The development and technologies of RNA therapeutics.

Since it was discovered for over 20 years ago, the potentiality of siRNAs in gene silencing in vitro and in vivo models has been recognized. Several studies in the new generation, molecular mechanisms, target attachment, and purification of RNA have supported the development of RNA therapeutics for a variety of applications. RNA therapeutics are growing rapidly with various platforms contributing to the standard of personalized medicine and rare disease treatment. Therefore, understanding the development and technologies of RNA therapeutics becomes a crucial point for new drug generation. Here, the primary purpose of this review is to provide a general view of six therapeutic categories that make up RNA-based therapeutic approaches, including RNA-target therapeutics, protein-targeted therapeutics, cellular reprogramming and tissues engineering, RNA-based protein replacement therapeutics, RNA-based genome editing, and RNA-based immunotherapies based on non-coding RNAs and coding RNA. Furthermore, we present an overview of the RNA strategies regarding viral approaches and nonviral approaches in designing a new generation of RNA technologies. The advantages and challenges of using RNA therapeutics are also discussed along with various approaches for RNA delivery. Therefore, this review is designed to provide updated reference evidence of RNA therapeutics in the battle against rare or difficult-to-treat diseases for researchers in this field.

[Hydrochemical Characteristics and Control Factors of Surface Water in Kuaize River Basin at the Upper Pearl River].

The Kuaize River is a small typical karst watershed in the source area of the Pearl River as well as an important coal mining area in Eastern Yunnan with a fragile ecological environment. Strengthening the research on the water environment in the region plays an important role in supporting the comprehensive management of the ecological environment and water resources in the source region of the Pearl River. Through the systematic collection of surface water, karst groundwater, and mine water samples, mathematical statistics analysis, correlation analysis, ion ratio analysis, absolute principal component scores multiple linear regression(APCS-MLR), and other methods were used to study the characteristics of hydrochemical evolution and control factors in Kuaize River Basin. The results showed that the average pH value of surface water in Kuaize River Basin was 7.8, which was weakly alkaline. The main cations were Ca2+ and Na+, showing the characteristics of Ca2+>Na+>Mg2+>K+. The main anions were HCO3- and SO42-, showing the characteristics of HCO3->SO42->NO3->Cl-. The variation coefficients of Na+, SO42-, and NO3- in surface water were high, showing strong spatial variability. The water chemical type of the trunk stream was mainly HCO3-Ca, whereas the water chemical type of the tributary was relatively complex, mainly HCO3-Ca, HCO3-Ca·Na, and HCO3·SO4-Ca·Na. The chemical composition of surface water was mainly affected by rock weathering, cation exchange, and human activities. Ca2+, Mg2+, Na+, and HCO3- in surface water mainly came from the weathering of carbonate rock and silicate rock; SO42- mainly came from the oxidation of sulfide, such as pyrite in coal seams; K+, Cl-, and NO3- mainly came from domestic sewage and agricultural activities. The APCS-MLR receptor model analysis results showed that the surface water in the Kuaize River Basin was mainly affected by sulfide oxidation, carbonate weathering, weathering of silicate rock in mine water, domestic sewage, agricultural activities, and unknown sources. In general, the contribution rate of human activities such as mining, domestic sewage, and agricultural activities to the surface water reached 47.17%, indicating that human activities were the key driving factor of surface water chemistry in the Kuaize River Basin.

[Hydrochemical Characteristics and Controlling Factors in Wudu River Basin of Guizhou Province].

