Objective To quantify the changes of tongue color with the development of the disease according to the characteristics of human vision.Methods Psychological scales of tongue color perception were obtained from thc psychophysical experiments.Polynomial regression and support vector regression (SVR) were used to establish the mathematical model between the physical values and the psychological scales of tongue color.Results The psychological scales exported from the model could correspond to the visual perception of tongue color change, and SVR has higher accuracy.Conclusions The psychological scale, can not only quantitatively evaluate the tongue color in the development of the disease, but also quantify the degree of disease, to assist the doctors for disease diagnosis and treatment.

Objective To observe the role and related mechanism of chemerin and its receptor ChemR23 in glomerular endothelial cells (GEnCs) stimulated by high glucose.Methods Mouse GEnCs were cultured and divided into control group,20.0 mmol/L high glucose group,40.0 mmol/L high glucose group and mannitol control group.Then the expressions of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in cell culture supematant as well as the expressions of intracellular protein and mRNA of chemerin,ChemR23,IL-6 and TNF-α were detected.Lentiviral transfection targeting ChemR23 was applied before high glucose-or Chemerin-stimulated,and expressions of supernatant and intracellular mRNA of IL-6 and TNF-α were measured.Meanwhile whether p38 mitogen-activated protein kinase (p38 MAPK) pathway was activated by high glucose was detected.The specific inhibitor of p38 MAPK was added prior to high glucose-stimulated,then supernatant and intracellular mRNA expressions of IL-6 and TNF-α was detected.The supernatant expressions of IL-6 and TNF-α were measured by ELISA.The intracellular protein expression and p38 MAPK phosphorylation activity were detected by Western blotting.The mRNA expression was detected by real time PCR.Results Compared with those in the control group,in high glucose groups the expressions of IL-6,TNF-α and chemerin were significantly increased (all P ＜ 0.05),however,the expressions of ChemR23 did not change (all P ＞ 0.05);the supernatant and mRNA expressions of IL-6 and TNF-α were also elevated in the chemerin group (all P ＜ 0.05).Lentivirus baring shRNA could efficiently suppress ChemR23 expression,and the Chemerin-or high glucose-induced expressions of IL-6 and TNF-α were reduced (all P ＜ 0.05).Also it could significantly reduce the expression of phosphorylated-p38 MAPK (p-p38 MAPK) induced by high glucose (P ＜ 0.05),as high glucose group had higher p-p38 MAPK than control group (P ＜ 0.05).While the high glucose-elevated expressions of IL-6 and TNF-α were significantly attenuated by p38 MAPK inhibitor (all P ＜ 0.05).Conclusions High glucose stimulation can induce the expression of chemerin in GEnCs.By binding to ChemR23,chemerin activates p38 MAPK signaling pathway,and then promotes the expressions of IL-6 and TNF-α.These inflammatory cytokines aggravate inflammation of GEnCs.

Objective To investigate the risk factors for stroke in population with family history in rural areas of Zhengzhou. Methods A cluster random sampling method was used to collect 386 residents with family history of stroke from 5 villages of Zhengzhou. The participants were divided into stroke group and non-stroke group according to diagnosis. IBM SPSS STATISTICS 21.0 and SPSS Modeler 14.1 software were used to analyze the data.Results Hypertension, dyslipidemia, atrial fibrillation or arrhythmia, smoking and drinking in stroke group were significantly higher than those of the non-stroke group (P < 0.05). Logistic regression analysis indicated that hypertension (OR=35.705, 95％ CI9.045～140.950, P =0.000) and dyslipidemia (OR=2.669, 95％ CI 1.077～6.614, P = 0.034) were linked with stroke. Artificial neural network (ANN) model indicated the independent variables in predicting stroke were hypertension, dyslipidemia, smoking, drinking and atrial fibrillation or arrhythmia according significance, respectively. The accuracy of the model was 82.0％. Conclusion Among population with family history of stroke, those who had hypertension, dyslipidemia, atrial fibrillation or arrhythmia, smoking and drinking were more susceptible to develop this condition.

Objective?To analyze the mediating effects of the sense of coherence between mental stress and depression in stroke patients, and to offer guidance and assistance to reducing mental stress and depression and improving mental health in stroke patients. Methods?Totally 468 stroke patients were selected from the Department of Neurology of a ClassⅢ Grade A hospital in Zhengzhou by convenient sampling between July 2016 and July 2017 and investigated with Sense of Coherence Scale (SOC-13), Chinese Perceived Stress Scale (CPSS) and Center for Epidemiologic Studies Depression Scale (CES-D). The data were statistically analyzed with SPSS 21.0 and AMOS 22.0. Results?The total average scores for SOC-13, CPSS and CES-D in these stroke patients were (63.39±9.92), (41.65±7.29) and (23.80±4.20), respectively. The sense of coherence was negatively correlated with mental stress and depression (r=-0.47,-0.51;P＜0.01), and mental stress was positively correlated with depression (r=0.52,P＜0.01). As a meditating variable, the sense of coherence reduced the adverse prediction effects of mental stress on depression from 0.632 to 0.283. According to the re-analysis of the structural equation model, the sense of coherence was the mediating variable between mental stress and depression. The fit indexes were good (χ2/df=2.450, GFI=0.942,AGFI=0.941, CFI=0.940, TLI=0.922, RMSEA=0.052, RMR=0.036). Conclusions?As the mediating effect between mental stress and depression, the sense of coherence reduces the adverse prediction effects of mental stress on depression to some extent. Therefore, the sense of coherence in stroke patients shall be enhanced to improve their mental health and reduce the incidence of depression.

