Objective To explore correlation between cerebral microbleeds(CMBs)and cognitive dysfunction in patients with cerebral small vessel disease.Methods A total of 80 patients with cerebral small vessel disease admitted to Department of Encephalopathy in Nanjing University of Chinese Medicine Affiliated Lianyungang Hospital from January 2020 to December 2022 were selected as research objects.They were divided into CMBs positive group(50 cases)and CMBs negative group(30 cases)based on the presence or absence of CMBs in the cerebral hemisphere.General clinical data of two groups were compared.Cognitive function was assessed by using Montreal cognitive assessment scale(MoCA).Results Age and incidence rate of hypertension in CMBs positive group were significantly higher than those in CMBs negative group(P<0.05).Total score of MoCA,scores of visuospatial and executive function,abstract thinking and delayed recall in CMBs positive group were significantly lower than those in CMBs negative group(P<0.05).Conclusion CMBs are closely related to the potential mechanism,clinical diagnosis and degree assessment of cognitive dysfunction in patients with cerebral small vessel disease.

Objective:To investigate the clinical effect of digital technology in the treatment of secondary deformity of orbitozygomatic fracture.Methods:The clinical data of 20 patients with secondary deformity of orbitozygomatic fracture treated in the Department of Plastic Surgery, the First Affiliated Hospital of Air Force Medical University from October 2015 to May 2019 were retrospectively analyzed, including 14 males and 6 females, aged 18-56 years. A computed tomography scan of the skull was performed before the operation. The data was three-dimensional(3D) reconstructed by Mimics software. The digital model was used to determine the surgical plan. Then the 3D head model was printed, osteotomy guide plate and reduction guide plate were used to guide osteotomy and reduction during surgery. Using Mimics software, the angle between orbital horizontal level and bilateral tragus linkage(A-OT value), the absolute value of the distance difference between bilateral zygomatic process point and facial midline (face width difference), and the absolute value of the distance difference between bilateral zygomatic process points and the vertical line passing through the central point of bony external auditory canal(facial process difference) were measured before and 3 days after operation. The exophthalmos of the affected side was measured by Hertel exophthalmos meter before and 6 months after operation. The paired t-test was used for comparison before and after operation. P<0.05 was statistically significant. Results:All the wounds healed well and the 20 patients were followed up for 6 months to 3 years. Before and after surgery, the A-OT values were (8.41 ± 2.46)° and (2.67 ± 0.55)°, with statistically significant difference ( t=11.242, P<0.001). Face width differences were (9.12 ± 1.02) mm and (1.51 ± 0.40) mm, with statistically significant difference( t=33.946, P<0.001). Facial process differences were (9.22 ± 0.95) mm and (1.53 ± 0.61) mm, with statistically significant difference ( t=33.484, P<0.001). Except for 4 patients with enucleation, the exophthalmos of the other patients was (7.81 ± 1.25) mm before operation and (12.78 ± 0.65) mm 6 months after operation. The difference was statistically significant ( t=-13.183, P<0.001). There was no diplopia and abnormal eye movement after operation. Conclusions:The application of digital technology in the treatment of secondary deformity of orbitozygomatic fracture is helpful to accurately diagnosis and reduction, and to improve the surgical effect.

