A Survey on Learning Objects' Relationship for Image Captioning.

Image captioning is a challenging modality transformation task in computer vision and natural language processing, aiming to understand the image content and describe it with a natural language. Recently, the relationship information between objects in the image has been investigated to be of importance in generating a more vivid and readable sentence. Many types of research have been done in relationship mining and learning for leveraging into the caption models. This paper mainly summarizes the methods of relational representation and relational encoding in image captioning. Besides, we discuss the advantages and disadvantages of these methods and provide commonly used datasets for the relational captioning task. Finally, the current problems and challenges in this task are highlighted.

Prevalence of anxiety disorder in adults in Ningxia Hui Autonomous Region / 中国心理卫生杂志

Objective:To investigate the prevalence of anxiety disorder and its distribution,and related factors in adults in Ningxia community.Methods:Using the method of China Mental Health Survey,anxiety disorder was investigated with the Composite International Diagnostic Interview,and related factors were analyzed.Twelve-month prevalence and life-time prevalence and their distributions were calculated according to DSM-Ⅳ criteria.Results:A total of 4 085 respondents were interviewed in the survey.The 12-month prevalence rate of any anxiety disorder was 4.2％,and the lifetime prevalence rate was 5.6％.The 12-month prevalence rates of social phobia,special phobia and generalized anxiety disorder were higher in women than in men(P＜0.05).The prevalence of special phobia and any anxiety disorder in rural area was higher than that in urban area.Logistic regression model revealed that fe-male(OR=1.86,95％CI:1.32-2.64)had higher prevalence risk of anxiety disorder,and individuals with somat-ic pain had higher risk of anxiety disorder than those without(P＜0.05).Conclusion:Anxiety disorder is prevalent in Ningxia.It suggests that strengthening somatic pain community mental health service is necessary to develop tar-geted intervention programs among the high-risk population.

Prevalence of alcohol use disorder in adult residents in Ningxia Hui Autonomous Region / 中国心理卫生杂志

Objective:To investigate the prevalence of alcohol use disorder in adult residents in Ningxia and related factors,and to provide scientific evidence for intervention.Methods:In this cross-sectional study,multi-stage sampling was administrated.According to the diagnostic criterion of the Diagnostic and Statistical Manual of Mental Disorder,Fourth Edition(DSM-Ⅳ),face-to-face interview in household was carried out using Composite Interna-tional Diagnostic Interview in Ningxia Hui Autonomous Region.The prevalence of alcohol use disorder and the re-lated factors were analyzed.Results:In 4 085 residents who completed the survey,the 12-month prevalence of alco-hol use disorder was 1.2％,and the life-time prevalence rate was 3.5％.The twelve-month prevalence rates of alco-hol abuse and alcohol dependence were 1.1％and 0.6％,respectively,and the life-time prevalence rates of them were 2.8％and 1.2％,respectively.Comparing with control population,male(OR=10.84,95％CI:2.88-40.87),age groups of 18 to 29 years old(OR=3.67,95％CI:1.27-10.59),30 to 39 years old(OR=5.12,95％CI:1.98-13.24),and 40 to 49 years old(OR=3.82,95％CI:1.45-10.06),secondary school(OR=3.07,95％CI:1.22-7.75),high school or above(OR=3.13,95％CI:1.21-8.12),smoking(OR=3.00,95％CI:1.34-6.70)and body pain(OR=1.88,95％CI:1.05-3.36)were risk factors of alcohol use disorder.Conclusions:The prevalence of alcohol use disorder in different populations distribute dissimilarly in Ningxia.Males,middle-aged and young people,smokers,and those with physical pain should be key objects of intervention for alcohol use disorders.

