Objective: To study the cognitive function of patients with myasthenia gravis.Methods: Cognitive function of 35 patients with general myasthenia gravis and 31 patients with Eye-Muscles myasthenia gravis,and 35 control subjects was examined with cognitive measures of Recall of Auditory Verbal Learning Test,Symbol Digit Modalities Test,Trail Making Test,Logic Memory Test,Stroop Color Words Test(A、B 、C),Verbal fluency Test and Boston Naming Test.Results: MG patients performed worse than the control subjects on several cognitive measures.Conclusion: There is disorder of cognitive function in the patients with myasthenia gravis,revealing that there may exist deficiency in the central neuroal system of the patients with myasthenia gravis.

Objective To explore the application effect of the wechat public platform in follow-up management of patients with moderate or severe craniocerebral injury.Methods 98 patients admitted in the craniocerebral department of our hospital from February to November 2014 were selected and divided into two groups by random number table method,with 48 cases in the control group and 50 cases in the observation group;the traditional follow-up management mode using telephone was adopted to patients in the control group,while the follow-up management mode using the wechat public platform was adopted to those in the observation group,with a follow-up period of 3 months;for patients in both groups,their activities of daily living (ADL) and exercise of self-care agency (ESCA) abilities before and after intervention,occurrence of adverse events and complications within the follow-up period,and their degree of satisfaction towards the follow-up management were collected.Results After intervention,ADL score,total scores of ESCA and total scores of satisfaction towards the follow-up management among patients in the observation group were 87.34±15.26,24.36±17.24 and 86.07±14.82,which were significantly higher than that among patients in the control group were 66.72±14.62,99.37±15.29 and 61.14±13.19 (t=7.941,7.982,6.962,all P ＜0.01);within intervention,the observation group had significantly lower total occurrence rate of adverse events and complications which was16.00％ (8/50) compared to the control group 39.58％ (19/48) (x2=6.824,P ＜ 0.01).Conclusions By establishing the follow-up management mode for patients with craniocrerbral injury through the wechat public platform,effect of the follow-up management can be effectively promoted,prognosis of patients can be improved and patients' degree of satisfaction can be enhanced;it is worth of being further promoted clinically.

Objective\ To evaluate the efficacy of atrial lead implantation during atrial fibrillation.Methods\ In 10 patients(group A),the atrial leads were implanted during atrial fibrillation and the sensing and pacing parameters before and after restoring to sinus rhythm were compared with the parameters of patients whose atrial leads were implanted during sinus rhythm (group B).Results\ During follow-up,the sensing and pacing parameters were measured,and there were no significant difference between group A and B.In group A,mean atrial potential amplitude during atrial fibrillation was correlated with the telemetered atrial potential amplitude during sinus rhythm.Conclusion\ Atrial lead implantation during atrial fibrillation is feasible.

