Objective:To characterize clinical and neuroimaging features, etiologies, and mechanisms of bilateral middle cerebellar peduncle (MCP) infarctions.Methods:Consecutive patients with bilateral MCP infarctions treated in the Beijing Tiantan Hospital, Capital Medical University between January 1, 2020 and April 30, 2022 were enrolled in this retrospective study. The demographic data, vascular risk factors, clincial manifestations and the National Institutes of Health Stroke Scale (NIHSS) scores were collected. Brain diffusion-weighted imaging was used to assess the regions of cerebral infarction, and the extracranial and intracranial segments of the vertebrobasilar artery were evaluated using magnetic resonance angiography, or computed tomography angiography. The stroke etiology and underlying mechanism were evaluated according to the Chinese Ischemic Stroke Subclassification.Results:Ten patients with bilateral MCP infarctions (8 men and 2 women) were analyzed ultimately. The onset age were 51.0-86.0 (64.8±11.4) years. NIHSS scores were 2.0-12.0 (4.9±2.9) points at admission. All patients had vascular risk factors, most of which were hypertension (10 cases) and dyslipoproteinemia (8 cases). The most common clinical manifestations were vertigo (10 cases), followed by ataxia (9 cases) and dysarthria (8 cases). Four cases were isolated bilateral MCP infarctions, while 6 patients were combined with other vertebrobasilar artery infarctions, 4 of which were combined with cerebellar hemisphere infarctions, consistent with the clinical symptoms. The etiology in all patients was large atherosclerosis (severe stenosis or occlusion of V4 segment of vertebral artery and anterior inferior cerebellar artery; 9 cases). Five patients were classified as hypoperfusion/impaired emboli clearance, while 4 patients were considered as artery-to-artery embolism, and 1 was considered as the parent artery (plaque or thrombosis) occluding penetrating artery.Conclusions:Bilateral MCP infarctions are an extremely rare cerebrovascular disease characterized by vertigo, ataxia, and dysarthria. Cerebral infarction can be isolated or often combined with cerebellar hemisphere infarction. The etiology was mostly stenosis or occlusion of V4 segment of vertebral artery and anterior inferior cerebellar artery.

Objective:To understand the incidence of post-traumatic stress disorder(PTSD) in fathers with premature infants and analyze the risk factors.Methods:Conveniently, the 203 fathers of premature infants in NICU of Affiliated Hospital of Jining Medical University of Shandong Province from May to August 2021 were selected as the subjects to fill in the general data questionnaire, Perinatal Post-traumatic stress disorder Questionnaire-Chinese edition (PPQ-C), Parents, Perception of Uncertainty Scale, Social Support Rating Scale, Simplified Coping Style Questionnaire. Logistic regression was used to analyze the risk factors of PTSD and establish a nomogram model. ROC curve was used to verify the discrimination ofthe model. Hosmer-Lemeshow goodness-of-fit test and Calibration Plot were used to verify the calibration.Results:PPQ-C total score of 203 fathers was 17.17 ± 8.77, 81 fathers, symptoms were positive and the incidence of PTSD was 39.90%(81/203). Logistic regression analysis showed college degree ( OR = 0.297, 95% CI 0.116 - 0.763, P<0.05), very low birth weight ( OR = 2.491, 95% CI 1.027 - 6.044, P<0.05), sense of disease uncertainty ( OR = 1.038, 95% CI 1.012 - 1.066, P<0.05), negative coping style ( OR = 1.871, 95% CI 1.127 - 3.108, P<0.05) were risk factors of PTSD in fathers with premature infants. The nomogram model was established basing on the results of the Logistic regression analysis, and the ROC curve proved (AUC = 0.751) the model having a good discrimination.The Hosmer-Lemeshow goodness-of-fit test ( P = 0.974) and the calibration plot demonstrated that the prediction values tends to coincide with the actual monitoring values. Conclusions:A higher incidence of PTSD was observed in fathers with hospitalized premature infant. It was related to education level, the infants′s birth weight, disease uncertainty and coping style. Therefore, the nurses should give information support and psychological guidance according to the individual situation of the infants′ father to reduce the incidence of PTSD.

