The study developed a memory task training system using functional near-infrared spectroscopy(fNIRS)and neurofeedback mechanisms,and acquired and analyzed subjects'EEG signals.The results showed that subjects participating in the neurofeedback task had higher correlated brain network node degrees and average cluster coefficients in the right hemisphere brain region of the prefrontal lobe,with relatively lower dispersion of mediator centrality.In addition,the subjects'left hemisphere brain region of the prefrontal lobe section had increased centrality in the neurofeedback task.Classification of brain data by the channel network model and the support vector machine model showed that the classification accuracy of both models was higher in the task state and resting state than in the feedback task and the control task,and the classification accuracy of the channel network model was higher.The results suggested that subjects in the neurofeedback task had distinct brain data features and that these features could be effectively recognized.

Objective A retrospective analysis was carried out for the classification and character-istics of fever of unknown origin, and its trend in recent years. Methods A total of 1192 patients with fe-ver of unknown origin, who were admitted to the First Affiliated Hospital of Xinjiang Medical University from January 2010 to December 2016, were enrolled in this study. Descriptive analysis of the proportion, charac-teristics, and trend different diseases in the fever of unknown origin was performed. Results A total of 1080 cases was diagnosed in 1192 patients, with a diagnosis rate of 90. 6％. The final diagnoses included infections, inflammatory diseases, malignancies and miscellaneous conditions in 72. 9％, 9. 1％,5. 1％ and 3. 4％ of subjects, whereas 9. 4％ of cases remained undiagnosed. The results of variance analysis showed that the white blood cells and hemoglobin of infectious diseases were higher than those of connective tissue disease and malignancy were respectively [(11. 12 ± 2. 58) × 109/L vs (8. 82 ± 1. 12) × 109/L vs (9. 67 ±2.76) ×109/L, (116.81 ±20.77)g/L vs (103.25 ±22.84)g/L vs (102.30 ±25.14)g/L], While period of hospitalization and erythrocyte sedimentation rate were lower than that of connective tissue disease and malignancy were respectively [ ( 12. 15 ± 7. 91 ) days vs ( 19. 94 ± 10. 17 ) days vs ( 18. 85 ± 14. 37 ) days, (48.12 ±20.93)mm/h vs (58.13 ±20.24)mm/h vs (56.9 ±20.52)mm/h], and the age of ma-lignant was higher than that of infectious disease and connective tissue disease were [(56. 38 ± 17. 57)years vs (45. 99 ± 16. 79)years vs (41. 09 ± 16. 79)years], the difference was statistically significant (P<0. 05).The rank sum test showed that eosinophils, lymphocytes and interleukin-6 were not equal ( P <0. 05 ) . Conclusions Infectious diseases in fever of unknown origin ( FUO) are still the main cause. whereas blood cells, eosinophils, lymphocytes, hemoglobin,erythrocyte sedimentation rate, interleukin 6, age and hospi-talization time were predictive of disease diagnosis. In recent years, there was no obvious trend of all kinds of diseases.

Objective To describe the Xinjiang region of tuberculous meningitis (TBM) (age ＞ 18 years of age) in patients with the clinical features,analysis of factors influencing the prognosis.Methods A retrospective of cases included in the data collection,describe the clinical characteristics,using the single factor and multiple factors Logistic regression analysis of factors influencing the prognosis.Results A total of 200 cases of TBM patients had the following characteristics:120 cases of male,female 80 cases;age 18 -75 (37.35 ±+ 14.24) years old;the course of the disease 3-270 (36.86 +43.86)days;and 179 cases of survival,21 cases of death,with a mortality of l0.5％.Single factor analysis showed that hydrocephalus,encephaledema,clinical staging,erythrocyte sedimentation rate,cerebro-spinal fluid (CSF)-protein had statistically significant difference between survival group and death group,respectively (P ＜ 0.05).The multi-factor Logistic regression analysis showed that encephaledema and erythrocyte sedimentation rate were independent factors to affect the prognosis of TBM (P ＜ 0.05).Conclusions Encephaledema and erythrocyte sedimentation rate are independent risk factors of poor prognosis in patients with TBM,early identify predictors,formulate corresponding clinical countermeasures,and can improve the prognosis of patients with tuberculous meningitis.

