Objective To investigate the association between excessive daytime sleepiness （EDS） and other non-motor symptoms （NMS） in patients with Parkinson disease （PD） using a graphical LASSO （GLASSO） network analysis， as well as the potential role of the sleepiness-olfaction-emotion axis in the onset of EDS. Methods A total of 500 PD patients who attended Xuanwu Hospital， Capital Medical University， from February 2023 to February 2024 were enrolled， and according to the Epworth Sleepiness Scale （ESS） score， they were divided into EDS group （ESS score ≥10） and non-EDS group （ESS score<10）. General clinical data were collected from all patients， and NMSS， HAMA， HAMD， PDSS， RBDQ-HK， MoCA， MMSE， and QOD-F scales were used to assess NMS. A graphical LASSO analysis was used to construct the NMS network in PD， and centrality indices were calculated to investigate the core role of EDS in the NMS network. Results The incidence rate of EDS was 7.12% in this study population. Compared with the non-EDS group， the EDS group had significantly higher HAMA， HAMD， NMSS， PDSS， and RBDQ-HK scores （P<0.05）. The network analysis showed that NMSS had the highest centrality （strength=0.906） in the non-EDS group， serving as the core node of the NMS network. However， in the EDS group， there was a significant increase in the centrality of olfactory function （strength=0.930）， replacing NMSS as the core of the network， and there was also an increase in the influence of RBDQ-HK （strength=0.318）. Conclusion EDS is closely associated with multiple NMS in PD patients， and the state of somnolence may alter the structure of the NMS network. Further studies can be conducted to investigate the role of the sleepiness-olfaction-emotion axis in the development of EDS.
Parkinson Disease

BACKGROUND:Kinesio taping is often used for the treatment of various sports injuries.The methods of foot and ankle sports taping are complex and diverse.Among them,Fascia taping is applicable to a wider range of people and can be used for different foot posture types,but it still lacks of practical verification,and its specific biomechanical role is not clear. OBJECTIVE:To observe the changes in plantar pressure characteristics of subjects with different foot positions during walking and jogging after Fascia taping. METHODS:Thirty-seven young healthy subjects were recruited from the Yantai campus of Binzhou Medical University to conduct the test.They were scored according to the foot posture index-six items version,and were divided into the supination foot group,the neutral foot group,and the pronation foot group.The static foot morphological indexes(including navicular drop,arch height index,arch height flexibility-longitudinal arch,and arch height flexibility-transverse arch)and the pressure-time integral of each foot zone during walking and jogging were collected and calculated respectively before and after Kinesio taping.The specific biomechanical mechanism of Fascia taping was analyzed. RESULTS AND CONCLUSION:(1)General data:There was no statistical difference among the three groups of subjects in general data,such as gender,height,and body mass index(P>0.05).Before taping,there was a significant difference in the foot morphological indexes and the areas of the outer front foot,midfoot,and hindfoot between different foot posture groups(P<0.01).(2)Static foot morphological indexes:After taping,there was no statistically significant difference between the groups in navicular drop,arch height flexibility-longitudinal arch,and arch height flexibility-transverse arch(P>0.05),while there was still a significant difference between the groups in the arch height index(P<0.05).In the supination foot group,the arch height index increased slightly,but there was no significant difference before and after taping(P>0.05).In the pronation foot group,the navicular drop and arch height flexibility-longitudinal arch was significantly reduced,and the arch height index was increased.There was a significant difference before and after taping(P<0.05).(3)The index of plantar pressure during walking:After taping,there was no significant difference between the three groups in the area of lateral forefoot and medial midfoot(P>0.05).In the pronation foot group,the lateral load of the forefoot increased after taping(P<0.05).In the supination position group,the load of the lateral forefoot and midfoot regions increased significantly(P<0.05),while the difference in the rear foot region was not significant(P>0.05).(4)The index of plantar pressure during jogging:After taping,there was no statistically significant difference between groups in the lateral forefoot(P>0.05).In the pronation foot group,the load of the medial forefoot increased significantly(P<0.05).In the supination position group,the load of the lateral forefoot,the middle foot and the rear foot region increased significantly(P<0.05).(5)The results showed that the Fascia taping was suitable for different foot postures.It could not only correct the static foot structure of subjects with different foot postures,but also regulate the abnormal plantar pressure distribution during the dynamic activities of walking and jogging,and the load of the midfoot,forefoot,and hindfoot in the supination and pronation posture tended to normal foot posture load level.

