Objective To explore the MRI features of patients with multiple system atrophy (MSA) and Parkinson's disease (PD) for providing early evidence in differential diagnosis. Methods The MRI features of 24 patients with MSA, 30 patients with PD and 30 healthy people as controls were retrospectively analyzed. Abnormal intensity in MRI included the hot-cross bun sign and the slitlike changes. The atrophies of brain included cerebellar, middle cerebellar peduncles, medulla oblongata and pon. Cerebral ventricle dilatation included fourth ventricle and cisterna pontis. The midbrain area, pons area and middle cerebellar peduncles width were measured. Results All patients with MSA had at least one of the features observed on MR images, and there were some differences in the subtypes of MSA. The high sensitive features were the atrophies of middle cerebellar peduncles (79.2%), the atrophies of pons (79.2%) and the hot-cross bun sign (75.0%). The parameters with high specificity and high positive predictive value were hot-cross bun sign (both 100%), the slit-like sign (both 100%), the atrophies of middle cerebellar peduncles (93.3% and 90.1%), and the atrophies of pons (96.7% and 95.0%). MSA group had the statistically significantly decreased values of pons area, midbrain area and middle cerebellar peduncles width [(288. 7±75. 4) mm2, (127.8±25.8) mm2 and (10. 7±2.8) mm, respectively], as compared with PD group [(477. 5 ± 54. 3) mm2, (145.9±21.6) mm2 and (16.2±1.3) mm, respectively] and healthy group [(454. 5±36. 8) mm2 , (146.4±17.4) mm2 and (16.7±1.2) mm, respectively] (all P ＜0. 05). Conclusions The routine MRI is helpful in differential diagnosis between MSA and PD and has some values in diagnosing the subtypes of MSA.

Objective To investigate the influence of Ulinastatin (UTI) on the hyper-permeability of vascular endothelial cells induced by tumor necrosis factor alpha (TNF-α).Methods Inflammation model was induced by TNF-α in human umbilical vein endothelial cell line (EA.hy926).The experiment was designed into 4 groups:normal group,TNF-α group,UTI group and TNF-α with UTI (U + T) group.Methyl thiazolyl tetrazolium (MTT) method and epithelial voltameter (EVOM) method were used to measure cell viability [absorbance (A) value] and transepithelial electrical resistance (TER) of EA.hy926 cells respectively.The expression of VE-cadherin was measured by reverse transcription polymerase chain reaction (RT-PCR) and immunocytochemistry.Results Compared with normal group,the TER of EA.hy926 cells induced by TNF-α was significantly decreased (67.200 ± 8.937 vs.33.600 ± 8.771,P =0.010).The permeability in EA.hy926 cells increased obviously.The hyper-permeability of EA.hy926 cells induced by TNF-α could be alleviated by UTI at the concentrations of 1-100 U/mL in a dose-dependent manner (40.133 ±7.484 vs.33.600 ±8.771,P=0.382;49.232 ± 3.162 vs.33.600 ± 8.771,P =0.044;63.700 ± 8.515 vs.33.600 ± 8.771,P =0.013).The expression of VE-cadherin mRNA reduced significantly in the TNF-α group (1.089 ±0.018 vs.0.835±0.021,P =0.000) compared with normal group.This effect of TNF-α could be attenuated by UTI.When EA.hy926 cells exposed to UTI at 10 U/mL and 100 U/mL,a significant increase of the expression of VE-cadherin mRNA was observed (0.976 ±0.014 vs.0.835 ±0.021,P =0.001;1.115 ±0.015 vs.0.835 ± 0.021,P =0.000).And the inhibition of UTI manifested a dose-dependent manner (1-100 U/mL).The results of the immunocytochemistry showed that the expression of VE-cadherin in TNF-o group was decreased significantly (0.061 ± 0.013 vs.0.093 ± 0.014,P =0.049) compared with normal group.And the low-expression of VE-cadherin could be alleviated by UTI (0.032 ± 0.004 vs.0.061 ± 0.013,P =0.016).Conclusion The high permeability of EA.hy926 cells induced by TNF-α could be inhibited by UTI at the concentrations of 1-100 U/mL in a dose-dependent manner.

