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Objective To measure and compare the cerebral blood flow(CBF)of children with autism spectrum disorder(ASD),global developmental delay(GDD),and ASD with GDD groups via arterial spin labeling(ASL)technique,and to evaluate the diag-nostic value of CBF values.Methods ASL images of ASD,GDD,and ASD with GDD groups of children were firstly acquired,and the CBF values of frontal lobe,temporal lobe,parietal lobe,occipital lobe,striatum and thalamus region of interest(ROI)were fur-ther measured,respectively.One-way analysis of variance or Kruskal-Wallis H test was used to compare the differences in CBF values among these three groups,and the receiver operating characteristic(ROC)curve was used to analyze the efficacy of CBF values in distinguishing ASD with GDD from without GDD.Results ASD with GDD had significantly lower CBF values in the left and right frontal lobes than those with ASD or GDD alone,and the differences were statistically significant(P<0.05).The CBF values in the left and right frontal lobes effectively distinguished ASD with GDD from without GDD[area under the curve(AUC)>0.7].Conclusion ASL technique can noninvasively assess CBF in children with or without GDD,helping to understand the pathophysiology of ASD with GDD and improving diagnostic accuracy.
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Objective To analyze the efficacy and adverse reactions of donepezil in the treatment of patients with a continuous disease spectrum of Alzheimer's disease(AD)with pharmacogenomics.Methods Seventy-two patients who took donepezil therapy at the time of initial molecular pa-thology diagnosis of AD continuous disease spectrum in Chinese PLA General Hospital from Jan-uary 2022 to January 2023 were recruited.Cells from the oral buccal mucosa were collected,and MassARRAY nucleic acid mass spectrometry was applied to detect the genotypes of CYP2D6,the gene encoding cytochrome P450 2D6 enzyme,and CHAT,the gene encoding acetylcholine trans-ferase.After 9 months of follow-up,drug efficacy was indirectly determined by neurological func-tion scales,caregiver evaluations,and drug prescribing behaviors,and thus,the 50 patients on donepezil alone were divide into effective group(n=28)and ineffective group(n=22).Seventy-two patients were divided into adverse reaction group(n=12)and no adverse reaction group(n=60).Multivariate logistic regression analysis was used to analyze the correlation between donepezil efficacy and pharmacogenomics.Results The frequencies of CHAT rs3793790 locus carrying G allele and rs2177370 locus carrying A allele were significantly higher in the effective group than the ineffective group(35.71％vs 9.09％,P=0.029;42.86％vs 9.09％,P=0.008).Multivariate lo-gistic regression analysis showed that donepezil was more effective in those who carrying rs3793790 G allele and/or rs2177370 A allele in the CHAT gene than those who carrying neither of the alleles(95％CI:1.20-34.47,P=0.030).There were no statistical differences in the CYP2D6 gene-adjusted activity score and whether or not carrying*10 between the patients with and without adverse reactions(P＞0.0 5).Conclusion In patients with a continuous spectrum of AD,donepezil efficacy is associated with CHAT gene polymorphisms,but there is no correlation between donepezil adverse reactions and CYP2D6 genotype.
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OBJECTIVE To identify the chemical constituents of Rhamni Songoricae Fructus and to establish their fingerprints and the method for simultaneous determination of four constituents to comprehensively evaluate the quality of Rhamni Songoricae Fructus. METHODS The chemical constituents in Rhamni Songoricae Fructus were qualitatively analyzed by ultra-performance liquid chromatography quadrupole-time-of-flight tandem mass spectrometry. The fingerprints of 15 batches of Rhamni Songoricae Fructus were established by HPLC and chemometric analysis was performed by using SPSS 26.0 and SIMCA 14.1 software； the contents of quercetin， kaempferol， kaempferide and emodin were determined by the same method. RESULTS A total of 35 constituents were identified， including 28 kinds of flavonoids， 5 kinds of anthraquinones and 2 kinds of organic acids. A total of 19 common peaks were identified in the HPLC fingerprints， recognizing quercetin， kaempferol， kaempferide and emodin. The similarities between HPLC fingerprints of 15 batches of samples and control chromatograms were greater than 0.9. The results of cluster analysis showed that 15 batches of samples were divided into 2 classes， of which S1-S5， S7 and S9 were one class and the rest were one class， similar to the results of principal component analysis. The results of the orthogonal partial least squares- discriminant analysis showed that the variable importance projections of peaks No. 2， 6， 1， 11 （quercetin）， 3， 14， 8， 10， 19 （emodin）， 5 were all greater than 1. The contents of quercetin， kaempferol， kaempferide and emodin ranged from 0.710 to 10.478 mg/g， 0.236 to 0.660 mg/g， 0.334 to 3.039 mg/g， and 0.261 to 0.504 mg/g. CONCLUSIONS The constructed chemical constituent identification， fingerprint and content determination methods are simple， feasible and reproducible， which combined with chemometric analysis can be used for comprehensive evaluation of the quality of Rhamni Songoricae Fructus.
