Effectiveness and Safety of Edaravone Combined with Oxiracetam in the Treatment of Acute Cerebral Infarction:A Meta-analysis / 医学研究杂志

Objective To evaluate the effectiveness and safety of edaravone combined with oxiracetam in the treatment of acute cere-bral infarction.Methods PubMed,Embase,Cochrane Library,CNKI,Wanfang Data and other databases were comprehensively searched from database inception until October 27,2022,to collect randomized controlled trials of edaravone combined with oxiracetam in the treatment of acute cerebral infarction(ACI).RevMan5.4software was used to analyze the collected data.Results A total of9studies involving 887 patients were included.Meta-analysis results showed that the overall effective rate and Barthel index in the observation group were significantly higher than those in the control group(OR=4.66,95％CI:2.74-7.93,P＜0.001;MD=14.57,95％CI:8.58-20.56,P＜0.001),the NIHSS scores in the observation group were significantly lower than that in the control group(MD=-5.28,95％CI:-6.42--4.13,P＜0.001).There was no significant difference in adverse effect rate between the two groups(RR=1.11,95％CI:0.63-1.95,P=0.72).Conclusion The combination of edaravone and oxiracetam in the treatment of ACI can significantly reduce NIHSS scores,and improve Barthel index and overall effective rate.The efficacy is better than edaravone alone,and a more comprehensive evaluation of safety is needed in the future.

Iodine nutrition status of children in Henan Province after four years of implementation of the standard of "Definition and demarcation of water-borne iodine-excess areas and iodine-excess endemial areas" (GB/T 19380-2016) / 中华地方病学杂志

Objective:To investigate the iodine nutritional status of children and the consumption condition of non-iodized salt in Henan Province after implementation of the new standard of "Definition and demarcation of water-borne iodine-excess areas and iodine-excess endemial areas" (GB/T 19380-2016, hereinafter referred to as new standard) for four years (2021), and to provide a basis for scientific adjustment of intervention strategies.Methods:In 2021, according to the requirements of the new standard and based on the results of the water iodine survey in Henan Province from 2017 to 2020, a survey was conducted on the iodine nutrition status of children in water-borne high iodine areas in 47 counties (cities, districts, hereinafter referred to as counties) with high iodine administrative village (neighborhood committee, hereinafter referred to as administrative village). In each county, 5 administrative villages with median water iodine > 100 μg/L were selected as the investigation villages, and water samples were collected to determine the water iodine value. Forty non-boarding students aged 8 - 10 (age balanced, half male and half female, age increased to 6 - 12 when less than 40) were selected from each village as investigation subjects. Salt samples from their homes and urine samples were collected to detect salt iodine and urine iodine content, and thyroid volume of children was measured. And the monitoring results of areas where the supply of iodized salt had been suspended for less than 4 years (in newly high iodine areas) and more than 10 years (in previously high iodine areas) were further compared and analyzed.Results:A total of 257 administrative villages in the province were monitored, and the range of water iodine was 1.6 - 609.5 μg/L, with a median of 132.5 μg/L. A total of 8 611 children were tested for salt iodine, urine iodine and thyroid volume. The non-iodized salt rate was 58.3% (5 017/8 611), and the median urine iodine was 342.2 μg/L, thyroid enlargement rate was 2.9% (250/8 611). The median water iodine (153.0 vs 118.4 μg/L), the median urine iodine in children (371.6 vs 287.7 μg/L) and the goiter rate [3.8% (211/5 537) vs 1.3% (39/3 074)] in the newly high iodine areas were higher than those in the previously high iodine areas, and the differences were statistically significant ( Z = 583.12, - 14.09, P < 0.001; χ 2 = 44.40, P < 0.001); the non-iodized salt rate was lower than that of the previously high iodine areas [37.2% (2 057/5 537) vs 96.3% (2 960/3 074)], and the difference was statistically significant (χ 2 = 2 841.37, P < 0.001). Conclusions:The iodine nutrition level of children in water-borne high iodine areas of Henan Province in 2021 is at an excess level, but the non-iodized salt rate in residential households is low. We should make every effort to ensure the precise supply of non-iodized salt in high iodine areas after implementation of the new standard, and strengthen iodine nutrition monitoring and health education for key populations to prevent the occurrence of high iodine hazards.

