Objective To investigate the changes and the correlation between the levels of plasma lysophosphalidic acid(LPA),acid phospholipid(AP),low density lipoprotein(LDL) and carotid artery atherosclerosis in patients with acute cerebral infarction(ACI).Methods The levels of plasma LPA,AP and LDL were examined in 67 ACI patients and 30 normal controls,the carotid arteries were investigated with B mode ultrosand.Results The levels of plasma LPA,AP and LDL were higher in ACI group than those in the normal control group(all P

Objective Comparing the influence on cardiac-pulmonary function of health and acute lung injury (ALI)dogs by proportional assist ventilation(PAV)and pressure support ventilation(PSV)modes.Methods Use intermittent positive pressure ventilation(IPPV)mode in health and ALI dogs,calculate elastance(Ers)and resistance(Rrs),then change to PAV,set the assist ratio 60%.Then change the mode into PSV,set the inspiratory pressure(IPAP)according to PAV,so that tidal volume(VT)and peak pressure(Ppeak)were the sanle as that of PSV respectively.Observe the changes of respiratory mechanics,blood gas analysis and hemodynamics during mechanical ventilation.Results For health dogs,compared with PAV,mean airway pressure(mPaw)and work of breath of ventilator(WOBv)of PSV was higher than those of PAV when VT were similar,the difference was remarkable;while the influence on hemodynamics was not different.For ALI dogs,compared with PAV,Ppeak,mPaw and pulmonary capillary wedge pressure(PCWP)of PSV was higher than those of PAV when VT were similar,the difference was remarkable.Conclusion For health and ALI dogs,compared with PSV,PAV has lower airway pressure and less influence on hemodynamies.

Objective To evaluate gray matter volume,white matter volume and FA value changes in amyatrophic lateral sclerosis(ALS)patients by voxel-based morphometry(VBM)and voxel-based diffusion tensor analysis(VBDTA).Methods Thirty-nine definite or probable ALS patients diagnosed by El Escorial standard and 39 healthy controls were recruited and underwent conventional MR scans and the neuropsychological evaluation.The 3D FSPGR T_1WI and DTI data were collected on GE Medical 3.0 T MRI system.The 3D T_1 structural images were normalized,segmented and smoothed,and then VBM analysis was performed.DTI data were acquired from 76 healthy controls,and FA map template was made.FA maps generated from the DTI data of ALS patients and healthy controls were normalized to the FA map template for voxel-based analysis.ANCOVA was applied,controlling with age and total intracranial volume for VBM and age for VBDTA.A statistical threshold of P＜0.01(uncorrected)and cluster level of more than continuous 20 voxels determined significance.Results Statistical results showed no significant difference in the global volumes of gray matter and white matter,total intracranial volumes and gray matter fraction between ALS patients and healthy controls,but the white matter fraction of ALS patients(0.29±0.02)was significantly less than that of healthy controls(0.30±0.02)statistically(P=0.003).There was significant reduction of gray matter volumes in bilateral superior frontal gyri and precentral gyri,right middle frontal gyrus,right middle and inferior temporal gyrus,left superior occipital gyms and cuneus and left insula in ALS patients when compared with healthy controls;and the regional reduction of white matter volumes in ALS patients mainly located in genu of corpus callosum,bilateral medial frontal gyri,paracentral lobule and insula,right superior and middle frontal gyrus and left postcentral gyrus.VBDTA showed decrease in FA values in bilateral parahipocampal gyri and cingulate gyri in ALS patients compared with healthy controls.Conclusions VBM and VBDTA analysis results suggest that ALS is not simply a motor neuron disease but a multisystem disorder;and VBDTA has a potential value for the detection of FA value changes of cingulate and parahippocampal gyral white matter in suspected cognitive impairment of ALS patients.

Purpose At present,morphological observation and CT value measurement were mainly used to evaluate ground-glass nodule (GGN),and there was no effective image feature-quantization evaluation method.Therefore,in this study,a follow-up quantization analysis was conducted on GGN within 2 years using texture feature analysis method to confirm reasonable GGN follow-up time.Materials and Methods Baseline and highresolution CT images of 100 GGN follow-up patients were retrospectively analyzed.They were assigned into three groups,3 months follow-up (group A),6 to 12 months follow-up (group B) and 2 years follow-up (group C).For each group,using firstly founded GGN image as baseline,GGN texture features (including energy,contrast,autocorrelation,inverse difference moment and entropy) were analyzed.Results There were 1 case of narrowed nodules in group A,1 case of increased nodules and 1 case of narrowed nodules in group B,and 4 cases of increased nodules in group C,2 of which showed density differences.There was no significant change in shape,density and size of the remaining nodules.There were no significant differences in texture features (energy,contrast,autocorrelation,deficit,entropy) among group A,group B and group C (P＞0.05).Conclusion Texture feature analysis can quantitatively evaluate the change of GGN attribute characteristics,and as a GGN follow-up quantitative tool,it can guide patients to choose reasonable follow-up mode.

