Post-stroke fatigue is a common symptom after stroke independent of depression. It impacts functional recovery of limbs, psychological rehabilitation and quality of life, and has been linked w ith a higher mortality rate. Identifing the risk factors of post -stroke fatigue and clarifying the diagnosis and conducting effective intervention may contribute to the early rehabilitation. This article review s the advances in research on the incidence, risk factors, mechanisms, diagnosis and treatment of post -stroke fatigue.

[Abstract ] Objective To compare the accuracy between regular computed tomography colonography (CTC)and dual-energy CTC in lesion detection.Methods Twenty-eight patients with clinical suspicious space occupying lesions of the colon were selected.All patients were underwent dual-energy mode contrast-enhanced CT scan and the data were reconstructed with colonography and dual-energy iodine maps methods.The diameter,enhanced computed tomography (CT)value and iodine value were measured.The results of colonoscopy and pathology were taken as gold standard.The sensitivity, specificity,accuracy,positive predictive value and negative predictive value of regular CTC and dual-energy CTC were compared.Variance analysis was performed for measurement data comparison among groups and chi-square test was used for count data analysis.Results Among 28 patients,colorectal lesions were detected in 24 cases by regular CTC,of which four cases were false-positive and one case was false-negative confirmed by colonoscopy and pathology.Colorectal lesions were detected in 20 cases by dual-energy CTC,of which no false-positive and one case was false negative confirmed by colonoscopy and pathology.The contrast enhanced CT value of polyps,adenoma,adenocarcinoma and stool was (38.54± 6.82),(49.16±7.31 ),(52.61 ±5 .93 )and (34.00±1 .41 )Hu,respectively.The enhanced value of adenoma and adenocarcinoma was significantly higher than that of polyps and stool,the differences were statistically significant among groups (F = 10.760,P = 0.001 ).There was no significant difference between polyps and stool (t=1 .44,P =0.188).The sensitivity of regular CTC and dual-energy CTC in lesion detection was 95 .6% (95 %cofidence interval(CI ):77.9%-99.2%)and 95 .6% (95 %CI :77.9%-99.2%),respectively.The specificity was 42.8% (95 %CI :15 .4%-93.5 %)and 100.0% (95 %CI :47.9%-100.0%).Conclusion Compared with traditional CTC,dual-energy CTC would distinguish lesions from stool,help differentiate between benign and malignant tumors and further increase the accuracy of CTC diagnosis.

Objective To observe the effect of reperfusion therapy on the prognosis of acute myocardial infarction (AMI) complicated by eardiogenic shock(CS)in reperfusion era.Methods 89 cases of AMI with CS were included with 57 male and 32 female.50 cases received conservative therapy and 39 cases reperfusion therapy.28 of the 39 cases had suecessflll reperfusion and 11 eases failed.18 patients had intra-aortic balloon pump (IABP) within 1 hour of CS,they constituted an early group;35 patients treated with IABP 1 hour after CS were of a late group.A group of 36 cases were not treated with IABP (no IABP group).Results The mortality of the early group with IABP Was significantly lower than that of the late and no IABP group(33.3% vs.74.2% vs.86.1%,P＜0.01).The mortality of the group with sucessful reperfusion was significantly lower than that of unsuccessful reperfusion and conservative no IABP group (42.8% vs.81.8% vs.84.0%,P＜0.01).logistic regression analysis showed that successful reperfusion therapy (OR 4.232,95% CI 1.407～12.730,P=0.01) and THE TIME of using IABP(OR 0.22.95% CI 0.063～0.764,P=0.017)were independent risk factors for death.Conclusion Early successful reperfusion and early institution of IABP were the most important therapeutic measures for reducing mortaliIv of AMI complicated by CS.

Purpose To investigate the clinical characteristics and Oxford classification of IgA nephropathy patients with hyperurice-mia. Methods 151 IgA nephropathy patients confirmed by renal biopsy in 2013 were analyzed retrospectively. The patients were di-vided into the two groups:IgA nephropathy patients with or without hyperuricemia. Morphological changes were evaluated with Oxford classification scoring system and Lee’s grades. A comparative analysis of clinical manifestations and pathological injuries was performed between the two groups. Results Incidence of hyperuricemia in IgA nephropathy patients was 48. 3% and was more common in young men. Hypertension was associated with hyperuricemia. Oxford classification of IgA nephropathy patients with hyperuricemia was pre-dominant M1E0S1T0 and Lee’s grades presented with grade Ⅲ. The outstanding histopathologic features with higher plasma uric acid levels indicated higher tubulointerstitial chronicity, higher glomerular sclerosis ratio, accompanied by a decline in glomerular filtration rate. There was no significant difference of vascular lesions. Conclusions The prevalence of hyperuricemia in IgA nephropathy pa-tients is high. Oxford classification shows IgA nephropathy with hyperuricemia are associated with more severe tubulointerstitial lesions and lower GFR.

