Clinical study of scalp acupuncture combined with repeated transcranial magnetic stimulation in the treatment of dysphagia after ischemic stroke / 国际中医中药杂志

Objective:To evaluate the effect of scalp acupuncture combined with repeated transcranial magnetic stimulation (rTMS) on dysphagia after ischemic stroke.Methods:Prospective cohort study. A total of 94 patients with dysphagia after ischemic stroke in our hospital who met the inclusion criteria from December 2020 to February 2022 were randomly divided into two groups with 47 patients in each group. The control group was treated with rTMS and conventional acupuncture, while the scalp acupuncture group was treated with rTMS and scalp acupuncture (scalp acupuncture+seven points at the skull base). Both groups were treated for 4 weeks. Before and after treatment, Traditional Chinese Medicine (TCM) symptoms were scored, and the morphology, movement and food swallowing process of the patient's swallowing anatomy were observed with fiber optic endoscopy (FEES), and assessed by the leakage aspiration scale (PAS). The Yilang Fujishima swallowing efficacy evaluation and standard swallowing assessment (SSA) were used to evaluate swallowing function. The dysphagia quality of life scale (SWAL-QOL) were used to evaluate patients' quality of life. Magnetic resonance diffusion tensor imaging (DTI) scanning was performed to observe the anisotropy fraction (FA value) of the selected region of interest (ROI).Results:During the treatment period, each group dropped off 1 patient, and 92 patients entered the statistics. After treatment, the scores of salivation, food retention, eating and drinking cough in the scalp acupuncture group were significantly lower than those in the control group ( t values were 6.87, 4.90, 5.01, respectively, P<0.01), and the PAS grading was significantly better than that in the control group ( χ2=7.80, P=0.025), the swallowing efficacy evaluation and SWAL-QOL score of Yilang Fujishima were significantly higher than those of the control group ( t=6.81, 5.98, P<0.01), and the SSA score was significantly lower than that of the control group ( t=5.68, P<0.01). The FA values of parieto occipital cortex (0.47 ± 0.06 vs. 0.42 ± 0.04, t=3.16), insular cortex (0.44 ± 0.07 vs. 0.40 ± 0.05, t=3.00) and posterior limb of internal capsule (0.58 ± 0.04 vs. 0.54 ± 0.05, t=2.80) of ROI in the head acupuncture group after treatment were significantly higher than those in the control group ( P<0.05). Conclusion:The scalp acupuncture combined with rTMS can improve the swallowing function of patients with dysphagia after ischemic stroke and improve their quality of life.

Preliminary exploration of clinical prediction model of severe swallowing disorder after acute ischemic stroke based on nomogram model / 中华危重病急救医学

OBJECTIVE@#To establish a predictive model for severe swallowing disorder after acute ischemic stroke based on nomogram model, and evaluate its effectiveness.@*METHODS@#A prospective study was conducted. The patients with acute ischemic stroke admitted to Mianyang Central Hospital from October 2018 to October 2021 were enrolled. Patients were divided into severe swallowing disorder group and non-severe swallowing disorder group according to whether severe swallowing disorder occurred within 72 hours after admission. The differences in general information, personal history, past medical history, and clinical characteristics of patients between the two groups were compared. The risk factors of severe swallowing disorder were analyzed by multivariate Logistic regression analysis, and the relevant nomogram model was established. The bootstrap method was used to perform self-sampling internal validation on the model, and consistency index, calibration curve, receiver operator characteristic curve (ROC curve), and decision curve were used to evaluate the predictive performance of the model.@*RESULTS@#A total of 264 patients with acute ischemic stroke were enrolled, and the incidence of severe swallowing disorder within 72 hours after admission was 19.3% (51/264). Compared with the non-severe swallowing disorder group, the severe swallowing disorder group had a higher proportion of patients aged of ≥ 60 years old, with severe neurological deficits [National Institutes of Health stroke scale (NIHSS) score ≥ 7], severe functional impairments [Barthel index, an activity of daily living functional status assessment index, < 40], brainstem infarction and lesions ≥ 40 mm (78.43% vs. 56.81%, 52.94% vs. 28.64%, 39.22% vs. 12.21%, 31.37% vs. 13.62%, 54.90% vs. 24.41%), and the differences were statistically significant (all P < 0.01). Multivariate Logistic regression analysis showed that age ≥ 60 years old [odds ratio (OR) = 3.542, 95% confidence interval (95%CI) was 1.527-8.215], NIHSS score ≥ 7 (OR = 2.741, 95%CI was 1.337-5.619), Barthel index < 40 (OR = 4.517, 95%CI was 2.013-10.136), brain stem infarction (OR = 2.498, 95%CI was 1.078-5.790) and lesion ≥ 40 mm (OR = 2.283, 95%CI was 1.485-3.508) were independent risk factors for severe swallowing disorder after acute ischemic stroke (all P < 0.05). The results of model validation showed that the consistency index was 0.805, and the trend of the calibration curve was basically consistent with the ideal curve, indicating that the model had good prediction accuracy. ROC curve analysis showed that the area under the ROC curve (AUC) predicted by nomogram model for severe swallowing disorder after acute ischemic stroke was 0.817 (95%CI was 0.788-0.852), indicating that the model had good discrimination. The decision curve showed that within the range of 5% to 90%, the nomogram model had a higher net benefit value for predicting the risk of severe swallowing disorder after acute ischemic stroke, indicating that the model had good clinical predictive performance.@*CONCLUSIONS@#The independent risk factors of severe swallowing disorder after acute ischemic stroke include age ≥ 60 years old, NIHSS score ≥ 7, Barthel index < 40, brainstem infarction and lesion size ≥ 40 mm. The nomogram model established based on these factors can effectively predict the occurrence of severe swallowing disorder after acute ischemic stroke.

