Assessment of pesticide exposure to applicators during spraying in orchards with a stretcher-mounted sprayer.

Various health risk assessment models have been developed to evaluate occupational pesticide exposure in China. However, there has been limited investigation into the relationship between health risks and pesticide spraying in orchards. In this study, we analyzed pesticide exposure of applicators while spraying with a stretcher-mounted sprayer in orchards located in four different climatic regions. All garments' unit exposure (UE) demonstrated a right-skewed distribution, with gloves and shins accounting for the highest proportion of dermal pesticide exposure. We observed little difference in dermal and inhalation UE levels between apple and citrus orchards, except for pesticide exposure levels on wipes and faces. While 57% of the inhalation UE distribution variance was attributed to clustering and location effects, no significant differences were observed in dermal exposure levels. We evaluated the impact of different levels of protective clothing on pesticide exposure levels, according to applicators' working habits in China. Our findings revealed that improved levels of protection significantly reduced dermal exposure to pesticides, particularly when wearing gloves during spraying with a stretcher-mounted sprayer. Based on our empirical data, we utilized a simple random sampling model and an intercept-only lognormal mixed model to estimate dermal and inhalation exposure levels. The estimated dermal UE was accurate to within 3-fold with 95% confidence, and half of the estimated inhalation UE was acceptable according to the fold relative accuracy (fRA). Our established and verified statistics for dermal and inhalation UE can be utilized to evaluate the potential pesticide exposure to applicators during spraying in orchards with a stretcher-mounted sprayer.

Effect of robot-assisted training on upper limb motor in patients with stroke: a meta-analysis / 中国康复理论与实践

ObjectiveTo systematically review the efficacy of robot-assisted training on upper limb motor dysfunction in stroke patients. MethodsRelated literatures were searched in PubMed, Medline, Embase, Cochrane Library, Web of Science, CNKI, Wanfang Data, SinoMed, VIP data from July 1, 2019 to July 1, 2022. Two researchers screened the studies and extracted the data independently, and evaluated the methodological quality. Rev Man 5.4 was used for meta-analysis. ResultsA total of 19 randomised controlled trials with 1 258 subjects were finally included. The scores of Fugl-Meyer Assessment-Upper Extremity (SMD = 0.55, 95%CI 0.40 to 0.71, P < 0.001), modified Bathel Index (MD = 7.55, 95%CI 6.55 to 8.54, P < 0.001) and Motor Activity Log (SMD = -0.84, 95%CI -1.38 to -0.31, P = 0.002) were better in the experimental group than in the control group. However, no significant difference was found in the scores of Brunnstrom stages (upper extremity) (SMD = 0.61, 95%CI -0.08 to 1.30, P = 0.08) and modified Ashworth Scale (MD = -0.51, 95%CI -1.18 to 0.17, P = 0.14) between two groups. ConclusionRobot-assisted training could significantly improve the motor function of upper limbs in stroke patients.

Aquaporins: Important players in the cardiovascular pathophysiology.

Aquaporin is a membrane channel protein widely expressed in body tissues, which can control the input and output of water in cells. AQPs are differentially expressed in different cardiovascular tissues and participate in water transmembrane transport, cell migration, metabolism, inflammatory response, etc. The aberrant expression of AQPs highly correlates with the onset of ischemic heart disease, myocardial ischemia-reperfusion injury, heart failure, etc. Despite much attention to the regulatory role of AQPs in the cardiovascular system, the translation of AQPs into clinical application still faces many challenges, including clarification of the localization of AQPs in the cardiovascular system and mechanisms mediating cardiovascular pathophysiology, as well as the development of cardiovascular-specific AQPs modulators.Therefore, in this study, we comprehensively reviewed the critical roles of AQP family proteins in maintaining cardiovascular homeostasis and described the underlying mechanisms by which AQPs mediated the outcomes of cardiovascular diseases. Meanwhile, AQPs serve as important therapeutic targets, which provide a wide range of opportunities to investigate the mechanisms of cardiovascular diseases and the treatment of those diseases.

Analysis of factors affecting the compliance of postpartum pelvic floor muscle training / 预防医学