On the basis of the clinical characteristics of atherosclerosis(AS)in traditional Chinese medicine(TCM)and Western medicine,this paper analyzes common animal models of AS.The coincidence of clinical characteristics of the models was scored in the hope of providing new ideas and a reference for those studying AS.This paper reviews the varieties,modeling method,modeling principles,and characteristics of common animal models of AS.Moreover,similarities among common animal models,in terms of their clinical diagnostic criteria and symptom characteristics,were assessed.High-fat feeding type,mechanical injury combined with high-fat feeding type,genetic engineering combined with high-fat feeding type,chemical induction combined with high-fat feeding type,and combined Chinese clinical syndrome and Western disease AS models are widely established.Comparative analysis showed that balloon injury combined with high fat feeding type,ApoE receptor-knockout mouse combined with high-fat diet type,and phlegm and blood stasis type models of disease and symptom combinations showed a comparatively high level of clinical agreement between Chinese and Western medicine.Presently,most animal models of AS have a high degree of relevance to Western medicine,and the evaluation criteria used for the models are predominately from a Western medicine perspective.Models that combine disease and syndrome are lacking,hindering the development of wholism concepts and treatment through the differentiation of syndromes used in TCM.Therefore,establishing an animal model with a high degree of accuracy and coincidence between TCM and Western perspectives that combines the disease and its TCM symptoms is a top priority for studying the prevention and treatment of AS.

ObjectiveTo explore the effect of core stability training on dynamic balance and surface electromyography (sEMG) after anterior cruciate ligament reconstruction (ACLR), and to analyze the correlation between balance index and sEMG. MethodsFrom March to December, 2022, 32 patients with ACLR in Yantai Affiliated Hospital of Binzhou Medical University were randomly divided into control group (n = 16) and experimental group (n = 16). The control group accepted routine rehabilitation treatment, and the experimental group added core stability training, for six weeks. They were evaluated with American Hospital for Special Surgery Knee Score (HSS) and International Knee Documentation Committee Knee Score (IKDC), and the dynamic balance function and sEMG were measured before and after treatment, and the correlation between dynamic balance index and root mean square (RMS) of sEMG was analyzed. ResultsAfter treatment, the scores of HSS and IKDC increased significantly in both groups (|Z| > 3.526, |t| > 63.544, P < 0.001), and were better in the experimental group than in the control group (Z = -2.392, t = 2.650, P < 0.05); the length of gait line and single support line increased significantly, the medial-lateral displacement displacement decreased (|t| > 2.368, Z = -3.516, P < 0.05), and they were better in the experimental group than in the control group (|t| > 2.497, Z = -3.091, P < 0.05); the RMS of gluteus maximus and gluteus medius increased in the experimental group (t = -5.900, Z = -2.741, P < 0.01), and were better than those in the control group (t = 3.930, Z = -3.260, P < 0.01). After treatment, the RMS of gluteus maximus and gluteus medius in both groups were positively correlated with gait line length and single support line length, and were negatively correlated with medial-lateral displacement (|r| > 0.502, P < 0.01). ConclusionCore stability training could significantly improve knee joint function and dynamic balance, and enhance the activation of gluteus maximus and gluteus medius. Dynamic balance is highly correlated with sEMG.

