Objective Diffusion tensor imaging(DTI)was used to explore the characteristics of white matter (WM)microstruc-ture lesion in patients with temporal lobe epilepsy(TLE)and hippocampal sclerosis(HS).Then we investigated the influence of the age of epilepsy onset and the course on WM changes.Methods DTI data were obtained in 30 TLE patients with HS and 23 age and sex-matched healthy controls.Thirteen patients had left HS (LHS)and seventeen had right HS (RHS).Between-group compari-sons of fractional anisotropy (FA)were carried out by using track-based spatial statistics (TBSS).In addition,FA in regions of in-terest (ROI)where white matter lesions had statistically significant difference was correlated with the age of onset and the course. Results Subjects in the LHS group,as compared to healthy controls,demonstrated these clusters of reduced FA:bilateral corona radiata,the left genu of corpus callosum,the right body and splenium of corpus callosum,the right posterior thalamic radiation,ex-ternal capsule and superior longitudinal fasciculus.White the subjects in the RHS group,the clusters of reduced FA are involving bi-lateral corpus callosum,corona radiata,posterior thalamic radiation,cingulum,superior longitudinal fasciculus,and the right ante-rior limb of internal capsule,the right retrolenticular part of internal capsule and external capsule.In LHS group,the FA of the left genu of corpus callosum was negatively correlated with the course,and the FA of the right anterior corona radiata was positively cor-related with the age of onset.In RHS group,the FA of the bilateral superior corona radiata was positively correlated with the course.Conclusion DTI detects extensive changes in TLE with HS that are not confined to temporal lobe.The age of epilepsy onset in LHS was correlated with the changes of anterior corona radiata,while the course and the WM change were not definitely linked to each other.

The Offsite Medical Accounting Information Supervising System was developed for patients of Sichuan new rural cooperative medical scheme (NRCMS) using the C#programming language under .NET development environ-ment based on Microsoft Visual Studio 2010 in order to solve the problems in offsite medical accounting information statistics and supervision for patients of NRCMS.The system is a B/S-based MVP 3-tier structure with VPN hard-ware firewall and VPN client software plus certificate built-in, and can thus be used to supervise the offsite medical accounting for patients of NRCMS, analyze their medical advice seeking indexes at other places, and provide data for the NRCMS fund management .

Objective To assess the efficacy and safety of mifepristone combined with oral or vaginal misoprostol for termination of pregnancy between 8 and 16 weeks of gestation. Methods This was a randomized, multi-center, open clinical trial. A total of 625 women at 8-16 weeks of gestation were randomized to receive 200 mg oral mifepristone followed by either oral misoprostol 400 μg every 3 hours or vaginal misoprostol 400μg every 6 hours for a maximum of 4 doses 36-48 hours later. There were 417 women in oral group with 198 at 8-9 weeks and 219 at 10-16 weeks, while 208 women in vaginal group with 99 at 8-9 weeks and 109 at 10-16 weeks. The outcome measures were the success abortion rate, induction to abortion interval, the amount of bleeding, reoccurrence of menstruation and adverse events. Results Abortion rate was significantly higher in vaginal group [98.1% (202/206)] than that in oral group [94.0%(390/415), P=0.023]; concerning termination of pregnancy at 8-9 weeks and 10-16 weeks respectively, there were no significant differences between oral and vaginal groups (P=0.156, P=0.073). The induction to abortion interval was no significant difference in oral and vaginal group in different gestational weeks ( P=0.238, P=0.273). The average induction to abortion interval was (4.1 ± 6.6) hours and (6.0 ± 4.5) hours respectively in terminating 8-9 weeks and 10-16 weeks of gestation. Concerning the amount of bleeding within 2 hours of placenta expulsion, there was significant difference between oral group [(63±46) ml] and vaginal group [(55 ± 45) ml] in terminating 8-9 weeks of gestation (P=0.047), while there was no significant difference between groups in terminating 10-16 weeks of gestation [oral group (76 ± 52) ml versus vaginal group (76 ± 61) ml, P=0.507]. The reoccurrence of menstruation was about 37 days in both oral and vaginal groups. Two cases of incomplete abortion were serious adverse events (SAE) relating to treatment. The common adverse events (AE) of nausea and vomiting were significantly higher in oral group [57.2% (239/417), 36.3% (151/417)] than those in vaginal group [45.4% (94/208), 26.1% (54/208); P=0.005, 0.011]. Conclusion Oral or vaginal misoprostol combined with mifepristone, is effective and safe for termination of pregnancy between 8 and 16 weeks of gestation.