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Autapses selectively form in specific cell types in many brain regions. Previous studies have also found putative autapses in principal spiny projection neurons (SPNs) in the striatum. However, it remains unclear whether these neurons indeed form physiologically functional autapses. We applied whole-cell recording in striatal slices and identified autaptic cells by the occurrence of prolonged asynchronous release (AR) of neurotransmitters after bursts of high-frequency action potentials (APs). Surprisingly, we found no autaptic AR in SPNs, even in the presence of Sr2+. However, robust autaptic AR was recorded in parvalbumin (PV)-expressing neurons. The autaptic responses were mediated by GABAA receptors and their strength was dependent on AP frequency and number. Further computer simulations suggest that autapses regulate spiking activity in PV cells by providing self-inhibition and thus shape network oscillations. Together, our results indicate that PV neurons, but not SPNs, form functional autapses, which may play important roles in striatal functions.
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Parvalbúminas/metabolismo , Cuerpo Estriado/metabolismo , Interneuronas/fisiología , Neuronas/metabolismo , NeostriadoRESUMEN
Xanthocillin is a unique natural product with an isonitrile group and shows remarkable antibacterial activity. In this study, the genome of an endophytic fungus Penicillium chrysogenum MT-40 isolated from Huperzia serrata was sequenced, and the gene clusters with the potential to synthesize xanthocillin analogues were mined by local BLAST and various bioinformatics analysis tools. As a result, a biosynthetic gene cluster (named for) responsible for the biosynthesis of xanthocillin analogues was identified by further heterologous expression of the key genes in Aspergillus oryzae NSAR1. Specifically, the ForB catalyzes the synthesis of 2-formamido-3-(4-hydroxyphenyl) acrylic acid, and the ForG catalyzes the dimerization of 2-formamido-3-(4-hydroxyphenyl) acrylic acid to produce the xanthocillin analogue N, N'-(1, 4-bis (4-hydroxyphenyl) buta-1, 3-diene-2, 3-diyl) diformamide. The results reported here provide a reference for further discovery of xanthocillin analogues from fungi.
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Penicillium chrysogenum/genética , Huperzia/microbiología , Acrilatos , Familia de MultigenesRESUMEN
Objective To investigate the clinical effects of two methods of compressive coverage with aseptic gauze dressing and alginate dressing on haemostasis in placement of peripherally inserted central catheter(PICC)so as to provide a new dressing method for clinical application.Methods A total of 416 breast cancer patients undergoing PICC were randomly divided into two groups,with 208 per group.In the control group,the puncture sites for PICC were dressed with aseptic gauze immediately after the placement of PICC,with a daily aseptic gauze dressing change once per 24 hours.In the trial group,the puncture sites were dressed with alginate dressing immediately after the placement of PICC,with a weekly dressing change at the 7th day after PICC placement,while no local bleeding on the puncture site.The incidence,within 24 hours,of bleeding,degree of comfort,frequency and cost of dressing change as well as the infection rate within 7 days after the PICC placement were monitored and compared between the groups.Results A total of 205 patients in the control group and 208 in the observation group had completed the study.In the trial group,the incidence of bleeding at puncture sites within 24 hours after placement of PICC was significantly lower than that of the control group(27.88%vs.38.05%,χ2=4.829,P=0.028).The frequency of dressing change within 24 hours in the observation group was significantly less than that of the control group(Z=205.235,P<0.001).The cost of dressing change in the observed groups was also significantly less than that of the control group(56.94 vs.10.20 yuan in average,Z=-8.990,P<0.001).The incidence rates of local pain and itche reported by the patients in the observation group were significantly lower than those in the control group(Z=-12.079,P<0.001;Z=-12.194,P<0.001).No infection at the puncture site was observed in both groups.Conclusions Application of alginate dressing immediately after PICC placement in breast cancer patients can extend the time for initial dressing change up to 7 days in the patient without bleeding at the puncture site within 24 hours after the placement of PICC.An alginate dressing can reduce the incidence of bleeding at the puncture site,increase the comfort of patients,lower the frequency and cost of dressing change hence the nursing workload.
