Exploration and thinking of online teaching of medical microbiology experiment / 中华医学教育探索杂志

Medical microbiology experiment is faced with many problems in online teaching. This study adopts the teaching mode of online live broadcast + operation video + virtual experiment, and make up the operation gap to some extent through operation video and virtual experiment. The mode of assessment is subjective thinking question (closely following the operation process) + experiment design + literature review (focusing on the key technology or new technology of clinical assessment that cannot be carried out due to the limitation of conditions in traditional experiments, such as mass spectrometry, fluorescence quantitative PCR, and G-test), and it is helpful to understand students' mastery of teaching objectives, and the ability of comprehensive application and innovative thinking. The student questionnaire shows that most students hold a positive attitude towards the online experimental teaching mode, and the quality of students' homework shows that most students have a good learning effect.

Anatomical relationship between the brachiocephalic trunk and the trachea and the clinical implications / 南方医科大学学报

OBJECTIVE@#To observe the anatomical features and relative position of the brachiocephalic trunk and the trachea to provide an anatomical basis for diagnosis and treatment of mechanical airway obstruction and for facilitating the performance of tracheotomy.@*METHODS@#A total of 91 formalin- fixed adult cadavers (70 male and 21 female) were used in this study. The whole length of the larynx and the trachea were separated and exposed from the neck to the chest, followed by separation of the aortic arch and its 3 branches to observe the anatomical position of the brachiocephalic trunk and the trachea.@*RESULTS@#The brachiocephalic trunk and the trachea did not intersect in 3.30%, partially intersected in 71.43%, and completely intersected in 25.27% of the 91 cadaveric specimens. The male specimens all showed greater outer diameter of the aortic arch, the brachiocephalic trunk and the trachea with a greater length of the trachea than the female specimens (P < 0.05), while the distances from the aortic arch to the brachiocephalic trunk or the cricoid cartilage did not differ significantly between them (P > 0.05). The number of the tracheal cartilage rings above the brachiocephalic trunk ranged from 3 to 10, and the mean number did not differ significantly between the male and female specimens (P > 0.05).@*CONCLUSION@#The brachiocephalic trunk has complex anatomical relationship with the trachea, and caution should be taken to avoid injuries of the brachiocephalic trunk and the aortic arch in the diagnosis and treatment of mechanical respiratory obstruction and during tracheotomy.

Analysis of urinary calculi composition in Longnan, Gansu province / 现代泌尿外科杂志

【Objective】 To analyze the composition of urinary calculi in Longnan, Gansu province, and the relationship between the composition and clinical characteristics of patients, so as to provide reference for the prevention and treatment of this disease. 【Methods】 The composition of 500 cases of urinary calculi hospitalized in our department during Apr. 2021 and Feb.2023 were analyzed using the infrared spectrum stone composition analyzer. The clinical characteristics of the patients were evaluated and analyzed. 【Results】 The male-to-female ration of patients was 2.70∶1. Most patients aged 21 to 60 years (437, 87.4%). Most cases were ureteral calculi (72.8%), followed by renal calculi (22.2%), and bladder calculi (5.0%). There were 166 cases of calcium oxalate calculi, 293 cases of calcium oxalate + carbonated apatite calculi, 24 cases of calcium oxalate + carbonated apatite + hydroxyl apatite calculi, 4 cases of calcium oxalate + calcium bicarbonate calculi, 7 cases of urate calculi, 6 cases of carbonated apatite + struvite calculi. Oxalate calculi were the most common in all age groups, and urate calculi were the most common in the 21 to 40 age group. Calcium oxalate calculi were most common in the ureter (127, 76.5%), significantly higher than in other sites (χ2=3.222, P=0.020). Calcium oxalate + calcium hydrogen phosphate calculi was the least common in the bladder, significantly different from the other parts (χ2=2.092, P=0.037). Magnesium ammonium phosphate hexahydrate and/or calcium carbonate or calcium oxalate calculi were the most common in the kidney (50.0%), significantly different from the other parts (χ2=9.448, P=0.007). 【Conclusion】 In Longnan area, the incidence of urinary calculi is significantly higher in male than in female. Ureteral calculi are mainly composed of calcium oxalate + carbonated apatite and calcium oxalate. According to different risk factors, individual prevention programs should be developed.

