Objective:To observe the effects of transcranial direct current stimulation (tDCS) on functional connectivity (FC) in language-related brain regions of patients with picture-naming dysfunction after cerebral infarction by using resting state functional magnetic resonance imaging(rs-fMRI).Methods:Twenty-eight patients with post-infarction picture-naming dysfunction were divided into an acute stage group( n=16) and a recovery stage group( n=12) according to the course of the disease, and 18 middle-aged and elderly volunteers were recruited as the normal control group.The anodic tDCS was applied on the posterior perisylvian region(PPR) of the left sylvian of the patients, 5 days a week for 2 weeks.Before and after the 2 weeks′ treatment, the rs-fMRI and Psycholinguistic Assessment of Chinese Aphasia (PACA)-picture-naming subscale were performed, and FC changes in language-related brain areas were observed. Results:After treatment, the PACA scores of patients in both acute and recovery stage groups were significantly improved after treatment( P<0.05). Compared with normal subjects, FC in multiple brain regions and particularly the Wernicke area was reduced in both cerebral hemispheres among the patient group. It was more severe in the dominant hemisphere.After the tDCS treatment, FC in both frontotemporal lobes and in the Wernicke area was significantly enhanced in both the acute and recovery groups. Further comparison showed that in the acute group FC in both temporo-occipital lobes was significantly enhanced after treatment. In the recovery group, the enhanced FC in the left temporal lobe before the treatment was significantly reduced after treatment. Conclusion:The fMRI technique can evaluate changes in brain connectivity in aphasia patients with picture-naming dysfunction after cerebral infarction accurately and non-invasively.tDCS may improve picture-naming function of stroke patients by enhancing the FC in bilateral language-related brain areas(concentrated in frontotemporal lobes) and Wernicke area.

Background::Intrauterine valvuloplasty is an innovative therapy, which promotes ventricular growth and function in some congenital heart diseases (CHDs). The technique remains challenging and can only be performed in a few centers. This study aimed to assess the feasibility and mid-term outcomes of fetal cardiac intervention (FCI) in fetuses with critical CHD in an experienced tertiary center.Methods::Five fetal aortic valvuloplasty (FAV) or fetal pulmonary valvuloplasty (FPV) procedures were performed in our fetal heart center between August 2018 and May 2022. Technical success was defined as crossing the aortic or pulmonary valve and balloon inflation, followed by evidence of increased blood flow across the valve and/or new regurgitation. Follow-up clinical records and echocardiography were obtained during the prenatal and postnatal periods.Results::Five fetuses received FAV or FPV, including critical aortic stenosis ( n = 2) and pulmonary atresia with intact ventricular septum ( n = 3). The mean maternal age was 33.0 ± 2.6 years. The median gestational age (GA) at diagnosis was 24 weeks (range, 22-26 weeks). The median GA at intervention was 29 weeks (range, 28-32 weeks). All five cases underwent successful or partially successful procedures. One patient had pulmonary valve perforation without balloon dilation. No procedure-related deaths or significant complications occurred. However, one neonatal death occurred due to heart and renal failure. The median follow-up period was 29.5 months (range, 8.0-48.0 months). The four surviving patients had achieved biventricular circulation, exhibited improved valve, and ventricular development at the last follow-up visit. Conclusion::Intrauterine FCI could be performed safely with good prognosis in critical CHD.

