Objective:To investigate the potential factors influencing the recovery of consciousness levels during the rehabil-itation process of patients with prolonged disorders of consciousness (DOC) following brain injury,and to as-sess the impact of different treatment strategies on consciousness level recovery.Method:A retrospective analysis was conducted on clinical data,consciousness level scores,clinical medica-tion usage,and rehabilitation treatment plans of 72 patients with DOC who were admitted to our rehabilitation medicine department from 2017 to 2022.Result:Factors such as difficulty in tracheostomy tube removal,hydrocephalus,elevated muscular tension ab-normalities,poor infection control,and inadequate control of non-infectious complications significantly affected the improvement of consciousness levels. Regarding medications,the injection of botulinum toxin for muscular tension control and the use of amantadine had a significant impact on improving consciousness levels. The use of selective serotonin reuptake inhibitors (SSRIs) showed a trend towards improving consciousness levels,but the differences were not statistically significant.Conclusion:During the rehabilitation process of patients with DOC following brain injury,addressing factorsthat influence consciousness levels is crucial. These factors include effective infection control,management of complications,early removal of tracheostomy tubes when feasible,active management of hydrocephalus,local injection of botulinum toxin to control elevated muscular tension,and the use of medications that may im-prove consciousness levels,such as amantadine and SSRIs.

Objective:To investigate the potential factors influencing the recovery of consciousness levels during the rehabil-itation process of patients with prolonged disorders of consciousness (DOC) following brain injury,and to as-sess the impact of different treatment strategies on consciousness level recovery.Method:A retrospective analysis was conducted on clinical data,consciousness level scores,clinical medica-tion usage,and rehabilitation treatment plans of 72 patients with DOC who were admitted to our rehabilitation medicine department from 2017 to 2022.Result:Factors such as difficulty in tracheostomy tube removal,hydrocephalus,elevated muscular tension ab-normalities,poor infection control,and inadequate control of non-infectious complications significantly affected the improvement of consciousness levels. Regarding medications,the injection of botulinum toxin for muscular tension control and the use of amantadine had a significant impact on improving consciousness levels. The use of selective serotonin reuptake inhibitors (SSRIs) showed a trend towards improving consciousness levels,but the differences were not statistically significant.Conclusion:During the rehabilitation process of patients with DOC following brain injury,addressing factorsthat influence consciousness levels is crucial. These factors include effective infection control,management of complications,early removal of tracheostomy tubes when feasible,active management of hydrocephalus,local injection of botulinum toxin to control elevated muscular tension,and the use of medications that may im-prove consciousness levels,such as amantadine and SSRIs.

Alcoholic liver disease (ALD) is a growing global health concern, and its early pathogenesis includes steatosis and steatohepatitis. Inhibiting lipid accumulation and inflammation is a crucial step in relieving ALD. Evidence shows that puerarin (Pue), an isoflavone isolated from Pueraria lobata, exerts cardio-protective, neuroprotective, anti-inflammatory, antioxidant activities. However, the therapeutic potential of Pue on ALD remains unknown. In the study, both the NIAAA model and ethanol (EtOH)-induced AML-12 cell were used to explore the protective effect of Pue on alcoholic liver injury in vivo and in vitro and related mechanism. The results showed that Pue (100 mg·kg^-1) attenuated EtOH-induced liver injury and inhibited the levels of SREBP-1c, TNF-α, IL-6 and IL-1β, compared with silymarin (Sil, 100 mg·kg^-1). In vitro results were consistent within vivo results. Mechanistically, Pue might suppress liver lipid accumulation and inflammation by regulating MMP8. In conclusion, Pue might be a promising clinical candidate for ALD treatment.

Objective:To explore the relationship between the changes of anorectal angle (ARA) under 3 physiological states and pelvic organ prolapse(POP) in postpartum women by transperineal ultrasound.Methods:The retrospective study enrolled 147 female in 6-8 weeks after delivery examined by pelvic floor ultrasound examinations in Fujian Medical University Second Affiliated Hospital from November 2019 to June 2021, who were divided into POP group and control group. Volume data of pelvic floor ultrasound examinations were obtained at rest, during contraction and during maximal Valsalva maneuver. The differences in the changes of ARA under 3 physiological states between the two groups were compared, and the correlation between the change state of ARA during maximal Valsalva maneuver and POP was analyzed.Results:Compared with ARA at rest, ARA decreased during contraction (χ 2=42.64, P<0.001) and increased during maximal Valsalva maneuver (χ 2=38.43, P<0.001). There was no difference of ARA between the POP group and control group in the 3 physiological states ( P>0.05). However, the risk of POP increased when ARA decreased during maximal Valsalva maneuver ( OR=2.690, 95% CI=1.074-6.739, P<0.05). Conclusions:The decrease of ARA during maximal Valsalva maneuver may increase the risk of POP, and the change of ARA during maximal Valsalva maneuver can be brought into the ultrasonic observation indicators of POP.