Risk factors of apathy and correlations with cognitive function in patients with hypertension combined with cerebral small vessel disease / 中国介入影像与治疗学

Objective To explore the risk factors of apathy and correlations with cognitive function in patients with hypertension combined with cerebral small vessel disease(CSVD).Methods Totally 141 patients with hypertension combined with CSVD were prospectively enrolled and were divided into apathy group(n=43)and non-apathy group(n= 98)according to neuropsychiatric inventory-apathy scale(NPI-Apathy)scores.The general data,imaging marker scores and total imaging burden scores were compared between groups.In hypertension combined with CSVD patients,multivariate logistic regression analysis was performed to screen the independent risk factors of apathy,and Spearman correlation analysis was also performed to observe the correlation of apathy and cognitive function.Results The patients'age,high density lipoprotein cholesterol(HDL-C),Fazekas scores of lateral periventricular white matter hyper-intensity(WMH),cerebral microbleed of depth/infratentorial and total imaging burden scores of apathy group were all higher,while mini-mental state examination(MMSE)and Montreal cognitive assessment(MoCA)scores were both lower than those of non-apathy group(all P＜0.05).HDL-C and Fazekas scores of lateral periventricular WMH were both independent risk factors for apathy(both P＜0.05),while NPI-Apathy scores were moderately negatively correlated with cognitive function in patients with hypertension combined with CSVD(r=-0.543,-0.484,both P＜0.001).Conclusion HDL-C and Fazekas scores of lateral periventricular WMH were both independent risk factors for apathy in patients with hypertension combined with CSVD.The more severe the apathy,the lower the cognitive function.

Ultrasound for assisting acupuncture therapy / 中国介入影像与治疗学

Acupuncture therapy needs to cause enough somatosensory stimulation to achieve therapeutic effect.How to identify the site and depth before acupuncture,assess therapeutic effect after acupuncture and ensure the safety of treatment are the points for clinical application of acupuncture therapy,but no standard objective and quantitative access has been achieved.Under assistance of ultrasound,precise positioning before acupuncture,visualization of anatomical structures and quantification of the depth during acupuncture became feasible.The research progresses of ultrasound for assisting acupuncture therapy were reviewed in this article.

Functional study on elastase regulation of inflammatory neutrophils recruitment / 中国免疫学杂志

Objective:To explore the effect of neutrophil elastase(NE)on neutrophil inflammatory recruitment.Methods:Mice bone marrow-derived neutrophils were pretreated with an exogenous elastase inhibitor-sivelestat sodium.The effects of elastase inhibition on the in vivo inflammatory recruitment,chemotaxis,adhesion,cell polarization and spreading of NE were examined by peritonitis adoptive transfer assay,dunn chamber,flow chamber,immunofluorescence staining and spreading assay,respectively.The effects of elastase inhibition on NE phagocytosis and reactive oxygen species(ROS)release capacity were detected by flow cytom-etry and the luminol chemiluminescence system.Results:Sivelestat sodium pretreatment significantly attenuated neutrophil in vivo in-flammatory recruitment(P<0.001);impaired neutrophil perception of chemotaxis in vitro(P<0.05),slowed chemotactic velocity(P<0.05),and decreased the chemotactic distance(P<0.05);reduced the adhesion of neutrophils to inflamed endothelial cells(P<0.000 1)and inhibited the phagocytosis of bacteria by neutrophils(P<0.01);however,there was no significant effect on neutrophil spreading,polarization and ROS.Conclusion:NE inhibition significantly impaired the inflammatory recruitment cascade response and phagocyto-sis of neutrophils in vitro and in vivo but had no significant effect on the spreading,polarization and ROS release of neutrophils.

Predictive value of quantitative EEG parameters on prognosis of patients with severe aneurysmal subarachnoid hemorrhage / 中国脑血管病杂志

