Development and validation of a method for quantitation of cefepime/avibactam in M-H broth: application to antibacterial activity using in vitro PK/PD Model / 中国临床药理学与治疗学

AIM: To establish a method for quantitation of cefepime and avibactam in M-H broth, and applicated in the in vitro dynamic PK/PD model. METHODS: The cefepime was also determined using the high-performance liquid chromatography method (HPLC), the avibactam was also determined using the liquid chromatography-mass spectrometry (LC-MS/MS), an in vitro dynamic PK/PD model was established to study the PK/PD relationship of cefepime/avibactam against carbapenem resistant Klebsiella pneumoniae (CRKP). RESULTS: The linear ranges of cefepime and avibactam were good at (0.5-20) and (0.1-25) μg/mL (r=0.999), and the lower limit concentrations were 0.5 and 0.1 μg/mL. The extraction recoveries of cefepime and avibactam in M-H broth were 88.0%-101.7% and 90.9%-95.2%, the relative standard deviation of intra-day precision and inter-day precision were less than 5.2%. The concentration-time curves were well simulated by the PK/PD model. All observed concentrations in each experiment were in the range of 20% of the targeted values. For the CRKP of MIC=8 μg/mL and MIC=16 μg/mL, the colony decreased to 2.783Log10 CFU/mL and 1.325Log10 CFU/mL at the cefepime/avibactam 2.5 g q8 h administration after 24 h. CONCLUSION: The determination method of cefepime and avibactam in broth established in this study has high sensitivity and good stability. For the CRKP with MIC≤8 μg/mL,cefepime/avibactam showed that good anti-CRKP activity under routine administration in vitro dynamic PK/PD model.

Dynamic changes in cytoskeletal elements following acute cerebral ischemia and reperfusion in rats / 中国药理学通报

Aim To investigate the dynamic time-course changes in neuronal cytoskeleton after acute ischemia and reperfusion in rats. Methods Reperfusion was performedin rats by blocking the middle cerebralarteryfor 90 min, then therats wereobserved and collected at different time points. The brain damage wasobserved by Nissl staining,and neurobehavioural function was evaluated with neurological deficit score and forelimb placement test. The cellular changes in the alternations of cytoskeletal elements including microtubule associated protein 2 (MAP2) and neurofilament heavy chain (NF-H) were observed by immunohistochemistry staining and Western blot. Impaired axons, dendrites and cytoskeletal alternations were detected by electron microscope. Results Brain damage and neurobehavioural function were gradually aggravated with the prolongation of reperfusion. Brain damage appeared earlier and more severe in striatum than in cortex. Moreover, decreased MAP2-related and increased NF-H-related immunoreactive intensities were found in the ischemic areas. Impaired cytoskeletal arrangement and reduced dense were indicated. Damaged cytoskeletal components such as microtubules and neurofilament arrangement, decreased axonal filament density, and swelled dendrites were observed after cerebral ischemia reperfusion by ultrastructural observations. Conclusions Different brain regions have diverse tolerance to ischemia-reperfusion injury. Major elements of neuronal cytoskeleton show dynamic responses to ischemia and reperfusion, which may further contribute to brain damage and neurological impairment following MCAO and reperfusion.

Application status of risk assessment models for periodontal disease / 口腔疾病防治

@#Risk assessment models for periodontal disease provide dentists with a precise and consolidated evaluation of the prognosis of periodontitis, enabling the formulation of personalized treatment plans. Periodontal risk assessment systems have been widely applied in clinical practice and research. The application fields of periodontal risk assessment systems vary based on the distinctions between clinical periodontal parameters and risk factors. The assessment models listed below are commonly used in clinical practice, including the periodontal risk calculator (PRC), which is an individual-based periodontal risk assessment tool that collects both periodontal and systemic information for prediction; the periodontal assessment tool (PAT), which allows for quantitative differentiation of stages of periodontal disease; the periodontal risk assessment (PRA) and modified periodontal risk assessment (mPRA), which are easy to use; and the classification and regression trees (CART), which assess the periodontal prognosis based on a single affected tooth. Additionally, there are orthodontic-periodontal combined risk assessment systems and implant periapical risk assessment systems tailored for patients needing multidisciplinary treatment. This review focuses on the current application status of periodontal risk assessment systems.