Objective:To explore the effects of pedicled flap combined with membrane induction technique in repairing foot and ankle wounds in diabetic patients.Methods:A retrospective observational study was conducted. From March 2019 to July 2021, 12 patients with diabetic foot and ankle wounds who met the inclusion criteria were admitted to Wuxi Ninth People's Hospital, including 7 males and 5 females, aged 20 to 92 years. The wound area before debridement was 4.0 cm×2.5 cm to 16.0 cm×12.5 cm. The patients underwent debridement+antibiotic cement tamponade in stage Ⅰ; according to the wound site, peroneal artery perforator flap or posterior tibial artery perforator flap was chosen to repair the wound in stage Ⅱ, with the area of the resected flap ranging from 4.5 cm×3.0 cm to 18.5 cm×14.0 cm. The donor site was directly closed in 4 patients or covered by full-thickness inguinal skin graft in 8 patients. After the operation of stage Ⅱ, the survival of flap and skin graft, the scar in donor and recipient sites of flap, the appearance of flap, and the function of ankle joint of affected extremity were followed up. The recovery of foot and ankle function was evaluated and rated by the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scoring System at the last follow-up.Results:During the follow-up of 4 to 15 months after the operation of stage Ⅱ, both the flap and skin graft survived, without obvious infection recurrence. Linear scars were left in donor and recipient sites of flap, with good appearance in flap. The function of ankle joint in the affected extremity was nearly normal. At the last follow-up, the AOFAS scores of patients were 79 to 93, with excellent in 8 cases and good in 4 cases.Conclusions:The pedicled flap combined with membrane induction technique for repairing foot and ankle wounds in diabetic patients has the advantage of simple operation, preserved ankle joint function, and less postoperative infection recurrence, which is worth popularizing in clinical practice.

Objective To explore the effect of early administration of high-dose amino acids in parenteral nutrition for low birth weight infants of prematurity.Methods A total of 191 prematures admitted to the First Affiliated Hospital of Nanjing Medical University from June 2015 to December 2016 were selected,and they were randomly divided into the study group (n =110) and the control group (n =81).The starting amino acid dose was 1.8-2.5 g/(kg · d)and 1.0-1.5 g/(kg · d) in the study group and the control group,respectively.Lipids,glucose,and electrolytes in parenteral nutrition were applied according to standard protocol of the guideline.And the start of enteral feeding,the recovery of birth weight,the duration of parenteral nutrition,the time before total enteral nutrition,duration of hospital stay,incidence of respiratory distress syndrome,duration of mechanical ventilation and incidence of kaliopenia were compared between the 2 groups.Results The start of enteral feeding,the recovery of birth weight,the duration of parenteral nutrition,the time before total enteral nutrition in the study group were earlier than those in the control group [(3.83 ±3.15) d vs.(5.53 ±5.63) d,(15.47±10.54) d vs.(19.47 ± 14.57) d,(16.46 ± 10.33) d vs.(21.41 ±18.00) d,(6.36 ± 4.88) d vs.(8.48 ± 9.27) d],and the differences were all statistically significant (t =2.455,2.097,2.217,2.041,P =0.016,0.038,0.029,0.043).The duration of hospital stay was shorter and the hospitalization expenses were lower in the study group than those in the control group,but the differences were not significant (all P ＞ 0.05).The incidence of respiratory distress syndrome in the study group was significantly lower than that in the control group[20.91％ (23/110 cases) vs.35.80％ (29/81 cases)],and the difference was statistically significant (x2 =5.223,P =0.022).The duration of mechanical ventilation in study group was shorter than that in control [(1.12 ± 2.62) d vs.(3.31 ± 8.13) d],and the difference was statistically significant (t =2.231,P =0.028).The incidence of kaliopenia in the study group was higher than that in the control group [30.91％ (34/110 cases)vs.17.28％ (14/81 cases)],and the difference was statistically significant (x2 =4.603,P =0.032).There were not significant differences in terms of complications of necrotizing enterocolitis,sepsis,extrauterine growth retardation,hospital infection,metabolic acidosis,hyperglycemia,glucopenia,patent ductus arteriosus and respiratory distress syndrome between 2 groups (all P ＞ 0.05).Conclusions Early administration of high-dose amino acids in parenteral nutrition for preterm infants can result in earlier enteral nutrition,shorter parenteral nutrition duration without increasing incidence of complications and hospitalization expenses.

Objective:To investigate the effect and indications of pedicled myocutaneous flap and modified Masquelet technique in the repair of diabetic soft tissue and tibial bone defects.Methods:From January, 2017 to October, 2019, data of surgical treatment of 20 patients with diabetic soft tissue and tibial bone defects were retrospectively studied. The detects were repaired by the pedicled myocutaneous flap combined with modified Masquelet technique. There were 13 males and 7 females aged 40 to 65(average 51) years old. Preoperative ultrasound and CTA had confirmed that there was no occlusion in anterior and posterior tibial arteries. After debridement, the bone defect was 4-9 cm in length and the soft tissue defect was 3 cm×6 cm to 7 cm×10 cm. The initial antibiotic loaded bone cement filling of the bone and soft tissue defects was carried out. Then at 7-10 days later, had the bone cement placed earlier removed the remaining spaces of bone defect were again filled by antibiotic loaded bone cement. Meanwhile, the pedicled myocutaneous flap was transferred to repair the wound. The second stage of Masquelet technique was performed later, with an interval of 8-12(mean 9) weeks. The healing of wound and bone defect, and the complications were recorded. At 12 months after the surgery, the healing and appearance of the flap were evaluated by the standard proposed by Zhang Hao, and the functional recovery of the adjacent joint was evaluated by Johner-Wruhs standard. The treatment was considered successful when the symptoms were disappeared and no recurrence occurred.Results:All patients entered 13 to 28 months of follow-up, 20 months in average. The healing time for bone defect was 6-11 (average 9.0) months. All myocutaneous flaps survived with 18 flaps healed in the stage one and 2 delayed healing. Nine flaps appeared almost normal and 11 shown bloating. Seventeen flaps were found with partial sensation and 3 without sensation at all. The temperature of 7 flaps was found normal and 13 were slightly lower. Fourteen donor site scars were mild and 6 were obvious. The overall curative effect was satisfactory. Two patients had recurred infection. The rates of excellent and good functional recovery, infection control and success of treatment were at 90%(18/20) for each.Conclusion:Pedicled myocutaneous flap combined with modified Masquelet technique can repair diabetic soft tissue and tibial bone defects. It has a good therapeutic effect for short and medium terms.

