases of VPI including 1 364 cases without BPD and 1 150 cases with BPD were enrolled.The incidence of BPD was 45.7%.The smaller the gestational age and weight, the higher the incidence of BPD( P<0.001). Compared with non BPD group, the average birth age, weight and cesarean section rate in BPD group were lower, and the incidence of male infants, small for gestational age and 5-minute apgar score≤7 were higher( P<0.01). In BPD group, the incidences of neonatal respiratory distress syndrome(NRDS), hemodynamically significant patent ductus arteriosus, retinopathy of prematurity, feeding intolerance, extrauterine growth restriction, grade Ⅲ~Ⅳ intracranial hemorrhage, anemia, early-onset and late-onset sepsis, nosocomial infection, parenteral nutrition-associated cholestasis were higher( P<0.05), the use of pulmonary surfactant(PS), postnatal hormone exposure, anemia and blood transfusion were also higher, and the time of invasive and non-invasive mechanical ventilation, oxygen use and total hospital stay were longer( P<0.001). The time of starting enteral nutrition, cumulative fasting days, days of reaching total enteral nutrition, days of continuous parenteral nutrition, days of reaching 110 kcal/(kg·d) total calorie, days of reaching 110 kcal/(kg·d) oral calorie were longer and the breastfeeding rate was lower in BPD group than those in non BPD group( P<0.001). The cumulative doses of amino acid and fat emulsion during the first week of hospitalization were higher in BPD group( P<0.001). Multivariate Logistic regression analysis showed that NRDS, invasive mechanical ventilation, age of reaching total enteral nutrition, anemia and blood transfusion were the independent risk factors for BPD in VPI, and older gestational age was the protective factor for BPD. Conclusion:Strengthening perinatal management, avoiding premature delivery and severe NRDS, shortening the time of invasive mechanical ventilation, paying attention to enteral nutrition management, reaching whole intestinal feeding as soon as possible, and strictly mastering the indications of blood transfusion are very important to reduce the incidence of BPD in VPI.

Bioinformatics analysis of expression of reduced folate carrier(RFC1) in colorectum, related signaling pathways and its relationship with patient prognosis / 国际生物医学工程杂志

Objective:To investigate the expression and related signaling pathways of reduced folate carrier 1 (RFC1) in colorectal cancer (CRC) and its relationship with the prognosis of patients.Methods:The expression of RFC1 gene in various solid tumors and CRC was analyzed in the Cancer Genome Atlas(TCGA) database. The RFC1 protein-protein interaction network was established using the search tool for the retrieval of interacting genes (STRING). The differences in survival rate between patients with high and low expression of RFC1 were compared using the Gene Expression Profile Interaction Analysis (GEPIA) database. Differentially expressed genes were subjected to Gene Oncology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis using the Annotation, Visualization and Integrated Discovery (DAVID) database. The immunohistochemical expression level and location of RFC1 in CRC tissues and adjacent normal tissues were analyzed.Results:The expression difference of RFC1 mRNA in various human solid tumors was not obvious. In CRC tissues, the expression level of RFC1 was higher than that in adjacent normal tissues, but the expression level of RFC1 was not related to the tumor stage of the CRC patients. The correlation index between RFC1 proteins was 119, and the average inter-protein region clustering coefficient was 0.836. There was significant protein network enrichment between RFC1 and its interacting genes ( P<0.05). The biological processes of RFC1 are mainly enriched in DNA replication, semi-conservative replication to maintain telomere activity, DNA metabolism, error-free translation synthesis, DNA synthesis involved in DNA repair, etc. The cellular components are mainly enriched in replication forks, chromosomes, nucleoplasm, DNA replication factor C complex, Ctf18 RFC complex, etc. The molecular functions are mainly enriched in DNA binding nucleic acid binding, impaired DNA binding, DNA activity, catalytic activity, etc. For the KEGG signaling pathway, RFC1 is mainly enriched in DNA replication, nucleotide excision repair, mismatch repair, and malignant tumorigenesis. The disease-free survival rate and overall survival rate of CRC patients with high expression of RFC1 were lower than those of low expression group, and the difference in overall survival rate between the two was statistically significant ( P<0.05). The RFC1 protein was mainly expressed in the cytoplasm, and the positive expression was yellow-brown granular and evenly distributed in the cells. Most of the RFC1 proteins were highly or moderately expressed in colorectal cancer tissues, but low in normal intestinal epithelium. Conclusions:The expression of RFC1 is increased in CRC tissues, and its high expression is related to the decreased overall survival rate of CRC patients. RFC1 can be used as a molecular marker of poor prognosis in CRC and may become a potential target for CRC therapy.

