Objective Evaluation of the efficacy of high-frequency repetitive transcranial magnetic stimulation for chronic disturbance of consciousness after severe craniocerebral injury based on magnetic resonance spectroscopy.Methods The clinical data of 106 patients with chronic disturbance of consciousness after severe craniocerebral injury from January 2018 to December 2022 were retrospectively analyzed,and they were divided into control group(conventional rehabilitation treatment)and observation group(high frequency repetitive transcranial magnetic stimulation treatment)by propensity score matching method(1∶1),with 53 cases in each group.Both groups were examined by magnetic resonance spectroscopy(MRS)before and after treatment.The brain metabolic indexes[N-acetyl aspartate(NAA)/creatine(Cr)value,choline complex(Cho)/Cr value],Glasgow coma scale(GCS)score,electroencephalogram(EEG)grading,coma recovery scale(CRS-R)score,brainstem auditory evoked potential(BAEP)grading,upper limb sensory evoked potential(SSEP)grading and Cerebral blood flow perfusion index[cerebral blood volume(CBV),mean transit time(MTT),cerebral blood flow(CBF)]were compared between the two groups.Results After treatment,the NAA/Cr values of the thalamus and brainstem in the two groups increased,while the Cho/Cr values decreased,and the levels of brain metabolic indexes in the observation group were signifi-cantly better than those in the control group(P<0.05).The two groups'GCS score and CRS-R score increased,and the improvement of the observation group was better than that of the control group(P<0.05).The BAEP grading,EEG grading,and SSEP grading of the two groups improved,and those of the observation group were better than the control group(P<0.05).The CBF and CBV of the two groups increased,and MTT decreased,and the level of cere-bral blood perfusion index in the observation group was better than that in the control group(P<0.05).Conclusion High frequency repetitive transcranial magnetic stimulation has a significant effect on the recovery of patients with chronic consciousness disorders after severe craniocerebral injury.The mechanism may be related to improving the blood flow velocity of brain tissue and metabolism in the brain.

OBJECTIVE To investigate the expression of transforming growth factor-beta 1(TGF-β1)and bone morphogenetic protein-2(BMP-2)in patients with chronic rhinosinusitis with nasal polyps(CRSwNP).METHODS A cohort of 44 CRSwNP patients and 32 control subjects was included in the study.The expression levels of TGF-β1 and BMP-2 proteins in the peripheral blood and nasal polyp tissues of CRSwNP patients were measured.The correlations with Lund-Mackay scores and global osteitis scoring scale(GOSS)scores were analyzed.RESULTS Compared to the control group,the peripheral blood level of TGF-β1 protein in CRSwNP patients was significantly reduced(t=2.650,P=0.009),while the expression difference of BMP-2 was not statistically significant.In the nasal polyp tissues,both TGF-β1(t=13.180,P<0.001)and BMP-2(t=8.699,P<0.001)protein expressions were decreased.TGF-β1 was most abundantly expressed in the glandular epithelium of the polyps,whereas BMP-2 showed higher expression in the mucosal epithelium.CONCLUSION The expression of TGF-β1 is downregulated in CRSwNP patients;an increase in BMP-2 may assist in the identification of refractory CRSwNP cases.