Objective To develop a new strategy for preparing large-area full-thickness skin grafts with donor incisions small enough to allow direct suture under low pressure.Methods A geometrical analysis was carried out to design the best strategy to obtain skin grafts with minimal donor defect.In this strategy,two semicircular donor skin grafts are subjected to a malpositioned joining to form a circle which is equal in size to the large-area skin defect.Seven patients with cutaneous malignancy were managed by this operation regimen,including three cases of basal cell carcinoma,three cases of squamous cell carcinoma,and one case of malignant melanoma.Tumors were located in the face or head in five patients,and in feet in two patients.Results The width of donor incisions was significantly reduced by this strategy,and donor defects were sutured directly with the minimal loss of donor graft.Of the five patients with malignancies of the head or face,three achieved complete survival of skin grafts,two experienced mild erosion at the margin of skin grafts.A 10％-20％ necrosis of skin graft was observed in the sole of feet in 2 patients,which healed 1-2 months after dressing changes.Conclusion Joined grafts of equal size may be an effective approach to the repair of large skin defect.

OBJECTIVE: To explore the changes of mTOR signal pathway in HeLa cells under different nutritional conditions infected with Coxsackie virus B3 (CVB3). METHODS: The HeLa cells were cultured with two methods: the conventional culture method cultured HeLa cells with medium with 10% fetal bovine serum for 24 h and changed the medium next day, and then infected with CVB3; the serum starvation method cultured HeLa cells with medium without fetal bovine serum for 24 h, and then infected with CVB3. The expression of the coat protein of CVB3, mTOR, p70S6K mRNA was detected with RT-PCR at different time points. RESULTS: The virus group showed the expressions of mTOR and p70S6K mRNA were significantly higher than those in the control group at 12 h and 24 h (P<0.05) in the conventional culture. The virus group showed the expressions of mTOR and p70S6K mRNA were lower than those in the control group (all P<0.05) in the starvation serum. The expression of mTOR mRNA in the starvation serum virus group was higher than that in the conventional culture virus group (all P<0.05) and the control group. The expression of p70S6K mRNA was not significantly different in the two groups (P>0.05). CONCLUSION CVB3 can down-regulate the expressions of mTOR and p70S6K mRNA. The mTOR expression in the starvation serum is higher than that in the conventional culture.
Cell Culture Techniques ; Down-Regulation ; Enterovirus B, Human ; pathogenicity ; HeLa Cells ; Humans ; RNA, Messenger ; genetics ; metabolism ; Signal Transduction ; physiology ; TOR Serine-Threonine Kinases ; genetics ; metabolism

Objective To observe the effect of Yiaikang capsules on viral load, immunologic function and quality of life of patients with human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS). Methods A prospective randomized controlled clinical study was conducted, 118 patients with HIV/AIDS admitted to Department of Integrated Traditional Chinese and Western Medicine of Qinghai Fourth People's Hospital from July 2015 to February 2017 were enrolled, and they were divided into two groups by random digital table method, 59 cases in each group. The control group received highly active anti-retroviral therapy (HAART); while the treatment in combined Chinese and western medicine group was additionally given Yiaikang capsules on the basis of the therapy in control group, 5 capsules (0.5 g per grain,) once and 3 times a day for 12 months. The differences of World Health Organization HIV quality of life scale (WHOQOL HIV-BREF) score, CD4+, CD8+T-lymphocyte and viral load levels were compared between the two groups. Results After treatment for 12 months, the results of WHOQOL HIV-BREF scores in two groups were reduced significantly compared with those before treatment (P ＜ 0.05), and the degree of decrease of WHOQOL HIV-BREF score in combined Chinese and western medicine group was slower than that in control group (82.57±8.76 vs. 70.53±9.45, P ＜ 0.05). The CD4+, CD8+levels in control group after treatment were of no significant change compared with those before treatment (P ＞ 0.05), but the viral load level was decreased significantly after treatment compared with that before treatment (log/mL: 3.57±0.82 vs. 3.89±1.32, P ＜ 0.05); the CD4+in combined Chinese and western medicine group after treatment was obviously higher compared with that before treatment (number/μL: 413.67±187.39 vs. 376.65±206.51), the viral load level was markedly lowered compared with that before treatment (log/mL: 3.14±0.76 vs. 3.81±1.27) and the level of CD4+was significantly higher in combined Chinese and western medicine group than that in control group (413.67±187.39 vs. 382.72±194.82), viral load level in combined Chinese and western medicine group was siginificantly lower that in the control group (3.14±0.76 vs. 3.57±0.82, P ＜ 0.05), but the number of CD8+in two groups after treatment was of no significant change (P ＞ 0.05). Conclusion Yiaikang capsules possibly may elevate the number of CD4+T-lymphocytes and decrease the level of viral load to improve the quality of life in patients with HIV/AIDS.