The mechanism by which epidermal growth factor 8 regulates microglia polarization in transient cerebral ischemia / 中华物理医学与康复杂志

Objective:To explore the function of epidermal growth factor 8 in the polarization of microglia after ischemic brain injury and its mechanism.Methods:Forty C57BL/6 mice were randomly divided into a sham operation group, an ischemia group, a recombinant mouse milk fat globule epidermal growth factor 8 (rmMFG-E8) group and an rmMFG-E8 + colivelin TFA group, each of 10. The middle cerebral artery occlusion and reperfusion model (tMCAO) was established in all except the sham operation group. Right after the modelling the mice in the rmMFG-E8 group were immediately injected with 2μL of 0.4μg/μL of rmMFG-E8 into the ventricle contralateral to the cerebral infarction. The rmMFG-E8+ Colivelin TFA group was injected with the same dose of rmMFG-E8 plus 2μL of 5pmol/μL colivelin TFA. On the 1st, 3rd, 5th and 7th day after the modelling, neurological functioning was documented using behavioral tests. The volume proportion of the cerebral infarction was observed after tissue staining on the 7th day after the operation. The gene expression levels of M1 polarization marker-induced nitric oxide synthase (iNOS), M2 polarization marker arginase-1 (Arg1) and mouse chitinase-like molecule 3 (YM1) in the microglia were detected using real-time fluorescence quantitative polymerase chain reactions. The protein expression levels of MFG-E8, phosphorylated signal transduction and transcription factor 3 (p-STAT3) and cytokine signal transduction inhibitor-3 (SOCS3) were determined using western blotting.Results:The behavior tests revealed significant differences between the sham operation group and the other groups on all four days. Compared with the sham operation group, the average expression of MFG-E8 gene and its protein, Arg1 and Ym1, and the SOCS3/GAPDH protein ratio had decreased significantly in the ischemic group, while the average expression of iNOS and the p-STAT3/STAT3 protein ratio had increased significantly. On the 7th day after the modelling, compared with the ischemic group, the infarct volume was significantly smaller in the rmMFG-E8 group. The average expression of iNOS and the average p-STAT3/STAT3 ratio in the rmMFG-E8+ colivelin TFA group had increased significantly compared with the rmMFG-E8 group, while the average expression of Arg1 and Ym1, and the SOCS3/GAPDH ratio were significantly lower.Conclusion:MFG-E8 promotes the polarization of M2-type microglia after cerebral ischemia through STAT3 signaling, promoting the recovery of neurological functioning.

Prenatal diagnosis of a fetus with chromosome 18p deletion and duplication / 中华医学遗传学杂志

OBJECTIVE@#To assess the value of chromosomal microarray analysis (CMA) to verify a fetus with partial 18p deletion signaled by non-invasive prenatal testing.@*METHODS@#G-banding chromosomal karyotyping analysis was carried out on amniotic fluid sample of the fetus and peripheral blood samples from the parents. Amniotic DNA was also subjected to CMA analysis. The fetus was also subjected to systematic ultrasound scan.@*RESULTS@#The fetus was found to have a karyotype of 46,XX,18p+. CMA has revealed a 5 Mb deletion at 18p11.32-p11.31, a 2.9 Mb duplication at 18p11.31-p11.23, and a 2.5 Mb duplication at 18p11.23-p11.22. No chromosomal aberration or microdeletion/microduplication was detected in either parent.@*CONCLUSION@#Non-invasive prenatal testing and CMA are both sensitive for the detection of chromosomal microdeletions and microduplications. CMA can help with clarification of genotype-phenotype correlation and facilitate prenatal diagnosis and genetic counseling for the family.