Objective: To explore the relationship between abuse experience with suicidal ideation and suicide attempts of junior middle school students, and to provide a reference for suicide prevention of junior middle school students. Methods: Cluster sampling method were used to selct 10 289 junior middle school students from 25 districts and counties of Chongqing were included in the analysis of this study from July to September in 2020. And Questionnaire on Abuse in Childhood and Mental Health Scale for Middle School Students were applied to collect the data about demographic information, suicide ideation and behavior. Results: The prevalence of suicidal ideation and suicide attempts among junior middle school students were 20.93% and 10.83%, respectively. Multivariate Logistic regression model found that after controlling for demographic variables and mental health, emotional abuse ( OR =2.07) and emotional neglect ( OR =2.03) showed higher correlations with suicidal ideation than the other three types of childhood abuse( OR physical neglect =1.19, OR physical abuse =1.60, OR sexual abuse =1.37, P <0.05); and sexual abuse ( OR =2.29) and physical neglect ( OR =1.87) showed higher associations with suicide attempt than the other three types of abuse( OR emotional abuse =1.63, OR emotional neglect =1.59, OR physical abuse =1.50, P <0.01). Conclusion All five types of child abuse were independent risk factors for suicidal ideation and suicide attempts, and emotional neglect and emotional abuse had a greater effect on suicidal ideation, sexual abuse and physical neglect had a greater effect on suicide attempts.

Objective To investigate the nutritional status of vitamin D and its relationship with age, sex and season in children aged 0-6 in Yiling District of Yichang, and to provide a scientific basis for children to appropriately supplement vitamin D. Methods A total of 11 656 children aged 0 to 6 who had undergone physical examinations in Yiling Maternal and Child Health Hospital from January 2017 to July 2018 were tested for peripheral blood 25-hydroxyvitamin D levels by fluorescence immunochromatography. Results The level of 25-vitamin D in 11,656 children tested in Yiling area was (29.35 ± 7.59) ng / mL, of which 566 (4.86%) were in vitamin D deficiency, 6,579 (56.44%) were in vitamin D insufficiency, and 4,511 were in vitamin D sufficiency (38.70%). The levels of vitamin D in peripheral blood of infants under 1 year old were significantly higher than that of infants and preschool children (P<0.05). The levels of 25-hydroxyvitamin D in peripheral blood of children aged 3-6 years were significantly lower than that of other age groups (P<0.01). The levels of 25-hydroxyvitamin D in children's peripheral blood were highest in spring and lowest in winter. There was no significant difference in peripheral blood levels of 25-hydroxyvitamin D between two genders (t=0.841, P>0.05). The levels of 25-hydroxyvitamin D in peripheral blood aged 0-3 years had no significant difference between urban and rural areas in Yiling area (P>0.05). Conclusion The levels of 25-hydroxyvitamin D in children aged 0-6 years are mostly inadequate. Vitamin D intake should be increased, especially in preschool children. Outdoor activities in winter are necessary in this area.

Objective To explore the transformation of three-dimensional curve,and to observe effect of three-dimensional remodeling surgery in order to find an ideal method to achieve upper eyelid rejuvenation.Methods Retrospective analysis was conducted after surgical correction for three-dimensional reconstruction in 48 patients with upper eyelid that were female,aged 58 to 76 years;all of them had simultaneous surgery of both eyes.Using double eyelid crease incision to remove loose and redundant skin,we transplanted the herniated fat of the medial orbital septum to the deep surface of the orbicularis oculi muscle in the distinct bony structure of the extra-supraorbital margin,folded and lifted orbital septum fascia;at the same time lifted eyebrow through eyebrow incision,transplanted and filled dermis and muscle fascia flap to remodel the transverse S-shaped stereo curve of the coronal plane of the upper eyelid.Results A lot of 41 cases were followed up more than 6 months from 48 patients,except that one patient had a second surgery due to double eyelid asymmetry after one year,eyelid rejuvenation in 40 patients were improveed.Effect of 33 cases was satisfactory.Satisfaction rate was 80.49％.Less satisfaction were 6 cases,accounting for 14.63％.No satisfaction was 1 case,ac counting for 2.44 ％.Conclusions The surgery can reshape the concavity inside,the full crown outside of upper eyelid by the skin removing,fat shifting,leather fat muscle flap filling,and restore the upper eyelid to three-dimensional full round young shape.It is an ideal surgical method for eye anti-aging treatment.

Objective:To translate and culturally adjust Decisional Fatigue Scale (DFS) , and test its reliability and validity.Methods:The Chinese version of DFS was formed through the method of double translation, back translation and expert consultation. Using the convenient sampling method, 247 medical staffs from 16 departments in 76 wards of Xiangyang No.1 People's Hospital Affiliated to Hubei University of Medicine were selected as the research objects. Content validity, criterion validity and structure validity were used for validity evaluation, and internal consistency reliability, split half reliability and retest reliability were used for reliability evaluation. A total of 247 questionnaires were sent out in this study and 247 were effectively received, with effective recovery of 100.00%.Results:The total Cronbach's α coefficient of Chinese DFS was 0.933, the half-reliability coefficient was 0.849 and the retest reliability coefficient was 0.838 ( P<0.01) . Both the item content validity index and scale content validity index were 1.00, and the correlation coefficient with the total score of SRF-S was 0.729 ( P<0.01) . One common factor was extracted by exploratory factor analysis and 65.64% of the variation was explained cumulatively, which was consistent with the dimensions of the original scale. Confirmatory factor analysis showed that all fitting indexes were up to standard and the fitting degree was good. Conclusions:The reliability and validity of the Chinese version of DFS in medical staffs is good, which can be used to evaluate the degree of decision-making fatigue of Chinese medical staffs.