OBJECTIVETo study the structural integrity and continuity of the bilateral uncinate fasciculus (UF) in patients with temporal lobe epilepsy (TLE) using magnetic resonance diffusion tensor imaging (DTI) and evaluate the impact of structural damage of the UF on the executive function of the patients.

METHODSThirty patients with TLE (14 left, 16 right) and 15 healthy control subjects underwent DTI scanning between January, 2007 and July, 2011, and the left and right UF were analyzed for fractional anisotropy (FA) and fiber mean length.

RESULTSIn the control subjects, the average FA was significantly higher in the left than in the right UF (P<0.01). In patients with left TLE, the average FA of the left UF was significantly lower than that of the control subjects (P<0.01), but the FA of the right UF was comparable with that of the control group (P>0.05). In patients with right TLE, the average FA of the left and right UF was significantly lower than that of the control group (P<0.05 and P<0.01). In patients with unilateral TLE, the FA of their bilateral UF was similar. No significant difference was found in the mean length of UF fiber between these 3 groups.

CONCLUSIONSFA is normally higher in the left UF than in the right UF, but inpatients with TLE, the left FA tends to have a lowered UF regardless of which hemisphere is involved, suggesting an early pathology in the microstructure of the left UF. This finding may help in the investigation of possible reasons for executive function damage in TLE patients.

Phytochemical studies of the the herb Sarcopyramis bodinieri var. delicate (Melastomataceae) have been carried out. The compounds were separated by repeated D101 macroporous adsorption resin column combined with Sephadex LH-20, ODS, and silica gel chromatgrophy. The structures were identified on the basis of extensive spectroscopic data analysis, and by comparison of their spectral data with those reported. Eight flavonoid compounds isolated from the ethyl acetate extract was identified as isorhamnetin (1), quercetin (2), isorhamnetin-3-O-beta-D-glucopyranoside (3), quercetin-3-O-beta-D-glucopyranoside (4), isorhamnetin-3-O-(6"-acetyl)-beta-D-glucopyranoside (5), isorhamnetin-3-O-(2"-acetyl)-beta-D-glucopyranoside (6), quercetin-3-O-(6"-acetyl)-beta-D-glucopyranoside (7), and quercetin- 3-O-(6"-O-E-p-coumaroyl)-beta-D-glucopyranoside (8). All of the compounds were separated from the genus of Sarcopyramis for the first time.
Flavonoids ; analysis ; isolation & purification ; Magnetic Resonance Spectroscopy ; Melastomataceae ; chemistry ; Spectrometry, Mass, Electrospray Ionization

Objective:To design and develop an unplanned extubation clinical decision support system, aiming to provide a reference for nurses' clinical decision-making.Methods:Through literature review and expert consultation, the knowledge base of the clinical decision support system for unplanned extubation was constructed, and the system function and interface were designed.Results:The authoritative coefficients of the two rounds of expert consultation were 0.853 and 0.867, respectively, and the Kendall ′s W were 0.458 and 0.492, respectively. The final built knowledge base included catheter evaluation module, unplanned extubation evaluation module, and knowledge reasoning rule module. At present, the knowledge base had sorted out 48 first-level items, 9 second-level items, 72 third-level items in the catheter evaluation module, and 5 first-level items, 12 second-level items, and 73 third-level items in the unplanned extubation evaluation module. Entry, 40 knowledge reasoning rules. Conclusions:The clinical decision-making system for unplanned extubation has changed the implementation of unplanned extubation risk early warning, optimized the management process, and realized the interaction of the hospital system. It can conduct dynamic unplanned extubation risk assessment based on individualization and assist nurses Make clinical decisions and promote the safety of nursing management.

