Objective To analyze the magnetic resonance imaging (MRI) of the spinal cord and clinical characteristics in patients with autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy.Methods A total of 1 040 samples of cerebrospinal fluid (CSF) and sera collected in the Second Affiliated Hospital of Guangzhou Medical University from March 2013 to June 2018 were tested with tissue-and cell-based assays,and 42 patients were found positive for GFAP-IgG.The clinical data and MRI characteristics of the spinal cord of 19 patients who were positive for GFAP-IgG in CSF with autoimmune GFAP astrocytopathy and lesions in the spinal cord were retrospectively reviewed.Results There were 12 females and seven males among the 19 patients,with onset age of (44±17) years.The main manifestations of these patients included limb weakness (14/19),abnormal vision (5/19),headache (4/19),seizure (4/19),dementia (3/19),etc.On MRI of the spinal cord,five patients showed involvement in the cervical cord alone,eight showed involvement in the thoracic cord alone and six had both cervical and thoracic segment involvement.Fifteen patients had longitudinally extensive myelitic abnormalities (≥3 vertebral segments long).Seven enhancement patterns were encountered.Lesions were displayed in the spinal cord and brain in eight patients.Central gray matter involvement in the spinal cord was found in all the 19 patients.Conclusions Autoimmune GFAP astrocytopathy more frequently presents in females than in males.MRI of the spinal cord has complex presentations and longitudinally extensive myelitic abnormalities usually.Patients often show central gray matter involvement in the spinal cord.Myelitic abnormalities present more often in thoracic segment than in cervical segment.Abnormalities in lumbar segment are less encountered.

Brain-computer interface (BCI) provides a direct communicating and controlling approach between the brain and surrounding environment, which attracts a wide range of interest in the fields of brain science and artificial intelligence. It is a core to decode the electroencephalogram (EEG) feature in the BCI system. The decoding efficiency highly depends on the feature extraction and feature classification algorithms. In this paper, we first introduce the commonly-used EEG features in the BCI system. Then we introduce the basic classical algorithms and their advanced versions used in the BCI system. Finally, we present some new BCI algorithms proposed in recent years. We hope this paper can spark fresh thinking for the research and development of high-performance BCI system.
Algorithms ; Brain ; physiology ; Brain-Computer Interfaces ; Electroencephalography ; Humans ; Pattern Recognition, Automated

Objective: To examine the association of pre-pregnancy body mass and weight gain during pregnancy with macrosomia. Methods: From January 2015 to December 2015, a total of 20 477 pregnant women were recruited by probabilistic proportional scale sampling with simple randomization in Sichuan, Yunnan and Guizhou Provinces. Basic information of pregnant women, weight gain during pregnancy and weight of newborn were collected. A multiple logistic regression model was used to assess the association between the pre-pregnancy body mass and gestational weight gain indicators with macrosomia. Results: 20 321 mother-infant were included in the final analysis. 20 321 pregnant women were (30.09±4.10) years old and delivered at (39.20±1.29) weeks, among which 12 341 (60.73%) cases were cesarean delivery. The birth weight of 20 321 infants were (3 292.26±431.67) grams, and 970 (4.77%) were macrosomia. The multiple logistic regression model showed that after adjusting for the age of women, compared to the normal weight group in the pre-pregnancy, the overweight and obesity group elevated the risk of macrosomia, with OR (95%CI) about 1.99 (95%CI: 1.69−2.35) and 4.05 (95%CI: 3.05−5.39), respectively. After adjusting for the age, the pre-pregnancy BMI, delivery weeks, delivery mode and infant′s gender, compared to the weight-gain appropriate group, higher weight gain rate in the mid-pregnancy and excessive total gestational weight gain elevated the risk of macrosomia, with OR (95%CI) about 1.99 (95%CI: 1.66−2.39) and 1.80 (95%CI: 1.55−2.08), respectively. Conclusion The overweight before pregnancy, obesity before pregnancy, the rate of weight gain in the second trimester and the high total weight gain during pregnancy could increase the risk of macrosomia.

The standardization training of residents playsan important role in cultivating high and comprehensive quality of specialists.How to carry out the standardized training of thyroid specialist residency effectively and speed up the training of high-quality thyroid specialist are the key problems to be solved.Breast and Thyroid Diseases Center of Southwest Hospital integrated the concepts of evidence-based medicine into the training of thyroid specialist residencies,using the assessment,diagnosis,treatment and follow-up of thyroid nodules as example,and successfully establish the training system of thyroid specialist residency.

