Objective To evaluate the application of STIC with segmented analytical method in the diagnosis of fetal atrial septal defect. Method Review the 6600 high-risk pregnant women who accepted PHILIPS iE33 Echocardio graphy examination in our hospital , twelve cases by two-dimensional echocardiographicas atrial septal defect then using real-time STIC method to collect data and offline playback compared with sonography after birth. Results Compared with two-dimensional gray-scale ultrasonography , in the diagnosis of fetal atrial septal defect the coincidence rate of STIC with segmented analytical method was 96.5% and 96.7% respectively , no statistically difference between them (P > 0.03). However, the operating time in STIC with segmented analytical method is shorter, and with the statistically significant (P < 0.03). Conclusion Compared with gray-scale ultrasound , STIC technique combined with segmented analytical method can obtain more valuable information and improve the diagnosis coincidence rate , which is a valuable new technology.

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Objective To investigate the reliability and validity of Simple Facial Grading System (SFGS) in patients with idiopathic facial palsy. Methods 80 patients with idiopathic facial palsy were evaluated with the House-Brackmann (H-B) scale and SFGS before and every 2 weeks after treatment until 12 weeks or recovery. They were assessed by 2 testers before and 2 weeks after treatment. The results were analyzed and compared. Results The Cronbach's α coefficient was 0.93 of SFGS, and 0.74 of H-B scale. The intraclass correlation coefficient (ICC) between testers was 0.84 or higher of SFGS, and 0.77 or higher of H-B scale. The Spearman's rank correlation coefficient between SFGS and H-B scale was 0.73, Kappa coefficients was 0.81 for grade II, 0.74 for grade III, 0.49 for grade IV, 0.66 for grade V, and 0.92 for grade VI. The scores of SFGS and H-B scale positively correlated with the recovery time. Conclusion SFGS is a kind of evaluation for peripheral facial paralysis with satisified reliability and validity, which can be applied to evaluate the severity and outcome during acute stage.

Objective To investigate the effect of polylactic-co-glycolic acid (PLGA)/graphene oxide (GO) nanofibers combined with brain derived neurotrophic factor (BDNF) on neural stem cells (NSCs) proliferation and differentiation as well as on the spinal cord injury repair.Methods PLGA/GO nanofibers were manufactured and absorbed with BDNF,and the microstructure of PLGA/GO nanofibers was observed by scanning electron microscope.The loading efficiency and release curve of BDNF on PLGA/GO nanofibers were measured by ELISA.NSCs were implanted on the surface of PLGA/GO and PLGA/GO/BDNF nanofibers.The absorbance values of each group were measured by MTT method,and the expression of Tuj-1 was observed by immunofluorescence and PCR.A total of 30 female SD rats were divided into control group (n =10),PLGA/GO group (n =10) and PLGA/GO/BDNF group (n =10) according to random number table.T9 spinal cord tissue was cut by Venus scissors to establish spinal cord hemisection injury model of rats.PLGA/GO and PLGA/GO/BDNF nanofibers were implanted onto the surface of injury site.BBB score was used to assess the motion functional recovery of the rats at 1,7,14 and 28 days after operation.Immunofluorescence staining of neuron specific nucleoprotein (NeuN)and glial fibrillary acidic protein (GFAP) were performed to observe the expressions of neurons and astrocytes at the injured site respectively one month after injury.Results The PLGA/GO nanofibers showed an irregular smooth fiber-like structure,and the average fiber diameter was (987.5 ± 176.3)nm.NSCs could differentiate into neurons on the nanofibers.The result of ELISA showed loading rate of BDNF on PLGA/GO nanofibers was about 47.5％.The release curve showed that BDNF was first released about 30％ on the first day and then about 60％ on the 21st day.The results of MTT and PCR showed that optical density value and Tuj-1 gene expression in the PLGA/GO/BDNF group were significantly higher than those in the PLGA/GO group (P ＜ 0.05).The animal experiment results showed that the BBB score of PLGA/GO/BDNF group was (15.3 ±0.7) points at 28 days after injury,which was significantly higher than that of the injury control group [(11.8 ± 0.8) points] and that of PLGA/GO group [(12.7 ±0.8) points] (P ＜ 0.05).Immunofluorescence results showed that the expression of NeuN in PLGA/GO/BDNF group was 13.7 ± 2.2,significantly higher than that in injury control group (4.3 ± 2.9) (P ＜0.05),and the expression of GFAP in PLGA/GO group was (25.6 ± 4.3) ％ significantly lower than that in injury control group [(38.5 ± 6.2) ％] and PLGA/GO group [(36.7 ± 7.3) ％] (P ＜ 0.05).Conclusion PLGMGO nanofibers combined with BDNF can effectively promote the proliferation and neuron differentiation of NSCs in vitro and repair spinal cord injury in vivo through orthotopic transplantation at the injury site.

