Dementia with Lewy bodies (DLB) is the second most prevalent type of dementia among neurodegenerative disorders. The latest guideline for diagnosis and treatment of DLB in China has defined electroencephalography abnormalities as one of the supportive biomarkers. Seizures and epileptiform discharges in patients with DLB are gradually attracting attention and research, and there is increasing evidence of the correlation between DLB and epilepsy. However, the identification and diagnosis of seizures in DLB patients are challenging. In addition to clinical seizures, subclinical epileptiform activity is also an important part in DLB research. The underlying pathological mechanism of DLB epileptic seizures is still unclear. The current connection, potential pathological mechanisms, and possible future research directions between epilepsy and DLB were summarized in this review. The current relationship between epilepsy and DLB, potential pathological mechanisms and possible future research directions were summarized in this review, reminding clinicians to pay attention to the epilepsy and subclinical epilepsy activity in the diagnosis and treatment process, early identification, and timely intervention of the DLB patients.

Objective To explore the diagnostic value of electrocardiogram parameters combined with serum microRNA(miR)-322 and miR-568 levels in patients with chronic heart failure(CHF)complicated with ventricular arrhythmias(VA).Methods A total of 230 CHF patients admitted to Zhangjiakou First Hospital from April 2020 to April 2023 were selected as the study objects,including 120 VA patients(VA group)and 110 non VA patients(non VA group),and 110 patients who underwent health examinations in Zhangjiakou First Hospital during the same period as the control group.Compared three sets of general information,electrocardiogram parameters,left ventricular ejection fraction(LVEF),cardiac function grade and serum miR-322 and miR-568 levels.Logistic regression analyzed the influencing factors of VA in CHF patients.Receiver operating characteristic curve(ROC)analyzed electrocardiogram parameters combined with serum miR-322 and miR-568 for the diagnostic value of VA in CHF patients.Results The three groups showed statistically obvious differences in classification of nyha heart function(NYHA)and left ventricular ejection fraction(LVEF)(F=6.033,691.853,all P<0.05).The electrocardiogram parameters of CHF patients,including QT interval dispersion(QTD),QRS wave duration and corrected QT systolic time(QTc)were obviously higher than those in the control group(t=16.539,17.709,14.414),and the VA group were obviously higher than the non VA group(q=10.984,7.794,10.174),and the differences were statistically significan(all P<0.05).The serum levels of miR-322 and miR-568 were obviously lower than those in the control group(t=23.719,17.359).and the VA group were obviously lower than the non VA group(q=10.345,9.941),the differences were statistically significant(all P<0.05).Logistic regression analysis showed that NYHA grading,LVEF,QTD,QRS,wave duration,QTc,serum miR-322 and miR-568 levels were all influencing factors in the complication of VA in patients with CHF(Wald χ2=4.267～9.839,all P<0.05).The combination of electrocardiogram parameters and serum miR-322,miR-568 was better diagnosing CHF patients with concurrent VA that QTD,QRS duration,QTc and serum miR-332,miR-568 were measured separately.Conclusion Serum levels of miR-322 and miR-568 are obviously reduced,and the combination of electrocardiogram parameters with serum miR-322 and miR-568 has high diagnostic value for CHF patients with VA.