TheWudu River is a typical mining-type watershed in the karst mountainous area of western Guizhou Province. Based on the collection of the main stream, tributaries, spring water, and mine water samples in Wudu River Basin, the hydrochemical characteristics and control factors of Wudu River Basin were studied using Gibbs diagram, Piper diagram, and mathematical statistics analysis, and the solute contribution rate of different sources was calculated. The results revealed that the pH value of the water in the Wudu River Basin ranged from 7.87 to 8.52, with an average of 8.14. The TDS values ranged from 135 to 243 mg·L-1, with an average of 191.7 mg·L-1. The major cations in natural river and spring water were Ca2+ and Mg2+, the major anion was HCO3-, and the hydrochemical type was HCO3-Ca. However, owing to the influence of mining activities, the major cations in some tributaries were Ca2+ and Na+, and the hydrochemical types transitioned to HCO3·SO4-Ca and HCO3·SO4-Ca·Na. The ion components of river water in Wudu River Basin were affected by mine water discharge and cation exchange, carbonate rock weathering, silicate rock weathering, and agricultural fertilization. The high concentration of SO42- and Na+in mine water was the primary source of SO42- and Na+in the tributaries of the Wudu River. The method for calculating chemical material balance showed that the contribution rate of carbonate rock weathering ranged from 44.12% to 86.92%, with an average of 74.32%. The contribution rate of mining activities ranged from 3.28% to 37.07%, with an average of 11.61%. Carbonate rock weathering was the main controlling factor of hydrochemical components in the Wudu River Basin; meanwhile, mining activities also had a certain impact on river water chemistry but they showed spatial heterogeneity. The average contribution rates of atmospheric precipitation, silicate rock weathering, agricultural activities, and domestic sewage were 3.75%, 4.67%, 2.85%, and 2.81%, respectively, which had a limited impact on the hydrochemical components of the basin.

Head Trauma Associated with Supra- and Infratentorial Epidural Hematoma: Diagnostic and Surgical Considerations.

BACKGROUND: Supra- and infratentorial epidural hematoma (SIEDH) is a rare type of intracranial epidural hematoma. Due to the potential of vigorous hemorrhage from the injured transverse sinus (TS), it poses a challenge for neurosurgeons to evacuate the SIEDH. METHODS: The medical records and radiographic studies were retrospectively reviewed to investigate the clinical and radiographic characteristics, clinical course, surgical findings and outcome in 34 patients with head trauma associated with SIEDH. RESULTS: Patients treated surgically had a lower Glasgow Coma Scale score than those treated conservatively (P = 0.005). The surgical group had statistically larger thickness and volume of the SIEDH than those in the conservative group (P < 0.0001 and P < 0.0001, respectively). Six patients experienced significant intraoperative blood loss, and copious bleeding from the injured TS was noted in 5 (83.3%) of these patients. Five (50%) of 10 patients undergoing simple craniotomy experienced significant blood loss. However, only 1 patient (11.1%) undergoing strip craniotomy experienced significant blood loss, but no intraoperative shock. All patients experiencing massive blood loss and intraoperative shock underwent simple craniotomy. There was no statistical difference in the outcome between the conservative and surgical groups. CONCLUSIONS: When operating on SIEDH, the possibility of vigorous bleeding from the injured TS and intraoperative massive bleeding should be kept in mind. Strip craniotomy that allows hitching the stripped dura to the bone strip overlying the TS may be a better method for the evacuation of SIEDH.

Vertex epidural hematoma: Diagnosis, therapeutic consideration and outcome.