Temporal Unfolding of Racial Ingroup Bias in Neural Responses to Perceived Dynamic Pain in Others / 神经科学通报·英文版

In this study, we investigated how empathic neural responses unfold over time in different empathy networks when viewing same-race and other-race individuals in dynamic painful conditions. We recorded magnetoencephalography signals from Chinese adults when viewing video clips showing a dynamic painful (or non-painful) stimulation to Asian and White models' faces to trigger painful (or neutral) expressions. We found that perceived dynamic pain in Asian models modulated neural activities in the visual cortex at 100 ms-200 ms, in the orbitofrontal and subgenual anterior cingulate cortices at 150 ms-200 ms, in the anterior cingulate cortex around 250 ms-350 ms, and in the temporoparietal junction and middle temporal gyrus around 600 ms after video onset. Perceived dynamic pain in White models modulated activities in the visual, anterior cingulate, and primary sensory cortices after 500 ms. Our findings unraveled earlier dynamic activities in multiple neural circuits in response to same-race (vs other-race) individuals in dynamic painful situations.

Utilização de dispositivos digitais, funcionamento familiar e desenvolvimento da linguagem em crianças de idade pré-escolar: um estudo transversal / Use of digital devices, family functioning, and language development in preschool children: a cross-sectional study

RESUMO Objetivo Este estudo teve como objetivo analisar a relação entre a utilização de dispositivos digitais, o funcionamento familiar e o desenvolvimento da linguagem em crianças de idade pré-escolar. Método Estudo transversal, descritivo-correlacional com uma amostra de 93 díades pais-crianças. As crianças tinham uma média etária de 57,01 ± 9,95 meses, sendo a maioria do gênero feminino. Os instrumentos de recolha de dados incluíram um questionário sobre o uso de dispositivos digitais, a versão portuguesa da Escala de Avaliação da Flexibilidade e Coesão Familiar - Versão IV (FACES-IV) e o Teste de Linguagem - Avaliação de Linguagem Pré-Escolar (TL-ALPE). Resultados As respostas demonstram uma maior tendência para a utilização do smartphone, tablet e televisão entre 0 e 3 horas por dia nas crianças. Com a aplicação da FACES-IV e do TL-ALPE, verificou-se que a maioria das famílias participantes eram do tipo equilibrado e que a maioria das crianças apresenta um normal desenvolvimento da linguagem. Observaram-se relações estatisticamente significativas entre a FACES-IV e o TL-ALPE; a FACES-IV e a utilização de dispositivos digitais; a utilização de dispositivos digitais e o TL-ALPE. Verificou-se que crianças com um funcionamento familiar mais equilibrado pontuam mais alto nas provas do TL-ALPE e que o tempo de uso de dispositivos digitais pode comprometer o desenvolvimento da linguagem. Conclusão Destaca-se o impacto da utilização dos dispositivos digitais e o papel do funcionamento familiar no desenvolvimento da linguagem da criança, sugerindo que uma utilização moderada de dispositivos digitais e um funcionamento familiar equilibrado são fatores facilitadores de um bom desenvolvimento da linguagem.

ABSTRACT Purpose This study aimed to analyse the relationship between the use of digital devices, family function, and language development in preschool children. Methods This cross-sectional, descriptive-correlational study included a sample of 93 parent-child dyads. The children were of an average age of 57.01 ± 9.95 months, and the majority were female. The data collection instruments included a questionnaire on the use of digital devices, the Portuguese version of the Family Flexibility and Cohesion Evaluation Scale - Version IV (FACES-IV), and a Preschool Language Test (TL-ALPE). Results The findings showed a greater tendency of children to use smartphones, tablets, and television for 0-3 hours daily. The analysis of the responses on the FACES-IV and TL-ALPE instruments showed that most of the participating families were of the balanced type and that most children had normal language development. Statistically significant relationships were found between the FACES-IV subscales and TL-ALPE subtests, FACES-IV subscales and the use of digital devices, and the use of digital devices and TL-ALPE subtests. Notably, children in more balanced family functioning scored higher on TL-ALPE tests, and the time spent using digital devices may compromise language development. Conclusion This study highlights the impact of digital device use and the role of family functioning on children's language development, suggesting that moderate digital device use and balanced family functioning are facilitating factors for good language development.

