In order to meet the need of autonomous control of patients with severe limb disorders, this paper designs a nursing bed control system based on motor imagery-brain computer interface (MI-BCI). In view of the low decoding performance of cross-subjects and the dynamic fluctuation of cognitive state in the existing MI-BCI technology, the neural network structure optimization and user interaction feedback enhancement are improved. Firstly, the optimized dual-branch graph convolution multi-scale neural network integrates dynamic graph convolution and multi-scale convolution. The average classification accuracy is higher than that of multi-scale attention temporal convolution network, Gram angle field combined with convolution long short term memory hybrid network, Transformer-based graph convolution network and other existing methods. Secondly, a dual visual feedback mechanism is constructed, in which electroencephalogram (EEG) topographic map feedback can improve the discrimination of spatial patterns, and attention state feedback can enhance the temporal stability of signals. Compared with the single EEG topographic map feedback and non-feedback system, the average classification accuracy of the proposed method is also greatly improved. Finally, in the four classification control task of nursing bed, the average control accuracy of the system is 90.84%, and the information transmission rate is 84.78 bits/min. In summary, this paper provides a reliable technical solution for improving the autonomous interaction ability of patients with severe limb disorders, which has important theoretical significance and application value.
Humans ; Brain-Computer Interfaces ; Deep Learning ; Electroencephalography ; Feedback, Sensory ; Neural Networks, Computer ; Beds

Objective To investigate the mechanism of Yes-associated protein 1(YAP1)ameliorating aristolochic acid 1(AAI)-induced liver injury in mice based on untargeted metabolomics techniques.Methods There were 83-week-old male hepatocyte-specific Yap1 gene knockout mice(genotyped as Yap1Flox/Flox,Albumin-Cre,aka.Yap1LKO)were randomly selected as the Yap1LKO+AAI group,and 8 Yap1Flox control mice as the Yap1Flox+AAI group.Both groups were injected intraperitoneally with AAI at a dose of 2.5 mg·kg-1·d-1 for 14 consecutive days.Genotypes were identified by tail PCR;serum alanine transaminase(ALT)and aspartate transaminase(AST)activities were determined by microplate assay;histopathological changes of liver tissue were observed by HE staining;and the protein expression of YAP1 in liver tissue was determined by immunohistochemistry.The untargeted metabolomics approach was used to analyze the liver tissue differential metabolites,and the samples were analyzed by ultra performance liquid chromatography-quadrupole-electrostatic field orbit trap high-resolution mass spectrometry,and the differential metabolites were screened by principal component analysis(PCA),Partial least square-discriminant analysis(PLS-DA),and orthogonal partial least squares-discriminant analysis(OPLS-DA);using HMDB database and METLIN database to identify metabolites,and the pathway enrichment of differential metabolites was analyzed by KEGG database.Results(1)After 14 days of AAI induction,the increase of body mass in Yap1LKO mice was lower than that in Yap1Flox mice,but there was no statistical significance(P＞0.05).On day 14,compared with the Yap1Flox+AAI group,the serum ALT and AST enzyme activities in the Yap1LKO+AAI group of mice were significantly increased(P＜0.05),and the histopathological damage of the liver was significantly aggravated.The livers of the Yap1Flox mice had a positive protein expression of YAP1,whereas the Yap1LKO mice did not have a positive protein expression of YAP1.(2)A total of 139 differential metabolites with significant changes(VIP＞1 and P＜0.05)were screened by metabonomic analysis;compared with Yap1LKO+ AAI group,62 liver metabolites in Yap1Flox+AAI group were up-regulated,including choline,taurine,hypotaurine,α-linolenic acid,eleostearic acid,chenodeoxycholic acid and so on.Seventy-seven metabolites were down-regulated including glycerophosphocholine,L-phosphatidylcholine,L-glutamine,L-serine,L-glutathione,5-methionine,phenylalanine,glucose 6-phosphate,lactic acid,uric acid glycosides,etc..KEGG-enriched pathways were mainly choline metabolism,glycerophospholipid metabolism,insulin resistance,glutathione metabolism,etc..Conclusion Hepatocyte-specific Yap1 gene knockout exacerbated AAI-induced liver injury in mice,and YAP1 was involved in the regulation of choline metabolism and glycerophospholipid metabolism through the up-regulation of unsaturated fatty acids,such as choline and taurine,which ameliorated AAI-induced liver injury in mice.

