Objective To investigate the application of proton magnetic resonance spectroscopy (1H-MRS) in patients with white matter lesions (WMLs).Methods Patients with WML were enrolled.According to imaging and clinical symptoms,they were divided into either a subcortical atherosclerotic encephalopathy (SAE) group or a simple leukoaraiosis (LA) group.All patients completed the examinations of MRI,1H-MRS,and auditory event-related potential P300.Multi-voxel 1H-MRS acquisition range was lateral periventricular white matter region.N-acetyl aspartic acid (N-acetylaspartate,NAA),creatinine (Cr),choline (Cho),NAA/Cr,and P300 latency and amplitude were documented.Results A total of 50 patients with WML were enrolled,including 30 patients with SAE and 20 with simple LA.NAA (median,quartile interval; M,IQR) (0.732 [0.680-0.804] vs.0.915 [0.866-0.963] ; Z =5.634,P ＜ 0.001) and NAA/Cr(M,IQR)(1.533 [1.317-1.817] vs.2.003 [1.794-2.387];Z=-3.921,P＜0.001) intheSAE group were significantly lower than those in the simple LA group.The htency of P300 (M,IQR) in the SAE group was significantly bnger than that in the LA group (370.50 [363.50-385.25] msvs.351.50 [342.75-359.00] ms; Z =-4.382,P ＜ 0.001),and the amplitude (M,IQR) was significantly lower than that in the simple LA group (4.35 [2.90-7.20] mVvs.6.95 [5.93-9.10] mV; Z=-2.942,P=0.003).Conclusions 1H-MRS can be used to identify the patients with SAE and simple LA,and provide an objective basis for the prevention of progress from LA to SAE.

Objective To investigate the significance of lactate dehydrogenase(LDH) in the diagnosis and treatment of children with refractory Mycoplasma pneumoniae pneumonia(RMPP).Methods This was a study of children with Mycoplasma pneumoniae pneumonia(MPP) admitted to hospital from June 2013 to June 2016.All patients were treated with erythromycin.Based on the definition of RMPP,subjects were divided into usual MPP group and RMPP group.The children in RMPP group were treated with erythromycin combined with methylprednisolone.The indicators including LDH,WBC counts,C-reactive protein,erythrocyte sedimentation rate(ESR),alanine aminotransferase(ALT),aspartate amino ransferase(AST) and creatine kinase were analyzed between RMPP group and usual MPP group.The differences of the above indicators between the effective and ineffective group before and after methylprednisolone treatment were also compared.Results In total,253 subjects were enrolled,including 161 in the usual MPP group and 92 in the RMPP group.The average age in RMPP group was older than that in the usual MPP group.The indicators(including LDH,AST,ALT,and ESR) of RMPP group were higher than those in the usual MPP group.Logistic regression showed that LDH and ESR were the significant factors in predicting RMPP.The odds ratio(OR) of LDH was 1.029 with 95%CI 1.020-1.037,and the OR of ESR was 1.063 with 95%CI 1.009-1.120.Receiver operating characteristic curve analysis showed that the area under the curve of LDH(400.50U/L) was the largest(0.959,95%CI 0.936-0.983).The administration of methylprednisolone to patients in the RMPP group resulted in the rapid improvement of symptoms and decrease in serum LDH and ESR levels in effective group(P＜0.05).Conclusion Serum LDH may be used as a biomarker to predict RMPP at the early stage,also may be an important marker for the evaluation of therapeutic efficacy in RMPP.