Objective To analyze the infection status of Mycoplasma pneumoniae(MP)in the First Affilia-ted Hospital of Shandong First Medical University(the hospital)from 2019 to 2023 and explore the related influencing factors.Methods Basic admission information,test results,and related diagnostic results of 16 465 MP positive patients admitted to the hospital were collected,and the distribution characteristics of the number and disease types of MP positive patients in the hospital were analyzed.Results The positive rate of MP from high to low in the 5 years was in the years of 2021,2019,2020,2022,2023(P＜0.05).The proportion of MP positive cases in outpatient department from high to low was in the years of 2023,2021,2022,2019 and 2020(P＜0.05).Incidence was higher in spring and winter.In 5 years,the positivity rate of MP in respiratory tract infection patients was slightly higher in males than in females,the proportions of males in 2020 and 2022 were higher than those in 2019 and 2021(P＜0.05),and the proportions of males in 2019,2020,and 2022 were higher than that in 2023(P＜0.05).The age groups of MP infected patients were mainly concentrated in ado-lescents and infants under 14 years old.The positive results of patients in the 5 years were mainly distributed in titers of 1∶40,1∶80,and＞1∶160.There was no statistically significant difference in the proportion of positive results with MP total antibody≥1∶160 detected(P＞0.05).The top 5 clinical diagnoses of MP in-fected patients in thed hospital were fever,acute bronchitis,bronchopneumonia,chronic bronchitis,and pneu-monia,and the difference in the proportion of diagnostic results was statistically significant(P＜0.05).Conclu-sion This study clarifies the infection status of MP in the hospital from 2019 to 2023,and analyzes the impact of factors such as season,gender,and age on MP infection,which is of great significance for the prevention and control of respiratory infectious diseases in the hospital.

Objective:To investigate the echocardiographic features, consistency of diagnosis between fetal and postnatal periods and postnatal clinical outcomes of fetal pulmonary valve stenosis (PS) with different degrees.Methods:This study was a retrospective cohort study comprising 108 cases of fetal PS diagnosed during the fetal period and followed up postnatally at Xinhua Hospital, Shanghai Jiaotong University School of Medicine from November 2012 to February 2023. Echocardiographic characteristics, including morphological and hemodynamic features were collected for all fetuses who were then were followed up to at least 6 months after birth. One-way analysis of variance and Kruskal-Wallis test were used to compare the differences in the echocardiographic features among fetuses with different degrees of PS. Subsequently, McNemar test was used to assess the consistency of diagnosis between the fetal and postnatal periods. Furthermore, Logistic regression analysis was applied to explore the risk factors for neonatal intervention in fetuses with moderate PS and the receiver operating characteristic (ROC) curve was utilized to ascertain the optimal cut-off value for continuous variables.Results:The age of the mothers of the 108 fetuses at the initial assessment was (30.8±4.0) years, and the gestational age was 26.5 (24.6, 30.0) weeks. The fetuses were categorized into mild (17 cases), moderate (49 cases), and severe groups (42 cases) based on the initial echocardiographic features. Mild PS was characterized by valve thickening and hyperechogenicity combined with systolic flow acceleration or dilation of main pulmonary artery. Moderate PS exhibited both restricted valve motion and a colorful blood flow pattern at the valve orifice. The peak flow velocities of fetuses with moderate and critical PS were notably higher than those in the mild group ((2.66±0.86) and (2.77±1.30) vs. (1.43±0.59)m/s, F=14.52, P<0.001). In critical PS, all cases showed retrograde ductal flow, with a significantly higher proportion of a small right ventricle compared to the mild and moderate PS (42.9% (18/42) vs. 0 and 2.0% (1/49), χ2=31.73, P<0.001). The proportion of severe tricuspid regurgitation was also higher (35.7% (15/42) vs. 0 and 10.2% (5/49), χ2=36.94, P<0.001). Compared to mild and severe PS, the consistency of diagnosis between fetal and postnatal periods in moderate PS was lower (40.8% (20/49) vs.13/17 and 80.3% (35/42), χ 2=12.45, P=0.006). The systolic flow velocity was identified as an independent risk factor for neonatal intervention in fetuses with moderate PS ( OR=7.21, 95% CI2.11-24.62). A flow velocity of ≥2.18 m/s in second trimester and ≥3.15 m/s in third trimester indicated the necessity of neonatal intervention for fetal moderate PS. Among the 108 fetuses, 68 underwent surgical intervention and all survived. Additionally, 39 fetuses were regularly followed up. A sole non-surgical fatality occurred, leading to a 6-month survival rate of 99.1% (107/108). Conclusions:Various degrees of fetal PS demonstrate distinctive morphological and hemodynamic alterations in echocardiography. The disparity in severity between the postnatal and fetal stages requires ongoing monitoring for fetal PS. The prognosis for fetal PS is generally favorable.

