Advance of research on Hereditary spastic paraplegia type 4 / 中华医学遗传学杂志

Spastic paraplegia type 4 (SPG4) is the most common type of autosomally inherited spastic paraplegia. Its main clinical features include typical simple hereditary spastic paraplegia, with neurological impairments limited to lower limb spasticity, hypertonic bladder dysfunction, and mild weakening of lower limb vibration sensation, without accompanying features such as nerve atrophy, ataxia, cognitive impairment, seizures, and muscle tone disorders. SPAST is the main pathogenic gene underlying SPG4, and various pathogenic SPAST variants have been discovered. This disease has featured a high degree of clinical heterogeneity, and the same pathogenic variant can have different age of onset and severity among different patients and even within the same family. There is a lack of systematic research on the correlation between the genotype and phenotype of SPG4, and the pathogenic mechanism has remained controversial. This article has provided a review for the clinical characteristics, pathogenic gene characteristics, correlation between the genotype and phenotype, and pathogenic mechanism of this disease, with an aim to provide reference for its clinical diagnosis and treatment.

Effect of Qingjin Huazhuo Decoction combined with conventional therapy on blood hypercoagulability in patients with acute exacerbation of chronic obstructive pulmonary disease with phlegm-heat stasis and lung syndrome / 国际中医中药杂志

Objective:To investigate the effect of Qingjin Huazhuo Decoction combined with conventional western medicine on blood hypercoagulability in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) of phlegm-heat stasis lung syndrome.Methods:Randomized controlled trial. According to random number table method, allocation of cases in the observation and control groups. From April 2021 to March 2022, 66 hospitalized patients with AECOPD of phlegm-heat stasis and lung syndrome were randomly divided into control group ( n=32) and study group ( n=34). The control group was treated with conventional western medicine. The study group was treated with Qingjin Huazhuo Decoction on the basis of the control group. Both groups were treated for 7 days. Plasma thrombomodulin (TM), thrombin-antithrombin complex (TAT), tissue plasminogen activator-plasminogen activator inhibitor-1 complex (t-PAIC), plasmin-antiplasmin complex (PIC), prothrombin time (PT), partial thromboplastin time (APTT) and D-dimer levels were measured by automatic immunoassay analyzer; serum TNF-α levels were measured by ELISA and CRP levels were measured by immunoturbidimetry. Adverse reactions and acute thrombotic events during treatment were recorded. Results:During the treatment period, 4 of 66 patients had hemolysis, 2 were mistakenly included in the withdrawal study, 28 in the final control group and 32 in the study group were included for the analyses. After treatment, plasma t-PAIC [(6.19±1.93) μg/L vs. (7.42±2.71) μg/L, t=2.04] level in study group was significantly lower than that of the control group ( P<0.05), and the serum TNF-α [(71.15±25.25) ng/L vs. (122.60±98.76) ng/L, t=2.42] level was significantly lower than that of the control group ( P<0.05), plasma PT [(11.98±0.74) s vs. (11.55±0.77) s, t=-2.19] was significantly longer than that of the control group ( P<0.05). No thrombotic events occurred during hospitalization in the study group, and 1 case of acute myocardial infarction occurred in the control group. Conclusion:Qingjin Huazhuo Decoction combined with conventional western medicine therapy can improve the blood hypercoagulability of AECOPD patients with phlegm-heat stasis lung syndrome.

Overview on Traditional Chinese Medicine syndrome differentiation and treatment of Coronavirus Disease 2019 (COVID-19) / 国际中医中药杂志

This paper reviews the Traditional Chinese Medicine (TCM) diagnosis and treatments for Coronavirus Disease 2019 (COVID-19) and the theories of different experts in TCM. The pathogenesis of COVID-19 involves dampness, toxin, heat, cold, blood stasis and deficiency. Dampness and poison were the core pathological factors. The treatment is based on the situation of patients in different regions and different stages of the disease, and focuses on dampness and toxin, with the purpose of eliminating evil and consolidating the foundation. Oral TCM prescriptions such as Qingfei-Paidu Decoction, Qingfei-Touxie-Fuzheng Decoction, Lianhua-Qingwen capsule (granule) show good curative effect. TCM non drug therapies, such as acupuncture, moxibustion, acupoint application, ear acupuncture, traditional exercises, etc., are mostly aimed at light, ordinary and convalescent patients, which can improve symptoms. However, high-quality TCM research is still needed.

