Objective To investigate the effects of methycobal on the expression of Caspase-3 in brain tissue after cerebral ischemia reperfusion in rats. Methods Rats were randomly divided into sham-operation group, model control group, nimodipine group and low-dose methycobal group, high-dose methycobal group(n=30 in each group).Rats in the sham-operation group and model control group were administered intragastrically with 0.9% sodium chloride solution, rats in the nimodipine group were treated with 1 mg . kg-1 . d-1 of nimodipine, rats in the low- and high-dose of methycobal groups were given 50 and 100 μg.kg-1 .d-1 of methycobal, respectively. The rat model of cerebral ischemia reperfusion was established by middle cerebral artery occlusion with suture method for 3 h.Neurological deficit scores were evaluated 24 h after reperfusion.The apoptosis of perifocal cortex cells was detected by TUNEL method and the expression of Caspase-3 was analyzed by RT-PCR 6, 12 and 24 h after reperfusion. Results Neurological deficit scores in model control group, nimodipine group, low-dose methycobal group and high-dose methycobal group were 2.70±0.52, 1.30±0.51, 2.20±0.75 and 1.30±0.81, respectively.Compared with model control group, neurological deficit scores were significantly different in the nimodipine group, low-dose methycobal group and high-dose methycobal group(P<0.05 or P<0.01).There were no significant differences between the high-dose methycobal group and nimodipine group ( P>0. 05 ) . There was a significant difference between the high-dose methycobal group and low-dose methycobal group( P<0. 05 ) . The results of apoptosis by TUNEL were as follows: compared with model control group, the apoptosis decreased obvsiouly in the nimodipine group, low-dose methycobal group, and high-dose methycobal group at each time point.There was significant difference between the high-dose methycobal group and nimodipine group at the end of the 24th hours (P<0.01).Compared with low-dose methycobal group, there were significant differences in the high-dose methycobal group at the end of 6th, 12th and 24th hours(P<0.01 or P<0.05).The results of RT-PCR were as follows: there was expression of caspase-3 mRNA in the perifocal cortex of all groups, with weak expression in the sham-operation group.Compared with the sham-operation group, the expression of caspase-3 mRNA was increased significantly in the model control group(P<0.01).The expression of caspase-3 mRNA was reduced significantly in the nimodipine group, the low-dose methycobal group and high-dose methycobal group as compared with model control group at each time point( P<0.05 or P<0.01) , but it was not significantly different in the low-dose methycobal group and high-dose methycobal group as compared with that of the nimodipine group(P>0.05).There were significant differences between the high-dose methycobal group and low-dose methycobal group at the end of 24 h(P<0.05). Conclusion Methycobal can protect the brain cells from injury after cerebral ischemia reperfusion by adjusting the expression of Caspase-3m RNA, and the high-dose methycobal is more effective.

ObjectiveTo explore the best time for replacing the long-term indwelling catheter in patients with silicone catheter.MethodsDomestic literature were retrieved and analyzed using Cochrane systematic review,and the meta-analysis of randomized controlled trials was conducted in accordance with inclusion criteria and exclusion criteria so as to look into the most suitable time for replacing the indwelling catheter for patients with silicone catheter at clinical trials.The replacement frequency for the catheters of different size together with the relevant infections in urinary tract infection and relative risk(RR)were used as values for effectiveness of interventions.ResultsA total of 11 literature were retrieved. Meta-analysis results suggested that the RR values of urinary tract infections when the catheters were replaced once every two weeks vs. every four weeks,and once every three weeks vs. every four weeks were 0.51[95% CI(0.40,0.66),P <0.001],0.79[95% CI(0.58,1.08),P = 0.14],respectively.The urinary infection rate of replacing a silicone cathether every 2 weeks was higher than that of every 4 weeks,but there was no difference between that of every 3 weeks and 4 weeks.Conclusion According to the nature of silicone catheter material as well as the clinical indexes, it is most reliable to replace a silicone catheter every four weeks to reach a best clinical outcome.

