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The prevalence rate of tic disorder in Chinese children and adolescents is relatively high, and tic disorder is often co-occurring with psychiatric disorders such as attention deficit and hyperactive disorder and obsessive compulsive disorder.The cognitive impairments of tic disorder patients with different clinical types, course of disease and comorbidities are different, but all affect the learning and life quality of patients.Exploration of the cognitive function characteristics of tic disorder patients is conducive to further understanding of the disease and its etiological mechanism, and has guiding significance for clinical recognition, diagnosis and treatment.
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Objective:To evaluate the impact of different methods of human milk fortifier (HMF) on the growth and development of preterm infants.Methods:Computer searches were conducted in PubMed, Embase, Clinicaltrials, Cochrane Library, China National Knowledge Infrastructure, Wanfang Data, VIP Database, and China National Full-text Database for biomedical literature from database inception to December 1, 2022. The inclusion criteria encompassed randomized controlled studies (RCTs) involving infants with a gestational age of less than 37 weeks who were subjected to HMF. The quality of included studies was assessed using the Cochrane bias analysis tool. Meta-analyses were performed using RevMan 5.3 software to compare individual fortification with standard fortification, targeted fortification with adjusted fortification of breast milk, and their effects on preterm infant weight gain, length, head circumference growth rates, as well as the incidence of bronchopulmonary dysplasia, osteopenia, feeding intolerance, and necrotizing enterocolitis.Results:A total of 11 RCTs were included, with 10 having low to moderate bias risk and 1 having a high bias risk. The results of meta-analysis showed that compared to standard fortification, individual fortification led to an increase in the weight gain rate of preterm infants ( SMD=0.87,95% CI 0.36-1.38 ,P<0.001), with no statistically significant differences observed in the effects on length and head circumference growth rates ( SMD=0.64,95% CI -0.07-1.34, P=0.08; SMD=0.58, 95% CI -0.06-1.22, P=0.08). The incidence of feeding intolerance and necrotizing enterocolitis in the individual intensive group was lower than that in the standard intensive group ( RR=0.45, 95% CI 0.22-0.89, P=0.02; RR=0.32, 95% CI 0.13-0.78, P=0.01), but no statistically significant difference in the incidence of bronchopulmonary dysplasia ( RR=0.93, 95% CI 0.76-1.20, P=0.67). Only two studies compared targeted fortification with adjusted fortification for growth and development outcomes in preterm infants, but the results were not consistent. Only one RCT showed no statistically significant difference in the incidence of osteopenia between the targeted fortification and adjusted fortification groups. Conclusions:Compared with standard fortification, individual intensive breastfeeding appears to promote the early growth and development of preterm infants. However, the effect of targeted and adjustable fortification on the growth and development of preterm infants is not significantly different.
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Objective:To investigate the long-term clinical effect of deep brain stimulation (DBS) on patients with Parkinson's disease (PD) at Hoehn-Yahr stage 2.5-5 and the differences of clinical effect among patients at different Hoehn-Yahr stages.Methods:A total of 69 PD patients (7 at Hoehn-Yahr stage 2.5, 27 at stage 3, 31 at stage 4, and 4 at stage 5) accepted DBS in Department of Functional Neurosurgery, Affiliated Brain Hospital of Nanjing Medical University from May 2014 to December 2016 were selected for long-term follow-up observation at 60 months after DBS. Unified Parkinson's Disease Rating Scale (UPDRS) was evaluated in the "off" phase of the patients before DBS and the "off" phases of the drugs under DBS start-up and continuous treatment at 6, 12, 24, 36, 48 and 60 months after DBS, respectively; Parkinson's Quality of Life Questionnaire (PDQ-39) and levodopa equivalent dose (LED) data were collected before and 6, 12, 24, 36, 48 and 60 months after DBS. DBS parameters of the patients were collected at 12 months after DBS; the total stimulation power, single pulse average energy and large single pulse energy were calculated. The differences in UPDRS-III scores, PDQ-39 scores and LEDD in these patients before DBS and at different time points after DBS were compared; the differences in UPDRS-III and PDQ-39 scores at different time points after DBS and postoperative DBS parameters at 12 months after DBS in patients at different Hoehn-Yahr stages