Isatis indigotica Fort. (Ban-Lan-Gen) is an herbal medicine prescribed for influenza treatment. However, its active components and mode of action remain mostly unknown. In the present study, erucic acid was isolated from Isatis indigotica Fort., and subsequently its underlying mechanism against influenza A virus (IAV) infection was investigated in vitro and in vivo. Our results demonstrated that erucic acid exhibited broad-spectrum antiviral activity against IAV resulting from reduction of viral polymerase transcription activity. Erucic acid was found to exert inhibitory effects on IAV or viral (v) RNA-induced pro-inflam-matory mediators as well as interferons (IFNs). The molecular mechanism by which erucic acid with antiviral and anti-inflammatory properties was attributed to inactivation of NF-kB and p38 MAPK signaling. Furthermore, the NF-kB and p38 MAPK inhibitory effect of erucic acid led to diminishing the transcriptional activity of interferon-stimulated gene factor 3 (ISGF-3), and thereby reducing IAV-triggered pro-inflammatory response amplification in IFN-β-sensitized cells. Additionally, IAV- or vRNA-triggered apoptosis of alveolar epithelial A549 cells was prevented by erucic acid. In vivo, erucic acid administration consistently displayed decreased lung viral load and viral antigens expression. Meanwhile, erucic acid markedly reduced CD8+cytotoxic T lymphocyte (CTL) recruitment, pro-apoptotic signaling, hyperactivity of multiple signaling pathways, and exacerbated immune inflammation in the lung, which resulted in decreased lung injury and mortality in mice with a mouse-adapted A/FM/1/47-MA(H1N1) strain infection. Our findings provided a mechanistic basis for the action of erucic acid against IAV-mediated inflammation and injury, suggesting that erucic acid may have a therapeutic potential in the treatment of influenza.

Objective:To evaluate the effect of oropharyngeal colostrum administration on building adequate enteral feeding process of very low birth weight neonates and extremely low birth weight neonates.Methods:A total of 62 very/extremely low birth weight neonates in NICU were selected from a tertiary hospital in shandong province. They were randomly assigned to the observation group ( n=32) and the control group ( n=30) according to the random number table. The observation group was given oropharyngeal colostrum administration. The control group was given oral care with 0.9% sodium chloride solution, and the wiping method and frequency was the same as the observation group. Gastric retention, enteral feeding time, adequate enteral feeding time, the weight at the time of discharge, etc. were compared between two groups. Results:Gastric retention times on the 10th day in the observation group (1.90±1.30) was significantly lower than that in the control group (2.77±1.50), and the two groups were statistically significant ( t value was -2.449, P<0.05). The duration of 100 ml·kg -1·d -1 enteral feeding and adequate enteral feeding (150 ml·kg -1·d -1) in the observation group [(24.63±9.42) days, (29.75±10.15) days] were significantly shorter than those in the control group [(33.90±2.73) days, (35.13±9.29)days], and the two groups were statistically significant ( t value was-4.621, P<0.01; t value was -2.362, P<0.05). The weight of the observation group was higher than that in the control group at the time of discharge ( t value was 4.677, P<0.05). Conclusion:Oropharyngeal colostrum administration can reduce gastric retention times, shorten the adequate enteral feeding time, promote growth and development in very low birth weight neonate and extremely low birth weight neonate.But it had not been proved to reduce the incidence of related infection indicators.

Objective:To investigate the current status of intensive care unit-acquired weakness (ICU-AW) assessment, analyze the assessment barriers, and to provide reference to improve ICU-AW assessment.Methods:A convenient sampling cross-sectional survey was conducted. First, an interview outline which based on related domestic and international literatures and combining with the research purpose of this study were designed. Thirteen medical personnel (8 ICU nurses, 3 ICU doctors, 1 respiratory therapist and 1 physiotherapist) who worked in the intensive care unit (ICU) of the First Hospital of Lanzhou University were enrolled with convenience sampling method to interview. Second, the topics were comprehensively analyzed and extracted, and then a questionnaire was constructed, and the reliability and validity was assessed. Finally, the questionnaire survey including the general situation of ICU medical staffs, the current practices of ICU-AW and influencing factors was implemented in China.Results:The retest reliability was 0.92 and expert validity was 0.96 of the questionnaire. There were 3 563 respondents in 31 provinces, municipalities and autonomous regions which eliminated 357 unqualified questionnaires, including 173 respondents from neonatal or pediatric ICU, 89 respondents whose working time was less than 6 months, and 95 invalid respondents, and then there were finally 3 206 valid questionnaires and the response rate were 90.0%. Those 3 206 respondents included 616 doctors (19.2%), 2 371 nurses (74.0%), 129 respiratory therapists (4.0%), 51 physiotherapist (1.6%) and 39 dietitians (1.2%). The mean age was (30.7±6.3) years old. Most of them had bachelor's degree (65.9%), master and above was 14.1%. Associate senior physician and above was 8.0%; ICU working time was (5.94±4.50) years. In clinical practice, only 26.5% of the ICU medical staffs confirmed that they had treated or taken care for ICU-AW patients; 52.9% of medical staffs evaluated ICU-AW only based on clinical experience, and only 12.3% used ICU-AW assessment tools. The majority of respondents believed that ICU-AW knowledge training should be performed (81.8%), ICU-AW assessment should be as important as other complications (pressure sore, infected ventilator associated pneumonia, etc., 75.1%), and ICU-AW assessment should be part of daily treatment and care activities (61.2%). However, only 10.2% of respondents had received ICU-AW related knowledge training, and 42.7% respondents believed that their ICU-AW related knowledge could not meet clinical needs. Only 18.7% respondents would actively assess whether patients suffered from ICU-AW or not, and 42.3% respondents thought that ICU-AW should be assessed every day, and the assessment tools were also inconsistent. There were 44.0% respondents considered the Medical Research Council Muscle score (MRC-score) scale was the optimal tool for diagnosing ICU-AW, the following were neuro-electrophysiological examination (17.2%) and manual muscle strength (MMT, 11.1%). The main cause of the ICU-AW assessment barriers was the lack of ICU-AW related knowledge (88.1%), and the following were lack of ICU-AW assessment guidelines (76.5%), patients' cognitive impairment or limited understanding ability (84.6%), unable to cooperate with the assessment due to critical illness (83.0%), and inadequate attention to ICU-AW assessment by the department (77.5%).Conclusion:The current status of ICU-AW assessment were unsatisfying in China, and the main barriers were lack of skills and knowledge.

