Objective:To observe the relationship between preoperative controlling nutritional status(CONUT)score and cognitive impairment,as well as short-term prognosis after intravenous thrombolysis(IVT)in patients with acute ischemic stroke(AIS).Methods:187 patients with AIS who were admitted to Shandong Provincial Third Hospital from January 2023 to May 2024 were selected,they were divided into non cognitive impairment group(n=106)and cognitive impairment group(n=81)based on whether cognitive impairment occurred,they were divided into poor prognosis group(n=58 cases)and good prognosis group(n=129 cases)according to the prognosis.Preoperative CONUT scores of patients with AIS for different cognitive impairments and prognoses were compared,correlation was analyzed by Spearman rank correlation,influencing factors were analyzed by multivariate logistic regression model.Results:Preoperative CONUT score in the cognitive impairment group was higher than that in the non cognitive impairment group(P＜0.05).Preoperative CONUT score in the poor prognosis group was higher than that in the good prognosis group(P＜0.05).Spearman rank correlation test results showed that,preoperative CONUT score was positively correlated with cognitive impairment and short-term prognosis after IVT(P＜0.05).Cognitive impairment were associated with age,concomitant hypertension,baseline national institutes of health stroke scale(NIHSS)score,and 25 hydroxyvitamin D3[25-(OH)2D3](P＜0.05).Age increase,concomitant hypertension,baseline NIHSS score increase,25-(OH)2D3 decrease,preoperative CONUT score increase were risk factors for cognitive impairment in patients with AIS(P＜0.05).Conclusion:Preoperative CONUT score increase is positively correlated with cognitive impairment and short-term prognosis after IVT.Meanwhile,age increase,concomitant hypertension,baseline NIHSS score increase,25-(OH)2D3 decrease,preoperative CONUT score increase are risk factors for cognitive impairment in patient with AIS.

Objective:To observe the relationship between the severity of acute pancreatitis(AP)and anxiety,quality of life and nutritional status.Methods:157 AP patients who were admitted to Shandong Provincial Third Hospital from January 2021 to May 2024 were included,they were divided into severe AP(SAP)group(n=68)and non-SAP(NSAP)group(n=89)according to the severity of the disease.The geriatric nutritional risk index(GNRI),self-rating anxiety scale(SAS)and short form-36 healthsurvey(SF-36)were compared between SAP group and NSAP group.Spearman was used to analyze the correlation between the severity of AP patients with anxiety,quality of life and nutritional status.General data of AP patients were collected,and the influencing factors of SAP occurrence were analyzed by univariate and multivariate logistic analysis.Results:SAS scores in SAP group was higher than that in NSAP group,and GNRI and SF-36 scores were lower than those in NSAP group(P＜0.05).The severity of AP patients was positively correlated with SAS scores,but negatively correlated with GNRI and SF-36 scores(P＜0.05).There were significant differences in age,length of stay,white blood cell count(WBC),blood amylase,serum albumin(HAS),lymphocyte count,blood calcium,urea nitrogen(BUN),D-dimer,fibrinogen,neutrophil count,alanine aminotransferase(ALT),aspartate transferase(AST),platelet count,procalcitonin(PCT),total bilirubin(DBIL),interleukin-6(IL-6),prothrombin time,and acute pancreatitis severity Bedside index(BISAP)scores in SAP group and NSAP group(P＜0.05).Multivariate logistic regression analysis showed that,high age,high PCT,high DBIL,high BISAP score,low GNRI,low SF-36 score and high SAS score were risk factors for AP patients of SAP occurrence,and high blood calcium was protective factor(P＜0.05).Conclusion:The severity of AP is associated with anxiety,malnutrition and low quality of life.High age,high PCT,high DBIL,high BISAP score,low GNRI,low SF-36 score and high SAS score are the risk factors for AP patients of SAP occurrence,and high blood calcium is the protective factor.