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Objective:To evaluate the effects of peroneal osteotomy combined with arthroscopic knee debridement on perioperative indexes, X-ray indexes, Japanese Orthopaedic Association Assessment score (JOA score), American Hospital for Special Surgery knee score (HSS score) and complication rate of patients with knee osteoarthritis.Methods:A prospective research method was adopted. A total of 110 patients with knee osteoarthritis who were admitted to Chengde Central Hospital from April 2016 to April 2021 were selected as the research objects and divided into the control group (55 cases), the combined group (55 cases) by random number table method. The control group underwent arthroscopic debridement of the knee joint. On the basis of the control group, the combined group was combined with fibula osteotomy. The control group and the combined group were followed up for 6 months after operation. The perioperative indicators, score of JOA before and after 1 month of treatment, X-ray indicators, score of HSS before and after 6 months of treatment, and the incidence of complications during the follow-up period were compared between the control group and the combined group.Results:The operation time of the combined group was longer than that of the control group: (84.36 ± 14.64) min vs. (75.88 ± 12.86) min; compared with before operation, 1 month after operation, the scores of swelling, pain while up and down stairs, walking pain, joint range of motion were increased in the control group and the combined group, and the combined group was higher than the control group: (8.35 ± 0.73) points vs. (6.74 ± 0.67) points, (15.05 ± 1.74) points vs. (13.96±1.66) points, (21.75 ± 2.07) points vs. (18.58 ± 1.73) points, (27.59 ± 3.25) points vs. (25.74 ± 2.83) points; the femoral tibial angle and the range of motion of the knee joint in the control group and the combined group were increased, and the combined group was greater than the control group: (1.94 ± 0.60)° vs. (3.02 ± 0.67)°; the scores of stability, flexion deformity, muscle strength, range of motion, function, and pain in the control group and the combined group increased, and the combined group was higher than the control group: (8.62 ± 0.86) points vs. (6.89 ± 0.78) points, (7.86 ± 0.96) points vs. (6.27 ± 0.68) points, (7.79 ± 0.62) points vs. (6.95 ± 0.57) points, (14.95 ± 2.60) points vs. (12.48 ± 2.33) points, (17.46 ± 2.21) points vs. (14.59 ± 1.76) points, (24.83 ± 3.25) points vs. (18.59 ± 2.57) points, the difference was statistically significant ( P<0.05). During the following up period, there were no significant differences in the incidences of osteofascial compartment syndrome, neurovascular injury, intraarticular adhesion and incision infection between the two groups ( P>0.05). Conclusions:The operation time of fibular osteotomy combined with arthroscopic debridement of knee joint in patients with knee osteoarthritis was longer, but fibular osteotomy combined with arthroscopic debridement of the knee joint can reduce the valgus of the patient and improve the range of motion of the joint. It could effectively reduce the degree of pain and improve the function of knee joint, and the safety was good, with good therapeutic effect.
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Objective:To explore the related risk factors for systemic embolism (SE) in patients aged≥75 years with non-valvular atrial fibrillation (NVAF).Methods:A case-control study. NVAF patients aged≥75 years who were hospitalized at the First Affiliated Hospital of Xinjiang Medical University from October 2018 to October 2020 were divided into no SE ( n=1 127) and SE ( n=433) groups according to the occurrence of SE after NVAF. Multivariate logistic regression was used to analyze SE-related factors in patients with NVAF without anticoagulation treatment. Results:In the multivariate model, the following factors were associated with an increased risk of SE in patients with NVAF: history of AF≥5 years [odds ratio ( OR)=2.75, 95% confidence interval ( CI) 1.98-3.82, P<0.01], lipoprotein(a)>300 g/L ( OR=2.07, 95% CI 1.50-2.84, P<0.01), apolipoprotein (Apo)B>1.2 g/L ( OR=1.91, 95% CI 1.25-2.93, P=0.003), left ventricular ejection fraction (LVEF) of 30%-49% ( OR=2.45, 95% CI 1.63-3.69, P<0.01), left atrial diameter>40 mm ( OR=1.54, 95% CI 1.16-2.07, P=0.003), and CHA 2DS 2-VASc score≥3 ( OR=15.14, 95% CI 2.05-112.13, P=0.01). ApoAI>1.6 g/L was negatively correlated with the occurrence of SE ( OR=0.28, 95% CI 0.15-0.51, P<0.01). Conclusions:History of AF≥5 years, lipoprotein(a)>300 g/L, elevated ApoB, left atrial diameter>40 mm, LVEF of 30%-49%, and CHA 2DS 2-VASC score≥3 are independent risk factors for SE whereas ApoAI>1.6 g/L is a protective factor against SE in patients with NVAF.