Objective To explore the effects of subanesthetic dose esketamine in endoscopic thyroidectomy through the chest and breast approach.Methods 68 female patients who underwent complete endoscopic thyroidectomy through the chest and breast approach from August 2023 to February 2024 were selected as the study subjects and divided into a control group(34 cases)and esketamine group(34 cases)by random number table method.In the esketamine group,sufentanil 0.2 μg/kg plus esketamine 0.2 mg/kg.In the control group,sufentanil 0.4 μg/kg intravenous infusion was given.Observe the systolic blood pressure(SBP),mean arterial pressure(MAP),and heart rate(HR)of the patients at each time point post-sedated(T0),immediately after induction(T1),immediately before intubation(T2),3 min after intubation(T3),5 min after intubation(T4),10 min after intubation(T5),immediately after skin incision(T6),5 min after incision skin(T7),and electroencephalogram bispectral index(BIS)of electroencephalogram at time points T1,T2,T3,T4,T5,T6 and T7 time points;The peroperative blood,anesthesia-related conditions[recovery time,PACU stay time and intraoperative utilization rate of vasoactive drugs],the incidence of adverse reactions(choking cough during recovery,incidence of hypotension after induction,tachycardia during induction,postoperative nausea,vomiting)and the degree of postoperative pain were compared between the two groups of patients.Results Compared to the control group,the esketamine group showed significantly higher SBP and MAP at T2,T4,and T5,the differences were statistically significant(P<0.05);There were 3 cases of tachycardia in the control group and 2 cases in the esketamine group.However,there was no statistically significant difference in HR at each time point between the two group(P>0.05).The BIS at T2 time point in the esketamine group was higher than that of the control groups,the difference was statistically significant(P<0.05),there was no statistically significant difference at the other time points(P>0.05).The use of vasoactive drugs of norepinephrine in the esketamine group was significantly lower than that of the control group(P<0.05).There was no statistically significant difference in the recovery time and PACU stay time between the two groups of patients(P>0.05).The esketamine group exhibited fewer cough reflexes during recovery,lower incidence of hypotension at T2 and T5 time points,lower incidences of nausea and vomiting at 12 and 24 h postoperatively,the differences were statistically significant(P<0.05).There were no statistically significant difference in the peroperative blood and incidence of tachycardia during induction between the two groups of patients(P>0.05).There was no statistically significant difference in the visual analogue scale(VAS)score of the two groups of patients 2 h after surgery(P>0.05).The VAS score of the esketamine group at 12 and 24 h after surgery were significantly lower than those of the control group,and the differences were statistically significant(P<0.05).Conclusion The subanesthetic dose of esketamine used in endoscopic thyroidectomy through the chest and breast approach can maintain hemodynamic stability in patients,reduce the incidence of hypotension after induction,decrease postoperative nausea,vomiting and choking cough,and provide long-lasting analgesia.It is worthy of clinical promotion and application.

Objective To explore the effects of subanesthetic dose esketamine in endoscopic thyroidectomy through the chest and breast approach.Methods 68 female patients who underwent complete endoscopic thyroidectomy through the chest and breast approach from August 2023 to February 2024 were selected as the study subjects and divided into a control group(34 cases)and esketamine group(34 cases)by random number table method.In the esketamine group,sufentanil 0.2 μg/kg plus esketamine 0.2 mg/kg.In the control group,sufentanil 0.4 μg/kg intravenous infusion was given.Observe the systolic blood pressure(SBP),mean arterial pressure(MAP),and heart rate(HR)of the patients at each time point post-sedated(T0),immediately after induction(T1),immediately before intubation(T2),3 min after intubation(T3),5 min after intubation(T4),10 min after intubation(T5),immediately after skin incision(T6),5 min after incision skin(T7),and electroencephalogram bispectral index(BIS)of electroencephalogram at time points T1,T2,T3,T4,T5,T6 and T7 time points;The peroperative blood,anesthesia-related conditions[recovery time,PACU stay time and intraoperative utilization rate of vasoactive drugs],the incidence of adverse reactions(choking cough during recovery,incidence of hypotension after induction,tachycardia during induction,postoperative nausea,vomiting)and the degree of postoperative pain were compared between the two groups of patients.Results Compared to the control group,the esketamine group showed significantly higher SBP and MAP at T2,T4,and T5,the differences were statistically significant(P<0.05);There were 3 cases of tachycardia in the control group and 2 cases in the esketamine group.However,there was no statistically significant difference in HR at each time point between the two group(P>0.05).The BIS at T2 time point in the esketamine group was higher than that of the control groups,the difference was statistically significant(P<0.05),there was no statistically significant difference at the other time points(P>0.05).The use of vasoactive drugs of norepinephrine in the esketamine group was significantly lower than that of the control group(P<0.05).There was no statistically significant difference in the recovery time and PACU stay time between the two groups of patients(P>0.05).The esketamine group exhibited fewer cough reflexes during recovery,lower incidence of hypotension at T2 and T5 time points,lower incidences of nausea and vomiting at 12 and 24 h postoperatively,the differences were statistically significant(P<0.05).There were no statistically significant difference in the peroperative blood and incidence of tachycardia during induction between the two groups of patients(P>0.05).There was no statistically significant difference in the visual analogue scale(VAS)score of the two groups of patients 2 h after surgery(P>0.05).The VAS score of the esketamine group at 12 and 24 h after surgery were significantly lower than those of the control group,and the differences were statistically significant(P<0.05).Conclusion The subanesthetic dose of esketamine used in endoscopic thyroidectomy through the chest and breast approach can maintain hemodynamic stability in patients,reduce the incidence of hypotension after induction,decrease postoperative nausea,vomiting and choking cough,and provide long-lasting analgesia.It is worthy of clinical promotion and application.