Objective To observe the effects of 2 Gy γ-ray irradiation on regulatory T cells (Tregs) and Th17 cells and immune balance of mice.Methods A total of fifty C57BL/6 male mice were randomly divided into two groups,the irradiated group exposed to 2 Gy of whole body γ-ray irradiation,and the control group sham-irradiated.At 1,3,7,14 and 28 d after radiation,changes of peripheral haemogram were detected respectively and Tregs in peripheral blood,thymus and spleen and Th17 cells in spleen were analyzed by flow cytometry.Results Compared with control group,the number of peripheral blood white cells (WBC) and lymphocyte in irradiated group reduced significantly post-irradiation (t =8.89-33.54,P ＜ 0.05),while the cell number of peripheral CD4 + CD25 + Tregs post-irradiation rose but not significantly.Thymic Treg cells increased 1 and 3 d post-irradiation(t =-6.45,-10.59,P ＜0.05),but reduced 28 d post-irradiation (t =5.34,P ＜ 0.05).Splenic Treg cells ascended obviously from 1 to 14 d post-irradiation (t =-6.82-3.89,P ＜ 0.05).After irradiation splenic Th17 cells increased at 1 d,and reached the maximal level at 3 d (t =-2.42,P ＜ 0.05),more obviously than splenic Treg cells.The reduction of Treg/Th17 ratio from 1 to 14 d post-irradiation disturbed Treg/Th17 balance and made it drift to the direction of Th17 (t =4.02-8.04,P ＜ 0.05).Conclusions Treg/Th17 imbalance plays an important role in immune injury induced by irradiation.

Objective　To analyze the causes of death of one case of imported falciparum malaria in Guangxi Zhuang Autonomous Region in January 2023, to provide a reference for the prevention of fatal malaria cases. Methods Interviews were conducted with the doctors who received and consulted the patient, as well as the family members of the patient. Clinical data from the patient's diagnosis and treatment process were collected, and the patient's clinical records and epidemiological investigation data were analyzed. Results The patient, Mr. He, a 53-year-old male from Pingnan County, Guigang City, Guangxi Zhuang Autonomous Region, returned from working in Côte d'Ivoire, Africa, and entered Guangxi on December 26, 2022. He returned home after his centralized quarantine was lifted on January 3, 2023. On January 4th, 2023, the patient developed dizziness and vomiting, considering himself to a possible COVID-19 infection, he did not seek treatment. On the morning of January 6, the patient developed a fever (peak body temperature of 40 ℃), accompanied by fatigue and sore throat, and the preemptive symptoms were aggravated. The patient was admitted to the Guancheng Town Health Center with "Pneumonia" and treated with ribavirin, dexamethasone, ceftriaxone sodium, etc. On January 7, the patient again experienced a high fever (40 ℃) and was discharged to the Emergency Department of the First Affiliated Hospital of Guangxi Medical University. Upon admission, the patient's blood pressure was measured at 78/53mmHg, further comprehensive examination showed a decrease in platelets and abnormalities in liver and renal function, procalcitonin levels at 49.9 ng/mL. Chest CT showed pneumonia, and fluid supplements and antibiotics were given. On January 8, malaria parasites were found in the patient's blood smear, and the patient was diagnosed with malaria (not classified, confirmed as falciparum malaria on January 9th). The patient was recommended to transfer to the provincial malaria-designated hospital, but his family refused. On January 8 at 13:27, the patient excreted approximately 700 g of dark red bloody stools accompanied by blurred consciousness and received hemostasis treatment. After coordinating with multiple parties, four doses of "artemisinin injection " (60 mg/dose) were taken for treatment. At 18:59 on January 8, intravenous administration of 60 mg injectable Artesunate was given, accompanied by symptomatic treatment for fever reduction and rehydration. At 19:40, the patient developed severe hypoglycemia, and severe metabolic acidosis, and blood pressure continued to decrease despite the use of vasopressors. After comprehensive treatment at 3:00 am on January 9, the patient's condition continued to deteriorate, the patient's shock could not be corrected, he lapsed into a coma, and the family requested to be discharged from the hospital. The patient returned home at 7:00 am and died of multiple organ failure at 7:30 am. Conclusions For imported malaria, early and precise diagnosis based on epidemiological history, clinical symptoms, laboratory test results, early antimalarial treatment, and management of organ dysfunction are the keys to avoiding fatal outcomes.