Objective To compare the effects of Acceptance Commitment Therapy(ACT) and Cognitive Behavior Therapy(CBT) on anxiety and depression in the elderly,and to explore the psychological mechanism of ACT to improve anxiety and depression.Methods A total of 25 elderly people were screened from four communities in Beijing.According to the place of residence,12 persons were enrolled in the ACT group and 13 persons were enrolled in the CBT group.The mindful attention awareness scale,geriatric anxiety inventory,geriatric depression scale,the acceptance and action questionnaire-Ⅱ and cognitive fusion questionnaire were evaluated before regrouping (T1),after six regiments (T2) and 5 weeks after the end of the intervention (T3).Results (1) On the level of mindfulness,the score of ACT group was higher than that in CBT group at T2(ACT:80.31 ±6.18,CBT:74.20±4.48,t=2.52,P＜0.05) and T3 (ACT:82.20±4.48,CBT:70.00± 12.23,t=4.56,P＜0.01).(2) On the level of anxiety there was significant difference between the two groups at T2(ACT:2.88±1.86,CBT:8.87±2.80,t=-8.15,P＜0.01) and T3(ACT:5.38±2.02,CBT:10.50±2.66,t=-6.93,P＜0.01),and ACT group was higher than the CBT group.(3)On the levels of depression there was significant difference between the two groups at T 1 (ACT:4.59 ± 3.97,CBT:7.89± 6.39,t =-2.25,P＜0.05),the ACT group was lower than the CBT group.The CBT group on the levels of depression there was a significant difference T1 and T2 (t=2.92,P＜0.05).(4) On the level of psychological flexibility,there was a significant difference between the two groups at T2 (ACT:41.38 ± 8.28,CBT:49.60± 3.52,t =-3.64,P＜0.01)and T3(ACT:40.80±7.66,CBT:52.47±6.23,t=-4.98,P＜0.01),and ACT group was lower than the CBT group.(5) Empirical avoidance only achieved a significant level of intermediate effects between ACT therapy and anxiety.In the ACT group,the median effect of empirical avoidance on anxiety was 11.40％.Conclusion The effect of CBT on depression is better than that of ACT,while the effect of ACT on the level of mindfulness,anxiety and mental flexibility is better than that of CBT.ACT with psychological flexibility as a psychological mechanism can improve the mental flexibility of the individual more than the CBT.

Objective To summarize the experience of patient positing,port placements setting and robot cart docking in pediatric robot-assisted laparoscopic upper urinary tract operations.Methods From March 2017 to December 2017,140 robot-assisted laparoscopic upper urinary tract procedures were performed in our institution,including 110 cases of pyeloplasty,15 upper pole heminephroureterectomy,12 simple nephrectomy and 3 adrenalectomy.There were 103 males and 37 females with a range age from 1 month to 18 years.The assistant surgeon was adjacent to the instrument nurse,and patients were placed in a supine position with 60°-80° inclination and keep the legs low to the body.Room setup and patient positioning were similar to the traditional laparoscopic surgery.Semi-hidden incision technique was used in 140 patients:the camera port was placed umbilicus,two additional arm ports (one 5 mm and one 8 mm) were placed under direct vision,the 8 mm arm port was placed on the line of a Pfannenstiel incision and the 5 mm arm port was placed below the Xiphoid along the midline.Finally,a 3 or 5 mm assistant port was placed approximately 3 cm lateral to the inferior arm port,the line of a Pfannenstiel incision.Results The average time was (11.5 ± 3.2) min (10.5-16.5 min) from skin incision to robot cart docking completed.All surgeries were successfully completed without open conversion.One patient required an additional assist port for severe adhesion after the previously open surgery,there was no injury to other viscera.Average operative time was (146.9 ± 48.7)min (78-259 min) and average post-operative hospitalization time was (5.7 ± 1.4) d(4-10 d),respectively.There was no visual scar on abdominal 6 weeks postoperatively,and all parents made comments about their satisfaction with the cosmetic appearance.All operations got complete success at a mean follow up of 6 (1-9) months.Conclusions A good room setup,patient positioning and the semi-hidden incision technique port placements are maintaining the safety of the patient,avoiding compression injuries,allowing maximum mobility of the robotic arms,and facilitating a smooth and efficient surgery,and improving post-operative recovery.