Hedgehog signaling in gastrointestinal carcinogenesis and the gastrointestinal tumor microenvironment

The Hedgehog (HH) signaling pathway plays important roles in gastrointestinal carcinogenesis and the gastrointestinal tumor microenvironment (TME). Aberrant HH signaling activation may accelerate the growth of gastrointestinal tumors and lead to tumor immune tolerance and drug resistance. The interaction between HH signaling and the TME is intimately involved in these processes, for example, tumor growth, tumor immune tolerance, inflammation, and drug resistance. Evidence indicates that inflammatory factors in the TME, such as interleukin 6 (IL-6) and interferon-

Insulin-like growth factor 1 modulates the phosphorylation, expression, and activity of organic anion transporter 3 through protein kinase A signaling pathway

Organic anion transporter 3 (OAT3) plays a vital role in removing a broad variety of anionic drugs from kidney, thus avoiding their possible toxicity in the body. In the current study, we investigated the role of insulin-like growth factor 1 (IGF-1) in the regulation of OAT3. We showed that IGF-1 induced a dose- and time-dependent increase in OAT3 transport activity, which correlated well with an increase in OAT3 expression. The IGF-1-induced increase in OAT3 expression was blocked by protein kinase A (PKA) inhibitor H89. Moreover, IGF-1 induced an increase in OAT3 phosphorylation, which was also blocked by H89. These data suggest that the IGF-1 modulation of OAT3 occurred through PKA signaling pathway. To further confirm the involvement of PKA, we treated OAT3-expressing cells with PKA activator Bt2-cAMP, followed by examining OAT activity and phosphorylation. We showed that OAT3 activity and phosphorylation were much enhanced in Bt2-cAMP-treated cells as compared to that in control cells. Finally, linsitinib, an anticancer drug that blocks the IGF-1 receptor, abrogated IGF-1-stimulated OAT3 transport activity. In conclusion, our study demonstrated that IGF-1 regulates OAT3 expression and transport activity through PKA signaling pathway, possibly by phosphorylating the transporter.

Neonatal succinate-CoA ligase deficiency presented as mild methylmalonic aciduria: a case report / 中华围产医学杂志

To report a case of neonatal succinate-CoA ligase deficiency with mild methylmalonic aciduria caused by SUCLG1 compound heterozygous mutation. Our proband developed the disease at the 2nd day of life, manifested by vomiting and milk rejection. Blood gas analysis indicated metabolic acidosis and hyperlactacidemia. Laboratory tests showed mild hyperammonemia, mild elevation of serum aminotransferase and normal homocysteine. Imageology examination showed brain dysplasia and multiple cardiac malformations. Mild methylmalonic aciduria was suggested by blood acylcarnitines and urine organic acids analysis. Two novel mutations, c.40A>G (p.M14V) and a heterozygous deletion of exon 6 to 9, were identified by whole-exome sequencing in SUCLG1, which came from the mother and father, respectively. Metabolic acidosis turned better by volume expansion and acidosis correction, but lactic acidosis was persistent. Edema and respiratory failure occurred, after which the parent gave up treatment and the patient died after discharged from hospital. The mutations of SUCLG1 gene lead to succinate-CoA ligase deficiency and mitochondrial DNA depletion syndrome. There is no specific treatment for this disease. For infants with feeding difficulties, lactic acidosis and multiple organ damage, metabolic abnormality screening should be performed. Genetic analysis is the diagnostic method.