OBJECTIVE: To investigate the clinical value of negative pressure tympanograms for diagnosis of middle ear effusion in adults. METHOD: GSI-Tympstar II Middle Ear Analyzer of America was used to test tympanogram peak pressure (TPP); tympanogram width (TW); middle ear resonant frequency and stapedius muscle reflex for sceptical secretory otitis media (SOM) adult patients. Patients (207 ears) with C type tympanograms accepted tympanocentesis after tests. According to middle ear effusion quantity, 207 ears have been divided to three groups: non-effusion group (123 ears), small-effusion group (45 ears) and mickle-effusion group (39 ears). Acoustic immittance and ipsilateral stapedius muscle reflex were statistically analysed. RESULT: About TPP and resonant frequency, non-effusion group and small-effusion group have statistical difference (P < 0.05); non-effusion group and mickle-effusion group have significant statistics different (P < 0.01). About TW, non-effusion group have significant difference from mickle-effusion group (P < 0.01). There was statistical difference on ipsilateral stapedius muscle reflex (P < 0.01) among three groups. CONCLUSION Negative pressure tympanograms has diagnostic value for middle ear effusion combined to TPP, TW, middle ear resonant frequency and ipsilateral stapedius muscle reflex.
Acoustic Impedance Tests ; methods ; Adolescent ; Adult ; Aged ; Ear, Middle ; pathology ; Female ; Humans ; Male ; Middle Aged ; Otitis Media with Effusion ; diagnosis ; Young Adult

Objective To observe the effect of γ-ray irradiation on CD4 + CD25 + regulatory T cells (Tregs),and to investigate the mechanism of immune injury induced by irradiation.Methods The thymus and spleen of C57BL/6 mice were taken and weighted 1-28 d after γ-ray irradiation,and the organ coefficients were calculated.The amount of mouse peripheral WBC measured,CD4 + T cells and Tregs in peripheral and splenic were analyzed by flow cytometry.Results Coefficients of mouse thymus and spleen decreased significantly 1 d post irradiation,and reached to the bottom at 7 d.Coefficients did not recover to control level 28 d after radiation.Peripheral WBC continuously decreased and reached the bottom at 7 d,and did not recover to control level up to 28 d postirradiation.Peripheral CD4 + T lymphocyte temporally reduced at 1 d,while it increased at 7 d,and it approached to control level at 28 d after radiation.Splenic CD4 + T cells slightly reduced at 7 d however,they basically maintained as the same level as control 14 d and 28 d after radiation.Peripheral Tregs ascended at 1 d and reached the peak at 7 d,and reduced at 14 d and 28 d postirradiation,although they still were significantly higher than those of control group.At the same time,splenic Tregs increased significantly and achieved peak value at 1 d,and then gradually decreased and reached the minimum at 28 d after irradiation,which were significantly lower than those of control group( t =2.731,P ＜ 0.05).Conclusions Mouse thymus and spleen were injured severely,and the number of immunocytes decreased after 6 Gy whole body γ-ray irradiation.However,Tregs with immunosuppressive action increased significantly postirradiation,revealing that Tregs were closely correlated with immune function depression and immunomodulation imbalance induced by ionizing radiation.

Objective: To explore the improvement effect of hypnotherapy on dysmenorrhea symptoms of female college students with primary dysmenorrhea, in order to provide reference for the intervention and treatment of female college students with primary dysmenorrhea. Methods: From Septerber to December 2021, 90 female college students diagnosed with primary dysmenorrhea in Qinzhou First People s Hospital were randomly divided into hypnotic suggestion group( n =30), hypnotic relaxation group ( n =30) and control group( n =30). The 10 session hypnotic suggestion and 10 session hypnotic relaxation interventions were carried out while the control group received no intervention. Participants in the three groups were assessed by using the Visual Analogue Scale(VAS), Beck Depression Inventory Ⅱ(BDI Ⅱ), State Anxiety Inventory(SAI), Questionnaire of Quality of Life of College Students(QOLCS), Cox Dysmenorrhea Symptom Scale (CMSS) before and after intervention. Results: After intervention, the VAS, BDI Ⅱ and SAI scores of the hypnotic suggestion group and the hypnotic relaxation group significantly decreased compared to those before the intervention( t =7.04, 13.32, 3.58, 2.15, 2.52, 2.01, P <0.05). There were statistically significant differences in VAS, BDI Ⅱ and SAI scores among the three groups( F =24.71, 29.57, 6.60, P <0.01). After intervention, the QOLCS total score, physical, psychological and behavioral dimension scores in the hypnotic suggestion group and the hypnotic relaxation group significantly improved( t =-4.61, -3.36, -3.12, -2.81, -2.71, -2.19, -2.69, -2.28, P <0.05). There were statistically significant differences in QOLCS total score, physical, psychological, behavioral, environmental, and social support dimension scores among the three groups( F =10.36, 4.14, 5.14，4.81, 7.07, 5.53, P <0.05). After the intervention, the CMSS dysmenorrhea severity and dysmenorrhea duration scores in the hypnotic suggestion group and the hypnotic relaxation group were significantly lower than those before the intervention( t =5.66, 4.70, 3.09, 2.21, P <0.05). There were significant differences in CMSS dysmenorrhea severity and dysmenorrhea duration scores among the three groups( F=15.33, 12.33, P <0.05). Conclusion Hypnotherapy can help relieve pain of female college students with primary dysmenorrhea，improve depression and anxiety.