Advances in the application of lyophilized platelets and derivative products / 中国输血杂志

Platelets are important components of the blood system. There are many kinds of concentrated platelets and their derivatives, among which platelet-rich plasma (PRP ), growth factors (GFs) and platelet-rich fibrin (PRF) have been widely used in clinical practice. Lyophilized platelets (Lyo-P) or freeze-dried platelets (FDP) are prepared from concentrated platelets by freeze-drying and have the advantages of long storage time at room temperature, light weight, convenient transportation, inactivation of pathogens, etc. Lyo-P contain high concentration of GFs, fibrin, white blood cells and various cytokines. In addition to their hemostatic and coagulative functions, Lyo-P and their products are increasingly used in wound healing, tissue repair, cosmetology, reproductive medicine and other fields.

The influence of early removal of urinary catheters on urinary complications in middle-aged and elderly patients after transurethral resection of the prostate: a meta-analysis / 中华老年医学杂志

Objective:To systematically analyze the influence of early removal of urinary catheters on urinary complications in middle-aged and elderly patients after transurethral resection of the prostate.Methods:Randomized controlled trials or clinical controlled trials on early removal of urinary catheters in patients after transurethral resection of the prostate were retrieved from PubMed, Embase, the Cochrane Library, the Web of Science, CNKI, Wanfang Data, VIP database and CBM.RevMan 5.3 was used to analyzed the data.Results:Nine randomized controlled trials and one controlled clinical trial involving a total of 1529 patients were included.The results of meta-analysis showed that there was a significant difference between catheter removal within three days after surgery and removal 4-7days after surgery in the incidence of urinary tract infections[ OR=0.34, 95% CI(0.20-0.58), P<0.01], but there was no significant difference in secondary hemorrhage[ OR=0.86, 95% CI(0.44-1.66), P>0.05].There was no significant difference in the incidence of re-catheterization or secondary hemorrhage between ≤24 hours and 2-3 days after surgery[ OR=1.32, 95% CI(0.57-3.06), P>0.05; OR=3.18, 95% CI(0.32-31.56), P>0.05]. Conclusions:Early postoperative catheter removal(within 3 days)has a clear advantage in reducing the incidence of urinary tract infections, and urinary catheter removal within 24 hours does not increase the incidence of re-catheterization or secondary hemorrhage compared with removal after 24 hours.

Reliability and validity of the 10-item resilience sale in Chinese community-dwelling adults / 中华行为医学与脑科学杂志

Objective:To explore the reliability and validity of the 10-item Connor-Davidson resilience scale (CD-RISC-10) in Chinese community-dwelling adults.Methods:Using multistage stratified sampling, totally 2 051 community-dwelling adults were selected and they were investigated by the 10-item Connor-Davidson resilience scale, the center for epidemiological studies depression scale (CES-D) and 10-item Kessler psychological distress scale (K10). The exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to evaluate the CD-RISC-10 by SPSS 22.0 and AMOS 22.0.A parallel analysis and Velicer's minimum average partial (MAP) test were also supplemented to confirm the EFA-derived structure of the scale.Results:The Cronbach α coefficient of the CD-RISC-10 was 0.94, and the Spearman-Brown reliability was 0.89.The total correlation of the questions ranged from 0.74 to 0.81 (all P<0.01). The exploratory factor analysis retained its single dimension, which can explain 63.24% of the total variance.Confirmatory factor analysis revealed the single factor model fit data adequately ( χ2/ df=4.596, CFI=0.967, TLI=0.973, RMSEA=0.065). The resilience(27.02±13.50) was negatively correlated with depression(9.75±5.24) and psychological distress (19.23±6.37)( r=-0.32, -0.35, both P<0.01). Conclusion:The CD-RISC-10 scale has acceptable reliability and validity, with using easily and conveniently.Therefore, it is an effective tool for measuring the resilience of the community-dwelling adults.

