Dysphasia is a fatal complication of stroke, and may result in other complications. Transcranial direct current stimulation (tDCS) is helpful for the recovery of dysphasia associated with stroke, which may involve in the polarity and cerebral plasticity. There are advantages and disadvantages of tDCS compared with repetitive transcrnial magnetic stimulation.

Purpose To investigate the expression pattern and c1inicopatho1ogica1 significance of D2-40 in craniopharyngioma( CP). Methods Immunohistochemica1 method was used to assess D2-40 expression in 126 cases of craniopharyngioma. Statistic software was used to ana1yze the corre1ation between D2-40 expression and c1inicopatho1ogica1 features. Results The overa11 positive rate of D2-40 expression in 126 craniopharyngioma was 87. 30%. The rate of +, and  were 44. 44%( 56/126 ),37. 30%( 47/126 )and 5. 56%(7/126)respective1y. In adamantinomatous CPs,D2-40 expression was observed in epithe1ia1 components corresponding to the stratum intermedium,whi1e in papi11ary CPs,it was immuno-positive in basa1 ce11s. With the increasing of the existence of inf1amma-tion in tumor,D2-40 expression was up-regu1ated. Tumor ce11s were over-expressed for D2-40 in basa1 ce11s and stratum intermedium ce11s of the invasive frontier. D2-40 expression was higher in the invasive craniopharyngioma than in the non-invasive craniopharyngio-ma. In addition,D2-40 expression was higher in the recurrent craniopharyngioma than in the non-recurrent craniopharyngioma. There were no significant re1ationship between D2-40 expression and gender,and histo1ogica1 c1assification of tumors. Conclusions D2-40 expression is associated with the deve1opment of craniopharyngioma,which can 1ead to enhance the tumor ce11 invasion,and may be re-1ated to inf1ammation-re1ated mechanisms. D2-40 expression may be one of the recurrence factors in patients with craniopharyngioma.

Objective To observe the value of three-dimensional constructive interference in steady state (3D-CISS) sequence for displaying anterolateral ligament (ALL) of knee joint.Methods MR scans of right knee joint were performed on 30 healthy volunteers,and the protocol included axial and coronal fat saturation proton density weighted imaging (FS-PDWI) and 3D-CISS sequence.MRP and CPR (reconstructive angles including 0°,30°,60°,90°,120°,150° and 180°) images were generated from of 3D-CISS sequence.The visibility rates of the femoral part,meniscal part,tibial part,meniscal insertion,femoral footprint and tibial footprint of ALL were compared among different protocols.Results The visibility rates of tibial footprint and femoral footprint of ALL on 3D-CISS CPR images were both 96.67％ (29/30),and on 3D-CISS MPR images were both 93.33％ (28/30),all of them were higher than those on FS-PDWI images (all P＜0.017).The visibility rates of tibial part,meniscal part and meniscal insertion of ALL on 3D-CISS CPR images were 96.67％ (29/30),83.33％ (25/30) and 83.33％ (25/30),respectively,and all of them were higher than those on FS-PDWI images (all P＜0.05).There was no statistical difference of visibility rate of femoral part between 3D-CISS CPR images and FS-PDWI images (P=0.095).Conclusion 3D-CISS sequence with CPR can significantly enhance the ability to identify ALL.

BACKGROUND: Intervertebral disk (IVD) degeneration, which can cause lower back pain, is a major predisposing factor for disability and can be managed through multiple approaches. However, there is no satisfactory strategy currently available to reconstruct and recover the natural properties of IVDs after degeneration. As tissue engineering develops, scaffolds with embedded cell cultures have proved critical for the successful regeneration of IVDs. METHODS: In this study, an integrated scaffold for IVD replacement was developed. Through scanning electron microscopy and other mechanical measurements, we characterized the physical properties of different hydrogels. In addition, we simulated the physiological structure of natural IVDs. Nucleus pulposus (NP) cells and annulus fibrosusderived stem cells (AFSCs) were seeded in gelatin methacrylate (GelMA) hydrogel at different concentrations to evaluate cell viability and matrix expression. RESULTS: It was found that different concentrations of GelMA hydrogel can provide a suitable environment for cell survival. However, hydrogels with different mechanical properties influence cell adhesion and extracellular matrix component type I collagen, type II collagen, and aggrecan expression. CONCLUSION This tissue-engineered IVD implant had a similar structure and function as the native IVD, with the inner area mimicking the NP tissue and the outer area mimicking the stratified annulus fibrosus tissue. The new integrated scaffold demonstrated a good simulation of disc structure. The preparation of efficient and regeneration-promoting tissueengineered scaffolds is an important issue that needs to be explored in the future. It is hoped that this work will provide new ideas and methods for the further construction of functional tissue replacement discs.