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Objective:To observe the intervention effect of neuromuscular joint facilitation (NJF)in patients with functional ankle instability (FAI).Methods:Fifty-three FAI subjects from North China University of Science and Technology from October 2020 to January 2021 were selected by cruamberland ankle instability tool (CAIT). According to the computer random number method, the 53 subjects were randomly divided into the control group (27 cases) and NJF group (26 cases). The control group received routine rehabilitation training, while the NJF group received NJF manipulation intervention on the basis of routine rehabilitation training. Before intervention and 8 weeks after intervention,ankle joint isokinetic muscle strength (invertor\evertor relative reak tergue) and the ratio of invertor to evertor of subjects in the two groups was evaluated and compared by Biodex isokinetic test training system, and the static balance ability of subjects in the two groups was evaluated and compared by Tecnobody balance instrument,and the dynamic balance ability of subjects in the two groups was evaluated and compared by star excursion balance test (SEBT), and the two groups were recorded and compared using the CAIT. A prospective cohort study was used. The measurement data of normal distribution are expressed by ± s. The mean between the two groups is compared by independent sample t-test, and the comparison before and after Intervention in the group is compared by paired t-test; The counting data were expressed in cases (%), and the comparison between groups was adopted χ 2 inspection. Results:After intervention, the NJF group at 60°/s angular velocity: invertor relative reak tergue (30.28±5.17) 0%, evertor relative reak tergue (28.93±5.15)%, the ratio of invertor to evertor (1.05±0.08) and 180°/s angular velocity: invertor relative reak tergue (27.17±5.24)%, evertor relative reak tergue (24.62±3.57)%, the ratio of invertor to evertor (1.10±0.12) were better than control group (27.05±5.95)%, (23.90±3.81)%, (1.13±0.15) and (24.12±5.36)%, (20.35±3.74)%, (1.19±0.18), and the differences were statistically significant ( t value were 2.11, 4.06, 2.35, 2.09, 4.25, 2.10, respectively; P value were 0.040, <0.001, 0.024, 0.042, <0.001, 0.040, respectively). After intervention, average AP speed of COP in the NJF group (open eyes: (23.19±5.25) mm/s; closed eyes: (65.65±10.51) mm/s), average ML speed of COP (open eyes: (23.73±4.73) mm/s; closed eyes: (72.08±10.28) mm/s), ellipse area of COP (open eyes: (913.77±348.90) mm 2; closed eyes: (3 271.65±1 024.48) mm 2) and perimeter of COP (open eyes: (845.04±146.68) mm; closed eyes: (2 055.42±548.89) mm) were lower than those of the control group (26.41±4.89) mm/s, (71.52±9.85) mm/s, (27.56±7.68) mm/s, (78.67±11.74) mm/s, (1 174.33±424.20) mm 2, (3 989.41±1 410.00) mm 2, (1 041.93±291.28) mm, (2 490.93±541.94) mm, the differences were statistically significant ( t value were 2.31, 2.10, 2.17, 2.17, 2.44, 2.11, 3.13, 2.97, respectively; P value were 0.025, 0.041, 0.034, 0.035, 0.018, 0.040, 0.003, 0.005, respectively). After intervention,the 8 directions of SEBT scores in the NJF group:Anterior (73.16±6.04)%, Anterolateral (65.90±5.54)%, Lateral (74.36±7.77)%, Posterolateral (88.05±6.76)%, Posterior (83.31±6.64)%, Posteromedial (86.01±7.62)%, Medial (77.39±8.44)% and Anteromedial (72.36±6.74)% were all higher than the control group (67.65±6.03)%, (61.08±5.96)%, (67.72±8.28)%, (78.33±8.06)%, (76.22±8.71)%, (79.31±7.24)%, (71.36±7.00)%, and (67.12±7.21)%,the differences were statistically significant ( t value were 3.32, 3.05, 3.01, 4.75, 3.33, 3.28, 2.83, 2.73, respectively; P value were 0.002 ,0.004, 0.004, <0.001, 0.002, 0.002, 0.007, 0.009, respectively). After intervention, the CAIT score of NJF group (23.04±3.96) points was higher than that of control group (19.15±3.56) points, and the difference was statistically significant ( t=3.76, P<0.001). Conclusion:NJF can significantly improve the internal and external muscle strength of the ankle joint and enhance the coordination of the internal and external muscle group, and effectively improve the static and dynamic balance ability of FAI patients.
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Objective:To investigate the immediate and short-term effects of virtual games on balance function in patients with functional ankle instability(FAI).Methods:Fifty-six FAI subjects from North China University of Science and Technology from September 2020 to December 2020 were selected by cruamberland ankle instability tool(CAIT). According to the computer random number method,the 56 subjects were randomly divided into the control group and the observation group with 28 subjects in each group,and the prospective cohort study method was used for this study. Control group accepted routine balance training,observation group based in the control group carries on the virtual game training. Before and immediately after intervention and 4 weeks after intervention,the static balance ability of subjects in the two groups was evaluated and compared by Tecnobody balance instrument,and the dynamic balance ability of subjects in the two groups was evaluated and compared by star excursion balance test(SEBT),and the CAIT score of subjects in the two groups was recorded and compared. The measurement data conforming to normal is expressed in xˉ ± s means independent sample t-test or paired t-test. χ2 test was used for counting data. Results:Immediately after intervention,the 8 directions of SEBT scores in the observation group are significantly improved compared with those before intervention: Anterior(69.06±7.57)% and (63.69±8.05)%, Anterolateral (61.14±6.68)% and (55.77±7.39)%, Lateral (67.71±7.99)% and (62.93±7.56)%, Posterolateral (76.43±6.98)% and (71.31±7.86)%, Posterior (75.45±6.78)% and (68.72±6.65)%, Posteromedial (79.13±8.09)% and (72.72±9.03)%, Medial(72.67±7.43)% and (65.67±8.16)%, Anteromedial (67.75±8.30)% and (63.18±8.95)% ( t values were 8.03, 11.88, 9.72, 6.43, 19.53, 9.36, 11.06 and 6.46, respectively; all P<0.001), and the observation group was significantly better than the control group (63.24±6.72)%, (55.41±7.74)%, (61.49±8.37)%, (70.02±6.81)%, (69.06±9.46)%, (72.41±7.20)%, (66.37±6.57)% and (62.15±6.89)%. There were significant differences between the two groups ( t values were 3.04, 2.97, 2.84, 3.47, 2.90, 3.28, 3.36 and 2.75, respectively; P values were 0.004, 0.004, 0.006, 0.001, 0.005, 0.002, 0.001 and 0.008,respectively). After 4 weeks of intervention,the static balance parameters in the observation group were significantly reduced compared with before intervention under the condition of opened eyes and closed eyes (open eyes: average AP speed of COP (24.68±6.85) mm/s and (27.57±7.15) mm/s,average ML speed of COP (26.25±6.20) mm/s and (30.61±6.99) mm/s, ellipse area of COP (915.75±356.08) mm and (1 286.54±530.05) mm, perimeter of COP (823.82±173.80) mm and (1 142.89±297.03) mm ( t values were 4.02, 3.09, 4.89 and 6.74, respectively; all P<0.001); closed eyes:average AP speed of COP (66.82±15.02) mm/s and (73.71±11.12) mm/s, average ML speed of COP (76.93±13.36) mm/s and (84.39±10.05) mm/s, ellipse area of COP (3 318.54±958.75) mm and (4 174.21±1 310.54) mm, perimeter of COP (2 156.96±665.80) mm and (2 817.75±528.22) mm ( t values were 3.23,3.29,4.95,5.02, respectively; P values were 0.003, 0.003,<0.001,<0.001,respectively). Average ML speed of COP (open eyes:(26.25±6.20) mm/s), ellipse area of COP (open eyes: (915.75±356.08) mm;closed eyes: (3 318.54±958.75) mm and perimeter of COP (open eyes: (823.82±173.80) mm; closed eyes: (2 156.96±665.80) mm) in the observation group were lower than those of the control group(30.68±9.81) mm/s, (1 137.25±423.27) mm, (3 973.36±1 306.61) mm, (1 038.79±242.90) mm, (2 603.43±703.81) mm, the differences were statistically significant ( t values were 2.02,2.12,2.14,3.81,2.44,respectively; P values were 0.049,0.039,0.037, <0.001,=0.018, respectively). After 4 weeks of intervention,the 8 directions of SEBT scores in both groups were significantly improved compared with those before intervention (Anterior:observation group (72.84±6.76)% and (63.69±8.05)%,control group (69.05±6.16)% and (62.96±6.56)%. Anterolateral:observation group (65.24±7.68)% and (55.77±7.39)%,control group (60.65±8.11)% and (54.65±8.98)%. Lateral: observation group(73.97±8.80)% and (62.93±7.56)%, control group (68.34±9.14)% and (61.24±9.42)%. Posterolateral: observation group (81.68±6.69)% and (71.31±7.86)%, control group (76.39±6.78)% and (69.74±8.11)%. Posterior: observation group (81.41±7.86)% and (68.72±6.65)%, control group (75.21±8.48)% and (68.45±9.96)%. Posteromedial: observation group (82.77±8.69)% and (72.72±9.03)%,control group (78.38±6.84)% and (72.36±7.34)%. Medial:observation group (77.47±7.85)% and(65.67±8.16)%, control group (72.66±6.93)% and (65.95±7.09)%. Anteromedial:observation group(73.33±8.91)% and (63.18±8.95)%, control group (68.35±6.53)% and (61.66±6.80)% ( t values were 14.19, 10.17, 12.71, 12.35, 12.32, 8.99, 11.38, 6.95, 12.66, 7.94, 9.54, 11.53, 11.89, 12.87, 11.69 and 12.53, respectively; all P<0.001)), and the observation group was significantly better than the control group,the differences were statistically significant ( t values were 2.19, 2.18, 2.35, 2.94, 2.84, 2.10, 2.43 and 2.38, respectively; P values were 0.033, 0.034, 0.023, 0.005, 0.006, 0.040, 0.018 and 0.021, respectively). After 4 weeks of intervention,the CAIT score of subjects in both groups was significantly improved compared with before intervention (observation group (18.89±3.62) points and (14.93±4.09) points,control group (16.96±3.18) points and (15.25±3.81) points ( t values were 10.54 and 5.65; all P<0.001), and The CAIT score in observation group was higher than that in control group,the differences were statistically significant ( t=2.12, P=0.039). Conclusion:Virtual games could immediately improve the dynamic balance ability of FAI patients,which combined with conventional balance training intervention for 4 weeks significantly also improved the balance ability and ankle joint stability of FAI patients.
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Objective:To explore the intervention effect of cognitive-walking dual-task training on executive and walking function in patients with cerebral apoplexy.Methods:A total of 70 stroke patients who were hospitalized in the Department of Rehabilitation Medicine of Baoding Taihe Rehabilitation Hospital from June 2020 to October 2020 were selected as the study subjects.All 70 hemiplegic patients with stroke were randomly divided into control group ( n=35) and test group ( n=35) by random number table method, and a prospective study was conducted.The control group was given routine walking training, and the test group was given cognitive-walking dual-task training at the same time and frequency as the control group.E-Prime software was used to evaluate the executive function of patients before and 4 weeks after intervention, including three sub-tests of Flanker, 1-back and More-odd shifting, and the reaction time of each test was recorded.The score changes of Mini-Mental Status Examination (MMSE) and Modified Rankin Scale (MRS) were recorded.The single-task walking time, dual-task walking time and dual-task walking time cost during 10 m Walk Test were calculated.Finally, 33 cases in the experimental group and 31 cases in the control group completed the study.Finally, 33 cases in the experimental group and 31 cases in the control group completed the study. Results:After 4 weeks of intervention, the MMSE scores of the experimental group and the control group were improved compared with those before intervention (the experimental group (26.39±1.90) and (24.42±2.69), t=10.824, P<0.001; the control group (25.45±1.77) and (24.61±2.16), t=7.325, P<0.001), and the experimental group was significantly better than the control group ( t=2.049, P=0.045)). The duration of three tests of executive function in the experimental group and the control group was significantly shorter than that before the intervention (Flanker task: the experimental group (752.38±178.28) ms and (939.42±260.11) ms, t=10.467, P<0.001; the control group (863.40±227.86) ms and (951.67±265.93) ms, t=8.140, P<0.001.1-back task: the experimental group (983.31±314.16) ms and (1 242.10±444.77) ms, t=10.386, P<0.001; the control group (1 186.89±293.80) ms and (1 238.27±305.95) ms, t=9.569, P<0.001.More odd shifting task: the experimental group (1 121.29±260.17) ms and (1 362.32±352.80) ms, t=13.084, P<0.001; the control group (1 255.81±269.41) ms and (1 351.37±287.46) ms, t=8.550, P<0.001), and the experimental group was significantly better than the control group (Flanker task: t=2.198, P=0.032; 1-back task: t=2.691, P=0.009; more odd shifting task: t=2.044, P=0.045). The results of 10 m walking test in the experimental group and the control group were improved compared with those before the intervention (single task walking time: the experimental group (20.71±9.61) s and (26.10±13.88) s, t=6.312, P<0.001; the control group (22.42±9.60) s and (25.62±10.97) s, t=13.009, P<0.001). The duration of dual task walking: the experimental group (22.73±10.28) s and (31.64±16.07) s, t=7.931, P<0.001; the control group (28.30±11.72) s and (31.89±13.65) s, t=9.348, P<0.001.The cost of dual task walking: the experimental group (10.32±6.87)% and (23.26±11.40)%, t=10.602, P<0.001; the control group (27.39±7.38)% and (24.94±7.48)%, t=2.719, P=0.011). The 10 m walking test time of the experimental group was shorter than that of the control group ( t=2.027, P=0.047), and the walking time cost of the experimental group was lower than that of the control group ( t=9.583, P<0.001). Conclusion:Cognitive walking dual task training can improve the walking function of patients, which is more conducive to the recovery of executive function than conventional walking training.
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Dyslipidemia is one of the most common complications of primary biliary cholangitis (PBC). This article reviews the latest research on lipid profile, the risk of cardiovascular diseases, and treatment of PBC with hyperlipidemia. Different from other liver diseases, PBC with hyperlipidemia has a unique lipid profile, which changes dynamically with disease progression. It is generally not considered that there are increased risks of atherosclerosis and cardiovascular disease. For those who have indications for treatment, statins are recommended as the first choice. In the future, more in-depth systematic studies are needed to clarify its diagnosis, treatment, and management processes.
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Abdominoscrotal hydrocele is rare in clinic. In the past, routine examination and diagnosis were difficult, easy to be misdiagnosed. The daily operations were mostly completed through the groin area or abdominal incision, the wound is large. The application of laparoscopy can clearly diagnose the abdominoscrotal hydrocele through "springing back ball" sign, and can cure the disease by laparoscopic resection of interperitoneal mass and closure of the internal ring. It is worthy of clinical application. In this article, we summarized and analyzed the clinical experience of 15 cases of children with abdominoscrotal hydrocele diagnosed and treated by laparoscopy, to explore the value of the laparoscopic technology in the diagnosis and treatment of the abdominoscrotal hydrocele.
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Objective:To investigate the needs of ICU transitional care for patients with pancreas disease, and to provide the reference for further implementation of ICU transitional care for patients with pancreas disease.Methods:The qualitative interview was conducted in ICU nurses, ward nurses and ICU referral patients during March and May in 2017. The data were analyzed by content analysis method, the needs of ICU transitional care for patients with pancreas disease were obtained through the refined theme.Results:Combined with the purpose of the study, six main topics were obtained through the analysis and refinemen. Expressed needs from patients: support of others, disease experience, and uncertainty in illness. Expressed needs from nurses: identify changes in condition, professional care, and psychological counseling.Conclusions:Patients with pancreatic disease need to pay attention to many aspects during the transition period of ICU, which can be better for meeting the needs of patients with pancreas disease and promoting the safety of patients during the transition period.
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During the treatment of critically ill patients, the application of enteral nutrition is increasingly widespread, but its series of complications also deserve attention. Among them, the incidence of intestinal nutrition intolerance is as high as 30.5%-75%. In recent years, researchers at home and abroad have carried out researches on the evaluation and intervention of intestinal nutrition intolerance. The application of the research results has improved the nutritional tolerance of patients. In order to provide more comprehensive and new research information, the following review is now conducted.