Diagnosis of a child with mitochondrial myopathy and cerebellar atrophy with ataxia due to compound heterozygous variants of MSTO1 gene / 中华医学遗传学杂志

OBJECTIVE@#To explore the genetic basis for a child with myopathy and cerebellar atrophy with ataxia.@*METHODS@#Clinical examinations and laboratory testing were carried out for the patient. The proband and the parents' genomic DNA was extracted from peripheral blood samples and subjected to trio whole-exome sequencing. Candidate variant was validated by Sanger sequencing.@*RESULTS@#The 1-year-and-8-month-old boy manifested motor developmental delay, ataxia, hypomyotonia, increased serum creatine kinase. Cranial MRI showed cerebellar atrophy with progressive aggravation. Genetic testing revealed that the patient has harbored compound heterozygous variants of the MSTO1 gene, namely c.13delG (p.Ala5ProfsTer68) and c.971C>T (p.Thr324Ile), which were respectively inherited from his mother and father. The former was unreported previously and was predicted to be likely pathogenic, whilst the latter has been reported previously and was predicted to be of uncertain significance.@*CONCLUSION@#The compound heterozygous c.13delG (p.Ala5ProfsTer68) and c.971C>T (p.Thr324Ile) variants probably underlay the disease in the proband. Above finding has enriched the spectrum of MSTO1 gene variants underlying mitochondrial myopathy and cerebellar atrophy with ataxia.

Effect of trehalose on platelets stored at 4℃ in vitro / 中国输血杂志

【Objective】 To investigate the effect of trehalose added to M-Sol on platelet preservation at 4℃ in vitro. 【Methods】 Seven bags of ABO homotype concentrated platelets were randomly selected and divided into 7 groups according to storage temperature, preservation medium and trehalose concentration: 22℃+ PRP group, PRP group, M-Sol+ PRP group, M-Sol+ PRP+ 1 g/L trehalose group, M-Sol+ PRP+ 5 g/L trehalose group, M-Sol+ PRP+ 15 g/L trehalose group and M-Sol+ PRP+ 25 g/L trehalose group. PRP group and M-Sol preservation groups were stored at 4℃. Plt, PDW, MPV, maximum aggregation, CD62p positive rate, GLU and LAC concentration were detected on the 1st, 3rd, 5th and 7th day after preservation, and the changes of GLU and LAC concentration within 7 days were calculated. 【Results】 With the extension of preservation time, Plt decreased in all groups, and there was no significant difference among groups at the same time (P>0.05). PDW and MPV increased in all groups. When preserved to the 7th day, the PDW 10.22±0.43(fL) and MPV 8.74±0.40(fL) of M-Sol+ PRP+ 5 g/L trehalose group were the lowest, which was significantly different from that of 22℃+ PRP group (P0.05). During the preservation period, the maximum aggregation degree of each group decreased gradually. Except for the PRP group, the maximum aggregation degree of the M-Sol+ PRP+ 5g/L trehalose group was the highest(27.29±6.62), which was significantly higher than that of the 22℃+ PRP group on the 7th day after preservation (P<0.05). On the 7th day after preservation, the positive rate of CD62p in M-Sol+ PRP+ 5g/L trehalose group was the lowest(15.46±2.46), and there was significantly different compared with other groups (P<0.05). 【Conclusion】 Adding appropriate concentration of trehalose to M-Sol can inhibit platelet activation at 4℃ and reduce platelet storage lesion.

