Objective:To investigate the effect of shoulder girdle strengthening exercise combined with acupuncture and rehabilitation exercise on the recovery of stroke patients with hemiplegic shoulder pain.Method:Eighty-six stroke patients with hemiplegic shoulder pain who received treatment in the Department of Neurology of Ningbo No. 6 Hospital from January 2017 to December 2019 were included in this study. They were randomly assigned to undergo rehabilitation exercise and acupuncture (control group, n = 41) or shoulder girdle strengthening exercise combined with acupuncture and rehabilitation exercise (observation group, n = 45) for 8 successive weeks. The recovery of limb function, activities of daily living and shoulder pain were evaluated. Results:After intervention, the Visual Analogue Scale score in the observation group was significantly lower than that in the control group [(1.14 ± 0.48) points vs. (3.01 ± 0.62) points, t = 15.530, P < 0.05]. The Fugl-Meyer assessment score in the observation group was significantly higher than that in the control group [(42.68 ± 5.46) points vs. (30.78 ± 4.93) points, t = 10.622, P < 0.05]. The modified Barthel index in the observation group was significantly higher than that in the control group [(82.75 ± 8.93) vs. (71.48 ± 9.06), t = 5.801, all P < 0.05]. Conclusion:Shoulder girdle strengthening exercise combined with acupuncture and rehabilitation exercise can help improve patient’s ability of daily living and strengthen limb function. This treatment method is of great clinical significance and worthy of clinical popularization.

Objective To evaluate the efficacy and safety of low?level laser therapy(LLLT)for androgenetic alopecia, and to compare the therapeutic effect of LLLT alone versus in combination with finasteride tablets. Methods Thirty?nine male patients were randomly divided into the LLLT group(n=21)and combination group(n=18)to be treated with LLLT alone or in combination with oral finasteride tablets(1 mg/d)for 6 months. LLLT was given twice a week, and each session lasted 30 minutes. All the patients were photographed and asked to fill a questionnaire about subjective symptoms, and hair density (the number of hairs per unit area on the scalp) was determined by using a dermatoscope to evaluate the grade of alopecia, before the treatment, and 3 and 6 months after the treatment. Results The hair density in the LLLT group was significantly higher after 6 months than after 3 months of treatment and before the treatment(184.59 ± 21.17 vs. 169.24 ± 29.21 and 166.67 ± 32.94 hairs/cm2, both P<0.05), but was insignificantly different between before and after 3 months of treatment (P > 0.05). The hair density in the combination group significantly increased after 6 and 3 months of treatment compared with that before the treatment(201.80 ± 16.55 and 186.39 ± 17.97 vs. 157.85 ± 27.97 hairs/cm2, both P < 0.05), and was significantly higher after 6 months than after 3 months of treatment(P<0.05). No significant difference was observed in hair density between the two groups before the treatment(P>0.05), but the combination group showed increased hair density compared with the LLLT group after 3 and 6 months of treatment(both P<0.05). After 6 months of treatment, LLLT alone was effective in 17 patients, but ineffective in 4 patients, and the combination therapy was effective in 16 patients, but ineffective in 2 patients, with no significant difference in the response rate between the LLLT group and combination group (χ2 = 0.057, P > 0.05). During the treatment, 24(62%)patients felt less greasy, and 22(56%)reported less hair loss, with no discomforts reported by the patients except local warm feeling. Conclusion LLLT is indeed effective for the treatment of androgenetic alopecia with no adverse reactions.