OBJECTIVE: Vertex epidural hematoma (VEDH) is a relatively uncommon type of intracranial hematoma. Because of its unique location and the potential of massive intraoperative bleeding, diagnosis and surgical intervention of VEDH may be challenging. MATERIALS AND METHODS: A retrospective analysis of 32 patients with VEDH was undertaken to investigate the prognostic factor and therapeutic strategy of VEDH. Special attention was paid to the relationship between fracture pattern, surgical method, intraoperative blood loss and outcome. RESULTS: Patients treated surgically had a higher percentage of consciousness disturbance and a significantly larger size of VEDH compared with patients treated conservatively (p = 0.029 and p < 0.0001, respectively). Bleeding from the injured superior sagittal sinus (SSS) was noted in six of nine patients (67%) with a linear fracture parallel to the SSS. Only one patient (20%) with a linear fracture crossing the SSS had bleeding from the injured SSS. Five of eight patients (63%) with sagittal suture diastasis experienced bleeding from the SSS. All patients with massive blood loss and six of seven patients developing intraoperative shock had copious bleeding from the injured SSS. All patients with intraoperative massive bleeding and shock underwent traditional "simple craniotomy". No patients undergoing "strip craniotomy" experienced massive bleeding. Thrombocytopenia (p = 0.008), headache (p = 0.015), consciousness disturbance (p = 0.043), pupil reactivity (p = 0.010), GCS score (p < 0.0001) and the relationship between skull fracture and the SSS (p = 0.037) were significant prognostic factors. CONCLUSION: Our study demonstrated GCS score may be a significant prognostic factor in patients with VEDH. Bleeding from the injured SSS occurred frequently in VEDH patients with a linear skull fracture parallel to the SSS or sagittal suture diastasis and could cause devastating hemorrhage. When operating on such patients, the surgical team should prepare for the possibility of massive blood loss and intraoperative shock. Bilateral parasagittal craniotomies with preservation of a central bone strip containing the sagittal suture (strip craniotomy) to allow application of tack-up sutures from the dura to the bone strip may be more suitable for VEDH evacuation.

Imaging study of lymphomatosis cerebri characterized by diffuse lesions of bilateral cerebral white matter / 中华神经科杂志

Objective:To investigate multimodality imaging characteristics and clinical features of lymphomatosis cerebri (LC) and reasons for misdiagnosis,with the goal of potentially facilitating an early and accurate diagnosis for this often-missed disease.Methods:Clinical data and cerebral multimodality imaging findings from 11 patients with LC proven basing on pathology in the Affiliated Hospital of Guizhou Medical University from November 30, 2011 to December 28, 2020 were retrospectively extracted, analyzed, and reviewed in combination with the literatures.Results:The common presenting symptoms with subacute onset included cognitive decline (8/11), gait disturbance (9/11), and behavioral disturbance (5/11). Test of cerebrospinal fluid showed that the number of cells and the level of protein increased (8/10), the sugar content (2/10) and chloride (4/10) decreased. The imaging manifestations of 11 patients with LC were diffuse lesions of bilateral cerebral white matter in the both deep and lobar lesion distribution, involving the cerebral cortex and subcortical white matter in eight cases (8/11), basal ganglia in seven cases (7/11), thalamus in five cases (5/11), cerebellum in six cases and brain stem in six cases (6/11). All 11 patients showed equal or slightly low-density shadows on CT plain scan and slightly longer T 1WI and T 2WI signals on magnetic resonance imaging. Six cases (6/11) had no obvious enhancement in the early stage, and five cases and six follow-up cases showed heterogenous spots, patches, nodules or clusters of distinct enhancement. Diffusion-weighted imaging showed non restricted diffusion in nine (9/11) cases initially diagnosed, and restricted diffusion in two cases (2/11) and nine follow-up cases, which were hyperintense on diffusion-weighted imaging and hypointense on apparent diffusion coefficient maps. Five patients (5/5) presented a marked decrease in N-acetyl aspartic acid (NAA)/creatine (Cr) and increase in choline (Cho)/Cr on hydrogen proton magnetic resonance spectrum, including an increase in lipid/Cr in three cases. One case (1/3) showed no abnormal increase in lesion metabolism, and two cases (2/3) showed slightly increased uptake on positron emission tomography/CT. Conclusions:Diffuse bilateral cerebral lesions especially in deep and lobar region, without enhancement or with patchy enhancement, marked decrease in NAA/Cr and increase in Cho/Cr and Lip/Cr are suggestive of LC. Misdiagnosis may be mainly due to insufficient understanding and improper brain biopsy.

Simultaneous cranioplasty and ventriculoperitoneal shunt placement in patients with traumatic brain injury undergoing unilateral decompressive craniectomy.

