Objective:To test the reliability and validity of a multi-dimensional, quantitative video evaluation system (the Multi-dimensional system) for evaluating hand dysfunction among stroke survivors so as to provide an objective basis for its clinical application.Methods:Sixty stroke survivors with single dysfunctional hand were evaluated using the Multi-dimensional system and also using the Fugl-Meyer Upper Extremity Assessment (FMA-UE) and the Action Research Arm Test (ARAT) and in terms of their active range of hand motion (AROM-H). The Multi-dimensional system′s internal consistency, composite reliability, split-half reliability, parallel-forms reliability as well as intra- and inter-observer reliability were quantified. Its validity was tested in terms of content validity, structural validity, convergent validity and criterion validity.Results:The system′s Cronbach′s α was determined to be 0.86. Its one-dimension composite reliability was 0.939, its split-half reliability coefficient was 0.88 and its parallel-forms reliability was 0.922. The inter-evaluator reliability was between 0.965 and 0.998 [95%CI= (0.919, 0.999)], and the single evaluator ICC value was 0.973 to 0.998 [95%CI= (0.937, 0.999)]. The validity test produced a content validity index of 1, and the Pearson correlation coefficients between each sub-item and the total score were all greater than 0.60. The KMO value for structural validity was 0.882, and there was a common factor in the component matrix which reflected 60.9% of the information in the original variables. The system′s convergent validity AVE was 0.609 with Pearson correlation coefficients between the multidimensional system and the FMA-UE and ARAT both > 0.70.Conclusion:The multi-dimensional quantitative video evaluation system has good reliability and validity in the evaluation of stroke survivors with hand dysfunction.

Group A Streptococcus (GAS) is a very important pathogen, especially for children.On a global scale, GAS is an important cause of morbidity and mortality.But the burden of disease caused by GAS is still unknown in China and also has not obtained enough attention.For this purpose, the expert consensus is comprehensively described in diagnosis, treatment and prevention of GAS diseases in children, covering related aspects of pneumology, infectiology, immunology, microbiology, cardiology, nephrology, critical care medicine and preventive medicine.Accordingly, the consensus document was intended to improve management strategies of GAS disease in Chinese children.

Matching is a standard method for selecting research objects regarding the observational research, which controls confounding factors and improves statistical efficiency. However, its role in controlling confounding is not consistent in different observational studies. Matching can eliminate the confounding bias of matching variables in cohort studies, but checking on itself cannot eliminate confounding bias in case-control studies. In matched case-control studies, researchers may not accurately judge whether the variable is a confounder. Sometimes the variables that are not confounders are mistakenly matched. In that case, it will result in overmatching, which will lead to the decline of statistical efficiency or the introduction of unavoidable bias or increase of workload. If the real confounding factors are omitted, it will cause confounding bias. Therefore, researchers should consider what kind of matching variable selection criteria should be formulated. A directed acyclic graph is a visual graphic language that can show the complicated causality among different epidemiological research designs. This article analyzes the role of Matching in different observational research designs from the perspective of the directed acyclic graph, formulates the selection criteria for matching variables in matched case-control studies, and provides some reference suggestions for future epidemiological research design.

Objective:To investigate the influence of the prevalence and co-prevalence of risk factors for metabolic syndrome on the scores of different levels of metabolic syndrome in people receiving physical examination in Urumqi.Methods:Using the 2017 Xinjiang Health Examination Database, a total of 175 927 people from 7 districts and 1 county in Urumqi were selected as subjects. Face-to-face survey and body measurements were used to collect cardiovascular risk factors and metabolic syndrome scores. Metabolic syndrome scores were used. For the 0-5 points at 6 levels, χ2, χ2 trend test, correlation analysis of ordered variable Kendall’s tau-b, and logistic regression analysis of ordered results were used to analyze the influence of prevalence and co-prevalence of behavioral risk factors on the MS scores. Results:The percentages of 6 metabolic syndrome scores in the sample population were 23.82 %, 27.87 %, 22.41 %, 16.03 %, 8.02 %, and 1.85 %, respectively. The scores of metabolic syndrome were different in different age groups, ethnic groups, groups with different drinking rates, and groups with different dietary types, with the differences all significant ( P<0.05).The MS score in men increased with the increase of oil/salt rate and excessive drinking rate ( P<0.01). The score in women increased with the increase of the current smoking rate, oil/salt rate, and increased with the decrease of physical activity ( P≤0.01). There was no significant difference in the distribution of regular drinking rates between different score groups ( P>0.05). The scores of metabolic syndrome increased with the increase of risk factors ( P<0.05). Ordered results logistic analysis found that in the men with ≥3 risk factors and the metabolic syndrome score was 1.15 (1.06-1.26) times higher than that in the men without risk factor, as well as in women with 2 risk factors and≥3 risk factors. The metabolic syndrome scores were 1.38 (1.22-1.55), 2.02 (1.53-2.66) times higher than those in the women without risk factors. Conclusions:The physical examination group in Urumqi, the more the metabolic syndrome disease behavior risk factors clustered, the higher the metabolic syndrome score was. Therefore, comprehensive intervention measures should be taken to control the different forms of metabolic syndrome to prevent the occurrence and progress of the disease.

