Neural prosthesis control system is based on brain-computer interface and functional electrical stimulation technology, by an-alyzing the electroencephalograph control commands directly into the muscle system or an external device, which compensated efferent pathway from the brain-spinal cord, and recovered motor function of patients with cervical spinal cord injury. This paper described the basic structure, working principle and key technology of neural prosthetic system, summarized the application, problems and prospects of neural prosthetic technology in the rehabilitation of cervical spinal cord injury.

Interferons (IFNs) are cytokines playing an important role in immune responses. Interferons are classified into two distinct types according to specific interferon receptors(IFNR). Type I IFNs include IFN-α and IFN-β, whereas IFN-γ is type II IFN. It is well known that type I IFNs have important roles in the host defense against viruses through activation of interferon receptor A (IFNAR). However, many recent studies have also demonstrated that type I IFNs have effects on immune responses to bacterial infection. This review focuses on the immune regulation of type I IFN-mediated signal pathways in bacterial infections such as Listeria monocytogenes, Streptococcus, Mycobacterium tuberculosis, Bacillus anthracis, Legionella, Pseudomonas aeruginosa and others.
Animals ; Bacterial Infections ; immunology ; Humans ; Immunity, Innate ; Interferon Type I ; immunology ; Signal Transduction

Objective:To investigate the association between estradiol on the day of human chorionic gonadotropin (HCG) administration and birth outcomes among singleton live births following fresh embryo transfers.Methods:Based on the clinical reproduction medicine management system of the First Affiliated Hospital of Nanjing Medical University, this retrospective cohort study collected data of fresh embryo transfer cycles during January 2013 and December 2016, including pregnant women’s age, body mass index (BMI), type and cause of infertility, assisted reproductive therapy indicators (fertilization mode, ovulation stimulation protocol, estradiol levels on HCG administration day), adverse birth outcomes[small for gestational age (SGA), premature and low birth weight (LBW)], etc.. A total of 2 060 women with singleton pregnancy (2 061 fresh embryo transfer cycles) were enrolled. Multivariate logistic regression was used to analyze the association between estradiol on HCG administration day and singletons’ adverse birth outcomes.Results:The age and BMI of the 2 060 pregnant women were (29.63±3.92) years old and (22.29±2.86) kg/m 2. Incidences of SGA, premature and LBW were 9.8% (201/2 061), 6.9% (143/2 061) and 3.5% (73/2 061), respectively. After adjusting for confounders, the risk of LBW in 4 000-4 499 pg/ml group was significantly elevated when compared to estradiol<1 500 pg/ml group [ OR (95% CI): 4.42 (1.13-17.24)]. A protective effect of premature was observed in estradiol≥4 500 pg/ml group [ OR (95% CI): 0.50 (0.25-0.97)]. Conclusion:The high level of estradiol on HCG administration day might be a risk factor for LBW, but a protective factor for premature.

Objective To evaluate the efficacy and safety of fluorouracil and leucovorin and oxaliplatin(FOLFOX)regimen hepatic artery infusion chemotherapy(HAIC)combined with lenvatinib(LEN)and immune checkpoint inhibitors(ICIs)in treating patients with hepatocellular carcinoma(HCC)after the occurrence of transcatheter arterial chemoembolization(TACE)refractoriness.Methods The clinical data of 54 HCC patients who developed TACE refractoriness,were admitted to the Jiangsu Provincial Cancer Hospital of China to receive FOLFOX-HAIC combined with LEN and ICIs therapy between January 2019 and December 2022,were retrospectively analyzed.The modified Response Evaluation Criteria in Solid Tumors(mRECIST)was used to statistically analyze the clinical efficacy,the Common Terminology Criteria For Adverse Events version 5.0(CTCAE 5.0)was adopted to record and evaluate the treatment-related adverse events(TRAEs).The primary endpoints were progression-free survival(PFS)and overall survival(OS),the secondary endpoints were objective response rate(ORR),disease control rate(DCR),and safety.Results The median PFS was 11.7 months(95％CI:8.124-15.276 months),the median OS was 23.1 months(95％CI:19.508-26.692 months),the ORR was 46.3％,and the DCR was 87.0％.The most common TRAE at all levels was elevated alanine aminotransferase(51.9％),and the most common TRAE of grade 3/4 was hypertension(9.3％).No treatment-related death occurred.Conclusion For the treatment of HCC patients who developed TACE refractoriness,FOLFOX-HAIC combined LEN and ICIs is clinically safe and effective.(J Intervent Radiol,2024,33:610-615)