Aim To establish a simple and practical method for visualizing neurovascular coupling in the mouse barrel cortex in vivo.Methods Male C57BL/6J mice received stereotaxic in-jections of pAAV-hSyn-jGCaMP7s-WPRE into the barrel cortex to monitor neuronal activity.Three weeks post-injection,a crani-al window was implanted,and TRITC-Dextran 155 ku was ad-ministered intravenously to visualize the vasculature and blood flow dynamics.A custom-built whisker stimulator was used to e-voke controlled neuronal excitation.Two-photon microscopy was employed to monitor neuronal and vascular responses to whisker stimulation in real-time.Results Neuronal calcium signals and plasma signals were clearly observed using two-photon microsco-py.Whisker stimulation led to a significant increase in neuronal calcium signals in the barrel cortex,indicating effective neuronal activation.This neuronal excitation was accompanied by a syn-chronous increase in blood vessel diameter,blood flow velocity and overall blood flow.Conclusions This study successfully establishes a three-dimensional visualization framework(spatial,temporal,and functional)for in vivo visualization of neurovascu-lar coupling in the mouse barrel cortex,which provides a useful tool for investigating the pathophysiological mechanisms of neuro-vascular dysfunction and evaluating the efficacy of potential ther-apies.

Objective:To observe the relationship between the severity of acute pancreatitis(AP)and anxiety,quality of life and nutritional status.Methods:157 AP patients who were admitted to Shandong Provincial Third Hospital from January 2021 to May 2024 were included,they were divided into severe AP(SAP)group(n=68)and non-SAP(NSAP)group(n=89)according to the severity of the disease.The geriatric nutritional risk index(GNRI),self-rating anxiety scale(SAS)and short form-36 healthsurvey(SF-36)were compared between SAP group and NSAP group.Spearman was used to analyze the correlation between the severity of AP patients with anxiety,quality of life and nutritional status.General data of AP patients were collected,and the influencing factors of SAP occurrence were analyzed by univariate and multivariate logistic analysis.Results:SAS scores in SAP group was higher than that in NSAP group,and GNRI and SF-36 scores were lower than those in NSAP group(P＜0.05).The severity of AP patients was positively correlated with SAS scores,but negatively correlated with GNRI and SF-36 scores(P＜0.05).There were significant differences in age,length of stay,white blood cell count(WBC),blood amylase,serum albumin(HAS),lymphocyte count,blood calcium,urea nitrogen(BUN),D-dimer,fibrinogen,neutrophil count,alanine aminotransferase(ALT),aspartate transferase(AST),platelet count,procalcitonin(PCT),total bilirubin(DBIL),interleukin-6(IL-6),prothrombin time,and acute pancreatitis severity Bedside index(BISAP)scores in SAP group and NSAP group(P＜0.05).Multivariate logistic regression analysis showed that,high age,high PCT,high DBIL,high BISAP score,low GNRI,low SF-36 score and high SAS score were risk factors for AP patients of SAP occurrence,and high blood calcium was protective factor(P＜0.05).Conclusion:The severity of AP is associated with anxiety,malnutrition and low quality of life.High age,high PCT,high DBIL,high BISAP score,low GNRI,low SF-36 score and high SAS score are the risk factors for AP patients of SAP occurrence,and high blood calcium is the protective factor.