Objective To determine the factors influencing the results of open reduction and internal fixation for displaced intra-articular calcaneal fracture (DIACF).Methods From May 2009 to June 2013, 80 patients with DIACF involving in 91 feet were treated by open reduction and internal fixation.Mean age was 38.7 years (range, 18-72 years).Patients were grouped according to the possible factors related to the operative results, including the Sanders classification of fracture, quality of fracture reduction, postoperative B(o)hler angle, width of postoperative calcaneus, and time to surgery after injury.Clinical result was evaluated and compared within each group.Results Mean duration of follow-up was 18.3 months (range, 14-26 months).The clinical results were excellent for 67 feet (74％), good for 12 feet (13％), fair for 7 feet (8％) and poor for 5 feet (5％), which yielded 87％ good to excellent results.Good to excellent results in Sanders Ⅱ , Ⅲ and Ⅳ groups reached 94％, 85％ and 53％ respectively, in quality of fracture reduction ≤ 2 mm and ＞ 2 mm groups reached 93％ and 30％ respectively, in postoperative B(o)hler angle ＜ 15° and ≥15° groups reached 33％ and 90％ respectively;in broadening of postoperative calcaneus ＜ 1 cm and ≥ 1 cm groups reached 92％ and 17％ respectively, in time to surgery after injury ≤14 days and ＞ 14 days groups reached 91％ and 43％ respectively, in age ≤60 years old and ＞ 60 years old groups reached 85％ and 88％ respectively.Except for the age group, the clinical result differed significantly within group (P ＜ 0.05).Conclusions Fracture type, reduction quality, postoperative B(o)hler angle, width of postoperative calcaneus, time to surgery after injury are the factors influencing on the operative results of patients with displaced intra-articular calcaneal fracture.Thereupon the unfavorable influences should be avoided to improve the operative results.

Objective: To explore the correlation between depression severity and neurocognitive function in patients with late-onset depression . Methods: The patients with late-onset depression treated in Jinhua Second hospital from February 2015 to December 2017 were assigned into the mild,moderate and severe groups according to the severity of depression assessed by the Hamilton Depression Scale-17（HAMD-17）. At the same time,some healthy persons were selected as the control group. Wisconsin Card Sorting Test（WCST）,Verbal Fluency Test（VFT）and Stroop Test were carried out,and the scores of these tests were compared in the four groups. The correlations of WCST, VFT, Stroop Test and HAMD-17 scores were analyzed . Results: There were 32,28,35 and 35 subjects involved in the mild,moderate,severe and control group,respectively. The subjects of the mild group,moderate group and severe group had more total errors,perseverative responses and perseverative errors than the control group,and less percent conceptual level responses than the control group （all P<0.05）. The total errors,perseverative responses,perseverative errors and percent perseverative errors increased and the percent conceptual level responses decreased gradually with the severity of depression（all P<0.05）. The correct numbers of Stroop-consistent group and VFT in the severe group were less than those in the control,mild and moderate group（all P<0.05）,which was significantly different between the mild,moderate and control group （P>0.05）. The HAMD-17 scores were negatively correlated with the correct numbers of Stroop congruent group（r=-0.448,P<0.001）and VFT（r=-0.401,P<0.001）,and were positively correlated with perseverative responses in the WCST（r=0.784,P<0.001） . Conclusion The neurocognitive impairment in patients with late-onset depression aggravated with the severity of depression.

Objective To study the clinicopathological features in the diagnosis of serous microcystic adenoma of pancreas.Method A clinicopathological and immunohistochemical study was conducted on 7 patients with serous microcystic adenoma of pancreas.Results All the patients were female,with a mean age of 51 years.Clinical symptoms were present in 2(28.6％)patients.On microscopy,the tumor composed of variable-sized cysts.The cyst wall was covered by simple cuboidal epithelium.The cytoplasm was clear and glycogen-rich.The nucleus of the epithelial cells was small and round.In the center,there was no nucleolus and no nuclear division.There were bulky fibrous tissues between the cystic cavities.Immunohistochemical study showed AE1/AE3,CK7,CK8,CK19,CK/LMW,EMA were positive,and CEA,CD31,CD34,D2-40,Syn,CgA,Calretinin,Vim were negative.Conclusions Serous microcystic adenoma of pancreas is a rare tumor,which was common in old women.Serous microcystic adenoma of pancreas is a benign tumor with good prognosis.The diagnosis is made on histopathological and immunohistochemical study.