Objective:To compare the efficacy and safety of 2 940 nm fractional erbium laser combined with fractional micro-plasma radiofrequency (FMR) therapy and 2 940 nm fractional erbium laser in the treatment of atrophic acne scars.Methods:A prospective randomized controlled research was conducted. A total of 100 atrophic acne scar patients (38 males and 62 females, aged 18-37 years) who were treated in the Scar Laser Clinic of the Department of Plastic and Reconstructive Surgery of Shanghai Ninth People's Hospital of Shanghai Jiao Tong University School of Medicine from March 2018 to March 2021 and conformed to the inclusion criteria were recruited. The patients were randomly divided into erbium laser+FMR group and erbium laser alone group, with 50 cases in each group. The facial acne scars of patients in erbium laser alone group were treated with 2 940 nm fractional erbium laser, while the facial acne scars of patients in erbium laser+FMR group were treated with erbium laser as above, besides, the scars of U and M types were treated with FMR, once every 3 months for a total of 3 times. Before the first treatment and 3 months after each treatment, the Echelle D'Assessment Clinique des Cicatrices D'Acne (ECCA) was used to score the scar. The occurrence of adverse reaction during the treatment process was observed and recorded, and the incidence was calculated. Three months after the last treatment, the 5-level classification method was used to evaluate the satisfaction of patients with the treatment effect, and the satisfaction rate was calculated. Data were statistically analyzed with independent sample t test and chi-square test. Results:A total of 89 patients completed the study, including 46 patients in erbium laser+FMR group (19 males and 27 females, aged (26±5) years) and 43 patients in erbium laser alone group (15 males and 28 females, aged (27±6) years). The ECCA scores before the first treatment and 3 months after the first treatment of patients were similar between the two groups ( P>0.05). The ECCA scores of patients in erbium laser+FMR group at 3 months after the second and third treatment were 72±23 and 61±18, respectively, which were significantly lower than 85±26 and 76±25 in erbium laser alone group (with t values of -2.45 and -3.26, respectively, P<0.05). During the treatment process, the incidence of adverse reaction of patients in erbium laser+FMR group and erbium laser alone group were 23.91% (11/46) and 16.28% (7/43), respectively, and there was no statistically significant difference between the two groups ( P>0.05). The satisfaction rate of patients in erbium laser+FMR group was 78.26% (36/46) at 3 months after the last treatment, which was significantly higher than 53.49% (23/43) in erbium laser alone group ( χ2=6.10, P<0.05). Conclusions:The 2 940 nm fractional erbium laser combined with FMR is superior to 2 940 nm fractional erbium laser alone in the treatment of facial atrophic acne scars, achieving significantly higher efficacy without significantly increasing the incidence of adverse reaction, and patients are more satisfied with the efficacy. It can be used as a recommended therapy in clinical practice.

ObjectiveTo study the epidemiological characteristics of deaths due to pneumoconiosis and its complications in order to improve the prevention and management of pneumoconiosis. MethodsThe pneumoconiosis deaths who died during 1959‒2019 in Chongming District of Shanghai were investigated and analyzed retrospectively by the descriptive epidemiological methods. The correlation of the age of onset and the course of disease was analyzed by Spearman rank correlation，as well as the duration of dust exposure and the course of disease in pneumoconiosis patients. ResultsFrom 1959 to 2019， there were 226 pneumoconiosis deaths， 223 males （98.67%）. The mortality of silicosis was the highest （82.07%）. The age of onset of pneumoconiosis was negatively correlated with the course of disease （r_s=-0.596，P<0.001）.There was no correlation between the duration of dust exposure and the course of disease in pneumoconiosis patients （r_s=-0.107，P=0.109）.There were statistically significant differences in mortality among groups in different types and stages of pneumoconiosis（χ²=59.250，27.666，both P<0.05）. The mortality increased with the increase of stage of pneumoconiosis. The mortality of pneumoconiosis was significantly different in 1959‒1979， 1980‒1989， 1990‒1999， 2000‒2009 and 2010‒2019 （χ²=29.750， P<0.05）. The top three causes of death in pneumoconiosis cases were respiratory diseases， malignant tumor and cardiovascular and cerebrovascular diseases.ConclusionIt is suggested to further strengthen the health monitoring and management of pneumoconiosis patients，control lung and chronic respiratory diseases to delay the life expectancy and improve quality of life of pneumoconiosis patients.

Objective:To explore the significance of empathy and executive function indexes in the diagnosis and classification of autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD).Methods:According to DSM-Ⅴ diagnostic criteria, 33 children with ASD, 30 children with ADHD and 39 typical development (TD) children and adolescents were enrolled as the research subjects.The empathy and executive function characteristics were compared and analyzed in the subjects.Based on empathy and executive function indicators, the three groups of subjects were diagnosed and classified by machine learning method.Results:The total score of Griffith empathy measure parent ratings(GEM-PR)(ASD: (0.67±0.64), ADHD: (1.00±0.79), TD: (0.98±0.73)) and each factor score ( F=3.595-10.363, all P<0.05) and the total score of behavior rating inventory of executive function(BRIEF)(ASD: (62.79±7.45), ADHD: (59.47±8.77), TD: (49.08±7.91)) and each factor score of the three groups were different ( F=6.557-33.205, all P<0.01). Among them, the scores of empathy and executive function in ASD and ADHD groups were generally higher than those in TD children (all P<0.05). When combined with BRIEF scale and GEM scale, the classification accuracy of the three groups reached 62.75%. Conclusion:Both ASD and ADHD children have damages in empathy and executive function.Combining empathy and executive function indexes are more helpful for diagnosis and classification than single index.