Objective:To observe the relationship between preoperative controlling nutritional status(CONUT)score and cognitive impairment,as well as short-term prognosis after intravenous thrombolysis(IVT)in patients with acute ischemic stroke(AIS).Methods:187 patients with AIS who were admitted to Shandong Provincial Third Hospital from January 2023 to May 2024 were selected,they were divided into non cognitive impairment group(n=106)and cognitive impairment group(n=81)based on whether cognitive impairment occurred,they were divided into poor prognosis group(n=58 cases)and good prognosis group(n=129 cases)according to the prognosis.Preoperative CONUT scores of patients with AIS for different cognitive impairments and prognoses were compared,correlation was analyzed by Spearman rank correlation,influencing factors were analyzed by multivariate logistic regression model.Results:Preoperative CONUT score in the cognitive impairment group was higher than that in the non cognitive impairment group(P＜0.05).Preoperative CONUT score in the poor prognosis group was higher than that in the good prognosis group(P＜0.05).Spearman rank correlation test results showed that,preoperative CONUT score was positively correlated with cognitive impairment and short-term prognosis after IVT(P＜0.05).Cognitive impairment were associated with age,concomitant hypertension,baseline national institutes of health stroke scale(NIHSS)score,and 25 hydroxyvitamin D3[25-(OH)2D3](P＜0.05).Age increase,concomitant hypertension,baseline NIHSS score increase,25-(OH)2D3 decrease,preoperative CONUT score increase were risk factors for cognitive impairment in patients with AIS(P＜0.05).Conclusion:Preoperative CONUT score increase is positively correlated with cognitive impairment and short-term prognosis after IVT.Meanwhile,age increase,concomitant hypertension,baseline NIHSS score increase,25-(OH)2D3 decrease,preoperative CONUT score increase are risk factors for cognitive impairment in patient with AIS.

Aim To establish a simple and practical method for visualizing neurovascular coupling in the mouse barrel cortex in vivo.Methods Male C57BL/6J mice received stereotaxic in-jections of pAAV-hSyn-jGCaMP7s-WPRE into the barrel cortex to monitor neuronal activity.Three weeks post-injection,a crani-al window was implanted,and TRITC-Dextran 155 ku was ad-ministered intravenously to visualize the vasculature and blood flow dynamics.A custom-built whisker stimulator was used to e-voke controlled neuronal excitation.Two-photon microscopy was employed to monitor neuronal and vascular responses to whisker stimulation in real-time.Results Neuronal calcium signals and plasma signals were clearly observed using two-photon microsco-py.Whisker stimulation led to a significant increase in neuronal calcium signals in the barrel cortex,indicating effective neuronal activation.This neuronal excitation was accompanied by a syn-chronous increase in blood vessel diameter,blood flow velocity and overall blood flow.Conclusions This study successfully establishes a three-dimensional visualization framework(spatial,temporal,and functional)for in vivo visualization of neurovascu-lar coupling in the mouse barrel cortex,which provides a useful tool for investigating the pathophysiological mechanisms of neuro-vascular dysfunction and evaluating the efficacy of potential ther-apies.