Objective To explore the diagnostic value of electrocardiogram parameters combined with serum microRNA(miR)-322 and miR-568 levels in patients with chronic heart failure(CHF)complicated with ventricular arrhythmias(VA).Methods A total of 230 CHF patients admitted to Zhangjiakou First Hospital from April 2020 to April 2023 were selected as the study objects,including 120 VA patients(VA group)and 110 non VA patients(non VA group),and 110 patients who underwent health examinations in Zhangjiakou First Hospital during the same period as the control group.Compared three sets of general information,electrocardiogram parameters,left ventricular ejection fraction(LVEF),cardiac function grade and serum miR-322 and miR-568 levels.Logistic regression analyzed the influencing factors of VA in CHF patients.Receiver operating characteristic curve(ROC)analyzed electrocardiogram parameters combined with serum miR-322 and miR-568 for the diagnostic value of VA in CHF patients.Results The three groups showed statistically obvious differences in classification of nyha heart function(NYHA)and left ventricular ejection fraction(LVEF)(F=6.033,691.853,all P<0.05).The electrocardiogram parameters of CHF patients,including QT interval dispersion(QTD),QRS wave duration and corrected QT systolic time(QTc)were obviously higher than those in the control group(t=16.539,17.709,14.414),and the VA group were obviously higher than the non VA group(q=10.984,7.794,10.174),and the differences were statistically significan(all P<0.05).The serum levels of miR-322 and miR-568 were obviously lower than those in the control group(t=23.719,17.359).and the VA group were obviously lower than the non VA group(q=10.345,9.941),the differences were statistically significant(all P<0.05).Logistic regression analysis showed that NYHA grading,LVEF,QTD,QRS,wave duration,QTc,serum miR-322 and miR-568 levels were all influencing factors in the complication of VA in patients with CHF(Wald χ2=4.267～9.839,all P<0.05).The combination of electrocardiogram parameters and serum miR-322,miR-568 was better diagnosing CHF patients with concurrent VA that QTD,QRS duration,QTc and serum miR-332,miR-568 were measured separately.Conclusion Serum levels of miR-322 and miR-568 are obviously reduced,and the combination of electrocardiogram parameters with serum miR-322 and miR-568 has high diagnostic value for CHF patients with VA.

Dementia with Lewy bodies (DLB) is the second most prevalent type of dementia among neurodegenerative disorders. The latest guideline for diagnosis and treatment of DLB in China has defined electroencephalography abnormalities as one of the supportive biomarkers. Seizures and epileptiform discharges in patients with DLB are gradually attracting attention and research, and there is increasing evidence of the correlation between DLB and epilepsy. However, the identification and diagnosis of seizures in DLB patients are challenging. In addition to clinical seizures, subclinical epileptiform activity is also an important part in DLB research. The underlying pathological mechanism of DLB epileptic seizures is still unclear. The current connection, potential pathological mechanisms, and possible future research directions between epilepsy and DLB were summarized in this review. The current relationship between epilepsy and DLB, potential pathological mechanisms and possible future research directions were summarized in this review, reminding clinicians to pay attention to the epilepsy and subclinical epilepsy activity in the diagnosis and treatment process, early identification, and timely intervention of the DLB patients.