In recent decades, event-related potentials have been used for the clinical electrophysiological assessment of patients with disorders of consciousness (DOCs). In this paper, an oddball paradigm with two types of frequency-deviant stimulus (standard stimuli were pure tones of 1000 Hz; small deviant stimuli were pure tones of 1050 Hz; large deviant stimuli were pure tones of 1200 Hz) was applied to elicit mismatch negativity (MMN) in 30 patients with DOCs diagnosed using the JFK Coma Recovery Scale-Revised (CRS-R). The results showed that the peak amplitudes of MMN elicited by both large and small deviant stimuli were significantly different from baseline. In terms of the spatial properties of MMN, a significant interaction effect between conditions (small and large deviant stimuli) and electrode nodes was centered at the frontocentral area. Furthermore, correlation coefficients were calculated between MMN amplitudes and CRS-R scores for each electrode among all participants to generate topographic maps. Meanwhile, a significant negative correlation between the MMN amplitudes elicited by large deviant stimuli and the CRS-R scores was also found at the frontocentral area. In consequence, our results combine the above spatial properties of MMN in patients with DOCs, and provide a more precise location (frontocentral area) at which to evaluate the correlation between clinical electrophysiological assessment and the level of consciousness.
Acoustic Stimulation ; Adolescent ; Adult ; Aged ; Auditory Perception ; physiology ; Brain Injuries ; complications ; physiopathology ; Consciousness Disorders ; etiology ; physiopathology ; Electroencephalography ; Evoked Potentials ; Female ; Humans ; Male ; Middle Aged ; Neuropsychological Tests ; Severity of Illness Index ; Wavelet Analysis

Objective To investigate the feasibility of Multi-dimensional Visual Hand Function Rehabilitation Quantitative Assessment System in the assessment of hand function for stroke patients. Methods From November, 2017 to July, 2018, 17 stroke inpatients were assessed with Fugl-Meyer Assessment-upper extremities (FMA-UE) and the Multi-dimensional Assessment System. Results The results of Multi-dimensional Assessment System positively correlated with the score of FMA-UE (r = 0.609, P = 0.010). Conclusion The Multi-dimensional Visual Hand Function Rehabilitation Quantitative Assessment System can be used to assess the hand function for stroke patients quantitatively.

Objective To reduce the dose to organ at risk ( OAR) by script-based optimizing the gantry angles of tangential beams for forward-planned intensity-modulated breast radiotherapy ( fIMRT ) plans. Methods A total of 46 patients with breast cancer (26 in left and 20 in right) after conservative surgery who were treated with manually planned fIMRT were retrospectively re-planned using a script to place the tangential beams automatically. The script program was developed using Pinnacle3 scripting language as imbedded in the Pinnacle3 treatment planning system, and the Python scripting language. Dosimetric indices, including V20 of the ipsilateral lung, D1 of the contralateral breast and V10 of the heart were extracted by the script for plans of different gantry angles. Then the optimal tangential angles were selected by a penalty function. Results For the 26 left breast cancer cases, V20 of the ipsilateral lung for manual and script were (18.2 ±3.4)% and (18.1 ±3.4)%, respectively(P>0.05), while D1 of the contra-lateral breast(249. 2 ± 88. 4) cGy and (230. 4 ± 80. 2) cGy, respectively( t=2. 27, P<0. 05), V10 of the heart (13. 7 ± 5. 7)% and (13. 1 ± 5. 7)%(t=2. 82, P<0. 05). The V20 of the ipsilateral lung of the 20 right breast cancer cases were (19. 8 ± 3. 8)% and (19. 8 ± 3. 9)%, respectively(P>0. 05). The script plans achieved better V10 of the heart[(298. 0 ± 239. 7) cGy] than the manual plans[(340. 0 ± 286. 2) cGy] (t =2. 53, P <0. 05). Conclusions Compared with the manualmethod, the script can assess of the impact of tangential beam angles on the OAR dose, patient-specifically and quantitatively, hence make better trade-offs and improve the plan quality.