Objective@#To investigate the difference in behavioral characteristics among different phenotypes of attention deficit hyperactivity disorder (ADHD) using amplitude of low-frequency fluctuation (ALFF), so as to provide insights into clinical differentiation of behavioral characteristics among different phenotypes of ADHD.@*Methods@#The children with ADHD admitted to The Affiliated Hospital of Hangzhou Normal University were enrolled and classified into the inattentive type (ADHD-I), hyperactive/impulsive type (ADHD-HI) and combined type (ADHD-C). The reaction time (RT) was measured using integrated visual and auditory continuous performance test, and the mean (RT-mean) and standard deviation of RT (RT-SD) were estimated. In addition, the ALFF was calculated at 0.010 to 0.027, 0.027 to 0.073, 0.073 to 0.167 Hz, and the difference of ALFF was compared among children with different types of ADHD. @*Results@#A total of 107 children with ADHD were enrolled, including 95 boys and 12 girls, with a mean age of (8.89±1.93) years. There were 69 children with ADHD-I, 8 children with ADHD-HI and 30 children with ADHD-C. The RT-SD was significantly higher among children with ADHD-C than among children with ADHD-I [(126.003±51.619) ms vs. (97.720±45.302) ms; P=0.007]; however, there was no significant difference in RT-mean among children with various ADHD phenotypes (F=1.386, P=0.255). There was an interaction between frequency and ADHD phenotypes (F=2.754, P=0.032), and the ALFF was significantly higher among children with ADHD-C than among children with ADHD-I at 0.010 to 0.027 [(5 590.567±231.595) ms vs. (4 694.001±154.397) ms; P=0.002] and 0.073 to 0.167 Hz [(4 312.609±174.709) ms vs. (3 690.805±116.473) ms; P=0.005].@*Conclusions @#The ALFF varies in ADHD phenotypes, and there is a frequency-specific difference.

Screening of marine resistant strain based on PKS and NRPS genes and the activity of its metabolites / 生物工程学报

Based on polyketide syntheses gene (PKS) and non-ribosomal peptide synthetases gene (NRPS), one strain with high anti-pathogenic activity was screened from 77 strains isolated from Arctic marine sediments and identified. By optimizing the composition of culture medium and fermentation conditions, the production of this strain's active metabolites was improved and the main metabolites were identified by HRMS, 1H NMR and 13C NMR. The antibacterial spectrum of the main metabolites and the effect of the metabolites on cucumber Fusarium wilt were also determined. The results showed that the strain was Bacillus velezensis and it showed growth promoting effect on plants. When the strain was cultured in 5 g/L maltose, 10 g/L tryptone, 10 g/L sodium chloride, at 30 ℃, 150 r/min for 60 h, the diameter of the inhibition zone increased from (16.23±0.42) to (24.42±0.57) mm. The metabolites of this strain mainly contain macrolide compound macrolactin A, which has antagonistic effect on a variety of pathogenic bacteria and fungi. Cucumber seedling experiments showed that the metabolites of this strain had a protective effect on cucumber Fusarium wilt, and showed a good potential for development and application as a biocontrol agent.

The value of urinary neutrophil gelatinase-associated lipocalin and cystatin C in clinical diagnosis of sepsis with acute kidney injury in preterm infants / 中国医师进修杂志

Objective:To investigate the clinical diagnosis value of urinary neutrophil gelatinase-associated lipocalin (NGAL) and Cystatin C (Cys C) of late onset sepsis (LOS) with acute kidney injury(AKI) in preterm infants.Methods:A case-control study was used among preterm infants diagnosed with LOS and admitted to the NICU of Dalian Women and Children′s Medical Group from November 2018 to October 2021, including 24 cases of sepsis AKI group and 40 cases of sepsis non-AKI group. The blood creatinine, urine NGAL, Cys C levels and urine volume were measured at 1 d after birth and 1 d after sepsis. The t-test was used for statistical analysis, and the receiver operating characteristic (ROC) curves were plotted to analyze the diagnostic value of blood creatinine, urinary NGAL and Cys C in LOS combined with AKI. Results:Blood creatinine, urinary NGAL and Cys C levels were significantly higher in the sepsis AKI group than that in the sepsis non-AKI group: (53.667 ± 20.040) μmol/L vs. (35.975 ± 9.048) μmol/L, (1.613 ± 0.405) μg/L vs. (0.839 ± 0.258) μg/L, (39.524 ± 11.619) μg/L vs. (21.778 ± 3.302) μg/L ( P<0.01). Comparison of ROC curves showed that in sepsis AKI group the AUC (0.946 and 0.965, respectively), sensitivity (97.5% and 100.0%, respectively) and specificity (75.0% and 79.2%, respectively) of the urinary NGAL and Cys C levels were higher in than those of creatinine level (AUC 0.771, sensitivity 95.0%, specificity 62.5%), with statistically significant differences ( P<0.05). Conclusions:Urinary NGAL and Cys C are more sensitive than creatinine and can be used as biological indicators for the early diagnosis of sepsis with AKI in preterm infants.

