Objective:To explore the diagnosis and clinical characteristics of congenital meningocele combined with type 1 neurofibromatosis (NF1).Methods:Clinical data of a child with congenital meningoencephalocele complicated with NF1 diagnosed and treated by the Hunan Provincial Brain Hospital on July 12, 2021 were collected, and relevant literature was reviewed.Results:Patient, female, 9 years old, with milk coffee stains on the skin of the trunk and limbs, mostly with a length greater than 1.5 cm; A three-dimensional CT scan of the skull showed a skull defect in the left temporal occipital region (approximately 7.5 cm×6.7 cm) and below the right posterior occipital tuberosity (approximately 3 cm×3 cm). The patient′s clinical whole exome sequencing detected one pathogenic mutation (NF1: p. Arg681Ter), and underwent lumbar cistern drainage, cyst resection, occipital cistern ostomy, and titanium mesh repair and shaping surgery. The pathological result showed proliferation of arachnoid and fibrous tissue, and good postoperative recovery.Conclusions:Congenital meningoencephalocele combined with NF1 is extremely rare, and early surgery has more advantages than disadvantages. The use of titanium mesh with sliding groove can alleviate the limitation on skull growth to a certain extent. NF1 has diverse clinical manifestations and different onset ages, and should be followed up by a multidisciplinary team for a long time.

As the search for effective treatments for COVID-19 continues, the high mortality rate among critically ill patients in Intensive Care Units (ICU) presents a profound challenge. This study explores the potential benefits of traditional Chinese medicine (TCM) as a supplementary treatment for severe COVID-19. A total of 110 critically ill COVID-19 patients at the Intensive Care Unit (ICU) of Vulcan Hill Hospital between Feb., 2020, and April, 2020 (Wuhan, China) participated in this observational study. All patients received standard supportive care protocols, with a subset of 81 also receiving TCM as an adjunct treatment. Clinical characteristics during the treatment period and the clinical outcome of each patient were closely monitored and analysed. Our findings indicated that the TCM group exhibited a significantly lower mortality rate compared with the non-TCM group (16 of 81 vs 24 of 29; 0.3 vs 2.3 person/month). In the adjusted Cox proportional hazards models, TCM treatment was associated with improved survival odds (P < 0.001). Furthermore, the analysis also revealed that TCM treatment could partially mitigate inflammatory responses, as evidenced by the reduced levels of proinflammatory cytokines, and contribute to the recovery of multiple organic functions, thereby potentially increasing the survival rate of critically ill COVID-19 patients.
Humans ; COVID-19 ; Medicine, Chinese Traditional ; SARS-CoV-2 ; Critical Illness ; Treatment Outcome

【Objective】 To analyze the expression of lncRNA SNHG25 in prostate cancer and its significance, so as to explore the biomarkers and potential therapeutic targets for the diagnosis and prognosis of this disease. 【Methods】 Based on the TCGA database, differential, survival, and clinical correlation analyses of SNHG25 were performed.SNHG25 expression in prostate cancer was analyzed in the UALCAN database to determine its relationship with the clinical and pathological characteristics.The lncRNA-miRNA-mRNA correlation analysis was performed.The relevant ceRNA regulatory network was constructed.Prostate cancer samples were divided into high and low SNHG25 expression groups, and differential SNHG25 related genes were filtered and then enriched. 【Results】 SNHG25 expression was significantly upregulated in prostate cancer specimens compared to normal prostate specimens (P<0.001), and the progression-free survival of the low SNHG25 expression group was significantly longer than that of the high SNHG25 expression group (P<0.001).There were no significant differences in age, T-stage and N-stage between the two groups, and there was no significant correlation between the expression of SNHG25 and Gleason score (P>0.05).Regulatory networks of SNHG25/miR-330-3p/DLX1 and RPL22L1 were constructed. 【Conclusion】 SNHG25 is highly expressed in prostate cancer tissues and correlated with poor prognosis.SNHG25 expression does not significantly correlate with age, T-stage, N-stage, and Gleason score.SNHG25/miR-330-3p/DLX1 and RPL22L1 regulatory networks may play an important role in the development of prostate cancer.SNHG25 may become a biomarker and potential therapeutic target for prostate cancer.