were compared.Results:Compared with those before DBS, the UPDRS-III scores, PDQ-39 scores and LED were significantly reduced at 6, 12, 24, 36, 48 and 60 months after DBS ( P<0.05). Significant differences in UPDRS-III scores were noted between patients at Hoehn-Yahr stage 5 and Hoehn-Yahr stage 2.5 and stage 3 at 12 and 24 months after DBS ( P<0.05); however, no significant differences in UPDRS-III scores were noted between patients at Hoehn-Yahr stage 5 and Hoehn-Yahr stage 4 at same time points ( P>0.05); and no significant differences in UPDRS-III scores were noted between patients at Hoehn-Yahr stage 5 and patients at Hoehn-Yahr stage 2.5, stage 3, and stage 4 at other time points ( P>0.05). No significant differences in PDQ-39 scores were noted between patients at different Hoehn-Yahr stages at 6, 12, 24, 36, 48, and 60 months after DBS ( P>0.05). No significant difference in total stimulation power, single pulse average energy or large single pulse energy was noted among patients at different Hoehn-Yahr stages at 12 months after DBS ( P>0.05). Conclusion:DBS is long-term effective in improving motor function and quality of life in PD patients at Hoehn-Yahr stage 2.5-5, and patients at Hoehn-Yahr stage 5 do not need higher DBS parameters to obtain similar clinical improved effects as patients at Hoehn-Yahr stage 2.5-4.
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BackgroundAssisted reproductive technology is increasingly mature and widely used in clinic. As more and more newborns are born with assisted reproductive technology, the health problems of these newborns also need more attention. ObjectiveTo investigate the effects of assisted reproductive technology on newborn physique and autistic behavior, and to raise the attention of autistic behavior of assisted reproductive children. MethodsFrom the medical record information system, 588 assisted reproduction newborns (assisted reproduction group) born in the obstetrics department of Chaohu Hospital of Anhui Medical University from August 2018 to August 2019 were selected as the study objects. From the medical records information system, 600 newborns born naturally in the obstetrics department in the same period of time were selected as the control group. The basic information of all newborns was collected, including the mother's age and years of education, sex, gestational age, birth weight and birth length, and they were assessed by the Clancy Autism Behavior Scale (CABS) at 3 years of follow-up. ResultsThe educational years of mothers in assisted reproduction group were longer than those in control group [(12.04±1.96) years vs. (11.34±2.90) years, t=-4.887, P<0.01], gestational age and birth weight of assisted reproduction group were lower than those of control group [(38.68±2.56) weeks vs. (39.53±2.91) weeks, t=5.315, P<0.01; (3 273.27±720.39) g vs. (3 158.29±701.74) g, t=2.792, P<0.05]. There was no significant difference in birth length between the two groups [(49.97±5.94) cm vs. (50.07±6.08) cm, t=-0.287, P>0.05]. At the age of three, the weight and height of the assisted reproduction group were both lower than those of the control group [(16.16±2.53)kg vs.(16.96±1.67)kg, t=6.393, P<0.01, (95.81±4.50)cm vs.(97.47±7.49)cm, t=4.626, P<0.01]. Respectively, 6 (1.00%) and 15 (2.55%) children with autism were detected in the control group and assisted reproduction group, and the difference was statistically significant (χ2=4.113, P<0.05). ConclusionAssisted reproductive technology may affect the physical and neurological development of children. [Funded by Outstanding Young Talents Support Program of Anhui Education Department (number, gxyqZD2022022)]
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Organoid, formed from organ-specific cells, is a group of self-renewal and self-organizing cells growing in a 3-dimensional structure. With the recent progress on microenvironment regulation, stem cell differentiation and organ development, organoids have been constructed and used as promising tools for a wide range of multidisciplinary biomedical applications. Exercise disrupts the internal environment homeostasis, which brings a series of physiological alterations to the digestive system. The current animal or human models are necessary, but not sufficient to monitor the fluctuating microenvironment of gastrointestinal epithelial cells or hepatocytes during exercise. This review described the construction and application of digestive system organoids, as well as the effect of exercise on the microenvironment of intestinal epithelial cells and hepatocytes. The perspective applications of digestive system organoids in exercise physiology were also stated. Using organoid technologies, the possible mechanisms of the exercise-induced dynamic physiological changes would be explored in a new dimension.
