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Objective:To investigate the cognitive-related networks of patients with different cognitive impairment related to white matter lesions (WMLs), and explore the correlation between the altered functional connectivity and the executive function.Methods:Patients with white matter lesions in Beijing Tiantan Hospital from January 2016 to December 2020 were selected , who were divided into WML-non-dementia vascular cognitive impairment (WML-VCIND) group( n=19)and WML-vascular dementia (VaD) group( n=19). At the same time, 24 normal control group (NC) with no cognitive impairment with age, gender and education level matched were enrolled. The Stroop B, Stroop C, trail making test(TMT-B) and verbal fluency test (VFT) were used to evaluate the executive function of all subjects. The ICA method was used to identity four cognitive-related RSNs: frontoparietal network (FPN), salience network (SN), default network (DMN), and dorsal attention network (DAN). Using SPSS 20.0 software, the functional connectivity (FC) of the regions of interest of the selected RSNs among the three groups were compared by analysis of covariance, and correlation between the altered FCs and executive function scores were explored by Spearman correlation analysis. Results:(1) The FC of the medial prefrontal cortex (MPFC)-left inferior parietal lobe (IPL.L) in the VaD group(0.267±0.320) was significantly lower than that in the NC group (0.520±0.253)( P=0.005). The FC of MPFC-posterior cingulate (PCC) was significantly lower in the VaD group(0.655±0.284) than that in the VCIND group(0.810±0.232) ( P=0.017). The FC of MPFC-left insula and MPFC-left dorsolateral prefrontal cortex (DLPFC.L)was significantly higher in the VaD group(0.411±0.277, 0.545±0.311)than that in the VCIND group(0.239±0.308, 0.353±0.270)( P=0.044, 0.028). The FC of the left superior parietal lobe (SPL.L)-right dorsolateral prefrontal cortex (DLPFC.R) in the VCIND group(0.488±0.157) was significantly higher than that in the NC group(0.301±0.257) ( P=0.010). The FC of MPFC-left insula and MPFC-DLPFC.L was higher in NC group than that in VaD group ( P=0.020, 0.037). (2) The FC of MPFC-PCC was negatively correlated with Stroop C score ( r=-0.279, P=0.036), and TMT-B score ( r=-0.313, P=0.018). The FC of MPFC-IPL.L was negatively correlated with Stroop B score ( r=-0.311, P=0.018), Stroop C score( r=-0.308, P=0.020) and TMT-B score ( r=-0.367, P=0.005), while positively correlated with VFT score ( r=0.357, P=0.006). The FC of SPL.L-DLPFC.R was positively correlated with the Stroop B score ( r=0.305, P=0.021). Conclusion:There are certain differences in the functional connectivity between brain areas within the cognitive related brain networks, and the differences in FC between different brain areas are correlated with executive function scores. The changes of the FC may indicate possibly decline in executive function, which can explain the mechanism of cognitive declines.