Three-dimensional spine morphology measuring technology for daily surface monitoring / 生物医学工程学杂志

In order to conduct surface monitoring of the three-dimensional spine morphology of the human body in daily life, a spine morphology measuring method using "single camera, multi-view" to construct stereo vision is proposed. The images of the back of the human body with landmarks of spinous process are captured from multiple angles by moving a single camera, and based on the "Zhang Zhengyou calibration method" and the triangulation principle of binocular stereo vision, the spatial conversion matrices corresponding to each other between all images and the 3D coordinates of the landmarks are calculated. Then the spine evaluation angle used to evaluate the spine morphology is further calculated. The tests' results showed that the spine evaluation angle error of this method is within ±3°, and the correlation between the results and the X-ray film Cobb angles is 0.871. The visual detection algorithm used in this paper is non-radioactive, and because only one camera is used in the measurement process and there is no need to pre-set the camera's shooting pose, the operation is simple. The research results of this article can be used in a mobile phone-based intelligent detection system, which will be suitable for the group survey of scoliosis in communities, schools, families and other occasions, as well as for the long-term follow-up of confirmed patients. This will provide a reference for doctors to diagnose the condition, predict the development trend of the condition, and formulate treatment plans.

Mechanism and treatment progress of prolonged postoperative ileus / 国际外科学杂志

Prolonged postoperative ileus(PPOI), as a common surgical complication, has attracted more and more attention of domestic scholars in recent years. PPOI is often manifested as intolerance of oral feeding, nausea and vomiting, abdominal pain, abdominal distention, delayed exhaust and defecation, and prolonged hospital stay and increased medical expenditure. At present, the pathogenesis of PPOI has not been determined, but it is certain that the disease is mediated by a variety of mechanisms. In clinical work, PPOI still have no general diagnostic criteria, treatment methods and prevention strategies. The theory and practice of accelerated rehabilitation surgery may bring new ideas for the prevention and treatment of PPOI. This paper reviews the research status and prevention strategies of PPOI.

Mechanism and treatment progress of prolonged postoperative ileus / 国际外科学杂志

Prolonged postoperative ileus(PPOI),as a common surgical complication,has attracted more and more attention of domestic scholars in recent years.PPOI is often manifested as intolerance of oral feeding,nausea and vomiting,abdominal pain,abdominal distention,delayed exhaust and defecation,and prolonged hospital stay and increased medical expenditure.At present,the pathogenesis of PPOI has not been determined,but it is certain that the disease is mediated by a variety of mechanisms.In clinical work,PPOI still have no general diagnostic criteria,treatment methods and prevention strategies.The theory and practice of accelerated rehabilitation surgery may bring new ideas for the prevention and treatment of PPOI.This paper reviews the research status and prevention strategies of PPOI.

Local anatomical characteristics of complete mesocolic excision in the right hemicolectomy / 中华消化外科杂志

Objective To investigate the local anatomical characteristics of the associated membrane and mesangial space in the complete mesocolic excision (CME) of right hemicolectomy and provide the surgical practical anatomical evidence to CME.Methods The experimental study was conducted.Department of Anatomy of Capital Medical University provided 20 adult cadavers.The surgical pictures came from Beijing Friendship Hospital of Capital Medical University.The local anatomy of CME in 20 cadavers was simulated after fascia perfusion.Observation indicators:(1) the local anatomy of the visceral fascia and parietal fascia was studied by simulating the operation of CME in cadaver specimens;(2) observing the integrity and barrier action of the visceral layer of the membrane after fascia perfusion solution freezing;(3) distribution and variation of superior vessels of rightsemi mesocolon.Results (1) The local anatomy of the visceral fascia and parietal fascia was studied by simulating the operation of CME in cadaver specimens:posterior lobe of the interposition mesocolon merged completely with visceral fascia,parietal fascia and front fascia of duodenum,and superior mesenteric vein (SMV) and superior mesenteric artery (SMA) were found.The ureters and reproductive vessels were covered with Gerota fascia,with a complete membrane structure.The specimens from simulated CME in 20 adult cadavers and CME of right hemicolectomy accorded with a requirement of CME.(2) Observing the integrity and barrier action of the visceral layer of the membrane after fascia perfusion solution freezing:posterior lobe of the right-semi mesocolon merged completely with visceral fascia,with a complete parietal fascia structure and without exudation of fascia perfusion solution.The right ureter and reproductive vessels were completely covered with Gerota fascia.The serosal surface of right-semi mesocolon maintained integity,with exudation of fascia perfusion solution.(3) Distribution and variation of superior vessels of right-semi mesocolon:major blood vessels of right-semi colon included superior mesenteric vessels,including SMA and SMV.The major branches of vessels included ileocolic artery,right colic artery,middle colic artery,right and left branches of middle colic artery,ileocolic vein,middle colic vein and gastrocolic stem.The gastrocolic stem and main stem of right colic artery had more variations.Conclusion The posterior lobe of the interposition mesocolon merges with fascia,and complete visceral fascia,can be separated,these provide anatomical evidences for safety and radical resection of right hemicolectomy based on following the principles of CME.