Objective To investigate the clinical value of Fluorine-18-fluorodeoxyglucose (18 F-FDG) PET/CT examination to predict the prognosis of patients after colorectal cancer operation.Methods The retrospective cross-sectional study was adopted.The clinicopathological data of 80 patients with colorectal cancer who were admitted to the First Hospital of Nanjing Medical University from March 2007 to October 2015 were collected.Eighty patients received first preoperative 18 F-FDG PET/CT examination and underwent operations under decisions of patients and their families,and then adjuvant chemotherapy were performed according to the patients' condition.Observation indicators included:(1) preoperative imaging examination,(2) situations of treatment and follow-up,(3) analysis of prognostic factors.The patients were followed up by outpatient examination and telephone interview once every 3 months within postoperative 1 year,once every half a year within postoperative 2 years and then once a year up to May 2016.The follow-up included tumor recurrence or progression and survival of patients.Tumor-free survival time was from postoperative day 1 to tumor recurrence or progression and death or end of follow-up.Overall survival time was from postoperative day 1 to death or end of follow-up.Measurement data with skewed distribution were represented as M (Qn) and M (range).The optimal cutoff point of tumor-free survival of maximum standardized uptake value (SUVmax),mean standardized uptake value (SUV),metabolism of volume (MTV) and total lesion of glycolysis (TLG) were investigated using the ROC curve analysis,and calculating area under the curve (AUC).The median was used as a cutoff point if there was smaller AUC.The Kaplan-Meier method and Log-rank test were respectively used for survival analysis and univariate analysis,and COX proportional hazards model for multivariate analysis.Results (1) Results of preoperative imaging examination:results of PET/CT in patients with colorectal cancer showed there were circumscribed thickening of bowel wall,intestinal cavity strictures,fuzzy fat space around the some lesions,enlarged lymph node and 18 F-FDG uptake increased abnormally.The SUV SUV MTV and TLG of 80 patients were 11.83(4.26,35.42),7.06(2.38,20.92),20.47 cm3 (1.29 cm3,161.50 cm3) and 138.58 (14.17,857.89),respectively.ROC curve showed that the AUC of SUV SUV MTV and TLG were 0.453,0.448,0.815 and 0.749 [95％ confidence interval (CI):0.307-0.600,P ＞0.05;0.303-0.594,P ＞ 0.05;0.717-0.913,P ＜ 0.05;0.635-0.863,P ＜ 0.05],respectively.The median SUVmax (11.83) and SUV (7.06) were used as the cutoff points due to smaller AUC of SUVmax and SUV.The cutoff point of MTV was 18.79 cm3 (sensitivity =86.2％ and specificity =68.3％),and the cutoff point of TLG was 142.05 (sensitivity =75.9％ and specificity =70.7％).(2) Situations of treatment and follow-up:among 80 patients,13 underwent the radical resection of colorectal cancer and resection of liver metastasis and 67 underwent radical resection of colorectal cancer.Sixty-two patients received postoperative chemotherapy,including 45 with chemotherapy regimens of capecitabine and 17 with fluorouracil.Eighty patients were followed up for 41.8 months (range,6.5-109.1 months).During the follow-up,29 patients had tumor recurrence or progression,and 19 patients were dead.The median tumor-free survival time,1-,3-and 5-year tumor-free survival rates in 80 patients were 19.5 months (range,2.0-109.1 months),73.7％,36.3％ and 18.8％,respectively.The median overall survival time,1-,3-and 5-year overall survival rates were 31.8 months (range,3.3-109.1 months),76.3％,37.5％ and 20.0％,respectively.(3) Analysis of prognostic factors:results of univariate analysis showed that tumor location,N staging,M staging,clinical staging,postoperative chemotherapy,MTV and TLG were relative factors affecting postoperative tumor-free survival rate (HR =3.469,5.325,5.295,8.605,2.630,7.388,5.155,95％ CI:1.522-7.906,2.256-12.568,2.405-11.657,2.969-24.937,1.063-6.504,2.550-21.403,2.178-12.204,P ＜ 0.05).The tumor location,tumor differentiation,N staging,M staging,clinical staging,MTV and TLG were relative factors affecting postoperative overall survival rate (HR =2.697,2.814,3.083,2.916,4.193,5.450,4.876,95％ CI:1.011-7.197,1.121-7.062,1.166-8.149,1.140-7.454,1.386-12.678,1.581-18.786,1.727-13.766,P ＜ 0.05).In multivariate analysis,stage Ⅲ-Ⅳ of clinical staging and TLG≥ 142.05 were independent risk factors affecting postoperative tumor-free survival rate (HR =9.879,3.569,95％ CI:1.854-22.836,1.127-11.306,P＜0.05).The stage M1,stage Ⅲ-Ⅳ of clinical staging and TLG≥ 142.05 were independent risk factors affecting postoperative overall survival rate (HR =4.522,9.315,10.120,95％ CI:1.223-16.717,1.338-24.864,2.385-12.947,P＜0.05).Conclusion TLG through 18 F-FDG PET/CT examination is an independent prognostic factor affecting postoperative tumor-free survival rate and overall survival rate in patients with colorectal cancer after curative resection,and it has certainly reference value for prognosis.

The angiotensinogen(AGT) expression and angiotensin Ⅱ (AngⅡ ) secretion levels in cultured SD rat mesangial cells were determined. High glucose up-regulated AGT mRNA(0. 29±0.07 vs 0. 20±0. 05,P< 0.05)and protein(0.66±0.23 vs 0.37±0. 15,P<0.05) expression and Ang Ⅱ secretion [(9.85±2.08 vs 7.50± 1. 51) pg/ml,P<0. 05]levels, which were down-regulated by pyrrolidine dithiocarbamate( PDTC) treatment via inhibiting NF-κB activity.

Objective To investigate the possible effects and underlying mechanisms of desferroxamine (DFO) preconditioning against hypoxia in neurons. Methods Cortical neurons were cultured in DFO under ischemia condition of oxygen-glucose deprivation (OGD). Cell viability was determined by cell counting kit-8 (CCK-8) method; apoptotic cell ratio was examined with Hoechst 33342 staining; the morphological change was observed. Middle cerebral artery was occluded with or without DFO administration to establish the cerebral ischemia rat model. Infarct sizes were examined by TIC staining, and the neurological severity score was evaluated. Meanwhile immunofluorescent staining was employed to detect the protein synthesis of hypoxia inducible factor-1 (HIF-1) and erythropoietin (EPO), RT-PCR was performed to detect the mRNA expression of HIF-1 and EPO as well Results Neuronal viability kept in 49% (OGD group was 25%, t =8. 544, P<0. 05), the rate of apoptosis was 38% (OGD group was 30%, t = 4. 409, P <0.05 ) after administration of DFO (post-DFO) , the morphology of neurons improved. In the model of focal cerebral ischenfia of 30 mg/kg group, neurological severity score was reduced, the percentage of brain infarct decreased 8.5% (t=4.649, P<0.05) 3 days post-DFO(vs control). In the 100 mg/kg group, neurological severity score was 7.44 ±0.39 (t=2.903, P<0.05 ) ,5.60±0.47 (t=10.143, P < 0.01 ) ,6.97 ±0.73 (t=3.142, P<0.05 ), the percentage of brain infarct decreased 12. 0% (t=5.056, P<0.05), 32.3% (t =10.993, P<0.01), 10.6% (t =4.385, P<0.05)2,3 and7 days post-DFO(vs control), respectively. Immunofluorescent staining found synthesis of HIF-1α and EPO in cultured cortex neurons after DFO pretreated; HIF-1α and EPO were upregulated in the neurons of rat brain after DFO pretreated. The mRNA of HIF-1α and EPO upregulated in vivo and in vitro. Conclusion DFO preconditioning can protect the brain against ischemic damage, which is related to the protective effect on neurons. The mechanism of DFO preconditioning may be involved in the expression of HIF-1α and EPO in vivo and in vitro.