This study was aimed to optimize the extraction technology of Wei-Kang (WK) Capsule. Orthogonal test and comprehensive evaluation were used to optimize the extraction process of compound preparation. The icarrin, to-tal ginkgo flavone glycosides and the dried decocting rates were used as index components for optimizing the effect of ethanol concentration, ethanol volume, extraction duration and extraction frequency. The results showed that the opti-mal ethanol extraction technology was adding 12 times of 60% ethanol and extract for 3 times with 1 h for each ex-traction time. It was concluded that the optimized extraction technology was stable, practical, scientific and reason-able, which can be used in the large-scale industrial production.

The stable quality of Chinese herbal medicines is a critical factor for their reliable clinical efficiency. An improved liquid-liquid extraction procedure and a liquid chromatographic method were developed to simultaneously analyze five anthraquinones (aloe-emodin, rhein, emodin, chrysophanol and physcion) in a Chinese traditional hospital preparation, Fuyankang mixture, in order to quantitatively control its quality in a more effective way.

Objective To investigate the clinical data of a family diagnosed with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy(CADASIL) with isolated vertigo as the initial symptom. Methods The clinical manifestations,imaging findings,pathology,genetic testing results,and CADASIL scale score of a patient with CADASIL were summarized,and a family investigation was conducted. Results The proband of this case experienced recurrent isolated vertigo and gradually developed emotional disorder. Cranial magnetic resonance imaging(MRI) FLAIR revealed extensive subcortical white matter degeneration in both hemispheres,characteristic abnormal hyperintensity in bilateral temporal poles and external capsules,abnormal hyperintensity in bilateral brainstems,and multiple lacunar infarctions in bilateral corona radiata and basal ganglia. The score of CADASIL scale was 16 points. Skin biopsy showed the deposition of electron-dense granular osmiophilic material around vascular smooth muscle. Genetic testing identified a heterozygous mutation of c. 1163G>A(p. C388Y) in the NOTCH3 gene. The elder sister of the proband also had isolated vertigo and was found to have the same mutation by genetic testing. The father and uncle of the proband died of cerebral infarction,while the aunt of the proband suffered from severe dementia,and all of them had experienced dizziness in the early stage. Conclusion CADASIL has clinical heterogeneity and can manifest as isolated vertigo. Abnormal signals in temporal poles and external capsules on cranial MRI have an important value in the diagnosis of this disease,while pathological examination is required to make a confirmed diagnosis,and genetic testing can further clarify the diagnosis and perform screening of other family members.

Objective:To explore the application effect of family-centered empowerment model (FCEM) in rehabilitation nursing of children with femoral shaft fractures treated by skin traction.Methods:A retrospective case-control study was conducted to analyze the clinical data of 107 children with femoral shaft fractures treated with skin traction in Anhui Children′s Hospital from April 2019 to October 2021, including 67 males and 40 females; aged 1.5-5.0 years [2.8(2.0, 3.5)years]. Fracture types included oblique fracture ( n=50), comminuted fracture ( n=26), transverse fracture ( n=14) and spiral fracture ( n=17). FCEM nursing was implemented in 55 patients (family empowerment group) and routine home rehabilitation nursing guidance was performed in 52 patients (routine nursing group). The face, legs, activity, cry, consolability (FLACC) behavioral score on admission and at days 1, 3 and 7 after skin traction, treatment compliance rate at 1 month after skin traction, complication rate at 1 month after skin traction, length of hospital stay and fracture healing time were compared between the two groups. Results:All patients were followed up for 12-18 weeks [13.4(12.7, 13.9)weeks]. There was no significant difference in FLACC behavioral score between the two groups on admission ( P>0.05). The FLACC behavioral score was (4.0±0.7)points,(3.4±0.6)points and (2.4±0.6)points in family empowerment group at days 1, 3 and 7 after skin traction, lower than (4.8±0.7)points, (3.9±0.8)points and (3.3±0.5)points in routine nursing groups (all Ρ<0.01). One month after skin traction, treatment compliance was excellent in 51 patients, good in 4, poor in 0, with treatment compliance rate of 92.7% (51/55) in family empowerment group, and was excellent in 40 patients, good in 9, poor in 3, with treatment compliance rate of 76.9% (40/52) in routine nursing group ( Ρ<0.05). The complication rate was 5.4% (3/55) in family empowerment group, lower than 21.2% (11/52) in routine nursing group ( Ρ<0.05). The length of hospital stay and fracture healing time were (15.6±0.3)days and (7.1±0.8)weeks in family empowerment group, shorter than (16.8±0.3)days and (8.2±0.4)weeks in routine nursing group (all Ρ<0.01). Conclusion:For children with femoral shaft fractures treated by skin traction, nursing using FCEM can alleviate pain, improve treatment compliance, reduce complication rate, reduce hospital stay and shorten fracture healing time.