Dynamic evaluation of liver fibrosis to assess hepatocellular carcinoma risk in patients with chronic hepatitis B receiving nucleoside analogs treatment

ABSTRACT Despite good hepatitis B virus (HBV) inhibition by nucleoside analogs (NAs), cases of hepatocellular carcinoma (HCC) still occur. This study proposed a non-invasive predictive model to assess HCC risk in patients with chronic hepatitis B (CHB) receiving NAs treatment. Data were obtained from a hospital-based retrospective cohort registered on the Platform of Medical Data Science Academy of Chongqing Medical University, from 2013 to 2019. A total of 501 patients under NAs treatment had their FIB-4 index updated semiannually by recalculation based on laboratory values. Patients were divided into three groups based on FIB-4 index values: < 1.45, 1.45-3.25, and ≥ 3.25. Subsequently, HCC incidence was reassessed every six months using Kaplan-Meier curves based on the updated FIB-4 index. The median follow-up time of CHB patients after receiving NAs treatment was 2.5 years. HCC incidences with FIB-4 index < 1.45, 1.45-3.25, and ≥ 3.25 were 1.18%, 1.32%, and 9.09%, respectively. Dynamic assessment showed that the percentage of patients with FIB-4 index < 1.45 significantly increased semiannually (P < 0.001), and of patients with FIB-4 index ≥ 3.25 significantly decreased (P < 0.001). HCC incidence was the highest among patients with FIB-4 index ≥ 3.25. The FIB-4 index effectively predicted HCC incidence, and its dynamic assessment could be used for regular surveillance to implement early intervention and reduce HCC risk.

Factores dinámicos asociados a la reincidencia de menores infractores en España y Portugal: revisión sistemática y metaanálisis / Dynamic factors associated with recidivism among juvenile offendersin Spain and Portugal: systematic review and meta-analysis / Fatores dinâmicos associadosà reincidência entre delinquentes juvenis na Espanha e em Portugal: revisão sistemática e meta-nálise

El presente artículo analiza la evidencia empírica que aportan los estudios sobre la influencia de los factores dinámicos asociados a la reincidencia criminal de menores infractores dentro del contexto español y portugués. La búsqueda de los términos Juvenile delinquency* OR juvenile offenders* AND recidivism* OR Risk factors * se realizó en las bases de datos Scopus, ScienceDirect, Web of science, Dialnet, Scielo y ProQuest. Aplicados los criterios de inclusión y exclusión, de un total de 105 653 artículos, se seleccionaron 20 para análisis cualitativo y 3 para incluir en el metaanálisis. El estudio permite concluir que los factores dinámicos con mayor capacidad de predicción son la educación, la relación con el grupo de pares, el tiempo de ocio, la familia y el consumo de SPA.

This article analyses the empirical evidence provided by studies on the influence of dynamic factors associated with the criminal recidivism of juvenile offenders in the Spanish and Portuguese context. The search for the terms Juvenile delinquency* OR juvenile offenders* AND recidivism* OR Risk factors* was carried out in the databases Scopus, ScienceDirect, Web of science, Dialnet, Scielo and ProQuest. After applying the inclusion and exclusion criteria, out of a total of 105 653 articles, 20 were selected for qualitative analysis and 3 for inclusion in the meta-analysis. The study allows us to conclude that the dynamic factors with the greatest predictive capacity are education, relationship with peer group, leisure time, family and PAS consumption.

Este artigo analisa as evidências empíricas fornecidas por estudos sobre a influência de fatores dinâmicos associados à reincidência de crimes de menores nos contextos espanhol e português. A busca pelos termosjuvenile delinquency* OR juvenile offenders* AND recidivism* OR risk factors* foi realizada nos bancos de dados Scopus, ScienceDirect, Web of Science, Dialnet, SciELO e ProQuest. Após a aplicação dos critérios de inclusão e exclusão, de 105.653 artigos, 20 foram selecionados para a análise qualitativa e 3 para a inclusão na meta-nálise. O estudo nos permite concluir que os fatores dinâmicos com maior capacidade preditiva são educação, relacionamento com o grupo de pares, tempo de lazer, família e consumo de PAS.

Cierre dinámico y toxina botulínica: una alternativa novedosa para el cierre definitivo del abdomen abierto y contenido / Dynamic closure system and botulinum toxin: a novel alternative for definitive closure of open abdomen

RESUMEN Se presenta el caso de un paciente masculino de 54 años que, cursando internación por neumonía- COVID-19, intercurrió con shock séptico por diverticulitis aguda Hinchey IV, por lo que se realizó cirugía de Hartmann. Evolucionó con isquemia colónica, se realizó colectomía total y abdomen abierto y contenido (AAyC). El manejo del AAyC se realizó con sistema de vacío (VAC) durante 7 semanas, resultando un AAyC tipo IIIa (Björck) con un gap de 16 cm. Se decidió iniciar, una vez dadas las condiciones clínicas del paciente, el cierre dinámico (CD) con tracción fascial con malla de polipropileno asociado a inyección de toxina botulínica (TB). Esta estrategia permitió el cierre fascial primario (CFP) de la pared abdominal en la quinta semana de comenzado el tratamiento, evitando de esta manera la morbilidad de un cierre por segunda intención.

