Objective To investigate the clinical and imaging characteristics of bilateral medial medullary infarction. Methods The clinical data of 3 patients with bilateral medial medullary infarction admitted to Shengjing Hospital of China Medical University were analyzed retrospectively. The related literature was reviewed. Results Three patients in this group were all males. Their main clinical manifestations were quadriplegia, dysarthria, and paresthesia, and 1 of them complicated with respiratory failure. One patient was suspected of having Guillain-Barre syndrome. The hyperintensities of heart-shape,Y- shape,and V- shape were its imaging features of typical MRI diffusion weighted imaging. Conclusion Bilateral medial medullary infarction is a rare posterior circulation ischemic lesion in clinical practice. Its early symptoms are not typical and easy to be misdiagnosed and missed. MRI diffusion weighted imaging is its main imaging examination method.

Objective To explore the effect of goal-oriented repetitive training on motor function of upper limb in patients with stroke. Methods From March, 2014 to February, 2016, a total of 60 stroke patients were randomly divided into experiment group (n=30) and con-trol group (n=30). Both groups received routine rehabilitation, while the experiment group received goal-oriented repetitive training in addi-tion, 30 minutes once a day, 5 days a week for 4 weeks. They were assessed with simple Fugl-Meyer Assessment-Upper Extremity (FMA-UE) and modified Barthel index (MBI) before and after training. Results There was no difference in the scores of FMA-UE and MBI between two groups before training (Z<1.153, P>0.05). The scores of FMA-UE and MBI significantly improved in both groups after treat-ment (Z>5.645, P<0.001), in which the scores were higher in the experiment group than in the control group (Z>2.275, P<0.05), as well as the D-value of scores before and after training (t>5.770, P<0.001). Conclusion Goal-oriented repetitive training could promote the recovery of upper limb motor function in patients with stroke.

BACKGROUND:Most of lumbar degenerative diseases, such as lumbar instability, lumbar disc herniation and discogenic lumbago, need lumbar spinal fusion for the spine stability, but the choice of internal fixation approaches is controversial.
OBJECTIVE:To compare the effectiveness between lateral lumbar interbody fusion with single cage and single cage combined with unilateral pedicle screw fixation for the 4th and 5th single-level lumbar degenerative disease.
METHODS:The clinical data of patients with single-level lumbar degenerative diseases (L4 and L5) undergoing lateral lumbar interbody fusion with single cage in 30 cases (experimental group) and single cage combined with unilateral pedicle screw fixation in 45 cases (control group) were analyzed retrospectively, and the curative effects were compared between the two groups.
RESULTS AND CONCLUSION:Al patients in the two groups were fol owed up for 13 months on average (ranged from 10 to 37 months). The incisions in the two groups were stage I healing. One case in the experimental group occurred cage displacement, but no obvious syndromes were detected. No significant difference in the effective rate after operation, hospital stay, and volume of drainage was detected (P>0.05). The operative time and bleeding volume in experimental group were better than those in the control group (P<0.05). ODI and JOA scores were significantly improved after treatment when compared with preoperative ones in the two groups (P<0.05), but no significant difference was visible between the two groups (P>0.05). The effectiveness of lateral lumbar interbody fusion with single cage and single cage combined with unilateral pedicle screw fixation for single-level degenerative lumbar diseases was similar. However, the former has the advantages of less invasion and quick recovery.

BACKGROUND:At present, it remains unclear whether delayed functional exercises after arthroscopic rotator cuff repairs could elevate the healing rate of tendon. The opportunity of functional exercises after rotator cuff repairs is stil controversial, and there is no relevant system evaluation.
OBJECTIVE:To systematical y evaluate the differences in curative effects of early and delayed functional exercises after arthroscopic rotator cuff repairs.
METHODS:We searched the Pubmed, EMBASE, Cochrane Central Register of Control ed Clinical Trials, Chinese Biomedical Literature Database, Wanfang Data, China National Knowledge Infrastructure, and Chongqing VIP Database. The key words were“arthroscopy, rotator cuff, rehabilitation”. The references of the included literatures were re-retrieved. The deadline of retrieval was August 15, 2012. The included literatures were randomized control ed trials on early and delayed functional exercises after arthroscopic rotator cuff repairs. Methodological quality evaluation, screening and heterogeneous test were conducted. REVMAN5.1 software was utilized to analyze the extracted data.
RESULTS AND CONCLUSION:We included three randomized control ed trials, including 237 patients:119 in the early movement group and 118 in the delayed movement group. During fol ow-up at 1 year after operation, no significant differences in range of motion, pain degree, American Shoulder and Elbow Surgeons Scale, Simple Should Test scores and re-tear rate of rotator cuff were detected between the two groups. Results confirmed that compared with delayed functional exercises, early functional exercises after arthroscopic rotator cuff repair did not have advantages on the improvement of joint function and range of motion, but also did not negatively affect cuff healing. Postoperative rehabilitation can be modified to ensure patient’s compliance.

