Objective To evaluate the effect of neoadjuvant chemotherapy by different arteriovenous ways on ovarian function of patients with locally advanced cervical cancer after surgery. Methods We retrospectively studied 38 cases of young women (surgical age <45 years) who were diagnosed with locally advanced squamous cell carcinoma of the cervix and undergone radical hysterectomy with ovaries. According to the way of adjuvant chemotherapy, these cases were divided into 20 cases of group A (arterial embolization chemotherapy), 18 cases of group B (intravenous chemotherapy). Each patient underwent a course of chemotherapy. Then we retrospectively analyzed and compared serum estradiol (E2 ), follicle stimulating hormone (FSH), lute-inizing hormone (LH) in two groups before and after surgery to assess ovarian function. We compared E2 ,FSH and LH levels 2-3 weeks after chemotherapy (before surgery) and 1 month after surgery,and 6 months after surgery in two groups. Results The E2 levels in group A 1 month before and after surgery significantly decreased, while FSH increased compared with those be-fore chemotherapy(P<0. 05). LH levels in two groups at different time points and 6 months after surgery showed no significant difference (P>0. 05) compared with those before chemotherapy. the E2 , FSH and LH levels in group B at different time points presented no significant difference (P>0. 05). Only E2 level in group A was significantly lower than that in group B before surger-y. Conclusion For patients with locally advanced cervical cancer, the effect of arterial embolization chemotherapy before sur-gical intervention on ovarian function is transient and reversible, while intravenous chemotherapy before surgery exerts few effects on ovarian function. Retaining ovaries in radical hysterectomy is a safe and effective method to protect the endocrine function for young patients with locally advanced cervical cancer.

Objective To investigate the effect of DPP-4 inhibitor sitagliptin on atherosclerosis and its mechanism.Methods Thirty male ApoE-/-mice were randomly divided into two groups:experimental group(n=15) and control group(n=15).The mice in the experimental group were fed with high-fat mixture of sitagliptin and the control group was fed with high fat.Collected blood in the eyeballs in order to analyze serum levels of blood lipids and blood glucose after 16 weeks of feeding,and detected serum nitric oxide synthase(eNOS),vascular adhesion molecule-1(VCAM-1) with ELISA method.Collected aortic tissue in order to analyze atherosclerotic plaque.Results There was no significant difference in blood glucose,triglyceride and total cholesterol level between the two groups(P>0.05).The serum high density lipoprotein in the experimental group was significantly higher than that in the control group(P<0.05).The atherosclerotic plaque in the experimental group(7.55±1.87)%, which was significantly smaller than that in the control group(11.67±1.32)%.The serum VCAM-1 in the experimental group was lower and the eNOS was higher than that in the control group(P<0.05).Conclusion DPP-4 sitagliptin can increase the expression of HDL and eNOS and inhibit the expression of VCAM-1,thereby inhibiting the progression of atherosclerosis in ApoE-/-mice.

To enhance speech recognition, as well as Mandarin tone recognition in noice, we proposed a speech coding strategy called zero-crossing of fine structure in low frequency (LFFS) for cochlear implant based on low frequency non-uniform sampling (LFFS for short). In the range of frequency perceived boundary of human ear, we used zero-crossing time of the fine structure to generate the stimulus pulse sequences based on the frequency selection rule. Acoustic simulation results showed that although on quiet background the performance of LFFS was similar to continuous interleaved sampling (CIS), on the noise background the performance of LFFS in Chinese tones, words and sentences were significantly better than CIS. In addition to this, we also got better Mandarin recognition factors distribution by using the improved index distribution model. LFFS contains more tonal information which was able to effectively improve Mandarin recognition of the cochlear implant.
Acoustics ; Cochlear Implants ; Equipment Design ; Humans ; Language ; Noise ; Recognition (Psychology) ; Speech Perception

