Duchenne muscular dystrophy(DMD)is a fatal muscular wasting disease in children.Because of various factors such as DMDˊs low incidence,quick progression,limited knowledge of this disease,and treat-ment outcomes of respiratory failure,heart failure has become the leading cause of death in these patients.Early diagnosis and treatment is essential for prolonging the survival time and improving the quality of life.This review describes recent progress in the study of epidemiology,pathogenesis,early diagnosis,prevention and treatment of cardiac injury in patients with DMD.

Objective To investigate the prognostic value of decreased vasopressin (VP)modulation in the late-phase of septic shock. Methods A prospective study was conducted. Fifty-five septic shock patients hospitalized in intensive care unit (ICU)of the First Hospital of Hebei Medical University from January 2012 to February 2014 were enrolled. All patients received 3% hypertonic saline solution infusion. Serum concentrations of sodium and VP were measured before and after hypertonic saline solution infusion. Patients with ratio of difference in sodium and VP before and after infusion of 3%hypertonic saline (△VP/△Na)≤0.5 pg/mmol were defined as non-responders,and who>0.5 pg/mmol were defined as responders. The levels of lactic acid,C-reactive protein (CRP),and vasoactive drug〔dopamine(DA)and norepinephrine(NE)〕usage between the two groups were compared. The 28-day mortality,live time in the dead,and ICU day in survivors were analyzed between the two groups. The receiver operating characteristic curve (ROC curve)was drawn to assess prognostic value of VP. Results There were 30 cases (54.5%) in non-responsive group,and 25 (45.5%)in responsive group. There were no significant differences in the age,acute physiology and chronic health evaluationⅡ (APACHEⅡ)score,central venous pressure (CVP),blood pressure, plasma albumin level,sodium level before and after hypertonic saline solution infusion between the two groups. The baseline level of VP in the non-responsive group was markedly lower than that of the responsive group (ng/L:10.66± 1.57 vs. 17.13 ±5.12,t=6.091,P<0.001). After hypertonic saline solution infusion,the VP level was also significantly decreased compared with that in the responsive group(ng/L:11.65±1.74 vs. 22.50±5.31,t=9.758,P<0.001). The non-responders showed higher lactic acid (mmol/L:3.04±0.55 vs. 2.28±0.38,t=-5.881,P<0.001) and CRP (mg/L:117.9±23.0 vs. 94.9±17.0,t=-4.143,P<0.001),and received larger dosage of vasoactive drugs〔DA(μg·kg-1·min-1):14.8±3.9 vs. 8.9±1.6,t=-5.725,P<0.001;NE(μg·kg-1·min-1):0.96±0.42 vs. 0.40± 0.09,t=-5.625,P<0.001〕for maintaining blood pressure compared with those in responders. The non-responsive group showed higher 28-day mortality(66.7%vs. 40.0%,χ2=3.911,P=0.048)and longer ICU day(days:9.9±2.3 vs. 6.7±1.7,t=-4.044,P<0.001),but the live time in the dead showed no difference between non-responsive group and responsive group(days:5.8±1.9 vs. 6.1±2.3,t=0.384,P=0.704). ROC curve showed that the area under ROC curve(AUC)forΔVP/ΔNa predicting the outcome was 0.828,and theΔVP/ΔNa threshold value of 0.5 pg/mmol had the sensitivity of 66.7%and specificity of 64.0%for prediction of the outcome(95%confidence interval:0.722-0.934). Conclusion Osmotic pressure-regulated VP secretion was impaired and decreased in the late-phase of septic shock, and made the sense in prognosis.

Objective:To investigate the application effects of MOTOmed in stepped individualized rehabilitation intervention of older adult patients with post-stroke hemiplegia.Methods:A total of 130 older adult patients with post-stroke hemiplegia who received treatment in the Affiliated People's Hospital of Ningbo University from June 2019 to June 2021 were included in this study. They were randomly assigned to undergo either stepped individualized rehabilitation intervention with MOTOmed training system (observation group, n = 65) or routine rehabilitation intervention (control group, n = 65) for 1 month. Before and after intervention, the Fugl- Meyer Assessment score, Berg Balance Scale score, Functional Ambulation Category scale score, modified Ashworth scale score, and modified Barthel Index, Self-Perceived Burden Scale score, nerve growth factor, brain-derived neurotrophic factor and neurotrophin 3 levels were compared between the two groups. Results:After intervention, Fugl-Meyer Assessment and Berg Balance Scale scores in the observation groups were (75.48 ± 6.54) points and (48.55 ± 5.18) points, which were significantly greater than (72.55 ± 6.33) points and (46.50 ± 4.79) points in the control group ( t = 2.59, 2.34, both P < 0.05). Functional Ambulation Category scale score in the observation group was significantly higher than that in the control group [(3.22 ± 0.43) points vs. (3.05 ± 0.39) points, t = 2.36, P < 0.05). Modified Ashworth scale score in the observation group was significantly lower than that in the control group [(1.23 ± 0.24) points vs. (1.33 ± 0.26) points, t = 2.27, P < 0.05). Modified Barthel Index score in the observation group was significantly higher than that in the control group [(59.32 ± 5.18) points vs. (57.33 ± 4.92) points, t = 2.24, P < 0.05]. There was no significant difference in Self-Perceived Burden Scale score between the two groups ( t = 1.64, P > 0.05). Nerve growth factor level in the observation group was significantly higher than that in the control group [(12.93 ± 2.31) ng/L vs. (12.06 ± 2.29) ng/L, t = 2.15, P < 0.05]. There were no significant differences in brain-derived neurotrophic factor and neurotrophin 3 levels between the two groups ( t = 0.91, 1.25, both P > 0.05). Conclusion:The stepped individualized rehabilitation intervention with MOTOmed training system can greatly improve the limb function, balance ability, walking ability and self-care ability, reduce muscle tension, and increase nerve growth factor level in older adult patients with post-stroke hemiplegia, which are conducive to the rehabilitation and prognosis of post-stroke hemiplegia.

The status of lymph node metastasis is an important prognostic factor for many malignant tumors, including lung cancer. In the 8th edition of the TNM staging system for lung cancer, the T staging had obvious changes and refinements, but the N staging had little changes. Recently, several studies have found that the prognosis of patients with the same N stage can vary greatly, suggesting that a more detailed subgroup of patients with the same N stage should be subdivided, including the inclusion of extra-capsular lymph node metastases (ENE). In this review, we reviewed the definition, classification/grading, imaging diagnosis, pathological diagnosis, related molecular markers and their relationship with the prognosis of lung cancer patients.