Clinical study on the treatment of gastrointestinal neurosis with insomnia by combination of "stomach ten acupuncture" and domperidone tablets / 国际中医中药杂志

Objective:To study on the effect of "stomach ten acupuncture" combined with domperidone tablets on clinical symptoms and sleep quality of gastrointestinal neurosis patients with insomnia based on the theory of "stomach harmonious leading to restless".Methods:Randomized controlled trial. From March 2020 to March 2021, 98 patients with gastrointestinal neurosis and insomnia in our hospital who met the inclusion criteria were randomly divided into two groups, with 49 patients in each group. The control group took domperidone tablets orally, and the observation group was treated with "stomach ten acupuncture" on the basis of the control group. Both groups were treated for 8 weeks. Before and after treatment, TCM syndromes were scored, the severity of gastrointestinal symptoms was assessed with Gastrointestinal Symptom Rating Scale (GSRS), anxiety and depression were assessed with Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD), and sleep quality was assessed with Pittsburgh Sleep Quality Index Scale (PSQI).Results:After treatment, the scores and total scores of epigastric pain, belching, abdominal distension, anorexia, noisy acid regurgitation, tiredness and asthenia, constipation and loose stools in the observation group were significantly lower than those in the control group ( t values were 19.61, 19.30, 23.10, 22.05, 20.43, 21.81, 20.51, 16.38, respectively, P<0.01); the scores and total scores of typical symptoms, abdominal pain symptoms, reflux symptoms, diarrhea symptoms, constipation symptoms were significantly lower than those in the control group ( t values were 10.10, 11.14, 11.04, 9.31, 11.24, 5.30, respectively, P<0.01); HAMA and HAMD scores were significantly lower than those in the control group ( t values were 6.96 and 6.85, respectively, P<0.01). The scores of time to fall asleep (1.15 ± 0.56 vs. 2.11 ± 0.75, t=7.18), time to sleep (0.92 ± 0.63 vs. 1.52 ± 1.12, t=3.27), sleep quality (1.02 ± 0.66 vs. 1.96 ± 0.80, t=6.35), sleep efficiency (0.86 ± 0.62 vs. 1.68 ± 0.85, t=5.46), sleep disorders (0.92 ± 0.36 vs. 1.48 ± 0.55, t=5.96), daytime dysfunction (0.96 ± 0.42 vs. 1.97 ± 0.87, t=7.32), hypnotics (0.98 ± 0.45 vs. 1.81 ± 0.62, t=7.58) and total scores (6.85 ± 1.47 vs. 12.73 ± 2.95, t=12.49) were significantly lower than those in the control group ( P<0.01). Conclusion:The "stomach ten acupuncture" combined with domperidone tablets can improve the clinical symptoms and sleep quality of gastrointestinal neurosis patients with insomnia.

Progress on Regulation of NLRP3 Inflammasome by Chinese Medicine in Treatment of Ulcerative Colitis / 中国结合医学杂志

Ulcerative colitis (UC) is a chronic, non-specific intestinal disease that not only affects the quality of life of patients and their families but also increases the risk of colorectal cancer. The nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing protein 3 (NLRP3) inflammasome is an important component of inflammatory response system, and its activation induces an inflammatory cascade response that is involved in the development and progression of UC by releasing inflammatory cytokines, damaging intestinal epithelial cells, and disrupting the intestinal mucosal barrier. Chinese medicine (CM) plays a vital role in the prevention and treatment of UC and is able to regulate NLRP3 inflammasome. Many experimental studies on the regulation of NLRP3 inflammasome mediated by CM have been carried out, demonstrating that CM formulae with main effects of clearing heat, detoxifying toxicity, drying dampness, and activating blood circulation. Flavonoids and phenylpropanoids can effectively regulate NLRP3 inflammasome. Other active components of CM can interfere with the process of NLRP3 inflammasome assembly and activation, leading to a reduction in inflammation and UC symptoms. However, the reports are relatively scattered and lack systematic reviews. This paper reviews the latest findings regarding the NLRP3 inflammasome activation-related pathways associated with UC and the potential of CM in treating UC through modulation of NLRP3 inflammasome. The purpose of this review is to explore the possible pathological mechanisms of UC and suggest new directions for development of therapeutic tools.