Objective: Idiopathic intracranial hypertension (IIH) is a condition of unknown etiology associated with venous sinus stenosis. This study aimed to develop a magnetic resonance venography (MRV)-based radiomics model for predicting a high trans-stenotic pressure gradient (TPG) in IIH patients diagnosed with venous sinus stenosis. Materials and Methods: This retrospective study included 105 IIH patients (median age [interquartile range], 35 years [27– 42 years]; female:male, 82:23) who underwent MRV and catheter venography complemented by venous manometry. Contrast enhanced-MRV was conducted under 1.5 Tesla system, and the images were reconstructed using a standard algorithm. Shape features were derived from MRV images via the PyRadiomics package and selected by utilizing the least absolute shrinkage and selection operator (LASSO) method. A radiomics score for predicting high TPG (≥ 8 mmHg) in IIH patients was formulated using multivariable logistic regression; its discrimination performance was assessed using the area under the receiver operating characteristic curve (AUROC). A nomogram was constructed by incorporating the radiomics scores and clinical features. Results: Data from 105 patients were randomly divided into two distinct datasets for model training (n = 73; 50 and 23 with and without high TPG, respectively) and testing (n = 32; 22 and 10 with and without high TPG, respectively). Three informative shape features were identified in the training datasets: least axis length, sphericity, and maximum three-dimensional diameter.The radiomics score for predicting high TPG in IIH patients demonstrated an AUROC of 0.906 (95% confidence interval, 0.836– 0.976) in the training dataset and 0.877 (95% confidence interval, 0.755–0.999) in the test dataset. The nomogram showed good calibration. Conclusion Our study presents the feasibility of a novel model for predicting high TPG in IIH patients using radiomics analysis of noninvasive MRV-based shape features. This information may aid clinicians in identifying patients who may benefit from stenting.