ABSTRACT We report the case of a 54-year-old male patient hospitalized for COVID-19 pneumonia who developed septic shock due to acute Hinchey IV diverticulitis and required Hartmann's surgery. The patient evolved with colonic ischemia and underwent total colectomy and open abdomen (OA) with temporary abdominal closure (TAC) that was managed with a vacuum-assisted wound closure (VAWC) system for 7 weeks, resulting in a Björck grade 3A OA with a 16-cm gap. As he had a favorable clinic course, dynamic closure with mesh-mediated fascial traction was decided, associated with botulinum toxin (BT) injection. This strategy allowed primary fascial closure (PFC) of the abdominal wall 5 weeks after treatment was initiated, thus avoiding the complications of healing by secondary intention.

Cardiopulmonary effects of prolonged surgical abdominal retractors application during general anesthesia: a prospective observational comparative study

Abstract Introduction: Increasing abdominal pressures could affect pulmonary compliance and cardiac performance, a fact based on which the aim of the present study to detect the cardiopulmonary burden of multiple retractors application during supine versus lateral abdominal surgeries. We hypothesized that surgical ring multiple retractors application would affect the pulmonary and cardiac functions during both lateral and supine abdominal surgeries. Methods: Prospective observational comparative study on forty surgical patients subdivided into two groups twenty each, comparing pulmonary compliance and cardiac performance before, during and after retractors application, group (S) supine position cystectomy surgery, and group (L) lateral position nephrectomy surgery under general anesthesia, Composite 1ry outcome; dynamic compliance C-dyn and cardiac index CI and Other outcome variables ICON cardio-meter were also recorded. Results: C-dyn and C-stat were significantly decreased late during retractor application in lateral compared to supine surgery with significant decrease compared to basal values all over the surgical time. CI was significantly increased after retractor removal in both of the study groups compared to basal values. PAW P was significantly increased in -lateral compared to supine surgery -with significant increase compared to basal value all over the surgical time in both of the study groups. significant increase in DO2I compared to basal value during both supine and lateral positions. Conclusion: Surgical retraction results in a short-lived significant decreases in lung compliance and cardiac output particularly during the lateral-kidney position than the supine position compliance.

Advances in Shock Management and Fluid Resuscitation in Children

Shock in children is associated with signifcant mortality and morbidity, particularly in resource-limited settings. The principles of management include early recognition, fuid resuscitation, appropriate inotropes, antibiotic therapy in sepsis, supportive therapy for organ dysfunction, and regular hemodynamic monitoring. During the past decade, each step has undergone several changes and evolved as evidence that has been translated into recommendations and practice. There is a paradigm shift from protocolized-based care to personalized management, from liberal strategies to restrictive strategies in terms of fuids, blood transfusion, ventilation, and antibiotics, and from clinical monitoring to multimodal monitoring using bedside technologies. However, uncertainties are still prevailing in terms of the volume of fuids, use of steroids, and use of extracorporeal and newer therapies while managing shock. These changes have been summarized along with evidence in this article with the aim of adopting an evidence-based approach while managing children with shock.

Tratamiento de las fracturas del antebrazo con placas de compresión dinámica

Introducción: Las fracturas del antebrazo comprometen la diáfisis del radio y el cúbito. Su relación anatómica desempeña un papel importante porque el antebrazo se vincula con los movimientos de la mano para garantizar la función de la extremidad y de los tejidos blandos. Objetivo: Evaluar los resultados del tratamiento de la fractura diafisiarias de antebrazo con placa de compresión dinámica. Métodos: Se realizó un estudio prospectivo, longitudinal y descriptivo en 28 pacientes con fractura diafisaria de antebrazo, intervenidos quirúrgicamente con placa de compresión dinámica en el Hospital Ortopédico Docente "Fructuoso Rodríguez". Los resultados fueron evaluados según la escala funcional de Grace-Eversmann. Resultados: La edad media fue de 38 años, con una proporción entre sexos de 2,1:1. Predominaron las fracturas del tercio medio del radio y del cúbito. Se afectó más el lado izquierdo, pero en el 75 % de los casos hubo un excelente resultado. No se registraron fallas con la técnica quirúrgica aplicada. Conclusiones: La osteosíntesis con placa de compresión dinámica en las fracturas diafisarias de antebrazo es una alternativa adecuada para garantizar tasas de consolidación elevadas y resultados funcionales excelentes.

