Objective To explore the effect of Quality Control Circle(QCC) on patients in the recovery phase with post stroke depression at rehabilitation therapy.Methods 80 patients in the recovery phase with post stroke depression were collected.According to the digital table, they were randomly divided into control group and QCC group,40 cases in each group.All the patients got treatment as rehabilitation medical care routine, rehabilitation exercise and medical treatement.And patients of QCC group received extra QCC management.The activities of daily living(Barthel Index Scale),severity of depression(Hamilton Depression Scale HAMD),rehabilitation exercises compliance were evaluated in the two groups.Results After intervention, the scores of ADL,HAMD and rehabilitation exercises compliance in the control group were (33.50±6.22)points,(22.23±3.30)points,(2.70±1.32)points,respectively,which in the QCC group were (54.13±8.84)points,(14.75±4.14)points,(4.45±0.90)points,respectively.The scores of activities of daily living(ADL)(t=15.06,26.03,all P<0.01) and rehabilitation exercises compliance(t=1.78,12.2,all P<0.01) had been improved, which in the QCC group was more obvious(t=12.10,6.90,all P<0.01)).The depression scores in both two groups were decreased(t=13.35,25.78,all P<0.01),and the decrease in the QCC group was significantly higher than that in the control group(t=8.93,P<0.01).Conclusion QCC application in post stroke depression at the recovery phase can effectively reduce the degree of depression, improve patients' ADL and rehabilitation exercise compliance.

Epigenetics is the study of heritable changes in gene expression other than the changes in the underlying DNA sequence. Such changes include DNA methylation,genomic imprinting,X chromosome inactivation and non-coding RNA regulation. Recent progresses on epigenetics offer new ideas to tackling these problems in forensic science,including determination of the necessary allele in paternity,identification of fetal paternity testing in embryonic period,discrimination of identical twins,origination analysis of tissue,and individual age estimation. This review focuses on the main concept of epigenetics and its application in the field of forensic science.

Objective To explore the relationship of intelligence among memory, sustained attention and executive function of schizophrenic patients. Methods 120 schizophrenic inpatients and 60 healthy subjects matched in age, gender and years of education with the patients were assessed with Wechsler Adult Intelligence Scale-fourth edition (WAIS-IV) and Wechsler Memory Scale-fourth edition (WMS-IV), Continuous Performance Test (CPT), Wisconsin Card Sorting Test (WCST). Results The intelligence quotient (IQ), memory quotient (MQ), scores of CPT and WCST were poor in the patients (P<0.05). IQ was correlated with MQ (r=0.837, P<0.01), the scores of CPT (r=0.613, P<0.01) and WCST (r=0.466, P<0.01). The scores of CPT and MQ were the independent factors related with IQ (P<0.001).Conclusion There is intelligence impairment in schizophrenics, which may related with the impairment of memory and sustained attention.

Objective To investigate the intellectual characteristics and related factors for patients with mental retardation. Methods 118 patients with mental retardation and 118 normal subjects were assessed with Wechsler Adult Intelligence Scale-fourth edition of Chinese (WAIS-Ⅳ). Results The full intelligence quotient (FIQ), index and scores of subtests were significantly lower in the patients than in the controls (P<0.01), especially for those of working memory and processing speed index. The difference in percentage of significance between verbal comprehension and working memory was higher (P<0.05). The FIQ and some index of patients positively correlated with age, education level and their parents' education level (P<0.01). Conclusion The patients with mental retardation present an overall decline in intelligence,especially in the working memory and processing speed. The mental development is unbalanced in some patients, that the verbal comprehension is relatively better than working memory. The intelligence of patients with mental retardation may be related with their age, education level and their parents' education level.

Objective:To investigate the changes in cognitive and behavioral function in patients with cerebral small vessel disease and their correlation with serum homocysteine (Hcy) and cystatin C (CysC) levels.Methods:Ninety-four patients with cerebral small vascular disease who received treatment in Zhejiang Xin'an International Hospital from March 2019 to March 2021 were included in the observation group. An additional 80 healthy controls who concurrently received physical examination were included in the control group. The Mini-Mental State Scale (MMSE) and the Montreal Assessment Scale (MoCA) were used to evaluate cognitive function. The activity of daily living (ADL) was used to evaluate behavioral function. Enzyme-linked immunosorbent assay was used to measure serum Hcy and CysC levels. MMSE score, MoCA score, ADL score, serum Hcy and CysC levels were compared between the two groups. The receiver operating characteristic (ROC) curve was used to analyze the sensitivity and specificity of serum Hcy and CysC levels in the diagnosis of cerebral small vessel disease. Pearson correlation analysis was performed to analyze the correlation between serum Hcy and CysC levels and cognitive behavioral function.Results:MMSE score, MoCA score, and ADL score in the observation group were (21.21 ± 2.87) points, (20.18 ± 3.25) points, and (34.32 ± 5.45) points, which were significantly lower than (28.23 ± 1.02) points, (28.45 ± 0.89) points and (76.35 ± 8.29) points in the control group ( t = 20.78, 22.05, 40.03, all P < 0.05). Serum Hcy and CysC in the observation group were (16.28 ± 2.97) μmol/L and (1.21 ± 0.23) mg/L, which were significantly higher than (8.35 ± 1.76) μmol/L and (0.56 ± 0.12) mg/L in the control group ( t = 20.95, 22.77, both P < 0.05). ROC curve analysis showed that the sensitivity and specificity of serum Hcy in diagnosing cerebral small vessel disease were 85.29% and 53.85%, respectively; the sensitivity and specificity of serum CysC in diagnosing cerebral small vessel disease were 81.54% and 41.38%, respectively. Pearson correlation analysis revealed that serum Hcy level was linearly negatively correlated with MMSE score, MoCA score, and ADL score ( r = -0.79, -0.68, -0.71, all P < 0.05); serum CysC level was linearly negatively correlated with MMSE score, MoCA score, and ADL score ( r = -0.67, -0.75, -0.78, P < 0.05). Conclusion:The cognitive and behavioral function of patients with cerebral small vessel disease are decreased, and serum Hcy and CysC levels are increased. Serum Hcy and CysC levels are closely related to the cognitive and behavioral function of patients with cerebral small vessel disease.