Objective:To investigate any change in the effective connectivity between the bilateral anterior central gyruses after transcranial magnetic stimulation (TMS).Methods:Twenty-one healthy subjects were examined using resting state functional magnetic resonance imaging (rs-fMRI) before and after receiving continuous theta burst stimulation (cTBS). The brain atlas of the Institute of Automation of the Chinese Academy of Sciences was used for fine partitioning of the bilateral anterior central gyruses. Granger causality analysis was used to compare any changes in the effective connectivity between them.Results:After the cTBS inhibited the right M1 area, significant changes in effective connectivity among the sub-regions of the bilateral M1 area were observed. The effective connectivity of the right upper limb to the left upper limb and the left head to face were weakened, while that of the left upper limb to the right head, as well as of the face to the right upper limb was enhanced.Conclusion:For people whose right M1 area has been inhibited by cTBS, the effective connectivity changes in both upper limb functional areas of the M1 region reflect inter-hemispheric inhibition. Opposite changes were found in the trunk and upper limbs.

Objective:To explore the effect of intermittent theta-burst stimulation (iTBS) of the cerebellum on the excitability of the M1 zone in the bilateral motor cortex and the duration of any effect.Methods:Twenty healthy youths were randomly assigned to a left or a right cerebellum iTBS group, each of 10. The resting motor threshold and motor evoked potential (MEP) of the motor cortex were determined before giving 600 pulses of iTBS. Then MEP was measured at the 5th, 10th, 15th, 20th, 25th, 30th, 35th and 40th minute after the intervention ended. Any changes in MEP amplitude were also analyzed.Results:①The average MEP amplitude in the right motor cortex had increased significantly in the left cerebellum iTBS group from the 5th to the 15th minute. The increase lasted at least 10 minutes. Then it had returned to the baseline value at the 35th minute. ②The MEP amplitude in the left motor cortex decreased slightly after iTBS of the left cerebellum began, but there were no significant changes. ③The MEP amplitude in the left motor cortex had a tendency to decrease after iTBS was administered to the right cerebellum, but that change too was not significant. ④The MEP amplitude of the right motor cortex decreased significantly only for the first 30 minutes.Conclusions:iTBS of the cerebellum can increase the excitability of the contralateral motor cortex. The effect can last 25 minutes. It can also decrease the excitability of the ipsilateral motor cortex for 30 minutes.

Objective: To investigate the diagnosis and clinical treatment of maxillofacial connective tissue hyperplastic trichoepithelioma. Methods: The clinical data of two cases of maxillofacial connective tissue hyperplastic trichoepithelioma were summarized and analyzed along with the literature Results : Two cases of maxillofacial connective tissue hyperplastic trichoepithelioma were male, aged 21 and 30 years. The clinical manifestations were painless pale brown and pale white plaques in the maxillofacial region. The lesion was tough and clear, with no ulcers in the middle depression. The course was 10-16 months, with 1-3 months before medical treatment, and the tumor had a significant history of enlargement. After surgery, the skin was cut 3 mm along the outer circumference of the tumor, and local tissue defects were repaired by the adjacent flap. The pathological report showed that the tumor cells were located in the dermis, and were striped, trabecular or nested. The tiny sac contained fibrous connective tissue proliferation. The tumor cells were amorphous without obvious nuclear division. Immunohistochemical analysis reported bcl-2(-), CK7(-), CK19(-), CD34(+), P63(+), CK56(+), and Ki67(±). The pathological diagnosis was connective tissue proliferative hair epithelial tumor. The patient was followed up for 24 months. There was no recurrence of the tumor, no obvious scarring, and no deformity or dysfunction of the maxillofacial region. Conclusion Pathological and immunohistochemical examination is the basis for the differential diagnosis of maxillofacial connective tissue hyperplastic trichoepithelioma, and surgical removal of tumors is an effective treatment.

Objective:To explore the effectiveness of evaluating voice disorders in dysarthria patients after brain injury using speech production measurements and analyze their phonics characteristics.Methods:Twenty-nine patients were divided into a severe dysarthria group ( n=19) and a mild dysarthria group ( n=10) through the subjective evaluation of their speech, and then evaluated using a computer speech monitor. The maximum phonation time (MPT), maximum counting ability (MCA), basic frequency (F0), standard deviation of F0 (F0SD), F0 range, intensity, formant, and the distance of jaw and tongue movements were recorded. Results:All of the patients displayed abnormal MPTs and MCAs, with the average MPT and MCA of the severe dysarthria group significantly lower than the mild group′s averages. In the severe dysarthria group, the abnormal F0s, F0SDs, F2(i)s and tongue movement distances were significantly greater than in the mild group.Conclusions:Speech production measurements can be applied to evaluate the speech dysarthria patients after brain injury. It is very common for such patients to have impaired speech and respiratory function, so this is worthy of attention.

