Objective To examine the level of sperm flagellar tubulin glycosylation(Gly-Tubulin)in asthenospermia patients(AP)and discuss its significance.Methods According to the principle of inclusion and exclusion criteria,108 patients treated in the Department of Andrology in Xinjiang Uygur Autonomous Region Maternal and Child Health Hospital from June 2021 to May 2022 were rolled in this study.According to the results of semen examine,they were divided into group AP(n=74),and normal control(NC)group(n=34).Colleced the clinical date of both group,such as the age,the sterility period.The levels of sex hormones were detected by chemiluminescence method.The glycosylated Tubulin levels of the sperm were detected by Western blot and immunofluorescence was used for localization analysis,and the relationship between the Gly-Tubulin of sperm flagellar and asthenospermia was analyzed by Multivariate Logistic regression analysis.Results Compared to NC group,the sterility period of group AP was prolong(3.98±0.30 vs 0.78±0.08),the percent of forward sperm motility was decreased(18.55±0.97 vs 46.24±1.89)and the expression level of Gly-Tubulin in the sperm flagellar was decreased(0.64±0.11 vs 1.00±0.00),the differences with statistical significance(t=62.038,χ2=14.394,3.148,all P＜0.05).There were no significant differences in follicle-stimulating hormone(FSH),luteinizing hormone(LH),prolactin(PRL),estradiol(E2),testosterone,semen volume,sperm concentration and total sperm between the two groups(t/χ2=0.043～1.503,all P>0.05).Multivariate Logistic regression analysis showed that the percent of forward sperm motility and the sperm flagellar Gly-Tubulin expression level were independent risk factors for male asthenospermia(Wald χ2=4.406,7.492,P<0.05).Conclusion Abnormal level of Gly Tubulin in sperm flagella may be closely related to the occurrence and development of asthenospermia.

Objective To examine the level of sperm flagellar tubulin glycosylation(Gly-Tubulin)in asthenospermia patients(AP)and discuss its significance.Methods According to the principle of inclusion and exclusion criteria,108 patients treated in the Department of Andrology in Xinjiang Uygur Autonomous Region Maternal and Child Health Hospital from June 2021 to May 2022 were rolled in this study.According to the results of semen examine,they were divided into group AP(n=74),and normal control(NC)group(n=34).Colleced the clinical date of both group,such as the age,the sterility period.The levels of sex hormones were detected by chemiluminescence method.The glycosylated Tubulin levels of the sperm were detected by Western blot and immunofluorescence was used for localization analysis,and the relationship between the Gly-Tubulin of sperm flagellar and asthenospermia was analyzed by Multivariate Logistic regression analysis.Results Compared to NC group,the sterility period of group AP was prolong(3.98±0.30 vs 0.78±0.08),the percent of forward sperm motility was decreased(18.55±0.97 vs 46.24±1.89)and the expression level of Gly-Tubulin in the sperm flagellar was decreased(0.64±0.11 vs 1.00±0.00),the differences with statistical significance(t=62.038,χ2=14.394,3.148,all P＜0.05).There were no significant differences in follicle-stimulating hormone(FSH),luteinizing hormone(LH),prolactin(PRL),estradiol(E2),testosterone,semen volume,sperm concentration and total sperm between the two groups(t/χ2=0.043～1.503,all P>0.05).Multivariate Logistic regression analysis showed that the percent of forward sperm motility and the sperm flagellar Gly-Tubulin expression level were independent risk factors for male asthenospermia(Wald χ2=4.406,7.492,P<0.05).Conclusion Abnormal level of Gly Tubulin in sperm flagella may be closely related to the occurrence and development of asthenospermia.