Objective To explore the feasibility of quantitative EEG parameters for prognostic prediction of patients with severe aneurysmal subarachnoid hemorrhage(SaSAH)90 d after the onset of the disease.Methods Patients with SaSAH admitted to the Neurosurgical Intensive Care Unit(NSICU)of Henan Provincial People's Hospital from September 2022 to September 2023 were prospectively consecutively enrolled,and baseline data were collected,including age,gender,medical history(hypertension,diabetes mellitus,coronary artery disease,and stroke),history of smoking,history of drinking,location of aneurysm(anterior circulation,posterior circulation),surgical modality(craniotomy,interventional surgery,hybrid surgery),Hunt-Hess classification,Glasgow coma scale(GCS)score,acute physiology and chronic health status scoring system Ⅱ(APACHE Ⅱ)score,subarachnoid hemorrhage early brain edema score(SEBES),first randomized blood glucose level after admission to NSICU,lactate level,and duration of NSICU stay.Quantitative EEG monitoring was performed in all patients within 48 h after admission to the NSICU,and amplitude-integrated electroencephalogram(aEEG)upper and lower boundaries,95％spectral edge frequency(SEF95),α change,(δ+θ)to(α+β)power ratio(DTABR),brain symmetry index(BSI),and spectral entropy were collected.Based on modified Rankin scale(mRS)scores 90 d after onset,patients were categorized into good prognosis(mRS score 2 points)and poor prognosis(mRS score 3-6 points)groups.Spearman rank correlation was used to analyze the correlation between quantitative EEG parameters and mRS scores in SaSAH patients.Multifactorial Logistic regression analysis was used to screen for correlates of poor prognosis,and receiver operating characteristic(ROC)curves were plotted to evaluate the efficacy of each index in predicting patients'poor prognosis.Results(1)A total of 72 patients with SaSAH were included,with 47 in the poor prognosis group and 25 in the good prognosis group,and the poor prognosis rate at 90 d after the onset was 65.3％.There was no statistically significant difference between the two groups in terms of gender,age,hypertension,diabetes mellitus,coronary artery disease,history of stroke,history of smoking,history of drinking,location of aneurysm,surgical modality,lactate level,and length of hospitalization in the NSICU(all P＞0.05);the differences between the Hunt-Hess grading,SEBES,and random blood glucose were statistically significant upon comparison(all P＜0.05).Compared with the good prognosis group,the changes of aEEG upper and lower boundary,SEF95,α change and spectral entropy were lower in the poor prognosis group,but DTABR and BSI were higher(all P＜0.05).(2)Spearman rank correlation analysis showed that the upper border of aEEG(r=-0.41,P＜0.01),lower border of aEEG(r=-0.54,P＜0.01),SEF95(r=-0.46,P＜0.01),α change(r=-0.53,P＜0.01)and spectral entropy(r=-0.39,P＜0.01)were negatively correlated with the mRS scores of SaSAH patients,and DTABR(r=0.52,P＜0.01)and BSI(r=0.33,P＜0.01)were positively correlated with poor prognosis of SaSAH patients.(3)The results of multifactorial Logistic regression analysis showed that Hunt-Hess grading(level Ⅳ vs.Ⅲ:OR,1.203,95％CI 1.005-1.441,P=0.044;level V vs.Ⅲ:OR,1.661,95％CI 1.109-2.487,P=0.014),SEBES(OR,1.647,95％CI 1.050-2.586;P=0.030),aEEG lower border(OR,0.687,95％CI 0.496-0.953l;P=0.024),SEF95(OR,0.436,95％CI0.202-0.937;P=0.034),α change(OR,0.368,95％CI0.189-0.717;P=0.003),DTABR(OR,1.324,95％CI 1.064-1.649;P=0.012),and BSI(OR,1.513,95％CI 1.026-2.231;P=0.036)were influencing factors of poor prognosis in SaSAH patients.ROC curve analysis showed that all of the above seven indicators had a certain predictive value for poor prognosis in SaSAH patients,among which the area under the curve of DTABR was the highest as 0.862(95％CI 0.761-0.932),with sensitivity 85.11％and specificity 80.00％.Conclusion Quantitative EEG parameters aEEG lower border,SEF95,α change,DTABR,and BSI may have certain predictive value for the short-term prognosis of SaSAH patients,which needs to be further confirmed in future multi-center large-sample studies.

Mechanism of icariin regulating the NLRP3 inflammasome against cerebral ischemia reperfusion / 中国实验动物学报

Objective To investigate the mechanism of icariin regulating the NLRP3 inflammasome in the treatment of cerebral ischemia-reperfusion injury in rats.Methods A rat model of focal cerebral ischemia-reperfusion was induced using the thread embolism method.At 24 hours post-operation,the rats were randomly allocated into a sham operation group,model group,butylphthalide group(70 mg/kg),ICA-low dose(20 mg/kg),ICA-middle dose(40 mg/kg),and ICA-high dose(80 mg/kg)groups.The corresponding drugs were administered by gavage at 10 mL/kg once a day for 13 consecutive days.One hour after the last administration,neurological function was scored.The cerebral cortex was observed by hematoxylin-eosin(HE)staining.Expression of interleukin(IL)-1β and IL-18 in the cerebral cortex was determined by immunohistochemistry.Expression of NLRP3,ASC,and Caspase-1 in the cerebral cortex was determined by Western Blot.Results In contrast to the sham operation group,there was a notable increase in neural function scores within the model group.The ischemic area around the visible cerebral cortex showed neuron necrosis at various level or glial cell proliferation,and the number of intact neurons was significantly reduced.IL-1β and IL-18 positive cells were significantly increased.Expression of NLRP3,ASC,and Caspase-1 was significantly increased(P＜0.01,P＜0.05).After treatment with icariin,the neural function score was decreased significantly.The degree of neuronal necrosis in the peri-ischemic area was significantly reduced,and the number of intact neurons was significantly increased.IL-1 β and IL-18-positive cells were decreased significantly.Expressions of NLRP3,ASC,and Caspase-1 were significantly decreased(P＜0.01,P＜0.05).Conclusions Treatment of cerebral ischemia-reperfusion injury by icariin may be related to regulation of the NLRP3 inflammasome.