Objective:To explore the effects of Jianpi Huaji Fuzheng Decoction supplemented with conventional chemotherapy on Traditional Chinese Medicine (TCM) syndromes scores, cellular immunity and coagulation-fibrinolysis function in patients with primary hepatic carcinoma of spleen-deficiency syndrome.Methods:Prospective cohort study. A total of 85 patients with primary hepatic carcinoma of spleen-deficiency syndrome who met the inclusion criteria in the hospital between March 2018 and March 2021 were divided into 42 cases in control group and 43 cases in observation group according to the random number table method. The control group was given conventional western medicine chemotherapy, and the observation group was given Jianpi Huaji Fuzheng Decoction on the basis of the control group. Both groups were treated for 3 months. Before and after treatment, the TCM syndromes were scored. The levels of CD4 + and CD8 + were detected by flow cytometry with indirect immunofluorescence, and the ratio of CD4 +/CD8 + was calculated. The plasma prothrombin time (PT), fibrinogen (Fg) and coagulation factor Ⅶ (CFⅦ) were detected by automatic blood coagulation analyzer. The toxic and side effects of chemotherapy during treatment were recorded and the clinical efficacy was evaluated. Results:The total effective rate of syndrome efficacy was 95.35% (41/43) in observation group and 78.57% (33/42) in control group ( χ2=3.92, P=0.047). After treatment, the scores of flank pain, lumps, fatigue and jaundice and total score in observation group were significantly lower than those in the control group ( t=2.60, 2.64, 2.85, 2.91, 3.79, P<0.01). The level of CD4 + [(37.68±3.72)% vs. (35.92±3.61)%, t=2.21] and CD4 +/CD8 + [(1.44±0.22) vs. (1.31±0.23), t=2.66] in observation group were significantly higher than those in the control group ( P<0.05), while the level of CD8 + [(26.20±2.72)% vs. (27.44±2.16)%, t=2.32] was significantly lower than that of the control group ( P<0.05). The levels of Fg [(3.11±0.85) g/L vs. (2.74±0.72) g/L, t=2.16] and CFⅦ [(1.76±0.44) mg/L vs. (1.58±0.37) mg/L, t=2.04] were significantly higher than those in the control group ( P<0.05). PT [(14.65±2.72) s vs. (15.91±3.03) s, t=2.02] was significantly shorter than that of the control group ( P<0.05). During treatment, the incidence rate of toxic and side effects of chemotherapy was 11.63% (5/43) in observation group and that in control group was 30.95% (13/42) ( χ2=4.75, P=0.029). Conclusion:Jianpi Huaji Fuzheng Decoction supplemented with conventional chemotherapy can improve the clinical symptoms, promote the recovery of cellular immune function and coagulation-fibrinolysis function, reduce the incidence rates of toxic and side effects of chemotherapy, and enhance the clinical efficacy of patients with primary hepatic carcinoma.

This article reviews studies on the heredity of personality disorders and family environment factors from the population-based studies, and summarizes the interaction between genetic factors and environmental factors. Studies have shown that there is a genetic basis for personality disorders, including family studies, twin studies, and neurophysiological studies. In addition, environmental factors, including social psychological factors, also play an important role in the development of personality disorder. In sum, the occurrence of personality disorder is the result of interactions between genetic factors and environmental factors. This paper snmmarizes sresearch on personality disorders, and investigates the role of interaction between genetic and environmental factors in the development of personality disorders. Such evidence has implications for effective prevention and intervention of personality disorders.