Objective:To investigate the characteristics of digestive system symptoms and its relation with the time of nucleic acid continuous positive in population infected with severe acute respiratory syndrome coronavirus 2 Omicron variant, and to analyze the abdominal computed tomography (CT) features of patients infected with Omicron variant.Methods:From April 11 to May 23, 2022, a questionnaire survey was conducted in patients infected with Omicron variant admitted to the Shanghai National Convention and Exhibition Center Fangcang Hospital. The questionnaire included basic information, the start time of nucleic acid positive, respiratory symptoms, digestive system syptoms and outcomes, etc.Combined with the clinical data, the relation between digestive tract symptoms and the time of nucleic acid continuous positive were analyzed. Thoracic and abdominal CT were performed for patients with continuous positive nucleic acid results ≥10 d, and the relationship between the abdominal CT imaging characteristics and the time of nucleic acid continuous positive was analyzed. Independent sample t-test and multivariate logistic regression were used for statistical analysis. Results:A total of 4 360 valid questionnaires were collected, including 2 475 males and 1 885 females, with a hospital stay of (6.8±4.9) d. Among the 4 360 patients, 1 979 patients (45.4%) had gastrointestinal symptoms such as loss of appetite, abdominal discomfort or pain, constipation and diarrhea. The time of nucleic acid continuous positive in patients with gastrointestinal symptoms was (7.4±5.5) d, which was longer than that of patients without gastrointestinal symptoms (6.5±3.6) d, and the difference was statistically significant ( t=3.78, P<0.001). During the isolation period in the Fangcang Hospital, the time of nucleic acid continuous positive in patients with complete remission of digestive tract symptoms was shorter than that of patients with no remission of digestive tract symptoms ((7.3±5.2) d vs. (8.5±5.7) d), and the difference was statistically significant ( t=2.25, P=0.025). The results of multivariate logistic regression analysis showed that the combination of gastrointestinal symptoms was an independent risk factor for continuous positive nucleic acid result ≥10 d ( OR=1.316, 95% confidence interval 1.294 to 2.205, P=0.046). Among the 299 patients with continuous positive nucleic acid results≥10 d, 187 cases (62.5%) had gastrointestinal symptoms, and 146 cases (48.8%) had abdominal CT findings of thickening of the gastroduodenal wall, thickening of the small intestinal wall, indistinct mesenteric vessels of the small intestine, and dilatation and pneumatosis of the colon. In patients with continuous positive nucleic acid results ≥10 d, abdominal CT indicated that patients with gastrointestinal imaging changes had a longer time of nucleic acid continuous positive than those without gastrointestinal imaging changes ((16.0±2.8) d vs. (13.0±2.1) d), and the difference was statistically significant ( t=2.62, P=0.009). Conclusions:Digestive system symptoms are common in patients infected with Omicron variant. The time of nucleic acid continuous positive in patients with gastrointestinal symptoms is longer than those without gastrointestinal symptoms. Some patients may have gastrointestinal lesions on abdominal CT.

BACKGROUND: Tri-ponderal mass index (TMI) has been reported to be a more accurate estimate of body fat than body mass index (BMI). This study aims to compare the effectiveness of TMI and BMI in identifying hypertension, dyslipidemia, impaired fasting glucose (IFG), abdominal obesity, and clustered cardio-metabolic risk factors (CMRFs) in 3- to 17-year-old children. METHODS: A total of 1587 children aged 3 to 17 years were included. Logistic regression was used to evaluate correlations between BMI and TMI. Area under the curves (AUCs) were used to compare discriminative capability among indicators. BMI was converted to BMI- z scores, and accuracy was compared by false-positive rate, false-negative rate, and total misclassification rate. RESULTS: Among children aged 3 to 17 years, the mean TMI was 13.57 ± 2.50 kg/m 3 for boys and 13.3 ± 2.33 kg/m 3 for girls. Odds ratios (ORs) of TMI for hypertension, dyslipidemia, abdominal obesity, and clustered CMRFs ranged from 1.13 to 3.15, higher than BMI, whose ORs ranged from 1.08 to 2.98. AUCs showed similar ability of TMI (AUC: 0.83) and BMI (AUC: 0.85) in identifying clustered CMRFs. For abdominal obesity and hypertension, the AUC of TMI was 0.92 and 0.64, respectively, which was significantly better than that of BMI, 0.85 and 0.61. AUCs of TMI for dyslipidemia and IFG were 0.58 and 0.49. When 85th and 95th of TMI were set as thresholds, total misclassification rates of TMI for clustered CMRFs ranged from 6.5% to 16.4%, which was not significantly different from that of BMI- z scores standardized according to World Health Organization criteria. CONCLUSIONS TMI was found to have equal or even better effectiveness in comparison with BMI in identifying hypertension, abdominal obesity, and clustered CMRFs TMI was more stable than BMI in 3- to 17-year-old children, while it failed to identify dyslipidemia and IFG. It is worth considering the use of TMI for screening CMRFs in children and adolescents.
Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Male ; Body Mass Index ; Dyslipidemias ; East Asian People ; Hypertension ; Obesity, Abdominal ; Pediatric Obesity/diagnosis* ; Cardiometabolic Risk Factors