Objective To observe the effects of tracer methodology when used to trace and manage emergency intravenous thrombolysis processes in patients with acute ischemic stroke (AIS). Methods The patients' attendance process was traced, improved and constantly optimized according to the theoretical basis of tracer methodology. A total of 112 AIS patients who received thrombolysis from September 2015 to August 2016 (before tracer methodology was implemented) were divided into the control group, while another 160 AIS patients who received thrombolysis between September 2016 and August 2017 (after tracer methodology was implemented). The time between arrival and thrombolysis administration and hospital treatment were compared between the two groups. Results After tracer methodology was carried out, the time used between arrival and admission by our stroke treatment team in the observation group was (4.1±1.2)min; the time between arrival and imaging examination was (18.8±11.2)min; the time between imaging examination and thrombolysis administration was (22.5±10.2)min; and the time between arrival and thrombolysis administration was (44.6±12.5)min, all shorter than that of the control group (P＜0.05). Conclusions The application of tracer methodology effectively reduces door to needle time, improves the efficiency of intravenous thrombolysis in AIS patients.

In recent years , with the increasing of immunocompromised patients , Trichosporon spp. has become a more and more significant clinical opportunistic pathogen .Medical staff should enhance the clinical awareness to this pathogen . In this paper , the classification , virulence factor and pathogenic mechanism, infections, diagnostic methods of laboratory , antifungal susceptibility and treatment of Trichosporon spp. were reviewed systematically . Trichosporon asahii is the major pathogen of invasive infections.Biofilm formation and enzyme production will promote its ability to escape from antifungal drugs and host immune responses .Matrix assisted laser desorption ionization time of flight mass spectrometry has the advantages of accurate , fast and low cost for identification of Trichosporon spp., and zoles is the first-line treatment for invasive infections .

The sensitivity of cardiac troponin testing for diagnosing acute myocardial infarction(AMI)varies over time from chest pain onset.This study aimed to determine the diagnostic performance of point-of-care testing cardiac troponin T(POCT-cTnT)at different time intervals post-symptom onset to refine rapid rule-out approaches for AMI.Methods This retrospective study included 6,024 patients presenting with chest pain from January 2018 to December 2022.POCT-cTnT and central lab cTnI levels were measured on admission.Receiver operating charac-teristics analysis stratified by time windows assessed the accuracy of POCT-cTnT for diagnosing AMI.Results The overall AUC of POCT-cTnT for diagnosing AMI was 0.826(95%CI:0.816～0.836),with a sensitivity of 72.81%and a specificity of 86.26%.According to the time intervals of chest pain onset(＜3 hours,3～6 hours,6～12 hours,12～24 hours,24～72 hours,and≥72 hours),the AUC values for groups after 6～12 hours were 0.918,0.928,0.920 and 0.908,respectively,with no statistically significant difference(P＞0.05),but all were higher than the groups within 6 hours(P＜0.001).According to the time of chest pain onset,the AUC for the≥8h group was 0.921,with a negative predictive value(NPV)of 98.1%and a negative likelihood ratio(-LR)of 0.11.Its AUC was higher than those of the≥3 h,≥2 h,≥1 h,and overall groups(P＜0.05),but there was no statistically significant differ-ence compared with the groups after≥4 h(P＞0.05).Conclusions Chest pain onset time has a certain impact on the performance of a single POCT-cTnT test for diagnosing AMI.The duration from chest pain onset to hospital admission combined with POCT-cTnT test may improve the reliability in diagnosing AMI.Specifically,a single POCT-cTnT test at four hours after chest pain onset,especially eight hours after chest pain onset,can diagnose or exclude AMI.

OBJECTIVE: To explore the genetic basis for a girl with febrile convulsion as the main manifestation. METHODS: The child was subjected to whole exome sequencing (WES) and copy number variation sequencing(CNV-seq). Fluorescence quantitative PCR was carried out to validate the microdeletion in her family. RESULTS: The 7-year-old girl was diagnosed with febrile convulsion (complex type) for having fever for 3 days, mild cough and low thermal convulsion once. Her father, mother and aunt also had a history of febrile convulsion. A heterozygous deletion with a size of approximately 1.5 Mb was detected in the 16p13.11 region by WES and CNV-seq. The deletion has derived from her father and was confirmed by fluorescence quantitative PCR. CONCLUSION 16p13.11 microdeletion syndrome has significant clinical heterogeneity. Different from those with epilepsy, mental retardation, autism, multiple malformations, carriers of 16p13.11 deletion may only manifest with febrile convulsion. Deletion of certain gene(s) from the region may be related to febrile convulsion and underlay the symptom of this child.
Child ; DNA Copy Number Variations ; Epilepsy ; Female ; Humans ; Seizures/genetics* ; Seizures, Febrile/genetics* ; Whole Exome Sequencing