Objective To investigate the clinical effect of minimally invasive extraction of anterior tooth residual root after root separation.Methods A total of 400 patients receivinganterior tooth residual root extraction were collected in the clinic of oral and maxillofacial surgery department between January 2015 and December 2016.The patients were divided into a control group and a study group according to their sequence to see the doctor,with an odd for the study group and an even for the control group.In the study group,residual roots were separated mesiodistally by high speed turbine before using minimally invasive extraction tool;while in the control group residual roots were extracted only using minimally invasive extraction tool.The surgical duration,postoperative damage rate of the lip side plate,degree of pain and patient satisfaction in the two groups were analyzed.Results The surgical duration was shorter in the study group compared with the control group (P ＜ 0.05).The postoperative damage rate of the lip side plate and the degree of pain were lower,while patient satisfaction was higher in the study group than in the control group (P ＜ 0.05).Conclusions The postoperative damage rate of the lip side plate is significantly lower in minimally invasive extraction of anterior tooth residual root after root separation.Smaller trauma is conducive to the implant afterwards.Root separation in minimally invasive extraction of anterior tooth residual root is valuable for clinical application.

OBJECTIVETo study the expression level of folate receptor α (FR-α) in glioma tissue and its clinical significance.

METHODSForty-eight human glioma specimens were collected from patients who underwent surgery from March 2012 to March 2013. These specimens were as follows:12 cases of glioblastoma (WHO IV), 6 cases of astrocytoma of each malignancy grade(WHO II, III), 6 cases of oligodendroastrocytoma of each malignancy grade (WHO II, III), 6 cases of oligodendroglioma of each malignancy grade (WHO II, III ). In addition, 6 cases of normal brain tissue resected from brain traumatic patients were taken as negative control, and one case of placental tissue (had got the consent of the parents and their families) was taken as positive control. The expression level of FR-α in tumor tissues was evaluated by Western blot analysis. The results of Western blot analysis were analyzed by t-test. The expression level of FR-α and Ki-67 in tumor tissues was evaluated immunohistochemistry, the results were analyzed by Kruskal-Wallis test and Nemenyi test. The correlation between the expression level of FR-α and cell proliferation index Ki-67 was analyzed by Pearson correlation analysis.

RESULTSWestern blot analysis showed that the FR-α was not expressed in normal brain tissue and oligodendroglioma tissue, but highly expressed in astrocytoma, oligodendroastrocytoma and gliomablastoma. The expression level in WHO III astrocytoma was significantly higher than in WHO II (t = 4.497, P < 0.05). FR-α was also highly expressed in oligodendroastrocytoma and its expression level in WHO III was also significantly higher than in the WHO II (t = 2.876, P < 0.05). Foremore, immunohistochemistry analysis also showed that FR-α was not expressed in oligodendroglioma, but expressed in astrocytoma, oligodendroastrocytoma and gliomablastoma. The positive rate of FR-α of WHO III was significantly higher than the WHO II astrocytoma(57.8% ± 2.2% vs. 45.7% ± 2.3%,χ(2) = 3.871, P = 0.034). In oligodendroastrocytoma, the positive rate of FR-α of WHO III was significantly higher than the WHO II(56.5% ± 5.4% vs. 37.1% ± 5.2%,χ(2) = 4.454, P = 0.021). Moreover, the expression level of FR-α in gliomablastoma was highest in all histological types of gliomas, the positive rate of FR-α was up to 65.0% ± 4.5%. Pearson correlation analysis showed that the positive rate of FR-α was positively correlated with Ki-67 index (r = 0.903, P < 0.05).

CONCLUSIONSFR-α is expressed in astrocytoma, oligodendroastrocytoma and glioblastoma, and the expression level of FR-α is positively correlated with malignancy grade and Ki-67 index. Therefore, FR-α may be applied as a special target for diagnosis and treatment of glioma.

Adolescent ; Adult ; Biomarkers, Tumor ; metabolism ; Brain Neoplasms ; metabolism ; Case-Control Studies ; Child ; Child, Preschool ; Female ; Folate Receptor 1 ; metabolism ; Glioma ; metabolism ; Humans ; Infant ; Ki-67 Antigen ; metabolism ; Male ; Middle Aged ; Young Adult