Objective To investigate the memory characteristics and related factors of patients with mental retardation. Methods 73 patients with mental retardation (patient group) and 73 normal subjects (control group) matched with the patient group were respectively tested with Wechsler Memory Scale-Fourth Edition of Chinese Version (WMS-IV). Results The scores of each subtest and composite scores of WMS-IV were significantly lower in the patient group than in the control group (P<0.01). All the composite scores positively correlated with each other in the patient group (r=0.38-0.90, P<0.01) and in the control group (r=0.31-0.94, P<0.01). Age and education level positively correlated with all the composite scores (except the Visual Working Memory Index) in the patient group (P<0.05). Conclusion The patients with mental retardation present an overall decline in memory, especially in the immediate memory. The memory function in patients is related with their ages and education levels.

Objective To study the effect of mitochondrial reactive oxygen species(ROS)on male fertility and its application value in assisted reproduction so as to provide a new method for fertility assessment and etiological treatment of male infertility.Methods The relationship between sperm ROS and male infertility,sperm nuclear DNA integrity and sperm membrane function was analyzed.Then the relationships of the ROS of sperms for fertiliza-tion with fertilization rate,cleavage rate,embryo rate and pregnancy outcome were analyzed.Results(1)The percentage of the high ROS in sperm membrane of the male infertility group was significantly higher than that of the normal fertility group(P<0.01),but there was no statistical difference in the percentage of the high ROS in the sperm mitochondria between the two groups.(2)The normal rate of sperm membrane function in the normal group was significantly higher than that in the abnormal group(P<0.01),but there was no significant difference in the sperm DNA fragmentation index(DFI)between the groups.(3)There was significant difference in the fertilization rate between the IVF control group and IVF observation group,but no significant difference was seen in the cleavage rate,excellent embryo rate and clinical pregnancy rate between the groups.Conclusion Sperm ROS is related to male fertility to some extent.Abnormal ROS may lead to impaired sperm membrane function and affect sperm fertilization ability,thus affecting male fertility.The detection of ROS in sperm can be used as a new method to evaluate male fertility and provide a basis for diagnosis or treatment of male infertility.For patients with ART or infertility,the appropriate time to conceive can be selected according to the sperm ROS level.

OBJECTIVE: To assess the practical and health economical values of non-invasive prenatal test (NIPT) in Changsha Municipal Public Welfare Program. METHODS: A retrospective analysis was carried out on 149 165 women undergoing NIPT test from April 9, 2018 to December 31, 2019. For pregnant women with high risks, invasive prenatal diagnosis and follow-up of pregnancy outcome were conducted. The cost-benefit of NIPT for Down syndrome was analyzed. RESULTS: NIPT was carried out for 149 165 pregnant women and succeeded in 148 749 cases (99.72%), for which outcome were available in 148 538 (99.86%). 90% of pregnant women from the region accepted the screening with NIPT. 415 (0.27%) were diagnosed as high risk. Among these, 381 (91.81%) accepted amniocentesis, which led to the diagnosis of 212 cases of trisomy 21 (PPV=85.14%), 41 cases with trisomy 18 (PPV=48.81%) and 10 cases with trisomy 13 (PPV=20.83%). The sensitivity and specificity of NIPT for trisomy 21, trisomy 18 and trisomy 13 were (97.70%, 99.98%), (97.62%, 9.97%) and (100%, 99.97%), respectively. In addition, 213 and 30 cases were diagnosed with sex chromosomal aneuploidies (PPV=46.2%) and other autosomal anomalies (PPV=16.57%), respectively. For Down syndrome screening, the cost and benefit of the project was 120.79 million yuan and 1,056.95 million yuan, respectively. The cost-benefit ratio was 1: 8.75, and safety index was 0.0035. CONCLUSION NIPT is a highly accurate screening test for trisomy 21, which was followed by trisomy 18 and sex chromosomal aneuploidies, while it was less accurate for other autosomal aneuploidies. The application of NIPT screening has a high health economical value.
Aneuploidy ; Cost-Benefit Analysis ; Female ; Humans ; Noninvasive Prenatal Testing ; Pregnancy ; Retrospective Studies ; Trisomy 18 Syndrome/genetics*