Objective:To explore the changes of gait flexibility and stability in patients with Parkinson's disease (PD) 2 years after deep brain stimulation (DBS).Methods:Twenty PD patients accepted DBS in Department of Neurosurgery, Tianjin Huanhu Hospital from October 2019 to November 2021 were enrolled. Motor symptoms were evaluated by Movement Disorder Society-unified Parkinson's disease rating scale III (MDS-UPDRS-III) at preoperative medication-off state, postoperative medication-off state, and postoperative medication-on state. Mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA) were used to assess the cognition and 39-item Parkinson's disease questionnaire (PDQ-39) was used to evaluate the quality of life at preoperative medication-on state and postoperative medication-on state. A three-dimensional gait analyzer was used to record the gait parameters during Instrumented Stand and Walk test (ISAW) at preoperative medication-off state, postoperative medication-off state, and postoperative medication-on state. Differences in motor symptom scores, cognitive scores, quality of life scores, as well as changes in gait flexibility and stability were compared before and after DBS.Results:(1) The MDS-UPDRS-Ⅲ scores at preoperative medication-off state, postoperative medication-off state, and postoperative medication-on state ([45.30±12.57], [24.95±10.74], [15.80±7.19]) were decreased successively, with significant differences ( P<0.05).(2) Compared with those before surgery, PD patients had significantly lower levodopa equivalent daily dose (LEDD), total scores of PDQ-39, and scores of question 9 "degree of concern about falling" in PDQ-39 at 2 years after DBS ([711.84±343.99] mg/d vs. [549.30±301.08] mg/d, 47.00[30.00, 64.00] vs. 13.50[7.75, 27.00], 2.00[0.00, 3.00] vs. 0.00[0.00, 1.75], P<0.05). (3) Compared with that at preoperative medication-off state, the arm swing velocity at postoperative medication-on state statistically increased in PD patients ( P<0.05); compared with those at preoperative medication-off state, the arm swing range and turning speed at postoperative medication-off and medication-on states significantly increased in PD patients ( P<0.05); compared with that at preoperative medication-off state, the turning duration at postoperative medication-off state statistically decreased in PD patients ( P<0.05). Compared with that at preoperative medication-off state, the range of motion of the trunk in the horizontal plane at postoperative medication-off and medication-on states increased significantly in PD patients ( P<0.05); compared with that at preoperative medication-off state, the range of motion in the sagittal plane of the lumbar, coronal plane of the trunk, and sagittal plane of the trunk all increased significantly in PD patients at postoperative medication-on state ( P<0.05); the mean velocity and root mean square acceleration at postoperative medication-on state increased significantly in PD patients compared with that at preoperative medication-off state ( P<0.05); conversely, the swing frequency at postoperative medication-off state decreased significantly in PD patients compared with that at preoperative medication-off state ( P<0.05). Conclusion:Two years after DBS, PD patients exhibit obviously improved gait, with enhanced flexibility, and dynamic and static stability.

Objective To explore the effect of physical exercise on semen quality in order to provide basic data and theoretical basis for the improvement of male reproductive health.Methods A cross-sectional study was conducted on 1 059 males who visited the Reproductive Medicine Center of Shandong Maternal and Child Health Hospital for medical treatment and physical examination during July 2022 and April 2023.Their demographic data and physical exercise data were surveyed with questionnaires.Total sperm count,sperm concentration,total sperm motility,forward movement and normal sperm morphology were analyzed with computer aided analysis.Logistic regression model and multiple linear regression model were applied to analyze the effects of physical exercise on semen quality.Results After adjustment for confounding factors such as age,body mass index,alcohol consumption and smoking,logistic regression analysis showed that the risk of abnormal semen quality was increased in patients with moderate and heavy exercise intensity(OR=2.103,OR=2.229).Compared with the participants with physical exercise ≤10 min per session,those with＞20 min per session had a lower risk of abnormal semen quality(OR=0.357,0.256,0.289 for exercise time for＞20～30,＞30～60,＞60 min,respectively).There was no statistical significance between physical exercise frequency and semen quality(P＞0.05).The participants having exercise well were at a lower risk for abnormal semen quality(OR=0.711).Multiple linear regression analysis revealed that the frequency of physical exercise was an influencing factor of sperm concentration(β=7.474,95％CI:4.800～10.149,P＜0.05);the time of physical exercise per session was an influencing factor for total sperm count(β=20.632,95％CI:7.634～33.629);the intensity of physical exercise(β=-1.461,95％CI:-2.392～-0.530)and time of physical exercise per session(β=2.608,95％CI:1.404～3.812,P＜0.05)were influencing factors for percentage of forward motility sperm(P＜0.05);and physical exercise intensity(β=-1.934,95％CI:-3.238～-0.630),time of physical exercise per session(β=4.211,95％CI:2.525～5.897)and frequency of physical exercise(β=-2.008,95％CI:-3.480～-0.536)were influencing factors of total sperm motility(P＜0.05).Conclusion Physical exercise may affect semen quality,greater intensity of physical exercise may be a risk factor for abnormal semen quality,and longer physical exercise time may be related to improving semen quality.Therefore,proper physical exercise can help improve semen quality.