Mediating role of peer relationships and self-esteem between family functioning and mobile phone dependency in middle school students / 中国医科大学学报

Objective To explore the predictive effect of family functioning on mobile phone dependency and clarify the mediating role of peer relationships and self-esteem.Methods A stratified cluster random sampling method was used to collect data related to family functioning,self-esteem,and mobile phone dependency of 1 326 middle school students.SPSS 25.0 software was used to describe the data statistically and compare the differences among the demographic characteristics.Mplus 8.3 software was used to test the mediating effect of self-esteem on family functioning and mobile phone dependency of middle school students and the moderating effect of peer relation-ships.Results Family functioning negatively predicted the mobile phone dependency of middle school students(β=-0.291;95%CI:-0.361--0.224;P<0.001),self-esteem mediated the relationship between family functioning and mobile phone dependency(β=-0.066;95%CI:-0.096--0.044;P<0.001),and peer relationship moderated the mediating role of self-esteem between family func-tioning and mobile phone dependency(β= 0.117;95%CI:0.046-0.188;P= 0.001).Conclusion Family functioning directly affected mobile phone dependency and impacted mobile phone dependency through self-esteem.The mediating effect of self-esteem increases as peer relationships improve.

miR-125a targeting transcription factor atonal homolog 8 is involved in the progression of lung adenocarcinoma / 中国医科大学学报

Objective To investigate the effect of transcription factor atonal homolog 8(ATOH8)and miR-125a on lung cancer progres-sion and its potential upstream regulatory mechanism.Methods ATOH8 expression levels in lung adenocarcinoma and their correlation with survival rate were analyzed using the online database UALCAN.miR-125a expression levels in lung adenocarcinoma and their rela-tionship with lung cancer progression were also analyzed using the UALCAN database.Total RNA extracted from lung adenocarcinoma tumors and adjacent normal tissues was used to perform real-time PCR in order to analyze these expression levels.The effect of ATOH8 overexpression on lung adenocarcinoma cell survival was detected using CCK-8 assays.A miR-125a mimic and inhibitor were transfected into lung adenocarcinoma cells,and ATOH8 expression levels were detected by real-time PCR and Western blotting.Results Statistical analysis showed that ATOH8 was significantly down-regulated in lung adenocarcinoma tissues(P＜0.01)and ATOH8 overexpression significantly reduced the survival of lung adenocarcinoma cells(P＜0.05).Furthermore,the five-year survival rate of patients with high ATOH8 expression levels was significantly increased(P＜0.05).miR-125a can bind to the 3'untranslated regions(3'UTR)of ATOH8 and significantly inhibit its expression levels(P＜0.05).However,miR-125a was significantly up-regulated in lung adenocarcinoma patients with a history of smoking,middle and advanced stage,and lymphatic metastasis(P＜0.05).Conclusion ATOH8,as a poten-tial tumor suppressor gene,can inhibit lung adenocarcinoma cell survival and affect the five-year survival rate of patients.miR-125a expression levels were closely related to smoking history,tumor stage,and lymphatic metastasis.Overall,the inhibiting effect of miR-125a against ATOH8 is a potential reason for abnormal ATOH8 expression in lung adenocarcinoma.

Research progress of Fengweiqi from"Qiyao"in Qinling Mountains / 中国药师

Fengweiqi is the whole plant of Rhodiola dumulosa.It is a kind of natural and precious folk medicinal plant,mainly distributed on hillside rocks and crevasses at the altitude of 1 600-4 100 m.Fengweiqi mainly contains flavonoids,volatile oil,polysaccharides,various amino acids and trace elements.Modern pharmacological studies have shown that Fengweiqi has many significant pharmacological activities,such as anti-oxidation,anti-fatigue,anti-hypoxia and bacteriostasis.In this paper,the textual research,chemical constituents,pharmacological actions and artificial cultivation of Fengweiqi were reviewed in order to provide reference for further research and development of Fengweiqi resources.

Research on the improvement of CBCT image quality based on region-discriminative generative adversarial networks in radiotherapy for cervical cancer / 中国医学装备

Objective:To propose a model that could improve image quality of cone-beam computed tomography(CBCT),which based on region-discriminative generative adversarial networks(GAN),in radiotherapy for cervical cancer,so as to meet the requirements of self-adaptive radiotherapy for image quality.Methods:We employed a region-discriminative strategy and a generative adversarial networks idea to construct a model of improving CBCT image quality that could focus on local details of the images of radiotherapy for cervical cancer,which discriminator could improve the quality of generating local details of images.This model of image quality was applied to CBCT images of radiotherapy for cervical cancer.And then,the effects of processing image were evaluated through quantitative indicators and visualization.Results:Both texture clarity and contrast were significantly enhanced after CBCT image quality was improved.The signal to noise ratio of peak value of images was increased by 47.2%,and the indicator of similarity of structure was enhanced to>0.838.Compared with other model,both visualization and indicators can appear better efficiency of model.Compared with Unet network and CycleGAN network,the similarities of structure were respectively increased by 11.88% and 19.54%,and the signal to noise ratios were respectively increased by 19.75% and 25.99%.Conclusion:The GAN bases on region-discrimination can significantly improve the quality of generating integral and detailed CBCT image of radiotherapy for cervical cancer,which can provide new technical pathway for image quality of CBCT with low dose,and can play an important role for improving safety and effectiveness of radiotherapy.It has importantly clinical value for formulating and executing radiotherapy plan.