Objective:To investigate the clinical effect of digital technology in the treatment of secondary deformity of orbitozygomatic fracture.Methods:The clinical data of 20 patients with secondary deformity of orbitozygomatic fracture treated in the Department of Plastic Surgery, the First Affiliated Hospital of Air Force Medical University from October 2015 to May 2019 were retrospectively analyzed, including 14 males and 6 females, aged 18-56 years. A computed tomography scan of the skull was performed before the operation. The data was three-dimensional(3D) reconstructed by Mimics software. The digital model was used to determine the surgical plan. Then the 3D head model was printed, osteotomy guide plate and reduction guide plate were used to guide osteotomy and reduction during surgery. Using Mimics software, the angle between orbital horizontal level and bilateral tragus linkage(A-OT value), the absolute value of the distance difference between bilateral zygomatic process point and facial midline (face width difference), and the absolute value of the distance difference between bilateral zygomatic process points and the vertical line passing through the central point of bony external auditory canal(facial process difference) were measured before and 3 days after operation. The exophthalmos of the affected side was measured by Hertel exophthalmos meter before and 6 months after operation. The paired t-test was used for comparison before and after operation. P<0.05 was statistically significant. Results:All the wounds healed well and the 20 patients were followed up for 6 months to 3 years. Before and after surgery, the A-OT values were (8.41 ± 2.46)° and (2.67 ± 0.55)°, with statistically significant difference ( t=11.242, P<0.001). Face width differences were (9.12 ± 1.02) mm and (1.51 ± 0.40) mm, with statistically significant difference( t=33.946, P<0.001). Facial process differences were (9.22 ± 0.95) mm and (1.53 ± 0.61) mm, with statistically significant difference ( t=33.484, P<0.001). Except for 4 patients with enucleation, the exophthalmos of the other patients was (7.81 ± 1.25) mm before operation and (12.78 ± 0.65) mm 6 months after operation. The difference was statistically significant ( t=-13.183, P<0.001). There was no diplopia and abnormal eye movement after operation. Conclusions:The application of digital technology in the treatment of secondary deformity of orbitozygomatic fracture is helpful to accurately diagnosis and reduction, and to improve the surgical effect.

Objective:To discuss the feasibility of offering specialized courses of critical care medicine in undergraduate clinical medicine education, so as to alleviate the shortage of critical care medicine staffs and lay a foundation for improving the success rate for the treatment of critical cases.Methods:The undergraduates majoring in clinical medicine from 2008 to 2011 in Guizhou Medical University (the former Guiyang Medical College) were enrolled. After they had been enrolled in the undergraduate education for 3 years and were ready for Grade four, which meant basic medicine teaching had been completed and clinical medicine teaching was about to start, they were introduced and preached to each discipline, including critical care medicine. The undergraduates were free to choose professional direction of clinical training in Grade four. Students majoring in clinical medicine from 2012 to 2014 were free to choose their major direction when they entered the school.Results:From September 2011 to July 2019, the university had cultivated 246 undergraduates majoring in clinical critical care medicine from 2008 to 2014, and the critical care medicine professional team of affiliated hospital had undertaken 540 teaching hours. By July 2019, all students had graduated on time, with an employment rate of 100%. Forty students took postgraduate programs in our school and other schools, accounting for 16.3%.Conclusions:Professional education of critical care medicine in the undergraduate course of clinical medicine can mobilize students' interest in learning and subjective initiative, which is conducive to career selection. During the clinical training, the students can identify and timely cure critical care cases in the early stage, and partly alleviate the current shortage of critical care medical staffs.

Vascular calcification is often observed in the angiographic examination of patients with cardiovascular and cerebrovascular diseases, especially in the elderly. There are many researches on the relation between intracranial artery calcification (ICA) and ischemic stroke (IS) in clinic, but the conclusions of these researches have not been unified yet. In this article, the researches on progression of relation between ICA and IS are used as a clue to review, and try to clarify the correlation between ICA and IS in the current researches, so as to provide a new strategy for the treatment of IS in clinic.