Sepsis is a complex syndrome caused by multiple pathogens and involves multiple organ failure, particularly spleen dysfunction. In 2017, the worldwide incidence was 48.9 million sepsis cases and 11 million sepsis-related deaths were reported (Rudd et al., 2020). Inflammation, oxidative stress, and apoptosis are the most common pathologies seen in sepsis. Liensinine (LIE) is a bisbenzylisoquinoline-type alkaloid extracted from the seed embryo of Nelumbo nucifera. Lotus seed hearts have high content of LIE which mainly has antihypertensive and antiarrhythmic pharmacological effects. It can exert anti-carcinogenic activity by regulating cell, inflammation, and apoptosis signaling pathways (Manogaran et al., 2019). However, its protective effect from sepsis-induced spleen damage is unknown. In this research, we established a mouse sepsis model induced by lipopolysaccharide (LPS) and investigated the protective effects of LIE on sepsis spleen injury in terms of inflammatory response, oxidative stress, and apoptosis.
Mice ; Animals ; Lipopolysaccharides/pharmacology* ; Spleen ; Inflammation ; Apoptosis ; Sepsis ; Oxidative Stress

Baylisascaris schroederi,a roundworm(ascaridoid)parasite specific to the bamboo-feeding giant panda(Ailuropoda melanoleuca),represents a leading cause of mortality in wild giant panda populations.Here,we present a 293-megabase chromosome-level genome assembly of B.schroederi to infer its biology,including host adaptations.Comparative genomics revealed an evolutionary trajectory accompanied by host-shift events in ascaridoid parasite lineages after host separations,suggesting their potential for transmission and rapid adaptation to new hosts.Genomic and anatomical lines of evidence,including expansion and positive selection of genes related to the cuticle and basal metabolisms,indicate that B.schroederi undergoes specific adaptations to survive in the sharp-edged bamboo-enriched gut of giant pandas by structurally increasing its cuticle thickness and efficiently utilizing host nutrients through gut parasitism.Additionally,we characterized the secretome of B.schroederi and predicted potential drug and vaccine targets for new control strategies.Overall,this genome resource provides new insights into the host adaptation of B.schroederi to the giant panda as well as the host-shift events in ascaridoid parasite lineages.Our findings on the unique biology of B.schroederi will also aid in the development of prevention and treatment measures to protect giant panda populations from roundworm parasitism.

Objective:To explore the effect of de-escalation thinking in the triage of critically ill children in the Department of Pediatrics.Methods:From January 2018 to January 2020, we selected a total of 486 critically ill pediatric patients admitted to Zhumadian Central Hospital in Henan Province. According to the random number table, the children were simply randomly divided into control group and observation group, each with 243 cases. Control group carried out traditional routine triage, and observation group conducted de-escalation thinking for pre-examination and triage. We observed the differences in the triage accuracy, satisfaction of the children and their parents and the quality of the triage between the two groups of children.Results:The scores of the disease classification and triage accuracy, total satisfaction, service attitude, treatment timeliness, health guidance as well as safety of children in observation group were higher than those in control group, and the differences were all statistically significant ( P<0.05) . Conclusions:De-escalation thinking has a high accuracy rate in the triage of critically ill children in the Department of Pediatrics, which can improve the treatment effect, reduce the adverse results of the rescue, and improve the satisfaction of the children and their family members.