OBJECTIVE: To explore the effect of arsenic on the homeobox D10( HOXD10) gene expression in peripheral blood lymphocytes and human lung adenocarcinoma cell A549. METHODS: ⅰ) A total of 59 workers exposed to arsenic from a arsenic factory were selected as the exposure group and 17 local people without arsenic exposure were chosen as controls by using judgment sampling method. Hydride generation-cold hydrazine trapping-atomic absorption spectrometry was used to detect arsenic levels in urine of these 2 groups. The expression of HOXD10 in peripheral blood lymphocytes was detected by real-time fluorescent quantitative polymerase chain reaction( qRT-PCR).ⅱ) The A549 cells were treated with arsenic trioxide( As_2O_3) with concentration of 0. 0,0. 1,0. 5,1. 0 and 2. 0 μmol/L,and the survival rate of cells was examined by colorimetric assay. The expression of HOXD10 was detected by qRT-PCR. RESULTS: ⅰ) The levels of inorganic arsenic,methylarsonic acid,dimethyl arsenate,total arsenic in the urine,and the relative expression of HOXD10 mRNA in peripheral blood lymphocyte in exposure group were higher than that of the control group( P < 0. 05).ⅱ) As_2O_3 decreased the survival rate of A549 cells in a dose-dependent manner( P < 0. 01) and lead to a dose-dependent increase of HOXD10 mRNA expression( P < 0. 01). A549 cell survival rate and relative expression of HOXD10 mRNA showed a negative correlation,the correlation coefficient was-0. 777( P < 0. 01). CONCLUSION: Arsenic can up-regulate HOXD10 expression in the peripheral blood of occupational arsenic exposure individuals. As_2O_3 can inhibit the proliferation of A549 cells,which may be related to the up-regulation of HOXD10 expression.

Objective:To explore a new method for correcting the senile blepharochalasis and depression of the upper eyelid.Methods:Fourteen female patients with blepharochalasis and depression of upper eyelid were treated with subcutaneous tissue flap filling during eyebrow lifting. The under-eyebrow incision was used to remove the loose skin and lift the eyebrow, and a subcutaneous tissue flap was made to fill up the upper eyelid depression.Results:All the incisions were healed in one stage without complications such as infection and subcutaneous hematoma. 12 patients were followed up for more than 6 months. In the 3rd month after operation, 1 patient had obvious scar under the eyebrow, 1 patient had skin traction wrinkles at the eyebrow. After 6 months, the incision scar was not obvious in all patients, the appearance of eyebrow ptosis was eliminated, the upper eyelid was smooth and flat, and no absorption and further depression of the upper filler were observed; the effect was satisfactory.Conclusions:The eyebrow lifting combined with the subcutaneous tissue flap filling to correct the senile upper eyelid chalasis and depression is significantly effective with less trauma and complications, and it is worthy to be promoted.

OBJECTIVES: Idiopathic intracranial hypertension (IIH) is a syndrome that excludes secondary causes such as intracranial space-occupying lesion, hydrocephalus, cerebrovascular disease, and hypoxic ischemic encephalopathy. If not be treated promptly and effectively, IIH can cause severe, permanent vision disability and intractable, disabling headache. This study aims to explore the clinical and image features for IIH, to help clinicians to understand this disease, increase the diagnose rate, and improve the outcomes of patients. METHODS: We retrospectively analyzed 15 cases of IIH that were admitted to Xiangya Hospital, Central South University, during January 2015 to September 2020. The diagnosis of IIH was based on the updated modified Dandy criteria. We analyzed clinical data of patients and did statistical analysis, including age, gender, height, weight, medical history, physical examination, auxiliary examination, treatment and outcome. RESULTS: There were 10 females and 5 males. Female patients were 22 to 42 years old with median age of 39.5. Male patients were 27 to 52 years old with the median age of 44.0. The BMI was 24.14-34.17 (28.71±2.97) kg/m CONCLUSIONS IIH primarily affects women of childbearing age who are overweight. The major hazard of IIH is the severe and permanent visual loss. Typical image signs have high specificity in IIH diagnosis. Prompt diagnosis and effective treatment are significantly important to improve the outcomes of patients.
Adult ; Anemia, Iron-Deficiency ; Female ; Humans ; Intracranial Hypertension ; Male ; Middle Aged ; Pseudotumor Cerebri/diagnostic imaging* ; Retrospective Studies ; Ventriculoperitoneal Shunt ; Young Adult