Objective To investigate the effect of spleen-supplementing and lung-strengthening therapy on patients with chronic obstructive pulmonary disease(COPD)treated by mechanical ventilation and enteral-parenteral nutritional support.Methods Acute exacerbation COPD patients complicated with respiratory failure treated by mechanical ventilation were randomized into group A(n=32)and group B(n=30).The two groups received invasive or non-invasive mechanical ventilation,routine western medicine and enteral-parenteral nutritional support.Group A received oral use of Jianpi Yifei Granules(mainly composed of Radix Ginseng Destillata,Rhizoma Atractylodis Macrocephalae,Poria,Radix Ophiopogonis,Cortex Mori,Radix Astragali)and electroacupuncture(EA)on bilateral acupoints of Zusanli additionally.The treatment lasted 2 weeks.The changes of leg circumference and arm circumference,and serum levels of total protein(TP),albumin(Alb),prealbumin(PAlb)and hemoglobin(Hb)were observed.The outcomes of mortality rate during hospitalization,success rate of removing respiratory machine,time for parenteral nutritional support,time for invasive or non-invasive mechanical ventilation,fee for nutritional support and hospitalization fee in intensive care unit(ICU)were compared in the two groups.The incidences of complications of pneumonia,fungal infection,and upper gastrointestinal hemorrhage were also observed during mechanical ventilation.Results After treatment,serum levels of TP and PAlb were higher in group A than those in group B(P0.05);leg circumference and arm circumference in the two groups increased(P0.05).Time for parenteral nutritional support,time for invasive or non-invasive mechanical ventilation,and fee for nutritional support and hospitalization fee in ICU were lower in group A than those in group B(P

Optically pure α-substituted propanoic acids and their derivatives represent as an important kind of organic building blocks and key intermediates,which has been widely used in the synthesis of chiral drugs.Some of them have been used directly as nonsteroidal anti-inflammatory drugs (NSAIDs),such as ibuprofen,naproxen,ketoprofen and so on.Dihydroartemisinic acid (DHAA),the same structure as the α-substituted propanic acids,is a key intermediate for the synthesis of artemisinin,the most effective and current used anti-malarial drug.Therefore,the asymmetric synthesis of α-substituted propanoic acids is always a hot topic for chemical scientists.Asymmetric catalytic hydrogenation attracts more and more attentions because of its atom economy and efficiency.This dissertation will disclose the asymmetric synthesis of α-substituted propanoic acids using transition metal-complex as a chiral catalyst.

Objective:Telemedicine financial operation mechanism was researched to promote long-term operation of the telemedicine in Hubei. Methods: Telemedicine operator was built to manage telemedicine services; the construction costs of the telemedicine system were analyzed to develop service prices; telemedicine services income distribution programs and cost clearing methods were analyzed. Results: The financial operaton models, including the price-setting, income distribution and the cost clearing methods were developed. Conclusion:The reasonable financial operation system ensured the involved parties ’ interests of telemedicine and it could promote long-term development of telemedicine.

Objective To quantify the validity and reliability of the Hong Kong version of the functional test for the Hemiplegic Upper Extremity (FTHUE-HK).Methods Forty-two stroke patients were studied.Patients were assessed twice within one week using the FTHUE-HK,the upper extremity component of Fugl-Meyer movement assessment (FMA) and the modified Barthel index (MBI).The test-retest reliability and inter-rater reliability of the FTHUE-HK were thus quantified.The FTHUE-HK's validity was evaluated according to the correlation between the FTHUE-HK,FMA and MBI results.Results Significant correlations between the three assessments were demonstrated(P≤0.01).The intra-and inter-class correlation coefficients were 0.983 and 0.985 respectively.Conclusion The FTHUE-HK is a simple and useful assessment of the upper extremity function of stroke patients with good validity and reliability.