Progress in clinical researches of platelet-rich plasma in the treatment of chronic refractory wounds / 中国输血杂志

Cutaneous chronic wounds are a major global health burden in continuous growth due to population aging and the higher incidence of chronic diseases, such as diabetes. In the process of spontaneous wound healing, growth factors play a vital role. Thanks to the high content of growth factors in platelet rich plasma(PRP), more and more PRP has been used to treat chronic refractory wounds, including diabetic ulcer, pressure ulcer, venous ulcer, and burns, etc., and has achieved significant results. Given the short duration of local growth factor release in the wound when PRP is applied alone, some studies have combined PRP with different tissue biology materials, such as hyaluronic acid, chitosan, and chitosan derivatives, to achieve better therapeutic results. In this paper, the preparation method of PRP, the mechanism of growth factors, the effect of PRP on wound repair, the combined application of PRP with repair materials and the advantages and disadvantages of PRP are reviewed.

The value of MAGiC short T 1 inversion recovery sequence in the detection of bone marrow edema in sacroiliitis / 中华放射学杂志

Objective:To evaluate the value of MAGiC STIR sequence inassessing bone marrow edema (BME) of the sacroiliac joint (SIJ) in ankylosing spondylitis (AS) patients.Methods:Twenty two AS patients from the Affiliated Fifth Hospital of Sun Yat-sen University from September 2019 to January 2020 underwent MR scanning, consisting of T 2WI fat-suppressed (FS) sequence and MAGiC sequence. Each SIJ was divided into four quadrants for analysis on oblique coronal MR image. Two radiologists [middle-higher seniority levels (radiologist 1 and radiologist 2) reviewed image sets of two sequences [T 2WI FS and MAGiC short T 1 inversion recovery (STIR) sequence] independently at separate times, using Hermann-Braun scoring system for degree of BME and summing numbers of quadrants based on BME findings. Disagreements were resolved to reach an agreement for final results.Assessments were repeated two weeks later by radiologist 2. Intra-class correlation coefficients (ICC) were calculated to assess the inter-and intra-observer agreement for the degree of BME and numbers of positive BME quadrants in the MAGiC STIR sequence, respectively. The differences between the two sequences for the degree of BME and numbers of positive BME quadrants were analyzed with Wilcoxon signed-rank test and Chi-square test, respectively. Taking the results of T 2WI FS sequence as a reference standard, the ROC curve was drawn, sensitivity, specificity, positive predictive value and negative predictive value in the detection of BME were calculated for the MAGiC STIR sequence. Results:Nineteen AS patients including 38 sacroiliac joints were enrolled in our study, being divided into 152 quadrants. Inter-and intra-observer agreement for the degree of BME and inter-observer agreement for numbers of positive BME quadrants in the MAGiC STIR sequence were all good (ICC=0.936, 95%CI 0.912-0.953, P<0.001; ICC=0.910, 95%CI 0.878-0.934, P<0.001; ICC=0.876, 95%CI 0.833-0.909, P<0.001). The difference between the two sequences for the degree of BME in quadrants was statistically significant ( Z=-3.132, P=0.002). But there was no statistically significant difference between sequences for numbers of quadrants in detecting BME (χ2=0.244, P=0.622). Area under the ROC curve of MAGiC STIR sequence in diagnosis of BME was 0.920 ( P<0.001). Sensitivity, specificity, positive predictive value and negative predictive value for the MAGiC STIR sequence in the detection of BME were 82.0%, 95.1%, 89.1% and 91.5%, respectively. Conclusion:MAGiC STIR sequence can be used to evaluate bone marrow edema of SIJ in AS patients with high sensitivity and specificity.

Cyanoacrylate adhesive for securing vascular access device / 中国实用护理杂志

Cyanoacrylate adhesive (CA) is a common clinical medical adhesive. In recent years, CA has been used as a securement device for vascular access devices. This paper reviews the development and properties of CA, the effect of CA on catheter failure rate, skin damages, the number and interval time of dressing change, the satisfaction of nurses and patients as well as economic benefits, which provides references for the clinical practice and scientific research.