Objective To detect the expression of EIF5A2 in hepatocellular carcinoma(HCC) and to explore its relation with clinicopathological characters and prognosis of HCC patients. Methods The expression of EIF5A2 mRNA and protein in 12 pairs of fresh HCC and corresponding non-tumor tissues adjacent to the cancer was examined by qRT-PCR and Western blot. The expression level of EIF5A2 in 284 pairs of HCC and adjacent non-tumor tissues was detected by IHC staining. Then we analyzed between EIF5A2 expression and clinical pathological parameters and prognosis of HCC patients. Results The relative expression levels of EIF5A2 mRNA and protein in fresh HCC tissues were significantly higher than those in the corresponding adjacent non-tumor tissues (t=5.305, P=0.0003; t=10.120, P < 0.001); EIF5A2 expression in 284 HCC tissues was significantly higher than that in the corresponding adjacent non-tumor tissues (z=-12.186, P < 0.001). The expression of EIF5A2 was significantly correlated with tumor size (χ²=13.079, P < 0.001), tumor multiplicity (χ²=4.589, P=0.032) and differentiation degree (χ²=4.844, P=0.028). The 3- and 5-year overall survival time and disease-free survival time of the patients with high expression of EIF5A2 were significantly shorter than those with low expression of EIF5A2 (P < 0.001). EIF5A2 was an independent prognostic factor affecting the 3- and 5-year overall survival time and disease-free survival time of HCC patients (P < 0.05). Conclusion The up-regulation of EIF5A2 expression may be related with the occurrence and development of hepatocellular carcinoma. The high expression of EIF5A2 is an independent influence factor for poor prognosis and EIF5A2 can be used as a potential molecular marker for predicting the prognosis of HCC patients.

Objective: To understand the epidemic trend of tobacco use among junior middle school students in Shunyi District of Beijing in recent 5 years, and to provide scientific basis for formulating adolescent tobacco control strategies and intervention measures. Methods: The two stage sampling method was used to survey 3 junior middle school schools randomly selected from Shunyi District, Beijing, in November 2013, December 2015 and November 2017. The number of students surveyed each year was 1 520, 1 404 and 1 467 respectively. Results: A total of 4 500 questionnaires were distributed and 4 391 questionnaires were valid, with an effective rate of 97.6%. The current smoking rate and the attempting smoking rate in Shunyi District junior high school students increased substantially, the difference was statistically significant(χ2=9.15, 11.54, P<0.01). The exposure rate of second-hand smoke among junior high school students in Shunyi District is increasing year by year. The current smoking rate and the attempting smoking rate of second-hand smoke at home and in public places were higher than those of non-exposed ones. The differences in the current smoking rates of junior high school students (χ2=25.86, 37.61, P<0.01) and the attempting smoking rate (χ2=49.51, 63-86, P<0.01) were statistically significant. The influence of Shunyi District junior high school students through different tobacco information access channels on the current smoking rate of junior high school students increased year by year. Different tobacco information access channels have significant difference in the influence of the junior middle school students’ attempting smoking rate(P<0.05). Conclusion The overall tobacco use of junior high school students in Shunyi District of Beijing is increasing by year. The exposure of second-hand smoke is not optimistic, and the supervision of tobacco information acquisition channels is urgent to be strengthened.

AIM: To establish an ultra high performance liquid chromatography (UPLC) method for the determination of micafungin in plasma of critically ill patients. And to establish a model for estimating the area under the concentration-time curve (AUC) of micafungin by limited sampling strategy. METHODS: Patients with severe infection were administrated with micafungin once a day, 1 h for each infusion. The blood samples were collected before administration and 1, 2, 4, 8, 12, 24 h after administration and were measured by UPLC. The pharmacokinetic parameters were calculated by Phoenix winnonlin 6.4, and the drug concentrations at 2-4 blood collection points were analyzed with SPSS 22.0 to establish limited sampling models. RESULTS: The calibration curve was linear over a concentration range of 1.0 to 50 μg/mL (r

Fibroblast growth factors (FGF) are a group of structurally related polypeptides which constitute an elaborate signaling system with their receptors. Evidence accumulated in the years suggests that the FGF family plays a key role in the repair of central nervous system injury. The main protective mechanisms include activating the expression of PI3K-Akt, peroxisome proliferator-activated receptor (PPARγ) and other signals; inhibiting NF-κB-mediated inflammatory response, oxidative stress and apoptosis; regulating neuronal differentiation and neuronal excitability as well as participating in protection of neurovascular units and nerve function repair. This paper comprehensively summarizes the latest research progress in FGF signaling related to diseases of the central nervous system such as cerebral infarction, cerebral hemorrhage, traumatic brain injury, Alzheimer's disease, Parkinson's disease, epilepsy and depression, aiming to provide scientific basis and reference for the development of innovative FGF drugs for the prevention and treatment of neurological diseases.
Humans ; Fibroblast Growth Factors ; Phosphatidylinositol 3-Kinases/metabolism* ; Central Nervous System/metabolism* ; Signal Transduction/physiology* ; Alzheimer Disease