Bridging the structure gap between pellets in artificial dissolution media and in gastro-intestinal tract in rats

Changes in structure of oral solid dosage forms (OSDF) elementally determine the drug release and its therapeutic effects. In this research, synchrotron radiation X-ray micro-computed tomography was utilized to visualize the 3D structure of enteric coated pellets recovered from the gastrointestinal tract of rats. The structures of pellets in solid state and in vitro compendium media were measured. Pellets in vivo underwent morphological and structural changes which differed significantly from those in vitro compendium media. Thus, optimizations of the dissolution media were performed to mimic the appropriate in vivo conditions by introducing pepsin and glass microspheres in media. The sphericity, pellet volume, pore volume and porosity of the in vivo esomeprazole magnesium pellets in stomach for 2 h were recorded 0.47, 1.55 × 108 μm3, 0.44 × 108 μm3 and 27.6%, respectively. After adding pepsin and glass microspheres, the above parameters in vitro reached to 0.44, 1.64 × 108 μm3, 0.38 × 108 μm3 and 23.0%, respectively. Omeprazole magnesium pellets behaved similarly. The structural features of pellets between in vitro media and in vivo condition were bridged successfully in terms of 3D structures to ensure better design, characterization and quality control of advanced OSDF.

The effect of "ten needles in the stomach" treatment on sleep perception for the patients with spleen-gastric damp-heat insomnia based on the theory of "stomach upset, sleep restlessness" / 国际中医中药杂志

Objective:To explore the effect of "ten needles in the stomach" on sleep perception of patients with spleen-gastric damp-heat insomnia based on the theory of "stomach discord, then sleep restlessness", to provide references for clinical diagnosis and treatment.Methods:The study subjects were 300 patients with insomnia from the sleep department and outpatient department of Shijiazhuang Traditional Chinese Medicine Hospital. According to the random number method, they were divided into the stomach ten needle group, the diazepam group, and the stomach ten needle plus diazepam group, with 100 in each group. Among them, the stomach ten needles group received "stomach ten needles" acupuncture treatment, the diazepam group was given diazepam therapy, and the stomach ten needles plus diazepam group was given diazepam combined with "stomach ten needles" acupuncture treatment. The Pittsburgh Sleep Quality Index (PSQI) scores, the self-rating disease symptom scale (SCL-90) scores, nighttime polysomnography (PSG) monitoring indicators, and the mean sleep latency (MSL) values were compared before and after treatment in the three groups. The difference in clinical efficacy between the two groups were observed.Results:The total effective rate was 94.0% (94/100) in the combined group, 77.0% (77/100) in the diazepam group, and 85.0% (85/100) in the stomach ten needle group. There were significant differences among the three groups ( χ2=11.56, P<0.01). After treatment, the daytime dysfunction, hypnotic drugs, sleep disturbance, sleep efficiency, sleep time, sleep time, sleep quality score and total score of the combined group were significantly lower than those in the diazepam group and the stomach ten needle group ( F=5.70, 3.65, 5.23, 6.37, 3.66, 6.19, 7.54, 6.40, all Ps<0.01); The scores of SCL-90 and MSL were significantly lower than those in the diazepam group and stomach ten needle group ( F=8.97, 7.53, all Ps<0.01). In the combined group, NWAK [(1.36 ± 0.87) times vs. (2.69 ± 1.15) times, (2.11 ± 1.05) times, F=5.88], SOL [(13.62 ± 5.85) min vs. (25.06 ± 9.42) min, (19.78 ± 7.63) min, F=6.49], N1/TST [(5.69 ± 1.09)% vs. (12.65 ± 2.58)%, (8.49 ± 2.45)%, F=5.13], N2/TST [(51.07 ± 10 2.06)% vs. (58.36 ± 2.18)%, (55.61 ± 2.04)%, F=9.86] were significantly lower than those in the diazepam group and stomach ten needle group ( P<0.01), SE [(90.33 ± 2.89)% vs. (85.39 ± 2.75)%, (87.53 ± 2.69)%, F=8.36], TST [(449.32 ± 23.65) min vs. (421.66 ± 25.33) min, (431.26 ± 25.98) min, F=8.26], REM/TST [(23.87 ± 4.52)% vs. (14.52 ± 3.87)%, (18.36 ± 3.25)%, F=5.34], N3/TST [(18.69 ± 2.02)% vs. (10.31 ± 1.64)%, (14.89 ± 1.74)%, F=7.69] were significantly higher than those in the diazepam group and stomach ten needle group ( P<0.01). Conclusion:Based on the "stomach discord, sleep restlessness" theory, the ten needles on the stomach can treat insomnia and improve psychological state and sleep quality, with the functions of clearing the damp and heat of the middle joker, regulating the lifting and lowering of qi in the middle.