Objective:To investigate the risk factors of ST-segment elevation myocardial infarction (STEMI) with early left ventricular thrombus (LVT) under emergency percutaneous coronary intervention(PCI)mode.Methods:The clinical data were collected from 784 patients with STEMI treated with emergency percutaneous coronary intervention (pPCI) in our hospital from January 2014 to April 2019 . The observation indexes included baseline data, coronary angiography, disease course, laboratory examination and auxiliary examination. Patients with severe organic heart disease and having previous history of LVA and LVT were excluded. Totally 38 patients with LVT were selected as the experimental group and 114 patients with non-LVT selected as the control group according to the principle of age (the smallest absolute age difference between the experimental group and the control group) and sex. Data was analyzed by software Graphpad Prism5, SPSS 22.0 and Medcalc software were used for statistical analysis, and the Logistic regression model was established. A P<0.05 was considered statistically significant, and the risk factors of early LVT formation were retrospectively analyzed. Results:There was a linear relationship between the prolongation of TIT and the occurrence of LVT ( χ2= 304, P<0.01), and the Spearman relation was highly positive ( ρ=0.626, P<0.01). Multivariate conditional logistic regression analysis showed that prolonged TIT (total ischemic time), increased total amplitude of ST elevation, TIMI blood flow ≤ grade 2 after pPCI, decreased LVEF and LVA were independent risk factors for LVT, and their odds ratios ( OR) were 1.996, 13.689, 16.996, 0.868 and 9.195, respectively. Model 1 was constructed as LVA and the total amplitude of elevation of ST segments, and the receiver operating characteristic (ROC) was drawn, and the area under the ROC curve (AUC) was calculated as 0.889. Model 2 was obtained by adding TIT, LVEF and postoperative TIMI blood flow≤2, and the AUC was 0.990. Delong method was used to compare the AUC values between the two groups, and there was a statistical difference ( Z=3.294, P=0.001). Conclusions:The risk factors of STEMI complicated with early LVT under "emergency PCI mode" may have changed. Clinicians should conduct early screening of high-risk people factors of LVT in order to reduce its incidence and improve the prognosis. It may be helpful to actively carry out emergency bedside echocardiography before operation.

Objective:To investigate the characteristics of coronary angiography and types of intracoronary thrombus in patients with acute myocardial infarction (AMI) who were classified according to changes of ST segment in electrocardiogram (ECG).Methods:A total of 232 consecutive AMI patients within 24 h of symptom onset undergoing primary percutaneous coronary intervention (PCI) in Henan Provincial People’s Hospital from September 2016 to August 2018 were included. According to the changes of ST segment, patients were divided into three groups: ST-elevated group (161 cases), ST-unoffset group (28 cases) and ST-depression group (43 cases). Optical coherence tomography (OCT) during primary PCI were performed and intracoronary thrombus types were differentiated according to OCT. One-way analysis of variance, Chi-square test and Fisher exact probability test were used to analyze the clinical baselines, angiographic characteristics and intracoronary thrombus types among the three groups. A P<0.05 was considered statistically significant. Results:Left anterior descending coronary artery and right coronary artery were the most common infarct related arteries in the ST-elevated group and ST-depression group, while left circumflex artery was more common in the ST-unoffset group ( P<0.001). The infarct sites in the ST-elevated group and ST-depression group were mostly located in the proximal and middLe segments, while those in the ST-unoffset group were mostly located in the middLe and distal segments ( P=0.008). The proportion of occlusive lesion in the ST-elevated group and ST-unoffset group was higher than that in the ST-depression group (68.3% vs. 30.2%, P<0.05; 67.9% vs. 30.2%, P<0.05). The proportion of single vessel in the ST-elevated group and ST-unoffset group was higher than that in the ST-depression group (36.0% vs. 4.7%, P<0.05; 39.3% vs. 4.7%, P<0.05). The proportion of collateral circulation of infarct related artery in the ST-unoffset group and ST-depression group was higher than that in the ST-elevated group (35.7% vs. 16.1%, P<0.05; 58.1% vs. 16.1%, P<0.05). The incidence of red thrombus in the ST-elevated group and ST-unoffset group was significantly higher than that in ST-depression group (76.4% vs. 34.9%, P<0.05; 64.3% vs. 34.9%, P<0.05). Conclusions:Compared with the ST-depression group, the proportions of single-vessel, occlusive lesion and red thrombus are higher in the ST-unoffset group and ST-elevated group. Therefore, in acute non ST-segment elevated myocardial infarction, those without ST-segment deviation are different from those with ST-segment depression. It is recommended to further divide acute myocardial infarction into ST segment elevation type, ST segment unoffset type and ST segment depression type according to ECG.