Effects of fertilization methods and sperm sources on the developmental capacity of surplus embryos / 重庆医学

Objective To analyze the effects of fertilization methods and sperm sources in intra‐cytoplasmic sperm injection (ICSI) on the developmental capacity of surplus embryos .Methods A retrospective study was carried out to compare the blasto‐cyst rate of the surplus embryos from 2 697 patients .According to the fertilization methods ,the embryos were divided into IVF group and ICSI group .According to sperm sources ,the ICSI group was divided into ejaculated group and testicular sperm group . The rates of blastocyst formation and good quality blastocysts were compared between different fertilization methods and sperm sources .Results There were 8 426 embryo developed in 2 697 patients .The blastocyst formation rate of surplus embryos was high‐er in the IVF group(n=1 048 ,53 .18% ) than that in the ICSI group(n=1 378 ,49 .27% ) ,but with no statistically significant differ‐ent(P> 0 .05) .The rates of blastocyst were not statistically significant different between the IVF group and in the rescue ICSI group(P>0 .05) .The rates of blastocyst were not statistically significant different between the ejaculated group and the testicular sperm group(P>0 .05) .Conclusion There were not statistically significant different of the rate of blastocyst between different fer‐tilization methods and sperm sources in ICSI .

Application of the glycogen phosphorylase BB and heart-type fatty acid binding protein to the early diagnosis of neonatal myocardial injury / 实用医学杂志

Objective To evaluate the efficiency of glycogen phosphorylase BB (GPBB) and heart-type fatty acid binding protein (H-FABP) in the early diagnosis of neonatal myocardial injury (NMI). Methods The GPBB and H-FABP levels in the blood were detected at 3, 6, 12 and 24 h after onset of the NMI. The GPBB and H-FABP levels were compared among NMI, Non-NMI and control groups. The NMI diagnosis sensitivity and specificity for GPBB, H-FABP, GPBB combined with H-FABP were compared. The relationships of GPBB, H-FABP levels with the risk factors were analyzed. Results The GPBB and H-FABP levels of NMI group were higher than those of Non-NMI and control groups (P < 0.01). The diagnosis sensitivity of four time points (3, 6, 12 and 24 h) of combined GPBB and H-FABP were higher than those of the GPBB and H-FABP (P < 0.05). The GPBB and H-FABP were negatively correlated with blood glucose level, positively correlated with asphyxia degree and septicemia degree. Conclusion The combined application of GPBB and H-FABP can improve sensitivity in the early diagnosis of NMI.