Objective To investigate the capability of 99 Tcm?tricine?EDDA/HYNIC?SFSIIHTPILPL ( SP94) as a specific probe for HCC imaging. Methods HYNIC?SP94 peptide was prepared by solid phase synthesis, followed by 99 Tcm labeling with tricine?EDDA as the coligand. After determination of radiochemical purity and stability, cell binding study was carried out by incubating Huh?7 cells with 99 Tcm?tricine?EDDA/HYNIC?SP94 at different specific activities (2.5, 4.0 and 30.0 GBq/μmol). The biodistribution studies and microSPECT/CT imaging were performed in Huh?7 tumor?bearing mice ( study group) and Hela tumor?bear?ing mice ( control group ) . Statistical analysis was by two?sample t test. Results 99 Tcm?tricine?EDDA/HYNIC?SP94 was synthesized with over 95% of labeling yield, which remained stable in saline and FBS up to 12 h. With increasing concentrations of 99 Tcm?tricine?EDDA/HYNIC?SP94, Huh?7 cell binding increased but became gradually saturated. In biodistribution studies, (1.02±0.26) %ID/g of tracer was accumulated in Huh?7 tumors at 0.5 h after injection of 99 Tcm?tricine?EDDA/HYNIC?SP94, higher than that in the HYNIC?SP94 blocking group ((0.34±0.09) %ID/g;t=3.537, P<0.05). Compared to Hela tumors, Huh?7 tumors were clearly visualized by microSPECT/CT, with which better imaging quality could be achieved with higher specific radioactivity. Conclusion 99 Tcm?tricine?EDDA/HYNIC?SP94 could achieve a high labeling effi?ciency and good in vitro stability as a potential diagnostic tracer specifically targeted for HCC.

Objective To investigate time distribution of pressure of footplate in each stage and vertical anti-force from ground of patients with knee osteoarthritis (KOA).Methods 40 KOA patients, 10 aged people, and 10 common saplings were selected to test time distribution of pressure of footplate in each stage and vertical anti-force from ground in period of monopodia support.Results To unilateral KOA patient, there was not obvious difference to be observed in initial contact phase and forefoot push off phase ( P>0.05), but there was a significant difference in forefoot contact phase and foot flat phase between health side and sick side ( P<0.001), and there was obvious difference decreased buffer time and buffer force coefficient between them ( P<0.01).Conclusion To KOA patients, the time decreases in weight-bearing phase and absorption shocks, and amortization coefficient also decreases. These indexes can be used as the walking index of functional assessment and the objective evidence of curative effect.

Objective:To investigate the feasibility and safety of laparoscopic liver tumor resection in children.Methods:The clinical data of 6 children undergoing laparoscopic liver tumor resection from June 2018 to March 2020 in the Affiliated Tumor Hospital, Zhengzhou University were retrospectively analyzed.Results:There were 4 males and 2 females among the 6 cases, with the average age of (7±2)years.All the children were admitted to the hospital with a liver occupying examination due to physical discomfort.Preoperative diagnosis: 3 cases of hepatoblastoma, 1 case of primary liver cancer, 1 case of hepatic adenoma and 1 case of hepatic nodular hyperplasia.All the children successfully completed laparoscopic liver tumor resection without conversion to open surgery.Among them, 3 children obtained left hemihepatectomy, 1 child underwent hepatic left lobectomy, 1 child was given VI hepatectomy, and 1 child accepted hepatic caudate lobectomy.The operation time was(90±9)min, and the average intraoperative blood loss was (83±26) mL.All children had no blood transfusion during or after operation.There were no bleeding, bile leakage, infection and liver failure after operation.All children had no gastric tube before surgery and the fluid diet was given on the first day after operation, and the postoperative median hospital stay was 4(3-5) days.The pathology were consis-tent with the preoperative diagnosis, and the resections were all radical operation resections.The follow-up period was from 2 to 23 months, and all the children recovered well and no recurrence was observed.Conclusions:Laparoscopic liver tumor resection in children is safe and feasible, which can minimize trauma, reduce intraoperative bleeding and shorten the hospital stay without increasing the incidence of postoperative complications.Laparoscopic liver tumor resection in children has certain advantages.

Hepatocellular carcinoma (HCC) is one of the most common malignant tumors, and its features of insidious onset, rapid development, and high recurrence bring great challenges to the long-term survival of HCC patients. Molecular-targeted drugs and immune checkpoint inhibitors have become the research hotspots in the treatment of HCC, and a large number of clinical trials have found that combined therapy has achieved a good clinical effect. This article mainly introduces the application of combined therapy with molecular-targeted drugs and immune checkpoint inhibitors and other combined therapies in HCC and points out that combined therapy related to systemic therapy or local therapy has become the latest research hotspot in HCC treatment.