Objective:To study the neural mechanism between abnormal brain functional activity and alertness function in temporal lobe epilepsy (TLE) patients with or without hippocampal sclerosis.Methods:A total of 21 TLE patients with hippocampal sclerosis (TLE-HS), and 18 TLE patients without hippocampal sclerosis (TLE-N) diagnosed in the Department of Neurology of the First Affiliated Hospital of Guangxi Medical University from May 2016 to November 2022 and 28 healthy controls (HC) matched with demographic data were recruited.All the 67 participants completed the attention network test (ANT) and resting-state fMRI (rs-fMRI) scans. The REST software was used to analyze fractional amplitude of low-frequency fluctuation (fALFF) and functional connectivity (FC) based on one-way ANOVA in order to obtain differential brain regions in abnormal spontaneous neuronal activity and functional connectivity among the three groups. The SPSS 26.0 software was used to analyze the correlation between fALFF/FC values in differential brain regions and alertness network efficiency by Pearson correlation analysis.Results:There was a significant difference in the alerting network effect among the three groups ( F=4.621, P=0.013), and the post-hoc analysis showed that the alerting network effect in the TLE-HS group((59.40±22.85)ms)was significantly higher than that in the HC group((38.85±21.08)ms)(Bonferroni correction, P=0.017). The fALFF analysis showed that the fALFF values of the right superior frontal gyrus in the TLE-HS group (0.16±0.52) and the TLE-N group (0.49±0.51) were significantly lower than that in the HC group (1.01±0.46), while the fALFF values of the left precentral gyrus in the TLE-HS group (0.60±0.55) was significantly higher than that in the TLE-N group (-0.19±0.51) and the HC group (-0.15±0.36) (Bonferroni correction, all P<0.05). The functional connectivity analysis revealed that the FC values between the left inferior frontal gyrus and the right superior frontal gyrus in the TLE-HS group (0.11±0.16) and TLE-N group (0.02±0.19) were significantly higher than those in the HC group (-0.18±0.18). The FC values between the right supramarginal gyrus and the right superior frontal gyrus in the TLE-HS group (0.10±0.21) were significantly higher than those in the HC group (-0.18±0.16). The FC values between the left supplementary motor area and the right superior frontal gyrus in the TLE-HS group (0.20±0.21) were significantly higher than those in the TLE-N group (-0.03±0.31) and the HC group (-0.10±0.15) (Bonferroni correction, all P<0.05). The correlation analysis showed that the FC values between the left supplementary motor area and the right superior frontal gyrus in the TLE-HS group were significantly positively correlated with alertness network efficiency ( r=0.436, P=0.048). Conclusions:There are abnormal spontaneous neuronal activity and brain functional connectivity in TLE patients with or without hippocampal sclerosis, and the abnormality is more pronounced in the TLE-HS group. The abnormal brain functional connectivity may play an essential role in alertness dysfunction.

Objective:To explore the changes in topological attributes of structural covariance network based on cortical thickness and the brain functional activities in patients with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis by graph theory and functional connectivity (FC) analyses, and to investigate whether these changes were correlated to cognitive impairment.Methods:A total of 33 patients with anti-NMDAR encephalitis from Department of Neurology of the First Affiliated Hospital of Guangxi Medical University(patient group) and 35 healthy controls(control group) with matched gender, age, and education were included from July 2018 to November 2021.All subjects received cognitive function assessments, structural and functional magnetic resonance imaging scans.Structural covariance networks were constructed in the two groups based on cortical thickness values and topological characteristics of networks were computed.A non-parametric permutation test which repeated 1 000 times was used to compare the characteristics of the networks between the two groups.Brain regions with abnormal topology were defined as region of interest(ROI), and FC values in global brain level were calculated.SPM 12 and RESTplus were used to identify the brain regions with significant differences in FC values between the two groups.Finally, Spearman correlation analysis between FC values of significant brain regions and cognitive scores were performed by SPSS 24.0.Results:The cognitive score of patients with anti-NMDAR encephalitis (27.0(23.5, 28.0)) was lower than that in control group(29.0(27.0, 30.0)) ( Z=-3.029, P=0.002). Graph theory analysis found that the patients showed significantly increased clustering coefficients ( P=0.004) and decreased global efficiency ( P=0.004) compared with healthy controls.Moreover, the nodal efficiency of left ventral posterior cingulate cortex (vPCC) and right dorsal posterior cingulate cortex (dPCC), as well as the nodal degree centrality of left vPCC and left polar planum of superior temporal gyrus (ppSTG) in patient group were significantly decreased ( P<0.05, FDR corrected) compared with control group.FC analysis showed the increased FC values between left vPCC and posterior cerebellum (MNI: x=6, y=-66, z=-21), as well as between left ppSTG and anterior cerebellum (MNI: x=6, y=-54, z=-12) (GRF corrected, voxel level P<0.001, cluster level P<0.05) in patient grooup.The FC values between left vPCC and posterior cerebellum were negatively correlated with the cognitive scores ( r=-0.403, P=0.020). Conclusion:Patients with anti-NMDAR encephalitis show abnormal topology of structural covariance network based on cortical thickness and altered FC values, some of which are correlated to cognition and may be the underlying neural mechanism of cognitive impairment in patients with anti-NMDAR encephalitis.