Objective:To observe the relationship between inducible carbon monoxide synthase (iNOS) and delayed encephalopathy after acute carbon monoxide poisoning (DEACMP), and explore its mechanism of action in DEACMP.Methods:This study was designed as prospective cohort study. Patients with acute carbon monoxide poisoning who met the diagnostic criteria and were admitted to Emergency Intensive Care Unit(EICU) of our hospital from June 2019 to June 2021 were selected as subjects. Patients were divided into the DEACMP group and non-DEACMP group according to the occurrence of DEACMP. Serum samples were collected on the first 24 h after admission and on day 7 and 14 after admission, and the serum nitric oxide (NO), neuronal nitric oxide synthase (nNOS), inducible carbon monoxide synthase (iNOS), and endothelial nitric oxide synthase (eNOS) level were measured by enzyme-linked immunosorbent assay. The generalized estimating equation was used to estimate the difference of NO, nNOS, iNOS and eNOS between DEACMP and non-DEACMP patients.Results:A total of 78 patients with carbon monoxide poisoning were included in our study finally, including 49 (62.82%) males and 29 (37.18%) females, with an average age of (53.96±14.95) years, 20 (25.64%) patients with DEACMP, and 1 (1.28%) death. Univariate analysis showed that patients with DEACMP had an average increase of 3 h (95% CI: 1.00, 5.00) in carbon monoxide exposure time and a 5-point decrease in GCS score (95% CI: 1.00, 6.00) than the patients without DEACMP, and the proportion of patients with severe carbon monoxide poisoning in the DEACMP group was higher than that of the non-DEACMP group (90.00% vs. 32.76%). According to the analysis of generalized estimation equation, on day 7 and 14 after admission, Compared with non-DEACMP patients, neither by performing unadjusted nor adjusted analysis with the iNOS of DEACMP patients was significantly higher than that in non-DEACMP patients regardless of whether exposure time, GCS score, coma time or severity of carbon monoxide poisoning were adjusted or not ( P <0.01 or P <0.05). Except for the level of nNOS in the GEE model adjusted with carbon monoxide exposure time, the levels of NO, nNOS and eNOS showed no significant difference between DEACMP and non-DEACMP patients ( P >0.05). Conclusions:The expression of iNOS level is increased in DEACMP patients, and its continuous expression may be involved in the pathogenesis of DEACMP.

Background In recent years, the incidence of metabolic syndrome (MS) is increasing significantly in China. Some studies have found that temperature is related to single metabolic index, but there is a lack of research on associated mechanism and identifying path of the influence of temperature on MS. Objective Based on the data of Guangdong Province, to investigate the effect of temperature on MS and its pathway. Methods A total of 8524 residents were enrolled by multi-stage random sampling from October 2015 to January 2016 in Guangdong. Basic characteristics, behavioral characteristics, health status, and physical activity level were obtained through questionnaires and physical examinations, and meteorological data were obtained from meteorological monitoring sites. We matched individual data both with the temperature data of the physical examination day and of a lag of 14 d. A generalized additive model was used to explore the exposure-effect relationship between temperature and MS and its indexes, calculate effect values, and explore the effects of single-day lag temperature. Based on the literature and the results of generalized additive model analysis, a path analysis was conducted to explore the pathways of temperature influencing MS. Results The association between daily average temperature on the current day or lag 14 day and MS risk was not statistically significant. When daily average temperature increased by 1 ℃, the change values of fasting blood-glucose (FBG), systolic blood pressure (SBP), diastolic blood pressure (DBP), and high density lipoprotein cholesterol (HDL-C) were −0.033 (95%CI: −0.040-−0.026) mmol·L⁻¹, −0.662 (95%CI: −0.741-−0.583) mmHg, −0.277 (95%CI: −0.323-−0.230) mmHg, and −0.005 (95%CI: −0.007-−0.004) mmol·L⁻¹ respectively. The effects of average daily temperature on FBG, blood pressure, HDL-C, and waist circumference lasted until lag 14 day. The effects of daily average temperature on SBP and DBP were the largest on the current day. Daily average temperature of current day had direct and indirect effects on FBG and SBP. Temperature had an indirect effect on TG, and the intermediate variables were waist circumference and FBG, with an indirect effect value of −0.011 (95%CI: −0.020-−0.002). The indirect effects of daily average temperature on SBP, FBG, and TG were weak. Conclusion There is no significant correlation between temperature and risk of MS, and daily average temperature of current day could significantly affected blood pressure and FBG with a lag effect. Daily average temperature of current day has indirect effects on FBG and TG.