Screening of ARVC desmosomal protein gene mutation in people from Yunnan unexplained sudden death area in Xiangyun County, Dali Prefecture, Yunnan Province / 中华地方病学杂志

Objective:To investigate the mutation of desmosomal protein gene of arrhythmogenic right ventricular cardiomyopathy (ARVC) in people from Yunnan unexplained sudden death (YUSD) area in Xiangyun County, Dali Prefecture, Yunnan Province, and to explore the etiological relationship between the mutation of ARVC desmosomal protein gene and YUSD.Methods:The autopsy cardiac blood sample of YUSD case ( n = 1) and the peripheral venous blood samples of the same time case ( n = 1) and relatives of YUSD case ( n = 16) were collected in Xiangyun County. Blood DNA was extracted for PCR amplification and sequencing of a total of 97 exons of the ARVC desmosomal protein genes [plakophilin 2 (PKP2), junction plakoglobin (JUP), desmoplakin (DSP), desmoglein 2 (DSG2) and desmocollin 2 (DSC2)] were conducted by Sanger method. At the same time, basic information and genetic family of YUSD case, the same time case and relatives of YUSD case were investigated, and gene mutations were comprehensively analyzed. Results:The YUSD case and the same time case carried JUP, DSP and DSG2 gene mutations. Among the relatives of YUSD case, 2, 14, 16, 15 and 4 cases had mutations in PKP2, JUP, DSP, DSG2 and DSC2 genes, respectively. The YUSD case, the same time case and the relatives of YUSD case carried 6 identical mutation sites: JUP gene exon 3 c.213 T>C synonymous mutation, exon 14 c.2089 A>T missense mutation; DSP gene exon 19 c.2631 G>A synonymous mutation, exon 24 c.8472 G>C synonymous mutation; DSG2 gene exon 8 c.861 C>T synonymous mutation, and exon 15 c.3321 T>C synonymous mutation.Conclusion:In Xiangyun County, six identical mutation sites (JUP gene c.213 T>C and c.2089 A>T, DSP gene c.2631 G>A and c.8472 G>C, DSG2 gene c.861 C>T and c.3321 T>C) carried by YUSD case, the same time case and the relatives of YUSD case may be related to the incidence of some YUSD cases.

Application of virtual reality technology combined with "flipped classroom" in stomatology practice teaching / 中华医学教育探索杂志

In view of the shortcomings of traditional oral practice course for clinical medicine undergraduate, such as less teaching time, more content, intensive students, special location of oral disease lesions, narrow observation range, teaching mainly by teacher lectures and less opportunities for students to operate, etc., based on the principles of oral medicine and the training goal of clinical medicine, a new teaching model of virtual reality technology (VR) combined with flipped classroom, the traditional teaching method and examination method of dental practice course for clinical medicine undergraduates have been reformed. The teaching mode after the reform has improved the students' interest in learning and the teaching quality of the oral practice course. In order to meet the essential requirements of "centered" clinical medical education, it provides an effective reference for training compound medical talents with stronger practical and operational ability.

Advances in applicaiton of platelets with cold storage at 4℃ and its storage lesion / 中国输血杂志

Platelet transfusion is one of the important therapeutic methods for clinical prevention of bleeding and hemostasis. At present, agitated storage at (22±2)℃used for platelets leads to risk of bacterial growth, which limits platelet shelf life and safety in transfusion. Cold storage at 4 ℃ can significantly promote the abovementioned drawbacks and present a better hemostatic effect. Platelets storage lesion(PSL) due to the cold storage, however, may lead to platelet activation following transfusion, thus reducing the effective survival rate in vivo. This paper reviews the research advances in PSL and the application of platelets stored at 4 ℃.

Analysis of magnetic resonance myelography in spontaneous intracranial hypotension / 中华神经科杂志