Differential diagnosis of benign and malignant breast lesions using quantitative synthetic magnetic resonance imaging / 南方医科大学学报

OBJECTIVE@#To investigate the value of quantitative synthetic magnetic resonance imaging (SyMRI) in distinguishing between benign and malignant breast lesions.@*METHODS@#We retrospectively collected data of preoperative conventional MRI and multi-dynamic multi-echo sequences from 95 patients with breast lesions showing mass-type enhancement on DCE-MRI, including 27 patients with benign lesions and 68 with malignant lesions. The MRI features of the lesions (shape, margin, internal enhancement pattern, time-signal intensity curve, and T2WI signal) were analyzed, and for each lesion, SyMRI-generated quantitative parameters including T1 and T2 relaxation time and proton density (PD) were measured before and after enhancement and recorded as T1p, T2p, PDp and T1e, T2e, and PDe, respectively. The relative change rate of each parameter was calculated. Logistic regression and all-subset regression analyses were performed for variable selection to construct diagnostic models of the breast lesions, and receiver-operating characteristic (ROC) analysis was used to assess the performance of each model for differentiation of benign and malignant lesions.@*RESULTS@#There were significant differences in the MRI features between benign and malignant lesions (P < 0.05). All the SyMRI-generated quantitative parameters, with the exception of T2e and Pdp, showed significant differences between benign and malignant lesions (P < 0.05). Among the constructed diagnostic models, the model based on all the DCE-MRI features combined with SyMRI parameters T2p and T1e (DCE-MRI+T2p+T1e) showed the best performance in the differential diagnosis malignant breast masses with an AUC of 0.995 (95% CI: 0.983-1.000).@*CONCLUSION@#Quantitative SyMRI can be used for differential diagnosis of benign and malignant breast lesions.

The scRNA-seq expression profiling of the receptor ACE2 and the cellular protease TMPRSS2 reveals human organs susceptible to COVID-19 infection

BackgroundCOVID-19 caused by SARA-CoV-2 is a disaster sweeping over 200 countries, and more than 2,150,000 people are suffering from the disease and 140,000 people died. ACE2 is a receptor protein of SARS- CoV-2, and TMPRSS2 promotes virus proliferation and transmission. Some patients developed multiple organ dysfunction syndromes other than lungs. Therefore, studying the viral susceptibility of other organs is important for a deeper understanding of viral pathogenesis. MethodsThe advantage of scRNA-seq data is the identification of cell types by clustering the gene expression of cells. ACE2 and TMPRSS2 are highly expressed in AT2 of lungs, we compared the ACE2 and TMPRSS2 expression levels of cell types from 31 organs, with AT2 of lungs to evaluate the risk of the viral infection using scRNA-seq data. FindingsFor the first time, we found the brain, gall bladder, and fallopian tube are vulnerable to COVID-19 infection. Besides, the nose, heart, small intestine, large intestine, esophagus, testis and kidney are also identified to be high-risk organs with high expression levels of ACE2 and TMPRSS2. Moreover, the susceptible organs are grouped into three risk levels based on the TMPRSS2 expression. As a result, the respiratory system, digestive system and reproductive system are at the top-risk level to COVID-19 infection. InterpretationThis study provides evidence for COVID-19 infection in the human nervous system, digestive system, reproductive system, respiratory system, circulatory system and urinary system using scRNA-seq data, which helps for the clinical diagnosis and treatment of patients.

Comparative Study on the Protective Effects of Different Effective Components of Astragali Radix against Ionizing Radiation-induced BMSCs DNA Damage / 中国药房

OBJECTIVE：To compare the protective effects of different effective components of Astragali radix against DNA damage of human bone marrow mesenchymal stem cells （BMSCs）induced by ionizing radiation. METHODS ：2 Gy X-rays were used to directly irradiate BMSCs to establish a radiation model. CCK- 8 method was used to detect the effects of different mass concentrations（25，50，75，100 μg/mL）of astragalus polysaccharide ，astragalus saponin and astragalus flavonoids for 1 day before radiation + 1 to 5 days after radiation on the proliferation of BMSCs. The dose concentration and the duration of intervention after radiation were selected. The irradiated BMSCs were divided into radiation group ，astragalus polysaccharide group ，astragalus saponin group and astragalus flavonoids group. The last three groups were treated with appropriate dosage of corresponding drugs before and 2 days after radiation ，and a blank groupwas set for comparison. Cytoplasmic division arrest qq.com micronucleus method was used to detect micronucleus cell rate and cell micronucleus rate after appropriate time of was used to detect th e number of 53BP1 foci in cells after appropriare time of intervention following radiation ；the number of 53BP1 foci were compared among different time points （0.5，2，12，24 h）. RESULTS ：Compared with blank group ，OD values of BMSCs were decreased significantly in radiation group （P＜0.05 or P＜0.01）. Compared with radiation group ，the OD values of BMSCs were significantly increased when 50 μ g/mL astragalus polysaccharide，astragalus saponin and astragalus flavonoids continuously intervened radiation for 2-3 days，there was significant difference in other groups at some time point （P＜0.05 or P＜ 0.01）. After consideration ，drug concentration was determined to be 50 μg/mL，and the continuous intervention time was 2 days after radiation. Compared with blank group ，the micronucleus cell rate and cell micronucleus rate of radiation group ，astragalus polysaccharide group ，astragalus saponin group and astragalus flavonoids group increased significantly ，and the number of 53BP1 focus cluster in radiation group and astragalus polysaccharide group increased significantly （P＜0.01）. Compared with radiation group and astragalus flavonoids group ，the micronucleus cell rate ，cell micronucleus rate and the number of 53BP1 focus cluster （continued intervention for 0.5，2，12 h）in the astragalus polysaccharide group and astragalus saponin group were significantly reduced，and the micronucleus cell rate and cell micronucleus rate in the astragalus polysaccharide group were significantly lower than astragalus saponin group （P＜0.05）. 53BP1 focus cluster could not be detected 24 h later （P＜0.05）. CONCLUSIONS ： Astragalus polysaccharide and astragalus saponin both have protective effects on BMSCs DNA damage induced by radiation ，and the protective effect of astragalus polysaccharide is better than that of astragalus saponin ；astragalus flavonoids has no protective effect on radiation-induced DNA damage.