Objective:To establish a three-dimensional (3D) U-net-based deep learning model, and to predict the 3D dose distribution in CT-guided cervical cancer brachytherapy by using the established model.Methods:The brachytherapy plans of 114 cervical cancer cases with a prescription dose of 6 Gy for each case were studied. These cases were divided into training, validation, and testing groups, including 84, 11, and 19 patients, respectively. A total of 500 epochs of training were performed by using a 3D U-net model. Then, the dosimetric parameters of the testing groups were individually evaluated, including the mean dose deviation (MDD) and mean absolute dose deviation (MADD) at the voxel level, the Dice similarity coefficient (DSC) of the volumes enclosed by isodose surfaces, the conformal index (CI) of the prescription dose, the D90 and average dose Dmean delivered to high-risk clinical target volumes (HR-CTVs), and the D1 cm 3 and D2 cm 3 delivered to bladders, recta, intestines, and colons, respectively. Results:The overall MDD and MADD of the 3D dose matrix from 19 cases of the testing group were (-0.01 ± 0.03) and (0.04 ± 0.01) Gy, respectively. The CI of the prescription dose was 0.70 ± 0.04. The DSC of 50%-150% prescription dose was 0.89-0.94. The mean deviation of D90 and Dmean to HR-CTVs were 2.22% and -4.30%, respectively. The maximum deviations of the D1 cm 3 and D2 cm 3 to bladders, recta, intestines, and colons were 2.46% and 2.58%, respectively. The 3D U-net deep learning model took 2.5 s on average to predict a patient′s dose. Conclusions:In this study, a 3D U-net-based deep learning model for predicting 3D dose distribution in the treatment of cervical cancer was established, thus laying a foundation for the automatic design of cervical cancer brachytherapy.

Dental resin materials have been widely used in the treatment of dental defects. However, the polymerization shrinkage of the resin materials tends to cause microleakage and accumulation of bacterial plaque, which leads to secondary dental caries. Endowing dental resin with antibacterial properties is an important way to solve this problem. Adding antibacterial agents to dental resin is the main method to give it antibacterial properties. Antimicrobial agents are mainly divided into three types: release type, non-release type and mixed type. In terms of antibacterial effects, the selection and addition of antibacterial agents will affect the antibacterial and mechanical properties of dental resin materials; and the long-term antibacterial effect of antimicrobial agents in the oral cavity remains to be verified; as antimicrobial agents or other environmental factors can lead to drug resistance and even dormant persistent bacteria. In recent years, researchers have been committed to improving the antibacterial effect by modifying antibacterial agents. The sustained release of antimicrobial agents via carriers is also the main research direction. This paper reviews the research progress on the antibacterial properties of dental resin materials.

Clonal hematopoiesis is a special mode of hematopoiesis in which hematopoietic stem cells with specific genetic and molecular biological characteristics differentiate into mature blood cells. It is the basis of a variety of hematological diseases. In depth study of its etiology, mechanism and characteristics are conducive to our understanding of the value of clonal hematopoiesis in different populations or diseases. This article reviews the latest progress in clonal hematopoiesis and its related clonal diseases.

Objective:To explore the effects of periodic target teaching combined with scenario simulation training in teaching for practical nurses in Cardiac Care Unit (CCU) .Methods:From January 2017 to December 2018, we selected practical nurses of CCU in the Yantai Affiliated Hospital of Binzhou Medical University by convenience sampling as the research object. Interns from January to December 2017 were in control group ( n=45) , and interns from January to December 2018 were in observation group ( n=51) . Control group implemented the traditional teaching model. On the basis of traditional teaching model, observation group applied the periodic target teaching combined with scenario simulation training. After one month of practice, we compared the theoretical and operational performance of interns between two groups and their satisfaction with teaching. Results:After one month of practice, the theoretical and operational performance of interns of observation group were higher than those of control group with statistical differences ( P<0.05) . Satisfaction with teaching of observation group was higher than that of control group also with a statistical difference ( P<0.05) . Conclusions:Periodic target teaching combined with scenario simulation has a good application effect in CCU interns which can improve the examination results of interns and their satisfaction with teaching.