Objective:To investigate the value and clinical significance of fasting plasma glucose (FPG) in early pregnancy (8-12 gestational weeks) as a predictor of gestational diabetes mellitus (GDM) among women with different pre-pregnancy body mass index (pre-BMI) categories.Methods:A retrospective study was conducted including 9 710 singleton pregnant women (FPG levels in early pregnancy ≤5.6 mmol/L) who underwent prenatal screening and delivery in Yuyao People's Hospital from January 2020 to December 2022. Participants were stratified based on their pre-BMI as follows: <18.5 ( n=1 406), ≥18.5 to <25.0 ( n=7 162), ≥25.0 to <30.0 ( n=978), and ≥30.0 kg/m 2 ( n=164). Within each pre-BMI category, women were further divided into four groups based on FPG levels in early pregnancy (<4.5, ≥4.5 to <4.8, ≥4.8 to <5.1, and ≥5.1 mmol/L). Univariate and multivariate logistic regression analysis were used to identify risk factors for GDM, and receiver operating characteristic (ROC) curve was applied to evaluate the efficacy of FPG in early pregnancy based on different pre-BMI in predicting GDM. Results:The overall incidence of GDM in the singleton pregnancy women with FPG levels in early pregnancy ≤5.6 mmol/L was 12.3% (1 197/9 710). For a pre-BMI of <18.5 kg/m 2, the ORs with 95% CIs for GDM within the different FPG categories (<4.5, ≥4.5 to <4.8, ≥4.8 to <5.1, and ≥5.1 mmol/L) were 0.041 (95% CI: 0.015-0.409), 1.834 (95% CI: 1.089-3.088), 6.779 (95% CI: 4.041-11.371), and 13.723 (95% CI: 5.560-33.871), respectively. For pre-BMI of ≥18.5 to <25.0 kg/m 2, the respective the ORs with 95% CIs were 0.048 (95% CI: 0.012-0.203), 2.573 (95% CI: 2.091-3.168), 9.023 (95% CI: 7.240-11.245), and 9.158 (95% CI: 6.484-12.937). For pre-BMI of ≥25.0 to <30.0 kg/m 2, the ORs with 95% CIs were 0.108 (95% CI: 0.053-0.446), 1.698 (95% CI: 1.064-2.654), 7.537 (95% CI: 5.285-13.080), and 9.994 (95% CI: 5.613-18.218). For pre-BMI of ≥30.0 kg/m 2, the ORs with 95% CIs were 0.098 (95% CI: 0.072-1.015), 2.888 (95% CI: 0.911-9.157), 13.674 (95% CI: 3.480-53.736), and 20.509 (95% CI: 6.674-63.019). The optimal cutoff value of FPG in early pregnancy for GDM prediction was 4.7 mmol/L with an area under the curve of 0.752, the risk of GDM significantly increased with FPG levels ≥4.7 mmol/L in early pregnancy across all pregnant women ( OR=17.356, 95% CI: 13.757-21.896, P<0.001). Conclusions:In the singleton pregnancy women with FPG levels in early pregnancy ≤5.6 mmol/L, FPG in early pregnancy is an independent risk factor for the occurrence of GDM; for pregnant women stratified by the same pre-BMI, the risk of developing GDM increases progressively with the rise of FPG in early pregnancy. FPG in early pregnancy has a certain value in predicting the occurrence of GDM.

Objective: To evaluate the dietary quality of residents in Wenzhou City, Zhejiang Province, so as to provide the basis for future health education and nutrition intervention programs. Methods: A stratified multi-stage random sampling method was used to select residents aged 18 years and older in 6 counties (cities, districts) of Wenzhou City as the study subjects, “24-hour dietary review for 3 consecutive days” was adopted to collect dietary intake, and the diet balance index (DBI_16) scoring method was applied to evaluate the dietary quality. Results: This study analyzed the dietary quality of 406 residents in Wenzhou City, including 197 males (48.52%) and 209 females (51.48%). The majority of the residents were aged 18-44 years (254 residents, 62.56%). The median DBI total score was -31 (interquartile range, 8), and 404 residents had insufficient dietary intake, accounting for 99.51%. The median DBI positive score was 5 (interquartile range, 6), and 288 residents had appropriate dietary intake, accounting for 70.94%. The median DBI negative score was 37 (interquartile range, 6), and 210 residents had a high level of insufficient dietary intake, accounting for 51.72%. Five dietary patterns, namely A, B, C, E and F, were identified, with pattern B being the most dominant, accounting for 75.62% of the total (307 individuals). Patterns D, H, I and G were not observed. Conclusions The dietary quality of the residents surveyed indicates the existence of dietary imbalances, mainly manifesting as inadequate intake. It is recommended to strengthen nutritional and health guidance.