Introduction: Fractures of the forearm compromise the diaphysis of the radius and ulna. Their anatomical relationship plays an important role because the forearm is linked to hand movements to ensure limb and soft tissue function. Objective: To evaluate the results of treating diaphyseal forearm fracture with dynamic compression plate. Methods: A prospective, longitudinal and descriptive study was carried out in 28 patients with diaphyseal fracture of the forearm. They underwent surgery with a dynamic compression plate at Fructuoso Rodríguez Teaching Orthopedic Hospital. The results were evaluated according to Grace-Eversmann functional scale. Results: The mean age was 38 years, with a gender ratio of 2.1:1. Fractures of the middle third of the radius and ulna predominated. The left side was affected more, but 75% of the cases had excellent result. No failures were recorded with the applied surgical technique. Conclusions: Osteosynthesis with dynamic compression plating in diaphyseal fractures of the forearm is a suitable alternative to guarantee high consolidation rates and excellent functional results.

Value of dynamic subtraction MRI in assessing HCC response to image-guided loco-regional therapy

Background: Hepatocellular carcinoma (HCC) is considered one of the foremost cancers worldwide. Although the hepatic resection of HCC has a high existence in the clinical scenarios, locoregional management is preferred owing to the preservation of hepatic parenchyma with lower morbidity and mortality. Dynamic contrast-enhanced MR with subtraction imaging improves the evaluation of managed HCC with easy detection of residual or recurrent viable lesions. Patients and methods: This study was designed in a retrospective pattern from December 2020 to December 2022. Forty patients were referred to our radiology department with solitary HCC, underwent therapeutic intervention, then underwent follow-up by dynamic MRI study. Results: Forty patients with solitary HCC were conducted during our study; all underwent locoregional therapy with follow-up by dynamic MRI with subtraction technique one month later. The subtraction image has a sensitivity of 100%, specificity of 100%, PPV of 100%, NPV of 100%, and 100% accuracy, compared to 90.91%, 77.78%, 83.33%, 87.5%, and 85% for conventional dynamic images, 45.45%, 100%, 100%, 60% and 70% for diffusion-weighted images. Analysis of those results exhibited a considerable additive value of the subtraction technique to the dynamic MRI to detect the response of HCC after management. Conclusions: Subtraction MRI is a pivotal tool to assess the interventional treatment of HCC, particularly in lesions having pre-contrast high signal intensity with distinguished radiologists' confidence

The application potential of a modified wireless intelligent capsule cystoscope for dynamic detection of porcine bladder mucosa / 中华泌尿外科杂志

Objective:To develop an improved wireless intelligent capsule cystoscope (WCE)for dynamic detection of bladder mucosa in a pig model.Methods:The WCE was introduced into a healthy experimental pig that under general anesthesia via urethra by applying an improved device. Multi-angle images of the bladder mucosa were then obtained by controlling the position of capsule cystoscope with an external magnetic field system. The shutter speed of the WCE was 2.5 fps and was automatically converted to 1.5 fps 30 minutes after initiation. The Vue software was utilized to download the shoot pictures which were former received by a computer via wireless transmission. The pig was roused and sent to the pigpen, without limitations in moving. The improved WCE was connected with a 2 cm thread. 12 hours later, the dilated sheath was inserted again, and the capsule was removed by a foreign body forceps under observation of a ureteroscopy.Results:The WCE was successfully placed and removed from the pig's bladder with the application of the improved devices. Over 20 thousand images that with 60K pixels of bladder mucosa were captured by the WCE at various angles within 12 hours, which revealed the process of urine filling and excreting in a time-dependent way. No notable adverse effects (bleeding, urinary tract injury, etc) were noted during the process of cystoscope placement, image acquisition, transmission, and removal.Conclusion:This study developed a novel WCE that could dynamically, intelligently and accurately monitor all aspects of the pig bladder mucosa, and has preferable application prospect.

Differences in dynamic functional connectivity density in individuals with light and heavy smoking addiction: a study based on functional MR / 中华放射学杂志