ObjectiveTo compare the therapeutic effec between sustained low-efficiency dialysis (SLED) and continuous blood purification (CBP) in critically ill patients.MethodsAccording to the treatment ways,96 critically ill patients were divided into SLED group and CBP group.A comparison was made on the biochemical indicators,in-hospital duration,hemodynamic parameters,acute physiology and chronic health evaluation (APACHE-Ⅱ ),the survival and the mortality rates.ResultsAfter treatment,the levels of serum creatine kinase isozyme MB (CK-MB),creatine kinase (CK),creatinine (Cr),glutamic-oxalacetic transaminase (AST),glutamate-pyruvate transaminase (ALT),APACHE Ⅱ score on the 1st,2nd and 7th day were lower than those prior to the treatment in both groups ( P ＜0.05).There were no statistical differences in in-hospital duration, biochemical indicators, APACHEⅡscore,hemodynamic parameters,the survival rate and the mortality rate between the two groups (P ＞ 0.05 ).ConclusionsSLED has similar hemodynamic stability with CBP,and the two methods have similar treatment effects in critically ill patients.However,SLED can be relatively economical and convenient for critically ill patients in clinical.

Objective:To investigate the abnormal dynamic characteristics of brain functional connectivity in patients with neuropsychiatric systemic lupus erythematosus (NPSLE) and its correlation with clinical indicators by using dynamic functional connectivity (dFC) analysis based on independent component analysis (ICA).Methods:The clinical and imaging data of female NPSLE patients diagnosed in the First Affiliated Hospital of Zhengzhou University from July 2018 to September 2019 were prospectively collected. The levels of complement C3, C4, CH50, glucocorticoid prednisone dosage, systemic lupus erythematosus disease activity index (SLEDAI) score and Systemic Lupus International Collaborating Clinics (SLICC)/American College of Rheumatology (ACR) damage index (SDI) score were recorded. Age and sex matched healthy controls (HC) were enrolled at the same time. All subjects underwent resting state functional MRI (rs-fMRI). The spatial group independent component analysis was performed on MRI data using GIFT software, and 29 independent components (IC) were selected as internal connectivity network; five functional connectivity states and three dFC indexes (fraction time, mean dwell time, number of transitions) were obtained by using sliding time window technology. Two independent sample t test was used to calculate the difference of functional connectivity in different states. Mann-Whitney U test was used to calculate the difference of dFC indexes between groups. Spearman correlation analysis was used to calculate the correlation between dFC index and clinical data in NPSLE group. Results:A total of 45 NPSLE patients and 35 HC patients were enrolled. There was no significant difference in age and education level between the two groups ( t=-0.327, -0.460, P>0.05). Compared with HC group, NPSLE group had higher fraction time and longer mean dwell time ( Z=-2.496, -2.462, P<0.05); in state3 strong connection, compared with HC group, functional connectivity (FC) between posterior cerebellar lobe (IC39) and basal ganglia (IC10) was enhanced ( t=-5.201, P<0.05); FC was found decreased between posterior cerebellar lobe (IC39) and temporal lobe (IC5), temporal lobe (IC7), superior parietal lobe (IC65) ( t=4.212, 5.572, 4.415, P<0.05), as well as between paracentral lobular region (IC12) and posterior cingulate gyrus (IC15) ( t=3.893, P<0.05) in NPSLE group. The SDI score of NPSLE patients was negatively correlated with the fraction time and mean dwell time of state1 and state3 strong connection state ( P<0.05), and the SLEDAI score was negatively correlated with the fraction time and mean dwell time of state1 and state2 ( P<0.05). The SDI and SLEDAI scores were positively correlated with the fraction time and mean dwell time of state4 weak connection state, respectively ( P<0.05). The levels of serum complement C3, C4 and CH50 in NPSLE patients were positively correlated with the number of transitions ( r=0.428, 0.354, 0.385, P<0.05), and the dosage of prednisone was negatively correlated with the number of transitions ( r=-0.466, P<0.05). The validation analysis results showed the experimental results could be effectively repeated. Conclusion:The dFC analysis method based on ICA can effectively identify the alterations of brain functional connectivity on a shorter time scale, which may provide a new perspective for further exploration of the neuroimaging mechanism of cognitive impairment in NPSLE.