Objective:Continuous glucose monitoring (CGM) technology is used to compare the advantages of insulin degludec (IDeg) as a basal insulin regimen compared with insulin glargine (IGlar) in the treatment of adult type 1 diabetes mellitus.Methods:30 adult patients with T1DM admitted to Heji Hospital Affiliated to Changzhi Medical College from September 2019 to December 2020 were screened. According to the random number table method, the patients were randomly divided into two groups (insulin degludec group and insulin glargine group) at a ratio of 1∶1, respectively treated with IDeg, IGlar and aspartate insulin for 12 weeks. The main outcome measures were the coefficient of variation of blood glucose (CV), mean amplitude of glycemic excursions (MAGE), time in range (TIR), time above range (TAR) and time below range (TBR). The secondary outcome measures were mean blood glucose (MBG), standard deviation of blood glucose (SD), fasting blood glucose (FPG), 2 h postprandial blood glucose (2 h BG), hemoglobin A1c (HbA 1c), means of daily differences (MOOD), and the frequency of hypoglycemic events. Results:At 12 weeks of treatment, the HbA 1c, FPG, 2 h BG, MBG, SD, CV and MAGE of insulin degludec group were lower than those of insulin glargine group, with statistically significant difference (all P<0.05). The TIR in the insulin degludec group was significantly higher than that in the insulin glargine group [73(63, 75)% vs 43(28, 63)%, P<0.001], and the TAR was lower than that in the glycerine group [25(17, 23)% vs 35(33, 64)%, P=0.003]. From the curve spectrum of blood glucose level of the two groups, the stability of blood glucose in the insulin degludec group was better than that in the insulin glargine group. After 12 weeks of treatment, 8 cases (8/15) in insulin degludec group had HbA 1c<7.0%, and 4 cases (4/15) in insulin glargine group had HbA 1c<7.0%, without statistically significant difference ( P=0.264). There were 7 cases (7/15) in the insulin degludec group and 1 case (1/15) in the insulin glargine group who achieved high quality blood glucose control, with statistically significant difference ( P=0.035). At the 12th week of outpatient follow-up, the incidence of nocturnal hypoglycemic events in insulin degludec group was significantly lower than that in insulin glargine group (4/15 vs 11/15, P=0.027). Conclusions:Compared with insulin glargine, insulin degludec can achieve higher blood glucose compliance rate, lower blood glucose level and reduce blood glucose fluctuations in patients with type 1 diabetes.

Objective:To investigate the clinical features of pregnant associated Takotsubo cardiomyopathy (PTCM).Methods:We reviewed reported PTCM cases published from January 2007 to June 2022 using the keywords "Tako-tsubo cardiomyopathy""Takotsubo cardiomyopathy" "stress cardiomyopathy" AND "parturition" "pregnancy" "cesarean delivery" "postpartum" "peripartum" "eclampsia" "abortion" in Pubmed and Web of Science databases and the corresponding Chinese words in Wanfang and Chinese Medical Journal Network. Age, obstetric history, mode of delivery, mode of anesthesia, etiological factors, clinical manifestations, treatment, and prognosis of PTCM were recorded. Descriptive statistical analysis was adopted.Results:A total of 55 articles were included, covering 60 patients with PTCM. (1) Age and time of onset: The age of onset was (32.4±6.0) years old. PTCM occurred most frequently during labor [42% (25/60)] and within one day postpartum [32% (19/60)] and during the gestational period [13%(8/60), 33.0 weeks (24.5-37.7 weeks)]. (2) Delivery-related factors: There were 38% (16/42) primiparas and 60% (25/42) multiparas. Among them, 67% (38/57) and 18% (10/57) were delivered by cesarean section and vaginal delivery, respectively. PCTM often lacks obvious triggers [40% (24/60)], with the most common inducing factor being pregnancy-related diseases [27% (16/60)]. (3) Clinical features: The initial symptoms of PTCM were dyspnea [44% (26/59)], followed by chest pain accompanied by dyspnea [17% (10/59)]. The most common subtype of PTCM was the apical type [45% (26/58)], followed by the basal type [24% (14/58)], while the biventricular type was the least common [3% (2/58)] in the PTCM classification. The left ventricular ejection fraction was (31.6±12.1) % at the onset of PTCM, which recovered to (58.2±7.6) % at discharge. PCTM was often complicated by pulmonary edema [67% (40/60)] and cardiogenic shock [55% (33/60)]. (4) Treatment and prognosis: Patients with PCTM usually require noninvasive or invasive ventilator-assisted ventilation [40% (23/58)]. One pregnant woman and five neonates died, while the remaining patients recovered well.Conclusions:PTCM should be considered in differential diagnosis of patients experiencing dyspnea and chest pain during labor and pregnancy. PTCM patients are younger and have more pulmonary edema and cardiogenic shock. Mechanical ventilation is often required, but the prognosis is favorable.