IgA nephropathy (IgAN) is one of the common primary glomerulonephritis, which is also an important risk factor for end-stage renal disease. Kidney transplantation is the optimal treatment for end-stage renal disease induced by IgAN, whereas there is still a risk of recurrence of IgAN after kidney transplantation. At present, research progress upon IgAN recurrence after kidney transplantation is relatively lacking. The pathogenesis of IgAN recurrence remains elusive, and its pathological manifestations are not specific. The diagnosis of IgAN recurrence still depends on renal biopsy. Besides, no effective prevention and treatment are available for recurrent IgAN. In this article, research progress on IgAN recurrence after kidney transplantation was illustrated from the perspectives of pathogenesis, diagnosis, risk factors and treatment, aiming to provide reference for clinical prevention and treatment of IgAN recurrence after kidney transplantation and improve clinical prognosis of kidney transplant recipients.

Objective:To explore the effect of different hemoperfusion times on the recovery of serum cholinesterase (ChE) in patients with severe acute oral organophosphorus pesticide poisoning (AOPP).Methods:This was a retrospective case-control study. Patients with severe AOPP admitted to our hospital were identified between January 2010 and December 2019. The clinical information of patients with severe AOPP was collected between January 2010 and December 2019, the patient's ChE vitality levels were collected on admission, at 1, 3 and 5 days after admission, and the sex, age, oral poison volume, and related treatments were recorded as well. The relationship between ChE, different HP treatment times and patients without HP treatment was analyzed by generalized estimation equations and multiple comparisons afterward.Results:A total of 159 patients with severe AOPP were included in our study. Among them, 60 (37.74%) patients were male and 99 (62.26%) were female, with a median age of 33 years old (range 13-75 years old). The median oral dose of OPs was 75 mL (range 15-500 mL). Multivariate analysis results showed that in the unadjusted generalized estimation equation, compared with patients without HP treatment, the average ChE value of patients with single HP treatment was 745.6 U/L higher (95% CI: 467.09 - 1024.1; P<0.01), the average ChE value of patients with 2 times HP treatment was 565.81 U/L higher (95% CI: 384.25-747.36; P<0.01), and the average ChE value of patients with 3 times HP treatment was 43.86 U/L higher (95% CI: 420.71-1 067.01; P<0.01), the differences were all statistically significant. After adjusting the amount of oral OPs at admission, age and PSS score in the multiple generalized estimation equations, the results showed that whatever single HP treatment or multiple HP treatment, the recovery rate of ChE was significantly faster than those without HP treatment. And the multiple comparison results of multiple models showed that the difference between 3 times HP treatment and 1 to 2 times HP treatment was not statistically significant, and the average difference between 2 times HP treatment and single HP treatment was also not statistically significant. Conclusions:Hemoperfusion therapy can accelerate the recovery rate of ChE in AOPP patients; Whatever single HP treatment or multiple HP treatments, the recovery rate of ChE in AOPP patients has no significant difference.