Preeclampsia (PE) is characterized by hypertension and proteinuria. Despite extensive research, the etiology and pathogenesis of PE are not completely understood. Increasing evidence suggests that an exaggerated maternal systemic inflammatofrery response may play a central role in the pathogenesis of preeclampsia (PE). Regulatory T cells (Tregs) are a specialized subpopulation of T cells that act as potent suppressors of inflammation to prevent autoimmunity and graft rejection. A reduction in maternal Treg populations could prevent immunological tolerance of the fetus and has been associated with obstetrical complications, such as miscarriage, PE. The research of Treg in immunology is the focus of current research. In this paper, the relationship between the occurrence and development of regulatory Treg in preeclampsia is reviewed.

Objective:To explore the influencing factors of self-management of diabetics in community so as to provide a scientific basis for personalized self-management of diabetics.Methods:From March 2016 to August 2017, this study selected 980 diabetics from 6 communities in Chaoyang District of Beijing by convenience sampling. All of patients were investigated with the self-management, nursing instruction need and medication adherence questionnaire and the medication adherence scale to understand the self-management, such as blood glucose management, exercise, medication adherence and nursing instruction need. Simple correlation and multiple regression were used to analyze the influencing factors of self-management, nursing instruction need and medication adherence.Results:Among those diabetics in community, the score of self-management was (1.76±0.25) . The score of nursing instruction need was (1.73±0.29) with medication instruction need dimension for the highest and diabetic knowledge instruction need dimension for the lowest. The score of medication adherence was (3.48±0.64) with unauthorized drug withdrawal dimension for the highest and times of taking medicine dimension for the lowest. Simple correlation showed that there were statistical differences in the scores of self-management among patients with different on-the-job situations and education levels ( P<0.05) , and in the score of nursing instruction need among patients with different education levels ( P<0.05) , and in the scores of medication adherence among patients with different ages, on-the-job situations and diagnosed ages ( P<0.05) . Multiple regression analysis showed that the influencing factor of self-management and nursing instruction need was the education level ( P<0.05) , and the influencing factor of self-management was the on-the-job situation ( P<0.05) , and the influencing factor of medication adherence was the age ( P<0.05) . Conclusions:Among diabetics in community, the self-management is influenced by the education level and on-the-job situation; nursing instruction need is influenced by the education level; the medication adherence is influenced by the age. We should increase the self-management of patients with the low level of education and on-the-job, provide nursing instruction for patients with the high level of education, promote the medication adherence of diabetics with low ages so as to improve the self-management and quality of life of patients.

Objective The aim of this study was to evaluate the number of Treg cells in preeclamp-sia (PE) patients, to explore the expression levels of microRNA-210 (microRNA-210) and forkhead box p3 (Foxp3) genes in preeclampsia, and to reveal the regulatory mechanism of microRNA-210 and Foxp3 in preeclampsia. Methods Serum levels of cytokines [ interleukin ( IL)-6, IL-10, IL-17, and transforming growth factor-beta 1 (TGF-β1)] were detected with enzyme-linked immunosorbent assay (ELISA). 29 pa-tients with late-onset preeclampsia (≥36 weeks of gestation) , 27 pregnant women with normal uncomplicat-ed pregnancies (≥36 weeks of gestation) and 20 healthy non-pregnant women were enrolled in the study. Reverse-transcription polymerase chain reaction ( qRT-PCR) was performed to detect mRNA expression for maternal placenta retinoic acid-related orphan receptor C (RORc), Foxp3, and miR-210. Foxp3 protein expression was evaluated by Western blot. Results ⑴The serum levels of IL-6, IL-17 and TGF-beta 1 in preeclampsia patients were significantly higher than those in normal pregnant women, and the level of Treg cytokine IL-10 was lower than that in normal pregnant women ( P <0. 05 ) . ⑵ The percentage of CD4 +CD25 +CD127 - /CD4 +T cells in peripheral blood of preeclampsia patients was significantly lower than that of normal pregnancy group and healthy non-pregnant women ( P <0. 001 ) . ⑶ The mRNA expression of Foxp3 in placenta of preeclampsia patients was significantly lower than that of normal pregnant women, RORc in preeclampsia patients was significantly higher than that of normal pregnant women, and the expres-sion of microRNA210 in preeclampsia patients was enhanced ( P<0. 01 ) . ⑷ Consistent with mRNA ex-pression results, lower protein expression levels of Foxp3 was observed in patients with PE compared with normal pregnant subjects. Conclusions Treg cells decreased in preeclampsia patients and Treg/Th17 im-balance existed in preeclampsia patients, which regulate maternal immune tolerance to fetuses. The expres-sion of Foxp3 in placenta of preeclampsia patients was significantly decreased, which was correlated with the expression of microRNA-210.