Hydrocephalus is a common complication after decompressive craniectomy (DC) in patients with traumatic brain injury (TBI). However, the strategy of managing TBI patients with a cranial defect and hydrocephalus remains controversial. Placement of a ventriculoperitoneal shunt (VPS) in patients with a cranial defect and hydrocephalus may aggravate sinking skin flap overlying the cranial defect and result in syndrome of sinking skin flap (SSSF) that causes neurological deterioration. A retrospective analysis of 49 TBI patients who developed hydrocephalus after unilateral DC was undertaken to investigate the safety of simultaneous cranioplasty and VPS placement, and the incidence of SSSF after VPS placement. Among these patients, 17 patients underwent simultaneous cranioplasty and VPS placement, and 32 patients underwent staged cranioplasty and VPS placement. The overall complication rate was 9.3% (3/32) in staged group and 29.4% (5/17) in simultaneous group, respectively. There was no statistically significance between two study groups regarding overall complication (p = 0.11) and reoperation rate (p = 0.47). Two patients with severe brain bulging in staged group developed SSSF after placement of a nonprogrammable VPS. Our study showed that simultaneous cranioplasty and VPS placement may be safe in TBI patients with a cranial defect and hydrocephalus. However, due to the contradictory results about the safety of simultaneous cranioplasty and VPS placement in the literatures, neurosurgeons should carefully consider whether patients are suitable for such treatment. In patients planning to undergo VPS placement first, a programmable shunt may be a better choice for the possibility of SSSF after shunt placement.

Induced experimental autoimmune encephalomyelitis shows the different phenotype of disease in C57BL / 6 mice with myelin oligodendrocyte glycoprotein35￣55 / 解剖学报

Objective To establish an experimental autoimmune encephalomyelitis (EAE) model in female C57BL / 6 mice aged 6-8 weeks and investigate its disease phenotype so as to build a better animal model of multiple sclerosis (MS) . Methods The EAE model was established in 50 female C57BL / 6 mice through intradermal injection of myelin oligodendrocyte glycoprotein 35-55 peptide. We assessed the disease progression daily according to a 15-point score for 90 days, and further observed the brain lesions in terms of pathology. Results There were three courses of disease in the EAE model: chronic course (3 mice), relapse and remission course (7 mice) and monophasic course (11 mice) . Interestingly, we identified some mice (28 mice) had changes in coat color, mental and motor activity, as well as inflammatory demyelinating lesions in the brain tissue although their neurological functions were scored as 0 point. Conclusion The EAE model in C57BL / 6 female mice shows disease phenotype similar to multiple sclerosis and can be used as a good animal model.

Risk factors for the development of posttraumatic hydrocephalus after unilateral decompressive craniectomy in patients with traumatic brain injury.

Decompressive craniectomy (DC) has been performed increasingly to control medically refractory intracranial hypertension in patients with traumatic brain injury (TBI). Although DC is a potentially life-saving procedure and technically straightforward, it is associated with some significant complications that include subdural hygroma (SDG) and posttraumatic hydrocephalus (PTH). A retrospective analysis of 143 TBI patients who underwent unilateral DC was undertaken to investigate the incidence and risk factors of PTH and investigate the relationship between the types of SDG and PTH. Among these patients, the incidence of PTH was 30.1%. SDG was noted in 25 patients (58.1%) who developed PTH. SDG was noted in 27 patients (27%) without PTH. The patients with PTH had a significantly unfavorable outcome (p < 0.0001). After stepwise logistic regression analyses, only age (p = 0.004, odds ratio [OR] = 1.036, 95% confidence interval [CI] = 1.011-1.061) and contralateral SDG (p < 0.0001, OR = 5.613, 95% CI = 2.232-14.115) remained independently associated with PTH development, and PTH development rate increased by 3.6% with every 1-year increase in age. Close surveillance is indicated in older TBI patients with contralateral SDG after unilateral DC to prompt early detection and timely management of PTH.

Comparing the Differences in Health of Body, Mental, and Spirit Among Category 3 and 4 Controlled Drug Users, Nursing Students, and Psychology Students.