Objective To explore the effects of lung rehabilitation using Spiro-tiger training apparatus on the respiratory mechanics and airway remodeling in patients with chronic obstructive pulmonary disease(COPD)in stable stage.Methods Ninety-three stable COPD patients admitted to Nanxiang Branch of Shanghai Ruijin Hospital were randomly divided into control group(46 cases)and observation group(47 cases).Control group was treated with the training for pursed lips breathing and abdominal breathing,and observation group was trained with Spiro-tiger training apparatus in addition to the treatment given to control group.Both groups were intervened continuously for 9 weeks.The two groups were compared in terms of respiratory mechanics(respiratory frequency,tidal volume,minute ventilation,and peak respiratory pressure),airway remodeling[matrix metalloproteinase-9(MMP-9),vascular endothelial growth factor(VEGF),and transforming growth factor-β1(TGF-β1)],and lung function[forced vital capacity(FVC),forced expiratory volume in the first second(FEV1),and FEV1/FVC],blood gas analysis indexes[arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2)],6-minute walking distance(6MWD)and health status[Borg scale and St.George's respiratory questionnaire(SGRQ)].The patients were followed up for 6 months,and the incidence of acute exacerbation of COPD was recorded.Results After 9 weeks of intervention,compared with control group,observation group had lower peak respiratory frequency and respiratory pressure,and higher tidal volume(P<0.05).There was no significant difference in minute ventilation between two groups(P>0.05).The levels of MMP-9,VEGF,TGF-β1 and PaCO2 were lower,and FVC,FEV1,FEV1/FVC and PaO2 were higher in observation group than in control group(P<0.05).Observation group had longer 6MWD,and lower Borg score and SGRQ score as compared with control group(P<0.05).After 6-month follow-up,the incidence of COPD acute exacerbation in observation group was lower than that in control group(4.26%vs19.57%,P<0.05).Conclusion Lung rehabilitation using Spiro-tiger training apparatus can effectively improve respiratory mechanics,lung function,blood gas analysis indexes and health status in stable COPD patients,alleviate airway remodeling,and avoid acute exacerbation of COPD.

Objective:To investigate changes of hip pain and physical function in patients with osteoarthritis (OA) and analyze the gait and postural factors related to pain progression and functional changes.Methods:From March 2019 to May 2021, a total of 300 patients with OA admitted to the First Affiliated Hospital of Zhengzhou University were consecutively enrolled. The visual analog scale (VAS) and the physical function subscale of the 36-item short form health survey (SF-36) were used to assess hip pain and physical function at enrollment (baseline) and after 12 months of follow-up, respectively. The Vicon 3D motion capture system was used to assess the gait of the patients, and the spinal line angle and mobility in the sagittal plane were measured using a spinal mouse. Linear regression analysis was performed with hip pain and changes in physical function as dependent variables and factors related to gait and standing posture as independent variables. Age, joint space width (JSW) , hip pain and physical function at baseline were adjusted.Results:Linear regression analysis showed that limited hip extension angle [standardized regression coefficient ( β) was -0.52, 95% confidence interval ( CI) : -0.88 to -0.17]and limited hip rotation ( β=-0.51, 95% CI: -0.85 to -0.18) were the influencing factors of hip pain ( P<0.05) . Increased thoracic kyphosis ( β=-0.54, 95% CI: -0.99 to -0.09) , decreased anterior sacral slope ( β=0.40, 95% CI: 0.01 to 0.79) , decreased thoracic range of motion ( β=0.59, 95% CI: 0.23 to 0.94) , decreased daily walking steps ( β=0.53, 95% CI: 0.13 to 0.92 ) and decreased walking speed ( β=0.45, 95% CI: 0.04 to 0.86 ) were the influencing factors of decreased physical function ( P<0.05) . Conclusions:Limited hip extension and external rotation during walking are related factors of hip pain aggravation in patients with OA. Increased thoracic kyphosis, decreased anterior sacral slope, decreased thoracic range of motion, decreased daily walking steps and decreased walking speed are the influencing factors of decreased physical function. It is suggested that nurses should take the above factors as the focus of clinical intervention to prevent the progression of OA.