Objective:To investigate the characteristics of magnetic resonance myelography (MRM) and its application in the treatment of spontaneous intracranial hypotension (SIH).Methods:The clinical data, MRM characteristics, and treatment of 15 patients with SIH who underwent MRM examination in the First Affiliated Hospital of Zhengzhou University from August 2014 to August 2019 were retrospectively analyzed. According to treatment methods, nine patients were divided into conservative treatment group and six patients were divided into combined epidural blood patch treatment group. The gender, age, time interval from onset to MRM examination, cerebrospinal fluid pressure and MRM characteristics between the two groups were compared. SPSS 20.0 software was used for statistical description, and independent sample t-test was applied to compare the differences between groups. Results:All of the 15 cases reported orthostatic headache. Their cerebrospinal fluid pressure was (29.67±19.77, range 0-55) mmH 2O (1 mmH 2O=0.009 8 kPa), and onset-MRM interval was (33.07±24.22, range 7-90) days. The MRM characteristics were observed, including all 15 cases with periradicular leaks, four cases with anterior epidural fluid collections, six cases with posterior epidural fluid collections, and eight cases with high cervical (C 1-2 to C 2-3) retrospinal cerebrospinal fluid collections. There were 2 to 32 leak sites with an average of (10.20±7.87) sites. Among the 153 leak sites, 58(37.9%) sites were located at cervical vertebra, 77(50.3%) sites at thoracic vertebra, 18(11.8%) sites at lumbar vertebra, and 61(39.9%) sites at either the cervicothoracic junction (C 7-T 1 to T 1-2) or the upper thoracic region (T 2-3to T 6-7). Five patients responded well to one-time targeted autologous epidural blood patch on the basis of the location of the cerebrospinal fluid leakage. Besides, one patient improved with targeted epidural blood patch twice. There were no statistically significant differences in gender, age, onset-MRM interval, cerebrospinal fluid pressure, number and location of leak sites between the conservative treatment group and combined treatment group. Conclusions:The periradicular leaks of cerebrospinal fluid at cervical vertebra and thoracic vertebra are the most common feature of MRM in patients with SIH. MRM can identify the existence and location of cerebrospinal fluid leakage, assist in the diagnosis of SIH, and guide targeted epidural blood patch.

Application influence of Maslow's theory of hierarchy of demands on the psychological and therapeutic compliance of patients with psychosis / 中国实用护理杂志

Objective@#To explore the application influence of Maslow's theory of hierarchy of demands on the psychological and therapeutic compliance of patients with psychosis.@*Methods@#Totally 100 patients with mental disorders who met the requirements of this study were selected from January 2016 to December 2016 in 984 Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army. They were randomly divided into 2 groups according to the number table method, 50 cases in each group. The control group adopted the routine nursing mode, while the experimental group followed the intervention mode guided by Maslow's hierarchy of needs theory, and implemented the corresponding nursing and health education. Concise Psychiatric Rating Scale (BPRS) was used to assess the severity of psychiatric symptoms, Self-knowledge and Treatment Attitude Questionnaire (ITAQ) was used to assess patients' compliance with treatment, and Quality of Life Scale (SQLS) was used to assess patients' quality of life.@*Results@#After intervention, the symptoms of anxiety, depression, lack of vitality, thinking disorder, activation, hostile suspicion score, and BPRS scores of the control group were (5.84±3.51), (6.24±3.05), (6.49±2.35), (3.72±1.42), (4.34±1.81), (26.14±6.21) points. After the intervention of the study group, they were (3.78±2.07), (4.11±2.28), (5.15±2.36), (3.02±1.23), (3.58±1.07), (23.08±5.95) points. The differences between the two groups were statistically significant (t=2.516-2.845, P<0.05 or 0.01). After the ITAQ score intervention, the control group and the study group were (10.85±3.41) and (12.34±3.89) points. The difference between the two groups was statistically significant (t=-2.037, P<0.05). After the intervention, the quality of life of the control group was compared with psychosocial, motivation/energy, symptom/adverse reaction score, and total score of SQLS (25.34±7.16), (18.69±9.09), (10.54±1.31), (24.00±10.31) points. The study group were (19.06±4.26), (14.75±8.89), (9.56±1.06), (19.36±9.11) points, and the differences between the two groups were statistically significant (t=2.191-5.330, P<0.05).@*Conclusion@#Maslow's hierarchy of needs theory can significantly improve mental symptoms, improve treatment compliance and quality of life in psychiatric patients, and is worthy of clinical application.