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Objective:To analyzed effect of stratified positive psychological intervention based on Self-reporting Inventory (SCL-90) in patients with digestive tract tumors.Methods:Totally 78 patients with digestive tract cancer from January 2019 to February 2020 were divided into observation group (78 cases) and control group (76 cases), the control group given disease knowledge education, psychological intervention, diet and exercise management, and complication prevention etc routine nursing intervention, the observation group combined with stratified positive psychological intervention based on SCL-90 assessment strategy. Cancer-related fatigue, hope level and nurse satisfaction were compared between two groups.Results:6 months after intervention, the observation group cognitive fatigue, mental fatigue, physical fatigue, the influence of fatigue on life, cancer-related fatigue score were respectively (7.24±1.21), (7.58±1.16), (5.16±1.24), (7.65±1.42), (27.63±4.32) points. The control group were respectively (8.35±1.32), (8.02±1.12), (5.87±1.16), (8.72±1.56), (30.96±4.56) points. There were statistically significant of difference between the two groups ( t values were 2.265-5.442, P<0.05 or 0.01). Observation group Grade Ⅲ cancer-related fatigue total score were respectively (27.34±4.32), (27.65±4.25), (27.63±4.41) points, and the control group were respectively (29.56±5.12), (30.23±4.35), (40.77±5.45) points. There were statistically significant of difference between the two groups ( t values were 8.528, 2.163, 5.812, P<0.05 or 0.01). Observation group attitudes towards reality and the future, maintain close relationships with others, adopt positive action, hope level total score were respectively (10.35±2.01), (9.87±1.43), (10.16±1.42), (30.28±5.20) points, and control group were respectively (9.12±1.45), (9.15±1.32), (9.24±1.36), (27.51±4.36) points. There were statistically significant of difference between the two groups ( t values were 3.245-4.104, P<0.05 or 0.01). Observation group second and third grade hope level total score were respectively (30.24±5.20), (31.87±5.45) points, control group were respectively (27.24±4.23), (19.41±3.52) points. There were statistically significant of difference between the two groups ( t values were 2.271, 5.644, P<0.05 or 0.01). 6 months after intervention, The observation group nurse satisfaction 94.87% (74/78) higher than that control group 82.89% (63/76) ( χ2 value was 5.623, P=0.021) . Conclusion:Stratified positive psychological intervention based on SCL-90 assessment strategy help to ensure the balance of the intervention effect, alleviate cancer-related fatigue, Promote development of hope levels, and improve nurse satisfaction.
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Objective:To analyze the characteristic of nerve tracts in different stages of cognitive impairment caused by white matter hypertensities, applying diffusion tensor imaging-peak width of skeletonized mean diffusivity as evaluation indicator.Methods:Demographic characteristics and vascular risk factors of all subjects were recorded.Screened out 50 subjects without WMH and whose MoCA scale was more than or equal 26 points as normal control group.Then, we assessed 85 patients with WMH using the MoCA scale and clinical dementia assessment. Of 85 patients, 45 cases were divided into the normal cognition group, 23 cases were assigned into non-dementia vascular cognitive impairment group, and 17 cases into the vascular dementia group.The diffusion tensor imaging-peak width of skeletonized mean diffusivity marking method was used to compare the integrity of white matter fibers in WMH patients with varying degrees of cognitive impairment and normal control group.Results:The difference of PSMD among the four groups was statistically significant(CN group: 3.558±0.157, VCIND group: 4.128±0.222, VaD group: 5.469±0.000, NC group: 2.612±0.105, F=42.479, P<0.05). PSMD in WMH groups were higher than that in NC group (all P<0.05). There was no significant difference between WMH-VCIND group and WMH-CN group ( P=0.067). The PSMD of WMH-VAD group was higher than that of WMH-CN group and WMH-VCIND group (both P<0.05). Conclusion:PSMD can accurately detect white matter fiber damage caused by WMH.The degree of WMH combined cognitive decline was not completely consistent with the degree of PSMD increase.Compared with the cases with normal WMH cognition, PSMD was not significantly increased when WMH was combined with VCIND, while PSMD was significantly increased when WMH was combined with VaD.DTI-PSMD value as imaging marker can provide objective basis for clinical diagnosis of WMH-VaD.
