Objective To evaluate the feasibility of using a microsensor motion capture unit (MCU) to assess the reaching characteristics of hemiplegic stroke patients. Methods Twenty-three hemiplegic stroke patients with an average age of (61 ± 11) years and ten normal subjects of matching age were asked to sit on a chair and use the affected arm (for the patients) or the right arm (for the normal subjects) to reach for a cup on a table just in front of the shoulder at arm's length away.Four small sensor boxes which could detect movement and its speed and smoothness in three dimensions were fixed to the subject's spine,upper arm,forearm and hand.The test was repeated four times after two trial runs.The average velocity,peak velocity,degree of joint dispersion,entropy of acceleration,joint coordination and active range of motion ( AROM ) of the shoulder were analyzed.The patients and normal subjects were statistically compared.The results were correlated with Fugl-Meyer upper extremity scores using Spearman correlation analysis. Results All of the measured variables showed significant differences between the patients and normal subjects.In the correlation study,the average velocity,peak velocity,AROM of the shoulder and joint coordination showed significant correlation with the Fugl-Meyer scores.There was,however,no significant correlation between degree of dispersion of the shoulder or elbow joints or the entropy of acceleration ( which represented the quality of movement) and Fugl-Meyer upper extremity scores. Conclusions The results suggest that microsensor MCUs can quantitatively assess the kinematics of reaching among hemiplegic stroke patients.They can provide valuable and objective data about the functional quality of multiple joint movements in three dimensions.

We identified and characterized the full-length genome of a GI.8 norovirus strain CHN/Huzhou/N10 isolated in an outbreak in Huzhou,China.The full-length genome of CHN/Huzhou/N10 was amplified using five pairs of primers which were designed according to the full-length GI norovirus genome sequences published in GenBank database.Multiple alignments were performed using DNAStar,the phylogenetic relationship of CHN/Huzhou/N10 and the representative NoV (Norovirus) strains from each genogroup were assessed using the software MEGA version 6.0.The viral genome of CHN/Huzhou/N10 was 7 740 nucleotides in length,which was consist of three ORFs spanning 5-5 404 nt (ORF1),5 388-7 019 nt(ORF2),and 7 019-7 660 nt (ORF3),respectively.Phylogenetic analysis based on polymerase and capsid sequences VP1 and VP2 region indicated that CHN/Huzhou/N10 belonged to GI.8 genotype.The amino acid sequence analysis of the VP1 region showed that CHN/Huzhou/N10 had 16 mutations compared with the representative strain Boxer/2001/US,12 of these variations were located in the P2 subregion.Moreover,a single amino acid change (T347S) occurred at histo-blood group antigen (HBGA) binding site Ⅱ and another single amino acid change (T397E) occurred at HBGA binding site Ⅲ.In this study,the first full genome of norovirus GI.8 isolated in Huzhou,China was extensively characterized.The data would be helpful not only for the epidemiology study,but also for the diagnostic tool development and effective vaccine design in the future.

Objective To observe the clinical efficacy of ZHU Lian's acupuncture-activatingmethod in treating deglutition disorder due to pseudobulbar palsy after cerebral stroke.Method Sixty patients with deglutition disorder due to pseudobulbar palsy after cerebral stroke in acute stage were randomized into an observation group and a control group, 30 cases in each group. The two groups both received symptomatic neurological treatment. In the two groups, acupoints including Lianquan (CV23), Huiyan (Extra), Baihui (GV20), and bilateral Shuaigu (GB8), Wangu (GB12), Zhaohai (KI6), Lieque (LU7),and Yinlingquan (SP9) were selected. The observation group was intervened by ZHU Lian's acupuncture-activating method; the control group was intervened by ordinary needling method plus G6805 therapeutic appliance with sparse-dense wave for 20 min. Prior tothe treatment and after 10 treatment courses, the two groups were evaluated by using Videofluoroscopic Swallowing Study (VFSS) and Kubota's water drinking test for swallowing function.Result After 10 treatment courses, the total effective rate was 96.7%in the observation group versus 83.3% in the control group, and the between-group difference was statistically significant (P<0.05); the VFSS score in the observation group was significantly different from that in the control group (P<0.01); the water drinking test score in the observation group was significantly different from that in the control group (P<0.01). The results indicated that the therapeutic efficacy was more significant in the observation group compared to that in the control group.Conclusion ZHU Lian's acupuncture-activating method can produce a more significant efficacy in treating deglutition disorder due to pseudobulbar palsy after cerebral stroke in acute stage compared with sparse-dense-wave electroacupuncture.