OBJECTIVETo assess the association of BDNF gene Val66Met polymorphism with efficacy of antidepressant treatment and plasma BDNF level.

METHODSTwo hundred and forty-nine ethnic Han Chinese patients with depression(study group), who have met the diagnostic criteria of DSM-IV, were prescribed with venlafaxine or paroxetine. Two hundred and two healthy individuals were recruited as the control group. General demographic information such as gender, age, educational status, occupation, and marriage status were collected. HAMD-17 was adopted as the primary rating tool to evaluate the severity of depression on the baseline and at the end of 1st, 2nd, 4th, 6th week of treatment. PCR-restriction fragment length polymorphism was applied to determine the Val66Met polymorphism of the BDNF gene in the two groups. Plasma BDNF concentration was measured with ELISA before and after 6 weeks of treatment.

RESULTSNo significant differences have been found in HAMD scores and reduction of HAMD scores on the baseline and at the end of 1 st, 2nd, 4th, 6th weeks of treatment for each genotype. Nor were significant differences found in the Val66Met genotypes and allelic frequency between patients who achieved remission or not after 6 weeks' treatment as well as the healthy volunteers. The plasma BDNF level in depression patients was lower than that in healthy controls. The BDNF level has increased significantly after 6 weeks' treatment with both venlafaxine and paroxetine, but was still lower than the healthy controls. The BDNF level in the patients achieved remission who were treated with venlafaxine was similar to the normal controls, while those treated with paroxetine was still lower than normal controls. The BDNF level in patients who have not achieved remission was lower than normal controls. The BDNF level was not associated with the Val66Met polymorphism on the baseline and the end of 6th week.

CONCLUSIONNo association has been found between the efficacy of venlafaxine or paroxetine and the BDNF Val66Met polymorphism. The BDNF level of patients with depression is significantly lower than healthy controls on the baseline, and can be enhanced with the treatment. Particularly, the BDNF level in patients who achieved remission after the treatment of venlafaxine can rise to normal. The level of BDNF has certain value in the forecasting of efficacy in the anti-depression therapy. BDNF level is not associated with the Val66Met polymorphism of the BDNF gene.

Adolescent ; Adult ; Aged ; Antidepressive Agents ; therapeutic use ; Brain-Derived Neurotrophic Factor ; blood ; genetics ; Depression ; blood ; drug therapy ; genetics ; Female ; Humans ; Male ; Middle Aged ; Polymorphism, Genetic

OBJECTIVETo study iodine nutrition of pregnant women in different occasions and thyroid function of their neonates.

METHODSUrinary iodine of pregnant women and their serum T(3), T(4), FT(3), FT(4) were determined by chloric acid-digestion thermostatic assay and RIA, TSH determination by IRMA; neonatal umbilical cord blood TSH was determined by ELISA.

RESULTSMedian urinary iodine of pregnant women were 206.3 microg/L, 161.4 microg/L, 203.3 microg/L at 10 - 14 (first occasion), 23 - 27 (second occasion) and 39 - 40 (third occasion) week but the percentage that lower than 100 microg/L were 14.6%, 17.1%, 11.1% respectively. Serum T(3), T(4) of pregnant women was significantly higher than those women of premarital health inspection (PHIW, P < 0.001). The difference of serum T(3), T(4) of pregnant women at 10 - 14 and 39 - 40 week was not significant. Serum FT(3), FT(4) of pregnant women at 39 - 40 week were 2.61 +/- 0.47 pmol/L and 5.50 +/- 1.57 pmol/L respectively. The difference of serum TSH concentration at third occasion and first occasion of pre-pregnancy was significant but the difference of TSH frequency distribution in three groups was not significant (chi(2) = 1.138, P > 0.5). Blood TSH median neonatal umbilical cord was 1.99 mU/L but the percentage that higher than 5 mU/L was 9.4%.

CONCLUSIONFor those areas with high iodized salt coverage, pregnant women had had sufficient iodine supplement and good thyroid function. The percentage of neonates from iodine sufficient pregnant women with TSH > 5 mU/L was lower than 10%. Using the normal range of nonpregnant FT(3) and FT(4) to estimate the thyroid function of pregnant women could cause mis diagnosis.

Female ; Fetal Blood ; chemistry ; Humans ; Infant, Newborn ; Iodine ; urine ; Pregnancy ; Thyroid Gland ; physiology ; Thyroid Hormones ; blood ; Thyrotropin ; blood