Efficacy of auricular point sticking therapy for abnormal blink in children and impact on the breakup time of tear film / 中国针灸

<p><b>OBJECTIVE</b>To observe the efficacy of auricular point sticking therapy for abnormal blink in children and the impact on the breakup time of tear film.</p><p><b>METHODS</b>A total of 123 cases (246 eyes) with abnormal blink were randomly assigned into two groups, 62 cases (124 eyes) to an observation group, 61 cases (122 eyes) to a control group. The observation group received auricular point sticking therapy with western medicine; the treatment was given 6 d per week; the next day received no treatment and changed dressing. The auricular points were yan (LO), pingjianqian (TG), pingjianhou (AT), gan (CO), pi (CO), wei (CO). The western medicine pateints took 1 oral multivitamins tablets per day, and received sodium hyaluronate eye drops and tobramycin eye drops in turn, 3 times per day, 7 day as a course; treatment was lasting 3 courses. Patients in the control group only received western medicine. The blink frequency score and breakup time of tear film of children were observed, the curative effect of the two groups was compared.</p><p><b>RESULTS</b>After treatment, the blink frequency score was lower significantly (<0.01), and lower significantly in subjects in the observation group compared to those in the control group (<0.01). After treatment, less than 10 s were 51 eyes (41.8%) and greater than 10 s (including 10 s) were 71 eyes (58.2%) in the 122 eyes from the control group; in the observation group, less than 10 s were 13 eyes (10.5%) and greater than 10 s (including 10 s) were 111 eyes (89.5%); there was significant difference between the two groups (<0.01). The effective rate of the observation group was 91.9% (114/124), which was higher than the control group 65.6% (80/122); the difference was statistically significant (<0.01).</p><p><b>CONCLUSION</b>The efficacy of auricular point sticking therapy combine western medicine is better in treating children with abnormal blink compared to western medicine by reducing the breakup time of tear film. This suggests that reduction of tear film stability is one of the main reasons which causes frequent eye blink, and breakup time of tear film can be used as the testing standard.</p>

Construction of the competency model for junior caregivers for the elderly based on the combination of medical and endowment model / 中南大学学报(医学版)

To construct a competency model for junior caregivers for the elderly and to provide a reference for the selection, evaluation and training for the junior caregivers for the elderly.
 Methods: Firstly, we drafted the primary competency model for junior caregivers for the elderly through literature review. Then, we used Delphi method to carry out 2 rounds of questionnaire survey for 20 experts to optimize the indicators for primary model. The weight of each indicator is determined by analytic hierarchy process (AHP) and expert sequencing method.
 Results: The effective recovery rates of the two-round questionnaire were 87% and 100%, respectively. The expert authority coefficient was 0.70-0.93, and the average authority coefficient was 0.80. The final version of the competency model for junior caregivers for the elderly included 4 first-grade indexes, 11 second-grade indexes and 37 third-grade indexes.
 Conclusion: The competency model for the junior caregivers for the elderly is reliable and can be used as the reference standard for the selection, evaluation and training for the junior caregivers for the elderly.