Objective·To investigate the clinicopathologic characteristics and prognosis of adult rhabdomyosarcoma (RMS).Methods·The clinical and pathological data,immunohistochemical test results of 9 RMS were analyzed retrospectively.Results·The information of 6 males and 3 females were collected in this research,whose average age was (46.89+20.09) years old.The tumors had a wide range distribution.The subtypes of histology included 6 cases of embryonal RMS,1 case of alveolar RMS,1 case of spindle cell RMS and 1 case of pleomorphic RMS.Immunohistochemically study showed that 6 cases were myogenin positive,4 cases were MyoDl positive and 8 cases were desmin positive.During the follow-up period of the 7 cases,only 2 patients survived free of tumors,2 patients presented with tumor recurrence and metastasis after the operations,and 3 patients died of tumor.Conclusion·In this study,embryonaI RMS is the most common type,and immunohistochemistry test is helpful to diagnosis of RMS.

Objective To analyze the characteristics of proximal deep vein thrombosis (DVT) after total joint arthroplasty.Methods 40 cases of proximal DVT were collected from May 2007 to October 2016 which were all diagnosed by lower limb venography or sonography.There were 9 males and 31 females aged from 38 to 86 years,average 67 years,and body mass index was from 16.94 to 31.25kg/m2,with an average of 24.3 kg/m2.29 cases of THA patients and 11 cases of TKA patients.The anatomical distribution,size,radiological performance,local physical findings were recorded and multivariable analysis was performed to evaluate the relationship between distribution of proximal DVT and related parameters including age,gender (male/female),side of leg(left/right),surgery type(knee and hip),preoperative diagnosis(femoral neck fracture/other disease),time of diagnosis with DVT (during hospitalization/after discharge).Results Among 40 proximal DVT cases,31 cases diagnosed by phlebography and 9 cases were diagnosed by ultrasound.2 cases were isolated proximal DVT while 38 cases connected with distal DVTs.9 cases of blood clots in the proximal and distal thrombosis connected discontinuously.There was no isolated proximal DVT in TKA group and 10 cases (90.9％) of blood clots in the proximal and distal thrombosis connected continuously while there were 2 cases (6.9％) isolated proximal DVTs in THA group and 21 (77.8％) of blood clots in the proximal and distal thrombosis connected discontinuously,and there was no statistic significant difference between the two groups.The average length of proximal was 8.85±9.3 1cm (range from 2-35cm) with 5.0±2.05 cm in TKA group and 10.31 ± 10.55 cmin THA group.A significant difference was found between the 2 groups (P=0.014).13 cases located in femoral veins and upper venous region which were all from THA group.There was a significant difference in the distribution between surgery type and preoperative diagnosis.However,there was no significant difference between other potential factors and distribution of proximal DVT.25 cases accepted the evaluation of symptom of DVT before scanning.However,no significant difference were found in edema,VAS score,Homans sign,Neuof sign between 9 TKA and 16 THA cases.Conclusion Proximal DVTs after knee and hip arthroplasty are more preferred to connect with distal DVT continuously.Surgery type and preoperative diagnosis have a significant effect on the distribution of proximal DVT.Proximal DVTs in THA and patients with preoperative femoral neck fracture could be more easily involving femoral veins and upper parts.

Glomerulonephritis, Membranoproliferative ; Humans ; Kidney Glomerulus ; pathology

Objective To detect the expression of Raf kinase inhibitor protein (RKIP) and NF-κB in renal tissue of diabetic kidney disease (DKD) rats model,and to investigate the effect of rituximab (RTX) on the expression of RKIP in the renal tissue of DKD rats. Methods SD rats were randomly divided into normal group (N),DKD model group (M) and RTX treatment group (D).Blood glucose and 24-hour urine protein of rats were determined in three groups.RKIP protein and NF-κB protein were determined by immunohistochemistry staining. RKIP protein expression was detected by Western blotting. Results Compared with N group,blood glucose,24-hour urine protein and NF-κB expression in M group increased significantly (all P＜ 0.01),the expression of RKIP in M group decreased significantly (P＜0.05).Compared with M group,the expression of RKIP increased significantly in D group (P＜0.05),and 24-hour urine protein and NF-κB expression decreased in D group (all P＜0.05).NF-κB protein expression was negatively correlated with RKIP expression in M group. Conclusions The NF-κB pathway regulated by RKIP plays an important role in the development and pathogenesis of diabetic nephropathy.Rituximab may have a role in treatment of DKD.