Objective:To explore the clinical efficacy of antibiotic bone cement combined with vacuum sealing drainage (VSD) in treating diabetes mellitus complicated with necrotizing fasciitis.Methods:The retrospective observational study approach was used. From January 2020 to March 2022, 12 patients with type 2 diabetes complicated with necrotizing fasciitis who met the inclusion criteria were admitted to Wuxi Ninth People's Hospital, including 7 males and 5 females, aged 27 to 76 years. The initial diagnosis of lesions was in the lower limbs. After admission, bedside incision and drainage were performed timely, and a sample of wound exudate was collected for microbial cultivation. At the same time, the comprehensive supportive treatment was performed. At stage Ⅰ, debridement was performed, and the skin and soft tissue defect area was 40 cm×15 cm to 80 cm×25 cm after debridement. The dead space was filled with bone cement containing gentamicin and vancomycin and VSD was performed. After there was no obvious infection on the wound, the antibiotic bone cement was removed and wound repair surgery was performed at stage Ⅱ. The times of debridement, amputation, infection control, wound treatment method and wound healing at stage Ⅱ, total hospitalization day, and recurrence of necrotizing fasciitis during follow-up after the stage Ⅱ surgery. At the last follow-up, the walking function of patients was evaluated according to the scoring standards of American Orthopedic Foot and Ankle Association (AOFAS).Results:Eleven patients had wound infection control with one debridement surgery and did not undergo amputation surgery; one patient had significant foot gangrene, and the infection was controlled after one debridement and amputation of the gangrenous limb. Blood routine and infection indicators gradually returned to normal within 7 days after surgery. At stage Ⅱ, the wounds in 4 patients were sutured directly, the wounds in 6 patients were repaired with full-thickness inguinal skin graft, while the wounds in 2 patients were repaired with pedicled or tongue-shaped flaps at the wound edge. The wounds healed well after surgery, with no ulceration. The total hospitalization day of patients was 20 to 45 days. Follow-up for 3 to 24 months after stage Ⅱ surgery showed no recurrence of necrotizing fasciitis in any patient. At the last follow-up, the walking function was evaluated as excellent in 10 cases and good in 2 cases according to the AOFAS scoring standard.Conclusions:Antibiotic bone cement combined with VSD used in treating type 2 diabetes complicated with necrotizing fasciitis can effectively control infection and reduce the times of debridement, with good wound healing and walking function after surgery.

Objective:To investigate the spectrum of amino acid, organic acid, and fatty acid oxidative metabolic diseases in children diagnosed by detecting urinary organic acid levels using gas chromatography-mass spectrometry.Methods:From January 2005 to December 2021, clinical data of 2 461 children diagnosed with inherited metabolic diseases (IMD) by gas chromatography-mass spectrometry, in combination with tandem mass spectrometry and genetic testing in Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine were retrospectively analyzed.Results:Among 2 461 children, 1 446 were male and 1 051 were female. A total of 32 types of IMD were detected among 2 461 patients, which included 10 amino acid disorders in 662 cases (26.9%), 6 common diseases were hyperphenylalaninemia, citrin deficiency, ornithine carbamoyltransferase deficiency, maple syrup urine disease, alkaptonuria, and tyrosinemia-I, 17 types of organic acidemias in 1 683 cases (68.4%), 6 common diseases were methylmalonic acidemia, propionic acidemia, valeric acidemia-type Ⅰ, isovaleric acidemia, 3-methylcrotonyl-CoA carboxylase deficiency and multiple carboxylase deficiency and 5 fatty acid β oxidative defects in 116 cases (4.7%), 2 common diseases were multiple acyl-CoA dehydrogenase deficiency and short-chain acyl-CoA dehydrogenase deficiency).Conclusion:Among the diseases diagnosed by analyzing urinary organic acid profiling with gas chromatography-mass spectrometry, the most common are organic acidemias, followed by amino acid disorders and fatty acid oxidation defects.