Risk factors and prognosis of persistent inflammation-immunosuppressive catabolism syndrome in malignant tumor patients with lung infection after chemotherapy / 肿瘤研究与临床

Objective To investigate the risk factors and prognosis of persistent inflammation-immunosuppressive catabolism syndrome (PICS) in malignant tumor patients with lung infection after chemotherapy.Methods A total of 128 malignant tumor patients with pulmonary infection after chemotherapy from January 2014 to January 2018 in Jilin Cancer Hospital were collected.According to whether the patients were complicated with PICS,the patients were divided into the PICS group (44 cases) and the control group (84 cases).The clinical characteristics and prognosis of the two groups were compared,and the risk factors of PICS during hospitalization were analyzed.Results The acute physiology and chronic health evaluation (APACHE) Ⅱ score and sequential organ failure assessment (SOFA) score in the PICS group were higher than those in the control group [(18.6±3.8) vs.(15.9±4.0),t =3.598,P ＜ 0.01;(4.8±1.5) vs.(4.0±1.6),t =2.832,P =0.005].When compared with the control group,the proportion of lung cancer in the PICS group was increased [47.7％ (21/44) vs.23.8％ (20/84),x2 =8.378,P =0.006],and the albumin was decreased [(28.8±3.3) g/L vs.(30.8±2.9) g/L,t =3.695,P ＜ 0.01],the C reactive protein was increased [(60±8) mg/L vs.(45±8) mg/L,t =9.520,P ＜ 0.01],hospital duration was prolonged [(33±7) d vs.(26±7) d,t =4.820,P ＜ 0.01],hospital mortality was increased [22.7％ (10/44) vs.4.8％ (4/84),x2 =9.567,P =0.002].Multiple factor logistic regression analysis showed that the APACHE Ⅱ score ＞ 20,lung cancer and the albumin ＜ 30 g/L were the risk factors for PICS in the malignant tumor patients with lung infection after chemotherapy (all P ＜ 0.05).Conclusion The incidence of PICS in malignant tumor patients with pulmonary infection after chemotherapy is high,and the risk factors for the poor prognosis include APACHE Ⅱ score ＞20,lung cancer and the albumin ＜30 g/L.

Construction a community pathway of chronic disease management for chronic obstructive pulmonary disease / 中国实用护理杂志

Objective@#To construct a community pathway of chronic disease management for chronic obstructive pulmonary disease (COPD), which provided a theoretical basis for community management of chronic disease in COPD.@*Methods@#Under the theoretical framework of the PDCA cycle management method, the questionnaire was formed with reference to the clinical pathway. This study conducted two-rounds of expert correspondence by using the Delphi method.@*Results@#After two rounds of expert letters, the effective recovery rate of the volume was 100% (15/15), the authoritative coefficient was 0.85, the familiarity coefficient was 0.76, and the judgment coefficient was 0.93, the path of COPD chronic disease management community was ultimately determined for 6 first-level indicators, including assessment, planning, implementation, variation, evaluation and feedback, 19 second-level indicators and 44 third-level indicators. The coordination coefficient of indicators was 0.12, 0.05, 0.12, and the coordination of expert opinions of the third-level indicators was statistically significant (P<0.05).@*Conclusion@#The community path of COPD chronic disease management has been tested by experts, with concentrated opinions and scientific and reliable, which provides a reference for COPD chronic disease community management.

