Objective To explore the effects of sertraline combined with attribution retraining in post-stroke depression and recovery of neurological function.Methods A total of seventy-eight patients with post-stroke depression were randomly divided into research group and control group.The research group was treated by sertraline combined with attribution retraining and the control group was treated by sertraline only for 8 weeks.Depressive symptoms were assessed using the Hamilton Depression Rating Scale (HAMD) and recovery of neurological functions using the National Institute of Health Stroke Scale (NIHSS) at baseline and at the end of the 24,44,64 and 84 week.Results Repeated measure ANOVA for the total scores of HAMD showed that the main effect of time,the main effect of group and the interactive effect of time and group were significant (P＜0.05).Total scores of HAMD in the research group were significantly lower than those in the control group at the end of the 2nd,44,64 and 84 week [(18.25±4.27) vs.(20.81±4.63),(15.94±3.47)vs.(18.12±4.51),(12.85±3.12) vs.(16.54±3.70),(10.42±3.66) vs.(13.09±3.59),P＜0.05].HAMD Total scores in two groups were showed significantly decreased on each time point after treatment (P＜0.01).Effective rates (using reduction rate of HAMD total scores as evaluation) were more significant in the research group than those in the control group at the end of the 8th week (77.5％ vs.52.6％,P＜0.05).The repeated measure ANOVA showed that the main effect of time in NIHSS total scores was significant (P＜0.01).The main effect of group and the interactive effect of time and group in NIHSS total scores were not significant (P＞0.05).Total scores of NIHSS in two groups significantly decreased on each time point after treatment (P＜0.01).Conclusions Sertraline combined with attribution retraining can significantly relieve post-stroke depression and attribution training does not have obvious effects on the recovery of neurological function.

ObjectiveTo retrospectively determine the prevalence of Ramp lesion (the peripheral attachment of the posterior horn of the medial meniscus) of the posterior horn of the medial meniscus with concurrent anterior cruciate ligament(ACL) ruptures and analyze the relevant risk factors.MethodsFrom April 2002 to October 2007,868 consecutive knees were diagnosed as ACL injury and received arthroscopic surgery for ACL reconstruction(ACLR).All the patients were verified for the tears of Ramp area under arthroscopy.The prevalence of Ramp lesion was evaluated respectively.Then all cases were divided into different groups depending on the time interval from ACL injury to ACLR (TFI) and other relevant risk factors as age and gender.ResultsAmong 868 knees underwent surgery for ACLR,144 knees were diagnosed as Ramp lesion.The average age was 24.7 years,113 males,31 females.The mean TFI to ACLR was 29.3months.The prevalence of Ramp lesion was 16.59％,which was analyzed as logarithmic correlation with TFI.Patients younger than 30-year old and male patients had significant higher prevalence of Ramp lesion.ConclusionRamp lesion is a common meniscus injury that can occur at the time of ACL rupture or as a result of knee laxity associated with ACL insufficiency.The prevalence of Ramp lesion is 16.59％ which increases with time until 24 months after initial injury.Patients younger than 30-year old and male patients have higher prevalence of Ramp lesion.

BACKGROUND:The ankle joint is capable of flexion and extension, including plantar flexion and dorsiflexion, to act as a support and a lever. An ankle injury, often accompanied by fracture and ligament injury, seriously threatens the ankle joint function. Previous diagnosis of ankle injury mainly relied on clinical signs and X-ray examination. However, X-ray examination is not accurate enough for ankle injury diagnosis because it cannot clearly diagnose damage to the surrounding ligaments, tendons and other soft tissues except for obvious fractures. Mutlisequence and multiplanar MRI is currently the optimal noninvasive method for high-resolution determination of soft tissue deformations, but little has been reported on the diagnostic accuracy of ankle ligament and tendon injury. OBJECTIVE:To observe the diagnostic value of MRI for ligament and tendon injury of the ankle in its normal position, and during complete plantar flexion and dorsiflexion. METHODS:It is a single-center, prospective, diagnostic trial that wil be completed at the First Hospital of Hebei Medical University, China. Sixty cases were recruited, including 30 cases of normal ankle joint and 30 cases of ankle ligament and tendon injury. MRI scans of the ankle joint in normal position, complete plantar flexion and complete dorsiflexion were performed in al the cases, and the multi-position MRI results were compared. The primary outcome measure is the sensitivity of MRI to ligament and tendon injury of the ankle during complete plantar flexion. The secondary outcomes include the specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio of MRI to ligament and tendon injury of the ankle during the complete plantar position as wel as rate of correct diagnosis;specificity and sensitivity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio in normal position or during the complete dorsiflexion as wel as rate of correct diagnosis;the morphology of the ankle on the multi-position MRI. This study design was registered at ClinicalTrial.gov (03049423) on February 8, 2017. This study protocol has been approved by the Medical Ethics Committee of Qinghai University Affiliated Hospital of China (approval No. 2015076) and wil be performed in accordance with the guidelines of the Declaration of Helsinki, formulated by the World Medical Association. Signed informed consent regarding trial procedure and treatment was obtained from each volunteer. DISCUSSION:This study aims to determine the rate of correct diagnosis of ankle ligament and tendon injury using the MRI, to clarify the diagnostic value of MRI for ankle ligament and tendon injury, and to provide a quantitative MRI diagnostic standard for developing a reasonable surgical treatment.

