Objective:To observe any effect of percutaneous tibial nerve stimulation (PTNS) combined with electro-acupuncture on detrusor overactivity after a spinal cord injury.Methods:Forty spinal cord injury survivors with neurogenic detrusor overactivity were randomly assigned to a control group or an observation group, each of 20. Both groups received routine bladder training and electro-acupuncture modulating 3 sacral spinal nerves. The observation group also received 20 minutes of bilateral PTNS five times a week for 8 weeks. The frequency was 10Hz with a pulse width of 200μs. Before and after the treatment, both groups′ urination frequency, incontinence and average daily urine volume were assessed using a urodynamics analyzer, bladder diaries and an incontinence quality of life questionnaire (I-QOL).Results:After treatment, the average involuntary detrusor contraction volume (IDCV), maximum detrusor pressure at filling time (P det·max), bladder compliance (BC), residual volume and the TL value of the electromyogram of the urethral sphincter (LgTLR) had all improved significantly in both groups. The 1st IDCV, BC and LgTLR of the observation group were then significantly better than in the control group, on average, with the average P det·max and residual volume significantly lower than in the control group. The average daily single urine output and I-QOL score of both groups had increased significantly, while the average daily urination frequency and frequency of urinary incontinence had decreased significantly. Both were again significantly better in the observation group. Conclusion:Combining percutaneous electrical stimulation of the tibial nerves with electro-acupuncture can effectively inhibit detrusor overactivity after a spinal cord injury, reducing urinary incontinence.

Objective:To seek a correlation between short-chain fatty acids (SCFAs) and skill in the activities of daily living (ADL) after an ischemic stroke.Methods:Ninety ischemic stroke survivors were assessed using the Barthel Index (BI). Fecal samples were collected and analyzed for the concentration of acetic acid, propionic acid, butyric acid, isobutyric acid, valeric acid, and isovaleric acid using gas chromatography. Spearman correlation analysis was conducted to identify SCFAs that correlated with the total BI score. Linear regressions were evaluated to explore the correlation between the total BI score and SCFAs.Results:The concentrations of propionic and butyric acids in the feces were found to correlate significantly with the total BI scores. Data including propionic acid and butyric acid levels, age, gender, body mass index, disease duration, any history of hypertension or diabetes, and other SCFAs were included in the regression models. Propionic and butyric acid levels were found to be potentially useful predictors of total BI scores.Conclusions:The concentration of propionic and butyric acids in the feces after an ischemic stroke can predict the survivor′s total BI score. Those concentrations could therefore be useful for predicting ADL ability.

Objective:To explore the predictors and reasons for restenosis in patients with Takayasu′s arteritis(TA) involved renal artery after plain old balloon angioplasty(POBA).Methods:The clinical data of 47 TA patients (47) with renal artery admitted to Xuanwu Hospital, Capital Medical University from January 2014 to December 2020 were analyzed, including 12 man and 35 female. The age ranged from 21 to 43 years old, with an average of (28.52±10.78) years old. All patient were diagnosed as TA and underwent POBA. The patients were divided into restenosis group ( n=18) and non-restenosis group ( n=29). The patients were followed up at 1, 3, and 6 months after surgery, and after 6 months, the patients were followed up every 6 months. All patients were followed up from 36 to 108 months.The basic clinical data of the two groups were compared, and the length of stent and residual stenosis were also compared. Measurement data were expressed as ( ± s), and t-test was used for comparison between groups. Counting data were expressed as the number of cases and percentage, and comparison between groups was analyzed using the chi-square test. Multivariate Logistic regression model was used to analyze the independent risk factors of restenosis after balloon dilation, and the OR value and 95% confidence interval were calculated. Logistic regression model was used to analyze the independent risk factors for restenosis after balloon dilation. Results:All patients received POBA and operation was successfully. Restenosis was found in 18 patients, and 29 patients remained normal during the follow-up. The primary patency rate was 61.7%. Multivariate Logistic regression analysis showed that HDL-C and lesion length were the influencing factors of restenosis after POBA in TA of renal artery. The serum HDL-C level was significantly lower and the lesion was significantly longer in restenosis group than in non-restenosis group ( P<0.05). The proportion of residual stenosis>20% was higher in restenosis group than in non-restenosis group ( P>0.05). Conclusion:Serum HDL-C level, lesion length may be may be independent influencing factors of restenosis after plain old balloon angioplasty in TA of the renal artery restenosis.

Objective:The study retrospectively analyzed the etiology, clinical manifestations, emergency treatment and etiological treatment of a large sample of cases with hypercalcemic crisis.Methods:The clincial data of patients with hypercalcaemia cirisis who were administered in First Medical Center of Chinese PLA General Hospital from January 2009 to July 2022 were analyzed, inculding the general data, clinical manifestations, etiology, photographic examination, emergency treatment, etiological treatment, serological examination before and after treatment, pathological immunohistochemical findings and prognosis.Results:A total of 143 hypercalcaemia crisis patients(84 males and 59 females) with a mean age of 53.51±16.60 were enrolled. The most common disease was hyperparathyroidism(62/143), followed by solid malignancy(57/143) and multiple myeloma(12/143). Patients presented with digestive system symptoms at 76.91%, followed by neurological symptoms at 63.60%, urinary system symptoms at 58.76%, musculoskeletal symptoms at 55.23%, and cardiovascular system symptoms at 32.91%. After emergency calcium-lowering treatment, the remission rate of hypercalcemic crisis in 143 patients was 100%(143/143), and after etiological treatment, the remission rate of hypercalcemia was 85.31%(122/143).Conclusion:Early identification, emergency treatment and etiology treatment of hypercalcaemia crisis are essential. Effective treament with comprehensive calcium reduction can quickly relieve clinical symptoms and create opportunities for treatment for the cause. Targeted etiological interventions can lead to the correction or long-term remission of hypercalcemia.

177Lu-prostate specific membrane antigen(PSMA)radio-ligand therapy has been approved abroad for advanced prostate cancer and has been in several clinical trials in China.Based on domestic clinical practice and experimental data and referred to international experience and viewpoints,the expert group forms a consensus on the clinical application of 177Lu-PSMA radio-ligand therapy in prostate cancer to guide clinical practice.

The clinical data, laboratory test, and gene mutations were collected from a family with Liddle syndrome. Literatures on Liddle syndrome published in domestic and abroad since 1994 were reviewed and the types of gene mutations were summarized. The proband was diagnosed with hypertension at the age of 24. Laboratory test showed that serum potassium was 3.65 mmol/L, plasma renin was <0.5 mU/L, and plasma aldosterone was 1.5 ng/dL. Proband′s father was diagnosed with hypertension at the age of 34 with the serum potassium 3.34 mmol/L, plasma renin 3.72 mU/L, and plasma aldosterone 6.04 ng/dL. A nonsense mutation(1724G>A, p.Trp575*) in exon 13 of SCNN1G gene was detected in the proband and his father. In 288 cases from 107 families reported in the review of domestic and foreign literature, the incidence of hypertension, hypokalemia, and low renin/low aldosterone were 95.1%, 55.2%, and 49.6%, respectively. This case suggests that the clinical phenotype of Liddle syndrome is heterogeneous. Patients with early-onset hypertension, regardless of whether they are accompanied by hypokalemia, should be screened for renin-angiotensin-aldosterone and genetic testing related to Liddle syndrome should be further detected in patients with low plasma renin/aldosterone.

