Semiology characteristics and location of epileptogenic zone in motor seizures of axial and shoulder girdle muscles assessed by video stereoelectroencephalography study in 65 patients.

OBJECTIVE: To study the semiology characteristics of motor seizures of axial and shoulder girdle muscles (ASMs) by stereoelectroencephalography (SEEG) and its value in determining location of epileptogenic zone. METHODS: A total of 598 patients underwent SEEG assessment in Sanbo Brain Hospital were reviewed; 65 patients with ASMs selected. Thirteen semiology feature items were extracted according to the location and symmetry of involved axial muscles, direction of movement, etc. Seizures were grouped with items, and the k-means was used to analyze association between ASMs semiology characteristics and seizure-onset zone (SOZ). RESULTS: The SOZs of ASMs involved 23 combinations of seven different brain regions: 31 patients (47.7%) had one brain region, 19 (29.2%) had two, 14 (21.5%) had three, and one patient (1.5%) had four. One hundred and fifteen brain regions were analyzed. Seven brain regions accounted for a significant difference in chi-square test, χ2 = 62.79, p < 0.0001, with the highest proportion of insular and perisylvian. The k-means method identified two clusters: cluster 1 had a high degree of agreement with temporal lobe epilepsy (12/15), characterized by less shrug-like movement, later involvement of axial shoulder girdle muscles, longer duration, and lower seizure frequency; cluster 2 had a high degree of agreement with posterior cortex epilepsy (14/18), characterized by earlier involvement of axial shoulder girdle muscles, shorter duration, and higher seizure frequency. In frontal lobe, insular and perisylvian, anterior and middle cingulate gyrus, are the two categories accounted for similar proportion. Seizure-onset lateralized at the contralateral of unilateral cervical tonic, with rate of seizure-free was 73.7%. SIGNIFICANCE: The incidence of ASMs is high in insular and perisylvian. Unilateral cervical tonic seizures have good lateralizing value. Based on semiology characteristics, ASMs can be roughly clustered into two categories, which can only effectively distinguish the origins of temporal lobe and posterior cortex, with low discrimination for the seizure-onset of other lobes.

Identification of the causative variants in five Chinese families with tuberous sclerosis complex / 基础医学与临床

Objective To identify the causative variants in 5 Chinese families with tuberous sclerosis complex(TSC)to provide genetic counseling and prenatal diagnosis.Methods Genetic counseling and clinical diagnosis were performed in 8 patients from five unrelated TSC families by teleconsultation.With informed consent obtained from the participants,3 to 5 mL peripheral blood samples were collected from the probands and their family mem-bers for the extraction of genomic DNA.Candidate pathogenic variants were screened by panel sequencing(PS).The candidate pathogenic variants found in TSC1 and TSC2 by PS were validated by PCR-Sanger sequencing and bioinformatics analysis.Results All the pathogenic mutations were identified in the probands and their available family members.Causative variants in TSC1 or TSC2 were detected in all patients,including three reported variants and two novel variants.The two novel variants,TSC2:c.245G＞A and TSC2:c.235delG,which were predicted to cause the nonsense variant p.(Trp82?)and the frameshift variant p.(Val79Lysfs27?)respectively was believed to introduce premature stop codons.The analysis of family co-segregation and bioinformatics were identified as very positive factors for pathogenicity.Conclusions This result provides more evidences for the genetic counseling and prenatal diagnosis in these families and expand the spectrum of TSC2 pathogenic variants.

Research on the current situation and influencing factors of nurses′growth mindset ability / 中国实用护理杂志