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Objective To investigate the incidence situation of metabolic syndrome (MS) in patients with continuous ambulatory peritoneal dialysis (CAPD),and analyze the correlation between MS and prognosis of patients.Methods The patients who received peritoneal dialysis from June 1,2002 to April 30,2018 and followed up regularly were divided into MS group and non-MS group according to the diagnostic criteria of MS.Follow-up was until July 31,2018.The differences of clinical data,metabolic indexes and clinical outcomes between the two groups were compared.The survival rates of the two groups were compared by Kaplan-Meier survival curve,and the risk factors of all-cause death and cardiovascular disease (CVD) death were analyzed by Cox regression analysis.Results A total of 516 patients with CAPD were enrolled in this study,including 340 males (65.9％)and 176 females (34.1％).Their age was (47.29± 12.20) years.The median follow-up time was 20 (9,39) months.According to the diagnostic criteria of MS,the patients were divided into MS group (210 cases,40.7％) and non-MS group (306 cases,59.3％).At baseline,there was no significant difference in age,educational background,duration of peritoneal dialysis,smoking history and drinking history between the two groups (P ＞ 0.05),but the patients in MS group were more exposed to high glucose peritoneal dialysate (P ＜ 0.05).The body mass index (BMI),blood phosphorus,blood glucose,blood potassium,triglyceride,cholesterol and systolic blood pressure in MS group were significantly higher than those in non-MS group (all P ＜ 0.05),and HDL-C level was significantly lower in MS group than in non-MS group (P ＜ 0.05).There were no significant differences in other indicators between the two groups (P ＞ 0.05).Kaplan-Meier survival curve showed that the cumulative survival rate in MS group was significantly lower than that in non-MS group,and the difference was statistically significant (Log-rank x2=14.87,P ＜ 0.001).If CVD death was taken as the end event,the cumulative survival rate in the non-MS group was significantly higher than that in the MS group (Log-rank x2=14.49,P ＜ 0.001).Multivariate Cox regression analysis showed that MS and high 4 h dialysate creatinine/serum creatinine ratio (4hD/Pcr) were independent risk factor for all-cause death (HR=1.982,95％CI 1.240-3.168,P=0.004;HR=3.855,95％CI 1.306-11.381,P=0.015) and CVD death (HR=2.499,95％CI 1.444-4.324,P=0.001;HR=5.799,95％ CI 1.658-20.278,P=0.006) in patients with CAPD.Conclusion The prevalence of MS in patients with CAPD is high,and MS and high 4hD/Pcr are independent risk factor for all-cause and CVD death in CAPD patients.They can be used as valuable indicators to predict the treatment outcomes and long-term prognosis of patients with CAPD.
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Objective@#To explore the effect of problem-based learning (PBL) health education and nursing mode on the occurrence of depression after primiparous women and its hormone levels.@*Methods@#A total of 468 primiparas who were delivered were selected. The number of singular numbers in the order of hospitalization was the control group, and the double number was the experimental group, 234 cases each. The control group used the traditional obstetric care model, and the experimental group used PBL health education model. The Edinburgh Postnatal Depression Scale (EPDS) and Self-rating Anxiety Scale (SAS) scores were compared between the two groups of prenatal women, 7 days, 42 days, and 3 months postpartum. Estrogen, progesterone, and 5-e were also tested. Serotonin levels. Postpartum depression rates were compared between the two groups according to EPDS and SAS scores. At the same time, the satisfaction rate of women on the quality of care in the two groups was investigated.@*Results@#The EPDS scores (8.3 ± 2.5), (9.0 ± 3.8), and (8.1 ± 2.2) points at 7 days, 42 days, and 3 months after birth were significantly lower in the experimental group than in the control group (9.8 ± 2.5), (11.1 ± 3.7), and (9.2 ± 2.1) points. The difference between the two groups was statistically significant (t =2.35, 1.76, 0.26, P < 0.01). The SAS scores (45.44±4.48), (49.28±3.59), and (38.16±4.45) points at 7 days, 42 days, and 3 months after birth were significantly lower in the experimental group than in the control group (51.69±4.93), (55.79±5.72), and (44.81±3.69) points. The difference was statistically significant (t =2.51, 3.65, 9.91, P < 0.01). There were 41 patients with post-production depression at 42 days postpartum, which was significantly higher than 13 patients in the experimental group. The difference was statistically significant (χ2=1.58, P<0.01). Maternal satisfaction in the experimental group was 96.15%(233/234), and in the control group was 89.32%(228/234), the difference was statistically significant (χ2=14.13, P<0.01). Estradiol levels (14 192.26±3 187.41), (2 954.44±326.16), (702.34±46.41) pmol/L at 7 days, 42 days and 3 months after birth were significantly higher in the experimental group than those in the control group (13 694.45±3 212.18), (2 316.16±391.22), (669.47 ± 53.25) pmol/L. The difference was statistically significant (t =5.16, 1.69, 4.26, P < 0.05). The serotonin levels (434.25±8.41), (315.05±12.35) ng/L at 42 days and 3 months after delivery were significantly higher in the experimental group than those in the control group (415.96±12.35), (308.15±11.35) ng/L. The difference was statistically significant (t=1.58, 3.25, P < 0.05). Progesterone levels (28.19±2.36), (8.25±0.98) µg/L at 42 days and 3 months after delivery were significantly lower in the experimental group than those in the control group (34.25±2.44), (9.69±1.25) µg/L. The difference was statistically significant (t =2.24, 5.16, P < 0.05).@*Conclusions@#PBL health education model can significantly reduce the risk of postpartum depression in primipara, regulate estrogen, progesterone and serotonin levels, and can be applied in obstetrics.
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OBJECTIVE To discuss the correlation between effectual time and the curative effect in patients with all frequency descending sudden deafness. METHODS According to effectual time,the subjects were divided into first week effectual group and second week effectual group and the curative effect of each group was compared. RESULTS In patients with flat descent sudden deafness, the curative rate of the first week effectual group was higher than that of the second week effectual group, but there was no significant difference between the two groups(χ2=1.599, P =0.206). Meanwhile, the total significant effective rate of the first week effectual group was higher than that of the second week effectual group, without obvious difference between the two groups(χ2=0.124, P =0.725). Furthermore, in patients with total deafness type of sudden deafness, the curative rate of the first week effectual group was higher than that of the second week effectual group, showing no remarkable difference between the two groups(χ2=2.493, P =0.114). Besides, there was no remarkable difference in the comparison of the total significant effective rate (χ2=2.308, P =0.129), which was higher in the first week effectual group than that in the second week effectual group. CONCLUSION The course of treatment should be at least 2 weeks in patients with all frequency descending sudden deafness after onset.
