Objective:To explore the clinical, imaging, and genetic characteristics of an adult patient with sporadic Neuronal intranuclear inclusion disease (NIID).Methods:A patient who had visited the First People′s Hospital of Chenzhou on August 6, 2023 was selected as the study subject. Results of clinical examination, neuroimaging, and genetic testing were retrospectively analyzed along with a literature review. The number of GGC trinucleotide repeats in the 5′-untranslated region of the NOTCH2NLC gene was determined by GC-PCR. Results:The patient had presented with episodic encephalopathy, with enhanced magnetic resonance imaging showing enhancement features of the posterior cerebral cortex during the period of acute episode. Genetic testing revealed an increased number of GGC repeats ( n = 97) in the 5′- untranslated region of the NOTCH2NLC gene, which confirmed the diagnosis of NIID. Conclusion:Clinical attention should be paid to the enhanced MRI findings of patients with adult-onset NIID, for whom posterior cortical enhancement may be characteristic manifestation during the acute phase of encephalopathy-like episode.

Objective:To explore the status and influencing factors of physical activity, sedentary behavior in middle-aged and elderly patients with stable coronary heart disease, and to provide reference for clinical medical staff to formulate targeted intervention measures.Methods:This was a cross-sectional survey. From March to June 2022, a convenience sampling was used to select 378 middle-aged and elderly patients with stable coronary heart disease in the ward and clinic of Department of Cardiology, Jinshan Hospital, Fudan University. The general information questionnaire, the International Physical Activity Questionnaire, the Adult Sedentary Behavior Questionnaire, the Tampa Scale for Kinesiophobia Heart, the Self-efficacy for Chronic Disease Scale and the Social Support Rating Scale were used for investigation.Results:The total metabolic equivalent of physical activity and sedentary time in middle-aged and elderly patients with stable coronary heart disease were 31.40 (21.73, 49.67) MET-h/w and 8(7, 9) h/d respectively. The 39.7% (150/378) patients reached physical activity guidelines recommendations and 61.4% (232/378) patients had a sedentary time ≥ 8 h/d. The 19.0% (72/378) patients were identified as physically active/low sedentary group, 20.6% (78/378) patients were identified as physically active/high sedentary group, 19.6% (74/378) patients were in physically inactive/low sedentary group and 40.7% (154/378) patients were in physically inactive/high sedentary group. The stepwise multiple regression analysis showed that sedentary behavior, working status, kinesiophobia, objective support and disease duration had significant impacts on physical activity ( t values were -9.81-2.67, all P<0.05). The influencing factors of sedentary behavior were physical activity, objective support, support utilization, gender, educational level and kinesiophobia ( t values were -10.77-4.63, all P<0.05). Conclusions:The status of physical activity, sedentary behavior in middle-aged and elderly patients with stable coronary heart disease is not good. Medical staff should intervene corresponding influencing factors to reduce the risk of physical inactivity and high sedentary behavior in this group.

Objective:To explore the clinical and imaging characteristics of patients with unruptured intracranial aneurysms accompanied by sentinel headache.Methods:Forty patients with unruptured intracranial aneurysms confirmed by DSA/CTA and accompanied by sentinel headache admitted to Department of Neurology, First Affiliated Hospital of Xiangnan University from January 2018 to August 2023 were selected as the study subjects; the clinical and imaging characteristics of these patients were summarized. Forty-four patients with unruptured intracranial aneurysms without sentinel headache and 40 patients with subarachnoid hemorrhage caused by ruptured intracranial aneurysms admitted to the hospital at the same period were selected as controls. The differences in aneurysm length (maximum diameter), morphology, tumor length (maximum diameter)/neck width (AR), and risk score for rupture of intracranial aneurysms (scores of population, hypertension, age, size of aneurysm, earlier aneurysm rupture, site of aneurysm [PHASES]) among the 3 groups were analyzed.Results:Among the 40 patients with unruptured intracranial aneurysms accompanied by sentinel headache, 20 (50%) presented with pain localized at the lateral frontal and orbital regions, 3 (7.5%) with pain at the posterior neck region, and 17 (42.5%) with irregular headache sites; 34 (85%) had new onset headache, and 6 (15%) had changes in headache nature besides chronic headache; 24 patients (60%) had posterior communicating artery aneurysm, 12 (30%) had internal carotid artery aneurysm, 1 (2.5%) had middle cerebral artery aneurysm, and 3 (7.5%) had vertebral artery dissection aneurysm; 36 (90%) had irregular aneurysm morphology. Compared with patients with unruptured intracranial aneurysms without sentinel headache, patients with unruptured intracranial aneurysms accompanied by sentinel headache and those with subarachnoid hemorrhage caused by ruptured intracranial aneurysms had larger aneurysm length (maximum diameter), higher proportion of irregular morphology, higher AR value, and higher PHASES scores, with significant differences ( P<0.05). Compared with patients with subarachnoid hemorrhage caused by ruptured intracranial aneurysms, patients with unruptured intracranial aneurysms accompanied by sentinel headache had larger aneurysm length (maximum diameter) and higher PHASES scores, with significant differences ( P<0.05). Conclusion:Sentinel headache is common in patients with unruptured posterior communicating artery aneurysms, and the relatively specific headache pattern is sudden periorbital pain or posterior neck pain; patients with unruptured intracranial aneurysms accompanied by sentinel headache have a higher rupture risk due to the larger size, more irregular shape, higher AR value of the aneurysm, therefore, same attention should be payed to these patients as those with ruptured aneurysms in clinical practice.