Objective To measure the body surface dose under different confinations of additional filters,tube voltage and tube current and discuss the lowest amount of different additional filters,tube voltage and tube current combination for crib side X-ray radiation dose while the quality of the image is guaranteed.Methods Japan Shimadzu wireless tablet mobile DR machine and Dutch Artinis CDRAD 2.0 phantom were used.The tube voltage and tube current for children's crib side X-ray normal work were 50 kV and 1.40 mAs to get the image quality figure inverse (IQFInv),respectively.Totally four filter combinations of 1 mm A1,2 mm A1,1+2 mm A1 and 0.3 mm Cu were added to the opening of collimator system by mobile DR machine.Phantom was shot by respectively combination of 50,66,83 and 100 kV tube voltages and different tube currents.All images to get the IQFInv value,Pearson correlation and regression analysis of the influence of tube voltage and current on IQFInv value were analyzed.The IQFInv value of the additional filter corresponds to the image quality of normal work.The combination of the additional filter with the tube voltage and the tube current was also found.Swedish RTI Barracuda diagnostic level dosimeter was used to measure the entrance surface dose of these combinations after filtration,20 times for each group.Results Comparisons among different filters,tube voltage and tube current combination with quality of daily work images:the tube voltage was positively correlated with IQFInv value in the test range(r=0.49,P＜0.05),and tube current was positively correlated with IQFInv value (r=0.36,P＜0.05).As the additional filters increase,it required greater tube current to acquire the desired value of images.Meanwhile,greater additional filters would increase the difference of IQFInv of tube voltage at each level.Comparisons among different filters,tube voltage and tube current combination with daily shooting dose,and after using additional filters,entrance surface dose changed from (30.58±0.21)to (10.49±0.09) μGy.There is a significant difference between each group (t=-15.306-514.585,P＜0.05).All additional filters effectively reduced entrance surface dose.Meanwhile,as the filter and tube voltage increased,entrance surface dose showed a more significant reduction.However,when the tube voltage exceeded 83 kV,all entrance surface dose of additional filters showed an increasing trend.Conclusions Additional filter is an effective method to reduce the crib side X-ray entrance surface dose.Under the premise of ensuring image quality,additional filter with high atomic number and second high kilovolt tube voltage with paired tube current is the best condition for crib side X-ray.

Objective To evaluate the effect of pulsed radiofrequency (PRF) on the phenotypic transformation of the lumbar sympathetic ganglion (LSG) in the rats with diabetic neuropathic pain (PDN).Methods Twenty-four clean-grade healthy adult male Sprague-Dawley rats,aged 2 months,weighing 180-220 g,were divided into 4 groups (n =6 each) according to the method of random number table:control group (group C),group PDN,group PRF,and PRF control group (group PC).The PDN model was established by intraperitoneal injection of streptozotocin 60 mg/kg in anesthetized rats.Citrate-sodium citrate buffer 6 ml/kg was intraperitoneally injected in group C.Group PC only received radiofrequency needle puncture.PRF was performed on the right L3 LSG in group PRF.The mechanical paw withdrawal threshold (MWT) to yon Frey filament stimulation was measured before intraperitoneal injection (baseline,T0),before PRF and at 1,3,5,7 and 14 days after PRF.The rats were then sacrificed,and ipsilateral L3 LSGs were removed for determination of the expression of tyrosine hydroxylase (TH) and vesicle glutamate transporter2 (VGLUT2) in LSGs (by double immunofluorescent staining) and for examination of pathological changes (with a light microscope).The number of neurons expressing VGLUT2 was counted.Results Compared with group C,the MWT was significantly decreased at T1-6,and the number of neurons expressing VGLUT2 was increased at T6 in PDN,PC and PRF groups (P＜0.05).Compared with PDN and PC groups,the MWT was significantly increased at T2-6,and the number of neurons expressing VGLUT2 was decreased at T6 in group PRF (P＜0.05).TH expression in LSGs was found,and no VGLUT2 expression in LSGs was observed in group C,the expression of TH and VGLUT2 in LSGs was found in the other three groups,especially in PDN and PC groups,and most of the neurons expressing VGLUT2 expressed TH simultaneously.Conclusion The mechanism by which PRF mitigates PDN is related to inhibiting the phenotypic transformation of LSGs in the rats.