Objective To assess the reaching ability of hemiplegic stroke survivors using a motion capture unit (MCU) combined with surface electromyography (sEMG).Methods Sixteen stroke survivors with hemiplegia formed the experimental group,while healthy counterparts were selected as the control group.Both groups were asked to sit on a chair and reach for a cup on a table in front of their shoulder at arm's length using their affected arms in the experimental group and their right arms in the control group.MCUs were fixed on their spines and arms to obtain kinematic signals,and the sEMG signals of the trapezius,the anterior deltoids,biceps and triceps of the tested limb were recorded.Each subject repeated the test 3 times,and the best result was retained for further analysis.After signal processing,the range of movement of the shoulders and elbows was extracted along with the time used to reach the cup,peak angular velocity,time to peak velocity of the shoulders and elbows,work of the muscles and work ratios of the trapezius/deltoid and biceps/triceps.The upper limb section of the Fugl-Meyer assessment (FMA) was also administered to evaluate the patients' upper limb function.Independent sample rank sum tests compared the patients with the controls in terms of kinematics and sEMG parameters.Spearman analysis was used to explore the correlation between the FMA scores and the kinematics and sEMG characteristics.Results Significant differences in the kinematic and myoelectric indicators were found between the patients and the controls.The average FMA score of the patients was correlated with the peak velocity of the shoulder joint.Moreover,the ROM of the shoulder was closely related to the work of the trapezius,while the time for the shoulder joint to reach peak velocity was closely related to the work ratio of the biceps and triceps.Conclusion An MCU integrated with synchronous sEMG can quantitatively assess the kinematics and kinetics of hemiplegic stroke survivors,at least in reaching.This can provide objective guidance to optimize clinical rehabilitation.

The construction of featured specialties is the current development strategy of community health service institutions to improve the service scope and to meet the health needs of residents. The rehabilitation medicine has undergone 12 years of development and become a relatively mature featured specialty in Fenglin Community Health Service Center. Based on the Fenglin′s experience, this article discusses the development status and restriction bottlenecks of general practice, and the development status and trend of rehabilitation medicine in the community; and also explores the integrated development model of community-featured specialty with general practice.

Community health institutions have entered a new development stage of featured specialty construction. After 12 years of development, rehabilitation medicine now is the featured specialty of Fenglin Community Health Service Center. This article presents the train of thought and key points of specialty construction in primary care institutions based on the Fenglin′s experience. The positioning of featured specialty should be based on the community. The construction process should include 7 elements, namely, the standard operation procedure(SOP)of service system construction, the detailed publicity and implementation of the collaboration of specialists, prevention and control knowledge promotion for general practitioners, prevention and control knowledge education for community residents, service list, clinical efficacy evaluation, and clinical database. In the later iterations, the head of the department should always focus on the service system construction SOP and clinical database construction, and the rest parts can be assigned to the relevant team members.

Objective To investigate gene pathways associated with severe acne.Methods Kyoto encyclopedia of genes and genomes (KEGG)-based pathway analysis was conducted using the genome-wide association study (GWAS) data on 1 056 patients with severe acne and 1 056 healthy controls,and each testee was tested for 900 015 SNPs.A hypergeometric distribution test was used to analyze the relationship between each pathway and severe acne,and the false discovery rate (FDR) to correct for multiple testing.Any pathway with an adjusted P value of ＜ 0.05 was considered to be associated with severe acne.Results Twelve genes were identified to be associated with severe acne (P ＜ 0.001),including TMPRSS11E,DDB2,RIC1,CLLU1OS,IL3,PLA2G4B,SLC16A14,SOX17,FAHD2A,ENTPD7,MRPL50 and TXLNB.Pathway analysis revealed 5 pathways associated with severe acne (adjusted P ＜ 0.05),including the prolactin signaling pathway,hepatitis C,renal cell carcinoma,high affinity receptor for immunoglobulin E (Fc epsilon RI) signaling pathway,and tyrosine metabolism.Conclusion The 5 identified pathways are associated with severe acne,which affect the endocrine,immune and metabolic processes in the human body.

Objective To obtain more insight into the genetic and structural bases of the selective advantage of new GGⅡ.4 variants over the old GGⅡ.4 variants.Methods We sequenced the complete capsid of 13 full-length GⅡ.4 norovirus virus VP1 region from 2008 to 2014 and find the key variable sites.Results GⅡ.4 norovirus virus has gone though three big variation during the past seven years.The noroviruses in 2008 and 2009 were the 2006b variant; virus detected in 2010 and 2011 were the 2010 variant ; virus detected in 2012-2014 were the latest 2012 variant.At the amino acid level,we found 77 information sites (540 amino acids in the 14.3％).39 of them located in the P2 region,N-terminal,4; S region,18; P1 region,16.Conclusions GⅡ.4 noroviruses have been recognized as a leading cause of severe viral gastroenteritis worldwide.During the past decades,four worldwide epidemics of acute gastroenteritis caused by emerging variants of GGⅡ.4 noroviruses have been described.Emerging new variant lineages replaced the previously circulating dominant types rapidly and completely.