Ankle stretching can improve stroke survivors′ ankle biomechanics, balance, walking and ability in the activities of daily living / 中华物理医学与康复杂志

Objective:To observe the effect of ankle stretching on ankle biomechanics, balance, walking ability and ability in the activities of daily living among stroke survivors.Methods:Eighteen hemiplegic stroke survivors were randomly divided into an experimental group ( n=9) and a control group ( n=9). In addition to routine medication and rehabilitation training, the experimental group received 20 minutes of ankle joint stretching daily while the control group underwent an additional twenty minutes of routine rehabilitation training. Before and after the treatment, both groups′ ankle joint stiffness (K), muscle strength, active range of motion (AROM) and passive range of motion (PROM) were evaluated. They were also assessed using the modified Ashworth scale (MAS), the Fugl-Meyer lower extremity assessment (FMA-LE), the Berg balance scale (BBS), the 6-minute walking test (6MWT) and the modified Barthel Index (MBI). Results:After two weeks of treatment significant improvement was observed in the AROM and muscle strength of both groups in dorsiflexion and plantarflexion. The average BBS and FMA-LE scores of both groups had also improved significantly. Significant improvement in the average PROM of plantarflexion and the K of dorsiflexion, as well as in average MBI score was observed only in the treatment group. After two weeks the treatment group′s average muscle strength in plantarflexion and dorsiflexion was significantly better than the control group′s.Conclusions:Stretching can reduce ankle stiffness, improve the range of motion, muscle strength, and ability of in the activities of daily living after a stroke.

The correlation of diffusional kurtosis imaging parameters with cognitive function and cytokine secretion in patients with Alzheimer's disease / 中国医师杂志

Objective To detect the diffusional kurtosis imaging (DKI) parameters of patients with Alzheimer's disease (AD),and evaluate the inner link of DKI parameters with cognitive function and serum nerve injury index.Methods 78 patients who were first diagnosed with AD in our hospital between December 2015 and January 2018 were enrolled in AD group,and 50 healthy volunteers who had physical examination in our hospital during the same period were enrolled in normal control group.The corpus callosum DKI parameters [mean kurtosis (MK),axial kurtosis (AK) and radial kurtosis (RK)] values,Mini-Mental State Examination (MMSE) score as well as serum nerve damage indexes [β amyloid 1-42 (Aβ1-422),S100B protein (S100B) and brain-derived neurotrophic factor (BDNF)] were compared between the two groups of subjects.Pearson test was used to evaluate the correlation of DKI parameters with MMSE score as well as serum nerve injury index in patients with AD.Results MK,AK and RK levels in AD group were lower than those in normal control group;MMSE score was lower than that of normal control group;serum Aβ1-42 and S100B contents were higher than those of normal control group while BDNF content was lower than that of normal control group (P ＜ 0.05).Correlation analysis revealed that the MK,AK and RK values in AD patients were directly correlated with the MMSE score as well as Aβ1-42,S100B and BDNF levels (P ＜ 0.05).Conclusions The corpus callosum DKI parameter levels decrease in AD patients,and the specific levels are closely related to the severity of cognitive function and nerve injury,which may be one of the effective methods for early assessment of AD condition.