Application of combined detection of H-FABP with cTnI in the diagnosis of myocardial damage caused by hypoglycemia / 重庆医学

Objective To investigate the clinical value of combined detection of H‐FABP with cTnI in the diagnosis of myo‐cardial damage caused by hypoglycemia .Methods Levels of blood H‐FABP and cTnI were examined at 0 to 3 h ,24 h ,48 h after hy‐poglycemia diagnosed ,and were compared with the control group .The levels of H‐FABP and cTnI at 24 h after hypoglycemia diag‐nosed were compared among different groups separated according to the decreasing extent of blood sugar (1 .0 to 2 .1 mmol/L ,0 .05) .The statistic difference of the increasing cTnI levels existed for 24 h (P0 .05) .The increasing extent of H‐FABP and cTnI levels was obvious for group with blood sugar <1 .0 mmol/L ,duration of hypoglycemia ≥24 h and have hypoglycemia symptom ,these data have obvious statistic difference compared with other groups(P<0 .05 ,P<0 .01 ,P<0 .01) .The sensitivity and specificity of H‐FABP methods were higher than those of cTnI ac‐cording to the 0 to 3 h and 24 h detection data ,while the opposite result was found for 48 h .Conclusion Combined detection of H‐FABP with cTnI could be well applied in the diagnosis of myocardial damage caused by hypoglycemia .

The levels of estradiol decline in the early luteal phase predictes the outcomes of in-vitro fertilization / 实用医学杂志

Objective To explore the role of estradiol decline in the early luteal phase (the 2nd day after oocyte retrieval) in the prediction of in-vitro fertilization outcomes. Methods A total of 236 cases under in vitro fertilization-embryo transfer (IVF-ET)/ intracytoplasmic sperm injection-embryo transfer(ICSI-ET) cycles were included in this retrospective study of their medical records. The cases were divided into three groups according to the levels of estradiol decline on the 2nd day following OPU: group A (n = 70) with the decline rate of less than 70%, group B (n=114) with the decline rate of 70%~80%and group C (n=52) at the decline rate of more than 80%. The comparisons were done among the three groups in terms of the number of oocyte retrieval, the rate of fertilization, the rate of best oocytes and the rate of miscarriage. Results There were no significant differences statistically in the number of oocyte retrieval, the rate of fertilization, the rate of best oocytes and the rate of miscarriage (P > 0.05). But the rates of clinical pregnancy rate in groups A and B were significantly higher than that in group C (68.6% and 68.4% vs. 44.2%) (P < 0.05). Conclusion The levels of estradiol declines in the early luteal phase may be important in the prediction of IVF outcomes.

NBNA used to assess the neurodevelopment of full-term small for gestational age infants / 国际儿科学杂志

Objective To investigate the difference of nerve behavior among the different types of fullterm small for gestational age infants(SGA) infants and the reasons.Methods The neonatal behavioral neurological assessment(NBNA) scores were given for 148 full-term SGA infants aged 7,14 and 28 days born in Affiliated Hospital of Hebei University.The comparason analysis was conducted among three types including symmetic,asymmetric and the mixture of them.Results Significant differences (P ＜ 0.05) were found between the NBNA scores for full-term SGA infants and normal infants.The NABA scores of full-term SGA infants were lower than those of normal infants.The NBNA scores for three types of full-term SGA infants followed the order of asymmetric ＞ symmetric ＞ mixture of them,significant difference was found between any two types of three types(P ＜ 0.05).Conclusion Full-term SGA infants show the poorer quality of nerve behavior compared with the nomal infants.The neurodevelopment levels for three types of full-term SGA infants are asymmetric,symmetric,mixture of them in the order.

Assessment for early embryo quality improves the sensitivity and specificity to predicting embryonic development potential / 中国组织工程研究

BACKGROUND:Embryo viability assessment is directly related to the selection of embryo transplantation and clinical outcome of assisted reproduction. OBJECTIVE:To summarize the assessment methods for early embryonic development. METHODS:The first author searched PubMed database for relevant articles published from January 1990 to December 2013 using the keywords of“assisted reproductive technology, art;pre-implantation embryo;embryonic development viability;evaluation methods”in English. Final y, 63 articles were included in result analysis. RESULTS AND CONCLUSION:In the embryo quality evaluation, the most widely used method is morphological evaluation method which is characterized as rapid, non-invasive, and simple. With the development of assisted reproductive technology, the morphological evaluation combined with time-lapse imaging analysis system has been recognized in embryo selection. Recently, targeted-metabolic analysis has been proposed as a useful tool for assessment of embryo development potential, involving pyruvate acid, glycometabolism, amino acid, and embryo-derived cytokines (soluble human leukocyte antigen G1, platelet-activating factor, etc.). Furthermore, the pre-implantation genetic screening method targeting gene and chromosome abnormality is expected to find more effective markers for evaluating embryo developmental potential.