Objective:To analyze the consistency and correlation of indirect calorimetry (IC) and Harris-Benedict estimation method (H-B) in measuring energy consumption in patients with severe acute pancreatitis (SAP), as well as the characteristics of energy metabolism at resting state of SAP patients with different etiologies, and so as to guide the formulation of clinical energy nutrition support program.Methods:From February 1 to December 31, 2019, 61 SAP patients admitted into the intensive care unit of the First Affiliated Hospital of Nanchang University were enrolled. Collected relevant data of patients, such as the etiology of SAP, whether mechanical ventilation was needed, as well as the metabolic status. All SAP patients accepted IC test on the first day after admission to intensive care unit. According to the energy consumption measured by IC (hereinafter referred to as IC value) and the energy consumption measured by H-B (hereinafter referred to as H-B value), SAP patients were determined to be in high, normal or low metabolic state. Bland-Altman method and Pearson linear regression were used to analyze the consistency and correlation of the two methods in measuring energy consumption, and the linear equation was fitted. Paired t test was used for statistical analysis. Results:Among the 61 SAP patients, 13 cases were biliary SAP, 30 cases were hyperlipidemic SAP, 6 cases were alcoholic SAP, and 12 cases were SAP of other causes or unknown causes. Nineteen cases needed mechanical ventilation and 42 cases did not need mechanical ventilation. There were 70.5% (43/61) of SAP patients in high metabolic state, 13.1%(8/61) of SAP patients in normal metabolic state, and 16.4% (10/61) of SAP patients in low metabolic state. The IC value in 61 SAP patients was higher than H-B value((8 604.7±367.8) kJ/d vs. (6 491.2±133.7) kJ/d), and the difference was statistically significant ( t=5.95, P<0.001). The IC value in patients with hyperlipidemic, alcoholic and biliary SAP was (8 815.2±537.9), (7 631.2±890.5), and (8 108.0±933.1) kJ/d, respectively, and the H-B value was (6 869.6±204.5), (5 916.8±153.7), and (5 974.2±200.9) kJ/d, respectively. The IC value in patients with biliary or hyperlipidemic SAP were higher than H-B value, and the differences were statistically significant( t=2.29 and 3.38, both P<0.05). The IC value and H-B value in SAP patients with mechanical ventilation and without mechanical ventilation were (10 485.0±741.1) and (6 462.6±222.8) kJ/d, (6 595.1±364.7) and (6 503.2±166.7) kJ/d, respectively. The IC value in SAP patients with mechanical ventilation was higher than H-B value and the IC value in SAP patients without mechanical ventilation, and the differences were statistically significant ( t=4.71 and 5.20, both P<0.001). The consistency analyzed by Bland-Altman method showed that the two methods had obvious biases, and the average bias value was 92.2 kJ/d. The result of Pearson linear regression analysis indicated that there was a linear relationship between two methods ( r=0.44, P<0.001). The linear equation fitted by the univariate regression was Y=1.240 6 X+ 154.42, in which X was the H-B value and Y was the IC value. Conclusions:SAP patients are mostly in a hypermetabolic state in the early stages of the disease. The IC value is higher than H-B value, and it is recommended to use IC to measure energy consumption in SAP patients.

Objective To observe the value of anatomical characteristics of femoral intercondylar notch of knee joint for predicting non-contact anterior cruciate ligament tear(NC-ACLT).Methods MRI data of knee joint of 55 patients with NC-ACLT(NC-ACLT group)and 55 controls(control group)were retrospectively analyzed.The parameters of intercondylar notch,including depth,width,depth/width ratio,opening width,opening width index,area and width of the femoral condyle's outer edge at the same level were measured between groups,and the types of intercondylar notch(type A,U and W)were recorded.Univariate and multivariate logistic regression analysis were used to screen the independent impact factors of NC-ACLT.Receiver operating characteristic curves were drawn,and the area under the curves(AUC)were calculated to evaluate the efficacy of each intercondylar notch parameter for predicting NC-ACLT.Results The depth and depth/width ratio of intercondylar notch in NC-ACLT group were both higher,while the opening width and opening width index of intercondylar notch in NC-ACLT group were both lower than those in control group(all P＜0.05).Multivariate logistic regression analysis revealed that the depth of intercondylar notch was an independent impact factors of NC-ACLT(P＜0.05).Taken 29.55 mm in depth of intercondylar notch,1.45 in depth/width ratio of intercondylar notch,21.15 mm in opening width of intercondylar notch and 0.29 in opening width index as the optimal cut-off value,respectively,the sensitivity of the above parameters for predicting NC-ACLT was 74.55％,58.18％,67.27％and 67.27％,the specificity was 69.09％,80.00％,61.82％and 78.18％,and the AUC was 0.720,0.713,0.652 and 0.710,respectively.Conclusion The anatomical characteristics of femoral intercondylar notch of knee joint could be used to predict NC-ACLT.The depth,depth/width ratio,opening width and opening width index of intercondylar notch could be used as predictive indicators.

Objective To study the effect of electroacupuncture and psychological rehabilitation on internet addiction disorder (IAD).Methods 111 IAD patients were divided into electroacupuncture group, psychology group and comprehension group (both electroacupuncture and psychological rehabilitation). They were measured with frequency and entropy of alpha competitive structure before and after treatment. Results The frequency increased and the entropy decreased in the comprehension group after treatment (P<0.05), and was significantly different from the other groups (P<0.05). There was no significant difference between the other 2 groups (P>0.05). Conclusion The combination of electroacupuncture and psychological rehabilitation may be effective on IAD.