The correlation of diffusional kurtosis imaging parameters with cognitive function and cytokine secretion in patients with Alzheimer's disease / 中国医师杂志

Objective@#To detect the diffusional kurtosis imaging (DKI) parameters of patients with Alzheimer's disease (AD), and evaluate the inner link of DKI parameters with cognitive function and serum nerve injury index.@*Methods@#78 patients who were first diagnosed with AD in our hospital between December 2015 and January 2018 were enrolled in AD group, and 50 healthy volunteers who had physical examination in our hospital during the same period were enrolled in normal control group. The corpus callosum DKI parameters [mean kurtosis (MK), axial kurtosis (AK) and radial kurtosis (RK)] values, Mini-Mental State Examination (MMSE) score as well as serum nerve damage indexes [β amyloid 1-42 (Aβ1-422), S100B protein (S100B) and brain-derived neurotrophic factor (BDNF)] were compared between the two groups of subjects. Pearson test was used to evaluate the correlation of DKI parameters with MMSE score as well as serum nerve injury index in patients with AD.@*Results@#MK, AK and RK levels in AD group were lower than those in normal control group; MMSE score was lower than that of normal control group; serum Aβ1-42 and S100B contents were higher than those of normal control group while BDNF content was lower than that of normal control group (P<0.05). Correlation analysis revealed that the MK, AK and RK values in AD patients were directly correlated with the MMSE score as well as Aβ1-42, S100B and BDNF levels (P<0.05).@*Conclusions@#The corpus callosum DKI parameter levels decrease in AD patients, and the specific levels are closely related to the severity of cognitive function and nerve injury, which may be one of the effective methods for early assessment of AD condition.

The correlation of whole brain apparent diffusion coefficient with neurological impairment, Hcy metabolism and oxygen free radical generation in patients with Alzheimer's Disease / 中国医师杂志

Objective To study the correlation of whole brain apparent diffusion coefficient (ADC) with neurological impairment,homocysteine (Hcy) metabolism and oxygen free radical generation in patients with Alzheimer's disease (AD).Methods The patients diagnosed as AD in Xuanwu Hospital of Capital Medical University from March 2014 to December 2017 were selected as AD group and healthy persons as control group.The ADC of whole brain was calculated after magnetic resonance scanning.The degree of neurological impairment was evaluated by Montreal Cognitive Function Assessment Scale (MoCA).The levels of Hcy metabolic index and oxygen free radical production were measured after collecting serum.Results ADC values of AD group in parietal lobe,frontal lobe,temporal lobe and occipital lobe were not significantly different from those of control group (P ＞ 0.05).The ADC value of hippocampus as well as serum Hcy,malondialdehyde (MDA) and nitric oxide (NO) contents were significantly higher than those of control group,while MoCA score as well as folic acid (FA),vitamin B12 (VitB12),superoxide dismutase (SOD) and glutathione peroxidase (GSH) contents in serum were significantly lower than those of control group (P ＜ 0.05);ADC value of hippocampus in AD patients was negatively correlated with MoCA score as well as serum FA,VitB12,SOD and GSH contents,and positively correlated with serum Hcy,MDA and NO contents.Conclusions The increased ADC value of hippocampus in AD patients was related to the cognitive function injury,Hcy metabolism disorder and excessive generation of oxygen free radicals.

Changes and Clinical Significance of serum IL-18,IL-6 and CRP in patients with hypoxic ischemic encephalopathy / 国际检验医学杂志

Objective To explore the clinical significance of changes of serum.IL-6,IL-18 and C-reactive protein(CRP) in patients with hypoxic ischemic encephalopathy (HIE).Methods Serum IL-6,IL-18 and CRP levels were measured by ELISA and immunity turbidimetry respectively in 100 patients with HIE and 100 health control.Results The HIE group serum IL-6,IL-18 and CRP levels were higher than the healthy control group,and Serum levels of IL-6,IL-18 and CRP increased when the clinical manifestation gradually increased.The CRP were positive correlation with serum levels of IL-6 and IL-18(r=0.663,0.725,all P<0.01).and the serum level of IL-6is positive correlation with IL-18(r=0.783,all P<0.01).Conclusion The serum IL-6,IL-18 and CRP may play an important role in the development process of HIE.Which were correlate to the severity of the disease and clinical change,measurements of their serum concentrations may help to predict these pathogenetic condition and prognosis criterion of the disease.

