Objective To explore the relationship between blood pressure at baseline and significant decline in cognitive function after 4 years in middle-aged and elderly people in rural Xi'an,and the potential effect of age on the relationship.Methods Data were collected from a cohort of middle-aged and elderly people with cognitive impairment in rural Xi'an,Shaanxi Province.The cohort consisted of people aged≥40 years from a village in Huyi District,Xi'an.The baseline survey was completed between October 2014 and March 2015,and two follow-up visits were conducted in 2016 and 2018.Blood pressure parameters studied included hypertension and high systolic blood pressure(≥140 mmHg vs.＜140 mmHg),and high diastolic blood pressure(≥90 mmHg vs.＜90 mmHg).The Mini-Mental State Examination(MMSE)was used to assess the whole cognitive function,and the decline of MMSE score ≥4 points in 4 years was defined as significant decline of cognitive function.Multivariate Logistic regression was used to analyze the relationship between blood pressure and cognitive function at baseline.Subgroup analysis was used to study the effect of age(＜65 vs.≥65 years)on the relationship.Results We recruited a total of 1 350 subjects in the analysis,including 235 subjects(17.4％)with baseline age ≥65 years and 533 male subjects(39.5％);671 subjects(49.7％)had hypertension,with systolic blood pressure of(131.71±17.79)mmHg;840 subjects(62.2％)had high systolic blood pressure,with diastolic blood pressure of(82.18±10.56)mmHg;395(29.3％)had high diastolic blood pressure.During the 4-year follow-up,56 cases(4.2％)met the criteria for significant decline of cognitive function.We did not find significant association of hypertension and high systolic blood pressure with cognitive decline in the general population,＜65-year-old subgroup,or ≥ 65-year-old subgroup.The incidence of significant cognitive decline was not statistically significant in the total population(3.6％vs.5.6％,P=0.092),the ≥65-year-old subgroup(7.5％vs.8.2％,P=0.855),the normal diastolic blood pressure group,or the high diastolic blood pressure group.However,in the subgroup＜65 years,the incidence of cognitive decline was higher in the high diastolic blood pressure group than in the normal diastolic blood pressure group(2.7％vs.5.1％,P=0.043).Multivariate analysis showed that high diastolic blood pressure was not found to be associated with significant cognitive decline in the total population(OR=1.744,95％CI:0.953-3.192,P=0.071),the subgroup of ≥65 years old(OR=0.858,95％CI:0.221-3.338,P=0.825),or the subgroup of ≥65 years old.In the＜65 age group,high diastolic blood pressure was significantly associated with cognitive decline(OR=2.051,95％CI:1.005-4.186,P=0.048).Conclusion High diastolic blood pressure is associated with 4-year cognitive decline in people aged 40-65 years,but not in those aged ≥65.No association is found between hypertension or high systolic blood pressure and significant cognitive decline.