Objective To understand the dominant pathogens of febrile respiratory syndrome (FRS) patients in Gansu province and to establish the Bayes discriminant function in order to identify the patients infected with the dominant pathogens.Methods FRS patients were collected in various sentinel hospitals of Gansu province from 2009 to 2015 and the dominant pathogens were determined by describing the composition of pathogenic profile.Significant clinical variables were selected by stepwise discriminant analysis to establish the Bayes discriminant function.Results In the detection of pathogens for FRS,both influenza virus and rhinovirus showed higher positive rates than those caused by other viruses (13.79％,8.63％),that accounting for 54.38％,13.73％ of total viral positive patients.Most frequently detected bacteria would include Streptococcus pneumoniae,and haemophilus influenza (44.41％,18.07％) that accounting for 66.21％ and 24.55％ among the bacterial positive patients.The original-validated rate of discriminant function,established by 11 clinical variables,was 73.1％,with the cross-validated rate as 70.6％.Conclusion Influenza virus,Rhinovirus,Streptococcus pneumoniae and Haemophilus influenzae were the dominant pathogens of FRS in Gansu province.Results from the Bayes discriminant analysis showed both higher accuracy in the classification of dominant pathogens,and applicative value for FRS.

OBJECTIVETo investigate the correlation between smoking status and carotid plaque in rural population residing in Eastern part of China.

METHODSBetween July and September of 2013, an epidemiological survey was carried out in residents aged 40 or above men who were enrolled randomly in rural areas of Anqing, Anhui province and Lianyungang, Jiangsu province. The data on epidemiological characteristics including smoking status, physical examination were collected using standardized protocol, and carotid ultrasonography was applied to examine the incidence of carotid plaque among never smokers, former smokers and current smokers. Logistic regress analysis was performed to determine the effect of smoking on carotid plaque.

RESULTSIn the study, a total of 625 male participants were included in the study. 51.4% (321 cases) were current smokers, 21.3% (133 cases) were former smokers, and 27.4% (171 cases) were never smokers. 32.0% (200/625) had carotid plaque. The incidence of carotid plaques was significantly higher in current smokers (35.2%, 113/321) than that in never smokers(23.4%,40/171) (χ(2) = 7.26, P = 0.007) and the incidence in former smokers (35.3%, 47/133) was also higher than that in never smokers (23.4%, 40/171) (χ(2) = 5.23, P = 0.022). Multiple logistic regression analysis showed that current cigarette smoking is significantly associated with the increased risk of carotid plaque (OR = 1.84, 95% CI: 1.13-2.98, P = 0.014) in comparison with never smokers, and there was an interaction between current smoking and age in association with carotid plaque. Compared with the young (≤60 years old) and never smoking group (8%, 3/40), prevalence of carotid plaque among the elderly (>70 years old) and smoking group (55%, 31/56) was significantly higher (OR = 8.06, 95% CI: 2.07-31.45) after adjusting for age, systolic blood pressure, diastolic blood pressure, blood glucose, total cholesterol, triglyceride high-density lipoprotein, body mass index, drinking and regional differences.

CONCLUSIONIt found that cigarette smoking was associated with increased risk of carotid plaque in rural elderly population residing in Eastern part of China.