Effect of three different fertilization modes of frozen-thawed embryos and blastocysts on pregnancy outcome / 国际检验医学杂志

Objective To compare the effect of three different fertilization modes of frozen-thawed embryos and blastocysts on the pregnancy outcome after thawed transplantation .Methods 3 586 cycles of frozen embryos transplantation (FET ) treatment in our center from January 2012 to December 2013 were retrospectively analyzed and divided into 3 groups according to the fertilization modes .The group A adopted the conventional in vitro fertilization (IVF) of frozen-thawed embryo transfer in 2 008 cases and blas-tocysts transfer in 954 cases .The group B adopted intracytoplasmic sperm injection (ICSI) of frozen-thawed embryo transfer in 361 cases and blastocysts transfer in 129 cases ;the group C was given early remedy intracytoplasmic sperm injection (r-ICSI) of frozen-thawed embryo transfer in 87 cases and blastocysts transfer in 47 cases .The recovery rate of embryo and blastocyst ,pregnancy rate ,abortion rate ,ectopic pregnancy rate were compared for determining whether the differences among the indexes existed . Results The thawing recovery rate ,pregnancy rate ,abortion rate and ectopic pregnancy rate in the three different fertilization modes of embryo and blastocyst had no statistically significant differences (P>0 .05) .Conclusion Compared with conventional in vitro fertilization and intracytoplasmic sperm injection ,early r-ICSI is one of effective treatment means .

Effects of frozen thawed embryos versus frozen thawed blastocysts on transfer period and delivery outcomes / 中国组织工程研究

BACKGROUND:Since the first frozen embryo transplantation succeeded in 1983, embryo cryotechnique has been an important component in human assisted reproductive techniques. It is controversial which embryos and blastocysts after cryopreservation is selected. OBJECTIVE:To compare the birth outcomes and neonatal status of frozen thawed embryos and blastocysts. METHODS:In frozen thawed embryo group (n=1 273) and frozen thawed blastocyst group (n=471), we compared pregnancy rate, abortion rate, ectopic pregnancy rate, premature delivery rate, average premature gestational weeks, term yield, average ful-term gestational age, newborn sex, birth weight, birth defects and so on. RESULTS AND CONCLUSION:There were frozen thawed blastocyst thaw cycles in 478 cases, 471 cases of transplantation period (including 7 cases without blastocyst transfer were canceled), 236 cases of pregnancy, 201 cases of delivery. Delivery number was 251, including 140 boys and 111 girls. The third day embryo thawing cycle of freezing and thawing appeared in 1 280 cases, 1 273 cases of transplantation period (including 7 cases of no embryo transplantation were canceled), 415 cases of pregnancy, 343 cases of delivery. The delivery number was 431, including 225 boys and 206 girls. Rate of pregnancy was significantly higher in frozen thawed blastocysts compared with frozen thawed embryos. No significant differences were detected in rate of miscarriage, ectopic pregnancy rate, premature delivery rate, average premature gestational weeks, term yield, average ful-termgestational age, newborn sex, and birth weight between frozen thawed embryos and blastocysts. There was no increase in birth defects between frozen thawed embryos and blastocysts. Results suggested that no significant difference was detected in birth outcomes and neonatal status of frozen thawed embryos and blastocysts. Nevertheless, pregnancy outcome is better in frozen thawed blastocysts than frozen thawed embryos.

Health inequalities during 20 years of rapid economic development in China (1980-2000): a mortality analysis / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To examine the influence of China's economic reforms on population health and regional mortality rates.</p><p><b>METHODS</b>Longitudinal study measuring the mortality trends and their regional variations. Using data from the three most recent national censuses, we used the model life table to adjust the mortality levels within the population for each census, and to calculate life expectancy. We then examined the variation in patterns of mortality and population health by economic status, region and gender from 1980-2000.</p><p><b>RESULTS</b>Life expectancy varied with economic status, province, and gender. Results showed that, although life expectancy in China had increased overall since the early 1980s, regional differences became more pronounced. Life expectancy for populations who live in the eastern coastal provinces are greater than those in the western regions.</p><p><b>CONCLUSION</b>Differences in life expectancy are primarily related to differences in regional economic development, which in turn exacerbate regional health inequalities. Therefore, it is necessary to improve economic development in less developed regions and to improve health policies and the public health system that address the needs of everyone.</p>