Objective:To investigate the clinical and imaging features of spontaneous convexal subarachnoid hemorrhage (cSAH) with acute cerebral infarction.Methods:Nine patients with cSAH complicated with acute cerebral infarction, admitted to our hospital from January 2018 to October 2021, were selected. The clinical data and efficacy of these patients were retrospectively analyzed.Results:The time from cSAH to the onset of acute cerebral infarction was 5-144 h, with median time of 2 d. The most common bleeding site of cSAH was the parietal lobe ( n=6); cSAH in the ipsilateral side of acute cerebral infarction was noted in 4 patients. Six patients had middle cerebral artery stenosis or occlusion, and 2 patients had anterior cerebral artery stenosis or occlusion. Hypertension ( n=7) was the most common primary disease; 7 patients were treated with antiplatelet drugs, anticoagulants and/or stents. The follow-up at 3 months after cSAH showed that 6 patients had good prognosis and one had poor prognosis. Conclusions:The cSAH often occurs 2 d after acute cerebral infarction; intracranial artery stenosis or occlusion may be the main cause of the disease. In patients complicated with cSAH, active antiplatelet, anticoagulation and/or stent therapy do not increase the risk of bleeding, and the prognosis is good.

Objective:To explore the application effect of transitional care mode (CTM) based on protective motivation theory (PMT) in patients with urinary calculus.Methods:A total of 156 patients with urinary calculus who were admitted to Henan Provincial People's Hospital from January to December 2019 were selected by the convenient sampling method. According to random number table method, they were divided into the control group and the observation group, with 78 cases in each group. The control group received routine nursing, while the observation group received CTM nursing based on PMT. The two groups were followed up for 1 year. The self-care ability, self-management efficiency score and recurrence rate of calculus were compared between the two groups before and after nursing intervention.Results:After 1 year of follow-up, the recurrence rate of calculus in the observation group was 1.28% (1/78) , lower than 8.97% (7/78) in the control group, and the difference was statistically significant ( P<0.05) . After nursing intervention, the self-care ability and self-management efficacy of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The implementation of PMT based CTM in patients with urinary calculus can reduce the recurrence rate of calculus and improve the self-care ability and self-management efficiency of patients.

Objective: To explore the effect of plan-do-check-act (PDCA) cycle on contraceptive methods after induced abortion in female college students. Methods: A total of 456 unmarried female college students who underwent artificial abortion in Tongde Hospital of Zhejiang Province from January 2018 to May 2019 were selected. These students were randomly divided into control group (n=228) and intervention group(n=228). Students from the control group accepted Post Abortion Care (PAC) service, while the intervention group accepted the management of PDCA cycle on basis of PAC services. Results: In the intervention group, the rate of highly effective contraception immediately after abortion and six months after abortion were 91.23% and 71.17% respectively, while in the control group were 82.89% and 60.00%, the intervention group was higher than the control group(χ2=7.03, 5.98, P<0.05). The rate of unsafe contraceptive in the intervention group six months after abortion was 3.60%, while in the control group was 20.00%, the intervention group was lower than the control group(χ2=28.35, P<0.05). Conclusion The PDCA cycle can effectively improve the utilization rate of high efficiency contraceptive methods after induced abortion in college students, reduce the rate of unsafe contraceptive six months after abortion, and it is helpful to reduce the incidence of short-term unplanned pregnancy after abortion.