OBJECTIVE:To optimize the technology of supercritical CO2 extraction from Zingiberis rhizoma. METHODS:With the comprehensive score of the contents of 6-ginger phenol,8-ginger phenol and 10-ginger phenol and the extraction rate of the oil from Z. rhizoma as the index,uniform design method was adopted to investigate the effects of extraction pressure,extrac-tion temperature and extraction duration on the extraction result;verification tests were conducted. RESULTS:The optimal condi-tions were as follows as the extraction pressure of 25 MPa,extraction temperature of 30 ℃ and extraction duration of 2 h. In the verification tests,the average extraction rate of the oil from Z. rhizoma was 3.2%(n=3),and the comprehensive score was 1.874 2 (RSD=0.65%,n=3),with the relative deviation of 0.6% between the measured value and the predicted value. CONCLUSIONS:The optimal extraction technology is stable and feasible,with the advantages of low temperature,short duration.

OBJECTIVE: To assess the value of fiberoptic ductoscopy (FDS) in the diagnosis of nipple discharge. METHODS: Clinical records of 1,025 patients with nipple discharge undergoing FDS from February 2006 to March 2008 were reviewed. RESULTS: There were obviously differences in the FDS diagnosis of various nipple discharge traits. The diagnosis by FDS was pathologically confirmed in 93.7%of patients with nipple discharge (404/431). CONCLUSION FDS can effectively improve the diagnosis of nipple discharge,and has great clinical significance.
Adolescent ; Adult ; Aged ; Breast Diseases ; diagnosis ; pathology ; Breast Neoplasms ; diagnosis ; metabolism ; pathology ; Child ; Endoscopy ; methods ; Female ; Fiber Optic Technology ; methods ; Humans ; Male ; Middle Aged ; Nipples ; metabolism ; Papilloma, Intraductal ; diagnosis ; metabolism ; pathology ; Retrospective Studies ; Sensitivity and Specificity ; Young Adult

In many neurodegenerative diseases,eye movement is disrupted,which is a common and early characteris-tic of neurodegenerative diseases.Characterizing eye movement is important for the diagnosis of neurodegenerative disea-ses,helping to track disease progression and response to treatment.In recent years,eye tracking technology has been ap-plied to the assessment of cognitive function in patients with neurodegenerative diseases.Compared to traditional cognitive assessment methods,the technology has higher temporal and spatial resolution for sensitive quantification.Eye tracking da-ta confirms that executive dysfunction is common in Parkinson's disease and amyotrophic lateral sclerosis,while attention deficit is a characteristic of Alzheimer's disease and multiple sclerosis.Research using eye tracking to evaluate the cogni-tive function of epilepsy patients is still in its early stages,but this method has shown advantages.In this article,the appli-cation of eye tracking technology in neurodegenerative diseases is reviewed.

Objective To investigate the effect of balloon bionic midwifery combined with epidural analgesia on pelvic floor function in vaginal birth after cesarean section(VBAC).Methods From January 2020 to December 2021 in Nanning Maternal and Child Health Hospital,120 cases of successful vaginal delivery after a previous cesarean section were selected as study objects,and they were divided into observation group and control group according to random number table method,with 60 cases in each group.The observation group received balloon bionic midwifery combined with epidural anesthesia during labor,while the control group received only epidural anesthesia during labor.The visual analog scale(VAS)scores,degree of perineal tear,total duration of labor,postpartum blood loss,and neonatal asphyxia rate,the incidence of urinary incontinence,vaginal or uterine prolapse,and pelvic floor muscle strength and functional status of two groups were compared.Results The total duration of labor in observation group was significantly shorter than that in control group,the amount of postpartum blood loss was significantly lower than that in control group,and the incidence of urinary incontinence was significantly lower than that in control group(P<0.05).The strength,fatigue and dynamic pressure of pelvic floor muscle in observation group were significantly better than those in control group(P<0.05).There was no significant difference in the incidence of perineal laceration or lateral incision,vaginal and uterine prolapse between two groups(P>0.05).Conclusion The use of balloon bionic midwifery combined with epidural analgesia during vaginal trial of labor after cesarean section can shorten labor duration,reduce postpartum blood loss,and improve postpartum pelvic floor function.

