Effects of lower limb exoskeleton robot gait training on balance function in children with spastic diplegia / 中国康复医学杂志

Objective:To investigate the effect of lower limb exoskeleton robots on balance function in children with spas-tic diplegia. Method:Twenty children with spastic diplegia who were admitted to the Department of Rehabilitation of the Children's Hospital of Zhejiang University School of Medicine from July 2022 to December 2022 were includ-ed in the treatment group.The other 20 children matched with age,gender and functional status were includ-ed in the control group.Both groups were given conventional rehabilitation training(exercise therapy,suspen-sion training,isokinetic muscle strength training),and the treatment group were received the 30-min lower limb exoskeleton robot training 5 times a week for 8 weeks.Before and after treatment,the two groups were tested with surface electromyography(sEMG)data,dynamic balance response displacement,static balance score,and Pediatric Balance Scale(PBS). Result:Before treatment,there was no statistically significant difference(P＞0.05)in sEMG values(gluteus maximus,gluteus medius,quadriceps femoris and tibialis anterior muscle),dynamic balance reaction displace-ment,static balance score,and PBS score between the two groups.There were significant improvements in the scores of these measurements(P＜0.05)in both group before and after treatment.Compared with the con-trol group,there were statistically significant differences in sEMG values(gluteus maximus P=0.021;gluteus medius P=0.016;quadriceps femoris P=0.004),dynamic balance reaction displacement(anterior P=0.014;left P=0.003;right P=0.003),static balance score(P=0.005),and PBS score(P=0.004)in the treatment group af-ter treatment. Conclusion:Lower limb exoskeleton robot gait training combined with conventional rehabilitation treatment can effectively improve the balance function of cerebral palsy children with spastic diplegia.

Regulation of DNA methylation during the testicular development of Shaziling pigs.

DNA methylation is one of the key epigenetic regulatory mechanisms in development and spermatogenesis. However, the dynamic regulatory mechanisms of genome-wide DNA methylation during testicular development remain largely unknown. Herein, we generated a single-base resolution DNA methylome and transcriptome atlas of precocious porcine testicular tissues across three developmental stages (1, 75, and 150 days old). The results showed that the dynamic methylation patterns were directly related to the expression of the DNMT3A gene. Conjoint analysis revealed a negative regulatory pattern between promoter methylation and the positive regulation of 3'-untranslated region (3'UTR) methylation. Mechanistically, the decrease in promoter methylation affected the upregulation of meiosis-related genes, such as HORMAD1, SPO11, and SYCE1. Demethylation in the 3'UTR induced the downregulation of the INHBA gene and knockdown of INHBA inhibited cell proliferation by reducing the synthesis of activin A. These findings contribute to exploring the regulatory mechanisms of DNA methylation in testicular development.

The influence of the value of the echocardiography in the detection of cancer therapeutics-related cardiotoxicity by World Alliance Societies of Echocardiography(WASE) study / 中华超声影像学杂志

Objective:To explore the influence of the value of the echocardiography in the detection of cancer therapeutics-related cardiotoxicity by World Alliance Societies of Echocardiography(WASE) study.Methods:Tirty-seven breast cancer patients underwent echocardiography at baseline before chemotherapy (T0) and after the second (T2), fourth (T4), sixth (T6) chemotheraphy cycles in Qilu Hospital of Shandong University from March 2017 to March 2018. According to different guidelines[ASE lower limit of normal left ventricular ejection fraction(LVEF-LLN) 53%, ESC LVEF-LLN 50% and the WASE study (Women LVEF-LLN 58%, Asian Women LVEF-LLN 59%)], the number of patients with myocardial injury during chemotherapy was evaluated, and compared with the global longitudinal strain(GLS) standard, the percentages of patients with myocardial injury in different standards were analyzed.Results:With the up-regulation of LVEF-LLN, more patients with early myocardial damage were found. During chemotherapy, 1 patient showed left ventricular ejection fraction (LVEF) fell by >10% from baseline to LVEF<50% (2016 ESC Guidelines), 3 patients showed LVEF fell by >10% from baseline to LVEF<53% (2014 ASE Guidelines), 7 patients for LVEF fell by >10% from baseline to LCVEF<58%, and 9 patients for LVEF fell by >10% from baseline to LVEF<59%, which was still less than the number of patients detected by GLS criteria (18 patients), but the sensitivity of LVEF fell of >10% from baseline to LVEF<59% was not statistically different from GLS standard ( P>0.05). Conclusions:With the up-regulation of LVEF-LLN, the sensitivity of LVEF in evaluating early myocardial damage was increased, but GLS was still the most sensitive index to monitor the cancer therapeutics-related myocardial damage.

Use of echocardiography to monitor myocardial damage during anthracycline chemotherapy.