Clinical and endoscopic characteristics analysis of 116 patients with pneumatosis cystoides intestinalis in colon / 中华消化内镜杂志

Objective To analyze the clinical and endoscopic characteristics of pneumatosis cystoides intestinalis ( PCI) in colon. Methods Data of 116 patients with colonic PCI admitted at Beijing Friendship Hospital from January 2005 to June 2018 were retrospectively collected, including age, gender, clinical manifestations, lesion size, location, and morphology. The clinical and endoscopic characteristics of colonic PCI were analyzed. Results The 116 patients included 54 males and 62 females, with age of 59. 11±13. 13 years (ranged, 17-91 years). Fifty cases (43. 10％) had a single lesion, and 66 cases (56. 90％) had multiple lesions. The detection rate of colonic PCI was 0. 40‰ ( 1/2524) to 2. 03‰(8/3945). Clinical manifestations included no symptom (24. 14％, 28/116), abdominal pain (18. 97％,22/116) , and elevated tumor markers ( 17. 24％, 20/116 ) . A total of 168 lesions were found under colonoscopy, and were single or multiple submucosal hemispherical or spherical cystic eminence of different sizes with soft surface, and some had hyperemia and erosion on the mucosal surface. The size of lesions was clearly recorded in 66 cases among the 116 patients, with 1. 61±0. 87 cm (ranged, 0. 3-5. 0 cm). The diameter of lesions was 1. 0-<2. 0 cm in 30 cases ( 45. 45％) . The single PCI was mostly located in ascending (38. 00％, 19/50) and transverse ( 28. 00％, 14/50) colon, and multiple PCIs were mostly located in ascending ( 28. 81％, 34/118 ) , sigmoid ( 22. 03％, 26/118 ) and descending ( 17. 80％, 21/118) colon. Conclusion Colonic PCI is a rare disease in clinic with non-specific clinical manifestations, and colonoscopy is an effective diagnostic method. It is apt to happen in elder patients and often found in ascending colon.

Clinical study of alprostadil combined with epalrestat and methylcobalamin in the treatment of type 2 diabetic peripheral neuropathy / 中国基层医药

Objective To study the effect of alprostadil combined with epalrestat and methylcobalamin in the treatment of type 2 diabetic peripheral neuropathy.Methods From January 2014 to June 2016,120 patients with type 2 diabetic peripheral neuropathy in the First People's Hospital of Baiyin were randomly divided into two groups according to the random number table method.64 patients of the observation group were given the treatment of alprostadil,epalrestat combined with methylcobalamin.56 patients of the control group were given the treatment of alprostadil and methylcobalamin.And the two groups were treated for 4 weeks.The blood glucose,clinical symptoms,adverse reaction,nerve conduction velocity index were compared between the two groups before and after treatment.Results The fasting blood glucose and 2-hour postprandial blood glucose of the two groups after treatment were significantly decreased (t =18.20,17.61,15.75,23.69,all P ＜ 0.05),and the conduction velocity of the common peroneal nerve,the median nerve and the ulnar nerve in the observation group were significantly higher than those in the control group (t =1.989,2.638,3.026,2.187,2.619,1.997,all P ＜ 0.05).The total effective rate of the observation group was significantly higher than that of the control group(95.3％ vs.82.1％,x2 =4.54,P ＜0.05).There were no statistically significant differences in the blood glucose and the incidence rate of adverse reactions between the two groups (t =0.267,0.176,0.695,0.658,x2 =1.356,all P ＞ 0.05).Conclusion Alprostadil combined with epalrestat and methylcobalamin in the treatment of type 2 diabetic peripheral neuropathy has good effect.

A new method for constructing engineered corneal epithelium based on embryonic stem cells / 中华实验眼科杂志

Objective To construct engineered corneal epithelium from embryonic stem cells (ESCs) using Rock inhibitor combined with hypoxia-normoxia culture condition. Methods Human ESC line H1 was induced to differentiate into epithelial-like cells by addition of retinoic acid (RA) and bone morphogenetic protein 4(BMP4) in the differentiation medium under the adherent culture condition. The ESCs derived epithelial-like cells were expanded in the mixed medium of SHEM and KSFM with the mixture ratio of 1 : 2 with or without Rock inhibitor Y27632. The H1 derived epithelial-like cells were seeded on the denuded ammonic membrane to construct engineered corneal epithelium under hypoxia,normoxia and hypoxia-normoxia culture conditions,respectively. The inducted effect of ESCs into epithelial-like cells,the expansion ability of the epithelial-like cells and the characteristics of the constructed engineered corneal epithelium were evaluated by morphological observation, real-time fluorescent quantitative polymerase chain reaction (RTFQ-PCR) and immunofluorescence technology. Results Compared with the control group,the relative expressions of ESCs marker Oct4 mRNA, Notch signaling pathway related factors Notch1 and Jagged1 mRNA,and Wnt signaling pathways related factors c-myc and Cyclin D1 mRNA were significantly reduced, and the relative expressions of cutaneous ectoderm markers p63 and K18 mRNA were significantly increased at day 8 after induction in the induced group,with significant differences between them (t =14.63,20.15,93.50,11.60, 19.30,18.44,22.63;all at P<0.05). Compared with the without Y27632 group,the relative expressions of p63 and K14 mRNA,Notch signal pathway receptor Notch1 and Jagged1 mRNA were significantly increased,and Wnt signaling pathways downstream targeted gene c-myc and CylinD1 mRNA were significantly decreased at day 8 after induction in the Y27632 group,with significant differences between them (t =20.29,59.22,2.90,39.59,5.32,10.14;all at P<0.05),and the relative expression of K18 mRNA in the two groups was not significantly changed(t=1.38,P>0.05). The ESCs derived epithelium and constructed under hypoxia-normoxia culture condition showed more obvious stratification and tighter cell arrangement in comparison with those cells cultured in consistent hypoxia culture condition or normoxia culture condition. Epithelial markers Pan-CK and K18 as well as epithelial progenitor cell markers p63 and K14 expressed in the whole cell layers of the ESCs derived epithelium constructed under hypoxia-normoxia culture condition. Conclusions The addition of Y27632 enhances the proliferation ability of H1 derived epithelial cells and actives Notch signaling pathway and inhibits Wnt signaling pathway. The culture and construction in the expansion medium with Y27632 under the hypoxia-normoxia culture condition can promote the stratification of H1 derived engineered corneal epithelium.