Objective:To investigate the changes in dynamic functional connectivity density (dFCD) and its relationship with Fagerstr?m test for nicotine dependence (FTND) scores in individuals with smoking addiction based on functional MR.Methods:The clinical and imaging data of 176 volunteers recruited through wechat and other online platforms from September 2019 to December 2020 in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed. The 176 volunteers were male, aged 20 to 55 years old, and were divided into light smoking addiction group (59 cases), heavy smoking addiction group (61 cases) and control group (56 cases). All subjects underwent resting state functional MR scanning and dFCD was calculated. The dFCD values of three groups were analyzed by ANOVA analysis (GRF corrected, voxel level P<0.005, cluster level P<0.01). Bonferroni correction was used for pairwise comparison. Pearson partial correlation analysis was used to analyze the correlation between dFCD values of brain regions with statistically significant differences and FTND scores. Results:Differences in dFCD among light smoking addiction group, heavy smoking addiction group and control group were mainly distributed in the right orbitofrontal cortex, left caudate nucleus, right putamen, bilateral calcarine sulcus cortex, right cuneus, left parahippocampal gyrus, left precuneus, left middle temporal gyrus and bilateral thalamus (GRF corrected, voxel level P<0.005, cluster level P<0.01). Compared with the control group, both the light and heavy smoking addiction groups showed decreased dFCD in the bilateral calcarine sulcus cortex, right cuneus and left precuneus, as well as increased dFCD in the right orbitofrontal cortex, right putamen, left caudate nucleus and left thalamus (Bonferroni corrected, P<0.05). Compared with the control group, the heavy smoking addiction group showed increased dFCD in the right thalamus, and the light smoking addiction group showed decreased dFCD in the left middle temporal gyrus (Bonferroni corrected, P<0.001). Compared with the light smoking addiction group, the heavy smoking addiction group showed increased dFCD in the left middle temporal gyrus and right thalamus, and decreased dFCD in the left parahippocampal gyrus (Bonferroni corrected, P<0.05). The mean value of dFCD in the right thalamus was positively correlated with FTND scores in smoking addiction patients ( r=0.227, P=0.014), and the mean value of dFCD in the right thalamus of the heavy smoking addiction subgroup was positively correlated with FTND scores ( r=0.323, P=0.013). There was no correlation between FTND scores and dFCD in the right thalamus of the light smoking addiction group ( P>0.05). Conclusion:There are changes of neural activity in brain regions related to smoking behaviors among people with different severity of smoking addiction, and smoking behaviors of people with heavy smoking addiction tend to be habitual compared with those with light smoking addiction.

Correlation between hemodynamic characteristics or dynamic cerebral autoregulation and postoperative hyperperfusion in patients undergoing carotid endarterectomy / 中华超声影像学杂志

Objective:To investigate the hemodynamic characteristics and dynamic cerebral autoregulation(dCA) of patients with severe carotid stenosis before carotid endarterectomy(CEA), and to analyze their correlations with hyperperfusion after CEA.Methods:A total of 63 patients with unilateral severe carotid artery atherosclerotic stenosis who underwent CEA were consecutively recruited prospectively in Xuanwu Hospital, Capital Medical University from January 2021 to August 2021. According to postoperative hyperperfusion, patients were divided into hyperperfusion group (13 cases) and non-hyperperfusion group (50 cases). The general clinical data and hemodynamic parameters were compared between the two groups. The dCA was evaluated by the transfer function analysis that measured the fluctuation amplitude of mean cerebral blood flow velocity(CBFV) with blood pressure change, the time difference of phase with blood pressure change, and the correlation between mean CBFV and blood pressure change. The value of dCA for predicting postoperative hyperperfusion was analyzed through the ROC curve and the area under the curve(AUC).Results:①The proportion of hypertension in hyperperfusion group was higher than that in non-hyperperfusion group ( P<0.05). ②The peak systolic velocity (PSV) at the stenosis lesion of the internal carotid artery, the end-diastolic velocity (EDV) at the stenosis lesion of the internal carotid artery and the ratio of PSV at the stenosis lesion of the internal carotid artery to the distal internal carotid artery in the hyperperfusion group were higher than the non-hyperperfusion group.And the PSV of the ipsilateral middle cerebral artery in the hyperperfusion group was lower than the non-hyperperfusion group (all P<0.05). ③In the very low-frequency and low-frequency region, the phase in the hyperperfusion group was lower than that in the non-hyperperfusion group (all P<0.05), while there was no significant difference in the high-frequency regions( P>0.05). In the three regions of very low-frequency, low-frequency and high-frequency, there were no significant differences in the gain and coherence between the two groups(all P>0.05). ④The best cutoff value of phase in the very low-frequency was 33.28 for predicting hyperperfusion after CEA (AUC=0.766, 95% CI=0.629-0.904, P=0.03), with the specificity of 0.700, and sensitivity of 0.846. Conclusions:There are differences in hemodynamics and dCA between the hyperperfusion group and the non-hyperperfusion group after CEA. The impaired preoperative dynamic cerebral autoregulation is an independent predictor of postoperative hyperperfusion.