Objective: To investigate the sleep and mental health status of adolescents in Shandong Province, to explore the correlation between sleep and mental health, so as to provide a basis for adolescent physical and mental health management. Methods: From February to March 2023,a multistage stratified whole cluster sampling method was used to randomly select 3 cities in Shandong Province, one urban area and one township in each city, one junior high school and one senior high school in the urban area and the township, respectively, and then 4 classes were randomly selected from each grade level of each school, and all 3 667 students in the classes were surveyed by using the Pittsburgh Sleep Quality Index Scale (PSQI) short form and the Chinese Middle School Students Mental Health Inventory (MMHI-60). Results: The prevalence of sleep deprivation among adolescents in Shandong Province was 37.44%, and the detection rate of psychological problems was 46.41%. Adolescent psychology could be divided into four latent categories:psychological immune group (39.6%), psychological low risk group (12.2%), psychological medium risk group (13.2%) and psychological high risk group (35.0%). Multifactorial Logistic regression analyses showed that gender, school year, sleep duration and sleep quality were influencing factors for the psychological latent categories ( OR =1.39-9.55, P < 0.05 ), and that adolescents with sleep deprivation and poor sleep quality were more inclined to be classified as being in the psychological medium and high risk groups. Conclusions The sleep and mental health of adolescents in Shandong Province is not very good. Comprehensive prevention and control of psychological problems should not only focus on personality and psychological characteristics, but also need to be combined with the sleep condition of adolescents.

Objective:To investigate the efficacy of liraglutide combined with enpagliflozin in the treatment of obesity complicated by type 2 diabetes mellitus.Methods:A total of 160 obesity patients with type 2 diabetes mellitus who received treatment in Yuyao People's Hospital, China between October 2018 and October 2019 were included in this study. They were randomly assigned to receive repaglinide, insulin detemir and metformin in combination (control group, n = 80) or liraglutide, enpagliflozin and metformin in combination (treatment group, n = 80). After 3 months of treatment, fasting blood glucose, glycosylated hemoglobin, 2-hour postprandial blood glucose, body mass index, tumor necrosis factor-alpha, C-reactive protein, interleukin-6, leptin, adiponectin, and vaspin as well as the incidence of adverse reactions were compared between the control and treatment groups. Results:After treatment, fasting blood glucose, glycosylated hemoglobin, 2-hour postprandial blood glucose and body mass index were reduced in each group. They were (7.89 ± 1.02) mmol/L, (8.10 ± 1.25) %, (11.10 ± 1.59) mmol/L, (23.18 ± 2.19) kg/m 2, respectively in the observation group, which were significantly lower than those in the control group [(9.88 ± 1.27) mmol/L, (11.20 ± 1.85)%, (13.67 ± 2.01) mmol/L, (27.80 ± 2.51) kg/m 2, t1 = 10.927, t2 = 12.418, t3 = 8.969, t4 = 12.405, all P < 0.001). After treatment, tumor necrosis factor-alpha, C-reactive protein and interleukin-6 levels were reduced in each group. Their levels in the observation group were [(51.19 ± 3.19) pg/L, (2.14 ± 0.31) mg/L, (4.07 ± 0.67) pg/L, respectively, which were significantly lower than those in the control group [(62.18 ± 4.10) pg/L, (3.66 ± 0.58) mg/L, (5.96 ± 0.81) pg/L, t1 = 18.922, t2 = 20.672, t3 = 8.969, all P < 0.001). After treatment, leptin and vaspin levels were reduced in each group, and their values in the observation group were (5.48±0.94) μg/L, (1.62 ± 0.37) μg/L, respectively, which were significantly lower than those in the control group [(6.59 ± 0.82) μg/L, (1.99 ± 0.52) μg/L, t1=7.959, t2=10.323, both P < 0.001]. Adiponectin level increased in each group, and it was significantly higher in the observation group than in the control group [(7.13 ± 1.52) mg/L vs. (5.12 ± 0.85) mg/L, t3 = 5.185, P < 0.001]. There was no significant difference in the incidence of adverse reactions between control and observation groups ( χ2 = 0.313, P > 0.05). Conclusion:Liraglutide combined with enpagliflozin for the treatment of obesity complicated by type 2 diabetes mellitus is highly effective. It can effectively lower blood glucose level, reduce body mass and inflammatory reactions, further regulate serum vaspin, leptin and adiponectin levels and is highly safe. Therefore, this method can be widely used in the clinic.