Objective:To investigate the microstructural abnormalities of the white matter in first-episode medication-free patients with schizophrenia (FESZ) based on inter-voxel diffusivity metric local diffusion homogeneity (LDH) and traditional intra-voxel diffusivity metric.Methods:A total of 56 FESZ patients admitted to our hospital from January 2020 to December 2021 were selected as research subjects, and 64 healthy volunteers recruited during the same period were selected as healthy controls. All subjects accepted magnetic resonance diffusion tensor imaging, and the LDH, anisotropy fraction (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD) were obtained by FSL and PANDA software. Tract-based spatial statistics (TBSS) method was employed to analyze and compare the differences in the diffusivity metrics of white matter fibers between the two groups. For white matter fiber tracts with significant inter-group differences, receiver operating characteristic(ROC) curve was used to evaluate the diagnostic value of each diffusivity metric in FESZ, and Spearman partial correlation was used to analyze the relation between each diffusivity metric and positive and negative symptom scale (PANSS) scores.Results:As compared with that in the heathy control group, LDH in partial voxel clusters in bilateral anterior thalamic radiation of the FESZ group was statistically increased ( P<0.05, FWE correction). As compared with that in the heathy control group, the mean LDH in the tracts of interest (TOI) of the right inferior longitudinal fasciculus and the right uncinate fasciculus in the FESZ group was significantly increased ( P<0.05, FDR correction). In the above 4 fasciculi, ROC analysis showed that LDH had diagnostic efficacy ( P<0.05), and the diagnostic efficacy of LDH was the highest when the fasciculi structures were combined (AUC=0.733, P<0.001). LDH in white matter fiber tracts with significant inter-group differences had no statistical correlation with PANSS scores ( P>0.05). No voxel clusters or TOIs enjoyed statistical differences between groups were noted in the FA, MD, AD and RD parameter maps ( P>0.05). Conclusion:The inter-voxel diffusivity metric LDH can detect the compensatory changes of white matter microstructure in FESZ patients that could not be detected by traditional intra-voxel diffusivity metric.

OBJECTIVETo investigate the dynamic changes in angiogenesis within the tumor tissue of mice bearing S180 tumor at different day-points of oral administration with a Chinese medicine compound "Yiliuyin" (YLY) and to explore the anti-tumor mechanisms of YLY in vivo.

METHODFifty-six BALB/c mice were divided into YLY group and control group (28 mice/group) and each group was divided into four subgroups (7 mice/subgroup), randomly. After 24 hrs of inoculation with S180 tumor cells subcutaneously in the right axilla, YLY in the mice of YLY group and equal volume of cold boiled-water in the mice of control group were administered orally twice every day, 0.5 mL each time. The mice of one subgroup from the two groups apiece were killed at 10, 20, 30 th and 40 th day-point of oral administration, respectively. The tumors were isolated and were made into paraffin embedded sections. The dynamic changes of the angiogenesis (CD34 staining), vascular endothelial growth factor (VEGF), vascular endothelial growth factor receptor-2 (VEGFR-2) and endostatin (ES) in tumor tissue were detected by immunohistochemistry staining, and the results were shown as PED (positive enzyme dot).

RESULTYLY could remarkably decrease the angiogenesis within tumor tissues. The PED of CD34 in control group at 10, 20, 30 th and 40 th day-point was 392.86+/-42.01, 481.49+/-58.34, 386.31+/-54.91 and 376.69+/-28.71, and that in YLY group was 334.46+/-33.38, 289.34+/-39.63, 257.09+/-40.00 and 246.57+/-36.78, respectively. The PED of CD34 in YLY group at each day-point was lower than that in control group (P<0.05, P<0.01, P<0.01 and P<0.01, respectively). The PED of VEGF in control group at 10, 20, 30 th and 40 th day-point was 852.63+/-81.65, 1168.40+/-96.69, 1292.60+/-147.54 and 1124.74+/-139.64, and that inYLY group was 718.40+/-94.94, 866.54+/-72.40, 859.31+/-74.02 and 753.34+/-72.95, respectively. The PED of VEGF in YLY group at each day-point was lower than that in control group (P <0.05, P <0.01, P <0.01 and P <0.01, respectively). The PED of VEGFR-2 in control group at 10th, 20th, 30th and 40th day-point was 618.63+/-59.08, 750.09+/-56.72, 684.91+/-72.86 and 644.06+/-60.25, and that in YLY group was 523.91+/-64.66, 449.03+/-46.85, 400.06+/-60.12 and 339.89+/-45.39, respectively. The PED of VEGFR-2 in YLY group at each day-point was lower than that in control group (P <0.05, P <0.01, P <0.01 and P <0.01, respectively). The PED of ES in control group at 10th, 20th, 30th and 40th day-point was 250.26+/-36.27, 298.60+/-44.41, 450.86+/-38.95 and 398.43+/-34.19, and that in YLY group was 249.57+/-40.23, 350.03+/-40.92, 499.40+/-40.29 and 497.94+/-42.76, respectively. There was no difference between the two groups at 10th day-point.The PED of ES in YLY group was higher than that in control group at 20, 30, 40 th day-point (P <0.05, P <0.01 and P <0.01, respectively) .