Objective: To investigate the expression of long non-coding RNA (lncRNA)H19 in gallbladder cancer and its relationship with clinicopathological parameters and prognosis. Methods: 74 cases of allbladder cancer resected in our hospital were collected and studied. At the same time, 66 cases of benign gallbladder lesions were selected as benign lesion group. The expression of lncRNA H19 in tissues was detected by real-time fluorescence quantitative polymerase chain reaction (qRT-PCR). The correlation between lncRNA H19 expression and clinicopathological parameters of gallbladder cancer patients was analyzed.The patients were followed up for 3 years and COX was used to analyze the prognostic factors affecting the survival rate.The survival was analyzed by Kaplan-Meier curve. The survival differences of lncRNA H19 expression groups were detected by Log-Rank method. Results: The expression level of lncRNA H19 in gallbladder cancer was significantly higher than that in benign lesions (P<0.05). The expression of lncRNA H19 was correlated with stage, differentiation and lymph node metastasis (P<0.05). Age, sex, histological grade, stage and depth of invasion of gallbladder cancer had no significant correlation with 3-year survival rate (P>0.05). The survival rate of patients with differentiated tumors and non-metastatic lymph nodes were higher (P<0.05). The survival rate of patients with low expression of lncRNA H19 was significantly higher than those with high expression of lncRNA H19 (P<0.05). Tumor differentiation, lymph node metastasis and lncRNA H19 expression were independent risk factors affecting the prognosis of patients with gallbladder cancer. Conclusions LncRNA H19 is highly expressed in gallbladder cancer, which is closely related to the degree of differentiation, lymph node metastasis and survival rate of patients.

Objective To understand the gender selection and prognosis of children with 46,XY disorders of sex development (DSD) after surgery,and to provide reference for future clinical decision-making.Methods Data of 85 (80 males and 5 females) postoperative patients with 46,XY DSD with follow-up age of 6(4,11) years who were treated at the Department of Endocrinology,Genetics and Metabolism of Beijing Children's Hospital Affiliated to Capital Medical University during the period from September 2009 to April 2018 were retrospectively analyzed.The patients were grouped based on diagnosis.The basis of postoperative gender selection,patient satisfaction and related factors,gender characteristics,and adolescent development were analyzed.The Pre-school Activities Inventory or the Children's Sex Role Inventory were used in the analysis of gender tendency.Mann-Whitney U test was used to compare postoperative gender satisfaction of different factors.The Kruskal-Wallis method was used to compare the postoperative gender satisfaction of each group.Fisher's test was used to compare the follow-up status of male children over 11 years old in each group.Results Among the 85 patients,62 individuals were raised as girls after birth,9 were facultative and 14 as boys.According to the diagnosis,there were 31 individuals in group 1 (with 5α-reductase deficiency),11 individuals in group 2 (with androgen insensitivity syndrome),9 individuals in group 3 (with NR5A1 gene mutation),4 individuals in group 4 (with hypergonadotropic gonadal dysplasia),and 30 indiviudals in group 5 (with unclear diagnosis and normal human choionic gonadotophin test).Among the 71 children who were raised as girls or facultative children after birth,66 selected as boys,and 5 continued as girls (among them,3 individuals were female with passive selection,and 2 individuals of testicular dysplasia with uterus in group 4 and 5 were female with active selection).Among the 71 patients faced with gender selection,only one was unsatisfied,that was a postoperative female.There was no significant difference in postoperative gender satisfaction among different disease diagnoses,surgical age and penis length (x2(H)=6.007,P=0.199;Z=-0.860,P=0.390;Z=-0.438,P=0.661).Fifty-nine of the 85 cases completed the gender tendency scale test and 46 cases (78％) were consistent.In the male patients,45 cases were consistent.Thirteen inconsistent patients (22％) were female or facultative after birth who were 5 years old or older.There was no stigmatization noticed in the inconsistent patients' daily life and school social settings.There were 22 male patients aged 11 years and older.They were 13(12,16) years old.Fourteen (64％) individuals' penile length reached the normal minimum,15 (68％) individuals' testicular volume were equal or more than 4 ml,16 (73％) individuals' sex hormones entered puberty levels,12 (55％) individuals had been spermatorrhea,the age of first spermatorrhea was (13.3±2.4) years.They were satisfied and adaptable after surgery.There was no significant difference in the above indicators among the groups (x2 =2.999,P=0.694;x2 =7.278,P=0.086;x2 =5.597,P=0.358;x2 =6.904,P=0.127).Conclusions The appropriate gender of 46,XY DSD patients was selected according to gonadal status after diagnosis.Regardless the diagnosis,the age of operation and the length of the penis at the first diagnosis,male patients were satisfied with the gender after the operation.A few of patients were inconsistent with the results of gender tendency scale test who were raised as girls or facultative children after birth,and they required sustained special attention.Some of the children showed natural adolescent development in males,and the prognosis may be ideal.