Drug abuse adversely affects the health of populations in many counties and contributes immensely to social issues. Schedule III and IV controlled drug abuse is popular in young adults. Medical education is one of the most stressful academic fields for students. The aim of this study was to compare the health differences in body, mind, and spirit among Schedule III and IV controlled drugs users, nursing students, and psychology students. This study uses a cross-sectional comparative study on a convenience sample. Four hundred eleven participants were recruited from three different samples that include Schedule III and IV controlled drug users (n = 211), nursing students (n = 100), and psychology students (n = 100), all from either a drug abuse prevention center or two universities in Southern Taiwan. Relying on the Health of Body, Mind and Spirit Scale, a linear regression model was used to identify the health differences among drug users, nursing students, and psychology students. The results show that drug users scored higher on the physical subscale (ß = -.249, p < .001), the mental subscale (ß = -.120, p < .05), the spiritual subscale (ß = -.154, p < .01), and the Health of Body, Mind and Spirit Scale (ß = -.210, p < .001) than psychology students. The nursing students scored higher on the mental subscale (ß = .146, p < .01) than drug users did. These results could help health staff and instructors understand the differences and improve the physical, mental, and spiritual health among Schedule III and IV controlled drug users, nursing students, and psychology students. Furthermore, future study could further investigate the factors that may affect physical, mental, and spiritual health.

Development and psychometric testing the Health of Body, Mind and Spirit Scale for assessing individuals who have drug abuse histories.

AIMS AND OBJECTIVES: To develop the Health of Body, Mind and Spirit Scale (HBMSS), which was designed to assess drug abusers' health condition. BACKGROUND: Helping drug abusers to become healthy is important to healthcare professionals. However, no instrument exists to assess drug abusers' state of health. DESIGN: A cross-sectional questionnaire survey was implemented to examine the validity of the HBMSS. METHODS: Data were collected from 2015-2016 at one drug abuse prevention centre in Taiwan. Participants (N = 320) who had abused drugs were invited to complete a preliminary 64-item version of the HBMSS. An item analysis, criterion-related validity analysis (using the Relapse Prediction Scale [RPS] score), split-half reliability testing and confirmatory factor analysis (CFA) were conducted to examine the psychometric properties of the HBMSS. RESULTS: The final version of the HBMSS contained 15 items that were divided into three subscales: the health of the body, mind and spirit. Cronbach's α and split-half reliability coefficients were all above .85. The factor loading of each item was between .74-.95. The HBMSS had satisfactory criterion-related validity with the RPS score (r = -.50, p < .001). A second-order CFA was conducted on the HBMSS. The fit indexes were good, χ2  = 184.060, df = 94, χ2 /df = 1.958 (p = .000). CONCLUSIONS: The entire HBMSS and the subscales had satisfactory reliability and validity. RELEVANCE TO CLINICAL PRACTICE: Healthcare professionals could use the HBMSS to evaluate the condition of the health of individuals with a drug abuse history.

Cortactin antibody in myasthenia gravis and its clinical significance / 中华神经科杂志

Objective To investigate the clinical significance of cortactin antibody in myasthenia gravis (MG).Methods Cortactin antibody in the serum of 100 MG patients, 40 normal controls and 40 other neuroimmune diseases patients was examined by Western blotting and ELISA using purified recombinant human protein cortactin as antigen .Acetylcholine receptor antibody ( AchR-ab ) and muscle specific kinase antibody (MuSK-ab) were parallely measured by ELISA.Results Antibodies to cortactin were found in nine (9％) serum samples of 100 MG patients.Four of the nine cortactin antibody positive sera were also positive for AChR-ab.The rest five MG patients only had antibodies against cortactin ( no detectable AChR-ab or MuSK-ab).None of the control subjects (including 40 normal controls and 40 other neuroimmune diseases patients ) had cortactin antibodies.Most (7/9) of the cortactin antibody positive MG patients presented with early-onset subgroup.Patients only with cortactin antibodies did not appear to have thymoma.Patients with MG who had both AChR and cortactin antibodies showed maximum involvement of muscles and severe Osserman's classification ( three cases of type ⅡB and one case of type Ⅳ) . Conclusion Cortactin antibody may be a new antibody for MG , which can provide clues for further exploring the potential pathogenic mechanisms of the disease .