Dynamic changes and predictive values of routine laboratory parameters in patients with hemorrhagic fever with renal syndrome / 中华传染病杂志

Objective:To investigate the dynamic changes of routine laboratory parameters during the course of hemorrhagic fever with renal syndrome (HFRS) and estimate the predictive value for the severity of the disease.Methods:A retrospective cohort study was conducted, which enrolled 394 HFRS patients admitted to the Second Affiliated Hospital of Air Force Medical University (374 cases) and the Second Affiliated Hospital of Xi′an Jiaotong University (20 cases) from January 2019 to January 2022. The patients were divided into mild (mild and moderate) and severe (severe and critical) groups.The basic information, personal history, past history, treatment, complications and other clinical data of patients were collected and the results of the laboratory examinations in the morning at day 1, 2, 3, 4, 5, 7, 10, 15, 20 and 25 of hospitalization and before discharge were recorded. The dynamic changes of the patients′ routine laboratory indicators and the dynamic predictive values of each indicator for severe condition were analyzed. Mann-Whitney U test and chi-square test were used for comparison, and receiver operator characteristic (ROC) curve was used for predictive value evaluation. Results:The age of 212 patients in the mild group was 38(27, 61) years, and that of 182 patients in the severe group was 49(32, 64) years, the difference was statistically significant ( Z=-2.24, P=0.025). The incidences of acute pancreatitis, acute respiratory distress syndrome, multiple organ dysfunction syndrome, the utilization rates of blood purification and mechanical ventilation in the severe group were 6.0%(11/182), 12.6%(23/182), 19.8%(36/182), 89.6%(163/182) and 22.5%(41/182), respectively, and those in the mild group were 0(0/212), 0(0/212), 0(0/212), 15.6%(33/212) and 0.5%(1/212) respectively, and the differences were all statistically significant ( χ2=13.18, 28.45, 46.15, 214.48 and 50.02, respectively, all P<0.05). The levels of white blood cell count, lymphocyte count, monocyte count and neutrophil count were all increased rapidly after onset and peaked at days 4 to 6 of illness, with the counts of 14.2(9.7, 20.7)×10 9/L, 4.2(2.3, 6.2)×10 9/L, 1.5 (0.8, 3.3)×10 9/L and 8.3(4.3, 11.4)×10 9/L, respectively. Aspartate aminotransferase peaked (102(66, 178) U/L) within three days after onset and then decreased rapidly, returned to normal level by day 12. Blood urea nitrogen and creatinine both increased steadily after onset, peaked at day 9 to 10, with the levels of 13.2(7.7, 19.1) mmol/L and 255.4(122.9, 400.9) μmol/L, respectively. Prothrombin time, activated partial thromboplastin time, fibrinogen degradation products and D-dimer levels at day 3 after onset were 12.7(12.0, 13.2) s, 38.7(33.5, 51.9) s, 12.6(6.9, 32.0) mg/L and 4.9(2.2, 13.7) mg/L, respectively.Platelet count at day 4, neutrophil count at day 5, creatinine at day 11 and blood urea nitrogen at day 14 after onset had decent predictive values for estimating severity, of which the area under curve (AUC) values were 0.801(95% confidence interval (95% CI) 0.727 to 0.875), 0.824(95% CI 0.770 to 0.878), 0.862(95% CI 0.805 to 0.919) and 0.810(95% CI 0.722 to 0.897), respectively. Conclusions:Routine blood count, liver function and coagulation are important reference indicators for early warning of severe disease of HFRS, while with the progress of the disease, renal function indicators are effective in differentiating the severity of the disease. The platelet count at day 4, neutrophil count at day 5, creatinine at day 11 and blood urea nitrogen at day 14 after onset have predictive values for severe HFRS.

Application value of CT plain scan and dynamic enhanced scan in the diagnosis of solitary pulmonary nodules / 中国医师杂志