Objective To understand the characteristics and relation of clinical stage and outcome of severe cases on hand,foot and mouth disease (HFMD) and to establish the evaluation method for understanding severity of this disease.Methods According to factors as geographical location,economic and epidemic levels,five provinces (Henan,Shandong,Yunnan,Zhejiang and Sichuan provinces) were selected.Reported severe cases of HFMD from the National Notifiable Diseases Reporting System were selected randomly in the five provinces.Basic epidemiological information,clinical data,and pathogen testing results in the involved hospitals were collected.Clinical stages on all the patients were decided in accordance with "the clinical expert consensus on diagnosis and treatment for severe case of enterovirus type 71 (EV71) infections (2011 edition)".Data were analyzed using SPSS software 18.0 and other epidemiological methods.Results A total of 657 severe HFMD cases were investigated,with 326 cases positive of EV71,accounting for 91.3％ (326/357) among all the laboratory-confirmed cases.Of the 657 cases,542 cases (82.5％,95％CI:79.4％-85.3％) were diagnosed as in stage 2 (with nervous system involvement),99 cases (15.1％,95％CI:12.4％-18.0％) in stage 3 (early phase of function failure on heart and lung),and 16 cases (2.4％,95％CI:1.4％-3.9％) were in stage 4 (function failure of heart and lung).11 cases (1.7％,95％CI:0.9％-3.0％) were with squeal when discharged from hospital with 8 cases (1.2％,95％CI:0.6％-2.3％) died.When comparing the proportions among stage 2,stage 3 and stage 4,significant differences were found between age groups (x2=22.632,P=0.012).The younger the patient was the lower the proportions of stage 2 and the more proportion of stage 3 appeared.When comparing the proportions of clinical stages among the five provinces,significant differences (x2=41.481,P =0.000) were noticed.Proportions of different clinical stages in gender,ethnicity,occupation,place of residence types and the type of pathogen appeared no significant differences,respectively.However,the proportions of squeal and death in stage 2,stage 3 and stage 4 showed significant differences (sequela:x2=12.960,P=0.001;Death:x 2=16.850,P=0.001),respectively.Conclusions The pcrccntage of clinical stages of severe HFMD patients related to the rate of squeal and death.Clinical staging can be used for assessing the clinical severity of complications and the effectiveness of treatment,of HFMD.

Objective To study the correlation among property, efficacy and target of herbal Chinese materia medica; To analyze the molecular mechanism of cold and heat property of Chinese materia medica; To provide references for explaination of microcosmic mechanism and scientific connotation of property of Chinese materia medica. Methods Recordings about property and efficacy of single medicine in 2015 edition of Pharmacopoeia of the People's Republic of China were sorted out. According to Pharmacological Research of New Ideas and New Targets and Pharmacology, 509 kinds of herbal Chinese materia medica were selected. Relevant articles about property, efficacy, pharmacologic action, and target in CNKI and Chinese Academic Journal Database (Wanfang Data) were searched by computers. The target information was screened and standardized, and the database was constructed by using MySQL5.7.13. The correlation between the property, efficacy and the target of the herbal Chinese materia medica was studied by using the frequency analysis and correlation rule algorithm of R software platform 3.3.1. Results 509 kinds of herbal Chinese materia medica were selected, including 227 kinds of cold-property medicine, 106 kinds of neutural-property medicine and 176 kinds of hot-property medicine. According to the result of data mining, efficacy of cold-roperty medicine was quenching thirst, clearing liver and treating stranguriaetc. The target was transforming growth factor β2 and liver microsome, etc. The efficacy of hot-property medicine was warming the middle, releasing cold and dissolving lumps. The target was bone morphology protein 2, rheumatoid factor, etc. The efficacy of neutural-property medicine was clearing lungs, diminishing distension and increasing energy. The target was β-amyloid and prostaglandin E2 receptors. Conclusion There is certain correlation in property, efficacy and target in Chinese materia medica.

Through the literature collection on Chinese marine materia medica,this study analyzed medication rules of Chinese marine materia medica prescription,understood general conditions of Chinese marine materia medica prescription,in order to conduct data mining on medication rules of Chinese marine materia medica prescription.The name of Chinese marine materia medica was used as the search term.Chinese marine materia medica prescriptions were searched in related literatures of Chinese Medicine Code,Chinese Marine Materia Medica,Chinese Materia Medica,Chinese Pharmacopoeia and Great Dictionary of Chinese Medicine.The information was extracted and standardized to construct database for the initial data mining of related information and medication rules of Chinese marine materia medica prescriptions.The results showed that 16715 Chinese marine materia medica prescriptions were screened,which contained 144014 items of data,involving 218 kinds of Chinese marine materia medica.Decoction was the most common dosage form.The amount of Chinese marine materia medica prescription in the Ming and Qing dynasties was the largest.The highest frequency of Chinese marine materia medica in one prescription was 1 to 3 types.The prescription composed all by Chinese marine materia medica occupied 8.065％.Other prescriptions contained the compatibility of Chinese terrestrial materia medica.The prescription containing materia medica half from the sea and half from the land,occupied 7.754％.The Chinese marine materia medica used with the highest frequency in all prescriptions was oyster.The frequently used Chinese terrestrial materia medica was licorice and angelica in Chinese marine materia medica prescriptions.It was concluded that the number of Chinese marine materia medica prescription was large.Its compatibility and clinical application had a certain characteristic,which provided data foundation for the further research and development of Chinese marine materia medica.

This study was aimed to analyze the cold and heat nature of Chinese herbal medicine as well as its relation with the major constituent part in order to illustrate the scientific connotation of the cold and heat nature of Chinese herbal medicine from the level of material basis.There were a total of 334 kinds of Chinese herbal medicine with 280 effective ingredients recorded in the first volume of the Chinese Pharmacopoeia.The molecular descriptors of each ingredient (including one-dimensional,two-dimensional,three-dimensional,and semi-empirical calculated molecular descriptors) were calculated.The generalized rule induction (GRI) algorithm was used to mine molecular descriptors with strong correlation to the cold or heat nature of the screened Chinese herbal medicine.The results showed that molecular descriptors of molecular energy state of main components had close relationship with the nature properties of herbs.Compounds with high-energy condition were most from herbs with heat nature;while compounds with low-energy condition were most from herbs with cold nature.In addition to the energy condition of the molecule,topological molecular water partition coefficient,lipid drug property but also the main component of the polar surface area,carbon,hydrogen,oxygen atoms,the number of hydrogen bond donors and other molecular structure descriptors had certain association relationships.It was concluded that the nature of Chinese herbal medicine had certain association relationships with its main ingredients.Among them,the most important molecular descriptors of molecular energy are three-dimensional molecular descriptors.It suggested that the comprehensive effect of Chinese herbal medicine may be relevant to the energy condition of the molecule in main active components of Chinese herbal medicine and the effect on the energy metabolism of the body.

Objective To investigate the diagnostic value of 18F-FDG PET/CT features of spinal tuberculosis.Methods 18 F-FDG PET/CT imaging manifestation of 125 cases (70 males,55 females,average age 44.3 years) with osseous or mixed vertebra bone destruction from January 2006 to June 2014 were analyzed retrospectively.The patients included 32 cases with spinal tuberculosis (50 lesions,study group) and 93 cases with other diseases (150 lesions,control group).The corresponding FDG PET/CT features were analyzed by two classification logistic regression (Forward:LR),then FDG PET/CT features with statistical significance in diagnosis of spinal tuberculosis were obtained.The sensitivity and specificity of those FDG PET/CT features were calculated.Results Odds ratio (OR) of FDG PET/CT features with statistical significance in diagnosis of spinal tuberculosis from high to low were paraspinal cold abscess (20.790),cold zone(10.528),intervertebral disc involvement(5.394),continuous vertebral involvement(3.493).The diagnostic sensitivity and specificity were 22.0％ (11/50),99.3％ (149/150) forcold abscess,70.0％ (35/50),90.0％ (135/150) for cold zone,82.0％ (41/50),83.0％ (125/150) for intervertebral disc involvement,82.0％ (41/50),78.0％ (117/150) for continuous vertebral involvement,respectively.Spinal tuberculosis often had two or more signs.The continuous vertebral involvement + intervertebral disc involvement was most common,with the diagnostic sensitivity and specificity of 78.0％ (39/50) and 88.7％ (133/150).The diagnostic sensitivity and specificity of continuous vertebral involvement+intervertebral disc involvement+cold zone were 58.0％ (29/50),96.0％ (144/150),and those of four features conourrence were 14.0％ (7/50),100％ (150/150),respectively.Conclusion Regression analysis shows that FDG PET/CT features with statistical significance in diagnosis of spinal tuberculosis are paraspinal cold abscess,cold zone,intervertebral disc involvement,continuous vertebral involvement,which have high diagnostic sensitivity and specificity.