Relationships of polymorphism of APOE gene and cognitive impairment in patients with CNS demyelinat-ing diseases / 中国神经精神疾病杂志

Objective To investigate the association between the level of polymorphism of APOE gene and cognitive impairment in patients with CNS demyelinating diseases. Methods 56 patients with central nervous system demyelinating disease were applied APOE genotyping,MoCA and expanded disability status (EDSS) scale score. Patients with MOCA scores <26 were divided into cognitive impairment group, and those with MOCA scores ≥26 were divided into normal cognitive preserved group. Results The probability of cognitive dysfunction in patients with central nervous system demyelinating diseases was 53.57%. There was no significant difference in age, gender, and disease duration between the CI group and the CP group(P>0.05), the difference in age and education among groups is statistically significant (P<0.05). There was no statistical significance in the difference in age, sex, education years and EDSS score between APOEε4 gene positive group and APOEε4 gene negative group (P<0.05). The difference of visual space and attention between different cognitive domains is statistically significant(P<0.05). Years of schooling is a risk factor for cognitive dysfunction in patients with central nervous system demyelinating disease(P<0.01). Conclusion The central nervous system demyelinating disease is impaired cognitive function. Patients with APOEε4 gene positive are more severely impaired in visual space and attention than patients with negative APOEε4 gene.Years of education are the risk factors of cognitive dysfunction in patients with central nervous system demyelinating disease. The course of disease and disabled function may not be significant related to cognitive impairment.

Posttraumatic cerebral infarction after decompressive craniectomy for traumatic brain injury: incidence, risk factors and outcome.

AIM: To investigate the incidence, timing, risk factors of posttraumatic cerebral infarction (PTCI) and its influence on mortality in patients with moderate to severe traumatic brain injury (TBI). MATERIAL AND METHODS: After reviewing the medical records and radiographs over a 6-year period, 173 patients with moderate to severe TBI were enrolled to determine the risk factors for the development of PTCI following unilateral decompressive craniectomy (DC). RESULTS: The incidence of PTCI following DC was 31.2%. Infarction in the posterior cerebral artery territory was the most common site of PTCI. The PTCI group had a significantly increased mortality (p 0.001) and unfavorable outcome (p 0.001). After stepwise logistic regression analysis, preoperative Glasgow Coma Scale (GCS) score (p 0.001, odds ratio [OR] = 0.536, 95% confidence interval [CI] = 0.407-0.706), pupillary dilation (p = 0.016, OR = 3.2, 95% CI = 1.24-8.28), subdural hematoma (SDH) (p = 0.01, OR = 16.87, 95% CI = 1.97-144.30) and craniectomy size (p = 0.017, OR = 1.02, 95% CI = 1.0-1.04) remained independently associated with PTCI development following DC. CONCLUSION: Our study demonstrated PTCI is a severe complication in patients with acute TBI. We recommend repeating computed tomography within 3 days of trauma to detect the occurrence of PTCI in patients with subdural hematoma who have low preoperative GCS score and pupillary dilation, irrespective of neurologic status. More studies are necessary to clarify the role and benefit of DC in patients with a GCS score of 5 or less.