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Objective:To explore abnormal microstructural changes of white matter in patients with white matter lesions(WML) using diffusion tensor imaging(DTI), and to determine the association of such abnormalities of DTI parameters with executive function.Methods:Totally 34 patients with WML were recruited from the department of Neurology, Beijing Tiantan Hospital, Capital Medical University from March 2012 to May 2019.All patients with WML were scored with Hamilton depression scale (HAMD) and Hamilton anxiety scale (HAMA), and assessed with Montreal cognitive assessment (MoCA) and clinical dementia rating(CDR). They were divided into WML-cognitive normal group, WML-vascular cognitive impairment-non dementia group and WML-Dementia group.The Stroop color and word test (SCWT), trail making test-A (TMTA), digit symbol test and verbal fluency test were carried out to evaluate executive function.In addition, the healthy elderly without WML lesions were selected as the control group after they were examined by MRI, and all brains of the subjects went through DTI with Siemens 3.0 T MR.The data were collected and analyzed by voxel based analysis (VBA). The anisotropy and mean diffusion coefficient of DTI in the region of interest (ROI) and other regions in the brain were studied in the four groups, and their correlation with scores of executive function in WML patients was analyzed.Results:(1)In these executive function test, there were significant differences between the patients with cognitive impairment (WML-VAD group, WML-VCIND group) and normal cognition group(WML-CN group, NC group), such as SCWT(B)(65.54±6.24 vs 43.67±0.95, 76.75±2.13 vs 43.67±0. 95, 65.54±6.24 vs 43.66±1.81, 76.75±2.13 vs 43.66±1.81), SCWT(C)(88.58±6.76 vs 61.63±1.31, 96.37±1.47 vs 61 63±1.31, 88.58±6.76 vs 66.31±8.19, 96.37±1.47 vs 66.31±8.19), TMTA(40.47±2.76 vs 30.92±0.47, 44.24±1.43 vs 30.92±0.47, 44.24±1.43 vs 31.99±2.07, 40.47±2.76 vs 31.99±2.07), TMTB(88.66±6.55 vs 80.34±0.61, 96.70±1.72 vs 80.34±0.61, 88.66±6.55 vs 83.10±5.91, 96.70±1.72 vs 83. 10±5.91), Digit Symbol Test(39.25±5.63 vs 47.00±2.55, 31.27±3.93 vs 47.00±2.5, 39.25±5.63 vs 48.86±4.34, 31.27±3.93 vs 48.86±4.34) and Verbal Fluency Test(8.94±1.00 vs 11.71±0.47, 6.64±0.81 vs 11.71±0.47, 8.94±1.00 vs 10.86±0.69, 6.64±0.81 vs 10.86±0.69) scores ( P<0.05); In the patients with cognitive impairment, there were significant differences between WML-VAD group and WML-VCIND group, such as SCWT(B), SCWT(C), TMTA, TMTB, digit symbol test and verbal fluency test scores ( P<0.05); There were significant differences between WML-CN patients and NC group in the scores of SCWT (C), verbal fluency test( P<0.05). (2)FA values in the genu of corpus callosum and the inferior longitudinal fasciculus were negatively correlated with the time of SCWT (B), SCWT (C) and the TMTA( r=-0.436--0.471), but positively correlated with the scores of digit symbol test and verbal fluency test( r=0.428-0.573). MD values in the genu of corpus callosum, the superior/inferior longitudinal fasciculus and the inferior fronto-occipital fasciculus were positively correlated with the time of SCWT (B), SCWT (C) and TMTA( r=0.432~0.609), but negatively correlated with the scores of digit symbol test and verbal fluency test( r=-0.424--0.630, all P<0.003125 after emendation). Conclusion:The executive function of patients with WML-Dementia decreases significantly.The more serious the damage of white matter microstructure, the more serious the damage of executive of function.
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@#Objective To study the relationship between executive function and activities of daily living for patients with periventricular white matter lesions (PWMLs). Methods From January, 2016 to January, 2017, 35 PWMLs patients and 35 normal controls were collected. Their executive function and activities of daily living were assessed with neuropsychological tests and Activities of Daily Living Scale (ADL).Results Compared with the normal control group, the scores of Mini-Mental State Exam (MMSE) and Montreal Cognitive Assessment (MoCA) significantly decreased (t>13.726, P<0.001), the times of Trail-Making Test and Stroop Colour Word Test significantly lengthened, the Verbal Fluency Test score decreased (t=6.891, P=0.013) and the Digit-Symbol Substitution Test score did not improve (t=3.372, P=0.072) in PWMLs group. The Z score of executive function was positively correlated with ADL score (r=0.438, P=0.008).Conclusion The executive function and activities of daily living are impaired in PWMLs patients, and their activities of daily living is related to the severity of the executive function impairment.