Objective:To document any effect of transcranial direct current stimulation (tDCS) on the picture naming ability of stroke survivors with aphasia.Methods:Twenty-eight aphasic stoke survivors with picture naming dysfunction were divided into an acute group (with a course of disease of <1 month) and a convalescent group (with a course of disease of 2 to 6 months). Eighteen healthy subjects well-matched for age, gender and years of education formed the healthy control group. The patient group received tDCS once a day, 5 days a week for 2 weeks. Before and after the intervention, they were assessed using the Chinese psycholinguistic aphasia assessment (PACA) instrument. The activation of speech-related brain areas in everyone was quantified using resting state functional magnetic imaging (rs-fMRI).Results:After treatment the average PACA image naming scores of both the acute and convalescent groups had improved significantly. ALFF showed significant positive activation in the patient group′s right inferior temporal gyrus and negative activation in their left posterior central gyrus, while ReHo was significantly and positively activated in the right orbital superior frontal gyrus, the left medial superior frontal gyrus, the pericalar fissure cortex and the left parietal gyrus. It was, however, significantly negatively activated in the right posterior central gyrus. In the acute stage group, the ALFF was significantly and positively activated in the right superior frontal gyrus and right angular gyrus after the treatment, while the significant positive ReHo activation was in the right direct gyrus, the right angular gyrus, the right superior frontal gyrus and the right inferior temporal gyrus. In the convalescent group after the intervention the ALFF was significantly and positively activated in the left middle occipital gyrus and the right fusiform gyrus but negatively and significantly activated in the right insula, while ReHo was significantly and positively activated in the left superior temporal gyrus and the right angular gyrus.Conclusions:tDCS can improve the image naming of aphasic stroke survivors. The compensatory activation of language function is mainly in the right hemisphere in the acute stage, but in the convalescent stage the unimpaired brain area of the left cerebral hemisphere is also activated. The long-term recovery of language functioning may be the result of synergy between the hemispheres.

Objective:To investigate the diagnostic value of 99mTc-methylenediphosphonate(MDP) whole body bone scintigraphy in early brucellosis patients with bone and joint injuries. Methods:According to the Diagnosis for Brucellosis (WS 269-2019), combined with epidemiological history, clinical manifestations and serological tests, from November 2020 to April 2021, 15 early brucellosis patients (the course of disease was within 6 months) who had not received any drug treatment diagnosed at the Department for Brucellosis Prevention and Control, Qinghai Institute for Endemic Disease Prevention and Control were selected as the research subjects, and 99mTc-MDP whole body bone scintigraphy was performed on the patients to evaluate the images and analyze the pathological changes. Results:The 99mTc-MDP whole body bone scintigraphy of 15 patients with early brucellosis showed abnormalities, and the abnormal concentration of radionuclides mainly occurred in the 8th to 12th thoracic vertebrae (T8-12), the 1st to 2nd lumbar vertebrae (L1-2) and L4-5. Among them, the thoracic vertebrae abnormalities were T8, T9, T10, T11 and T12 in 1 case each; lumbar vertebrae abnormalities were 1 case of L1, 1 case of L2, 4 cases of L4, and 5 cases of L5. Conclusions:The 99mTc-MDP whole body bone scintigraphy is abnormal in patients with early brucellosis. Bone scintigraphy has certain value in the diagnosis of bone and joint injuries in patients with early brucellosis.

Objective:To learn about the epidemic situation and trend of human brucellosis in Menyuan Hui Autonomous County (referred to as Menyuan County) of Qinghai Province, and to provide reference for formulating brucellosis prevention and control measures in Menyuan County.Methods:Data on human brucellosis in Menyuan County reported by the Infectious Disease Reporting Information Management System of China Disease Control and Prevention Information System from 2013 to 2020 were collected and analyzed by descriptive epidemiological analysis (three distribution).Results:A total of 186 cases of brucellosis were confirmed from 2013 to 2020, with an average annual incidence of 14.553/100 000. The annual incidence rate was increasing year by year(χ 2trend = 22.08, P = 0.002). The cases were distributed in 67 villages of 12 towns; cases were more common in the age group of 15-< 65 years old (96.24%, 179/186), and there were more men than women cases (sex ratio was 3.89∶1.00, 148/38). Conclusions:The incidence rate of brucellosis cases in Menyuan County is increasing year by year, and the scope of its impact is constantly expanding. A multi-sectoral joint prevention and control mechanism should be established to strengthen management, increase the prevention and control of brucellosis, and stop the spread of the epidemic to surrounding counties and cities.