Objective: To investigate the effect of hypnotherapy on improving pain degree,pain catastrophizing,pain self efficacy,coping styles of female college students with primary dysmenorrhea, and to provide the theoretical support for psychological intervention. Methods: Fifty six female college students with primary dysmenorrhea were randomly divided into experimental group( n =28) and control group( n =28).Samples in the experimental group received 10 session structured hypnotherapy, while the control group received no intervention (the control group could receive the intervention when the intervention was proved to be effective) .The effects were evaluated with Numerical Rating Scale (NRS),Pain Catastrophizing Scale (PCS),Pain Self Efficacy Questionnaire（PSEQ）,was proved to be effective .The effects were evaluated with Numerical Rating Scale (NRS),Pain Catastrophizing Scale (PCS),Pain Self Efficacy Questionnaire（PSEQ）,Simplified Coping Style Questionnaire（SCSQ）in the pretest，protest and tracking test. Results: The time effect，group effect and time group interaction on the NRS,PCS,PSEQ scores of the two groups of female college students were all statistically significant ( F =12.83，21.77，13.65； 22.96，28.98，24.84；25.35，18.26，27.02， P < 0.01 ).Immediately after the intervention and 3 months after the intervention，the scores of SCSQ positive coping dimension of the experimental group（1.43±0.35，1.50±0.39）were significantly higher than those of the control group（1.22±0.19，1.20±0.21），and the scores of SCSQ negative coping dimension of the experimental group（1.59±0.38，1.52±0.49）were significantly lower than those of the control group（1.80±0.17，1.80±0.20）, the differences were all statistically significant ( P <0.05);There were statistical differences among time effect，group effect and timegroup interaction on the positive coping and negative coping scores of SCSQ ( F = 15.14 ， 4.29 ， 14.37 ；7.66，4.10，6.95， P <0.05). Conclusion Hypnotherapy intervention for female college students with primary dysmenorrhea can effectively alleviate pain degree，and improve the pain catastrophizing and coping styles,enhance their pain self efficacy. The hypnotherapy also shows long term effects.

Objective:To study disease spectrum and genetic profiles of inborn errors of metabolism (IEM) among newborns in selected areas of Nanning city.Methods:From July 2019 to December 2021, neonates born and received IEM screening in our hospital were prospectively enrolled. Heel blood samples were tested using tandem mass spectrometry as IEM screening. Neonates with positive results were called back for recheck. Whole exome sequencing was used to detect possible pathogenic genes in suspected cases and IEM was diagnosed combining clinical manifestations. Sanger sequencing method was used for the diagnosed neonates and their parents to confirm the diagnoses.Results:A total of 16 207 live-birth neonates were enrolled. For initial IEM screening, 1 423 neonates were positive (8.8%) and 1 311 were called back (92.1%). 15 cases were suspected with IEM and 8 were diagnosed. The overall detection rate was 1∶2 026. Among 8 confirmed cases, 4 cases had amino acid metabolism disorders (2 cases of phenylketonuria, 1 case of Citrin deficiency and 1 case of tyrosinemia), 2 cases had organic acid metabolism disorders (1 case of methylmalonic acidemia and 1 case of glutaric acidemia) and 2 cases had fatty acid oxidation disorders (1 case of carnitine palmitotransferaseⅡdeficiency and 1 case of primary carnitine deficiency). 5 cases had homozygous genetic variants (2 in PAH, and 1 in SLC25A13, SLC22A5 and FAH, respectively) and 3 had heterozygous genetic variants (1 in CPT2, MUT, and GCDH, respectively). During follow-up, all 8 cases had normal growth and developmental outcomes after standardized treatment.Conclusions:The overall detection rate of IEM is high, with varied genetic profiles in selected areas of Nanning. Timely genetic testing may lead to early diagnosis and treatment and improve the quality of life of neonates.