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Objective To explore abnormal microstmctural changes of white matter in patients with white matter lesions using diffusion tensor imaging(DTI),and to determine the association of such abnormalities of DTI parameters with cognitive function.Methods The objects who have already confirmed with WML were collected from March 2012 to February 2018 through magnetic resonance imaging (MRI) scan from the neurology department of Beijing Tiantan Hospital.Use The hamilton depression scale(HAMD) and the hamilton anxiety scale (HAMA) to eliminate anxiety and depression,and divided into WML-CN group,WML-VCIND group and WML-VAD group with Mini-mental state examination (MMSE),Montreal Cognitive Assessment (MOCA)and clinical dementia rating(CDR).In addition,select the healthy elderly people without WML by MRI scan as the normal control group.All of the subjects were detected with the superconduct magnetic resonance imaging system (German SIEMENS 3.0T) for the DTI scanning.Original images were processed with VBA.Then explore the changes of FA and MD of DTI in whole brain and regions of interest in NC group,WML-CN group,WML-VCIND group and WWML-VAD group,and its correlation with the severity of cognitive impairment in patients with WML.Results The damage degree of the fiber microstructure of brain white matter was significantly correlated with the total grade point of MoCA (P＜0.01).In figure FA,the variance analysis of F test results showed that the significant brain areas were the splenium of the corpus callosum,the genu of corpus callosum,bilateral posterior internal capsule,retrolenticular part of internal capsule,anterior thalamic radiation,partial inferior longitudinal fasciculus and inferior fronto-occipital fasciculus,cingulate,external capsule,upper and posterior part of the radiation crowns,partial superior longitudinal fasciculus,etc.(P＜0.05 after FWE correction based on TFCE method).In Figure MD,the variance analysis of F test results showed that the statistically significant brain areas mainly included the left external capsule and hook,partial genu and splenium of corpus callosum,Bilateral,bilateral inferior fronto-occipital fasciculus,inferior longitudinal fasciculus,anterior thalamic radiation,retrolenticular part of internal capsule,cingulate,etc (P＜ 0.05 after FWE conection based on TFCE).Conclusion No matter whether cognitive impairment exists in patient with WML or not,all DTI parameters are different from those of normal people.The integrity of white matter fiber has been damaged with different degrees.The more severe the cognitive impairment in the external manifestations of patients with WML,the greater the damage to the intrinsic white matter microstructure.
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Objective To study the effect of white matter lesions location on cognitive function by comparing the correlation between the anatomical location of white matter lesions and cognitive function in leukoaraisosis(LA)patients. Methods A total of 75 LA patients with different degrees of white matter le-sion were randomly recruited.The modified Scheltens scale,Manolio scale and Fazekas scale were utilized to assess the severity of white matter lesions(WMLs)by two physicians.Montreal cognitive assessment (MoCA)was used to evaluate the cognitive function.The correlation between WMLs location and cognitive function was analyzed by spearman rank correlation analysis.The t-test was used to test the differences of periventricular white matter lesions with cognitive impairment(PWMLs-CI)and periventricular white matter lesions with cognitive normal(PWMLs-CN)in each goup. Results For Fazekas scale,PWMLs were signifi-cantly correlated with the decrease scores of MoCA score(r=-0.388,P=0.007),visuospatial and executive (r=-0.466,P=0.000),delayed recall(r=-0.461,P=0.001),abstraction(r=-0.355,P=0.011)and ori-entation(r=-0.337,P=0.016)(P<0.05).For Scheltens scale,PWMLs was negatively correlated with MoCA score(r=-0.390,P=0.003),visuospatial and executive(r=-0.464,P=0.000),delayed recall(r=0.484, P=0.000),attention(r=-0.375,P=0.008)and orientation(r=-0.342,P=0.013)(P<0.05),but not in deep white matter lesions(DWMLs)(P>0.05).Compared with PWMLs-CN,executive function(42.13 ± 0.89),attention(16.36±1.24)and visuospatial(2.25±0.31)in PWMLs-CI had statistical significance(P<0.05). Conclusion White matter lesions location affect cognitive function,PWMLs are more closely related to cognitive impairement,characterized by executive function,attention and visuospatial aspects.