Effects of surface electromyographic biofeedback and electrical stimulation on the swallowing function of stroke survivors with dysphagia / 中华物理医学与康复杂志

Objective To explore the effect of surface electromyographic biofeedback (SEMG-BFT) combined with electrical stimulation on the swallowing function of stroke survivors with dysphagia,and to evaluate the electromyographic activity of the submental muscles in swallowing various foods so as to provide a basis for future rehabilitation of such patients.Methods Sixty patients were randomly divided into a treatment group and a control group,each of 28.Both groups were given low-frequency electrical stimulation and conventional swallowing training.The treatment group was additionally provided with SEMG-BFT.Before the treatment as well as after 2 and 4 weeks of treatment,the swallowing function of both groups was evaluated using the Kubota drinking water test (KDWT) and a Gugging swallowing screen (GUSS).Surface electromyographs of the submental muscles were recorded during empty swallowing,swallowing 10 ml of dilute liquid and swallowing 10 ml of paste.Results After two and four weeks of treatment,the average KDWT and GUSS scores of both groups had improved significantly,but that of the treatment group was significantly higher than that of the control group at each time point.After 2 and 4 weeks of treatment,significant differences were found in swallowing duration and the average amplitude of the sEMGs compared with before the treatment in both groups.The difference between the groups was significant at each time point.Conclusions SEMG-BFT combined with electrical stimulation can significantly improve swallowing function.Paste food can be used safely in the early evaluation and treatment of swallowing dysfunction.

Risk Factors for the Development of Contralateral Epidural Hematoma Following Decompressive Craniectomy in Patients with Calvarial Skull Fracture Contralateral to the Craniectomy Site.

OBJECTIVE: To investigate the frequency and risk factors of contralateral epidural hematoma (CEDH) following decompressive craniectomy (DC) in patients with calvarial skull fracture contralateral to the craniectomy site. METHODS: After reviewing the medical records and radiographs over a 5-year period, 72 patients with calvarial fracture contralateral to the craniectomy site were enrolled to determine the risk factors for the development of CEDH following DC. RESULTS: Among 13 patients with CEDH following DC, all but 1 patient were younger than 60 years of age. In 10 patients (77%) with CEDH, the contralateral calvarial fracture involved more than 1 bone plate. Comparatively, contralateral calvarial fracture involving more than 1 bone plate was noted in 21 patients (35.6%) without CEDH. After multiple logistic regression analysis, only age (P = 0.008, odds ratio [OR] = 0.916, 95% confidence interval [CI] = 0.858-0.987) and number of fracture-involved bone plate (P = 0.006, OR = 10.971, 95% CI = 2.02-59.70) remained independently associated with CEDH development following DC, and CEDH development rate increased by 8.4% with every 1-year decrease in age. CONCLUSIONS: Age and number of fracture-involved bone plate are significant risk factors for CEDH development following DC. Involvement of 2 or more bone plates of contralateral calvarial skull fracture in young adult may prompt an immediate postoperative computed tomography scan to detect the occurrence of CEDH, irrespective of the operative findings and neurologic status. This may prevent devastating neurologic consequences of CEDH and improve therapeutic outcome.

Predictors of willingness to use cyber counseling for college students with disabilities.

BACKGROUND: Cyber counseling is a new method for assisting people in coping with distress. People in Taiwan are more familiar with face-to-face counseling than with cyber counseling. Using computers is the most popular activity among college students with disabilities. Cyber counseling is effective for lessening client disturbance. Therefore, cyber counseling is an alternative to face-to-face counseling. OBJECTIVE: This study measured the willingness of college students with disabilities to use cyber counseling to meet their mental health needs. In addition, the predictors of the willingness to use cyber counseling were explored. METHODS: The subjects were college students with disabilities who were recruited from universities in Southern Taiwan through the Internet and in college counseling centers. A total of 214 structured questionnaires were collected and subsequently analyzed using SPSS Version 18.0 through stepwise regression for discovering the crucial predictors of the willingness of college students to use cyber counseling. RESULTS: The crucial predictors of the willingness of college students to use cyber counseling were cyber-counseling needs, the need for cyber-counseling methods (the need to use various cyber-counseling methods), a help-seeking attitude in cyber counseling, a hearing disorder, cyber counseling need for academic achievement, and grade level. The explained proportion of variance was 65.4%. CONCLUSIONS: The willingness of college students with disabilities to use cyber counseling was explained according to cyber-counseling needs, cyber-counseling attitudes, disease type, and grades. Based on the results, this study offers specific suggestions and future directions for research on cyber counseling for college students with disabilities.