Objective:To investigate the molecular epidemiological characteristics and antibiotic resistance of Clostridioides difficile ( Cd) in hospitalized diarrhea patients in a tertiary hospital in Shaanxi Province. Methods:This study collected 425 stool samples of hospitalized diarrhea patients from October 2018 to December 2021 for isolation and identification of Cd. Toxin genes carried by the isolates were detected. Multilocus sequence typing (MLST) was performed to analyze the phylogenetic profile. Antibiotic susceptibility was analyzed by E-test. Results:Forty-nine strains of Cd were isolated from the 425 samples, including 37 strains of toxigenic Cd (75.5%, 37/49). The detection rate of Cd was 14.0% (25/179) in diarrhea patients aged ≥65 years old and 36.4% (4/11) in Nephrology Department. In the 37 toxigenic Cd strains, A -B + CDT -Cd, A + B + CDT -Cd and A + B + CDT +Cd accounted for 18.9% (7/37), 78.4% (29/37) and 2.7% (1/37), respectively. There were 24 ST types, among which ST2, ST3 and ST54 were the predominant types, each accounting for 12.2% (6/49). All strains were sensitive to metronidazole and vancomycin, with a high resistance rate of 93.9% (46/49) to ciprofloxacin and a low resistance rate of 12.2% (6/49) and 10.2% (5/49) to rifampicin and meropenem, respectively. Conclusions:The main type of toxigenic strains was A + B + CDT -. ST2, ST3 and ST54 were the predominant types and the distribution of ST types was scattered. All isolates were sensitive to metronidazole and vancomycin and most of them were resistant to ciprofloxacin.

This paper briefly described the present state of the use of major medical equipment in an island hospital. The intermittent idleness of the equipment increased the difficulty of maintenance. The gap between the current medical and equipment preparation, such as reagents, instruments, and equipment, and the demand for medical support was a major obstacle for diagnosis and treatment. Harsh climate, incomplete hospital information system, and poor handover process of medical staffs during rotation were the main challenges for medical equipment management in remote island hospitals. It is suggested that the island hospital improve its management regulation of medical instruments and equipment, ensure sufficient stock of key equipment and reagents, establish a regional medical consortium model to make full use of remote consultation and artificial intelligence in medical imaging, and make reasonable use of hospital ships to balance and coordinate medical resources for island hospitals, so as to effectively improve the medical support capacity on islands.

This paper briefly described the present state of the use of major medical equipment in an island hospital. The intermittent idleness of the equipment increased the difficulty of maintenance. The gap between the current medical and equipment preparation, such as reagents, instruments, and equipment, and the demand for medical support was a major obstacle for diagnosis and treatment. Harsh climate, incomplete hospital information system, and poor handover process of medical staffs during rotation were the main challenges for medical equipment management in remote island hospitals. It is suggested that the island hospital improve its management regulation of medical instruments and equipment, ensure sufficient stock of key equipment and reagents, establish a regional medical consortium model to make full use of remote consultation and artificial intelligence in medical imaging, and make reasonable use of hospital ships to balance and coordinate medical resources for island hospitals, so as to effectively improve the medical support capacity on islands.

Objective To compare the difference between color Doppler flow imaging (CDFI) and superb microvascular imaging (SMI) in the evaluation of vascular grading and the display rate of vascular in papillary thyroid carcinoma (PTC).Methods Between June 2015 and December 2015 in Beijing Chaoyang Hosptial,50 patients with 61 thyroid nodules were detected by ultrasonography,and pathologic types were confirmed as PTC.CDFI and SMI were used to evaluation the same nodule respectively according to Adler's grading criteria.The different flow characteristics were analyzed by the x2 test.Results In CDFI,the vascular grading of 33 patients were 0 ～ Ⅰ and these of 28 patients were Ⅱ ～Ⅲ by CDFI.In SMI,the vascular grading of 6 patients were 0 ～ Ⅰ and these of 55 patients were Ⅱ ～Ⅲ by SMI.There was a significant difference between CDFI and SMI for vascular grading (x2=27.475,P ＜ 0.01).In CDFI,50 patients with PTC showed punctiform and rod-like flow signals,and 5 patients showed more detail internal small branches by CDFI.In SMI,42 patients with PTC showed punctiform and rod-like flow signals,and 17 patients showed more detail internal small branches.There was a significant difference between CDFI and SMI about the display rate of vascular (x2=7.011,P ＜ 0.01).Conclusions Compared with CDFI,SMI is highly improved blood flow sensitivity.It can provide more detail internal small branches in PTC.The characteristics of vascular distribution are similar to strengthening mode of contrast-enhanced ultrasound in PTC,therefore,SMI is worth to further research.