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Objective To investigate the diagnostic value and clinical significance of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and lymphocyte-monocyte ratio (LMR) in children with bronchial asthma.Methods A total of 182cases newly diagnosed with asthma were divided into mild persistent group (68cases), moderate persistent group (63cases) and of severe persistent group (51cases), and 100ageand sex-matched pediatric healthy children at the same period were chosen as healthy control group.WBC, NEU, LYM, MON, EOS, PLT, IgE, NLR, PLR and LMR of all subjects enrolled in this research were retrospectively reviewed.Results There was no significant difference in age and sexuality between children with asthma and control group (P＞0.05), but WBC, EOS, NEU, MON, PLT and IgE were all significantly up-regulated, and LYM was down.NLR and PLR were significantly up-regulated in children with asthma, while LMR decreased significantly.The area under the curve (AUC) of ROC curve was 0.88and the cutoff value were 2.619for NLR in diagnosing asthmatic children.The diagnostic value of PLR was similar to that of NLR, the AUC of ROC value was 0.87, and the cutoff value was 111.1.The diagnostic value of LMR was only0.79, and the cutoff value was 5.093.In addition, there was a significant correlation between NLR and IgE or lung function indexes.PLR was also correlated with IgE, but only negatively correlated with lung function indexes such as FVC, FEV1and FEV1/FVC％.There was no significant correlation between LMR and all indexes.NLR and PLR were significantly decreased in children with severe asthma after treatment with budesonide, while LMR was significantly up-regulated.Conclusion There are abnormal changes in NLR, PLR and LMR in children with bronchial asthma, which can be used as an index for auxiliary diagnosis, disease assessment and therapeutic effect monitoring in children with bronchial asthma.
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Objective To explore the effect of problem-based learning (PBL) health education and nursing mode on the occurrence of depression after primiparous women and its hormone levels. Methods A total of 468 primiparas who were delivered were selected. The number of singular numbers in the order of hospitalization was the control group, and the double number was the experimental group, 234 cases each. The control group used the traditional obstetric care model, and the experimental group used PBL health education model. The Edinburgh Postnatal Depression Scale (EPDS) and Self-rating Anxiety Scale (SAS) scores were compared between the two groups of prenatal women, 7 days, 42 days, and 3 months postpartum. Estrogen, progesterone, and 5-e were also tested. Serotonin levels. Postpartum depression rates were compared between the two groups according to EPDS and SAS scores. At the same time, the satisfaction rate of women on the quality of care in the two groups was investigated. ResuLts The EPDS scores (8.3 ± 2.5), ( 9.0 ± 3.8), and ( 8.1 ± 2.2) points at 7 days, 42 days, and 3 months after birth were significantly lower in the experimental group than in the control group (9.8 ± 2.5), (11.1 ± 3.7), and (9.2 ± 2.1) points. The difference between the two groups was statistically significant (t=2.35, 1.76, 0.26, P<0.01). The SAS scores (45.44±4.48), (49.28±3.59), and (38.16±4.45) points at 7 days, 42 days, and 3 months after birth were significantly lower in the experimental group than in the control group (51.69±4.93), (55.79±5.72), and (44.81±3.69) points. The difference was statistically significant (t=2.51, 3.65, 9.91, P < 0.01). There were 41 patients with post-production depression at 42 days postpartum, which was significantly higher than 13 patients in the experimental group. The difference was statistically significant (χ2=1.58, P<0.01). Maternal satisfaction in the experimental group was 96.15%(233/234), and in the control group was 89.32%(228/234), the difference was statistically significant (χ2=14.13, P<0.01). Estradiol levels (14 192.26±3 187.41), ( 2 954.44±326.16), ( 702.34±46.41) pmol/L at 7 days, 42 days and 3 months after birth were significantly higher in the experimental group than those in the control group (13 694.45 ± 3 212.18), (2 316.16 ± 391.22), (669.47 ± 53.25) pmol/L. The difference was statistically significant (t=5.16, 1.69, 4.26, P<0.05). The serotonin levels (434.25±8.41), (315.05±12.35) ng/L at 42 days and 3 months after delivery were significantly higher in the experimental group than those in the control group (415.96 ± 12.35), (308.15 ± 11.35) ng/L. The difference was statistically significant (t=1.58, 3.25, P < 0.05). Progesterone levels (28.19 ± 2.36), (8.25 ± 0.98) μg/L at 42 days and 3 months after delivery were significantly lower in the experimental group than those in the control group (34.25±2.44), (9.69 ± 1.25) μg/L. The difference was statistically significant (t =2.24, 5.16, P < 0.05). ConcLusions PBL health education model can significantly reduce the risk of postpartum depression in primipara, regulate estrogen, progesterone and serotonin levels, and can be applied in obstetrics.