Objective To observe the clinical curative effect of traditional Chinese medicine hot compress combined with moxibustion in the treatment of urinary retention after orthopedic surgery.Methods 56 patients with postoperative uroschesis who underwent orthopedic surgerywere randomly divided into observation group and control group, and 28 cases in each group.All patients underwent pelvic muscle training, psychological counseling before surgery, and physical therapy with conventional methods such as induction of urination after surgery.The control group was treated with moxibustion Ququan acupoint, and the observation group was treated with Chinese herbal medicine hot compress on the basis of the above treatment.The patients in both two groups were treated for 28 days.At the end of the treatment, the clinical efficacy of the two groups was evaluated, also the time of first voiding after operation, the average effective time, urinary tract infection and urinary catheter replacement rate were compared.Results The total effective rate was 92.86% in the observation group and 78.57% in the control group.The effective rate in the observation group was higher than that in the control group (x2=46.86,P<0.05).The time of first voiding in the observation group was (32.13±4.42) mins and the control group was (61.37±5.87)mins.The time of first voiding in the observation group was shorter than that in the control group(t=21.06,P<0.05);The observation time was (57.34±2.63)mins,the control group was (73.23±3.87)mins,the average effective time of observation group was shorter than the control group (t=13.07,P<0.05).The rate of urinary tract infection in observation group was 10.71% and 17.86% in the observation group,the difference was not statistically significant (P>0.05).The urinary catheter replacement rate in the observation group was 7.14%,which was lower than 21.43% in the control group,the difference was statistical significance(x2=2.33,P<0.05).Conclusion The clinical curative effect of traditional Chinese medicine hot compress combined with moxibustion in the treatment of urinary retention after orthopedic surgery is better than moxibustion alone.The time of first urination and the average time of effect are shortened, and the rate of urinary catheter replacement is reduced.It is effective, simply and conductively to clinical use.

[Objective] To discuss the effect of point application therapy and massage combined with little dosage of midazolam in the sedation for polydactylism replantation. [Method] Select 82 patients, randomly divide them into control and observation groups, n=41 for each. The control group only took midazolam for sedation;the other one, point application therapy and massage combined with little dosage of midazolam; observe both sedation effect, side effects and comfort degree. [Result] By comparing both groups, the observation group was better than control one on sedation effect, side effect rate and comfort degree. [Conclusion] Taking point application therapy and massage combined with little dosage of midazolam had good sedation and high comfort degree, with little side effects, fit for sedation in polydactylism replantation under continual brachial plexus anesthesia.

Objective To investigate the relationship between the white matter fiber connectivity of the anterior commissure (AC) and schizophrenia, and to explore the role of AC connectivity in cognitive functions in first-episode schizophrenia. Methods Twenty-four patients with first-episode schizophrenia and 29 healthy controls underwent diffu-sion tensor imaging (DTI) to measure fractional anisotropy (FA). Fiber tracking was then used to reconstruct the white matter fiber connectivity of AC to examine the white matter integrity. We also analyzed the relationship between AC integ-rity and cognitive function. Results Compared to healthy controls, patients with first-episode schizophrenia had a signifi-cant reduction in mean FA of AC tracts [(0.48±0.07) vs. (0.54±0.05),P=0.002],longer completion time in trail making test(TMT)[TMT_A: (55.19 ± 19.15) vs. (36.61 ± 11.72), P<0.001;TMT_B: (88.84 ± 38.92) vs. (53.75 ± 23.41), P<0.001] and worse performance in logical memory test [immediate logical memory score:(6.12±3.85) vs. (11.69±3.68), P<0.001;delay logical memory score:(3.33±3.16) vs. (9.83±4.15), P<0.001]. In addition, there was negatively correlation of mean FA of AC tracts with TMT_A completion time (r=-0.458, P=0.037) or TMT_B completion time (r=-0.541, P=0.011) in patients with schizophrenia, but not in controls. Conclusion This study supports the disconnection hypothesis of schizo-phrenia. The deficit of AC microstructure integrity may be partly responsible for impaired executive functions in schizo-phrenia, suggesting that the integrity of white matter fiber is an important endophenotype of schizophrenia.