Ultrasonic monitoring of carotid blood flow in interposed abdominal pulling-pressing cardiopulmonary resuscitation / 中华危重病急救医学

Objective@#To explore the difference in ultrasonic monitoring in carotid blood flow, resuscitation effects and prognosis between interposed abdominal pulling-pressing cardiopulmonary resuscitation (IAPP-CPR) and standard cardiopulmonary resuscitation (STD-CPR).@*Methods@#Seventy-five cardiac arrest (CA) patients admitted to emergency department of Shijingshan Teaching Hospital of Capital Medical University from June 2015 to December 2017 were enrolled. The patients were divided into STD-CPR group and IAPP-CPR group according to the treatment orders of them and the desire of relatives. All patients were given persistent external compression, airway open, tube intubation, and mechanical ventilation, vasoactive drugs application, defibrillation if required. STD-CPR group was operated according to the 2015 American Heart Association (AHA) CPR guidelines. On the basis of the standard CPR, IAPP-CPR group was recovered using abdominal lifting and compressing CPR instrument to press down to lift the upper abdomen continuously, when the chest compressing relaxed (frequency 100 times/min, down and lift time ratio 1:1, compressing strength 50 kg, lifting strength 30 kg). The patients' gender, age and CA etiology were recorded in the two groups. The vital signs and blood flow of carotid artery were monitored with ultrasonic Doppler during the CPR. The return of spontaneous circulation (ROSC) rate and 48-hour survival rate were observed in patients. The influence factors of ROSC were screened by Logistic regression analysis.@*Results@#The data of 75 patients with CA were enrolled finally, with STD-CPR group of 38 patients and IAPP-CPR group of 37 patients. There were no significant differences in patients' gender, age or CA etiology between the two groups. Comparing with STD-CPR group, the peak blood flow velocity of carotid artery in IAPP-CPR group was speeded up significantly (cm/s: 107.16±13.75 vs. 78.99±14.77, P < 0.01), the overall blood flow volume of carotid artery was increased significantly (mL/min: 989.06±115.88 vs. 751.62±118.92, P < 0.01), but there was no significant difference in inner diameter of carotid artery between the two groups (mm: 4.55±0.25 vs. 4.61±0.21, P > 0.05) . During the CPR, the mean arterial pressure (MAP) and the transcutaneous oxygen saturation (SpO2) in IAPP-CPR group were significantly higher than those of STD-CPR group, but no significant difference was found in heart rate between the two groups. Four patients in STD-CPR group got ROSC, and 3 survived over 48 hours (1 myocardial infarction patient died of ventricular fibrillation) while 6 patients in IAPP-CPR group got ROSC and survived over 48 hours. There was no significant difference in ROSC rate or 48-hour survival rate between the two groups, but data of IAPP-CPR group was slightly higher than that of STD-CPR group [ROSC rate: 16.22% (6/37) vs. 10.53% (4/38), 48-hour survival rate: 16.22% (6/37) vs. 7.89% (3/38), both P > 0.05]. Multivariate Logistic regression analysis showed that the higher the MAP during CPR, the greater the possibility of ROSC was [odds ratio (OR) = 1.361, 95% confidence interval (95%CI) = 1.182-1.669, P = 0.030].@*Conclusions@#IAPP-CPR was superior to traditional STD-CPR in improving arterial blood flow and resuscitation effect, but no superiority was found in ROSC rate and survival rate, which may be relate to the small number of patients that included in this study. More clinic trials are needed.