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Objective To explore the clinical characteristics of cognitive impairment in different age groups with the same severity of white matter lesions.Methods This study involved 110 consecutively recruited patients with white matter lesions(WMLs)from the Department of Neurology at Beijing Tiantan Hospital from August 2014 to March 2017.Patients were aged from 50 to 85 with a mean age of 63.1±9.7,and they were divided into an elderly group with a mean age of 71.6±5.2 (range:65-85 years)and a middle aged group with a mean age of 54.8 ± 3.4 (range:50-60 years).The severity of white matter lesions was evaluated with the Fazekas scale.MoCA was used to evaluate the cognitive function of patients.Results For Fazekas 1,the MoCA score was 25.5 ± 2.2 in the elderly group and 28.1 ± 1.4 in the middle aged group(t =6.946,P =0.000);the score for visuospatial and execution abilities was 3.8 ± 0.9 in the elderly group and 4.5 ± 0.6 in the middle aged group(t =3.7 2 6,P =0.0 2 3);the score for delayed memory was 2.7 ± 1.5 in the elderly group and 4.0 ± 1.0 in the middle aged group(t =4.365,P =0.018).For Fazekas 2,the MoCA score was 22.5±2.5 in the elderly group and 24.1 ± 1.5 in the middle aged group(t =3.361,P =0.034);the score for visuospatial and execution abilities was 2.8 ± 1.2 in the elderly group and 3.8 ± 0.8 in the middle aged group(t=6.473,P=0.007);the score for concentration was 4.6± 1.3 in the elderly group and 5.6±0.5 in the middle aged group(t=0.491,P=0.721).For Fazekas 3:the MoCA score was 15.2 ± 3.4 in the elderly group and 19.4 ± 2.8 in the middle aged group(t =4.709,P =0.001);the score for visuospatial and execution abilities was 1.8 ± 1.1 in the elderly group and 2.8± 1.4 in the middle aged group(t =1.563,P =0.043);the score for concentration was 3.3± 1.1 in the elderly group and 4.4± 1.4 in the middle aged group(t=2.231,P=0.026);the score for orientation was 4.2 ± 1.3 in the elderly group and 5.7 ± 0.5 in the middle aged group (t=3.255,P =0.000).Conclusions WMLs can increase the risk of vascular cognitive impairment and cause decline in multiple cognitive functions in both middle aged and elderly people.Cognitive dysfunction in age-related WMLs is mainly characterized by impairment in visuospatial and execution abilities.
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Objective To review the methodological quality of evidence-based guidelines on prevention and repair of perineal injury at vaginal delivery,and analyze the characteristics of guidelines to provide references for evidence-based decision-making.Methods We systematically searched websites of professional organizations,websites of clinical practice guidelines and databases for guidelines on prevention and repair of perineal injury,and used AGREE Ⅱ to evaluate the chosen guidelines.Results We identified totally 7 relevant evidence-based guidelines in this field.The average standardized scores of guidelines in 6 domains of AGREE Ⅱ were 90.21％(scope and purpose),68.25％ (stakeholder involvement),69.94％ (rigor of development),89.41％ (clarity of presentations),70.63％ (applicability),and 68.25％(independence),respectively.The overall standardized score for 7 guidelines was 75.65％,and the total score was 5.67 (7 points).For overall quality,4 of them were grade A and 3 of them were grade B.Conclusion The overall quality of included guidelines were high,but stakeholder involvement,rigor of development and independence in some guidelines needs to be improved.There was no Chinese evidence-based gui-deline in this field,and high-quality foreign guidelines could be used as evidence in combination with local conditions.