Objective:To explore the current situation of nurses′growth mindset ability and study its related influencing factors, so as to serve as a reference for improving nurses′ growth mindset ability.Methods:This was a cross-sectional survey, and 310 nurses from 5 tertiary hospitals in Shandong Province, Shanghai City, and Guangdong Province were selected as the survey subjects from April to June 2022 using convenience sampling method. The General Information Questionnaire, the Nurses′ Growth Mindset Assessment Scale, the Psychological Adaptability Self-Assessment Scale, the Chinese Big Five Personality Inventory Brief Version and the Team Psychological Safety Atmosphere Scale were used to investigate the growth mindset ability of nurses and its influencing factors.Results:Finally, 307 valid questionnaires were collected. There were 46 males and 261 females, aged 20-50 years old. The scores of the Nurses′ Growth Mindset Assessment Scale were (108.89 ± 29.32) points, the scores of the Psychological Adaptability Self-Assessment Questionnaire were 10.0(0.0, 20.0) points, the scores of the Chinese Big Five Personality Inventory Brief Scale were (162.37±43.82) points, and the scores of the Team Psychological Safety Atmosphere Scale were (55.84 ± 15.12) points. The highest education level ( B = 0.028, P = 0.040), professional title ( B = 0.033, P = 0.032), family economic support ( B = 0.025, P = 0.048), Chinese big five personality ( B = 0.039, P = 0.037), team psychological safety atmosphere ( B = 0.600, P<0.001) and psychological adaptability ( B = 0.313, P<0.001) had a significant effect on nurses′ growth mindset ability. Conclusions:The growth mindset ability of nurses is at the upper middle level, and the educational background, professional title, family economic support, personality characteristics, team psychological safety atmosphere and psychological adaptability of nurses are the significant influencing factors. Hospitals, social and health education systems can combine influencing factors to provide a harmonious working atmosphere for nurses, focusing on the improvement of nurses′ academic qualifications and the promotion of professional titles, cultivating nurses′ psychological adaptability, improving nurses′growth mindset ability, and improving the overall quality of the nursing service team.

Practice and Exploration on Building a Financial Supervision System to Promote High-Quality Development of Public Hospitals / 中国卫生经济

Public hospitals are the mainstay of China's healthcare service system and play a crucial role in promoting the construction of a Healthy China.A scientific financial and accounting supervision system can effectively ensure the realization of the financial and accounting supervision objectives of public hospitals.Through the construction of the"1455"framework,it determines the goals and requirements for financial supervision,clarifies the functions,scope,and path of financial supervision.Taking China-Japan Friendship Hospital as an example,it summarizes the innovative practices and achievements in improving systems,strengthening budget management,and promoting digitalization,based on the five major systems and five functions of the supporting framework.It provides practical experience for the establishment and improvement of the financial supervision system in public hospitals,promotes the realization of the goals of financial supervision in the healthcare industry,and advances the modernization of the healthcare governance system and governance capabilities.

Association between fasting blood glucose level and the risk of early vascular aging / 中华内分泌代谢杂志

Objective:To investigate the association between fasting blood glucose levels and the risk of early vascular aging(EVA).Methods:The basic information, medical history, and laboratory results of 695 individuals who underwent health check-up at the Physical Examination Center of the First People′s Hospital of Changzhou from January 2020 to March 2021 were retrospectively analyzed.Results:A total of 695 healthy individuals were included in the study, among whom there were 249 cases of EVA and 446 cases of non-EVA. Compared to the non-EVA group, the EVA group showed significant differences in age, gender, triglycerides, high density lipoprotein-cholesterol(HDL-C), fasting blood glucose, left brachial-ankle pulse wave velocity(L-baPWV), right brachial-ankle pulse wave velocity(R-baPWV), systolic blood pressure, and diastolic blood pressure(all P<0.01). All participants were divided into three groups( T1, T2, T3) based on fasting blood glucose levels. As fasting blood glucose levels increased, body mass index, total cholesterol, triglycerides, HDL-C, low density lipoprotein-cholesterol, L-baPWV, R-baPWV, systolic blood pressure, diastolic blood pressure, and EVA indicators showed significant differences among the three groups(all P<0.05). Univariate logistic regression analysis showed that age, gender, triglycerides, HDL-C, systolic blood pressure, diastolic blood pressure, and fasting blood glucose levels were significantly associated with the occurrence of EVA(all P<0.05). For the continuous variable of fasting blood glucose, in the regression equations without correction, with preliminary correction, and with full correction of covariates, higher fasting blood glucose levels significantly increased the risk of EVA, with odds ratios( OR) of 2.249, 2.580, and 2.413, respectively(all P<0.001). Compared to the T1 group, the risk of EVA in the T2 group, after no correction, preliminary correction, and full correction of covariates, was 1.881, 2.040, and 1.972, respectively(all P<0.01). The risk of EVA in the T3 group, unadjusted, preliminary adjustment, and full adjustment of covariates, was 3.234, 3.733, and 3.410, respectively(all P<0.001). After adjusting for confounding factors, a linear relationship between fasting blood glucose levels and the occurrence of EVA was observed through smooth curve fitting. Conclusion:Elevated fasting blood glucose may increase the risk of developing EVA.