Objective:To investigate the association between estradiol on the day of human chorionic gonadotropin (HCG) administration and birth outcomes among singleton live births following fresh embryo transfers.Methods:Based on the clinical reproduction medicine management system of the First Affiliated Hospital of Nanjing Medical University, this retrospective cohort study collected data of fresh embryo transfer cycles during January 2013 and December 2016, including pregnant women’s age, body mass index (BMI), type and cause of infertility, assisted reproductive therapy indicators (fertilization mode, ovulation stimulation protocol, estradiol levels on HCG administration day), adverse birth outcomes[small for gestational age (SGA), premature and low birth weight (LBW)], etc.. A total of 2 060 women with singleton pregnancy (2 061 fresh embryo transfer cycles) were enrolled. Multivariate logistic regression was used to analyze the association between estradiol on HCG administration day and singletons’ adverse birth outcomes.Results:The age and BMI of the 2 060 pregnant women were (29.63±3.92) years old and (22.29±2.86) kg/m 2. Incidences of SGA, premature and LBW were 9.8% (201/2 061), 6.9% (143/2 061) and 3.5% (73/2 061), respectively. After adjusting for confounders, the risk of LBW in 4 000-4 499 pg/ml group was significantly elevated when compared to estradiol<1 500 pg/ml group [ OR (95% CI): 4.42 (1.13-17.24)]. A protective effect of premature was observed in estradiol≥4 500 pg/ml group [ OR (95% CI): 0.50 (0.25-0.97)]. Conclusion:The high level of estradiol on HCG administration day might be a risk factor for LBW, but a protective factor for premature.

BACKGROUNDCommunity-acquired pneumonia (CAP) remains one of the leading causes of death from infectious diseases around the world. Most severe CAP patients are admitted to the intensive care unit (ICU), and receive intense treatment. The present study aimed to evaluate the role of the pneumonia severity index (PSI), CURB-65, and sepsis score in the management of hospitalized CAP patients and explore the effect of ICU treatment on prognosis of severe cases.

METHODSA total of 675 CAP patients hospitalized in the Second Affiliated Hospital of Zhejiang University School of Medicine were retrospectively investigated. The ability of different pneumonia severity scores to predict mortality was compared for effectiveness, while the risk factors associated with 30-day mortality rates and hospital length of stay (LOS) were evaluated. The effect of ICU treatment on the outcomes of severe CAP patients was also investigated.

RESULTSAll three scoring systems revealed that the mortality associated with the low-risk or intermediate-risk group was significantly lower than with the high-risk group. As the risk level increased, the frequency of ICU admission rose in tandem and LOS in the hospital was prolonged. The areas under the receiver operating characteristic curve in the prediction of mortality were 0.94, 0.91 and 0.89 for the PSI, CURB-65 and sepsis score, respectively. Compared with the corresponding control groups, the mortality was markedly increased in patients with a history of smoking, prior admission to ICU, respiratory failure, or co-morbidity of heart disease. The differences were also identified in LOS between control groups and patients with ICU treatment, heart, or cerebrovascular disease. Logistic regression analysis showed that age over 65 years, a history of smoking, and respiratory failure were closely related to mortality in the overall CAP cohort, whereas age, ICU admission, respiratory failure, and LOS at home between disease attack and hospital admission were identified as independent risk factors for mortality in the high-risk CAP sub-group. The 30-day mortality of patients who underwent ICU treatment on admission was also higher than for non-ICU treatment, but much lower than for those patients who took ICU treatment subsequent to the failure of non-ICU treatment.

CONCLUSIONSEach severity score system, CURB-65, sepsis severity score and especially PSI, was capable of effectively predicting CAP mortality. Delayed ICU admission was related to higher mortality rates in severe CAP patients.

Adult ; Aged ; China ; Community-Acquired Infections ; mortality ; pathology ; Female ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Pneumonia ; mortality ; pathology ; Sepsis ; mortality ; pathology ; Severity of Illness Index