Effects of glenosphere offsets on impingement-free range of motion in reverse total shoulder arthroplasty: a standardized computer simulation study / 中华创伤骨科杂志

Objective:To compare the effects of glenosphere offset positions on the impingement-free range of motion (ROM) in reverse total shoulder arthroplasty (RTSA).Methods:Shoulder joint models were reconstructed using shoulder CT scans of 6 patients with primary osteoarthritis. RTSA was performed virtually according to standard surgical procedures, and shoulder movements were simulated. Reverse shoulder models were constructed with 2 lateral offsets (0 and 4 mm) and 6 positional offsets (center, inferior, posterior, anterior, anterior-inferior, and posterior-inferior). The impingement-free ROM and impingement sites for abduction-adduction, flexion-extension, total rotation (sum of internal and external rotation), and total ROM (sum of ROM in all movement modes) were evaluated.Results:All the 12 combinations of different glenosphere offsets achieved 50% of the original shoulder ROM in all movements. In the abduction-adduction motion with 0 and 4 mm lateral offsets, the anterior-inferior offset provided the largest ROM (94.4°±8.7° and 105.3°±6.9°, respectively), but there was no significant difference between the positions ( P>0.05). In the flexion-extension motion with 0 and 4 mm lateral offsets, the posterior-inferior offset showed the largest ROM (194.1°±6.9° and 196.9°±9.7°, respectively), but there was no significant difference between the positions ( P>0.05). In the total rotation motion with 0 and 4 mm lateral offsets, the anterior-inferior offset had the largest ROM (141.5°±5.9° and 160.6°±8.5°, respectively), showing significant advantages over the center, anterior, and posterior offsets ( P<0.05), but insignificant advantages over the inferior and posterior-inferior offsets ( P>0.05). In total ROM, the anterior-inferior offset provided the largest ROM. When the lateral offset was 0 mm, the anterior-inferior offset provided a ROM of 421.8°±16.4°, showing significant advantages over the center and posterior offsets ( P<0.05). Compared with the lateral glenosphere offset of 0 mm, the lateral glenosphere offset of 4 mm significantly improved total shoulder ROM (122.8°±10.6° versus 145.8°±4.8°) and total ROM (390.9°±11.6° versus 428.4°±19.8°) ( P<0.05). Conclusions:The anterior-inferior, inferior, and posterior-inferior glenosphere offsets can improve ROM in all movement patterns. The position and lateral offset of the glenosphere significantly affect the total rotation and total ROM of the shoulder joint. Specifically, the anterior-inferior and inferior offsets show significant advantages over the center position in total rotation and total ROM of the shoulder joint.

Role of CIP2A in preoperative sleep deprivation-induced aggravation of postoperative cognitive dysfunction in aged mice / 中华麻醉学杂志