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Animaux , Humains , Différenciation cellulaire , Cellules épithéliales , Hépatocytes , Intestins , OrganoïdesRésumé
Objective To research the clinical significance of the tibiofibular syndesmosis based on the anatomical characteristics of the tibiofibular syndesmosis. Methods A total of 51 tibiofibular syndesmosis collected from Southwest Medical University were measured based on the anatomical characteristics of the lower tibia and fibula of anticorrosive specimens. Results The geometrical data of the anterior tibiofibular ligament, posterior tibiofibular ligament and transverse tibiofibular ligament were measured respectively, and mean ± standard deviation was described. Include: the length, width, thickness of the anterior tibiofibular ligament (8. 53±0. 69, 19. 06±1. 34, 15. 99±1. 44) mm, the length, width, thickness of the posterior tibiofibular ligament (9. 34±0. 63, 16. 92±1. 76, 14. 36±0. 89) mm, the length, width, thickness of the transverse tibiofibular ligament (18. 42±2. 48, 21. 93±2. 59, 4. 56±0. 17) mm. The angel between the anterior tibiofibular ligament and the coronal surface and the angle of the horizontal plane were (20. 49±4. 86, 42. 20± 3. 42)°. The angel between the posterior tibiofibular ligament and the coronal surface and the angle of the horizontal plane were (13. 2±2. 06, 40. 92±3. 13) °. The angel between the transverse tibiofibular ligament and the coronal surface and the angle of the horizontal plane were (13. 45±1. 57, 32. 73±3. 70)°. According to the data analysis, the anterior, posterior and transverse tibiofibular ligaments have statistical difference between men and women, but there is no statistical difference between left and right feet. Conclusion The tibiofibular syndesmosis is of great significance to the stability of the ankle joint and the anatomical structure has important guiding significance for clinical treatment.
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OBJECTIVE@#To investigate the incidence of neonatal birth trauma in the department of obstetrics in a single-center medical institution and the risk factors for neonatal birth trauma.@*METHODS@#The maternal and infant medical records of all full-term singleton neonates delivered in the Department of Obstetrics, Peking University International Hospital, from October 2015 to September 2018 were collected. The neonates with birth trauma were assigned to case group, and those without birth trauma were assigned to control group. The risk factors for neonatal birth trauma were identified by multivariate logistic regression analysis.@*RESULTS@#Of the 4 682 full-term singleton neonates delivered during the study period, 201 (4.29%) were diagnosed with birth trauma. The most frequent type of birth trauma was cephalohematoma (81.7%), followed by facial nerve palsy (9.1%). The multivariate logistic regression analysis identified vaginal delivery, forceps-assisted delivery, induction of labor by oxytocin, premature rupture of membranes and a large neonatal head circumference as the risk factors for birth trauma (OR=5.020, 23.294, 1.409, 1.928 and 2.295 respectively; P<0.05).@*CONCLUSIONS@#The most frequent type of neonatal birth trauma is cephalohematoma. Vaginal delivery, forceps-assisted delivery, induction of labor by oxytocin, premature rupture of membranes and a large neonatal head circumference may increase the risk of neonatal birth trauma, and forceps-assisted delivery is the strongest independent risk factor for birth trauma.
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Femelle , Humains , Nouveau-né , Grossesse , Incidence , Études rétrospectives , Facteurs de risque , Plaies et blessuresRésumé
This article reports two cases of childhood-onset nemaline myopathy diagnosed by muscle pathology and genetic diagnosis. The two patients had onset in early childhood, with muscle weakness as the first manifestation, as well as long disease duration and slow progression. Gomori staining and hematoxylin-eosin staining showed red-stained rods in the sarcoplasmic cytoplasm and sarcolemma under a light microscope. Electron microscopy showed that the dense nemaline rods were located under the muscle fiber sarcolemma and parallel to the long axis of the muscle fibers, and some muscle fiber myofilaments were dissolved and necrotic. Gene testing found that one of the two patients had heterozygous mutation (c.1013A>C) in the ACTA1 gene, and the other had compound heterozygous mutation (c.18676C>T and c.9812C>A) in the NEB gene. The two mutations were more common in nemaline myopathy. Nemaline myopathy is a recessive or dominant inheritance myopathy, in which the nemaline rod in the cytoplasm of myocytes is a characteristic muscle pathological change. Pathological and genetic diagnosis is the gold standard for diagnosis of nemaline myopathy.