Objective To explore the relationship between blood pressure at baseline and significant decline in cognitive function after 4 years in middle-aged and elderly people in rural Xi'an,and the potential effect of age on the relationship.Methods Data were collected from a cohort of middle-aged and elderly people with cognitive impairment in rural Xi'an,Shaanxi Province.The cohort consisted of people aged≥40 years from a village in Huyi District,Xi'an.The baseline survey was completed between October 2014 and March 2015,and two follow-up visits were conducted in 2016 and 2018.Blood pressure parameters studied included hypertension and high systolic blood pressure(≥140 mmHg vs.＜140 mmHg),and high diastolic blood pressure(≥90 mmHg vs.＜90 mmHg).The Mini-Mental State Examination(MMSE)was used to assess the whole cognitive function,and the decline of MMSE score ≥4 points in 4 years was defined as significant decline of cognitive function.Multivariate Logistic regression was used to analyze the relationship between blood pressure and cognitive function at baseline.Subgroup analysis was used to study the effect of age(＜65 vs.≥65 years)on the relationship.Results We recruited a total of 1 350 subjects in the analysis,including 235 subjects(17.4％)with baseline age ≥65 years and 533 male subjects(39.5％);671 subjects(49.7％)had hypertension,with systolic blood pressure of(131.71±17.79)mmHg;840 subjects(62.2％)had high systolic blood pressure,with diastolic blood pressure of(82.18±10.56)mmHg;395(29.3％)had high diastolic blood pressure.During the 4-year follow-up,56 cases(4.2％)met the criteria for significant decline of cognitive function.We did not find significant association of hypertension and high systolic blood pressure with cognitive decline in the general population,＜65-year-old subgroup,or ≥ 65-year-old subgroup.The incidence of significant cognitive decline was not statistically significant in the total population(3.6％vs.5.6％,P=0.092),the ≥65-year-old subgroup(7.5％vs.8.2％,P=0.855),the normal diastolic blood pressure group,or the high diastolic blood pressure group.However,in the subgroup＜65 years,the incidence of cognitive decline was higher in the high diastolic blood pressure group than in the normal diastolic blood pressure group(2.7％vs.5.1％,P=0.043).Multivariate analysis showed that high diastolic blood pressure was not found to be associated with significant cognitive decline in the total population(OR=1.744,95％CI:0.953-3.192,P=0.071),the subgroup of ≥65 years old(OR=0.858,95％CI:0.221-3.338,P=0.825),or the subgroup of ≥65 years old.In the＜65 age group,high diastolic blood pressure was significantly associated with cognitive decline(OR=2.051,95％CI:1.005-4.186,P=0.048).Conclusion High diastolic blood pressure is associated with 4-year cognitive decline in people aged 40-65 years,but not in those aged ≥65.No association is found between hypertension or high systolic blood pressure and significant cognitive decline.

Objective:To explore the clinical characteristics of adult mediastinal bronchial cysts complicated with aspergillus infection, aiming to improve clinicians′ understanding of this rare lesion.Methods:A case of adult mediastinal bronchial cyst with aspergillus infection admitted to the Foshan Second People′s Hospital in February 2024, mainly presenting with fever and chest pain, was reported. Chest CT showed a mediastinal mass, and postoperative pathology confirmed bronchial cyst with aspergillus infection. Combined with relevant literature review, the clinical features, diagnosis and treatment points of the disease were summarized.Results:The patient successfully underwent surgical resection of the lesion, and pathological examination confirmed the diagnosis of bronchial cyst complicated with aspergillus infection. Literature review indicated that mediastinal bronchial cysts are relatively rare in adults, and cases complicated with aspergillus infection are even rarer.Conclusions:Adult mediastinal bronchial cyst complicated with aspergillus infection is a rare lesion with non-specific clinical manifestations. Imaging examination is an important diagnostic method, and the final diagnosis depends on pathological examination. Enhancing clinicians′ awareness of this disease is helpful for timely and accurate diagnosis and reasonable treatment.

Objective:To explore the clinical characteristics of adult mediastinal bronchial cysts complicated with aspergillus infection, aiming to improve clinicians′ understanding of this rare lesion.Methods:A case of adult mediastinal bronchial cyst with aspergillus infection admitted to the Foshan Second People′s Hospital in February 2024, mainly presenting with fever and chest pain, was reported. Chest CT showed a mediastinal mass, and postoperative pathology confirmed bronchial cyst with aspergillus infection. Combined with relevant literature review, the clinical features, diagnosis and treatment points of the disease were summarized.Results:The patient successfully underwent surgical resection of the lesion, and pathological examination confirmed the diagnosis of bronchial cyst complicated with aspergillus infection. Literature review indicated that mediastinal bronchial cysts are relatively rare in adults, and cases complicated with aspergillus infection are even rarer.Conclusions:Adult mediastinal bronchial cyst complicated with aspergillus infection is a rare lesion with non-specific clinical manifestations. Imaging examination is an important diagnostic method, and the final diagnosis depends on pathological examination. Enhancing clinicians′ awareness of this disease is helpful for timely and accurate diagnosis and reasonable treatment.