Peptide‒drug conjugates (PDCs) are drug delivery systems consisting of a drug covalently coupled to a multifunctional peptide via a cleavable linker. As an emerging prodrug strategy, PDCs not only preserve the function and bioactivity of the peptides but also release the drugs responsively with the cleavable property of the linkers. Given the ability to significantly improve the circulation stability and targeting of drugs in vivo and reduce the toxic side effects of drugs, PDCs have already been extensively applied in drug delivery. Herein, we review the types and mechanisms of peptides, linkers and drugs used to construct PDCs, and summarize the clinical applications and challenges of PDC drugs.

Objective:To explore the current situation of nursing human caring in hospital wards and analyze its influencing factors, so as to facilitate the development of nursing human caring practice.Methods:From July to November 2022, a total of 107 hospitals were surveyed through stratified convenience sampling method, and 4 072 ward nursing managers were recruited to finish the general information questionnaire and the ward nursing human caring status questionnaire. The general information included the region, class and type of the hospital, etc. The ward nursing human caring status questionnaire included 38 items in 5 dimensions of nursing human caring system and process, humanistic quality and training of nursing staff, humanistic environment and facilities, human caring procedures and measures, and human caring quality evaluation and improvement, with a full score of 190 points. Descriptive statistics were used to analyze the general data, independent samples t-test, ANOVA and correlation analysis were used to analyze the factors influencing the current status of nursing human caring in the ward, while multiple linear regression analysis was used to conduct a multivariate analysis. Results:The score of nursing human caring in hospital wards was 156.91±27.78. Whether the hospital had carried out nursing human caring pilot(demonstration) wards, whether the ward had previously been a hospital nursing human caring pilot(demonstration) nursing unit, the type of ward, and whether nursing managers had participated in human caring training were the influencing factors of the implication of nursing humanistic caring in wards( P<0.05). Conclusions:The practice of nursing human caring in hospital wards is at a good level, but needs to be further strengthened. Nursing managers should take systematically strategies to promote the development of nursing human caring practice.

Objective:To master the epidemic trend of human brucellosis in Qinghai Province, so as to provide basis for scientific prevention and control of the disease.Methods:In 2019 and 2020, at the national and provincial brucellosis monitoring sites in Qinghai Province, a total of 18 counties (cities and districts, hereinafter referred to as counties), no less than 400 serum samples were sampled every year for brucellosis Rose-Bengal plate agglutination test (RBPT) and serum tube agglutination test (SAT), which would be tested and judged according to the criteria of "Diagnosis for Brucellosis" (WS 269-2019).Results:In 2019, a total of 1 612 people were monitored in national brucellosis monitoring sites, 93 were RBPT positive, 54 were SAT positive, 54 were diagnosed, and the prevalence rate was 3.35% (54/1 612). In 2020, 1 677 people were monitored in national brucellosis monitoring sites, 151 were RBPT positive, 80 were SAT positive, 80 were diagnosed, and the prevalence rate was 4.77% (80/1 677). There were significant differences in RBPT positive rate, SAT positive rate and prevalence rate among national monitoring sites between the two years (χ 2 = 12.52, 4.24, 4.24, P < 0.05). In 2019, a total of 6 043 people were monitored in provincial brucellosis monitoring sites, 128 were RBPT positive, 91 were SAT positive, 87 were diagnosed, and the prevalence rate was 1.44% (87/6 043). In 2020, 5 664 people were monitored, 108 were RBPT positive, 59 were SAT positive, 52 were diagnosed, and the prevalence rate was 0.92% (52/5 664). There was no significant difference in RBPT positive rate among provincial monitoring sites between the two years (χ 2 = 0.66, P = 0.416), and the differences in SAT positive rate and prevalence rate were statistically significant among provincial monitoring sites between the two years (χ 2 = 4.98, 14.57, P < 0.05). Conclusion:In 2019 and 2020, there are human brucellosis in national and provincial brucellosis monitoring sites in Qinghai Province.