ObjectiveTo observe the clinical efficacy of relaxing needling plus joint needling from the Internal Medicine in treating post-stroke spastic hemiplegia.MethodTotally 121 eligible subjects were randomized intoan ordinary acupuncture group (61 cases) and a relaxing-joint needling group (60 cases). The two groups were treated for 2 weeks, 5 sessions each week. The spasm of the lower limb was evaluated by using Fugl-Meyer Assessment Scale (FMA), modified AshworthScale (MAS), Tardieu Scale, and Activities of Daily Living (ADL) before and after treatment. Besides, 4 patients from each group were randomly selected for the three-dimensional gait analysis, and the dorsi-extension, range of motion (ROM) of ankle, strephenopodia, and heel-raising height were observed.Result and ConclusionRelaxing-joint needling and ordinary acupuncture both can produce significant efficacies in treating post-stroke spastic hemiplegia. The relaxing-joint needling produced more significant efficacies in improving the body balance, ROM, muscular tension, and lower limb spasticity compared to ordinary acupuncture. It’s plausible that relaxing-joint needling improves the strephenopodia and hemiplagia gait through renovating body balance, ROM, muscular tension, and lower limb spasticity. Since the three-dimensional gait analysis can analyze the dorsi-extension, strephenopodia, and heel-raising height, thus it can be used to evaluate the change of the spastic gait of post-stroke hemiplegia in amore objective, elaborate, and correct way.

Objective To investigate the potential relationship between the characteristics of atherosclerotic plaque of carotid artery and cardiovascular events in a senior cohort of Renqiu region,Hebei.Methods A random cluster sampling method was used to identify study population among 60 -70 years old residence in Renqiu region, Hebei.In the face of health questionnaire survey,neck vascular ultrasound examination,a total of 4 413 cases,inclu-ding 1 876 males and 2 537 females,the occurrence of carotid artery plaque and stenosis were detected by ultrasound. Carotid ultrasound was used to identify the characteristic of atherosclerotic plaque of bilateral carotid arteries,which were categorized as with and without plaque,single and multiple plaque,homogenous and heterogeneous plaque,and with and without stenosis.Cardiovascular events were defined as composite events of myocardial infarction,cardiovas-cular death,fatal or non -fatal stroke during the subsequent 2 years follow -up after initial evaluation.Multiple Logis-tic regression was performed to identify the association between the characteristics of bilateral carotid arteries and cardiovascular events.Results A total of 4 413 case enrolled in the study.With carotid ultrasound,2 438 cases (55.2%)were found to be with atherosclerotic plaque formation and 235(5.3%)were with carotid artery stenosis. The proportion of single,multiple,homogeneous and heterogeneous plaques were 1 024cases(23.2%),1 114cases (32.0%),1 106cases(25.1%)and 1 333cases(30.2%),respectively.Among them,the single plaque and new cardiovascular and cerebrovascular events occured in 83 cases(P =0.168),the multiple plaques and new cardiovascular and cerebrovascular events occured in 161 cases(P <0.001 ),the homogeneous patch and new cerebral vascular events occured in 98 cases(P =0.032),the non -homogeneous patch and new cerebral vascular events occured in 146 cases(P <0.001),the stenosis and cerebral vascular events occured in 42 cases(P <0.001).Taken the new onset cardiovascular and cerebrovascular events as dependent variable,the single factor analysis showed that the carotid plaques(χ2 =14.969,P <0.001 ),and the multiple plaque(χ2 =22.509,P <0.001 ),the carotid artery stenosis (χ2 =27.561,P <0.001),the homogeneous plaque(χ2 =4.606,P <0.050),the non -homogeneous plaque(χ2 =18.301,P <0.001),the history of hypertension(χ2 =33.709,P <0.001),the high blood fat disease(χ2 =11.262, P <0.001),and the history of diabetes(χ2 =5.525,P <0.050),the coronary heart disease history(χ2 =10.440, P <0.001),the gender(χ2 =5.606,P <0.050),the smoking(χ2 =4.823,P <0.050)and the systolic blood pressure value,were all associated with the new cardio cerebral vascular events.Multivariate analysis showed that,the heterogeneous plaque(β=0.371,P <0.050),the carotid artery stenosis(β=0.621,P <0.050),the history of hypertension(β=0.517,P <0.001)and smoking(β=0.264,P <0.050)were shown to be significantly associates with new onset cardiovascular events.Conclusion The characteristics of atherosclerotic plaque of carotid artery were significantly associated with the subsequent cardiovascular events among 60 -70 years old residence in Renqiu region,Hebei.Routine carotid ultrasound screening might be useful for identify those people with high risk of develo-ping cardiovascular events.