Objective:To analyze the clinical feature of adult patients with infection-associated hemophagocytic syndrome (IAHS), and to improve the ability of clinicians to diagnose and treat IAHS.Methods:A retrospectively study was performed. The clinical data of 32 adult patients with IAHS admitted to the intensive care unit (ICU) of the First Affiliated Hospital of Kunming Medical University from July 2014 to November 2019 were analyzed. The general data, clinical manifestations, laboratory results, imaging findings, pathogen and clinical outcomes were collected, and the patients were divided into survival group and death group according to the 28-day prognosis. The clinical data between the two groups were compared, and multivariate Logistic regression analysis was used to analyze the variables with statistical significance in univariate analysis. The receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of variables with statistical significance in univariate analysis for 28-day prognosis of adult patients with IAHS.Results:Among 32 adult patients with IAHS, there were 17 males (53.1%) and 15 females (46.9%). Eighteen patients were bacterial infection, most of which were Acinetobacter baumannii and Escherichia coli; 14 patients were viral infection, mainly EB virus; and the overall 28-day mortality was 62.5% (20/32). ① Compared with the survival group ( n = 12), the levels of white blood cell (WBC), neutrocyte (NEU), lymphocyte (LYM), platelet (PLT) and oxygenation index (OI) in the death group ( n = 20) were lower, while the levels of aspartate aminotransferase (AST), K +, serum ferritin (SF) and lactate dehydrogenase (LDH) were higher [WBC (×10 9/L): 3.90±3.36 vs. 9.57±6.48, NEU (×10 9/L): 2.69±2.09 vs. 7.01±6.34, LYM (×10 9/L): 0.36 (0.23, 0.84) vs. 1.24 (0.61, 2.36), PLT (×10 9/L): 51.15±27.60 vs. 108.42±80.26, OI (mmHg, 1 mmHg = 0.133 kPa): 134.0 (77.5, 192.0) vs. 292.0 (187.0, 329.0), AST (U/L): 254.00 (67.80, 452.50) vs. 85.50 (38.38, 111.25), K + (mmol/L): 4.06 (3.65, 4.51) vs. 3.52 (3.26, 3.76), SF (μg/L): 6 290.0 (1 851.0, 13 904.8) vs. 1 777.1 (1 228.5, 3 486.3), LDH (μmol·s -1·L -1): 19.3 (11.9, 27.0) vs. 9.8 (6.9, 11.1), all P < 0.05]. In death group, duration of having a fever after admission was prolonged [days: 13.5 (9.0, 17.2) vs. 6.0 (2.5, 8.0), P < 0.05] and the incidence of cyanosis was higher (40.0% vs. 0%, P < 0.05). There was no significant difference in other indicators between the two groups. ② Multivariate Logistic regression analysis showed that low OI combined with high LDH were risk factors for 28-day mortality of adult patients with IAHS [odds ratio ( OR) was 0.967 and 1.007, respectively, both P < 0.05].③ It was shown by ROC curve analysis that WBC, NEU, AST, SF, LDH and OI had predictive value for 28-day prognosis of adult patients with IAHS (both P < 0.05), and the area under ROC curve (AUC) of OI and LDH was higher, that was both 0.847. When the best cut-off of OI was 145.5 mmHg, the sensitivity was 63.2%, and the specificity was 100%. When the best cut-off of LDH was 13.4 μmol·s -1·L -1, the sensitivity was 72.2%, and the specificity was 91.7%. Conclusion:OI < 145.5 mmHg, and LDH > 13.4 μmol·s -1·L -1 were significant predictors for poor 28-day prognosis of adult patients with IAHS.

OBJECTIVETo explore the relationship between multi-trace elements levels in hair and human neural tube defects as well as other risk factors.

METHODSUsing 88 paired cases and controls, an 1:1 matched case control study was carried out. The study subjects were collected from the China-U. S. Collaborative Project on Neural Tube Defects Prevention and Birth Defects Surveillance System. Risk factors were obtained by field investigation with standardized questionnaires and hair trace elements levels were determined by AAS and ICP-MS methods. Microwave digestion was used to digest hair samples. The detected elements would include three groups, namely nutritional elements: Cr, Mn, Cu, Zn, Co, Mo; toxic elements: Pb, As, Cd, Hg; and Lanthanons: Y, La, Pr, Nd. Cox Proportional Hazard Regression Model was used to perform risk factors analysis.

RESULTSPregnancy fever appeared to be a risk factor of neural tube defects (OR = 6.525, P = 0.034) while hair zinc level (OR = 0.541 microg/100 g, P = 0.02) and times of prenatal physical examination (OR = 0.634, P < 0.001) served as two protective factors appeared in the last model.

CONCLUSIONZinc deficiency might serve as a risk factor for human neural tube defects, suggesting that the avoidance of pregnancy infection together with more periodical prenatal physical examination might reduce the incidence of neural tube defects.

Adult ; Analysis of Variance ; Case-Control Studies ; Diet ; Female ; Hair ; metabolism ; Humans ; Infant, Newborn ; Logistic Models ; Male ; Neural Tube Defects ; etiology ; metabolism ; Pregnancy ; Pregnancy Complications ; metabolism ; Prenatal Care ; Risk Factors ; Surveys and Questionnaires ; Trace Elements ; metabolism

ation were complicated, with the characteristics as the obvious decreasing number of patients, with no food-borne isolates in 2007.

Objective To investigate the factors affecting the prognosis of patients with malignant obstructive jaundice(MOJ)after receiving biliary stent placement combined with intraluminal brachytherapy with 125I seed-strip implantation.Methods The clinical data of 52 patients with MOJ,who received biliary stent placement combined with intraluminal brachytherapy with 125I seed-strip implantation at the Jiangsu Provincial Cancer Hospital of China between January 2019 and January 2023,were retrospectively analyzed.The difference value between preoperative and postoperative number of lymphoid immune cells was recorded as△X.X-tile software was used to calculate the optimal cut-off value of △X,based on which the patients were divided into two groups.Univariate and multivariate analysis were used to determine the risk factors for overall survival(OS).Results The mean survival time of the 52 patients was(201.0±32.1)days.Univariate analysis indicated that postoperative TACE,preoperative ALT,preoperative AST,△lymphocyte cell,△CD3+T cell,△CD8+T cell,△natural killer cell(NK)and △regulatory cell(Treg)were significantly associated with OS,the differences were statistically significant(all P＜0.05).Multivariate analysis revealed that △lymphocyte cell(P=0.007)and △Treg(P=0.038)were the independent risk factors for OS.Conclusion For MOJ patients whose△lymphocyte is ≥0.237 or △Treg is ≥0.21,a longer OS can be expected after receiving the treatment of biliary stent placement combined with intraluminal brachytherapy with 125I seed-strip implantation.