Objective:To analyze the influencing factors related to visiting rate of residents to contracted family doctors in a community health service center in Beijing.Methods:One thousand patients with contracted family doctor services who visited our center from January 2019 to December 2019 were selected for retrospective analysis. According to the corresponding visiting rate of contracted family doctors,patients were divided into low corresponding visiting rate, medium corresponding visiting rate and high corresponding visiting rate, and the influencing factors were analyzed.Results:Among the 1 000 patients, 481 (48.1%) were in the high corresponding visiting rate group, 342 (34.2%) in the middle corresponding visiting rate group, and 177 (17.7%) in the low corresponding visiting rate group. Univariate analysis showed that the corresponding visit rate was significantly associated with the age, marital status and educational level of patients, history of hypertension, the number of family doctor visits, the total visiting time and the consultation time per year (χ 2=12.55, 12.42, 7.69, 21.69, 253.97, 49.54, 9.07, all P<0.05). Multivariate logistic regression analysis showed that compared with the high corresponding visiting rate group, fewer of family doctor visits ( OR=0.68, 95 %CI: 0.58-0.78), lower education level( OR=0.65, 95 %CI: 0.46-0.92), history of hypertension ( OR=0.09, 95 %CI: 0.02-0.49), and 18-65 years old( OR=1.80, 95 %CI: 1.27-2.55) were the influencing factors for the low corresponding family doctor visiting rate(all P<0.05); while fewer of family doctor visits( OR=0.91, 95 %CI: 0.83-0.99),lower education level ( OR=0.74, 95 %CI: 0.55-0.98)and history of hypertension( OR=0.09, 95 %CI: 0.02-0.44)were the related factors of the medium corresponding visiting rate(all P<0.05). Conclusions:The visiting rate of patients to the contracted family doctor needs to be improved. The number of consultations of the contracted family doctor, educational background, history of hypertension, and age are the influencing factors of the corresponding visiting rate.

Objective:To explore the relationship between different gestational weeks of transvaginal ultrasound-guided fetal reduction and abortion in patients with multiple pregnancies after embryo transfer, and to seek the best gestational age for fetal reduction.Methods:The datas of 486 pregnant women with multiple pregnancies after embryo transfer in the Second Hospital of Hebei Medical University from January 2012 to December 2020 were retrospectively analyzed. The relationship between gestational weeks of fetal reduction and abortion rate was analyzed by curve fitting, threshold effect and multivariate logistic regression analysis.Results:After adjusting for age, infertility type, infertility years, number of births, abortion times, body mass index(BMI), various infertility and sterility factors, endometrial thickness on the day of transformation, monozygotic twins and reduction methods, when the gestational age was less than 8.43 weeks, the abortion rate increased significantly with the increase of reduction gestational age, and the abortion rate increased by 221% ( OR=3.21, 95% CI=1.47-6.99, P=0.003 3). When the gestational age of reduction ≥8.43 weeks, the abortion rate tended to be stable and did not increase ( OR=0.81, 95% CI=0.54-1.22, P=0.317 7); meanwhile, in stratified analysis, the OR value of the BMI ≥24 kg/m 2 was 12.38, and that of BMI <24kg/m 2 was 1.91, P=0.053 9. Conclusions:There is a non-linear relationship between gestational age and abortion rate of ultrasound-guided multiple pregnancy reduction in patients with embryo transfer. The abortion rate increases significantly with the increase of gestational age before 8.43 weeks of gestation. It is recommended to carry out the operation as early as possible before 8 weeks of pregnancy. The effect of BMI on the abortion rate of patients with fetal reduction needs further study.

Background::The goal of the assisted reproductive treatment is to transfer one euploid blastocyst and to help infertile women giving birth one healthy neonate. Some algorithms have been used to assess the ploidy status of embryos derived from couples with normal chromosome, who subjected to preimplantation genetic testing for aneuploidy (PGT-A) treatment. However, it is currently unknown whether artificial intelligence model can be used to assess the euploidy status of blastocyst derived from populations with chromosomal rearrangement.Methods::From February 2020 to May 2021, we collected the whole raw time-lapse videos at multiple focal planes from in vitro cultured embryos, the clinical information of couples, and the comprehensive chromosome screening results of those blastocysts that had received PGT treatment. Initially, we developed a novel deep learning model called the Attentive Multi-Focus Selection Network (AMSNet) to analyze time-lapse videos in real time and predict blastocyst formation. Building upon AMSNet, we integrated additional clinically predictive variables and created a second deep learning model, the Attentive Multi-Focus Video and Clinical Information Fusion Network (AMCFNet), to assess the euploidy status of embryos. The efficacy of the AMCFNet was further tested in embryos with parental chromosomal rearrangements. The receiver operating characteristic curve (ROC) was used to evaluate the superiority of the model. Results::A total of 4112 embryos with complete time-lapse videos were enrolled for the blastocyst formation prediction task, and 1422 qualified blastocysts received PGT-A ( n = 589) or PGT for chromosomal structural rearrangement (PGT-SR, n = 833) were enrolled for the euploidy assessment task in this study. The AMSNet model using seven focal raw time-lapse videos has the best real-time accuracy. The real-time accuracy for AMSNet to predict blastocyst formation reached above 70% on the day 2 of embryo culture, and then increased to 80% on the day 4 of embryo culture. Combing with 4 clinical features of couples, the AUC of AMCFNet with 7 focal points increased to 0.729 in blastocysts derived from couples with chromosomal rearrangement. Conclusion::Integrating seven focal raw time-lapse images of embryos and parental clinical information, AMCFNet model have the capability of assessing euploidy status in blastocysts derived from couples with chromosomal rearrangement.