Expression and the relative mechanisms of circular RNA hsa_circ_0001445 in patients with postmenopausal osteoporosis / 中华老年医学杂志

Objective:To investigate the clinical significance and regulatory molecular mechanism of the circular RNA(circRNA)hsa_circ_0001445 in postmenopausal osteoporosis(PMOP).Methods:RNA was extracted from clinically collected blood samples, and the expression of circRNA hsa_circ_0001445 was detected by quantitative real-time PCR(qRT-PCR). Luciferase reporter gene analysis and RNA pull-down experiments were performed to investigate the interaction between two genes.Results:Compared with healthy controls, the plasma circRNA hsa_circ_0001445 in PMOP patients was down regulated( P<0.001). The circRNA hsa_circ_0001445 distinguished PMOP patients from healthy controls with high sensitivity and specificity.The area under the ROC curve(AUC)was 0.9654(95% CI: 0.9361-0.9947, P<0.001), and the sensitivity was 94.0%, while the specificity was 88.0%.The circRNA hsa_circ_0001445 promoted the osteogenic differentiation and inhibited the adipogenic differentiation of hBMSCs.The circRNA hsa_circ_0001445 can directly bind to miR-127-5p. Conclusions:Plasma level of the circRNA hsa_circ_0001445 is a potential diagnostic biomarker of PMOP and regulates the balance between osteogenesis and adipogenesis in hBMSCs by sponging miR-127-5p.

Genetic testing and prenatal diagnosis for thirteen Chinese pedigrees affected with oculocutaneous albinism / 中华医学遗传学杂志

OBJECTIVE@#To identify the causative variants in 13 Chinese pedigrees affected with oculocutaneous albinism (OCA) so as to provide genetic counseling and prenatal diagnosis to them.@*METHODS@#Thirteen unrelated pedigrees with clinically diagnosed OCA were collected and classified based on the manifestation of skin and eyes. With informed consent obtained from the participants, peripheral blood samples were collected from the probands and their family members for the extraction of genomic DNA. Candidate variants were screened by targeted capture and next generation sequencing, and the results were validated by Sanger sequencing. Prenatal diagnosis was provided to the families upon their subsequent pregnancies.@*RESULTS@#Causative variants were detected in all probands, including 10 with compound heterozygotes or homozygotes for TYR gene variants and 3 with compound heterozygotes for OCA2 gene variants. Among these, two variants [TYR: c.650G>C (p.Arg217Pro) and OCA2: c.516-2A>T] were unreported previously. The pathogenicity of the novel TYR: c.650G>C (p.Arg217Pro) variant was verified through bioinformatic analysis and prediction of three dimensional structure of the protein. Prenatal diagnosis was provided to 6 fetuses with a high risk for OCA. Four fetuses were found to be carriers, one did not carry the variants of the proband, and one was affected with OCA.@*CONCLUSION@#Identification of the pathogenic variants in the 13 probands, including 2 novel ones, has expanded the mutational spectrum of OCA and enabled genetic counseling and prenatal diagnosis for the families.

Improvement Effects of Alisol B 23-acetate on Glycolipid Metabolism Disorder in Obesity Model Mice / 中国药房