Isokinetic training can improve endurance and walking capacity after incomplete lumbar spinal cord injury / 中华物理医学与康复杂志

Objective To explore the effects of isokinetic training on muscle endurance and the ambulatory capacity of patients with incomplete lumbar spinal cord injury ( SCI ) . Methods Sixty patients were randomly divided into a control group and a treatment group, each of 30. Both groups were given conventional rehabilitation, while the treatment group was additionally provided with isokinetic muscle strength and muscle endurance training for 3 months. The endurance ratio ( RO) of the quadriceps and hamstrings, the mean power frequency of the rectus femo-ris (RF-MPF) and the biceps flexor cruris (BF-MPF), and distance covered in the 6-minute walk test (6MWT) were evaluated before and after the treatment. An index of functional community ambulation was also compared be-tween the 2 groups. Results After the treatment significant differences were observed in all of the measurements compared to before the treatment for both groups. The average RO improvement of the quadriceps and hamstrings, the BF-MPF, the RF-MPF and the 6MWT distance of the treatment group were all significantly higher compared with the control group. After the treatment, 25 patients of the treatment group could demonstrate functional community ambula-tion, significantly better than that of 20 of the control group. Conclusion Isokinetic training can improve muscle endurance and the walking capacity of persons with an incomplete lumbar spinal cord injury.

Association between rs689466 in COX-2 gene and aspirin resistance in cerebral infarction patients / 实用医学杂志

Objective To investigate the association of single nucleotide polymorphisms (SNPs) in COX-2 with aspirin resistance in Chinese cerebral infarction patients. Methods A total of 150 Chinese cerebral infarction patients were recruited. Platelet aggregation response was measured by light transmission aggregometry method and four SNPs located in COX2 gene were genotyped by sequencing method. Results Sixty patients of the total were classified as aspirin non-responders. For clinical variables , concentrations of high homocysteine and the frequency of recurrence cerebral infarction were significantly higher in aspirin non-responders when compared with aspirin responders. Univariate analysis of SNPs showed that rs20417 , rs689465 and rs689466 were significantly associated with aspirin resistance. Multivariate analysis indicated that after adjusting other SNPs and clinical risk factors, rs20417 and rs689466 were still significantly associated with aspirin resistance. Conclusions Rs689466 is significantly associated with aspirin resistance in Chinese cerebral infarction patients even after the adjustment of rs20417. By combining rs689466 , rs20417 and other clinical risk factors , we may better classify the aspirin non-responders from aspirin responders.

Clinical and MRI features of posterior reversible encephalopathy syndrome in patients with systemic lupus erythematosus / 中华神经科杂志

Objective To investigate the clinical and MRI features and pathogenic mechanism of posterior reversible encephalopathy syndrome (PRES) in patients with systemic lupus erythematosus (SLE).Methods Six cases of PRES in SLE proved by integrated clinical diagnosis were collected from January 2008 to December 2013.The clinical and MRI features of these patients were studied retrospectively and the related literatures were reviewed.Results The initial episode of nervous system was involved in 4 cases.The clinical presentations were headache (2 cases),seizures (4 cases),acute confusion state (2 cases),altered mentation (1 case) and vision change (1 case).All cases had lupus nephritis and hypertension,in which 4 cases had renal failure;6 cases were treated with immunosuppressive agents and 4 cases with cyclophosphamide for lupus nephritis when they developed PRES.The vasogenic edema lesions were distributed in the parietal or occipital lobe (5 cases),the frontal lobe (4 cases),temporal lobe (4 cases),basal ganglia (3 cases),splenium (1 case) and cerebellar hemispheres (2 cases).Three major patterns of PRES included dominant parietal-occipital (2 cases),the holohemispheric watershed (3 cases),and superior frontal sulcal (1 case).Conclusions The clinical and MRI findings of PRES in patients with SLE are typical.Awareness of this entity as early as possible can help to improve curative effect and prognosis.