Objective:To evaluate the role of cancerous inhibitor of protein phosphatase 2A (CIP2A) in preoperative sleep deprivation (PSD)-induced aggravation of postoperative cognitive dysfunction (POCD) in aged mice.Methods:One hundred and ten healthy C57BL/6J mice of either sex, aged 18-20 months, weighing 29-35 g, were divided into 5 groups ( n=22 each) using a random number table method: sham operation group (S group), abdominal surgery group (O group), PSD + abdominal surgery group (D+ O group), CIP2A shRNA + abdominal surgery group (CS+ O group), and CIP2A shRNA+ PSD+ abdominal surgery group (CS+ D+ O group). At 14 days before surgery, control shRNA lentivirus was injected into the hippocampus in S, O and CS+ O groups, and CIP2A shRNA was injected into the hippocampus in D+ O and CS+ D+ O groups. PSD was carried out for 3 consecutive days prior to surgery. Cognitive function was assessed using the Morris water maze test at days 7-11 after surgery. The mice were sacrificed under deep anesthesia at day 3 after surgery, and hippocampal tissues were obtained to determine the expression of CIP2A, high mobility group box 1 (HMGB1), ionized calcium-binding adapter molecule 1 (Iba-1), alpha subunit of protein phosphatase 2A (PP2Aa), catalytic subunit of protein phosphatase 2A (PP2Ac), phosphorylated tau protein (p-tau) (S396), and p-tau (S404) (by Western blot), levels of reactive oxygen species (ROS), malondialdehyde (MDA), and superoxide dismutase (SOD), and count of Iba-1 positive cells in the hippocampal CA1 region (using immunofluorescence staining). Results:Compared with S group, the escape latency was significantly prolonged, the frequency of crossing the platform was reduced, duration of stay in the target quadrant was shortened, the expression of CIP2A, Iba-1 and HMGB1 was up-regulated, PP2Ac expression was down-regulated, levels of ROS and MDA and count of Iba-1 positive cells were increased, and the activity of SOD was decreased in O group ( P<0.05). Compared with O group, the escape latency was significantly prolonged, the frequency of crossing the platform was reduced, duration of stay in the target quadrant was shortened, the expression of CIP2A, Iba-1 and HMGB1 was up-regulated, PP2Ac expression was down-regulated, levels of ROS and MDA and count of Iba-1 positive cells were increased, and the activity of SOD was decreased in D+ O group, and the escape latency was significantly shortened, the frequency of crossing the platform was increased, duration of stay in the target quadrant was prolonged, the expression of CIP2A, Iba-1 and HMGB1 was down-regulated, PP2Ac expression was up-regulated, levels of ROS and MDA and count of Iba-1 positive cells were decreased, and the activity of SOD was increased in CS+ O group ( P<0.05). Compared with D+ O group, the escape latency was significantly shortened, the frequency of crossing the platform was increased, duration of stay in the target quadrant was prolonged, the expression of CIP2A, Iba-1 and HMGB1 was down-regulated, PP2Ac expression was up-regulated, levels of ROS and MDA and count of Iba-1 positive cells were decreased, and the activity of SOD was increased in CS+ D+ O group ( P<0.05). There was no significant difference in PP2Aa expression among the five groups ( P>0.05). Conclusions:The mechanism by which PSD aggravates POCD is related to up-regulating the expression of CIP2A and promoting oxidative stress responses, neuroinflammatory responses and phosphorylation of tau protein in aged mice.

Hypercalcaemia crisis: A retrospective series of 143 cases / 中华内分泌代谢杂志

Objective:The study retrospectively analyzed the etiology, clinical manifestations, emergency treatment and etiological treatment of a large sample of cases with hypercalcemic crisis.Methods:The clincial data of patients with hypercalcaemia cirisis who were administered in First Medical Center of Chinese PLA General Hospital from January 2009 to July 2022 were analyzed, inculding the general data, clinical manifestations, etiology, photographic examination, emergency treatment, etiological treatment, serological examination before and after treatment, pathological immunohistochemical findings and prognosis.Results:A total of 143 hypercalcaemia crisis patients(84 males and 59 females) with a mean age of 53.51±16.60 were enrolled. The most common disease was hyperparathyroidism(62/143), followed by solid malignancy(57/143) and multiple myeloma(12/143). Patients presented with digestive system symptoms at 76.91%, followed by neurological symptoms at 63.60%, urinary system symptoms at 58.76%, musculoskeletal symptoms at 55.23%, and cardiovascular system symptoms at 32.91%. After emergency calcium-lowering treatment, the remission rate of hypercalcemic crisis in 143 patients was 100%(143/143), and after etiological treatment, the remission rate of hypercalcemia was 85.31%(122/143).Conclusion:Early identification, emergency treatment and etiology treatment of hypercalcaemia crisis are essential. Effective treament with comprehensive calcium reduction can quickly relieve clinical symptoms and create opportunities for treatment for the cause. Targeted etiological interventions can lead to the correction or long-term remission of hypercalcemia.

Analysis of the clinical characteristics of V4 segment steal blood in the vertebral artery / 中华内科杂志

Objective:To explore the clinical characteristics of unilateral vertebral artery V4 segment occlusive lesions (severe stenosis or occlusion), where the contralateral vertebral artery can be compensated through blood flow and reverse supply to the posterior inferior cerebellarartery (PICA).Methods:This study is a retrospective case series of 66 patients with V4 segment occlusive lesions of unilateral vertebral artery diagnosed and treated from June 2020 to October 2022. Patient data were retrospectively collected, and their hemodynamic characteristics and imaging data were analyzed.Results:Of the 66 cases, 11 patients (16.7%) with V4 segment occlusive disease showed the blood flow of the vertebral artery on the opposite side of the lesion on the digital subtraction angiography (DSA), which can be reverse stolen to the posterior inferior cerebellar artery of the diseased side through the confluence point of the vertebrobasilar artery through the distal end of the ipsilateral vertebral artery V4. Owing to the lack of literature on this pathway and based on the characteristics of previous definitions of subclavian artery steal and carotid artery steal, we referred to this pathway as the vertebral artery V4 segment steal. In 6 patients (9.1%), transcranial Doppler ultrasound (TCD) and transcranial color Doppler ultrasound (TCCD) showed that the blood flow signal was not detected at the proximal end of the V4 segment of the affected side, rather the blood flow direction was reversed at the distal end of the V4 segment, resulting in compensatory acceleration of the blood flow velocity of the V4 segment of the contralateral vertebral artery.Conclusion:“V4 segment steal of vertebral artery” is a very rare route of vertebral artery steal. When V4 segment of the vertebral artery is occluded, clinicians should pay attention to observe the blood supply of PICA and whether there is such a steal route, to better evaluate the blood flow compensation and prognosis of patients.