Efflux mechanism on carbapenems of Acinetobacter baumannii / 中国基层医药

Objective To explore the drug fast mechanism on carbapenems of Acinetobacter baumannii,it is important for clinicians to choose appropriate antibiotics.Methods The influence of active efflux inhibitors carbonyl cyanide m -chlorophenylhydrazone (CCCP)on minimal inhibitory concentration (MIC)of Acinetobacter baumannii to imipenem(IMP)was measured by agar dilution method.Results At the concentration of 10mg/L,CCCP had obvi-ously effects on carbapenems MICs,the rate of resistance of imipenem decreased from 64.39% to 34.38%.In vitro CCCP enhanced the activities of imipenem.Efflux mechanism existed not only in IMP resistant strains,but also in IMP sensitive strains.But the affection of CCCP against IMP resistant strains was much stronger than that of IMP suscepti-ble strains.Conclusion Efflux pump may be one of the main mechanisms of Acinetobacter baumannii resistance to IMP,while efflux pump inhibitors may partly reduce the resistance.

[Three-stage surgery of combining auricle reconstruction, meatoplasty and tympanoplasty for patients with congenital microtia-atresia].

OBJECTIVE: To investigate the validity and feasibility of consecutive three-stage surgical technique of combining auricle reconstruction with external auditory canal atresia reconstruction in patients with congenital microtia-atresia, and to assess the post-surgery results by cosmetic and hearing aspects. METHODS: From Sep. 2007 to Jun. 2011, all 74 patients (79 ears) with congenital microtia-atresia treated in our department were enrolled in this study. They consecutively accepted the following three-stage surgical technique: The first stage was Brent' s technique as follows, rib cartilage graft harvest, framework fabrication, and implantation. The second stage combined transfer of the lobule with meatoplasty and tympanoplasty. The third stage was the elevation of the reconstructed auricle. Both the cosmetic and functional hearing results were recorded at follow-ups. RESULTS: Among these patients, 60 patients (78.5%), 62 ears, acquired extremely satisfactory cosmetic results; 10 patients (16.5%), 13 ears, acquired acceptable cosmetic results; while the remaining 4 patients (5.1%) acquired unsatisfactory cosmetic results. However, the height of elevation of the newly performed auricle framework was not enough due to the existence of newly formed external ear canal. Regarding the hearing results, there were 69 ears with followup audiograms. An air-bone gap (ABG) improvement of 12.5 dB was achieved. The air-conduction hearing threshold improved (10.9 ± 8.2) dBHL, 37 ears (53.6%) achieved serviceable hearing after surgery, with ABG less than 30 dB. There were multiple complications occurred after surgery with the incidence of 49.4% (39/79). CONCLUSIONS: The combined three-stage surgical microtia and canal atresia reconstruction technique is a viable choice for some suitable patients with microtia-atresia. However, the incidence of complication after meatoplasty is very high and the hearing restoration is not good enough, which need further investigation for the better results.

Clinical Study ofYiqi Huatan Granules Combined with Carbocisteine to Reduce Acute Exacerbation of Chronic Obstructive Pulmonary Disease / 中国中医药信息杂志

Objective To observe the efficacy and safety ofYiqi Huatan Granules combined with carbocisteine to reduce the acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods Totally 108 patients in the stationary phase of COPD with qi deficiency or merging phlegm blockage/blood stasis syndrome were randomly divided into two groups. Patients in the control group were treated with carbocisteine and inhaled bronchodilators on-demand, while patients in the treatment group were treated withYiqi Huatan Granules combined with carbocisteine and bronchodilators for 24 weeks. Times and severity of acute exacerbations of COPD, TCM syndrome scores, lung function, and 6-minute walking distances of the two groups during the treatment period were observed.Results The average times of acute exacerbations of COPD in the treatment group (0.33 ± 0.55) were fewer than the control group (0.62 ± 0.71);the average times of severe acute exacerbations of COPD in the treatment group (0.12 ± 0.33) were fewer than the control group (0.28 ± 0.45), with statistical significance (P<0.05). Comparison between the TCM syndrome scores before and after treatment, TCM total syndrome scores, breathless/dyspnea score, breath shortness and fatigue score, and 6-minute walking distance in the treatment group were better than the control group (P<0.05), with better safety.Conclusion The treatment ofYiqi Huatan Granules combined with carbocisteine for COPD patients can effectively decrease times and severity of acute exacerbations of COPD, and improve TCM syndrome scores and 6-minute walking distance.