The status of acupuncture-moxibustion is more and more recognized by mainstream medicine in the world in recent years, and literature regarding acupuncture-moxibustion with high impact factor (IF) published in the worldwide mainstream medicine journals is also gradually growing by years. To understand the situation of related literature, literature regarding acupuncture-moxibustion with IF of more than 10 in Science Citation Index (SCI) during the recent 5 years was retrieved. The number, the types, the diseases involved, the publishing states of the acquired articles and the source, the citation, the IF of the publishing journals were analyzed and summarized. Additionally, some of the research foci, the new research tendencies and the deficiencies of research were discussed. The thoughts and suggestions are expected to be provided for further research of acupuncture.
Acupuncture Therapy ; statistics & numerical data ; Bibliometrics ; Humans ; Journal Impact Factor ; Moxibustion ; statistics & numerical data ; Publications ; statistics & numerical data

Objective To compare the effect of Baikerui compound lysostaphin (FE complex phosphoesterasum) disinfectant and povidone iodine in treatment of burn wound infection resulted from gram-positive (G ±) coccus.Methods The study involved 60 patients with superficial second degree burns (1％-5％ TBSA； age range of 18-50 years).All the patients received bacterial culturing of wound secretions prior to treatment.Every 20 patients were indentified with infection of staphylococcus aureus (SA),staphylococcus epidermidis (SE),and enterococcus (EC) respectively and randomized into control group and experiment group,with 10 patients per group.Patients allocated to the experiment group were covered with four-layer sterile gauze soaked into the Baikerui compound lysostaphin disinfectant,while the patients in the control group were treated with four-layer sterile gauze soaked into the povidone iodine.Dressing was changed once a day.Wound culturing was performed again at each day of the 5-day treatment.Wound healing was compared among each group.Results SA wound infection turned negative for all the 10 patients in experimental group and three patients in control group (P ＜ 0.01).SE wound infection turned negative for all the 10 patients in experimental group and six patients in control group (P ＜ 0.05).EC wound infection turned negative for nine patients in experimental group and seven patients in control group (P ＞ 0.05).Mean wound healing time was (10.87 ± 1.93) days for experimental group and (13.31 ± 2.89) days for control group (P ＜ 0.05).Conclusion Baikerui compound lysostaphin disinfectant can effectively prevent burn wound infection with common G + coccus and accelerate wound healing.

Objective To examine the reliability and similarity of amplitude of low-frequency fluctuation (ALFF)for different scan duration.Methods 10 min 10 s resting state fMRI data acquired from 13 healthy volunteers separately were divided into 10 pieces of the same length.The reliability and similarity of ALFF were assessed for each scan length (1-10 min).Results Spatial maps of ALFF steadily appeared in each time period (1-10 min);but during the time evolution,both spatial distribution and extent of ALFF increased gradually.At only one minute,there were detectable statistical differences within the group.When the time ran-ging from 5 to 10 min,relatively stable ALFF results in the group achieved.Conclusion ALFF is a relatively stable index,it can be easily affected by scan duration.In the case of 1-5 min,it should be carefully analyzed and interpretated particularly.

Objective To compare the effect of endoscopic ultrasonography (EUS),magnetic resonance chlangiopancreatography (MRCP) and endoscopic retrograde cholangiography (ERCP) in the diagnosis of suspicious intermediate choledocholithiasis.Methods One hundred and eighty-six patients with suspicious intermediate of choledocholithiasis successively received MRCP,EUS,and ERCP examination.The stone taking out by endoscopic as diagnositic standard,and the sensitivity,specificity and accuracy in different methods was compared.Results Sensitivity and accuracy of EUS was significantly higher than that of MRCP [97.5％(155/159) vs.92.5％(147/159),97.3％(181/186) vs.91.9％(171/186)](x2 =4.21,5.30,P =0.04,0.02).There was no statistically significant difference between EUS and ERCP in specificity [96.3％(26/27) vs.88.9％ (24/27)] (x2 =115.40,P ＜ 0.05).Sensitivity,specificity and accuracy of ERCP was 98.9％(184/186),98.7％(157/159) and 100.0％(27/27),and there was no difference between EUS and ERCP in the diagnosis of choledocholithiasis (P ＞ 0.05).Conclusions EUS is similar with ERCP for the diagnosis of choledocholithiasis.By performing EUS or MRCP first,ERCP may be avoided in patients with suspicious intermediate choledocholithiasis.