Objective:To compare the clinical effects of ultrasound-guided intra-articular and coracohumeral ligament glucocorticoid injections versus ultrasound-guided intra-articular glucocorticoid injections alone on frozen shoulder in the elderly.Methods:A total of 44 patients with frozen shoulder admitted to the rehabilitation department of the Affiliated Hospital of Sichuan Nursing Vocational College from September 2019 to June 2020 were enrolled.They were randomly divided into the experimental group and the control group, with 22 patients in each group.The experimental group received two consecutive ultrasound-guided intra-articular injections and two coracohumeral ligament injections, while the control group received two consecutive ultrasound-guided intra-articular injections.The shoulder's passive range-of-motion(PROM), the 11-point numeric rating scale(NRS)as well as the Shoulder Pain and Disability Index(SPADI)were conducted before treatment, 1 week after the first treatment(1 week), 1 week after the second treatment(2 weeks)and 10 weeks after the second treatment(12 weeks).Results:There was no significant difference in baseline characteristics between the two groups(all P>0.05). Flexion, abduction, extension and external rotation increased whereas NRS and SPADI decreased after treatment, compared with pre-treatment in the experimental group( F=11.341, 20.965, 20.403, 32.470, 82.970 and 102.154, all P<0.05)and in the control group( F=7.012, 8.937, 23.265, 31.966, 52.500 and 41.356, all P<0.05). Compared with the control group, extension( t=0.365, 0.143 and 0.236, all P<0.05)and external rotation( t=0.205, 0.620 and 2.751, all P<0.05)increased at 1, 2 and 12 weeks after treatment.SPADI scores were lower in the experimental group than in the control group at 12 weeks after treatment( t=2.063, P=0.045). There was no significant difference in NRS, flexion or abduction between the two groups at any time point after treatment(all P>0.05). No serious adverse reactions occurred during treatment in either group. Conclusions:Both ultrasound-guided intra-articular injections plus coracohumeral ligament injections and ultrasound-guided intra-articular injections can effectively alleviate pain and improve function in elderly patients with frozen shoulder, but the former has better effects on extension.For patients with clear restricted extension and external rotation, ultrasound-guided intra-articular injections combined with coracohumeral ligament injections may achieve better clinical effects.

Perception ; Pupil ; Social Interaction

Diabetes diet management plays an important role in the treatment of diabetes. "Controlling diet" is the most basic and important part of diabetes treatment. Patients with mild diabetes can control blood glucose through diet therapy. Effective diet management assessment can quickly discover the deficiencies of diet self-management in diabetic patients. Artificial intelligence is widely used in the medical field. This article will briefly introduce the role and application progress of artificial intelligence technology in diabetes diet management, including diet recommendation and automatic monitoring.

Objective To investigate the protective effect of brain-derived neurotrophic factor (BDNF) on neuronal injury induced by ropivacaine (Rop) and its mechanism.Methods (1) Experiment one:0,1,2,3,4 and 5 mmol/L Rop was used to stimulate SH-SY5Y cells for 48 h to induce neuronal injury;the morphological changes of the cells were observed under microscope;MTT assay was used to detect the cell activity;flow cytometry was used to detect the cell apoptosis,and immunohistochemistry was used to detect the expressions of protein kinase B (Akt) and proliferating cell nuclear antigen (PCNA).(2) Experiment two:SH-SY5Y cells were treated with 0,1,3,5,7 mmol/L Rop,respectively;the cell activity was measured 48 h after Rop treatment;the semi inhibitory concentration (IC50) of Rop was calculated by MTT assay;the SH-SY5Y cells were divided into control group (PBS for 48 h),Rop group (Rop at IC50 for 48 h),BDNF+Rop group (20 μg/L BDNF for 2 h,and Rop at IC50 for 48 h),Akt pathway activator SC79+Rop group (5 mg/L SC79 for 2 h,and Rop at IC50 for 48 h),and BDNF+Akt pathway inhibitor API-2+Rop group (20 μg/L BDNF+10 μmol/L API-2 for 2 h,Rop at IC50 for 48 h);the morphological changes of the cells were observed under microscope;MTT assay was used to detect the cell activity;flow cytometry was used to detect the cell apoptosis,and immunohistochemistry was used to detect the expressions of Akt and PCNA;the expressions of B lymphoma-2 (Bcl-2),Bcl-2-associated X (Bax) and cysteine protease-3 (Caspase-3) were detected by reverse transcription (RT)-PCR and Western blotting.Western blotting was used to detect the expressions of Akt and phosphatidylinositol 3-kinase (PI3K).Results (1) As compared with the 0 mmol/L Rop group,the 1,2,3,4,and 5 mmol/L Rop group had significantly decreased cell activity,significantly increased apoptosis rate,and statistically smaller number of Akt and PCNA positive cells (P＜0.05).(2) As compared with the control group,the Rop group had significantly decreased cell activity,statistically increased apoptosis rate,significantly smaller number of Akt and PCNA positive cells,significantly decreased Bcl-2 mRNA and protein expressions,significantly increased Bax and caspase-3 mRNA and protein expressions,and significantly decreased phosphorylated-(p-) Akt and p-PI3K protein expressions;as compared with the Rop group,the BDNF+Rop group and SC79+Rop group had significantly higher cell activity,significantly decreased apoptosis rate,significantly larger number of Akt and PCNA positive cells,significantly increased Bcl-2 mRNA and protein expressions,statistically decreased mRNA and protein expressions of Bax and Caspase-3,and significantly increased p-Akt and p-PI3K protein expressions (P＜0.05);as compared with the BDNF+Rop group and SC79+Rop group,the BDNF+API-2+Rop group had significantly lower cell activity,significantly increased apoptosis rate,significantly smaller number of Akt and PCNA positive ceils,significantly decreased Bcl-2 mRNA and protein expressions,statistically increased mRNA and protein expressions of Bax and Caspase-3,and significantly decreased p-Akt and p-PI3K protein expressions (P＜0.05).Conclusion BDNF can alleviate ropivacaine-induced neuronal injury by activating Akt signaling pathway,consequently modulating the proliferation and apoptosis of neurons.

Objective: To investigate the current status of the ten-year implementation of the World Health Organization (WHO) surgical safety checklist (SSC) in China. Methods: A questionnaire was designed based on the three phases described by the checklist — the period before induction of anaesthesia, the period before skin incision, and the period before patient leaves operating room, taking into account some hotspots and disputes.The questionnaire was sent to the members of the Chinese-based online New Youth Anesthesia Forum through the WeChat platform.Answers were completed by mobile phones or desktop computers.Each WeChat ID number allowed only one answer for each individual participant. Results: A total of 3 943 members red the questionnaire invitation, of which 2 121 members completed the questionnaire with an overall completion rate of 53.79%.For checks completed before induction of anesthesia, the percentage of members who routinely practiced checks before induction of anesthesia was 93.35%, the percentage of members who completed each and every element of the checklist was 60.16%, and the percentage of members who selected the element of the checklist the surgeon was not involved in the check was 14.05%.For checks practiced before skin incision, the percentage of members who routinely completed checks before skin incision was 78.22%, the percentage of members who completed each and every element of the checklist was 51.91%, and the percentage of members who selected the element of the checklist surgeons and anesthesiologists routinely stated their own professional key information was 18.24% and 18.81%, respectively.For checks practiced before the patient leaved the operating room, the percentage of members who routinely completed checks before removing the patient from the operating room was 64.26%, and the percentage of members who completed each and every element of the checklist was 44.18%.The percentage of members who was really serious about practicing the checklist was 56.20%.The percentage of members who believed that surgeons should participated in checks practiced before induction of anesthesia was 81.47%.If the member himself or a member of his family needed a surgery, the percentage of members who hoped to implement the checklist was 98.35%.The percentage of members who believed that practicing WHO SSC could reduce the complications of surgery and improve the anesthetic safety of patients was 94.34%. Conclusion The implementing rate of checks practiced before induction of anesthesia is high, while the implementing rates of checks completed before skin incision and before patient leaves operating room are sequentially reduced in China.Although there are some problems with the implementation of WHO SSC, most respondents believe that implementing SSC can improve the anesthetic safety of patients undergoing surgery.