Objective: To observe any curative effect on dysphagia of freehand respiratory training applied to hemiplegic stroke survivors. Methods: Forty-eight hospitalized, hemiplegic stroke survivors were randomly divided into an observation group and a control group, each of 24. Both groups received routine stroke rehabilitation, including motor function training, exercise training, physical therapy and swallowing training. The observation group was additionally provided with barehanded breathing function training, mainly consisting of cough glottis exercise, lip constriction aspiration exercise, chest movement exercise, abdominal muscle contraction and relaxation exercise, as well as abdominal aspiration training. The intervention lasted for 6 weeks for both groups. Before and after the intervention the maximum breathing time, first and second forced volume (FEV₁), forced vital capacity (FVC), maximum inspiratory pressure (PImax), standardized swallowing assessment (SSA), Kubota drinking water test (KDWT) and functional dysphagia scale (FDS) scoring were quantified for both groups. Results: There was no significant difference between the two groups′ averages on any of the measurements before the intervention. Afterward, however, the average maximal breathing time, FEV₁, FVC, and PImax of the observation group were all significantly higher than before the intervention and significantly higher than those of the control group. After treatment, the observation group′s average KDWT efficiency was not, however, significantly better than that of the control group. Moreover, after the treatment the average SSA and FDS of the observation group were significantly lower than those of the control group, as well as significantly better than before the treatment. Conclusion Barehanded breathing function training can supplement routine rehabilitation to significantly improve the breathing of stroke survivors.

Objective:To explore the risk factors for post-stroke anxiety and depression, and analyze the therapeutic effect of Jiangqi Dayu Decoction on on post-stroke anxiety and depression.Methods:A total of 201 patients with post-stroke anxiety and depression admitted to the Wuhan First Hospital from October 2019 to October 2022 were selected and included in the anxiety and depression group. They were randomly divided into a control group ( n=100, treated with conventional western medicine) and an observation group ( n=101, treated with Jiangqi Dayu decoction on the basis of conventional western medicine) using a random number table method. The clinical efficacy, Hamilton Anxiety Scale (HAMA) scores, Hamilton Depression Scale (HAMD) scores, norepinephrine (NE), brain derived neurotrophic factor (BDNF), 5-hydroxytryptamine (5-HT), and adverse reactions were compared between the control group and the observation group. During the same period, 50 patients without anxiety and depression after stroke were selected and included in the non anxiety and depression group. The general information and laboratory indicators of patients in the non anxiety and depression group were compared with those in the anxiety and depression group. Univariate and multivariate logistic regression models were used to analyze the risk factors for anxiety and depression after stroke. Results:The total effective rate of clinical efficacy in the observation group was significantly higher than that in the control group (95.05% vs 76.00%) ( P<0.05). After treatment, the HAMA and HAMD scores of both groups were lower than before treatment (all P<0.05), and the serum levels of BDNF, NE, and 5-HT were higher than before treatment (all P<0.05); After treatment, the HAMA and HAMD scores of the observation group were lower than those of the control group (all P<0.05), and the serum levels of BDNF, NE, and 5-HT were higher than those of the control group (all P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups ( P>0.05). The age, proportion of females, National Institutes of Health Stroke Scale (NIHSS) score, proportion of family care<7, and number of comorbidities>2 were significantly higher in the anxiety and depression group than those in the non anxiety and depression group (all P<0.05). The education level and per capita monthly income of families were significantly lower than those in the non anxiety and depression group (all P<0.05). The body mass index (BMI), smoking history, drinking history, white blood cells, total cholesterol, and glycated hemoglobin of both groups were significantly higher There was no statistically significant difference in disease type and stroke site (all P>0.05). The multivariate logistic regression model showed that high NIHSS score, low per capita monthly income, female gender, family care score<7 points, and the number of comorbidities>2 were risk factors for post-stroke anxiety and depression (all P<0.05). Conclusions:NIHSS score, per capita monthly income of families, gender, family care level, and the number of comorbidities can all affect the occurrence of post-stroke anxiety and depression. Jiangqi Dayu decoction has a good therapeutic effect on patients with post-stroke anxiety and depression, helping to improve anxiety and depression symptoms. It upregulates NE, BDNF, and 5-HT levels, has high safety, and is worth promoting.