OBJECTIVE：To st udy the improvement effects and its mechan ism of alisol B 23-acetate on glycolipid metabolism disorder in obesity model mice. METHODS ：The mice was given high-fat diet for 10 weeks to induce obesity model. Model mice were randomly divided into model group ，orlistat group （positive control ，15.6 mg/kg）， alisol B 23-acetate low-dose ， medium-dose and high-dose groups （7.5，15，30 mg/kg），with 10 mice in each group. Another 10 mice fed with normal diet were set as normal group. The mice in normal group and model group were given water intragastrically ，and administration groups were given the corresponding drugs intragastrically ，with the volume of 20 mL/kg，once a day ，for consecutive 4 weeks. After last medication，body weight ，waist circumference ，body fat ，muscle and body fluid mass were measured ；the serum levels of blood lipids indicators （TC，TG，HDL-C，LDL-C）and blood glucose were determined. The levels of PPAR-γ，NF-κB and IL-6 in liver tissue as well as serum level of TNF-α were determined by ELISA. The pathomorphological changes of visceral fat and liver tissue in mice were observed by HE staining. RESULTS ：Compared with normal group ，body weight ，waist circumference ，body fat and body fluid mass were significantly increased in model group （P＜0.01）；serum levels of TC ，TG，HDL-C，blood glucose and TNF-α，the levels of PPAR-γ，NF-κB and IL-6 in liver tissue were increased significantly （P＜0.05 or P＜0.01）；the structure of adipocytes was ruptured ，the volume of adipocytes was increased ，accompanied by inflammatory cell infiltration ；a large number of liver cells were edema ，and cytoplasm was loose and light stained，accompanied by fatty degeneration. Compared with model group ，the body weight ，body fat and body fluid mass as well as serum le vels of TG and TNF-α in alisol B 23-acetate groups were significantly reduced （P＜0.01）；the levels of TC and blood glucose in serum ，IL-6 in liver tissue were significantly decreased in alisol B 23-acetate medium-dose and high-dose groups （P＜0.05 or P＜0.01），and the level of PPAR-γ in liver tissue was increased significantly（P＜0.05 or P＜0.01）； the waist circumference and NF-κB levels in liver tissue in alisol B 23-acetate high-dose group were decreased significantly （P＜ 0.01）；serum level of HDL-C in alisol B 23-acetate medium-dose group were decreased significantly （P＜0.01）；the adipocytes were closely arranged and small in size ；the hepatocytes were mild to moderate swelling ，a small amount of cytoplasm was loose ， light stained or vacuolated ，and a small number of hepatocytes were accompanied by steatosis and small focal infiltration of inflammatory cells. CONCLUSIONS ：Alisol B 23-acetate can improve the disorder of glucose and lipid metabolism in obesity model mice ，and its mechanism may be related to the regulation of PPAR-γ，NF-κB，IL-6 levels in liver tissue and TNF-α levels in serum.

Thoughts on the Construction of Standard and Method Database for Drug Quality Sampling and Inspection in Provincial Inspection Institutions / 中国药房

OBJECTIVE：To provide reference for improving the operation efficiency of drug quality sampling and inspection in China . METHODS ：Starting from the application and management situation of inspection standards/methods in provincial inspection institutions ，the problems existing in the application and management of inspection standards/methods in provincial inspection institutions were analyzed ；the inspection standards/methods database of provincial inspection institutions is attempted to build，combining with the relevant experience and practices of FDA. RESULTS & CONCLUSIONS ：The inspection methods involved in drug sampling and inspection could be divided into official standards and non-standard methods. Official standards were the main standards for drug sampling and inspection ，and were mainly used for routine inspection. Such kind of standards could be classified according to the characteristics of compiled ，single-page and later-issued supplementary ；an electronic catalogue should be established for unified management. Non-standard methods were only used for sample preliminary screening ，verification of official inspection results ，quality evaluation and inspection of unknown or suspicious samples in emergency inspection. Its tracking，collection and management mechanisms were not yet complete. It is recommended to draw on the experience of drug sampling and inspection in the United States so as to establish method database hierarchically. For the mature method established in drug supervision system ，an electronic catalog and document content database should be established and the method should be confirmed before use ；for national standards and the recommended methods published by authoritative institutions in other industries，and mature methods published in scientific and technological literature ，the retrieval channels should be listed ，the methods should be verified ，reviewed and approved before use ，and an electronic catalogue should be established and recorded in time after use. The electronic catalogue format of non-standard methods generally include controlled number ，applicable variety name，method name ，inspection items ，etc.

Semiological characteristics and clinical application value of bilateral asymmetrical tonic seizures / 中华神经科杂志