Research progress of C-X-C motif chemokine ligand 12 and its receptor signaling axis in the regulation of pulmonary fibrosis / 中华劳动卫生职业病杂志

Pulmonary fibrosis is an irreversible interstitial lung disease characterized by lung parenchyma remodeling and collagen deposition. In recent years, the incidence and mortality of pulmonary fibrosis caused by unknown causes have risen. However, its pathogenesis is still unclear. C-X-C motif chemokine ligand 12 (CXCL12)/C-X-C chemokine receptor 4 (CXCR4)/CXCR7 signal axis plays a critical regulatory role in pulmonary fibrosis disease. In addition, the signal axis has been shown to regulate recruitment and migration of circulating fibrocytes, mesenchymal stem cells to the damage lung tissue, the migration of endothelial cells, the proliferation and differentiation of fibroblasts and endothelial cells, which further affects the occurrence and progression of pulmonary fibrosis. In this review, we summarized the pathogenesis and treatment research progress of CXCL12 and its receptor CXCR4/CXCR7 in the occurrence and progression of pulmonary fibrosis.

Anti-contactin-associated protein-1 antibody associated chronic inflammatory demyelinating polyradiculoneuropathy: a case report / 中华神经科杂志

Chronic inflammatory demyelinating polyneuropathy (CIDP) with positive anti-contactin-associated protein-1 (Caspr1) antibody is a rare autoimmune antibody mediated peripheral neuropathy. A 62-year-old male patient was reported in this article, whose clinical manifestations were subacute onset, abnormal distal limb motor sensation, and increased cerebrospinal fluid protein level. The patient had a good response to plasma exchange. Electromyography of lower limbs showed that motor involvement was dominant, motor conduction velocity slowed down, compound motor active potential (CMAP) and sensory nerve active potential amplitude decreased, and F wave was not elicited; electromyography of upper limbs without symptoms showed that CMAP amplitude of median nerve decreased, and conduction velocity was normal. There are few reports of anti-Caspr1 positive CIDP in the world. The article summarized the characteristics of the patient and reviewed the relevant literature, in order to improve clinicians′ understanding and diagnosis and treatment ability of the disease.

Quantile regression model-based analysis of influencing factors on quality of life of inpatients with type 2 diabetes / 中华疾病控制杂志

Objective This study aimed to understand the status of health-related quality of life (HRQOL) among the hospitalized patients with type 2 diabetes (T2DM) in Yinchuan, so as to analyze the factors associated with HRQOL of hospitalized T2DM patients. The applied value of quantile regression in analysis of HRQOL was explored. Methods A cross-sectional study was conducted to obtain data of 480 hospitalized T2DM patients. The Chinese Normal Audit of Diabetes-Dependent Quality of Life (CN-ADDQoL) scale was used to assess the HRQOL status of patients. Traditional linear regression and quantile regression were used to analyze the influencing factors of HRQOL in hospitalized T2DM patients. Results The average weight impact (AWI) of hospitalized T2DM patients was-2.7(-3.6,-1.9), and the items with lowest score were in the dimension of “work life” (AWI,-4(-6,-2)), “eat” AWI,-4(-6,-2)) and “Anything of Drinking” (AWI,-4(-6,-2)). Linear regression results showed that 18-59 years old or the renal and circulatory complications were risk factors for HRQOL in T2DM hospitalized patients. Quantile regression further found that the better the quality of life, the weaker the effect on age (β1=0.931, P1=0.001; β2=0.699, P2=0.001; β3=0.370, P3=0.012; β4=0.313, P4=0.035), the rural residents (β5=-0.421, P5<0.001), insulin treatment (β3=-0.325; P3=0.024), the ocular (β1=-0.546, P1=0.008; β5=-0.352, P5=0.008), renal (β5=-0.358, P5=0.025) and circulatory complications (β1=-0.803, P1<0.001; β5=-0.302, P5=0.011) had effect on HRQOL at different quantiles. Conclusions Age, urban and rural residence, whether receive insulin therapy and complications are the influencing factors of HRQOL in hospitalized T2DM patients. The quantile regression model can show different factors affecting the quality of life of patients at different quintiles. The results from quantile regression can provide the targeted and reasonable recommendations for improvement of HRQOL of T2DM patients.