Biomarkers for assessing motor dysfunction after stroke / 中华物理医学与康复杂志

Objective@#To investigate whether diffusion tensor imaging (DTI) and motor evoked potentials (MEP) can be used as biomarkers to assess the degree of motor dysfunction of stroke survivors.@*Methods@#Sixty partially-paralyzed stroke survivors were given Fugl-Meyer assessments (FMAs) and MEP tests and assessed using DTI seeking any correlations among the results. The receiver operating characteristics curves (ROCs) were prepared to determine the tests′ efficacy in assessing severe motor dysfunction.@*Results@#① Asymmetry in the fractional anisotropy (aFA) of the peduncles cerebra as measured by DTI was negatively correlated with the FMA scores of the upper and lower limbs on the affected side. The aFA values of the posterior limb of the internal capsule (PLIC) were negatively correlated with the FMA scores of the affected upper limb, but not with the FMA scores of the affected lower limbs. The abnormalities in central motor conduction time and motor threshold, which are MEP parameters, were negatively correlated with the FMA scores of the affected limbs. ② The ROCs showed that the aFA value of the PLIC was the best indicator for assessing severe upper limb motor dysfunction, with a cut-off value of 0.167 giving the best discrimination. MEP waveform loss could also be used. It has high sensitivity but low specificity. ③ A combination of DTI and MEP can improve specificity in assessing severe motor dysfunction in the upper limbs.@*Conclusion@#DTI and MEP can both be used to evaluate motor dysfunction in stroke survivors. They have high clinical value for assessing severe motor dysfunction of the upper limbs.

Biomarkers for assessing motor dysfunction after stroke / 中华物理医学与康复杂志

Objective To investigate whether diffusion tensor imaging ( DTI) and motor evoked potentials (MEP) can be used as biomarkers to assess the degree of motor dysfunction of stroke survivors. Methods Sixty partially-paralyzed stroke survivors were given Fugl-Meyer assessments ( FMAs) and MEP tests and assessed using DTI seeking any correlations among the results. The receiver operating characteristics curves ( ROCs) were prepared to determine the tests' efficacy in assessing severe motor dysfunction. Results ① Asymmetry in the fractional ani-sotropy ( aFA) of the peduncles cerebra as measured by DTI was negatively correlated with the FMA scores of the up-per and lower limbs on the affected side. The aFA values of the posterior limb of the internal capsule ( PLIC) were negatively correlated with the FMA scores of the affected upper limb, but not with the FMA scores of the affected low-er limbs. The abnormalities in central motor conduction time and motor threshold, which are MEP parameters, were negatively correlated with the FMA scores of the affected limbs. ②The ROCs showed that the aFA value of the PLIC was the best indicator for assessing severe upper limb motor dysfunction, with a cut-off value of 0.167 giving the best discrimination. MEP waveform loss could also be used. It has high sensitivity but low specificity. ③A combination of DTI and MEP can improve specificity in assessing severe motor dysfunction in the upper limbs. Conclusion DTI and MEP can both be used to evaluate motor dysfunction in stroke survivors. They have high clinical value for assess-ing severe motor dysfunction of the upper limbs.

Effects of urate-lowering therapy on inflammatory responses, gout flares occurances, and the achieved target rate of serum uric acid in acute gout / 中华内分泌代谢杂志