Objective: To explore the effect of reproductive health education on health literacy of hospitalized female adolescents,and to provide reference for the protection of their physical and mental health. Methods: A total of 102 female adolescents who were hospitalized in department of gynaecology from January 2019 to December 2019 were selected for reproductive health education and questionnaire survey. Results: There were 65 cases of unplanned pregnancy (4 cases of tubal pregnancy), 18 cases of gynecological tumor (1 case of ovarian malignancy), 11 cases of gynecological inflammation (1 case of tubal abscess), and 8 cases of abnormal uterine bleeding (2 cases of blood transfusion).Eighty-six patients (84.3%) were treated surgically, 7 cases had their ovaries and/or fallopian tubes removed. After reproductive health education,health literacy of menstruation and ovulation, reproductive organ tumor, gynecological inflammation(inducing factors,clinical manifestations,harmfulness), harm of premature sexual life, scientific contraception, sexually transmitted diseases(types,transmission routes,preventioe measures), abortion hazard(short-term and longterm complications) and necessity of health examination improved significantly(χ2=14.8, 25.1, 15.7, 30.6, 18.6, 25.9, 31.1, 17.8, 19.1, 15.2, 40.1, 58.6, 69.8, P<0.05). Conclusion The lack of reproductive health knowledge of female hospitalized adolescents may lead to unplanned pregnancy, tumor, inflammation and abnormal uterine bleeding.Reproductive health education can significantly improve the health literacy of female adolescents and ensure their physical and mental health.

Objective: To understand the influence of post-abortion care (PAC) on the reproductive health of unmarried female college students,and to provide scientific basis for reproductive health education. Methods: A total of 486 unmarried female college students who received artificial abortion voluntarily due to unwanted pregnancy and had complete follow-up data were investigated by questionnaires before and six months after the operation from July 2017 to June 2018 in the Tongde hospital of Zhejiang Province. Results: There were 248 patients with abortion history, including 15 patients with abortion frequency ≥3 times.72 cases of high-risk abortion, the high-risk factors were re-abortion within half a year and the number of abortion ≥3 times; After PAC intervention, the awareness rate on menstruation and ovulation knowledge, scientific contraceptive knowledge, prevention of sexually transmitted diseases knowledge(types of diseases,raltes of transmission and preventive measures), and the harm of abortion knowledge(short-term and longterm complications), was higher than before(χ2=21.42, 69.65, 71.09, 52.80, 63.25, 187.59, 356.02, P<0.05). Before intervention, only 53.7% (261/486) of female college students used medium and low efficiency contraceptive measures, only 0.4% (2/486) were high-efficiency contraceptive measures. After intervention, all of them used contraceptive measures, The rate of effective contraceptive measures in the immediate and six months after operation was 85.4% (415/486) and 68.3% (332/486) respectively, which was significantly higher than before(χ2=786.10, P<0.05). Conclusion PAC service for female college students can improve awareness rate of sexual and reproductive health, enhance effective contraceptive measures, reduce the risk of repeated abortion.

In the original publication, the label of Fig. 2C should be read as "GFAP/lectin/DAPI" not "DMP1/GFAP/lectin/DAPI".

The blood-brain barrier (BBB) is a tight boundary formed between endothelial cells and astrocytes, which separates and protects brain from most pathogens as well as neural toxins in circulation. However, detailed molecular players involved in formation of BBB are not completely known. Dentin matrix protein 1 (DMP1)-proteoglycan (PG), which is known to be involved in mineralization of bones and dentin, is also expressed in soft tissues including brain with unknown functions. In the present study, we reported that DMP1-PG was expressed in brain astrocytes and enriched in BBB units. The only glycosylation site of DMP1 is serine89 (S89) in the N-terminal domain of the protein in mouse. Mutant mice with DMP1 point mutations changing S89 to glycine (S89G), which completely eradicated glycosylation of the protein, demonstrated severe BBB disruption. Another breed of DMP1 mutant mice, which lacked the C-terminal domain of DMP1, manifested normal BBB function. The polarity of S89G-DMP1 astrocytes was disrupted and cell-cell adhesion was loosened. Through a battery of analyses, we found that DMP1 glycosylation was critically required for astrocyte maturation both in vitro and in vivo. S89G-DMP1 mutant astrocytes failed to express aquaporin 4 and had reduced laminin and ZO1 expression, which resulted in disruption of BBB. Interestingly, overexpression of wild-type DMP1-PG in mouse brain driven by the nestin promoter elevated laminin and ZO1 expression beyond wild type levels and could effectively resisted intravenous mannitol-induced BBB reversible opening. Taken together, our study not only revealed a novel element, i.e., DMP1-PG, that regulated BBB formation, but also assigned a new function to DMP1-PG.
Animals ; Astrocytes ; cytology ; metabolism ; Blood-Brain Barrier ; cytology ; metabolism ; Cells, Cultured ; Extracellular Matrix Proteins ; genetics ; metabolism ; Female ; Glycosylation ; Male ; Mice ; Proteoglycans ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction