Objective To observe the positional relationship of lumbar nerve roots and its main adjacent structures with CT data, and to conduct 3D construction and measurement,so as to provide anatomical basis for percutaneous lumbar diskectomy(PLD).Methods CT serial tomography dataset of 30 healthy adults' lumbosacral portions were imported into Mimics 17.0 software to segment related structures and obtain the layers of different structures.The structures were 3D reconstructed and virtually demonstrated.The lumbar nerve roots and their main surrounding structures were observed and measured.Results The minimum distances between the lumbar nerve roots and the superior articular processes increased gradually from L3 to L4 intervertebral disc layer to L5 to S1 intervertebral disc layer.The 3D model clearly displayed the morphology and spatial relationship of the lumbar nerve roots and their adjacent structures in lumbosacral portion.The lower the lumbar intervertebral discs were,the thicker they were.The distances from the middle point of the back of lumbar intervertebral disc to the end of the superior spinous process of lumbar vertebra increased at first and decreased then,and the distance in L3 to L4 intervertebral disc layer was the farthest.Conclusion The relationship between lumbar nerve roots and superior articular processes,the intervertebral disc thickness variance and the change of the distances from lumbar intervertebral disc to the end of the superior spinous process have been analyzed in this study,and the clinic basis has been laid for percutaneous lumbar diskectomy.

Objective To evaluate the clinical effect of medical gymnastics combined with no-invasive treatment on prolapse of lumbar intervertebral disc (PLID).Methods64 patients with PLID were divided into the gymnastics group and control group with 32 cases in each group. The gymnastics group was treated by no-invasive synthesize treatment combined with medical gymnastics. The control group treated only with no-invasive synthesize treatment. The therapeutic effect was evaluated when patients were out of hospital and 3 months late.ResultsClinical effect of forward term (3 months) in the gymnastics group was batter than the control group ( P<0.05).ConclusionThe no-invasive synthesize treatment combined with medical gymnastics has an obvious effect on PLID.

Objective To observe the therapeutic effects of oral placement therapy (OPT) on managing sialorrhea after stroke.Methods A total of 37 stroke inpatients with sialorrhea were enrolled from January 2011 to September 2013 in the authors' department for the study and divided into 2 group on the basis of the time of enrollment.The control group (n =18) received 30min of routine treatment (including such neuromuscular facilitation techniques as Bobath and Rood techniques,motor relearning program,neuromuscular electrical stimulation and ice stimulation),twice daily,and the treatment group (n =19) received 15 min of routine treatment plus 15 min of OPT,twice daily.Frenchay Dysarthria Assessment was used to evaluate the sialorrhea severity and clinical efficacy before and 1,2 and 4 weeks after initiation of treatment.Results Sialorrhea symptom was significantly improved in treatment group after 1 week (P ＜ 0.05),while no significant improvement was observed in control group (P ＞ 0.05).After 2 and 4 weeks of treatments,significant improvements of sialorrhea were noted in both groups.After 1,2 and 4weeks of treatment,the total effective rate were 63.16％,94.74％ and 94.74％,respectively,in the treatment group,versus 5.88％,61.11％ and 61.11％,respectively,in the control group.The total effective rate of the treatment group were significantly higher in the above three time-points than the control group (P ＜ 0.05).Conclusions Oral placement therapy can improve sialorrhea symptom after stroke more effectively than routine treatment.

Objective To investigate the abnormalities of brain gray matter volume in patients with clinically-confirmed essential tremor (ET)of the hands only.Methods We analyzed brain gray matter voxel of 1 7 patients (younger than 55 years)with ET of the hands only and 1 7 healthy controls matched in age,gender and education by optimized voxel-based morphometry (VBM).Results VBM showed marked expansion of the bilateral cerebella, occipital fusiform cortices,and precentral lobes (P uncorrected < 0.005 )in ET patients compared with the controls. Atrophy was only detected in left parietal lobe.We also found volume enlargement in the thalamus,midbrain,and melluda of the left side by region of interest (ROI )analysis (P uncorrected <0.005).Conclusion Patients with arm tremor show expansion of gray matter,which might represent the adaptive reorganizational compensation through the increased demand on the visuospatial control of skilled movements in ET patients with early-stage arm tremor. These morphological changes may help to assess early stage and distinguish subtype of ET.

OBJECTIVETo learn the existence of natural focus of Lyme disease and its distribution.

METHODSA semi-nested polymerase chain reaction (PCR) method was developed for detection and genotyping of Borrelia burgdorferi on basis of outer surface protein A (OspA) gene. Ticks and mice collected from 6 forest areas in Beijing were detected with above methods. The positive PCR products were cloned and sequenced. The sequences were compared with published sequences for homology. IFA as used to detect IgG antibody on Borrelia burgdorferi. Lyme disease spirochete were isolated from H. longicornis were also attempted.

RESULTSB. Burgdorferi sensu lato were detected from 939 ticks and 250 mice specimens collected from above 6 study sites using primer pairs OA(1)/OA(4) and SL/OA(4). Only the specimens collected from Dongling mountain showed positive amplification. One in three adult Ixodes persulcatus with one of 57 nymph Ixodes persulcatus showed positive while 9 of 119 (7.56%) mice specimens showed positive, of which 8 were B. grinii and one B. afzelii. In this study, we attempted to isolate B. burgdorferi sensu lato strains from 160 H. longicornis ticks (20/group) but failed. Serological survey showed a 9.1% (5/55) infection rate with B. burgdorferi sensu lato in the mice of Dongling mountain forest areas.

CONCLUSIONSThe natural focus of Lyme disease including B. garinii and B. afzelii might have existed in Dongling mountain of Mentougou district, Beijing. Ixodes persulcatu and mice may serve as vectors and reservoirs, respectively.

Animals ; Antigens, Surface ; genetics ; Bacterial Outer Membrane Proteins ; genetics ; Bacterial Vaccines ; Borrelia burgdorferi ; genetics ; Borrelia burgdorferi Group ; classification ; genetics ; Humans ; Ixodes ; microbiology ; Lipoproteins ; Lyme Disease ; microbiology ; Mice ; Phylogeny ; Polymerase Chain Reaction ; methods

This study examined the incidence, neuropsychological characteristics and risk factors of cognitive impairment 3 months after stroke in China. Five regions that differed in geography and economy in China were selected. Patients from the hospitals located in the five regions were prescreened at admission, and the demographic data, vascular risk factors and clinical characteristics of stroke were obtained. A battery of cognitive-specific domain tests was performed in the patients who failed to pass cognitive screening 3 months post stroke. Patients were diagnosed as having post-stroke cognitive impairment (PSCI) or no cognitive impairment (NCI) based on the results of the neuropsychological tests. Univariate analysis was performed for suspect risk factors, and significant variables were entered in multivariable logistic regression analysis. Our results showed that a total of 633 patients were recruited 3 months after stroke; complete cognitive tests were performed in 577 of the stroke patients. The incidence of PSCI in these Chinese patients was 30.7%. There were 129 (22.4%) patients with visuospatial impairment, 67 (11.6%) with executive impairment, 60 (10.4%) with memory impairment and 18 (3.1%) with attention impairment. The risk factors associated with PSCI were older age (odds ratio [OR] 1.76, 95% confidence interval [CI] 1.20-2.58), low education level (OR 2.45, 95% CI 1.65-3.64), depressive symptom (OR 1.69, 95% CI 1.09-2.61), obesity (OR 2.57, 95% CI 1.41-4.71), stroke severity 3 months post stroke (OR 1.62, 95%CI 1.10-2.37) and cortex lesion (OR 1.55, 95% CI 1.04-2.31). It was concluded that PSCI occurs commonly 3 months after first-ever stroke in Chinese patients. Visuospatial ability may be the most frequently impaired cognitive domain for the patients with stroke. The critical risk factors of PSCI are older age, low education level, depressive symptom, obesity, stroke severity 3 months post stroke and cortex lesion.

Objective: To explore the relationship between plasma amyloid-β (Aβ) and cognitive decline during 2 year follow-up in a population-based cohort in Xi′an rural areas. Methods: The study was conducted in Qubao village in Xi′an suburbs cognitively normal residents over 40 years old were recruited from October 2014 to March 2015 and given a face-to-face standardized interview. Mini-mental state examination (MMSE) was employed to evaluate the global cognitive function, and quantification of plasma Aβ was measured by sandwich enzyme-linked immunosorbent assay (ELISA) at baseline. Two years later, MMSE was tested at the end of study. Then logistic regression was performed to analyze the relationship between baseline Aβ and cognitive change during 2 year follow-up. Results: A total of 1 020 participants completed the study, among whom 223 subjects (21.9%) presented MMSE scores decline (defined as MMSE scores decreased ≥2 points). Compared with those without decline, participants in the MMSE decline group were older (P<0.001) and had lower education level (P<0.001), while gender, hypertension, hyperlipemia, diabetes mellitus and APOE genotype were not significantly different between two groups. One-way analysis of variance (ANOVA) showed that the MMSE score decline was slighter in the lower tertile of baseline Aβ₁-40 compared with middle tertile (P=0.012), while MMSE decline were similar between different Aβ₁-42 level groups and Aβ_1-42/Aβ_1-40 ratio groups (P=0.758, P=0.671, respectively). Multivariable logistic regression analysis showed that MMSE scores in the lower baseline plasma Aβ_1-40 level declined more slowly (OR=0.565, 95%CI 0.379-0.845, P=0.005). However, the MMSE decline were also similar among different baseline plasma Aβ_1-42 levels groups and Aβ_1-42/Aβ_1-40 ratio groups. Conclusion Population with lower level of baseline plasma Aβ_1-40 manifests lower cognitive decline during 2 years, however further investigation on dynamics of plasma Aβ and long term follow up are needed.