Objective:To explore the protective mechanism of Xuebijing injection (referred to as Xuebijing) on sepsis-associated acute respiratory distress syndrome (ARDS).Methods:① Animal experiments: 100 mice were randomly(random number) divided into 4 groups, including sham operation (Sham) group, cecal ligation and puncture (CLP) group, CLP+low-dose Xuebijing (L-XBJ) group, and CLP+high-dose Xuebijing (H-XBJ) group. The survival rate, lung histological changes, lung wet/dry (W/D) ratio, cell count and protein concentration in bronchoalveolar lavage fluids (BALF), inflammatory factors levels in serum, oxidative stress indicators, cell apoptosis, and key proteins of HIF-1α/p38 MAPK/NF-κB signaling pathway were measured. ② Cell experiments: Mouse alveolar macrophages (MH-S) were cultured in vitro and divided into 6 groups, including control (Con) group, lipopolysaccharide (LPS) group, LPS+L-XBJ group, and LPS+H-XBJ group, LPS+H-XBJ+ dimethyloxallyl glycine (DMOG, HIF-1α activator) group, LPS+H-XBJ+ 2-methoxyestradiol (2ME2, HIF-1α inhibitor) group. The effects of Xuebijing on inflammatory factors, oxidative stress, and cell apoptosis and their relationship with HIF-1α/p38 MAPK/NF-κB signaling pathway were detected.Results:Xuebijing increased the survival rate of mice with sepsis-associated ARDS, relieved lung tissue damage [lung injury score: CLP group (8.778±0.588), CLP+L-XBJ group (5.833±0.310), and CLP+H-XBJ group (4.750±0.246)], alleviated lung W/D ratio, and decreased pneumonia cell infiltration and protein exudation (all P<0.05). Additionally, Xuebijing treatment also diminished the expression of inflammatory factors (TNF-α, IL-1β, and IL-6), intracellular reactive oxygen species (ROS) accumulation, malondialdehyde (MDA) formation, superoxide dismutase (SOD) depletion, and cell apoptosis in LPS-induced MH-S cells and CLP-induced sepsis-associated ARDS mice (all P<0.05). Furthermore, mechanistic investigation further clarified the effects of Xuebijing on inflammation, oxidative stress, and cell apoptosis through the HIF-1α/p38 MAPK/NF-κB signaling pathway. Conclusions:Xuebijing can exert anti-inflammatory, anti-oxidative, and anti-apoptotic effects by suppressing the HIF-1α/p38 MAPK/NF-κB signaling pathway, thereby conferring protection against sepsis-associated ARDS.

Objective By population survey,to explore the epidemiological characteristics of gastric precancerous lesions in Lishui District of Nanjing and provide objective basis for the prevention and treatment of early gastric cancer.Methods From July 2021 to December 2022,21 977 patients who received endoscopy and/or 13C-UBT in Lishui District People's Hospital and 6 medical community units in Nanjing City were retrospectively analyzed for demography characteristics,detection rate of gastric precancerous lesions,and H.Pylori infection rate.Results(1)590 cases of gastric precancerous lesions were detected(detection rate 2.68%);(2)The total detection rate of precancerous lesions and three pathological types in males were all higher than those in females(all P<0.001);(3)The minimum age for the total detection rate of precancerous lesions in males and the mini-mum age for each pathological type were lower than in females(P<0.001,0.009,0.005,0.002);(4)The popu-lation total H.pylori infection rate was 23.10%,the H.pylori infection rate in patients with precancerous lesions was higher than that in non-precancerous lesions(P<0.001),both H.pylori infection rate of male and female in precancerous lesions were all higher than those of non-precancerous lesions of the same sex(all P<0.001),in addition,the H.pylori infection rate of male whether in precancerous or non-precancerous lesions was higher than that of female(all P<0.001);(5)The precancerous lesions detection rate in male,female,and the overall age range of 20～29 to 70～79 years is positively correlated with age growth(P<0.001),and rapidly decreases after the age of 79,the of H.pylori infection rate was also positively correlated with age growth(P<0.001),and the trend of age change(P<0.001)was parallel to the precancerous lesions detection rate.Conclusions The detec-tion rate of gastric precancerous lesions in this region is above the average level in China;the total H.pylori infec-tion rate is at a relatively low level in China;the H.pylori infection rate is parallel to the age trend of the detection rate of gastric precancerous lesions,and increases with age.