OBJECTIVE: To retrospectively analyze the clinical efficacy of anterior cruciate ligament (ACL) reconstruction combined with anterolateral complex repair and ACL reconstruction combined with ALL reconstruction in the treatment of anterior cruciate ligament injuries with high-grade pivot shift. METHODS: From January 2018 to June 2022, 49 patients combined ACL and ALL injuries with high-grade pivot shift were retrospectively studied from three hospitals, 29 of them underwent ACL reconstruction with anterolateral complex repair (repair group), including 23 males and 6 females with an average age of (27.5±4.8) years old, ranged from 20 to 37 years old;the injured sides were 13 on the left and 16 on the right, and 11 patients were suffered with meniscus injury. The other 20 patients underwent ACL and ALL reconstruction (reconstruction group) including 17 males and 3 females with the mean age of (27.1±4.5) years old, ranged from 20 to 38 years old;the injured sides were 8 on the left and 12 on the right, and 6 patients were suffered with meniscus injury. Knee stability (pivot shift test, KT-2000), range of motion, knee function (Lysholm scoring scale, Cincinnati sports activity scale (CSAS) scoring scale, and Tegner activity level score between two groups were compared. RESULTS: A total of 49 patients were followed up, the repair group receiving 13 to 20(15.3±1.8) months and the reconstruction group receiving 12 to 21(16.0±2.2) months. There was no statistically significant difference in the preoperative pivot shift test grading distribution between two groups (P>0.05). At the last postoperative follow-up, there were 24 patients with grade 0 and 5 patients with grade 1 in the repair group, and there were 18 patients with grade 0 and 2 patients with grade 1 in the reconstruction group, there is no significant difference in the distribution of axial shift test grading between two groups(P>0.05). The preoperative KT-2000 tibial displacement of two groups were (9.39±0.77) mm (repair group) and (9.14±0.78) mm (reconstruction group) respectively, with no statistically significant difference (P>0.05). At the final postoperative follow-up, there were 24 patients with KT-2000 tibial displacement <3 mm and 5 patients with 3 to 5 mm in the repair group, while 18 patients with <3 mm and 2 patients with 3 to 5 mm in the reconstruction group, KT-2000 tibial displacement distribution of two groups was no significant difference (P>0.05), but the KT-2000 tibial displacement in the reconstruction group (1.30±0.86) mm was significantly smaller than that in the repair group (1.99±1.11) mm (P<0.05). The final postoperative follow-up range of motion of the contralateral side knee between two groups was no significant difference (P>0.05). The range of motion of the suffering knee in the repair group was less than that in the reconstruction group (P<0.05). There was no significant difference in preoperative Lysholm and CSAS scores between two groups (P>0.05). At the final postoperative follow-up, both groups showed significant improvement in Lysholm and CSAS scores, while the Lysholm and CSAS scores of the reconstruction group were better than those of the repair group, and the difference was statistically significant (P<0.05). Significant differences was found in Tegner scores between two groups, which 16 patients in the repair group returned to their pre-injury activity level, and 17 patients in the reconstruction group returned to their pre-injury level (P<0.05). CONCLUSION Compared to anterolateral complex repair, combined ACL and ALL reconstruction in the treatment of ACL injuries with high-grade pivot shift results in better knee joint function and stability. This is advantageous in reducing the risk of ACL reconstruction failure.
Humans ; Male ; Female ; Adult ; Anterior Cruciate Ligament Reconstruction/methods* ; Anterior Cruciate Ligament Injuries/surgery* ; Young Adult ; Retrospective Studies ; Anterior Cruciate Ligament/surgery* ; Range of Motion, Articular

In the progression of end-stage liver disease,the incidence of sleep disorders in patients with liver cirrhosis is high.Currently,western medicine treatment has obvious liver and kidney damage and adverse reactions after discontinuation,which affects the therapeutic effect.Cirrhosis and sleep disorders can be separately attributed to the category of"abdominal mass"and"insomnia"in traditional Chinese medicine.The"abdominal mass"is caused by the disorder of liver and spleen qi movement,as well as the obstruction of phlegm-dampness and blood stasis.In the development of"abdominal mass",the liver failed in ensuring free movement of qi,the spleen failed in transportation and transformation,liver yin and liver blood became insufficiency and the imbalance of yin and yang in the zang-fu organs became imbalanced,and then the ethereal soul depart from the housing,which leads to"insomnia"as an outward manifestation.Professor ZHOU Xiao-Zhou focuses on the concept of qi and blood,and points out that the pathogenesis of sleep disorder in cirrhosis is characterized by liver stagnation and spleen deficiency.He proposed that the treatment principle is to regulate the liver and spleen simultaneously,as well as to nourish the heart and calm the mind.Professor ZHOU has developed Ganyinghua Anshen Formula for treating sleep disorders in cirrhosis,which is derived from the modification of Xiangsha Liujunzi Decoction,and is composed of 14 Chinese medicines of vinegar-prepared Cyperi Rhizoma,Amomi Fructus,Coicis Semen,Dioscoreae Rhizoma,bran-fried Atractylodis Macrocephalae Rhizoma,Galli Gigerii Endothelium Corneum,Gardeniae Fructus,Codonopsis Radix,Salviae Miltiorrhizae Radix et Rhizoma,Citri Reticulatae Pericarpium,Sclerotium Poriae Pararadicis,Longan Arillus,Albiziae Cortex,and Glycyrrhizae Radix et Rhizoma Praeparata cum Melle.The formula has achieved remarkable clinical effect.The clinical experience of Professor ZHOU Xiao-Zhou for treating sleep disorders in cirrhosis through regulating the liver and spleen simultaneously will provide a reference for its clinical treatment with traditional Chinese medicine.