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AIM:To investigate the mechanism of angiotensinⅡ(AngⅡ)/angiotensinⅡ type 1 receptor (AT1R)pathway activating protein phosphatase 2A(PP2A)which leads to down-regulation endothelial nitric oxide syn-thase(eNOS)phosphorylation level in mesenteric arteries of rats.METHODS: METHODS: The mesenteric arteries of adult male SD rats(weighing 160~180 g;n=90)were isolated under aseptic conditions.Firstly,to determine the effect of angiotensinⅡdown-regulated eNOS(Ser1177)phosphorylation level,the mesenteric arteries were randomly divided into normal control(control)group and AngⅡgroup.The mesenteric arteries in AngⅡgroup were incubated with AngⅡat 1×10 -7mol/L,1×10 -6mol/L and 1×10 -5mol/L for 6 h,12 h and 24 h,respectively.Secondly,to investigate the mo-lecular mechanism by which angiotensinⅡ activated PP2A leading to down-regulation eNOS(Ser1177)phosphorylation level,the mesenteric arteries were randomly divided into control group, AngⅡ group and candesartan(CAN; a specific AT1R blocker)+AngⅡgroup.The mesenteric arteries were pretreated with 1×10 -5mol /L CAN for 1 h,then incubated with 1×10 -7mol/L AngⅡfor 12 h in CAN+AngⅡgroup.The protein levels of eNOS,p-eNOS(Ser1177),PP2Ac,p-PP2Ac(Tyr307)and protein phosphatase 2A inhibitor 2(IPP2A2 )in the arteries were determined by Western blot.The ac-tivity of PP2A in the arteries was detected by PP2A activity kit.RESULTS:Compared with the control group,the protein level of p-eNOS(Ser1177)in the mesenteric arteries was decreased after incubated with AngⅡfor 6 h,12 h and 24 h(P<0.05).The decreasing tendency of p-eNOS(Ser1177)showed concentration-dependently,especially in 12 h and 24 h groups.The expression of eNOS protein showed no significant difference in each group.Compared with the control group, the mesenteric arteries of the rats were incubated with AngⅡ at 1×10-7mol/L for 12 h in vitro, the protein levels of p-eNOS(Ser1177)were down-regulated(P<0.05); pretreatment with CAN significantly increased the protein level of p-eNOS(Ser1177)(P<0.05);the protein levels of eNOS showed no significant difference in each group.Compared with the control group,the protein levels of p-PP2Ac(Tyr307)and IPP2A2 were decreased after the mesenteric arteries were trea-ted with AngⅡat 1×10 -7mol/L for 12 h(P<0.05).Candesartan pretreatment restored the protein levels of p-PP2Ac (Tyr307)and IPP2A2 (P<0.05),however the expression of PP2Ac protein showed no significant difference in each group. Compared with the control group,the activity of PP2A was increased in the mesenteric arteries incubated with AngⅡat 1× 10-7mol/L for 12 h(P<0.05).Candesarten pretreatment inhibited the activity of PP 2A significantly(P<0.05).CON-CLUSION:AngⅡincreases PP2A activity via AT1R pathway,thus leading to down-regulation eNOS(Ser1177)phospho-rylation level in mesenteric arteries.The molecular mechanism of PP2A activation may be associated with decreasing the protein levels of p-PP2Ac(Tyr307)and IPP2A2.
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AIM: To investigate the quality of life in adults with strabismus and evaluate the improvement in quality of life after treatment. METHODS: In this prospective study, forty-five adults with a diagnosis of strabismus conform to the inclusion and exclusion standard were selected in our hospital from October 2013 to May 2014, as experimental group and 45 normal adults were enrolled as control group. A Chinese Adult Strabismus-20 questionnaire was used to evaluate the differences of quality of life between patients with strabismus and normal adults, and to evaluate the differences of quality of life in patients with strabismus preoperative and 6mo postoperative. RESULTS:The scores of quality of life in adult patients with strabismus preoperative and 6mo postoperative were statistically significant lower than those of normal adults (P CONCLUSION: Strabismus can decrease the quality of life in psychosocial and visual functional for adults and the surgical treatment can improve quality of life in patients with strabismus.