Objective To investigate the risk factors of lymphedema in patients with breast cancer after operation.Methods From January 2012 to May 2016,the clinical data of 350 patients with breast cancer who underwent surgical treatment in First People's Hospital of Foshan were collected.According to the occurrence of postoperative lymphedema,the patients were divided into lymphedema group (87 cases) and non lymphedema group (263 cases).The possible risk factors were evaluated from general demographic indicators,pathological data of breast cancer,perioperative related data and preventive action implementation.Results General demographic data:there was no correlation between the incidence of lymphedema and age,preoperative body mass index (BMI),postoperative BMI,educational level,marital status,residence,family income,menopause,hypertension history (P ＞ 0.05).Pathological data of breast cancer:the occurrence of lymphedema was related with tumor quadrant (x2 =20.039,P ＜ 0.001) and axillary lymph node metastasis (Z =4.713,P ＜ 0.001),but not related with clinical stage and pathological type of tumor (both P≥0.05).Perioperative data:the occurrence of lymphedema was related with the type of incision (x2 =16.921,P ＜ 0.001),axillary lymph node dissection level (x2 =4.433,P ＜ 0.001),the number of axillary lymph node dissection (Z =3.620,P ＜0.001),radiotherapy (x2 =33.290,P ＜ 0.001),endocrine therapy (x2 =10.428,P =0.001),but not related with surgical methods,postoperative complications (subcutaneous fluid,upper limbedema,infection,serum swelling),chemotherapy and neoadjuvant chemotherapy (all P ＞0.05).Comparison of preventive behaviors:avoiding injuries such as cuts and bites (x2 =15.754,P ＜0.001),trimming nails (x2 =9.018,P =0.003),avoiding grasping heavy objects (x2 =11.828,P =0.001) were related with postoperative lymphedema,but other preventive behaviors did not show significant correlation (all P ＞ 0.05).Lymphedema as the dependent variable,multivariate logistic regression analysis results showed that tumor located in the upper outer quadrant (OR =3.943,P ＜ 0.001),surgical incision for longitudinal incision (OR =3.767,P ＜0.001) or oblique incision (OR =2.492,P ＜ 0.001),Ⅱ (OR =1.707,P =0.003) or Ⅲ (OR =4.211,P ＜ 0.001) axillary lymph node dissection,breast/chest wall radiotherapy (OR =2.869,P ＜0.001) or lymph node radiotherapy (OR =4.829,P ＜ 0.001),grabing heavy objects or not (OR =3.264,P ＜ 0.001),avoiding injuries such as cuts and bites (OR =2.602,P ＜ 0.001) were independent risk influence factors of postoperative lymphedema.Conclusion A variety of factors affect the occurrence of postoperative lymphedema in breast cancer patients.Tumors located in the upper outer quadrant,longitudinal or oblique incision,high level of axillary lymph node dissection,radiotherapy,having injuries such as cuts and bites,grabing heavy objects are independent risk influence factors of postoperative lymphedema in breast cancer patients.More attention should be paid to the high risk of lymphedema,and the preventive measures should be taken actively.

ObjectiveTo observe the prepulse inhibition(PPI) ot the startle reflex of pure cerebral concussion (PCC) suffered from one concussion and multiple cerebral concussion (MCC) suffered from three concussions in rats,and to explore accumulate effect upon cognitive dysfunction of MCC.MethodsA metallic pendulum striker device for closed head injury was employed to duplicate PCC and MCC models in Stragu-Dawley rats.The MCC rats were hit three times on rats'head and it is interval 24 hours for every hit.According to the criteria of cerebral concussion,the investigated animals were divided into PCC group and MCC group at freedom.One control group was used.Each group included 10 animals.Each experience mental animal was tested from 3 days pre-injury to 28 days post-concussion.Startle reflex amplitude (for P values),pre-stimulation induced reflex amplitude on three standard stimulations,that was,67dB,69dB and 73dB (for PP67,PP69 and PP73 values) and prepulse inhibition of the startle reflex (PPI) were collected.ResultsThe P values and three PP values in the first three days of pre-replication experiment,there was no statistical significance in each group.However the P values and PP67,PP69 and PP73 values declined until to the 16th day after injury (P＜0.05),then recovered in PCC group.The P value and PP67,PP69 and PP73 values changes of MCC group declined and not recovered until to test end (P＜0.05 ) and they were more lower than PCC.The three PPI values were a little bit increase in both groups,there were statistics significance at some test points (P＜0.05) compared with control.ConclusionThe startle reflex amplitude and pre-stimulation induced reflex amplitude weaken after cerebral concussion and there is damaging accumulate effect to injury times,the PPI is enlanced by cerebral concussion.