CT and MRI diagnosis of primary middle ear carcinoma invading jugular foramen / 中华放射学杂志

Objective To study the CT and MRI features of primary middle ear carcinoma invading jugular foramen.Methods CT and MRI images of 7 patients with surgically and pathologically confirmed primary middle ear carcinoma invading jugular foramen were analyzed retrospectively,including high resolution CT (HRCT) scan in 6 cases,CT enhancement scan in 1 case and MR plain and enhancement scan in 7 cases.Results On HRCT,the soft tissue lesions mainly located in tympanum,tympanic sinus,the deep of external auditory canal and jugular foramen,and irregular “moth-eaten” bone destruction could be seen,including the destruction of jugular foramen in 7 cases,eustachian tube in 7 cases,facial nerve canal in 4 cases,carotid artery canal in 4 cases,external auditory canal wall in 3 cases,auditory ossicles in 2 cases,vestibular window and horizontal semicircular canal in 1 case.CT plain scan showed the density of soft tissue mass was uniform in 4 cases with CT value of 30-55 HU,and heterogeneous in 2 cases,in which small pieces high density lesions could be found.CT enhancement scan in 1 case revealed moderate and homogeneous enhancement.On MR plain scan,the soft tissue masses with hazy margins could be seen,and compared to the gray matter of brain,the lesions were isointense or slightly hypointense on T1 WI and isointense or slightly hyperintense on T2 WI.The signal was homogeneous in 5 cases and inhomogeneous in 2 cases with small pieces of hypointensity both on T1WI and T2WI.After enhancement,the lesions were enhanced moderately and homogeneously in 5 cases and inhomogeneously in 2 cases with small pieces of nonenhanced area.MRI also showed the erosion of carotid artery in 4 cases,sigmoid sinus in 1 case.Conclusion The primary middle ear carcinoma can invade the jugular foramen area extensively,which may lead to misdiagnosis.HRCT can precisely depict the bone destruction and the invasion of the important anatomic structures in the primary middle ear carcinoma,and the destruction of eustachian tube can help to reduce misdiagnosis.MRI can more clearly show the extent of tumor and the mass signal and enhancement pattern.

The character of superior semicircular canal dehiscence syndrome on multi-slice CT / 中华放射学杂志

Objective To better understand the MSCT characteristic of superior semicircular canal dehiscence syndrome (SSCDS). Methods A retrospective study was conducted on 8 patients who were diagnosed with SSCD syndrome in the otology and skull base surgery group of fudan university. All the patients CT features, the conventional axial and coronal images base on high-resolution MSCT and the images displayed the whole superior semicircular canal, which were reconstructed by using the technology of MPR, were reviewed. Results All the images that displayed the whole superior semicircular canal exhibited the dehiscence. Six patients' dehiscences occur in the middle of the roof over the superior semicircular (4 of 6 dehiscences also occur in the front of the roof), 2 patients dehiscences occur in the back of the roof over the superior semicircular. The range of the maximal diameter of the dehiscence was 0.8-4.2 mm, (median value: 2.4 mm). Conclusion The technology of MPR based on the high-resolution MSCT scan is very useful in diagnosis of the SSCDS.

The SSD Technique Applied in Spiral CT Diagnosis of Breast Carcinoma / 实用放射学杂志

Objective Identify CT signs of breast cancer and evaluate the value of the shaded-surface display technique in spiral CT diagnosis of breast cancer.Material:33 cases of breast cancer were analysed.Methods All of patients underwent spiral CT contrast enhanced scans in SSD technique.Results The CT appearances of breast cancer were round or irregular mass,spiculated border,duct retraction,involved coopers lignment,microcalcification,deformed adipose space and axillary lymph nodes contained metastases.Conclusion The SSD technique has proved to be of great value in spiral CT diagnoses and differential diagnoses of breast cancer.