Objective: To investigate the effect of hypertensive disorder complicating pregnancy (HDCP) on the mortality and early complications of premature infants. Methods: The general clinical data of preterm infants with gestational age 24-36^{+ 6} weeks were collected from the cooperative units in the task group from January 1, 2013 to December 31, 2014.According to the severity of HDCP, the infants were divided into 4 groups: HDCP group, preeclampsia group, eclampsia group and non HDCP group, the mortality and major complications of preterm infants were compared, and the influencing factors were analyzed. Results: The mortality rate of preterm in the HDCP group was significantly higher than that of non HDCP group, and there was statistical significance (χ²=9.970, P=0.019). Eclampsia had a highest fatality rate (4.8%) in the early stage, compared with non HDCP group (2.2%), and the difference was statistically significant.Comparison of HDCP group (1.8%) and eclampsia group (3.2%) suggested that there was no statistically significant difference.The incidence of respiratory distress syndrome (RDS) in preterm in HDCP group was significantly higher than that of non HDCP group, and there was statistical significance (χ²=13.241, P=0.004). Eclampsia group showed the highest incidence (35.4%), compared with non HDCP group (16.2%), the difference was statistically significant, but compared with HDCP group (19.9%), preeclampsia group (17.1%), there was no significant diffe-rence.The incidence of bronchopulmonary dysplasia (BPD) in preterm in HDCP group was significantly higher than that of non HDCP group (χ²=9.592, P=0.022), the highest incidence showed up in eclampsia group (9.7%), compared with non HDCP group (2.0%) and HDCP group (1.7%), the difference was statistically significant.But there was no statistically significant difference, compared with preeclampsia group.As the degree of HDCP aggravated, the incidence of BPD gradually rose.There was no significant impact on necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), intraventricular hemorrhage (IVH) and sepsis of HDCP (χ²=7.054, 7.214, 0.358, 3.852; P=0.070, 0.065, 0.949, 0.278). Considering the overall outcome of the child, that was, whether the child died or survived, he had at least one complication, and HDCP had an effect on it (χ²=15.697, P=0.001), so the incidence increased while the degree of HDCP rose gradually.After adjusting gestational age, birth weight, sex, way of delivery, placental abruption and front placenta, prenatal hormonal, gestational diabetes, neonatal asphyxia and other factors, the results displayed that HDCP was the factor leading to the death of premature baby (OR=2.159, 95%CI: 1.093-4.266), and comparison between preeclampsia and eclampsia showed no statistical difference (P=0.714, 0.389); HDCP had no significant influence on RDS, BDP, ICH, NEC, ROP and sepsis. Conclusions HDCP leads to increased risk of premature death, but also leads to the increased incidence of RDS and BPD, but it had no obvious effect on NEC, ROP, IVH, sepsis and other complications.

Objective To summary the electroencephalography characteristics of temporal lobe ganglion glioma (GG),and explore the role of electroencephalogram in diagnosis and treatment of temporal lobe GG.Methods Retrospective analysis of clinical features,diagnosis and treatment of 24 patients with temporal lobe GG,admitted to our hospital from September 2008 to September 2015,was performed.The temporal lobe GG electroencephalography features were accepted focused research.Results Break electroencephalography showed that:abnormal discharge of lesions in store area and contralateral brain regions was noted in 17 patients (70.8％).Episodes electroencephalography showed that:10 patients (41.6％) could be conformed that discharge was originated from the side of temporal sphenoid.Intra-operative electroencephalography showed that the medial temporal lobe in 22 patients (91.7％) had low amplitude fast wave with high reflection of sharp wave or spike wave;the temporal lobe cortex in 23 patients (95.8％) had high reflection of sharp wave or spike wave.The patients were followed up for one to 8 years.Engel's grading I was noted in 19 patients (79％),including 11 gradually stopped taking antiepileptic drugs after three years of free seizure;Engel's grading Ⅱ was noted in 5 patie nts (79％),and antiepileptic drugs were taken.Conclusions The temporal lobe GG electroencephalography shows that abnormal discharge is sharp and slow waves are noted,which are easy to generalize to other brain regions and the contralateral side.Monitoring of electroencephalography during operation can record the abnormal discharge around and in the center of GG with spike wave rhythms.Cortical electroencephalogram and deep electrode monitoring can help to determine the lesion and the around range of epilepsy,which can guide the operation and improve the control of seizures.