Objective:To analyze the clinical features and CBS gene variants of 13 patients with classic homocystinuria, and the strategies of individual treatment and prevention were explored.Methods:The general information, clinical manifestations, laboratory tests, cranial images, CBS gene variants, diagnosis and therapeutic strategies of 13 patients with classic homocystinuria admitted to the Department of Pediatrics of Children′s Hospital Affiliated to Zhengzhou University and Peking University First Hospital from November 2013 to June 2021 were analyzed retrospectively.Results:There were 13 patients diagnosed at the age of 10 days to 14 years, 6 were male and 7 were female. There were 3 patients detected by newborn screening and received treatment at the asymptomatic stage. There were 10 patients clinically diagnosed at the age of 5 to 14 years. Their symptoms appeared at age of 1 to 6 years. The major clinical manifestations were marfanoid features, lens dislocation and (or) myopia, developmental delay, osteoporosis, and cardiovascular diseases. Brain magnetic resonance imaging showed asymmetric infarcts in 4 patients and hypomyelination in 1 case. Increased blood methionine, plasma total homocysteine and urinary total homocysteine with normal urinary methylmalonic acid were found in 13 patients. The biochemical features were consistent with classic homocystinuria. Totally 18 variants were identified in CBS gene of 13 patients, 10 variants were novel and 8 were reported. only 1 patient was partially responsive to vitamin B 6 treatment, while 12 cases were non-responsive. They were mainly treated with low methionine diet and betaine supplement. Three vitamin B 6 non-responsive cases received liver transplantation at age of 3, 8 and 8 years, respectively. Their blood methionine and total homocysteine returned to normal within a week after liver transplantation. One patient died. Prenatal diagnosis was performed for a fetus when the mother was pregnant again. Two pathogenic CBS gene variants were identified from the amniocytes as same as the proband. Conclusions:The clinical manifestations of classic homocystinuria are complex and variable. Blood amino acid analysis, serum or urine total homocysteine assay and gene analysis are critical for its diagnosis. There were 10 novel CBS gene varients were identified expanding the CBS gene varient spectrum. Liver transplantation is an effective treatment. Prenatal diagnosis is important to prevent classic homocysteinuria.

Nosocomial infection poses a significant threat to patient safety and increase their disease burden. Outbreaks of nosocomial infection are the main harmfulness associated with nosocomial infection, which making them socially sensitive issues. Nosocomial infection surveillance and warning are core contents of nosocomial infection management. Accurate early warning technology for nosocomial infection outbreaks can reflect the management capability of infection prevention and control. This study designed an early warning system based on a multi-dimensional and multi-scale comprehensive information surveillance mode for nosocomial infection outbreaks which was launched in March 2023. This system extracted the process-related indicators of nosocomial infection from various hospital information systems into the nosocomial infection database center. Under the multi-dimensional and multi-scale surveillance mode, the process-related data were stratified according to the predefined dimensions and scales, then generating time-series datasets of numerous subgroups. The system conducted weekly for all time-series datasets of subgroups based on warning rules, and subsequently sent out warning signals to managers. These warning signals could be verified by managers through data check, case verification and epidemiological investigation. Once a nosocomial infection outbreak was confirmed, intervention measures could be implemented promptly. In practical application, the system generated warning signals for nosocomial infection clusters in 12 departments on August 7th, 2023. The traditional nosocomial infection case report system ultimately reported 54 nosocomial infection cases, which distributed across 13 departments, with clusters(more than 3 cases) observed in 6 departments. All these 6 departments received warning signals generated from our system. It has been demonstrated that our system could predicted the nosocomial infection clusters 5.3 days earlier than the traditional nosocomial infection case report system on average, with warning sensitivity of 100.0% and positive predictive value of 50.0%. Early warning under the multi-dimensional and multi-scale comprehensive information surveillance mode was able to transform the work pattern of nosocomial infection outbreaks control and management from passive to active. Particularly it has advantages in early detection for occult outbreaks, providing a valuable support for improving nosocomial infection management capability.