Ultrasonic monitoring of carotid blood flow in interposed abdominal pulling-pressing cardiopulmonary resuscitation / 中华危重病急救医学

OBJECTIVE@#To explore the difference in ultrasonic monitoring in carotid blood flow, resuscitation effects and prognosis between interposed abdominal pulling-pressing cardiopulmonary resuscitation (IAPP-CPR) and standard cardiopulmonary resuscitation (STD-CPR).@*METHODS@#Seventy-five cardiac arrest (CA) patients admitted to emergency department of Shijingshan Teaching Hospital of Capital Medical University from June 2015 to December 2017 were enrolled. The patients were divided into STD-CPR group and IAPP-CPR group according to the treatment orders of them and the desire of relatives. All patients were given persistent external compression, airway open, tube intubation, and mechanical ventilation, vasoactive drugs application, defibrillation if required. STD-CPR group was operated according to the 2015 American Heart Association (AHA) CPR guidelines. On the basis of the standard CPR, IAPP-CPR group was recovered using abdominal lifting and compressing CPR instrument to press down to lift the upper abdomen continuously, when the chest compressing relaxed (frequency 100 times/min, down and lift time ratio 1:1, compressing strength 50 kg, lifting strength 30 kg). The patients' gender, age and CA etiology were recorded in the two groups. The vital signs and blood flow of carotid artery were monitored with ultrasonic Doppler during the CPR. The return of spontaneous circulation (ROSC) rate and 48-hour survival rate were observed in patients. The influence factors of ROSC were screened by Logistic regression analysis.@*RESULTS@#The data of 75 patients with CA were enrolled finally, with STD-CPR group of 38 patients and IAPP-CPR group of 37 patients. There were no significant differences in patients' gender, age or CA etiology between the two groups. Comparing with STD-CPR group, the peak blood flow velocity of carotid artery in IAPP-CPR group was speeded up significantly (cm/s: 107.16±13.75 vs. 78.99±14.77, P < 0.01), the overall blood flow volume of carotid artery was increased significantly (mL/min: 989.06±115.88 vs. 751.62±118.92, P < 0.01), but there was no significant difference in inner diameter of carotid artery between the two groups (mm: 4.55±0.25 vs. 4.61±0.21, P > 0.05). During the CPR, the mean arterial pressure (MAP) and the transcutaneous oxygen saturation (SpO2) in IAPP-CPR group were significantly higher than those of STD-CPR group, but no significant difference was found in heart rate between the two groups. Four patients in STD-CPR group got ROSC, and 3 survived over 48 hours (1 myocardial infarction patient died of ventricular fibrillation) while 6 patients in IAPP-CPR group got ROSC and survived over 48 hours. There was no significant difference in ROSC rate or 48-hour survival rate between the two groups, but data of IAPP-CPR group was slightly higher than that of STD-CPR group [ROSC rate: 16.22% (6/37) vs. 10.53% (4/38), 48-hour survival rate: 16.22% (6/37) vs. 7.89% (3/38), both P > 0.05]. Multivariate Logistic regression analysis showed that the higher the MAP during CPR, the greater the possibility of ROSC was [odds ratio (OR) = 1.361, 95% confidence interval (95%CI) = 1.182-1.669, P = 0.030].@*CONCLUSIONS@#IAPP-CPR was superior to traditional STD-CPR in improving arterial blood flow and resuscitation effect, but no superiority was found in ROSC rate and survival rate, which may be relate to the small number of patients that included in this study. More clinic trials are needed.

Optimized combination of pre-and post-adaptive statistical iterative reconstruction-V in low dose abdominal CT scanning / 中国医学影像技术

Objective To observe the impact of adaptive statistical iterative reconstruction-V (ASiR-V) on image quality and radiation dose in abdominal CT imaging,and to optimize combination of pre-and post ASiR-V percentage.Methods Totally 160 patients underwent plain and contrast-enhanced abdominal CT were randomly divided into study group or control group (each n=80).In study group,plain images were reconstructed with 20％ pre ASiR-V combined with 20％,40％,60％ and 80％ post-ASiR-V,the arterial phase images were reconstructed with 40％ pre-ASiR V combined with 40％,60％ and 80％ post-ASiR-V,while the venous phase images with 60％ pre-ASiR-V combined with 60％ and 80％ post-ASiR-V,and the delayed phase images with 80％ pre-ASiR-V combined 80％ post-ASiR-V.In control group,images were reconstructed with filtered back projection (FBP) and 0 pre-ASiR-V combined post-ASiR-V (20％ in plain,40％ in arterial phase,60％ in venous phase and 80％ in delayed phase imaing).The objective parameters (image noise [SD] and CNR) and image quality scores were analyzed and compared.Results CT dose index,dose length product and effective dose of each phase in study group were lower than those in control group (all P＜0.001).In study group,with the increasing of post-ASiR-V percentage,SD values gradually decreased (P＜0.01),and CNR gradually increased or did not change.With the increasing of post-ASiR-V (20％-60％),image quality scores increased,and image quality of 80 ％ post-ASiR-V was low.In study group,image quality of 20％ pre-ASiR-V combined 40％ or 60％ post-ASiR-V was similar to 20％ post-ASiR-V image in control group in plain,and that of 40％ pre-ASiR-V combined 60％ post-ASiR-V was similar to 40％ post-ASiR-V image in control group in arterial phase (all P＞0.05),while image quality scores of other combinations of pre-and post-ASiR-V percentages were lower than those in control group.Conclusion ASiR-V can improve abdominal CT image quality,and 40％ pre-ASiR-V combined 60％ post-ASiR V is recommended.