Objective To observe learning and memory behavior changes of one time cerebral concussion called pure cerebral concussion(PCC)and three times cerebral concussion called multiple cerebral concussion (MCC)after injured 24 days in rats.Methods A metallic pendulum striker device was deployed to duplicate PCC and MCC model in SD rata which were the complete closed head injury model.The animals were divided into PCC and MCC groups at random.One control group was used,each group has eight animals(n=8).One 8-arms radial maze was used to assessed each animal's capabilities,that is,spatial reference memory,working memory,spirited activity and take in food.Results Compared with control group,there were some significance(P＜0.05)in both experiment groups post injury,that was,(1)The food intake decreased,PCC group from the 1st to the 11th day(from 0.00±0.00 to 2.62±1.76)after injury,MCC group from the 1st day to the 24th day(from 0.00±0.00 to 0.75±1.48)after injury.(2)Spirited activity depressed,PCC group on the 1st to the 7th,13rd day(from 4.87±1.24 to 10.0±2.39)after injury,MCC group on the 1st to 8th,22nd day(from 4.25±5.03 to 9.37±4.20)after injury.(3)The spatial reference memory was lower in early then gradually increased,PCC group on the 1 st to 7th day(from 0.50±0.75 to 3.O0±1.06)after injury,MCC group from the 1st to 19th day(from 1.88±2.10 to 2.50±2.44)after injury.(4)The working memory was delaying damaged,PCC group from the 1st to the 6th day and the 10th to the 23rd day(from 0.00±0.00 to 4.25±3.05)after injury,MCC group on the 1～4th,6th,9～13th,15th,16th,19th～22nd day(from 0.25±0.46 to 3.12±2.87)after injury.Conclusion The injured rata'capability of spatial reference memory,working memory,spirited activity and food intake were obviously damaged after CC,and the MCC group's capability of spatial reference memory,spirited activity and food intake was worse than PCC group.

[Objective] To explore how to deal with the paternity test of complex adoption cases. [Method] Samples from 13 families, in which adoptive parents were suspected related to biological parents, were genotyped using "Identifder + Sinofder + Powerplex 16" combined system (D8S1179, D21S11, D7S820, CSFIPO, D3S1358, TH01, D13S317, D16S539, D2S1338, D19S433, VWA, TPOX, D18S51, D5S818, FGA, D6S1043, D12S391, PentaD, PentaE) followed by further statistical analysis. [Result] Among all 13 cases, 2 were completely accordance with the Mendel law, PI > 10 000. There found more than 3 inconsistent loci in 8 cases. And found 1～2 inconsistent loci in 3 cases, needed to test more STR loci until PI≥10 000. The half sibling index (HSI) was also calculated with ITO method. The adoptive parents of 2 cases were not excluded from a full sibling with biological parents. In addition, Y-STR loci were tested for 4 cases (father/son). Two adoptive fathers of them were not excluded from the paternal relationship with biological fathers. [Conclusion] The most (76.9%) of all (13) complex adoptive cases of paternity test could be drawn a definite conclusion with combined system of "Identifder + Sinefiler + Powerplexl6". Minority (23.1%) of them was not definite yet and needed testing more STIR loci. Meanwhile, we suggested adding Y-STR tests and providing HSI for reference.