Objective Toidentify factors contributing to posthepatectomy liver dysfunction (PHLD),focusing on the Functional remnant liver volume to spleen volume ratio (FreLSVR).Methods The clinical data of 74 patients undergoing precise liver resection from January 2016 to October 2017 were retrospectively analyzed.IQQA liver system was used to reconstruct the liver and spleen 3D image by using patients' preoperative abdominal CT image data.Tumor volume,3D estimated functional residual liver volume,spleen volume and FreLSVR were measured and calculated.Preoperative and postoperative liver function test,blood coagulation function test,operation time,intraoperative blood loss,and the volume of daily postoperative abdominal drainage were recorded.Correlations between multiple parameters and PHLD were analyzed.Results PHLD occurred in 16 (21.6％).Single factor analysis revealed that the standardized residual liver volume ratio (P＜0.05),FreLSVR (P＜0.05) and preoperative AST value (P＜0.05) were correlated with postoperative hepatic insufficiency.Multivariate regression analysis showed that FreLSVR (OR=0.535,95％CI=0.305～0.936,P＜0.05) was the only independent factor of PHLD.In the ROC curve analysis for FreLSVR,a cut-off value of 2.56 (AUC=0.824,Sensitivity 81.1％,specificity 71.7％.) was the appropriate value for predicting the risk of PHLD according to Youden index.Then the patients were regrouped according to this cut-off value.Compared with the FreLSVR＞2.56 group (53 cases),the highest postoperative INR value (1.46± 0.19 to 1.29± 0.29,t=-2.405,P＜0.05) was higher that of FreLSVR≤2.56 group,and the amount of average daily abdominal drainage in one and two weeks after operation was higher,(188.0(79.2 ～ 375.1)ml to 96.0(46.5 ～ 179.3)ml,P＜0.05) and (207.2(125.6 ～ 827.1)ml to71.8(14.0 ～ 179.8) ml,P＜0.05),respectively.Conclusion FreLSVR has significant correlation with postoperative hepatic dysfunction,and provides guidance for the safety of liver resection in the future.

Objective:To explore the current status of clinical nurses' job well-being in Class Ⅲ Grade A general hospitals in Beijing, and analyze its influencing factors.Methods:From November 2019 to January 2020, convenience sampling method was used to select 528 clinical nurses from 4 ClassⅢ Grade A general hospitals in Beijing as the research object. The General Information Questionnaire, Perceived Organizational Support Scale, Psychological Capital Questionnaire-Revision (PCQ-R) and Employee Occupational Well-being Scale in Chinese Enterprises were used to conduct a cross-sectional survey to analyze the relationships among clinical nurses' perceived organizational support, psychological capital and job well-being and the influencing factors of well-being at work. A total of 528 questionnaires were collected in this survey, of which 518 were valid questionnaires, with an effective response rate of 98.1%.Results:Among 518 clinical nurses, the average score of job well-being was (5.13±0.96) . Pearson correlation analysis showed that the total scores of perceived organizational support and psychological capital of clinical nurses were positively correlated with the total score of job well-being with statistical differences ( r=0.802, 0.668; P<0.01) . Multiple linear regression analysis showed that monthly income, perceived organizational support and psychological capital were the influencing factors of clinical nurses' job well-being also with a statistical difference ( P<0.05) . Conclusions:Clinical nurses in four ClassⅢ Grade A general hospitals in Beijing have a good sense of job well-being. The more monthly income, the stronger the perceived organizational support, and the higher the psychological capital, the higher the job well-being of nurses is.