Objective To illustrate the semiological characteristics of the three sub-types within the broad bilateral asymmetric tonic seizures (BATS),summarize their predictive values on lateralization and localization of seizure onset zone (SOZ),and analyze the difference between BATS and asymmetrical tonic limb posturing (ATLP).Methods A retrospective review of 385 patients who underwent stereotactic electrode implantation in the Sanbo Brain Hospital,Capital Medical University from September 2011 to May 2018 was performed.As long as there was a clinical epileptic seizure in the presence of BATS or ATLP,the patients were classified into the corresponding groups.Postoperative prognosis was assessed using Engel's grading criteria for a follow-up of no less than six months.Seizure descriptions were based on the classification of epileptic seizures introduced by Lüiders,which used arrows to connect the symptoms in chronological order.Results There was no statistically significant difference between the classic BATS and bilateral proximal tonic seizure in terms of whether it could be an independent seizure,as the onset and end of the seizure,with version and generalized tonic-clonic seizure (P＞0.05).Compared with the ATLP,except for whether it could be an independent seizure (P=1.000) and onset before versive seizure (P=0.068),the BATS showed significantly different semiological features (P＜0.05).The classic BATS and secondary motor area epilepsy had a 100.0％ predictive accuracy on the lateralization of SOZ.In the patients with broad BATS,the SOZ distribution was more extensive,but it was rare in the orbitofrontal gyrus,frontal pole and mesial temporal lobe.Compared with the bilateral proximal tonic seizures from the other regions,those originated from supplementary somatosensory motor area and its adjacent areas were rare and showed no statistically significant difference (0/8 vs 40.0％ (18/45),x2=3.226,P=0.072) but a low trend.The predictive value of BATS on lateralization of SOZ was higher than that of ATLP (84.9％ (45/53) vs 57.1％ (24/42),x2=9.086,P=0.003),and BATS was less originated from temporal lobe than ATLP (3.8％ (2/53) vs 23.8％ (10/42),x2=8.523,P=0.004).Conclusion Different from ATLP,the broad BATS are characterized by tonic proximal upper limb posturing,and have a higher predictive value on lateralization and localization of SOZ.

Effects of isoflurane and pentobarbital on the establishment of subarachnoid block model in rats / 西安交通大学学报(医学版)

Objective To compare the effects of isoflurane and pentobarbital on the establishment of subarachnoid block model in rats.Methods 60 SD rats aged 4 months were randomly divided into Group A (n =30) and Group B (n=30).Rats in Group A received intraperitoncal injection of 10 g/L pentobarbital sodium solution 30 mg/kg and 1/4 of the initial dosage was added according to the operation effect.The induction and maintenance of anesthesia were achieved by isoflurane inhalation in Group B during operation.We recorded the time of anesthesia induction,quality of anesthesia,time of anesthesia,time of operation,and recovery time.The heart rate,respiration frequency,temperature,and saturation of blood oxygen were recorded during operation.We compared death from anesthesia and success of modeling in the two groups.Results There was no significant difference between the groups with regard to age,weight,body temperature or saturation of blood oxygen (P＞ 0.05).Compared to Group B,heart rate decreased 1-60 minutes after anesthesia and respiration frequency decreased 5 minutes after anesthesia in Group A (P＜0.05).The time of anesthesia induction,time of anesthesia,time of operation,and recovery time were shorter in Group B (P＜0.05).The quality of anesthesia was better in Group B (P＜0.05).The success rate of modeling was higher but mortality rate of anesthesia was lower in Group B than in Group A (P＜0.05).Conclusion Compared with intraperitoneal injection of pentobarbital sodium,isoflurane inhalation can provide a better anesthetic effect during the operation to establish a rat model of subarachnoid block.

Effects of GIK on liver injury induced by lipopolysaccharide in rats / 临床麻醉学杂志

Objective To investigate if glucose-insulin-potassium (GIK)would relieve the liver injury induced by endotoxemia in rats.Methods Sixty SD male rats,weight 200-250g,were randomly divided into three groups (n = 20):control group (group C),lipopolysaccharide group (group LPS,LPS 8 mg/kg)and Glucose-insulin-potassium group(group GIK,8 mg/kg LPS+GIK 4 ml·kg-1 ·h-1 ).All the rats were injected with 20 mg/kg ketamine intraperitonealy before trial. Erythrocin was daubed on the wound to avoid infection.The rats of group LPS and group GIK were injected LPS 8 mg/kg intraperitoneal,then,rats in group LPS and group GIK received saline(4 ml·kg-1 ·h-1 )or GIK(Glucose 200 g/L,Insulin 60 IU/L,KCL 60 mmol/L)infusion continuously. Liver and serum samples were collected on before injection,3 days after injection and 5 days after in-jection.Serum concentrations of ALT and AST were measured.TNF-αlpha of liver homogenate was detected by ELISA.The severity of liver damage was assessed by an approprite histopathological sco-ring system and apoptosis of parenchymal cells were assessed by TUNEL immunofluorescence assay. Results Compared with group control,the level of serum ALT and AST in group LPS and group GIK were significantly higher at 3 days after injection.The level of hepatic TNF-α,the hepatic damage score and the index of hepatic apoptosis in group LPS and group GIK were significantly higher on 3 days after injection and 5 days after injection.(P<0.05).Compared with group LPS,the level of hepatic TNF-αand the hepatocyte apoptosis rates decreased significantly in group GIK on 3 days after injection.The level of serum ALT and AST,hepatic TNF-α,the hepatic damage score and the hepatocyte apoptosis rates decreased significantly in group GIK at 5 days after injection(P <0.05).Conclusion Intraperitoneal injection of endotoxin can cause liver injury in rats,resulting in the liver hepatdysfunction and hepatocyte damage.GIK has protective effects on LPS induced liver injury in rats.