Objective: To learn the status and influencing factors of development among infants at ages of 0 to 36 months in Xiaoshan District, Hangzhou City, so as to provide the reference for promoting healthy development of infants. Methods: Infants at ages of 0-36 months who underwent physical examination in Child Health Clinic of Xiaoshan District Community Health Service Center were selected in 2022. General data of infants and their mothers were collected through questionnaires, and the development status of infants was screened by Age and Stages Questionnaire (third edition). Factors affecting the development status were identified using a multivariable logistic regression model. Results: A total of 2 519 infants were investigated, including 1 339 males (53.16%) and 1 180 females (46.84%). There were 608 infants with abnormal development of at least one functional area of communication (CM), gross motor (GM), fine motor (FM), problems solving (CG) and personal-social (PS). The abnormal rate was 24.14%, and the abnormal rates of the above functional areas were 9.77%, 6.59%, 7.98%, 6.39% and 9.33%, respectively. Multivariable logistic regression analysis showed that gender (male, OR=1.563, 95%CI: 1.191-2.052), mother's childbearing age (≥35 years, OR=1.411, 95%CI: 1.001-1.988), mother's educational level (lower than junior college, OR=1.460, 95%CI: 1.116-1.912) were factors affecting abnormal development of CM; preterm birth (OR=2.323, 95%CI: 1.315-4.103) was factors affecting abnormal development of GM; gender (male, OR=1.654, 95%CI: 1.225-2.232) was factors affecting abnormal development of FM; gender (male, OR=1.511, 95%CI: 1.086-2.102) and mode of delivery (cesarean section, OR=1.460, 95%CI: 1.060-2.010) were factors affecting abnormal development of CG; gender (male, OR=1.340, 95%CI: 1.019-1.763) and birth weight (low birth weight, OR=1.985, 95%CI: 1.149-3.432) were factors affecting abnormal development of PS. Conclusions The rate of abnormal development among infants at ages of 0 to 36 months in Xiaoshan District is 24.14%. Gender, preterm birth, mode of delivery, birth weight, mother's childbearing age and mother's educational level could affect the development status of infants.

Objective To investigate the difference in cognitive functions between first-episode schizophrenia pa-tients with and without family history. Methods One hundred twenty-seven patients with first-episode schizophrenia were recruited, including 40 patients with family history and 87 sporadic patients. Ninety-six matched normal subjects served as controls. Seven subscales of the Wechsler Adult Intelligence Scale-Revised in China (WAIS-RC) were used to assess the cognitive functions of all subjects. Positive and Negative Symptom Scale (PANSS) was used to assess patients ’ symptoms. The relationship between clinical symptoms and cognitive deficits was analyzed. Results There was no signifi-cant difference in the PANSS scores between familial patients and sporadic patients [(91.51±14.07) vs. (87.23±16.37), P>0.05]. The scores of full intelligence quotient (IQ), verbal IQ and operation IQ were lower in patient groups than in con-trol group (all P<0.05). The score of operation IQ was lower in sporadic patients than in familial patients (P<0.05). The scores of PANSS (r=-0.43, P=0.01), positive symptoms (r=-0.32, P=0.04) and negative symptoms (r=-0.38, P=0.02) were negatively correlated with operation IQ, and the scores of PANSS(r=-0.41,P=0.01) and positive symptoms(r=-0.54, P<0.01) were negatively correlated with block rectification scores in sporadic patient group but not in the familial patient group (all P>0.05). Conclusion The patients with schizophrenia have significant intelligence deficits in the early stages. Cognitive deficits are associated with the disease severity in sporadic patients while are independent of clinical symptoms in familial patients.

Objective To analyze etiology,clinical manifestation and diagnosis process of vertigo and dizziness in children.Method The clinical data of 82 children with vertigo and dizziness treated in our hospital from January 2006 to December 2016 were retrospectively analyzed.Results There were 46 girls and 36 boys with a female:male ration of 1.28:1.The median age of patients was 9.0 years (14 months-18.0 years) and 21 cases were less than 6 years old.The chief complaints were repeatedly falling,crying,walking unsteadily and scratching the ear for unknown reasons.For children aged ＞ 5 years may express " roof or tent rotation";for those aged ＞ 6-＜ 15 years (n =34),the main complaint was more ambiguous "dizziness";for those aged ≥ 15-≤ 18 years (n =27) with the main complaint of " dizziness" may clearly express the " sense of rotation" or " the feeling of feeling drowsy,the top-heavy sense," and the accompanying deafness,earfullness,tinnitus and so on.Among 82 cases,there were 15 cases of benign paroxysmal vertigo (BPV,18.3％),12 cases of secretory otitis media (SOM,14.6％),11 cases of vestibular migraine (VM,13.4％),9 cases of benign paroxysmal positional vertigo (BPPV,11.0％),8 cases of inner ear malformation (9.8％),8 cases of Meniere's disease (9.8％),7 cases of vestibular neuritis (8.5％),6 cases of sudden deafness with vertigo (7.3％),4 cases of central vertigo (4.9％),1 case of rare genetic disease (1.2％) and 1 case of vertigo due to mental psychological (1.2％).The incidence of BPV,VM and Meniere's disease in girls was higher than that in boys.There was a tendency to self heal in BPV with the age increasing,in 15 BPV cases,8 after 12 years of age,3 after 14 years old had no vertigo attacks,and 4 cases were still in follow-up.The attack frequency of VM was decreased,and the extent was reduced with the age.Children older than 6 years were able to cooperate to vestibular function tests,and the majority completed the tests.Conclusion The analysis shows that the etiology of vertigo and dizziness in children is different from that of adults.Central vertigo and rare genetic disorders with dizziness as the first symptom are of great harmfulness,so intensive observation and multidisciplinary consultations are recommended.