Objective To observe the clinical effect of mesalazine combined with bifidobacterium in the treatment of ulcerative colitis and its effect on serum inflammatory cytokines.Methods 80 patients with ulcerative colitis were selected as the subjects.Auording to the digital table,the patients were randomly divided into observation group(40 cases) and control group(40 cases) by random number tables.The control group was treated with oral mesalazine only.The observation group was treated with bifidobacterium on the basis of the control group.Both two groups were treated for 8 weeks.Before and after treatment,the symptoms and microscopic manifestations were observed.The levels of CRP,TNF-α,IL-6 and IL-8 in venous blood were measured before and after treatment in the morning,and the clinical curative effect was evaluated.Results The proportions of diarrhea,abdominal pain and mucus bloody in the control group and the observation group were 20.0％ and 0.0％,22.5％ and 2.5％,20.0％ and 0.0％,respectively,which were significantly lower than those before treatment (x2 =46.036,72.381,26.467,52.379,22.175,48.000,all P ＜ 0.01).The improvement of diarrhea,abdominal pain and mucus bloody of the observation group was better than those of the control group(x2 =8.941,7.895,9.574,all P ＜ 0.05).The percentages of ulcers,erosions and bleeding points in the observation group and the control group were 22.5％ and 5.0％,32.5％and 10.0％,37.5％ and 7.5％,respectively,which were significantly lower than those before treatment (x2 =31.427,48.813,12.832,32.273,29.574,64.962,all P ＜ 0.01).The improvement of ulcer,erosive and bleeding in the observation group was better than those in the control group (x2 =5.084,6.74,10.853,all P ＜ 0.05).The levels of CRP,TNF-αt,IL-6 and IL-8 in the control group and observation group were (13.6 ± 3.6)mg/L and (7.8 ±1.2)mg/L,(28.4 ±9.6)ng/L and (15.6 ±7.1)ng/L,(141.3 ±21.4) ng/L and (90.5 ± 14.7) ng/L,(202.4 ±32.8) ng/L and (155.2 ± 25.4)ng/L,respectively,which were significantly lower than those before treatment (t =15.525 and 20.672,13.851 and 17.524,8.243 and 12.021,9.101 and 11.132,all P＜0.01),the CRP,TNF-α,IL-6 and IL-8 levels in the observation group were significantly lower than those in the control group (t =7.456,6.325,7.543,all P ＜ 0.01).The effective rate in the observation group was 97.5 ％ (39/40),which was significantly higher than that in the control group (77.5 ％,31/40),the difference was statistically significant (x2 =7.680,P ＜0.05).Conclusion Mesalazine combined with bifidobacterium has exact clinical effect in the treatment of ulcerative colitis,it is more effective in improving clinical symptoms and microscopic manifestations,and can reduce the level of serum proinflammatory cytokines.It is worthy to be used.

Objective To investigate the prevalence and risk factors of chronic kidney disease (CKD) in Chengdu urban population and the prevalence of CKD in risk population.Methods Questionnaire (anamnesis,smoking,drink) of risk factors of CKD and somatoscopy (blood pressure,body height and body weight) were caried out in railman of Chengdu urban.Their blood and urine indicators (blood sugar,blood lipid,blood uric acid,blood creatinine,uromicroprotein/creatinine ratio,routine urine examination,etc) were measured.The prevalence and risk factors of CKD in Chengdu urban population and the prevalence of CKD in risk population were elucidated.Results Eligible data of 5326 subjects were enrolled in the study.After the adjustment of age and gender component,the prevalence of albuminuria was 11.54％,reduced eGFR was 5.54％,hematuria was 3.87％,and CKD was 18.32％; the recognition was 1.93％.In addition,the prevalence of albuminuria was respectively 23.79％,28.00％,14.08％; prevalence of reduced eGFR was respectively 4.76％,4.53％,3.26％; prevalence of hematuria was respectively 2.94％,3.20％,2.37％ in 3098 people with hypertension,diabetes or hyperlipaemia.Independent risk factors of albuminuria were female,hypertension,diabetes,hyperlipemia and high BMI.Independent risk factors of reduced eGFR were female,age,hyperuricemia and hypertension.Drink was negatively correlated with reduced eGFR.Independent risk factors of hematuria were female and age.Conclusions The prevalence of CKD is quite high and the recognition rate is low in the Chengdu urban populaton.Risk factors of CKD are age,female,diabetes,hypertension,hyperlipemia,hyperuricemia and high BMI.Control of the development of metabolic disease can reduce the CKD.

Hot spots and cold spots always appear in the matched region of electron-photon fields. The degree of this kind of dose heterogeneity depends on the physical characteristic of a treatment unit and the energy of electrons. In this paper, a set of dosimetric parameters have been measured on electron rays and x rays for the Elekta Precise treatment unit and the Elekta Synergy treatment unit, respectively. The hot spots and cold spots in the region of perpendicular electron-photon matching fields have been analysed quantitatively. The method to extend penumbra for photon beam profiles was proposed for improving the dose uniformity in the matched regions. And the dose profiles in the matched regions for different treatment units were compared. The results showed that there were stronger hot spots and cold spots for treatment unit with smaller penumbra for photon beams either under the condition of unmodified photon beam profile or the condition of modified photon beam profile.
Computer Simulation ; Electrons ; Head and Neck Neoplasms ; radiotherapy ; Humans ; Models, Theoretical ; Photons ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; methods ; Radiotherapy, High-Energy