Effect of glucose-insulin-potassium on intestinal injury in endotoxemic rats / 中华麻醉学杂志

Objective To evaluate the effect of glucose-insulin-potassium (GIK) on intestinal injury in endotoxemic rats.Methods Sixty male Sprague-Dawley rats, weighing 200-250 g, were equally and randonly divided into endotoxemia group (lipopolysaccharide [LPS] group) and GIK group.LPS 8 mg/kg was injected intraperitoneally once a day for 3 times in total to establish the model of endotoxemia-caused intestinal injury.Starting from 2 h after the initial injection of LPS, normal saline was continuously infused at 4 ml · kg 1 · h-t in group LPS, and GIK 4 ml · kg 1 · h 1was infused intravenously in group GIK.Before establishment of the model, and at 3 and 5 days after establishment of the model, 10 rats in each group were sacrificed, and blood samples were collected from the abdominal aorta for determination of tumor necrosis factor-α (TNF-α) and interleukin-10 (IL-10) and diamine oxidase (DAO) concentrations in plasma by enzyme-linked immunosorbent assay.TNF-α/IL-10 ratio was calculated.A segment of ileum of 2 cm in length, 20 cm from the ileocecal junction, was removed for microscopic examination.The degree of damage to the intestinal mucous membrane was scored according to Chiu.Results Compared with the values before establishment of the model, the plasma TNF-α/IL-10 ratio, DAO concentration, and Chiu's scores were significantly increased at 3 days after establishment of the model in the two groups, the plasma TNF-α/IL-10 ratio, DAO concentration, and Chiu's scores were increased at 5 days after establishment of the model in group LPS, and the plasma DAO concentration, and Chiu's scores were increased at 5 days after establishment of the model in group GIK (P＜0.05).Compared with the values at 3 days after establishment of the model, the TNF-α/IL-10 ratio and plasma DAO concentration were significantly increased in group LPS, and the TNF-α/IL-10 ratio and plasma DAO concentration were decreased in group GIK at 5 days after establishment of the model in group GIK (P＜0.05).Compared with group LPS, the TNF-α/IL-10 ratio, plasma DAO concentration, and Chiu's scores were significantly decreased at 3 and 5 days after establishment of the model in group G1K (P＜0.05).Conclusion GIK can reduce intestinal injury in endotoxemic rats.

RT-RPA-Cas12a-based discrimination of SARS-CoV-2 variants of concern

Timely and accurate detection of SARS-CoV-2 variants of concern (VOCs) is urgently needed for pandemic surveillance and control. However, current methods are limited by the low sensitivity, long turn-around time or high cost. Here, we report a nucleic acid testing-based method aiming to detect and discriminate SARS-CoV-2 VOCs by combining RT-RPA and CRISPR-Cas12a detecting assays (RRCd). With a detection limit of 10 copies RNA/reaction, RRCd was validated in 204 clinical samples, showing 99% positive predictive agreement and 100% negative predictive agreement, respectively. Critically, using specific crRNAs, representatives of single nucleotide polymorphisms and small deletions in SARS-CoV-2 VOCs including N501Y, T478K and {Delta}H69-V70 were discriminated by RRCd, demonstrating 100% accuracy in clinical samples with Ct < 33. The method completes within 65 min and could offer visible results without using any electrical devices, which may facilitate point-of-care testing of SARS-CoV-2 and its variants.