Aged ; Alcohol Drinking ; Blood Glucose ; Blood Pressure ; Body Mass Index ; Carotid Stenosis ; China ; Cholesterol ; Humans ; Lipoproteins, HDL ; Male ; Middle Aged ; Prevalence ; Risk Factors ; Rural Population ; Smoking ; Triglycerides

Objective To investigate the association of PR gene exon 5 region H770H (rs1042839) single nucleotide polymorphism (SNP) with the genetic susceptibility to endometriosis (EM) in southern Han Chinese women. Methods Totally 431 EM patients and 499 non-EM women were collected and separated into EM group and control group, that all cases were confirmed by operation and pathology. A case-control study was performed in EM and control groups to evaluate the association of these SNP with the susceptibility to EM by using a fluorescent quantitative PCR-based high resolution melting (HRM) method. Results The C and T of PR H770H allele frequencies among the EM and control groups were 97.9%(844/862), 2.1% (18/862) and 99.4% (992/998), 0.6% (6/998), respectively. The CC, CT and TT of PR H770H genotype frequencies among the EM and control groups were 95.8%(413/431), 4.2%(18/431), 0 and 98.8%(493/499), 1.2%(6/499), 0, respectively. There were statistical significances in the PR H770H alleles and genotypes distributions between the two groups (χ2=7.386, P=0.007;χ2=8.135, P=0.004). Carrying allele C reduced the risk of EM (OR=0.986, 95%CI: 0.976-0.996), while carrying allele T enhanced the risk of EM (OR=3.319, 95%CI: 1.323-8.325); carrying genotype CC reduced the risk of EM 0.970 time (OR=0.970, 95%CI: 0.949-0.991), whereas carrying genotype CT enhanced the risk of EM 3.473 times (OR=3.473, 95%CI:1.391-8.671). Conclusion There is significant association between the polymorphism of PR H770H and genetic susceptibility to EM in southern Han Chinese women.

Objective To investigate the effects of early sucking a lollipop and pacifier to improve the recovery of gastrointestinal function in infant after gastrointestinal operation. Methods The infants after gastrointestinal operation were divided into four groups according to the random number table method, namely group Ⅰ, Ⅱ, Ⅲ and Ⅳ. Four groups were given different interventions in addition to routine nursing care after anesthesia awake, group Ⅰsucked a lollipop,while groupⅡsucking pacifier. Intervention time of 2 groups were 20-30 minites. GroupⅢsucked the pacifier 20-30 minites first, then sucked a lollipop 20-30 minites. Each group was given one intervention every 4 hours until infant eated. Group Ⅳ was given no interventions. Bowel sounds recovery time, first bowel movement time for the first time were compared. SPSS 17.0 software was used for statistical analysis. Results A total of 82 infants completed the clinical observation. Bowel sounds recovery time of group Ⅰ,Ⅱ,Ⅲ were (28.54±9.93), (34.10±9.43), (28.50±9.52) h, while first bowel movement time were (50.02±11.60), (57.65±15.28), (49.97±15.46) h, which were earlier than group Ⅳ whose bowel sounds recovery time and first bowel movement time were (39.55 ±11.22) h, (65.43 ±14.78) h. The bowel movement time and first bowel movement time of group Ⅲ were earlier than that of groupⅡ (P<0.05), but groupⅠandⅢhad no obvious difference (P>0.05). Conclusions Infants early sucking a lollipop and pacifier after gastrointestinal operation help gastrointestinal function recovery, but the lollipop is superior to the pacifier, lollipops and no interaction between pacifier.

Objective:To study the effect of microsurgery for parasellar menningiomas and to analyze the impact factors of recurrence. Methods:Clinical and follow-up data in a consecutive series of 134 patients with parasellar meningiomas were retrospectively analyzed. Results:A total of 109 patients (81.3%) had radical removal (Simpson grade I and II), and 116 patients were followed up for an average period of 81.6 months. The mean quality of life score (KPS) was 91.9, 90 patients regained full daily activity and 16 patients were able to take care of themselves. Oculomotor paralysis occurred in 7 patients, epilepsy in 8, and another 9 patients suffered hemispheral paralysis. Tumor recurred atfer the radical removal in 12 out of the 96 follow-up patients (12.5%). Tumor progressed atfer subtotal removal in 12 out of the 20 follow-up patients (60%). Tumor with cavernous sinus (CS) invasion had significantly higher risk of recurrence campared with non-CS invasion (P=0.043). The recurrence rate increased with the pathological grade (P<0.01). Conclusion:Patients with parasellar meningiomas undergoing microsurgical resection may have a good long-term function outcome. For most patients, total removal by microsurgery is the ifrst choice. Careful follow-up is needed if tumor invaded the CS and radiosurgery is proposed for WHO grade 1 and 2.