A clinical and electrodiagnostic study of peripheral neuropathy in prediabetic patients / 中华神经科杂志

Objective:To explore the clinical and electrophysiological characteristics of peripheral neuropathy in prediabetic patients.Methods:Subjects aged 20-65 years with high-risk factors of impaired glycemia enrolled in Beijing Tiantan Hospital, Capital Medical University from 2019 to 2022 were recruited to conduct oral glucose tolerance test, after excluding other causes of neuropathy or radiculopathy. Patients with impaired fasting glucose or impaired glucose tolerance were defined by American Diabetes Association criteria. These patients were divided into clinical polyneuropathy (PN) and clinical non-PN groups, according to the 2010 Toronto consensus criteria and the presence of PN symptoms and signs or not. Nerve conduction studies (NCS), F wave, sympathetic skin response (SSR), R-R interval variation (RRIV) and current perception thresholds (CPT) were performed and the abnormal rate was compared between different electrodiagnostic methods and between clinical subgroups.Results:Among the 73 prediabetic patients ultimately enrolled, only 20 (27.4%) can be diagnosed as clinical PN according to the Toronto consensus criteria. The abnormal rate of CPT (68.5%, 50/73) was significantly higher than those of F wave (2.7%, 2/73), lower limb NCS (0, 0/73), upper limb NCS changes of carpal tunnel syndrome (26.0%, 19/73), SSR (6.8%, 5/73) and RRIV (5.5%, 4/73; McNemar test, all P<0.001). With sinusoid-waveform current stimuli at frequencies of 2 000 Hz, 250 Hz and 5 Hz, the CPT device was used to measure cutaneous sensory thresholds of large myelinated, small myelinated and small unmyelinated sensory fibers respectively. CPT revealed a 21.9% (16/73) abnormal rate of unmyelinated C fiber in the hands of prediabetic patients, significantly higher than that of large myelinated Aβ fibers [8.2% (6/73), χ2=5.352, P=0.021]. Both abnormal rates of small myelinated Aδ [42.5% (31/73)] and unmyelinated C fibers [39.7% (29/73)] in the feet of prediabetic patients were significantly higher than that of large myelinated Aβ fibers [11.0% (8/73), χ2=18.508, 15.965, both P<0.001]. Compared with the clinical non-PN group, the abnormal rates of CPT [90.0% (18/20) vs 60.4% (32/53), χ2=5.904, P=0.015] and SSR [20.0% (4/20) vs 1.9% (1/53), P=0.016) were significantly higher in the clinical PN group. Conclusions:Peripheral neuropathies in prediabetic patients are usually asymptomatic or subclinical, and predispose to affect unmyelinated and small myelinated sensory fibers. Selective electrodiagnostic measurements of small fibers help to detect prediabetic neuropathies in the earliest stages of the disease.

Data-driven DRG-DIP-clinical pathway multidimensional fusion analysis and evaluation / 中华医院管理杂志

Objective:To analyze the correlation between the grouping and weighting of two sets of disease combination systems, namely diagnosis-related groups(DRG) and diagnosis-intervention packet(DIP), and to establish a multidimensional analysis and evaluation mode by applying DRG, DIP, and clinical pathway to guide the standardized diagnosis and treatment and management of disease types.Methods:DRG grouping and DIP simulation full enrollment were applied to patients discharged from a tertiary Grade A general hospital in 2019. The correlation analysis between DRG, DIP, and clinical pathway inclusion(entry), correlation analysis between relative weight of DRG group and DIP standard score, and correlation analysis between clinical pathway entry and cost structure of the two disease groups were conducted by using chi-square test, Pearson correlation analysis, t-test, structural change value, degree of structural change, and incremental contribution rate. Results:Among the 130 395 patients, 41 460 cases entered the clinical pathway, 127 535 cases were enrolled in DRG, and 104 227 cases were enrolled in DIP. There was a correlation between the enrollment of DRG, DIP, and clinical pathway( P<0.05), and there was also a correlation between the relative weight of DRG groups and the enrollment of clinical pathway. The relative weight of the DRG disease group was positively correlated with the DIP standard score( r2=0.761 7, P<0.001). There was a significant difference in hospitalization costs between patients with and without clinical pathway access for some diseases( P<0.05), and different cost categories had different impacts on the total costs. Conclusions:The weight assignment and value orientation of DRG and DIP disease types are consistent, and the multi-dimensional fusion evaluation mode for DRG-DIP-clinical pathway is feasible. The correlation analysis of DRG, DIP, and clinical pathways can serve as the basis for disease classification and cost structure evaluation, which could help to carry out hospital′s refined management and optimize disease structure.