Objective:To investigate the relationship of delayed cardiac tamponade (CT) after left atrial appendage closure (LAAC) in atrial fibrillation (AF) patients and implanted occluders and adjacent anatomical structures.Methods:This study was a retrospective study. Thirteen AF patients with LAAC complicated with delayed CT and with concurrent emergency pericardiocentesis drainage in Zhoupu Hospital, Shanghai University of Medicine & Health Sciences from August 2016 to June 2021 were selected. The follow-up time was (16±12) months. The clinical data of these patients were retrospectively analyzed, including the relationship between the left atrial appendage and pulmonary artery, vein anatomy by left atrium computed tomography angiography (CTA) before and after LAAC.Results:Thirteen patients with delayed CT were treated by pericardiocentesis and drainage after LAAC and aged (72.1±8.3) years, and 7 patients were male, Six patients received cryoablation simultaneously. The classification types of left atrial appendage included cauliflower and chicken wing types were 8 and 5 respectively. The seal plate diameter of the lobe-and-disc devices was (29.5±2.8)mm; 10 patients had cardiac CTA reviewed. The occluder was attached to pulmonary artery in 8 patients, attached to left superior pulmonary vein only in one patient, and attached to pulmonary artery and left superior pulmonary vein in one patient. The prognosis was good except one patient who died 2 days after LAAC.Conclusions:Delayed CT after LACC is closely related to the location of left atrial appendage adjacent to pulmonary artery and left superior pulmonary vein, and is related to larger occluder and anchor hook.

Objective:To investigate the clinical characteristics and prognosis of coronavirus disease 2019 (COVID-19) patients with Omicron variant combined with atrial fibrillation (AF).Methods:From March 23, 2022 to May 15, 2022, 2 675 aged ≥ 50 years old COVID-19 patients with AF were admitted to Zhoupu Hospital, the designated hospital for COVID-19 in Shanghai. Patients were divided into mild symptoms group, normal group, and serious/critical group according to the symptoms. The clinical data, imaging examination and laboratory results and prognosis of the three group patients were compared.Results:The median age of 2 675 COVID-19 patients was 69.0 (60.0, 81.0) years old, the incidence of AF was 5.05% (135/2 675), the age range of AF patients were from 55 to 101 years old, with a median age of 84.0 (74.0, 89.0), and the number of mild symptoms, normal, serious/critical patients were 68, 30, 37, respectively, including 9 of serious and 28 of critical patients. In the serious/critical patients, aged 55-75 years old accounted for 43.2%, the rate of 2019 novel coronavirus vaccination was 32.4%. The identified new-onset AF was the highest among the three groups, but the rate of persistent AF was the highest in the mild symptoms group (58.8%). The severe/critical group complicated with fever (29.7%), hepatic insufficiency (13.5%), renal insufficiency (46.0%), type 2 diabetes (46.0%), and heart failure were higher in NYHA classification [compared with the mild symptoms and normal group (score): 1.8±1.1 vs. 1.1±0.8, 1.2±0.7, respectively, all P < 0.05]. In term of laboratory examinations, C-reactive protein (CRP), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) levels were significantly higher in serious/critical patients compared to the mild symptoms and normal groups [CRP (mg/L): 27.2 (6.0, 60.8) vs. 7.6 (3.1, 19.3), 12.8 (4.9, 26.3), ALT (U/L): 31.3±15.4 vs. 15.4±9.3, 19.3±11.7, AST (U/L): 78.0±21.7 vs. 34.7±15.6, 38.1±24.4, all P < 0.05]. The hemoglobin (Hb) and albumin (ALB) levels were significantly lower than those in the mild symptoms and normal groups [Hb (g/L): 105.3±22.5 vs. 125.8±25.4, 123.0±20.4, ALB (g/L): 33.7±6.0 vs. 39.0±5.5 and 39.6±13.1, all P < 0.05]. In addition, MB isoenzyme of creatine kinase (CK-MB) was significantly higher in the serious/critical group than that in the mild symptoms group [μg/L: 2.5 (1.5, 3.4) vs. 2.2 (1.2, 2.8), P < 0.05]. In terms of the treatment, the percentage of antiplatelet agents and low-molecular heparin ratio compared among the three groups were statistically significant, with the serious/critical group using the lowest percentage of antiplatelet agents (27.0%) and a higher percentage of low-molecular heparin usage than that in mild symptoms group [81.1% (30/37) vs. 51.5% (35/68), P < 0.05]. In terms of prognosis, the mortality of patients with AF was 18.5% (25/135), all of whom were critical ill, including 32.0% (8/25) with cerebral embolism, pulmonary embolism and cerebral hemorrhage. Among them, 40.0% (10/25) died of multiple organ failure (40.0% combined with gastrointestinal hemorrhage), 20.0% (5/25) died of heart failure, and 12.0% (3/25) died of respiratory failure; while there were no death cases recorded in the mild symptoms, normal group and 9 serious patients. Conclusions:The serious/critical patients infected with COVID-19 Omicron variant with AF, have a worse prognosis and high mortality. Multiple organ failure, heart failure, sudden cardiac death, respiratory failure and embolic disease are the major causes of death.