Objective:To explore the characteristics of the association between the triglyceride glucose (TyG) index and nonfatal cardio-cerebrovascular disease risk in a community population.Method:This was a prospective cohort study. From December 2011 to April 2012, the first investigation was conducted among subjects with more than 40-year old who were from Shijingshan district and Pingguoyuan community in Beijing. The second investigation was conducted from April to October 2015. All the subjects were divided into three groups according to the tertile of the TyG index at baseline. The multivariate Cox proportional risk regression model was established to explore the correlation between the TyG index and nonfatal cardio-cerebrovascular disease risk and the Kaplan-Meier survival curve of the TyG index group was drawn. Subgroup analyses were performed according to age, gender, body mass index, type 2 diabetes mellitus (T2DM), hypertension, and hyperlipidemia to determine the correlation characteristics between the TyG index and nonfatal cardio-cerebrovascular disease among subgroups.Results:A total of 9 577 subjects were finally included to analyze. The mean follow-up time of this study was (34.14±3.84) months. During the follow-up, 363 subjects (3.8%) occurred nonfatal cardio-cerebrovascular disease. The multivariate Cox regression analysis results showed that the hazard ratio ( HR) of nonfatal cardio-cerebrovascular disease in the high TyG index group was 1.54 (95% CI 1.19-1.98), 1.60 (95% CI 1.23-2.10), and 1.57 (95% CI 1.20-2.05) in the three models, compared with the low TyG index group. The Kaplan-Meier analysis showed that the risk of nonfatal cardio-cerebrovascular disease increased from the low-TyG index group to the high-TyG index group ( P=0.015). In the six subgroups analysis, only gender was shown to have a significant interaction effect with the TyG index and nonfatal cardio-cerebrovascular disease risk. In the female population, the risk of nonfatal cardio-cerebrovascular disease is significantly increased with the increase in the TyG index level ( P<0.001). Conclusions:A high TyG index is independently related to the increased risk of nonfatal cardio-cerebrovascular disease in the Beijing community population. Gender has a significant interaction with the TyG index and nonfatal cardio-cerebrovascular disease risk. Therefore, the TyG index may be a useful marker to predict the nonfatal cardio-cerebrovascular disease risk of a community population.

Balance impairment is a common complication after stroke, which often leads to difficulty in walking function recovery and high risk of fall, seriously affecting the independent activity ability and quality of life of stroke patients. Accurate assessment of balance is conducive to better formulation of rehabilitation plans, evaluation of rehabilitation effects, and guidance of safer daily living activities of stroke patients. This article reviews the research progress of various methods for accurate assessment of balance function in patients with stroke.

Objective:To observe any effect of dynamic motor instability training on the balance and postural control of stroke survivors.Methods:Forty stroke survivors with poor balance were randomly divided into a control group and an observation group, each of 20. In addition to routine rehabilitation, the observation group was given 20 minutes of dynamic motor instability training, 5 days a week for 8 weeks, while the control group underwent routine rehabilitation for the same length of time. Before and after the intervention, surface electromyogram of the rectus femoris, biceps femoris, and erector spinae were recorded during perturbation. Activation time and the intensity of the anticipatory and complementary postural adjustments (APAs and CPAs) were also observed. Balance and lower limb motor functioning were assessed using the Berg balance scale (BBS), the Fugl-Meyer lower extremity assessment (FMA-LE), and GaitWatch analysis.Results:After the treatment the average activation time of the rectus femoris, biceps femoris in the affected side and those of the biceps femoris [(-84.31±5.74)s] and erector spinae in the intact side in APAs were all significantly shorter in the observation group than in the control group, while the average activation intensity of the rectus femoris and erector spinae was significantly greater. There was no significant difference in the activation intensity of each muscle group in CPAs after the treatment. After the intervention the average BBS score, FMA-LE score, stride length and walking speed of the observation group all were significantly better than the control group′s averages.Conclusions:Supplementing traditional rehabilitation training with dynamic motor instability training can further improve the posture control of stroke survivors and promote recovery of their balance and walking ability.

Objective:To explore any effect of blood flow restriction during exercise on knee proprioception and motor coordination after anterior cruciate ligament (ACL) reconstruction.Methods:Thirty patients recovering from ACL reconstruction were randomly divided into an experimental group and a control group, each of 15. Both groups were given routine rehabilitation training, while the experimental group was additionally provided with 45 minutes of training with blood flow restriction, 3 times a week for 8 weeks. The blood flow restriction training involved constant pressure in the groin while the patient performed knee flexion and extension resistance training, squats, alternate knee flexion and extension and ergometer cycling. Before and after the intervention, both groups′ knee function, proprioception and lower limb motor coordination were evaluated using the Lysholm knee scale, the Humac isokinetic measurement system and surface electromyography.Results:Before the experiment there were no significant differences between the two groups in any of the measurements. After the intervention, both groups′ average Lysholm score had improved significantly, and errors in reproducing a knee angle had decreased significantly. Significantly better improvement was observed in the observation group than in the control group. That group′s average coordinated contraction rate on the affected side in extension and flexion was also significantly better than the control group′s ave-rage. Indeed, there were no significant differences in the contraction rates between the healthy and affected sides.Conclusions:Training with restricted blood flow can significantly improve knee function, proprioception and motor coordination after anterior cruciate ligament reconstruction.