Objective To investigate the clinical effect and hearing loss of endolymphatic sac decompression(ESD)combined with one or two semicircular canal obstruction(SCO)in treating the patient with stage Ⅲ or stageⅣ Meniere disease.Methods Forty-three patients with stage Ⅲ or stage Ⅳ Meniere disease,who failed to respond to conventional conservative treatment and had the expectation of preserving residual hearing function,were enrolled in the study.They were divided into three groups according to the operation they underwent:ESD combined with lateral and posterior semicircular canal obstruction(ESD+LPSCO)13 cases,ESD combined with lateral semicircu-lar canal obstruction(ESD+LPSCO)14 cases,and ESD only 16 cases.Data of vertigo,ear fullness and tinnitus be-fore and after operation was collected,analyzed and compared.Hearing function before and after the operation was also evaluated.Results The number of vertigo attacks in the three groups(ESD+LPSCO,ESD+LSCO,and ESD)were all significantly reduced after operation.The vertigo control rate were 92.3％,78.6％and 62.5％re-spectively.Compared with pre-operation,the vertigo severity post-operation in the three groups were also signifi-cantly reduced.And the improvement rate of vertigo severity after ESD+LPSCO and ESD+LSCO were both 100％,which were significantly higher than that of ESD(68.8％).The discomfort of tinnitus and ear fullness in the three groups were significantly improved compared with that of pre-operation.The improvement rates of tinnitus in the three groups were 46.2％,50.0％and 43.8％respectively,with no significant difference.The improvement rate of ear fullness in the three groups were 61.5％,57.1％and 50.0％respectively,with no significant difference either.The proportion of patients with decreased hearing after operation in the three groups was 15.4％,7.1％and 18.8％,respectively,and the differences were insignificant.Conclusion ESD combined with one or two SCO can effectively control vertigo and other symptoms of patients with stage Ⅲ or Ⅳ Meniere's disease who had failure to conventional conservative treatment,and can preserve the residual hearing function in considerable extent.

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in healthcare facilities in major regions of China in 2023.Methods Clinical isolates collected from 73 hospitals across China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2023 Clinical & Laboratory Standards Institute (CLSI) breakpoints.Results A total of 445199 clinical isolates were collected in 2023,of which 29.0％ were gram-positive and 71.0％ were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species (excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi) (MRSA,MRSE and MRCNS) was 29.6％,81.9％ and 78.5％,respectively.Methicillin-resistant strains showed significantly higher resistance rates to most antimicrobial agents than methicillin-susceptible strains (MSSA,MSSE and MSCNS).Overall,92.9％ of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 91.4％ of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis had significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 93.1％ in the isolates from children and and 95.9％ in the isolates from adults.The resistance rate to carbapenems was lower than 15.0％ for most Enterobacterales species except for Klebsiella,22.5％ and 23.6％ of which were resistant to imipenem and meropenem,respectively .Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.6％ to 10.0％.The resistance rate to imipenem and meropenem was 21.9％ and 17.4％ for Pseudomonas aeruginosa,respectively,and 67.5％ and 68.1％ for Acinetobacter baumannii,respectively.Conclusions Increasing resistance to the commonly used antimicrobial agents is still observed in clinical bacterial isolates.However,the prevalence of important crabapenem-resistant organisms such as crabapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a slightly decreasing trend.This finding suggests that strengthening bacterial resistance surveillance and multidisciplinary linkage are important for preventing the occurrence and development of bacterial resistance.