Visual acuity in preschool children of Yangpu District in Shanghai / 上海预防医学

Objective To investigate the visual acuity condition of preschool children in Yangpu District of Shanghai, providing the basis for formulation of corresponding intervention measures for myopia. Methods The inspection equipment was the international standard logarithmic E-word visual acuity chart, and the Canon RK-F1 automatic computer optometry instrument.By using cross-sectional study and random cluster sampling method, a total of 1 415 preschool children in 5 kindergartens in Yangpu District were selected according to their ages and genders, and their visual acuity and refractive parameters were examined with the result being statistically analyzed. Results In preschool children of Yangpu District, their envisage rate was 80.4%, myopia rate 16.7% and hyperopia rate 2.9%.There was no significant difference in the incidence rate of envisage, myopia and hyperopia between different age groups (χ2=3.419, P=0.755) and different genders (χ2=2.433, P=0.296).The rate of poor vision for preschool children in Yangpu was 10.5%.There was a statistically significant difference in the rate of poor vision between different age groups (χ2=9.637, P=0.022) and different genders (χ2=4.191, P=0.041). Conclusion The visual acuity rate and myopia rate in preschool children are not optimistic and need further screening and early intervention.

Visual acuity in preschool children of Yangpu District in Shanghai / 上海预防医学

Objective To investigate the visual acuity condition of preschool children in Yangpu District of Shanghai, providing the basis for formulation of corresponding intervention measures for myopia. Methods The inspection equipment was the international standard logarithmic E-word visual acuity chart, and the Canon RK-F1 automatic computer optometry instrument.By using cross-sectional study and random cluster sampling method, a total of 1 415 preschool children in 5 kindergartens in Yangpu District were selected according to their ages and genders, and their visual acuity and refractive parameters were examined with the result being statistically analyzed. Results In preschool children of Yangpu District, their envisage rate was 80.4%, myopia rate 16.7% and hyperopia rate 2.9%.There was no significant difference in the incidence rate of envisage, myopia and hyperopia between different age groups (χ2=3.419, P=0.755) and different genders (χ2=2.433, P=0.296).The rate of poor vision for preschool children in Yangpu was 10.5%.There was a statistically significant difference in the rate of poor vision between different age groups (χ2=9.637, P=0.022) and different genders (χ2=4.191, P=0.041). Conclusion The visual acuity rate and myopia rate in preschool children are not optimistic and need further screening and early intervention.

The analysis of the relationship between the fungal microbiota from soil and tongue coating of 18 patients with precancerous lesions of upper gastrointestinal / 中华预防医学杂志

The fungal microbiota from self-retained soil and tongue coating of 18 patients with precancerous lesions of upper gastrointestinal (PLUG) were sequenced. The diversity of α, β in and the structure of the microbial community were analyzed, and the association of them was quantified by using the Spearman rank correlation method. The richness index (1.67±2.79) and the diversity index (0.25±0.10) of the fungal microbiota from tongue coating of PLUG patients were significantly lower than those from soil (4.00±4.69; 0.99±0.18) (all P values<0.001). The relative abundance of 11 taxa from tongue coating of these PLUG patients was positively associated with that from soil (all P values<0.05).

Changes and enlightenment of diagnostic criteria for hypertension / 中国实用内科杂志

The definition of hypertension has been the object of controversy for many years. The First Report of the Joint National Committee( JNC-1) on Detection, Evaluation, and Treatment of High Blood Pressure was issued in 1977 and the levels of blood pressure above 160/95 mmHg was considered as high blood pressure(BP). The early JNC series guidelines are relatively vague on the diagnostic criteria and treatment goals of hypertension, and put more emphasis on diastolic blood pressure(DBP) in hypertension diagnosis. Since the publication of JNC VI reports, hypertension is defined as office systolic blood pressure(SBP) values≥140 mmHg and/or DBP values≥90 mmHg. The 2017 ACC/AHA Hypertension Guidelines changed the diagnostic criteria for hypertension by 130/80 mmHg and has caused widespread controversy at home and abroad. The Chinese Medical Doctor Association issued a scientific statement on the diagnostic criteria for hypertension and treatment targets of high BP in China. Although the standards proposed by the new ACC/AHA hypertension guideline is not recognized by other national guidelines, its concept of earlier prevention of hypertension has been widely accepted.