Triple positive breast cancer overexpress ER (estrogen receptor), PR and HER2 (human epidermal growth factor receptor 2, HER2), accounting for about 50%-60% of the HER2 positive breast cancer patients. Based on the data from clinical trials, the crosstalk between the ER signaling pathway and the HER2 signaling pathway in triple-positive breast cancer may weaken the efficacy of anti-HER2 therapy and endocrine therapy, and this feature has attracted widespread attention. Emerging evidence shows that while blocking HER2 signaling pathway, together with enhancing blocking of ER signaling pathway, such as anti-HER2 dual-targeting + endocrine therapy ± CDK4 / 6 inhibitors, could effectively overcome drug resistance, and improve the efficacy. Predictive biomarkers including Ki67, intrinsic subtypes, and multi-gene assay, which have the potential benefit for personalized treatment.

Objective To explore the incidence of dysphagia and its potential risk factors.Methods From January 2014 to December 2015,a total of 187 patients who underwent single-level anterior cervical spine surgery were recruited in this retrospective analysis study.Specific perioperative data including age,gender,smoking,alcohol use,BMI,estimated blood loss,surgical segment,length of incision,and length of hospital stay were recorded respectively.The Bazaz grading system and the swallowing quality of life (SWAL-QOL) score were used to assess the presence and severity of dysphagia.According to the Bazaz grading system,the patients were divided into dysphagia group and non-dysphagia group 1 week after operation.One-factor x2 test and one-sample t test were used to univariate analyze the two groups of related factors,and select the potential variables for multivariate logistic regression analysis to identify the risk factors leading to dysphagia.Results The number of dysphagia patient was 99 (52.94％) at 1 week after surgery,and 16 (8.56％) at 1 year.The preoperative mean SWAL-QOL score was 65.62±4.41 points,which decreased to 58.72±7.54 points after surgery and rose up to 64.66±5.26 points at the 12-month follow-up.The SWAL-QOL score at 1 week after surgery was correlated with the operative time (r=-0.474;P ＜ 0.001).Multivariate analysis indicated that preoperative tracheal exercise (OR=0.302,95％CI:0.131,0.748),operation time ＜ 60 min (OR=0.407,95％CI:0.190,0.878),and arthroplasty (OR=0.211,95％CI:0.102,0.425) were the independent factors to reduce the incidence of postoperative dysphagia.Conclusion The incidence and severity of dysphagia symptoms after single-level anterior cervical spine surgery gradually decreased with the extension of follow-up time.Preoperative tracheal exercise,shortened operative time and manual artificial disc replacement may be helpful to reduce the postoperative occurrence of dysphagia.

Objective To observe the effect of Yanshu compound radix sophora injection on the clinical efficacy of patients after interventional embolization for liver cancer rupture and hemorrhage. Methods Sixty-four patients with hepatic cancer rupture and hemorrhage admitted into Department of Hepatobiliary and Pancreatic Surgery in Wuhan Central Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology to undergo interventional embolization and hemostasis from January 2013 to December 2017 were retrospectively analyzed. According to whether the Yanshu compound radix sophora injection was used or not after surgery, the patients were divided into two groups: the patients in western medicine routine treatment control group (32 cases) were given blood transfusion, drugs for pain relief, stopping vomiting, liver protection and symptomatic treatment; the patients in Yanshu compound radix sophora injection group (32 cases) were given besides the above western medicine routine treatment, Yanshu compound radix sophora injection 20 mL in 250 mL 0.9% sodium chloride intravenous drip was additionally applied, once a day for consecutive 10 days. The times of postoperative using analgesics, antiemetics and the proportions of occurring myelosuppression, liver function damage tumor re-bleeding, and decrease of alpha-fetoprotein (AFP) level were observed in two groups. Results The times of using analgesics and antiemetics in patients of compound radix sophora injection group were significantly less than those in the routine treatment group [times of using analgesics (times): 3.2±1.2 vs. 7.4±1.3, times of using antiemetics (times): 4.1±1.1 vs. 7.2±1.2, both P < 0.05], the incidences of adverse reactions such as myelosuppression, liver function damage, tumor re-bleeding rate and AFP reduction rate in patients of compound radix sophora injection group were significantly lower than those in the routine treatment group [myelosuppression: 28.1% (9/32) vs. 56.2% (18/32), liver function damage: 9.4% (3/32) vs. 21.9% (7/32), tumor re-bleeding: 3.1% (1/32) vs. 9.4% (3/32), AFP reduction: 21.9% (7 /32) vs. 15.6% (5/32), all P < 0.05]. Conclusion Yanshu compound radix sophora injection combined with interventional embolization for treatment of patients with hepatic cancer rupture and hemorrhage can significantly improve the clinical efficacy, reduce the incidence of adverse reactions and protect liver function.

In this paper， the latest research progress on the mechanism of comorbid alcohol use disorder and depressive disorder at home and abroad is elucidated from genetic， neurochemical， neuroendocrine and neuroimmunologic perspectives. It aims to identify the gaps in current research and predict future research directions， providing a further basis for the clinical management of comorbid alcohol use disorder and depressive disorder.