Objective To summarize the clinical, electromyography and muscular pathological feature in adult spinalmuscular atrophy (SMA_4). Methods The clinical and electromyography and pathological materials from 48 patients withSMA_4. were studied in retrospect tively. Results SMA_4 onset was averaged 38.23 years old,The disease showed proximalweakness and atrophy. The electromyoguphy in the patients with SMA_4. presented as abnormal insertion potential,fibrilla-tion potential and fascicular potential, positive spike in some patients, remarkable increase of mean amplitude, mean timelimit and polyphasic action potential,and so on. Muscle biopsy showed: 1. small groups atrophy mainly;2. extensive fibertype grouping and more hypertrophic fiber. Conclusions SMA_4 could be diagnosed by the clinical manifestations andelectromyography and muscle biopsy.

Objective To evaluate the value of transcatheter arterial embolization(TAE) in the treatment of intractable epistaxis.Methods TAE using gelform or polyvinyl alcohol(PVA) particles of forty-one patients with intractable epistaxis were undertaken by the femoral artery approach,through selective catheterization of involved maxillary artery or the bleeding arteries for the stopage of bleeding..Results Of the forty-one patient,39 cases were cured by once TAE and the other 2 with recurrent bleeding on the next day after the TAE,to whom a second interventional treatment fullfilled the requirement.Conclusions Transcatheter arterial embolization is a simple,safe and effective treatment for the intractable epistaxis.

Objective To explore the clinical value of the interventional and comprehensive treatment of iliac-femoral venous thrombus(I-FVT).Methods 32 patients with I-FVT were underwent interventional therapy.First the filter was implanted into the inferior vena caval via opposite side of femoral vein,then the catheteres were implanted into the pathologic regions within the vena to process the emboluses,and balloon-directed extend when necessary.Results The procedure of treatment was successful in all patients.The iliac-femoral veins were patent,swollen and pain symptom of lower limb disappeared gradually after operation.The followed-up study the longest period for 30 months showed no severe complications and recurrence.Conclusion The interventional and comprehensive therapy is of ideal effect on treating I-FVT,occuring interventional and comprehensive treatment has ideally effect to cure the patients with I-FVT.

Objective:This study aims to investigate the effects of Zhibao Sanbian Pills on learning and memory ability and explore its mechanism.Methods:Cognitive decline and memory impairment in mice was induced by scopolamine. Morris water maze test, platform jumping test and dark avoidance test were used to evaluate the learning and memory ability of mice. TCMSP, TCMID database and literature search were used to search the chemical components of Zhibao Sanbian Pills. The potential active components were screened through ADMETlab 2.0. The targets were predicted by Swiss Target Prediction. GO function and KEGG pathway enrichment analysis were conducted through the Metascape database, and a PPI network was constructed for MCODE module analysis.Results:Compared with the model group, the latency of water maze test in the high-dose group of Zhibao Sanbian Pills was shortened ( P<0.05), and the time of platform quadrant and the number of crossing increased ( P<0.05). 863 active components and 401 potential targets of Zhibao Sanbian Pills were collected. The enrichment analysis of MCODE, GO and KEGG pathways found that the action pathways of Zhibao Sanbian Pills to improve cognitive impairment involve neuroactive ligand receptor pathway, calcium signal pathway, Rap1 signal pathway, PI3K-Akt signal pathway, MAPK signal transduction pathway, 5-hydroxytryptamine receptor pathway, etc. Conclusion:Zhibao Sanbian Pills have the potential to improve the learning and memory ability of mice, which may be realized through MAPK signaling pathway and other neural related signaling pathways.

ObjectiveTo explore the impact of autonomic nerve function on motor function in patients with post-stroke depression (PSD) from the perspective of regional homogeneity (ReHo). MethodsFrom January to December, 2020, a total of 60 inpatients and outpatients with cerebral infarction in the Affiliated Brain Hospital of Nanjing Medical University were divided into control group (n = 30) and PSD group (n = 30). Two groups were assessed using Fugl-Meyer Assessment (FMA), modified Barthel Index (MBI) and Hamilton Depression Scale (HAMD). Heart rate variability (HRV) was measured. Ten patients in each group were selected randomly to undergo resting state functional magnetic resonance imaging (rs-fMRI) to calculate ReHo. ResultsAll HRV indices were lower in PSD group than in the control group (|t| > 2.092, P < 0.05). In PSD group, FMA and MBI scores showed positive correlations with 24-hour standard deviation of normal-to-normal R-R intervals (SDNN), the root mean square of successive differences between normal heartbeats over 24 hours (RMSSD), the percentage of differences between adjacent normal R-R intervals over 24 hours that were greater than 50 ms (PNN50), total power (TP), very low frequency power (VLF) and low frequency power (LF) (r > 0.394, P < 0.05), and showed negative correlations with HAMD scores (|r| > 0.919, P < 0.001). HAMD scores in PSD group were negatively correlated with SDNN, RMSSD, PNN50, TP and VLF (|r| > 0.769, P < 0.001). Compared with the control group, the ReHo increased in PSD group in the right rectus gyrus (142 voxels, t = 6.575), the left medial and paracingulate gyri (204 voxels, t = 4.925) (GRF correction, P_-Voxel < 0.005，P_-Cluster < 0.05); and reduced in the right cerebellum (191 voxels, t = -6.487), the left middle temporal gyrus (140 voxels, t = -5.516), and the left precentral gyrus (119 voxels, t = -4.764) (GRF correction, P_-Voxel < 0.005，P_-Cluster < 0.05) in PSD group. ConclusionAutonomic nerve function is related to motor dysfunction in patients with PSD. The modulation of emotional, cognitive and motor brain regions by the autonomic nervous system may play a role in influencing the motor function in patients with PSD.