Construction and management practice of morphologic experimental center in medical university / 中华医学教育探索杂志

Based on the construction and management practice of the morphologic experimental center in Xi'an Medical University, the achievements in laboratory daily operation and institutional man-agement were summarized in the area of lab rules and regulations, instrument and equipment, experiment teaching, lab environment and safety, lab staff administration and so on. The management work has been refined using the practice model of resource sharing, system administration, individual responsibility, and unified staff supervision. The lab rules and responsibilities were also effectively implemented on specific person. Taking the opportunity in teaching evaluation at the experimental center, the lab connotation con-struction was further strengthened. The evaluation system was thoroughly examined in order to look for gaps and promote the lab construction. Further work could be carried out on the laboratory software and hard-ware, such as instrument and equipment update, experimental teaching system reformation in morphology, promotion on multidisciplinary integration and unified management of lab staff.

Roles of Moesin in tumor progression / 中国药科大学学报

@#Moesin is a component of ERM(Ezrin/Radixin/Moesin)family proteins linking cell membrane proteins with cytoskeleton. It is involved in cell morphological change and the maintaining of cell cortex and is also involved in cell adhesion, migration and polarization by regulating the signal transduction pathways. Moesin plays a vital role in several aspects of tumor initiation and progression through its regulation on cytoskeleton and signal transduction pathways. This article reviews the close relation between Moesin and its phosphorylated form with the higher level of malignancy and poor prognosis through clinic data analysis. Furthermore, the role and mechanism of Moesin on tumor migration, EMT and tumor proliferation are presented. Drug research and development based on the target of Moesin are also concluded.

Effect of standardized PICC training and management on the clinical effect and complication of catheterization / 中南大学学报(医学版)

OBJECTIVE@#To determine the clinical effect of standardized training and management of peripherally inserted central catheter (PICC) and catheter-related complications.@*METHODS@#A total of 610 patients were divided into a control group and an observation group, the control group (n=300) were catheterized by trainees who received "short-term intensive training", the observation group (n=310) by "system standardized training and management". The clinical efficacy of catheterization and the rate of catheter-related complications were compared.@*RESULTS@#There was significant difference in the one-time puncture success rate, one-time cannulation success rate, the time for operation and the pain score between the 2 groups (all P<0.01), and there was also significant difference in the occurrence of catheter extrusion, plug, arrhythmia, catheter-related thrombosis, phlebitis, puncture point effusion and catheter-related infection between the 2 groups (all P<0.05).@*CONCLUSION@#Standardized PICC training and management can improve the effect of catheterization and reduce the incidence of PICC-related complication.

Relationship between non-dipper hypertension and arteriosclerosis in the elderly / 中华老年医学杂志

Objective To investigate the influence of non-dipper blood pressure rhythm on peripheral atherosclerosis in elderly hypertensive patients.Methods The 199 elderly hypertensive patients with 24-hour average systolic blood pressure＜140 mmHg were selected.Body mass index (BMI),glycosylated hemoglobin,blood lipids,uric acid,creatinine,Brachial ankle pulse wave velocity (baPWV),ankle arm index(ABI) and 24-hour ambulatory blood pressure monitoring were tested and calculated.The elderly patients were divided into dipper hypertensive group (n=95),and non-dipper hypertensive group (n=104).The relationships of arteriosclerosis with lifestyle and the circadian rhythm of blood pressure (non-dipper hypertension) were analyzed.Results Circadian blood pressure rhythm,age,levels of total cholesterol,triglyceride and serum creatinine,nocturia times,and smoking index were significantly related with atherosclerosis.There was a relationship between circadian blood pressure rhythm and baPWV,with the greatest standardized regression coefficient of 0.439.There were obviously linear relationships between levels of serum creatinine,nocturia times,age and ABI.There were significant differences in baPWV,ABI and smoking index between dippers and non-dippers groups [(1746.0±246.9) vs.(2115.7±321.8),(1.14±0.10) vs.(1.11±0.18),(251.8±272.8) vs.(368.5±339.9),P＜0.05 or 0.001].The multiple linear regression analysis showed that smoking index was significantly correlated with baPWV,but not correlated with blood pressure rhythm.In the ROC curve of MAP difference percentage and baPWV diagnosis result,the area under the curve was 0.8188,the optimal cut-off was 10.9％,the sensitivity was 62.5％ and the specificity was 85.7％.In the ROC curve of MAP difference percentage and AMI diagnosis result,the area under the curve was 0.7589,the optimal cut-off was 8.1％,the sensitivity was 88％,and the specificity was 61％.These results reflected that there were better consistences between MAP difference percentage and baPWV,ABI,and indirectly indicted that there was a relationship between MAP difference percentage and atherosclerosis.Conclusions We advise the elderly patients to give up the bad habits,help them control the systolic blood pressure,and advise them to adjust the medication time according to the circadian rhythm of blood pressure of every elderly hypertensive patient in order to restore the normal circadian blood pressure rhythm and delay the atherosclerotic process.