Objective:To investigate the prognostic significance of anemia in elderly patients with stable coronary artery disease treated by percutaneous coronary intervention(PCI).Methods:In this retrospective cohort study, 180 patients with stable coronary artery disease aged ≥60 years undergone percutaneous coronary intervention and with complete clinical data, admitted to Nanjing Meishan Hospital between June 2016 and December 2017, were selected.Baseline clinical data of the patients were collected, including hemoglobin, C-reactive protein, lipids, fasting glucose, glycated hemoglobin, blood creatinine, and left ventricular ejection fraction on cardiac color ultrasound.The endpoints of the follow-up included major adverse cardiac events(MACE), such as all-cause death, non-fatal myocardial infarction, and non-fatal stroke.According to the hemoglobin level, participants were divided into an anemia group(n=32)and a non-anemia group(n=148). Clinical data of the two groups were compared, and the Kaplan-Meier method and multivariate analysis with the Cox regression method were used to evaluate the effect of anemia on the occurrence of MACE in elderly patients with stable coronary artery disease treated by PCI.Results:The median duration of the follow-up of the 180 patients was 702.5 days and MACE occurred in 27(15.0%). Compared with the non-anemia group, the anemia group had a higher age, C-reactive protein level and MACE ratio, lower levels of total cholesterol, triglycerides, low-density lipoprotein cholesterol and the glomerular filtration rate, and higher proportions of patients with smoking history and patients with dyslipidemia( P<0.05). Kaplan-Meier curves suggested that the incidence of MACE in the anemia group was higher than that in the non-anemia group[37.5%(12/32) vs.10.1%(15/148), P<0.05]. Multivariate analysis with the Cox regression method showed that the risk of MACE in the anemia group was 2.91 times higher than that in the non-anemia group( HR=2.91, 95% CI: 1.13-7.48, P<0.05). Conclusions:Anemia is an independent predictor of MACE in elderly patients with stable coronary artery disease after PCI.

Objective To evaluate the long-term efficacy of neonatal immunoprophylaxis in children born from mothers infected with hepatitis B virus (HBV),and to clarify whether a booster vaccination is required.Methods Totally 252 children of HBV infected mothers,who were negative for hepatitis B surface antigen (HBsAg) tested in Nanjing Drum Tower Hospital in 2012,were enrolled to participate in this study from July to September,2017.Revaccination of hepatitis B vaccine was recorded and other relevant informations were collected.HBV serologic markers were detected in each child.Results Totally 198 children (78.6％) were followed up.They were (8.4 ± 2.2) years old and 112 cases were boys.All 198 children were negative for both HBsAg and hepatitis B core antibody (anti-HBc).The overall positive rate of hepatitis B surface antibody (anti-HBs) (≥ 10 IU/L) was 65.7％.During period of 2012 to 2017,53 children were boosted with hepatitis B vaccine.Their median anti-HBs titer in 2017 was higher than that in 2012 (327.95 IU/L vs.158.01 IU/L),and the difference was significant (Z =-4.480,P ＜0.05).The other 145 children were not revaccinated,their median anti-HBs titer was decreased from 214.19 IU/L in 2012 to 70.49 IU/L in 2017,and the difference was significant (Z =-6.575,P ＜ 0.05).Of 145 children who were not revaccinated,25 cases had anti-HBs levels ＜ 10 IU/L and 120 cases ≥ 10 IU/L in 2012,and the other 47 cases also showed the antibody ＜ 10 IU/L in 2017,but none of them was infected with HBV.Conclusions Neonatal immunoprophylaxis in infants from HBV-infected can provide long-term protection against hepatitis B.The children with anti-HBs ＜ 10 IU/L are still immune to HBV and booster vaccination for them seems unnecessary.