Effect of mindfulness-based therapy on postoperative cognitive function and sleep quality in elderly patients after surgery under local anesthesia / 四川精神卫生

BackgroundPostoperative cognitive dysfunction （POCD） is a common complication in elderly patients after surgery， and has a great impact on postoperative rehabilitation of patients. ObjectiveTo explore the effect of mindfulness-based therapy on cognitive function and sleep quality in elderly patients after surgery under local anesthesia， so as to provide references for reducing their incidence risk of POCD and improving sleep quality. MethodsThe simple random sampling method was utilized to select 78 elderly patients who underwent surgery under local anesthesia in The Third Hospital of Mianyang from March 2022 to March 2023. Participants were assigned into study group and control group， each with 39 cases. All patients were subjected to conventional treatment and nursing interventions， and study group added mindfulness-based therapy on this basis. Mini-Mental State Examination （MMSE） was administered to patients on 1 day before surgery， and on the 1st， 3rd and 5th day after surgery. Pittsburgh Sleep Quality Index （PSQI） was employed on 1 day before surgery and on the 3rd day after surgery. ResultsMMSE scores revealed a significant time effect， group effect and time×group interaction effect （F=78.251， 197.071， 371.915， P<0.05）. Analysis of simple effect denoted that study group scored higher on MMSE on the 1st， 3rd and 5th day after surgery compared with control group， with statistical significance （t=-3.579， -1.764， -0.253， P<0.05）. Study group reported lower incidence rates of POCD on the 1st， 3rd and 5th day after surgery compared with control group， with statistical significance （χ2=2.631， 3.471， 5.135， P<0.05）. On the 3rd day after surgery，study group scored lower on PSQI than control group（P<0.05）， and PSQI total score， sleep latency， subjective sleep quality， daytime dysfunction and hypnotic drug use factor scores of study group were lower than baseline， with statistical significance（F=43.175， 12.594， 11.092， 4.579， 3.514， P<0.01）. ConclusionMindfulness-based therapy may have certain value in reducing incidence of POCD and improving sleep quality in elderly patients who underwent surgery under local anesthesia.

Research progress on serum inflammatory biomarkers in post-stroke anxiety disorder / 四川精神卫生

Post-stroke anxiety disorder （PSA） is a common psychiatric complication of stroke， which jeopardizes patients' recovery and their quality of life. Recent studies suggest that inflammation plays an important role in the pathogenesis of PSA. Therefore， this paper reviewed the related licture about the association between PSA and serum inflammatory biomarkers in order to provide references for the intervention of PSA. In this study， a comprehensive search was performed in China National knowledge Infrastructure （CNKI）， Wanfang Data， Web of Science and PubMed database to identify the well qualified literature focusing on the relationship between PSA occurrence and serum inflammatory biomarkers， and a total of 13 studies were retrieved. Analysis indicates a certain association between PSA occurrence and serum inflammatory biomarkers， and denotes that the elevation of inflammatory biomarkers may be a trigger for the disease occurrence and its progression， but the specific mechanism underlying this relationship requires further study.

Characteristics of sensory integration in static balance of 4 - to 5-year-old children / 中国儿童保健杂志

【Objective】 To analyze the sensory integration characteristics of 4- to 5-year-old preschool children while maintaining static balance, in order to provide reference for promoting the development of motor development. 【Methods】 A total of 128 preschool children were randomly selected in this study from a public kindergarten in Suzhou. Wearable sensor were worn at the center of mass(COM) position for four tests: T1 standing with eyes open, T2 standing with eyes closed, T3 standing with eyes open on a sponge pad, and T4 standing with eyes closed on a sponge pad. The angular velocity modulus(ω) of COM shaking was extracted, the Romberg quotient(RQ), vestibular Romberg quotient(VRQ), and the rate of increase in body stability when integrating different sensations were calculated. The contribution weights and sensory integration characteristics of visual, proprioceptive, and vestibular sensations to static balance were analyzed. Independent sample t-test was used to analyze the differences between different gender and age groups. 【Results】 The RQ was 1.20, and the VRQ was 1.58. The contribution rates of visual, proprioceptive, and vestibular senses to body balance were approximately 9.28%, 28.19% and 62.53%, respectively. The difference in the rate of increase in body stability between integrated vision and integrated proprioception with normal vestibular perception was statistically significant(P0.05) and the difference in half year old age was not statistically significant(P>0.05). 【Conclusions】 When preschool children aged 4 - 5 maintain static balance, the contribution of vestibular integration proprioception to body stability is greater than that of vestibular integrate vision. The contribution of vestibular and visual integrate proprioception to body stability is greater than that of vestibular and proprioception integrate vision. The sensory integration characteristics between boys and girls, as well as half year old children, are basically the same.