Recent development in hypertension gene study / 中国实用内科杂志

Genetic as well as genomic study has advanced the development of precision medicine. We are marching on the road for right patients who are receiving more and more right treatment at right time. In hypertension field, precision medicine is available, actionable and affordable. First and the most practical advancement is monogenic hypertension, the disease-genes have been found for at least 17 types of monogenic hypertension. These patients can be precisely treated according to their carried gene mutation. Secondly, pharmacogenetic and pharmacogenomic guided anti-hypertensive drug selection, very promising but lack of clinic outcome data to support widely clinical application. Majority of hypertension are due to multiple genetic and environmental factors. GWAS fund some genetic variants related to primary hypertension, but these variants can only be responsible for 1-10% of blood pressure variation. We have a long way to go in exploring the real cause of primary hypertension.

Research progress of drug delivery system with "gatekeeper" / 药学学报

The drug delivery system with "gatekeeper" is designed to achieve a stable entrapment state of the payload under normal physiological conditions through the gatekeepers. With tumor microenvironment or stimulation of exogenous factors, the gatekeeper is detached or altered to promote the responsive release of the drug. In this paper, we focus on applications of stimuli-responsive linkages and stimuli-responsive groups, and review research progresses of drug delivery system with "gatekeeper" developed over the past 10 years.

Association between maternal tea consumption in pregnancy and birth outcomes / 中华预防医学杂志

Objective@#The purpose of this study was to explore the relationship between maternal tea consumption and birth outcomes.@*Methods@#From January 2005 to December 2010, pregnant women were recruited from Nanjing Maternity and Child Health Hospital. The basic information and the situation of tea consumption during pregnancy were investigated using questionnaire and the birth outcomes of newborns were followed up. Finally, 500 pairs of mothers and infants with complete and standard-compliant data were included in the analysis. The differences of birth outcomes between the tea consumption group and the non tea consumption group were compared and the associations between tea consumption and birth outcomes were analyzed using multivariate logistic regression.@*Results@#Mother's tea consumption rate was 32.8% (164 cases) during pregnancy. The rate of low birth weight in the tea consumption group was (5.5%, 9 cases) and higher than that in the non-tea consumption group (2.1%, 7 cases) (P=0.042). There was no significant difference in the rate of premature birth, small for gestational age, fetal distress, and macrosomia between the two groups After the adjustment of maternal age, education level, family income, weight gain during pregnancy, pre-pregnancy BMI, parity, gestational hypertension, gestational diabetes, neonatal gender and gestational age, compared with non-tea consumption group, there was a positive effect on low birth weight, OR(95%CI) was 4.76 (1.06-21.48). The OR (95%CI) value of the low birth weight risk of the tea group was 5.30 (1.04-26.92) compared with the non-tea consumption group after the adjustment of additional factors such as passive smoking, coffee consumption, folic acid supplement, mineral supplement, carbonated beverage consumption. Simultaneously, compared with non-tea consumption group, there was no statistically significant association between tea consumption during pregnancy and premature birth, small for gestational age, fetal distress and macrosomia (P>0.05).@*Conclusion@#Tea consumption during pregnancy was a risk factor for low birth weight in offspring.

Influence of disease uncertainty to emotion among advanced lung cancer chemotherapy patients / 中国实用护理杂志

Objective In order to understand the influence of disease uncertainty to emotion among advanced lung cancer chemotherapy patients, in order to guide the clinical nursing work. Methods A total of 146 advanced lung cancer chemotherapy patients were selected as the research object, using the general information, Disease Uncertainty Scale and Brief Profile of Mood States Scale for investigation. Results The disease uncertainty scores of advanced lung cancer chemotherapy patients were 77.91 ± 16.87; scores of emotion was 39.37 ± 18.72; they were positively correlated (r=0.363,P<0.01). Patients′family per capita income, cultural degree, two dimensions of disease uncertainty (uncertainty, poor information) were the main influencing factors of emotion (t=-4.947-4.603, P<0.05). Conclusions Advanced lung cancer chemotherapy patients with the higher level of disease uncertainty have more bad emotion. The patient's family per capita income level, cultural level and disease uncertainty will affect the mood of patients. Targeted intervention measures should be taken to reduce the patient′s disease uncertainty, and improve the patient′s emotion, improve the quality of life.