Objective To investigate the delay of door to signature time in primary percutaneous coronary intervention (PCI) and its influence in patients with ST segment elevation myocardial infarction (STEMI),therefore to provide a scientific basis for further effective shortening the time of primary PCI in patients with STEMI.Methods A total of 226 patients who diagnosed with STEMI and underwent primary PCI at Henan Provincial People's Hospital from June 2016 to December 2017 were enrolled in the study.Observation indicators include:(1) baseline data of patients;(2) time segments in primary PCI:total ischemic time (TIT),door to balloon time (DTBT),door-to-signature time (DTST),signature to balloon time (STBT);(3) the demographic characteristics of the family members who signed informed consent;and (4) the psychological factors and coping strategies of family members before signing informed consent.All data was analyzed using SPSS software (version 22.0).Multiple linear regression analysis was used to analyze the influencing factors of delay of DTST.A P＜0.05 was considered statistically significant.Results In this study,226 patients with STEMI who were first diagnosed in our hospital had a mean age of 55.23±10.80 years,and 181 (80.1％) were male.The median of TIT,DTBT,DTST,STBT were 312 min,166 min,82 min,and 80 min.The ratio of DTST in DTBT and TIT was 50％ and 28.5％,respectively.The multiple linear regression analysis showed that the number of direct family members (P＜0.001),the degree of educational in middle school and below (P=0.010),high school/technical secondary school (P=0.029),families worrying about the high cost of medical care (P=0.020),families consulted each other repeatedly (P=0.022),and consulted the other medical staff(P=0.022) are risk factors of DTST delay,and city residence (P=0.048) is the protection factor of DTST delay.Conclusions The long time of DTS is a reality of the practice of primary PCI in China.The factors that lead to longer DTST include demographic characteristics,psychological factors and coping strategies of family members.The STBT of primary PCI in China should be taken into the value while emphasizing the DTBT.

Objective To explore the related factors affecting the formation of different types of thrombosis in patients with STEMI. Methods Retrospective data were collected from September 2014 to October 2018 in Henan Province People's Hospital for emergency interventional treatment of patients with STEMI. According to the type of thrombus detected by OCT, they were divided into two groups, which were red thrombus group and white thrombus group. Clinical baseline data, coronary angiographic findings, and OCT results were collected in patients with STEMI. Logistic regression analysis was used to analyze the type of thrombosis in patients with STEMI. Results The rate of thrombus detection was 100％ in 92 patients with STEMI. According to OCT diagnostic criteria, 73 (79.3％) patients were classified into red thrombus and 19 (20.7％) were white thrombus. There was no significant difference in infarct-related artery and location between the two groups (P>0.05) , but there was more multiple vascular lesions in the white thrombus group than that in the red thrombus group. There was significant difference in the incidence of plaque rupture and thin fibrous cap in the two groups (P<0.05). The incidence of plaque rupture and thin fibrous cap lipid plaque was higher in the red thrombus group. Plaque rupture (OR = 2.894, 95％CI:2.704-2.956) , thin fibrous cap plaque (OR = 8.033, 95％CI: 7.985-8.283) , single vessel disease (OR = 1.746, 95％ CI: 1.659-1.785) are risk factors for red thrombosis formation. Conclusion Single vessel lesion, plaque rupture andthin fibrous cap lipid plaque are associated with red thrombus formation.While, multiple vessel lesions and stable plaque are associated with white thrombus formation.

With the discovery of exosomes,new pathways of intercellular information and material exchange mediated by exosomes are attracting more and more attention from researchers. The process of exo-some production overlaps with many viral assembly and outflow pathways,suggesting that exosomes may be related to viral infections. In vitro experiments also show that exosomes play a very important role in viral in-fections. On one hand,exosomes can transfer viral nucleic acids and proteins,and may change microenviron-ment to promote the spread of infection. On the other hand,exosomes can induce immune responses by activa-ting antiviral pathways or transferring antiviral molecules. Do they promote or suppress the spread of infec-tion? What are the factors that affect their functions? In this paper,we review the role of exosomes in viral in-fection in order to provide a reference for better understanding the process of viral infection and immune re-sponses,and to provide a new train of thoughts for the prevention,diagnosis and treatment of viral diseases.