Objective To observe the effects of urate-lowering therapy ( ULT) on indexes of inflammation, the frequency of gout flares, compliance of ULT, and the achieved rates of serum uric acid in patients at acute stage. Methods 151 patients with acute gout flares were randomly divided into observation group ( 60 cases with ULT in the acute phase) and control group (91 cases with ULT after 2 weeks of complete remission from acute flares). Visual analogue pain scores (VAS), joint swelling scores, white blood cell counts, erythrocyte sedimentation rates (ESR), as well as high sensitive-C reactive protein (hs-CRP) were measured respectively and compared between two groups. The observation group was treated with 40 mg/d of febuxostat for 12 weeks after effectively achieved inflammation ( VAS<3 points) , while the control group was treated with the same therapy after 2 weeks of symptoms complete remission from acute gout flares. Finally, these indexes were followed and recorded, including the number of gout flares, the compliance of ULT, the changes of liver and kidney function, and the proportion of patients with serum uric acid<360μmol/L. Results There was no statistical difference in the baseline condition, VAS pain scores, joint swelling scores, white blood cell counts, ESR, and hs-CRP between two groups after different ULTs ( all P>0.05) . There was no statistical difference in the frequency of gout flares between two groups during the ULT of 12 weeks ( P=0.658) . At the end of 12 weeks, the serum uric acid in the observation group was significantly lower compared with the control group [(318.38±95.16 vs 398.12±120.13)μmol/L,P<0.01]. The compliance rate of ULT and the rate of reaching the standard of serum uric acid<360μmol/L in the observation group were higher than those in the control group ( both P<0.01) . Conclusion The treatment of ULT with patients after effective achieved of acute gout inflammation has no detrimental effects on VAS pain, joint swelling score, the conversion of inflammation index, and the number of gout flares, while improving the compliance of ULT and the achieved rate of serum uric acid.

The clinical significance of serum 25-hydroxy vitamin D and vitamin D binding protein in premature infants with bronchopulmonary dysplasia / 中国新生儿科杂志

Objective To study the relationship of serum 25-hydroxy vitamin D [25-(OH) D] and vitamin D binding protein (DBP) in premature infants with bronchopulmonary dysplasia (BPD) and their clinical significance.Method From March 2017 to September 2018,the premature infants with gestational age (GA)＜32 weeks admitted to the neonatal department of our hospital were prospectively studied.All the premature infants were given 800 IU/d vitamin D supplement from one week after birth.Venous blood sample were collected at birth and 28 d after birth to measure 25-(OH) D aud DBP levels.The infants were evaluated for BPD at 28 d after birth and then assigned into the BPD group and the non-BPD group.The differences of 25-(OH) D and DBP levels were compared.Result A total of 170 premature infants (GA＜32 weeks) were included,including 56 cases in the BPD group and 114 cases in the non-BPD group.The BPD group had 34 males,the GA was (29.8±1.2) weeks,the birth weight (BW) was (1 198± 157) g.The non-BPD group had 95 males,the GA was (30.2± 1.5) weeks,the BW was (1 243± 146) g.No significant differences existed in GA,BW and male gender proportion between BPD group and non-BPD group (P＞0.05).The BPD group had a lower levels of serum 25-(OH) D at birth [(27.8±5.9) nmol/L vs.(30.4±1.1) nmol/L,P＜0.05].The levels of serum 25-(OH) D in moderate/severe BPD group were significantly lower than mild BPD group [(25.3±4.9) nmol/L vs.(29.7±5.9) nmol/L,P＜0.05];25-(OH) D in BPD group was still lower than the non-BPD group at 28 days after birth (after vitamin D supplement) [(77.5±11.7) nmol/L vs.(83.8±11.6) nmol/L,P＜0.05].Comparison of serum DBP levels between the two groups showed that,DBP at 28 d after birth in BPD group were significantly lower than the non-BPD group,and DBP in moderate/severe BPD group were significantly lower than the mild BPD group [(373.9± 19.1) μg/ml vs.(391.4±23.6) μg/ml],the differences were both statistically significant (P＜0.05).Multivariate analysis showed that the high serum 25-(OH)D level at birth (OR=0.827,95％CI0.693～0.987) was protective factors for BPD,while neonatal pneumonia (OR=4.331,95％CI 1.269～14.784) and neonatal sepsis (OR=4.020,95％CI 1.153～14.015) were risk factors for BPD.Conclusion The high serum 25-(OH) D level at birth in preterm infants was protective factors for BPD,while neonatal pneumonia and sepsis were the risk factors for BPD.Moreover,low serum 25-(OH) D level at birth and low serum DBP level at 28 d after birth maybe useful indicators for the severity of BPD.