Objective:To explore benefit finding in patients receiving combined heart-lung transplantation (CHLT) , and provide a reference for improving clinical nursing work.Methods:From September to October 2019, totally 6 patients who survived after CHLT in the Department of Cardiac Surgery at the First Affiliated Hospital of Guangzhou Medical University were selected by purposive sampling for semi-structured interviews in terms of their benefit finding using phenomenological methods. Colaizzi's seven-step analysis was used to organize and analyze the interview results.Results:The patients undergoing CHLT showed a sense of benefit finding, which could be summarized into four themes, namely, changes in mental quality (learning to be grateful and contented, understanding the meaning of life, learning to be open-minded and optimistic) , improved learning initiative (actively learning drug-related knowledge, the knowledge of rehabilitation and exercise, the knowledge of diet and nutrition, and the knowledge of prevention of complications) , perceiving social support (family members changed life habits, family members actively learned disease knowledge, improved communication between patients and family members and friends) , and actively planning future life.Conclusions:The patients receiving CHLT can experience a sense of benefit finding in the rehabilitation after organ transplantation. Medical staff should understand the sense of benefit finding in patients receiving CHLT, promote the early generation of benefiting finding, and provide targeted guidance to patients.

OBJECTIVETo provide further pathogenic evidence of Granulocytic ehrlichia infection in China.

METHODSSpecific primers derived from 444-Epank gene were used to amplify Granulocytic ehrlichia DNA from specimens of ticks, animals and human blood. PCR products of ticks were cloned and sequenced.

RESULTS444 bp specific DNA fragments were amplified from 2 of 62 pools of Ixodes persulcatus collected from Heilongjiang province and 1 of 129 blood specimens from forest workers in Inner Mongolia. Eight animal specimens were negative. PCR products from ticks were then cloned and sequenced. It differed at 23 positions in comparison to American strain (AF047897) with 94.9% homology. The homology of deduced ammonia was 88.44%.

CONCLUSIONOur findings further confirmed that Granulocytic ehrlichia infection did exist in China.

DNA, Bacterial ; analysis ; Ehrlichia ; classification ; genetics ; isolation & purification ; Ehrlichiosis ; microbiology ; Genes, Bacterial ; Humans ; Phylogeny ; Polymerase Chain Reaction ; Sequence Analysis, DNA

To explore the relationship between plasma amyloid?β (Aβ) and cognitive decline during 2 year follow?up in a population?based cohort in Xi′an rural areas. Methods The study was conducted in Qubao village in Xi′an suburbs cognitively normal residents over 40 years old were recruited from October 2014 to March 2015 and given a face?to?face standardized interview. Mini?mental state examination (MMSE) was employed to evaluate the global cognitive function, and quantification of plasma Aβ was measured by sandwich enzyme?linked immunosorbent assay (ELISA) at baseline. Two years later, MMSE was tested at the end of study. Then logistic regression was performed to analyze the relationship between baseline Aβ and cognitive change during 2 year follow?up. Results A total of 1 020 participants completed the study, among whom 223 subjects (21.9%) presented MMSE scores decline (defined as MMSE scores decreased≥2 points). Compared with those without decline, participants in the MMSE decline group were older (P<0.001) and had lower education level (P<0.001), while gender, hypertension, hyperlipemia, diabetes mellitus and APOE genotype were not significantly different between two groups. One?way analysis of variance (ANOVA) showed that the MMSE score decline was slighter in the lower tertile of baseline Aβ1?40 compared with middle tertile (P=0.012), while MMSE decline were similar between different A β 1?42 level groups and A β 1?42/A β 1?40 ratio groups (P=0.758, P=0.671, respectively). Multivariable logistic regression analysis showed that MMSE scores in the lower baseline plasma A β 1?40 level declined more slowly (OR=0.565, 95%CI 0.379-0.845, P=0.005). However, the MMSE decline were also similar among different baseline plasma Aβ1?42 levels groups and Aβ1?42/Aβ1?40 ratio groups. Conclusion Population with lower level of baseline plasma Aβ1?40 manifests lower cognitive decline during 2 years, however further investigation on dynamics of plasma Aβ and long term follow up are needed.