Objective:To explore the application value of computed tomography (CT) plain scan and dynamic enhanced scan in the diagnosis of solitary pulmonary nodules.Methods:The clinical data of 120 patients with solitary pulmonary nodules detected by physical examination in Baoding First Central Hospital from January 2018 to December 2020 were retrospectively reviewed. All patients were confirmed by surgery and pathology, including 77 benign lesions and 43 malignant lesions; All patients underwent CT plain scan and dynamic enhanced scan before operation. The accuracy of the two examination methods in the diagnosis of benign and malignant lesions of solitary pulmonary nodules was analyzed and compared. The detection rate of CT dynamic enhanced scan imaging characteristics (vacuole sign, ground glass sign, spinous sign, lobulation sign, hair prick sign, blood vessel cluster, pleural depression) of benign and malignant lesions of solitary pulmonary nodules was compared, and the diagnostic value of CT plain scan and dynamic enhanced scan in the differential diagnosis of benign and malignant solitary pulmonary nodules was evaluated based on the results of surgical pathological diagnosis. The manifestations and characteristic curves of CT dynamic enhanced scan of solitary pulmonary nodules was analyzed.Results:The diagnostic accuracy of CT dynamic enhanced scan for solitary pulmonary nodules was 80.00% (96/120), which was higher than that of CT plain scan (63.33%) (76/120) ( P<0.05). The sensitivity, specificity, and negative predictive value of CT dynamic enhanced scan for the diagnosis of benign and malignant lesions of solitary pulmonary nodules were higher than those of CT plain scan (all P<0.05). Among the imaging characteristics of CT dynamic enhanced scans of malignant lesions, the ground glass sign, spinous process sign, lobulation sign, spiculation sign, vascular clustering and pleural indentation were detected more frequently than those of benign lesions (all P<0.05). Benign lesions usually showed homogeneous enhancement, and a few showed heterogeneous enhancement; Malignant nodules often showed uneven enhancement, and a few had even enhancement. The time density curves of dynamic enhanced CT values in the regions of interest of benign and malignant solitary pulmonary nodules were different. Conclusions:The value of dynamic enhanced CT scan in the differential diagnosis of benign and malignant lesions of solitary pulmonary nodules is higher than that of CT plain scan, and the imaging features are obvious, with higher sensitivity and specificity, which is worthy of application.

New understandings of the pathogenesis of primary angle-closure glaucoma / 中华实验眼科杂志

Primary angle-closure glaucoma (PACG) is still one of the common blinding eye diseases in China.Because of the irreversibility of the vision loss it caused, the factors affecting the early development of glaucoma are of great concern.The understanding of static anatomic structure of high-risk anterior segment, such as shallow anterior chamber, short axial length, thick iris and large anterior lens cannot fully explain the transformation process of PACG, so the specific role of dynamic changes in the development of glaucoma should be further considered.This article expounded the differences in iris volume and dynamic process of elasticity between normal people and patients with PACG, the incoordination between lens and intraocular structure during eyeball development, the dynamic block and expansion of ciliary body, vitreous and choroid, and the latest research on the relationship between the abnormal ocular nerve and vascular system adjustment and change with the onset of PACG, in order to provide guidance for understanding the pathogenesis of PACG, accurate clinical diagnosis and formulation of treatment strategies.

Dynamic relationship between changes of mortality rate and urban development level in Shanghai / 上海预防医学

ObjectiveTo analyze the dynamic response relationship between urban development and mortality rate in Shanghai， and to predict the trend of mortality rate changes. MethodsBy analyzing the total mortality rate （TMR）， gross domestic product （GDP） and socio-demographic index （SDI） in Shanghai from 1978 to 2017， a vector autoregressive （VAR） model was constructed to evaluate the impact of urban development on the mortality rate. ResultsThe fitted R2 of the VAR model was 0.92. The short-term effect of GDP on the improvement of death level was negative， while the long-term effect was positive， and the SDI was negative regardless of the short-term and long-term effects. By the tenth year， GDP and SDI contributed 10.61% and 27.25% to TMR changes， respectively. The model predicted that the mortality rate in Shanghai would be 9.17 per thousand by 2030. ConclusionLong-term economic growth can effectively promote a decline in population mortality. However， as the economy develops vigorously， the adverse effects of declining birth rates and population aging on population health during the era of high-level population development should not be ignored.

An Algorithm for Measuring Vertical Ground Reaction Force Based on Insole Sensors / 医用生物力学

Objective A practical and highly accurate algorithm for dynamic monitoring of plantar pressure was proposed, the magnitude of vertical ground reaction force (vGRF) during walking was measured by a capacitive insole sensor, and reliability of the prediction accuracy was verified. Methods Four healthy male subjects were require to wear capacitive insole sensors, and their fast walking and slow walking data were collected by Kistler three-dimensional (3D) force platform. The data collected by the capacitive insole sensors were pixelated, and then the processed data were fed into a residual neural network, ResNet18, to obtain high-precision vGRF. Results Compared with analysis of the data collected from Kister force platform, the normalized root mean square error (NRMSE) for fast walking and slow walking were 8.40% and 6.54%, respectively, and the Pearman correlation coefficient was larger than 0.96. Conclusions This study provides a novel algorithm for dynamic measurement of GRF in mobile scenarios, which can be used for estimation of complete GRF outside the laboratory without being constrained by the number and location of force plates. Potential application areas include gait analysis and efficient capture of pathological gaits.