BACKGROUND: Anthracycline-related cardiotoxicity has a poor prognosis; therefore, early detection of any change in LV function is critical. OBJECTIVE: The aim of this study was to evaluate the two-dimensional speckle tracking technique for the early detection of cardiac toxicity after low-dose anthracycline chemotherapy in the Chinese population. METHODS: Forty breast cancer patients were treated by chemotherapy using anthracycline for 4-6 cycles. Patients were examined by echocardiography before chemotherapy (T0) and after the second (T2), fourth (T4), and sixth (T6) cycle. LV ejection fraction (LVEF), LV global longitudinal strain (GLS) and endocardium, mid-myocardium, and epicardium global longitudinal strain (GLS-Endo, GLS-Mid, and GLS-Epi). Additionally, global circumferential strain (GCS), RV global longitudinal strain (RVGLS), and LA global longitudinal strain (LAGLS) were evaluated. RESULTS: Left ventricular ejection fraction was significantly reduced at T4 (P < 0.05). Compared with T0, GLS, GLS-Endo, GLS-Mid, and GLS-Epi were significantly reduced at T2, T4, and T6 (P < 0.05 for all), the apical septum wall (AS) was also reduced significantly at T2 (P < 0.05), and the apical anterior wall (AA) and the basal anterior wall (BA) longitudinal strains were significantly reduced at T4 (P < 0.05). GCS, RVGLS, and LAGLS were not significantly changed after treatment (P > 0.05). CONCLUSIONS: LV stratified strains and strain of the segments supplied by the left anterior descending coronary artery are more sensitive to the cardiac toxicity of anthracycline.

Exploration of blended teaching based on "Rain Class" in general practitioner training / 中华医学教育探索杂志

Objective To explore the effect of blended teaching model based on "Rain Class" in general practitioner training.Methods Random sampling method was adopted in which totally 132 general practitioners were divided into two groups,66 in experimental group,66 in the control group.Blended teaching method and traditional teaching method was implemented in the experimental group and the control group,respectively.At the end of the course,unified examination questions were used to evaluate the teaching effect,and questionnaires were used to investigate the students' evaluation of the "rain classroom" teaching method.Results The final exam score of experimental group was significantly higher than that of control group [(82.95 ± 12.86) vs.(60.45 ± 18.91),P=0.000].Further stratification analysis was conducted according to educational background,and the average score of low education group in the observation group was significantly higher than that of high education group [(88.06 ± 9.12) vs.(49.66 ± 13.88),P=0.000].55.3％ of the general practitioners in experimental group were very satisfied with "Rain Class" teaching,34.8％ satisfied,and only 9.9％ of the general practitioners were dissatisfied.Conclusion Blended teaching model could help to promote the exchange and interaction between students and teachers and improve learning efficiency and clinical ability.

The differences of left ventricular configuration between Chinese and international standard by echocardiography in Chinese adults with hypertension / 中华超声影像学杂志

Objective@#To compare the distribution characteristics of left ventricular configuration in Chinese adult patients with hypertension under Chinese and international standard using echocardiography.@*Methods@#A total of 201 patients with primary hypertension were included in the study.Left ventricular end systolic left atrial diameter (LAD), ascending aortic diameter (AO), left ventricular end diastolic diameter (LVDd), left ventricular posterior wall thickness (PWTd) and ventricular septal thickness (IVSd) were measured and then relative wall thickness (RWT), left ventricular mass (LVM), left ventricular mass index (LVMI) were calculated. Left ventricular systolic left atrial volume (LAV) was measured by Simpson′s biplane method and left atrial volume index (LAVI) was then calculated. Ganau classification was done according to Chinese and international standard respectively. The differences of left ventricular configuration in hypertension were compared.@*Results@#According to the Chinese standard, the analytic results of left ventricular configuration showed that there were 103 cases (51.2%) in normal configuration (NG) group, 28 cases (13.9%) in concentric remodeling (CR) group, 52 cases (25.9%) in eccentric hypertrophy (EH) group and 18 patients (9.0%) in hypertrophic (CH) group, respectively. Whereas, according to the international standard, there were 47 cases (23.4%) in NG group, 93 cases (46.3%) in CR group, 18 cases (8.9%) in EH group and 43 cases (21.4%) in CH group.Each group in the configuration analysis had significant difference between Chinese and international standard (P<0.01). Patients with left atrial enlargement according to the Chinese and international standard had statistical difference in the EH and CH groups (P<0.05).@*Conclusions@#Analysis of left ventricular configuration according to the Chinese and international standard has significant difference. According to Chinese standard, it may be more accurate to reflect the changes of left ventricular configuration in Chinese hypertensive population, so as to evaluate the changes of left heart structure and function more accurately.