Characteristics of Cerebral Blood Flow in Brain CT Perfusion Imaging for Vascular Cognitive Impairment / 中国康复理论与实践

@#Objective To evaluate cerebral perfusion through brain computed tomography perfusion imaging (CTP) in order to investigate the relationship between cerebral perfusion and vascular cognitive impairment (VCI).Methods A total of 103 patients with ischemic stroke were recruited, who received thrombolytic therapy and CTP test in the Fourth Affiliated Hospital of China Medical University from December, 2016 to May, 2017. The patients were divided into normal cognitive function group (control group, n=43), vascular cognitive impairment-no dementia group (VCIND group, n=48), and vascular dementia group (VD group, n=12) according to the degree of impairment in cognitive function after the assessment of Mini-Mental State Examination (MMSE) and Clock Drawing Test (CDT). The characteristics of cerebral blood flow perfusion in region of interest of brain CTP were analyzed.Results There was difference in incidence of diabetes among three groups (χ2=7.556, P<0.05). The rate of diabetes was higher in VCIND group and VD group than in the control group. Age and diabetes were the independent risk factors for VCI (OR>1, P<0.05). There was difference in cerebral blood volume (CBV) in frontal lobe, temporal lobe, and parietal lobe among three groups (F>3.216, P<0.05). CBV in frontal lobe, temporal lobe, and parietal lobe reduced in VD group than in the control group (P<0.05), while CBV in frontal lobe and temporal lobe reduced in VD group than in VCIND group (P<0.05). There was difference in mean transit time (MTT) in left temporal lobe, left parietal lobe, and centrum semiovale among three groups, while there was difference in left occipital lobe in time to peak (TTP) among three groups (F>3.116, P<0.05). MTT and TTP were higher in VD group than in the control group and VCIND group (P<0.05). There was no difference in cerebral blood flow (CBF) in both left and right brain, and MTT and TTP in right brain among three groups (P>0.05). CBV in frontal lobe, parietal lobe and right temporal lobe demonstrated positive relationship with the scores of MMSE (r>0.203, P<0.05). CBV in parietal lobe and left frontal lobe also demonstrated positive relationship with the scores of CDT (r>0.214, P<0.05).Conclusion The cerebral blood flow perfusion reduced in different levels of VCI, especially in frontal lobe, temporal lobe and parietal lobe. Cerebral blood flow perfusion reduced with the progress of cognitive impairment, and the left hemisphere injured earlier than the right one. Brain CTP may be applied in the early recognition of VCI.

Sleep deprivation disrupts the lacrimal system and induces dry eye disease

Sleep deficiency is a common public health problem associated with many diseases, such as obesity and cardiovascular disease. In this study, we established a sleep deprivation (SD) mouse model using a ‘stick over water’ method and observed the effect of sleep deficiency on ocular surface health. We found that SD decreased aqueous tear secretion; increased corneal epithelial cell defects, corneal sensitivity, and apoptosis; and induced squamous metaplasia of the corneal epithelium. These pathological changes mimic the typical features of dry eye. However, there was no obvious corneal inflammation and conjunctival goblet cell change after SD for 10 days. Meanwhile, lacrimal gland hypertrophy along with abnormal lipid metabolites, secretory proteins and free amino-acid profiles became apparent as the SD duration increased. Furthermore, the ocular surface changes induced by SD for 10 days were largely reversed after 14 days of rest. We conclude that SD compromises lacrimal system function and induces dry eye. These findings will benefit the clinical diagnosis and treatment of sleep-disorder-related ocular surface diseases.

Mechanism of Neural Stem and Progenitor Cells Mediated by Hypoxia Inducible Factor-1α in Ischemic Stroke Model (review) / 中国康复理论与实践

Hypoxia inducible factor-1αis a kind of hypoxia response factor. Acute cerebral ischemia and anoxia can induce up-regula-tion of hypoxia inducible factor-1α, and the downstream genes, which plays a role in both the energy metabolism and collateral circulation after cerebral ischemia. Neural stem and progenitor cells regeneration also benefit the functional outcome after ischemic stroke. Hypoxia in-ducible factor-1αmay induce proliferation and differentiation of neural stem and progenitor cells through Notch, Wnt/β-catenin pathways, etc., in the ischemic stroke model.