OBJECTIVETo assess the association of impairment of surface area of first-episode schizophrenia(SZ) with polymorphisms of COMT gene, and the difference in the impaired patterns between familial patients with schizophrenia(FPS) and sporadic patients with schizophrenia(SPS).

METHODSNinety-eight patients with first-episode SZ(FPS=40, SPS=58) and 78 healthy controls were recruited. COMT gene was genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Participants were scanned for 3.0T magnetic resonance images. Freesurfer software was used to analyze the difference in brain surface area between SZ and controls, its association with COMT genotypes, and the difference between SPS, FPS and control groups. Multiple tests were corrected using a Monte Carlo simulation at P<0.05.

RESULTSCompared with controls, SZ showed decreased surface area in right occipital cortex and left prefrontal cortex. No association was found between COMT polymorphisms and whole brain area difference. Among the three subgroups, SPS showed smaller left prefrontal area compared with both FPS and control groups. Patients with SPS also showed significant area reduction in right occipital lobe compared with controls.

CONCLUSIONSurface area impairment can be found in those with first-episode SZ, but without association with COMT gene polymorphisms. The SPS have more severe area impairment than FPS, indicating that SPS and FPS may be attributed to different etiological mechanisms.

Adult ; Brain ; diagnostic imaging ; Catechol O-Methyltransferase ; genetics ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Polymorphism, Restriction Fragment Length ; Radiography ; Schizophrenia ; diagnostic imaging ; enzymology ; genetics ; Young Adult

Background/Aims: Low educational attainment is a well-established risk factor for nonalcoholic fatty liver disease (NAFLD) in developed areas. However, the association between educational attainment and the risk of NAFLD is less clear in China. Methods: A cross-sectional study including over 200,000 Chinese adults across mainland China was conducted. Information on education level and lifestyle factors were obtained through standard questionnaires, while NAFLD and advanced fibrosis were diagnosed using validated formulas. Outcomes included the risk of NAFLD in the general population and high probability of fibrosis among patients with NAFLD. Logistic regression analysis was employed to estimate the risk of NAFLD and fibrosis across education levels. A causal mediation model was used to explore the potential mediators. Results: Comparing with those receiving primary school education, the multi-adjusted odds ratios (95% confidence intervals) for NAFLD were 1.28 (1.16 to 1.41) for men and 0.94 (0.89 to 0.99) for women with college education after accounting for body mass index. When considering waist circumference, the odds ratios (95% CIs) were 0.94 (0.86 to 1.04) for men and 0.88 (0.80 to 0.97) for women, respectively. The proportions mediated by general and central obesity were 51.00% and 68.04% for men, while for women the proportions were 48.58% and 32.58%, respectively. Furthermore, NAFLD patients with lower educational attainment showed an incremental increased risk of advanced fibrosis in both genders. Conclusions In China, a low education level was associated with a higher risk of prevalent NAFLD in women, as well as high probability of fibrosis in both genders.

Substantial evidence supports the neurodevelopmental hypothesis of schizophrenia. Meanwhile, progressive neurodegenerative processes have also been reported, leading to the hypothesis that neurodegeneration is a characteristic component in the neuropathology of schizophrenia. However, a major challenge for the neurodegenerative hypothesis is that antipsychotic drugs used by patients have profound impact on brain structures. To clarify this potential confounding factor, we measured the cortical thickness across the whole brain using high-resolution T1-weighted magnetic resonance imaging in 145 first-episode and treatment-naïve patients with schizophrenia and 147 healthy controls. The results showed that, in the patient group, the frontal, temporal, parietal, and cingulate gyri displayed a significant age-related reduction of cortical thickness. In the control group, age-related cortical thickness reduction was mostly located in the frontal, temporal, and cingulate gyri, albeit to a lesser extent. Importantly, relative to healthy controls, patients exhibited a significantly smaller age-related cortical thickness in the anterior cingulate, inferior temporal, and insular gyri in the right hemisphere. These results provide evidence supporting the existence of neurodegenerative processes in schizophrenia and suggest that these processes already occur in the early stage of the illness.