Electrophysiological characteristics of the split hand syndrome in amyotrophic lateral sclerosis and the variant / 中华神经科杂志

Objective To study the electrophysiological characteristics of hands muscle of upper limb onset amyotrophic lateral sclerosis (UL-ALS), and the variant-flail arm syndrome (FAS) for diagnosis and differential diagnosis. Methods We chose 55 UL-ALS and 12 FAS patients as the cases, 20 cervical spondylotic amyotrophy (CSA) patients as the case controls, and 20 healthy volunteers as the normal controls from January 2013 to March 2018 in the Third Central Hospital of Tianjin. Conventional nerve conduction studies of the median nerve and ulnar nerve were performed in all the patients. The main analysis was done in the compound muscle action potential (CMAP) recorded on the abductor pollicis brevis (APB) and abductor digiti minimi (ADM) and the ratio of the two. Results The ratio of CMAPAPB/CMAPADM of ALS was 0.59 (0.25, 0.79), which was depressed obviously compared with FAS (1.02 (0.92, 1.18), Z=-4.440, P=0.000), CSA (1.88 (1.42, 3.19), Z=-5.902,P=0.000) and the normal controls (0.96 (0.88, 1.15), Z=-5.416, P=0.000). The low ratio of CMAPAPB/CMAPADM (<0.6) was encountered in 40％(23/55) ALS patients, 0 CSA patient and 1/12 FAS patients. An absent APB CMAP and an abnormally low APB/ADM CMAP amplitude ratio (<0.25) were observed only in 25.4％ (14/55) ALS patients. The area under receiver operating characteristic curve in patients of UL-ALS was 0.911 (P=0.000), and in FAS was 0.518 (P=0.559). Using a cut-off value of CMAPAPB/CMAPADM=0.7 for diagnosing ALS yielded 85.5％sensitivity and 95.0％specificity. Conclusion The split hand syndrome is not specific for ALS; however, the low APB/ADM CMAP amplitude ratio may help predict prognosis and can be the diagnostic marker for ALS.

Increased BMR in overweight and obese patients with type 2 diabetes may result from an increased fat-free mass / 华中科技大学学报（医学）（英德文版）

The study aimed to determine the relationships between the basal metabolic rate (BMR) and body composition of overweight and obese Chinese adults with type 2 diabetes mellitus (DM). This cross-sectional clinical study enrolled 193 Chinese adults with type 2 DM who were overweight (24 kg/m(2)=BMI≤28 kg/m(2), n=99), or obese (BMI ≥28 kg/m(2), n=94). Ninety-seven adults with normal BMIs, including 50 DM patients and 47 healthy adults, were recruited as a control group. BMR was measured by indirect calorimetry; predicted BMR was calculated according to the Schofield equation; and the relationships between BMR, body composition, and biochemical results were determined by the Pearson correlation. The results showed that obese DM patients had significantly higher BMRs than both overweight patients (P<0.05) and patients with normal BMI did (P<0.05). The measured BMR was significantly lower than the predicted BMR (P<0.05) in all groups. Obese and overweight DM patients had significantly greater weight, waist circumference, hip circumference, BMI, body surface area, body fat percentage, fat mass, and fat-free mass than patients with normal BMI. Except for waist circumference, these body composition measurements were significantly increased in obese DM patients when compared with those in overweight DM patients (P<0.05). Fat-free mass was closely correlated with BMR in both DM patients (r=0.874, P<0.01) and in healthy controls (r=0.902, P<0.01). It was concluded that overweight and obese Chinese adults with type 2 DM had increased BMRs compared with normal-weight controls, which may result from the difference in fat-free mass.