Objective To certify that Chlamydia can spread from the genital tract to the gastrointestinal tract for long-lasting colonization.Methods Totally,120 female C57BL/6J mice aged 5-6 weeks were divided into 4 experimental groups to be inoculated with purified Chlamydia muridarum (C.muridarum) elementary bodies in the vagina (n =35),gastric area (n =30),anus and rectum (n =30),retro-orbital venous plexus (n =5) respectively.Moreover,corresponding negative groups inoculated with sucrose phosphate glutamate buffer (n =5) were set up for each experimental group.On days 3,7,and every 7 days,vaginal and rectal discharges were collected with swabs from the mice,and the number of live C muridarum orgnisms in exfoliated cells infected with C muridarum in the swabs was determined.Indirect immunofluorescence assay and quantitative PCR (qPCR) were performed to determine the number of live chlamydial organisms and the copy number of chlamydial genomes in the mouse genital tract (vagina,uterus,oviduct and ovary),gastrointestinal tract (stomach,small intestine,cecum,colon,rectum)and parenteral tissues (heart,liver,spleen,lung,kidney) on days 7,14,28,56 and 105 after the inoculation.The number of live chlamydial organisms and copy number of chlamydial genomes were transformed logarithmically with a base of 10.The degree of hydrosalpinx and inflammation in the genital tract,and histopathological changes of the gastrointestinal tract were observed.The infectivity and virulence of C.muridarum in the genital tract and gastrointestinal tract were evaluated in the intragastric inoculation group and intra-anal and intrarectal inoculation group on days 28 and 56 after the inoculation.Blood samples were obtained from the mouse caudal vein in the retro-orbital venous plexus inoculation group on days 3,5,7,10 and 14 after the inoculation,the number of live chlamydial organisms and the copy number of chlamydial genomes in the blood samples were determined,and chlamydial infectivity in the genital tract and gastrointestinal tract was evaluated on day 56.Results On day 7 after the inoculation in the vagina,both C.muridarum live organisms and genomes were detected in the genital tract,gastrointestinal tract and parenteral tissues of all the mice.The largest common logarithm of the number of C.muridarum inclusion forming units (IFU) was observed in the vagina (6.26 ± 0.56),with the common logarithm of the copy number of chlamydial genomes in the vagina being 7.30 ± 0.23,and the common logarithms of the number of Chlamydia IFU and genomic copy were 2.60 ± 1.95 and 4.87 ± 0.09 respectively in the rectum.On day 28,no live Chlamydia was detected in the heart,lung or other parenteral tissues,while live Chlamydia could be found in the genital tract and gastrointestinal tract.The common logarithms of the number of Chlamydia IFU and genomic copy were 3.47 ± 1.06 and 5.80 ± 1.49 respectively in the vagina,and 4.00 ±0.35 and 5.14 ± 0.81 respectively in the rectum.On day 56,live Chlamydia could only be detected in the gastrointestinal tract.On day 105,live Chlamydia and its genomes could be still detected in the gastrointestinal tract,and the common logarithms of the number of Chlamydia IFU and genomic copy could be up to 2.60 ± 0.65 and 4.29 ± 0.57 respectively in the rectum.On days 28 and 56 after the inoculation,both live Chlamydia and its genomes could be detected in the gastrointestinal tract of all the mice in the intragastric inoculation group and intra-anal and intrarectal inoculation group.Chlamydia could survive in the blood for about 14 days in the retro-orbital venous plexus inoculation group,and live Chlamydia was detected in anal-rectal swabs in all the mice on day 14.On day 56 after the intravaginal inoculation with C.muridarum,severe hydrosalpinx,chronic inflammation and oviduct dilation occurred in the genital tract of 5 mice,but there was no obvious infiltration of inflammatory cells in the gastrointestinal tract,and inflammatory pathological changes were not observed in the gastrointestinal tract of mice after inoculation with Chlamydia through other routes either.Conclusion The infection with Chlamydia in the genital tract can lead to systemic dissemination,and Chlamydia can be spread to the gastrointestinal tract,and colonize and survive in the gastrointestinal tract for a long time.