CONCLUSIONYLY could exert the anti- tumor role by down-regulating the expression of VEGF and VEGFR-2, up-regulating the expression of ES and inhibiting the angiogenesis within tumor tissue.

Administration, Oral ; Animals ; Drugs, Chinese Herbal ; administration & dosage ; pharmacology ; therapeutic use ; Endostatins ; metabolism ; Female ; Gene Expression Regulation, Neoplastic ; drug effects ; Mice ; Mice, Inbred BALB C ; Neoplasm Transplantation ; Neoplasms ; blood supply ; drug therapy ; genetics ; pathology ; Neovascularization, Pathologic ; drug therapy ; pathology ; Vascular Endothelial Growth Factor A ; metabolism ; Vascular Endothelial Growth Factor Receptor-2 ; metabolism

Objective:The matria-assisted laser desorption/ionization time of flight mass spectrometry(MALDI-TOF MS) and sequencing methods were performed to assess the methodology (biochemistry methods) for identifying the Pandoraea sputorum and provide the more preferred approach to identify Pandoraea species. Methods:This paper is a study on performance evaluation of identification method. Ten lines of Pandoraea sputorum were isolated from blood cultures of inpatients were collected at Zhongnan Hospital of Wuhan University from July to October 2018 and were confirmed by the cultural characteristics, colonial morphology and Gram′s stain. Further identification was carried out by using the manual biochemical method (API 20NE), automatic biochemistry systems(BioMerieuxVITEK 2 Compact, BD Phoenix-100andThemo ARIS 2X), MALDI-TOF MS (BioMerieuxVITEK MS and Bruker MALDI Biotyper) and the sequencing methods of the 16S rRNA to identify the Pandoraea sputorum. Results:Pandoraea sputorum was non-fermented gram-negative bacteria that are non-motile, oxidase positive, and catalase positive. Ten lines of Pandoraea sputorum were identified as Achromobacter denitrificans, Alcaligenes faecalis or Cupriavidus pauculus and the accuracy rate of genus and species identification was 0 by API 20NE. Among all the samples, six lines were identified as the Pandoraea spp. with the accuracy rate of genus identification was 6/10 by VITEK 2 Compact; whereas the other four lines were identified as the Burkholderia cepacia, Sphingomonas paucimobilis, Ralstonia pickettii, or "Low Discrim" . All of these were identified as "No Identification" by Phoenix-100, which the accuracy rate of genus and species identification was 0. Seven isolates were identified by ARIS 2X as Stenotrophomonas maltophilia, Acinetobacter lwoffii, Sphingomonas paucimobilis, Pseudomonas luteola, Acinetobacter baumannii/Acinetobacter haemolyticus; whereas the other three lines were identified as rare species, thus, the accuracy rate of genus and species identification was 0. Both VITEK MS and MALDI Biotyper indicated all the isolates were Pandoraea sputorum with the accuracy rate of genus and species identification was 10/10. 16S rRNA sequencing for the 10 isolates showed they have 100% of similarity to Pandoraea sputorum by blasting with Genebank. Conclusions:Methods based on biochemical reactions often failed to accurately identify the Pandoraea sputorum to species level. MALDL-TOF MS and 16S rRNA sequencing technology identify Pandoraea sputorum efficiently and precisely enough.