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Objectives To implement the guideline-based clinical practice program for identification and manage-ment of dysphagia in stroke patients,and to create a good evidence-based practice culture,and to improve the quality of clinical care. Methods In this study,we use the Iowa model of evidence-based practice as a guide, reference guide issued by RNAO to implement the corresponding implementation strategy tool,and gradually apply the program to the pilot ward. Results The implementation of the program had a positive impact on the patient level (quality of life,satisfaction and hospitalization),the nurse level(satisfaction and knowledge),and the level of eachau-ditcriteria. Conclusion It is possible to improve the clinical nursing quality by adapting the high quality guide-lines for the identification and management of dysphagia in foreign countries and this study can provide reference for the research of future guideline implementation.
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Objective To investigate the effect of preventive antidepressants application on the prognosis of and serum brain derived neurotrophic factor(BDNF) level in acute cerebral infarction(ACI).Methods One hundred and forty-one patients with ACI were prospectively and randomly selected.Seventy-two cases in the intervention group was added with sertraline for 12 weeks on the basis of the routine therapy,while 69 cases in the control group only used the routine therapy.The National Institutes of Health Stroke Scale (NIHSS) was used to evaluate the nervous function impairment degree and daily living ability.The Hamilton Depression Rating Scale-17 was used to evaluate the emotion after stroke.The cognition function was evaluated by the Mini-Mental State Examination (MMSE).The BDNF level was detected by using the double antibody sandwich enzyme-linked immunosorbent assay.Results The NIHSS and HAMD scores after 3-month treatment were (1.77±0.58)points and (5.43±1.77)points in the intervention group,and (4.06±0.79)points and(10.27±3.78)points in the control group,which were significantly decreased compared with before treatment(P＜0.05);the BI value in the intervention group and control group were (96.24±4.58) and (77.64±6.96),which weresignificantly increased compared with before treatment (P＜0.05),and serum BDNF levels were (8.38±0.74)ng/mL and (5.72 ±0.67)ng/mL respectively,which were significantly increased compared with before treatment,moreover the change in the intervention group was more obvious than that in the control group (P＜0.05).The MMSE score had no statistical difference between the two groups (P＞0.05).The PSD occurrence rate was 10.0％ in the intervention group,which was significantly decreased compared with 53.6％ in the control group (P＜0.05).Conclusion Preventive antidepressants application in the patients with ACI can increase the serum BDNF level,improves the prognosis and is worth promotion and application.
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Objective To explore the effect of leukoaraiosis (LA) on the efficiency of the brain function network and to analyze the features of the "small world" network with graph theory method.Methods This study involved 34 LA patients from the Department of Neurology,Beijing Tiantan hospital,Capital Medical University from January 2014 to September 2015 and 23 age-and sex-matched healthy controls(NC group).All participants underwent the neurocognitive tests including M MSE,MoCA and clinical dementia rating(CDR).The subjects were divided into LA with cognitive normal group (CN) (n=11) and LA patients with vascular cognitive impairment-non dementia group(VCIND) (n=23).Functional MRI (fMRI) was employed at resting state.And then,the functional network establishment and small-world network metrics (characteristic clustering coefficient and path length) were computed using graph analytical methods.Results In the range of 0.05 ≤ Kcost ≤ 0.5,the functional networks fitted the definition of small-worldness in LA (CN),LA(VCIND) and NC groups(δ＞1).The Lambda of group LA(CN) and LA (VCIND) were smaller than that of NC group at each threshold,and more closing to 1.The gamma of group LA(CN) were higher than that of NC group at each threshold.While the gamma of group LA(VCIND)were lower than that of NC group at each threshold.The sigma of group LA(CN) were higher than that of NC group at each threshold.Conclusion The LA patients exhibit abnormal small-world network properties.And compared with HCs,small world properties in LA (CN) patients have been increased,while that in LA (VCIND) patients have been reduced,which manifested that the altered topological properties may be responsible for cognitive dysfunction in LA patients.
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Leukoaraiosis (LA) has important clinical significance;however, the neurobiological mechanism was still unclear. In this pa-per, we reviewed literatures about the clinical symptoms, pathology and imaging of LA in order to improve the understanding of the patho-logic mechanism, recognize the reversible pathological change in the earliest stage, which can help to prevent dementia.
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Objective To explore the correlation between serum levels of CXC chemokine ligand 16(CXCL16) and carotid artery atherosclerosis in patients with acute cerebral infarction(ACI) .Methods A total of 36 cases of patients with ACI were enrolled in ACI group ,and 30 individuals received physical examination were enrolled into control group .Levels of blood lipid ,high‐sensitive C‐reactive protein(hs‐CRP) and serum CXCL16 were detected ,and the carotid atherosclerotic plaques and changes of carotid intimal‐medial thickness(IMT) were examined by using the Color Doppler ultrasonography .Results The serum levels of CXCL16 in ACI group[3 .58(1 .06 -12 .83)ng/L] was higher than that in control group[1 .57(0 .61 -3 .34)ng/L] ,had statistically significant difference(P<0 .05) .The carotid IMT were higher in ACI group[(1 .19 ± 0 .36)mm] than that in control group[(1 .01 ± 0 .18) mm] ,had statistically significant difference(P<0 .05) .In ACI group ,the serum level of CXCL16 was higher in patients with vul‐nerable plaques than that in patients with stable plaques ,had statistically significant difference(P<0 .05) ,Serum levels of CXCL16 were correlated with carotid IMT and levels of hs‐CRP(r=0 .497 ,P<0 .05 ;r=0 .442 ,P<0 .05) .Multiple linear stepwise regres‐sion analysis showed that CXCLl6 was one of the independent risk factors for the development of carotid atherosclerotic plaques . Conclusion High serum levels of CXCLl6 and hs‐CRP might be independent risk factors for the development of carotid atheroscle‐rotic plaques ,and CXCLl6 might be closely correlated to the vulnerability of carotid atherosclerosis plaques .
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Urine derived follicle-stimulating hormone [uFSH] contains a higher proportion of acidic isoforms, whereas recombinant FSH [rFSH] contains a higher proportion of less-acidic isoforms. Less-acidic isoforms have a faster clearance, and thus a shorter half-life than the acidic FSH isoforms. The slow clearance of the acidic isoforms has a longer half-life and higher biological activity. This study was designed to determine whether uFSH or rFSH is more effective in older Chinese women undergoing assisted reproductive techniques [ART]. This is a prospective, randomized, controlled cohort study. A total of 508 Chinese women over 37 years were randomized into two following study groups for their in vitro fertilization [IVF] or intracytoplasmic sperm injection [ICSI] cycles: i. group A [n=254] were treated with rFSH, and ii. group B [n=254] were treated with uFSH. Both groups were suppressed with a gonadotropin-releasing hormone [GnRH] analogue using a long down-regulation protocol. The main outcomes for comparison were days of stimulation, estradiol [E[2]] on the day of human chorionic gonadotropin [hCG] administration, number of oocytes collected, amount of FSH used, quantity of FSH/oocyte, endometrial thickness at hCG day, M II oocyte rate, 2PN zygote rate, grade I embryo rate, number of embryos cryopreserved, pregnancy rate, implantation rate, abortion rate and the rate of no transferable embryos. Twenty two cycles including 16 cycles with poor ovarian response and six cycles with ovarian hyperstimulation syndrome were cancelled. There were 243 cycles left in each group. The patients treated with uFSH had a significantly higher 2PN zygote rate [87.4 vs. 76.6%, p<0.001], grade I embryo rate [49.8 vs. 40.8%, p<0.001] and endometrial thickness on day of hCG [11.8 mm vs. 11.2 mm, respectively, p=0.006] and a lower rate of no transferable embryos [1.2 vs. 5.3%, p=0.019] than women treated with rFSH. The other measures evaluated showed no statistically significant differences between groups [p>0.05]. This study showed that uFSH produced a significantly higher proportion of grade I embryos than rFSH in older Chinese women and there was a significantly lower chance of no transferable embryos in uFSH cycles. The clinical efficacy of the two gonadotropins was equivalent
Sujets)
Humains , Femelle , Techniques de reproduction assistée , Études prospectives , Fécondation in vitro , Injections intracytoplasmiques de spermatozoïdesRésumé
In order to clarify the chemical composition and source of Banxia Xiexin decoction quickly and comprehensively, whole and individual herbs of Banxia Xiexin decoction were analyzed by ultra-performance liquid chromatography with quadrupole-time-of-flight mass spectrometry (UPLC/Q-TOF-MS(E)). Under identical experiment conditions, chromatography results were compared between experiment groups. Based on the Q-TOF-MS(E) analysis, 74 peaks were identified on line. The herbal sources of these peaks were assigned. The results implied that flavonoids, triterpenoid saponins, alkaloids and glycosides were the main components in effective part of Banxia Xiexin decoction. The method established is simple and rapid for elucidation the constituents of Banxia Xiexin decoction and the results could be used for the quality control of Banxia Xiexin decoction.
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Objective To explore the effect of the Yu-tone music to reduction of fear emotion. Methods 72 undergraduate students listened to Yu-tone Music or had a rest for ten minutes after elicitation of fear emotion by film clip;and measured from autonomic nerves system include skin conduction,BVP amplitude,heart rate,respiration,finger temperature and self-report subjective experience. Result 1.Compared with silence[(0.96±1.64)1/Ω,(0.85±1.73)min-1,(4.48±43.54)μV,(-5±15.37)min-1],music was associated with a significantly decreased skin resistance,respiration rate,heart rate and myoelectricity after fear emotion[(2.04±2.22)1/Ω,(0.09±1.79)min-1,(8.47±26.24) μV,(1.57±20.88) min-1,P <0.01,P <0.01,P <0.01,P <0.05]; 2.Compared with silence[(-0.37±2.71)μV, (0.13±1.16) ℃ ],music was enlarged BVP amplitude and skin temperature[(-0.53±3.8)μV,(-0.02±0.87)℃],but there was no significant difference( P ＞0.05,P ＞0.05).Conclusion Music advance the restore of negative emotion,and reduce excitability of the sympathetic and improve function of the parasympathetic nervous systems. Simultaneously,music significantly enhance the feelings of happiness as well as quietness of positive emotion.
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From air bacteria capable of decomposing creatinine, three single independent strains K9510、K9511 and K9512 have been isolated. The highest creatinine amidohydrolase (EC 3.5.2.10; creatininase) producing strain K9510 was screened out. The strain K9510 was identified as Pseudomonas sp. The results of culture condition for creatininase formation by strain K9510 were obtained as follows: creatinine and creatine were found to be the effective inducers for enzyme formation; the solution of mixed metallic salts could stimulate cell growth and enzyme formation. The suitable medium for creatininase formation was consisted of 0.9% creatinine、 0. 15% yeast extract、 0. 09% malt extract、0.05% NH4C1 and some amount of the solution of mixed metallic salts at pH5. 5. When the bacterium was grown in 250mL conic flask containing 50mL of the medium mentioned above on the rotary shaker(250r/min) at 35℃ for 33 h, about 50 u creatininase was obtained.
Résumé
A Computer-normalized micro-ELISA assay with some improvements to reduce non -specific binding for determination of Dermatophagoides farinae-specific IgE is desc- ribed.Bovine serum albumin was added to the conjugate buffer and serum dliuent to re- duce“noise”often encountered in ELISA assay,resulting in decreased background and increased sensitivity for determining specific IgE.An“IP”milliunit system was adopted to communicate the results of the assay in order that the clinician can compare them more easily.A computer programme for standardization of the results was developed. The automation and high efficiency of computer allowed a reliable and much more ra- pid management of all the experiment data.Interassay coefficients declined from 15.81% into 8.20% after normalization.This computerized normalization method can also be used in other allergen-specific IgE determinations,employing the same progra- mme.The specificity of this experiment was confirmed by absorption studies.