Objective:To analyze the safety and efficacy of left atrial appendage closure(LAAC)with Watchman in patients ≥85 years with atrial fibrillation(AF).Methods:515 elderly patients with atrial fibrillation, including 73 patients aged 85 years or older(85~91), who had undergone Watchman LAAC at Zhoupu Hospital affiliated to Shanghai Health Medical College from August 2016 to December 2020, were retrospectively analyzed.Of those ≥85 years, 44(60.3%)with transesophageal echocardiography records were assigned to the elderly group.Fifty-three patients aged 60 to 65 were selected as the control group.Differences in baseline data, intraoperative conditions, antithrombotic treatment plans and 1-year follow-up prognosis were compared between the two groups.Results:Compared with the control group, there was no difference in AF types, history of ischemic stroke/transient ischaemic attack(all P>0.05), but there were higher incidences of coronary heart disease and renal insufficiency, more severe heart failure, higher CHA 2DS 2-VASC(6.0±1.5 vs.3.6±1.5), HAS-BLED(3.2±1.2 vs.2.3±1.3)scores( t values were 7.682 and 3.871, respectively, P<0.05), and a lower one-stop surgery rate(6 cases or 13.6% vs. 27 cases or 50.9%, χ2=10.517, P<0.05)in the advanced age group.There was no difference in the diameter of the Watchman device, rate of device replacement, compression percentage and residual flow between the two groups during the perioperative period.The incidences of device-related thrombosis were 4.5%(2/44)and 3.8%(2/53)for the advanced age group and the control group, respectively, but the difference was not statistically significant( P>0.05). During the 12-month follow-up, there were no cases of ischemic stroke or intracerebral hemorrhage.Three died of heart failure and 1 died of cancer. Conclusions:LAAC with Watchman is safe and effective for patients over 85 years with AF, but the decision on the procedure should be based on careful assessment of patients' cardiac and renal function and general health.

Objective To investigate the occupational life status and occupational related stress factors of young hospital pharmacists, and to promote the healthy development of young pharmacists. Methods Questionnaire was designed and released on-line through Wenjuan Star APP. Demographic characteristic information, occupational stress and stress management data were obtained. Data were processed with SPSS. Results About sixty percent of 289 questionnaire respondents complained of occupational stress (178 respondents). Gender, education level, hospital grade, and job position had no significant effect on occupational stress difference. However, different age group showed different occupational stress. Pharmacist at the age of 31-35 complained more stress than the other age group. Pharmacist with high title complained more stress than the lower titles. Conclusion More than half of young pharmacists suffer from the high occupational stress, and various intervention measures should be taken to relieve the stress.