The effect of transcranial magnetic stimulation on the proliferation of neural stem cells and miR-9 in the brain after focal cerebral ischemia / 中华物理医学与康复杂志

Objective To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) on the proliferation of neural stem cells in the subventricular zone (SVZ) and the expression of miR-9 in the ipsilesional hemisphere of rats with focal cerebral ischemia.Methods A rat model of acute focal cerebral ischemia was established using transient middle cerebral artery occlusion (tMCAO).Rats were then randomly assigned to a sham group,a control group or an rTMS group.Daily rTMS treatments (10 trains with 30 pulses per train and 50-second breaks between trains at 120％ of the resting motor threshold) were targeted at the ipsilesional MI cortex beginning one day after the tMCAO.After the treatment the proliferation of neural stem cells in the ipsilesional SVZ was identified by double immunofluorescence staining (BrdU/nestin).The expression of miR-9 was evaluated using quantitative PCR.Results Compared with the other two groups,BrdU + Nestin + cells in the ipsilesional SVZs of the rTMS group increased and the expression of miR-9 decreased significantly.Conclusion rTMS can promote the proliferation of neural stem cells and inhibit the expression of miR-9 in the ipsilesional hemisphere after focal cerebral ischemia.

Comparison of the cervical intervertebral movements produced by posteroanterior cervical mobilization and posteroanterior cervical mobilization during cervical traction / 中华物理医学与康复杂志

Objective To compare the cervical intervertebral movements produced by posteroanterior cervical mobilization and posteroanterior cervical mobilization combined with cervical traction by using the radiographic measurement.Methods The study recruited 12 normal volunteers (6 men,6 women),aged 18 to 25 years (22.9±4.7 years),heighted (164± 7)cm and weighed (54.7 ± 7.6)kg.All the subjects were administered with posteroanterior cervical mobilization followed by posteroanterior cervical mobilization while having cervical traction,or vice versa,with an interval of 2 days in between.The X-ray films were collected before and after the treatment,using 4 static cervical lateral views.The axial displacement of posterior and anterior intervertebral separation (IVS),and the shear displacement of vertebral body as well as the rotation and displacement rate of the motion segments in the sagittal plane before and after the treatment were measured on the radiographic images and compared.Results It was shown that the posteroanterior cervical mobilization produced greater C2-C7 rotation range of motion in the sagittal plane,as compared to that by the posteroanterior mobilization while having cervical traction (P ＜ 0.05).The posteroanterior mobilization produced a significantly greater increase of anterior IVS of the C5 segment and the summation of C2-C7 posterior IVS than those by posteroanterior mobilization while having cervical traction (P ＜ 0.05).However,the posterior IVS and the posterior zygapophysial joints separation of C2-C7 produced by the posteroanterior mobilization during traction were more prominent (P ＜ 0.05).There was no statistical difference between anteroposterior displacements of the vertebral body produced by the two interventions.Comparing with the baseline,the posteroanterior mobilization caused posterior movement of the vertebral bodies of C5 to C2,while the posteroanterior cervical mobilization during traction produced posterior movement of C5 to C2 vertebral bodies and anterior movement of C6 body.Conclusion The cervical posteroanterior mobilization significantly increased the lordosis from C3 to C7,and reduced posterior IVS and zygapophysial joints separation.However,the posteroanterior mobilization during traction changed the intervertebral movements.