Objective:To observe the effect of intermittent theta burst transcranial magnetic stimulation (iTBS) on the language use, daily communication, and serum brain-derived neurotrophic factor (BDNF) levels of stroke survivors with motor aphasia (PSMA).Methods:A total of 60 PSMA patients were recruited and randomly divided into a control group and a treatment group, each of 30. Both groups received conventional speech training, while the treatment group additionally received daily 10-minute iTBS stimulation over the left dorsolateral prefrontal cortex, five days per week, for two weeks. Before and after the treatment, language function and daily communication were assessed using the Chinese Rehabilitation Research Center Standard Aphasia Examination (CRRCAE) and the Communication Activities of Daily Living (CADL) scale. Serum BDNF levels were measured using enzyme-linked immunosorbent assay.Results:After treatment, the CRRCAE and CADL scores in the treatment group were significantly higher than among the control group. The post-treatment serum BDNF levels in the treatment and control groups were (27.03±6.91)ng/ml and (22.20±5.89)ng/ml, respectively, both significantly higher than their pre-treatment levels. The average post-treatment serum BDNF level in the treatment group was significantly higher than the control group′s average.Conclusions:iTBS stimulation with speech training can better improve the language function and daily communication ability of stroke survivors with motor aphasia. The mechanism may be related to increased serum BDNF level.

Objective:To observe the effect of intermittent theta burst transcranial magnetic stimulation (iTBS) on the language use, daily communication, and serum brain-derived neurotrophic factor (BDNF) levels of stroke survivors with motor aphasia (PSMA).Methods:A total of 60 PSMA patients were recruited and randomly divided into a control group and a treatment group, each of 30. Both groups received conventional speech training, while the treatment group additionally received daily 10-minute iTBS stimulation over the left dorsolateral prefrontal cortex, five days per week, for two weeks. Before and after the treatment, language function and daily communication were assessed using the Chinese Rehabilitation Research Center Standard Aphasia Examination (CRRCAE) and the Communication Activities of Daily Living (CADL) scale. Serum BDNF levels were measured using enzyme-linked immunosorbent assay.Results:After treatment, the CRRCAE and CADL scores in the treatment group were significantly higher than among the control group. The post-treatment serum BDNF levels in the treatment and control groups were (27.03±6.91)ng/ml and (22.20±5.89)ng/ml, respectively, both significantly higher than their pre-treatment levels. The average post-treatment serum BDNF level in the treatment group was significantly higher than the control group′s average.Conclusions:iTBS stimulation with speech training can better improve the language function and daily communication ability of stroke survivors with motor aphasia. The mechanism may be related to increased serum BDNF level.

Objective:To summarize the prenatal diagnosis and postnatal follow-up of 15q11.2 BP1-BP2 microdeletion syndrome (Burnside-Butler syndrome, BBS), and provide a reference for the management of BBS.Methods:A retrospective analysis was performed on 27 singleton pregnancies with fetal BBS that were prenatally diagnosed by single nucleotide polymorphism(SNP) array of amniotic fluid in Wuxi Maternity and Child Health Care Hospital from January 2017 to September 2021. Prenatal diagnosis indications, serological screening, prenatal ultrasound features, SNP array results, and postnatal growth and development were described and summarized.Results:(1) Of the 27 cases, the indications of prenatal diagnosis in 14 cases were abnormal sonographic findings, including eight cases with increased nuchal translucency, two with cleft lip and palate/alveolar process cleft, one with fetal multiple joint contracture syndrome, one with fetal right diaphragmatic hernia and single umbilical artery, one with suspected fetal duodenal atresia and one with nasal bone absence. Other indications included high risk of Down syndrome by serological screening in six cases, history of adverse pregnancy in six cases, and advanced age in one case. (2) Karyotyping of amniotic fluid in these 27 BBS fetuses showed normal results and SNP array indicated the deletion range of 311.8-855.3 kb. Parental verification of 23 cases confirmed one was a new mutation, seven were inherited from the father and 15 from the mother. (3) Five pregnancies were terminated in the second trimester and the remaining 22 cases were live births. (4) The median follow-up of the 22 children was 1 year 8 months (range 0.5 months to 4 years 3 months), which found low body weight and/or growth retardation in six cases, low body weight with language retardation in one case, low body weight with growth retardation and hyperactive behavior in one case, language retardation with left ear appendage in one case, cleft palate accompanied by duodenum/cleft lip and alveolar cleft in two cases without abnormal development after surgical treatment, and no abnormal growth in the remaining 11 cases.Conclusion:For BBS fetuses, the proportion of ultrasound abnormalities is high but with a low specificity in prenatal diagnosis, and the risk of abnormal postnatal growth and development/behavior is high, which requires continuous monitoring.

Objective:To observe any effect of function-oriented training on the balance of recovering stroke survivors and on their ability in the activities of daily living.Methods:Sixty stroke survivors in recovery were randomly divided into an observation group ( n=30) and a control group ( n=30). The control group received routine rehabilitation training, while the observation group underwent function-oriented training for 6 weeks. Before and after the intervention, both groups were evaluated using the Berg balance scale (BBS), the Fugl-Meyer lower extremity assessment (FMA-L), the timed up-and-go test (TUGT) and the modified Barthel index (MBI). Results:After the treatment, significant improvement was observed in all of the measurements in both groups. The improvements in the average BBS, FMA-L and MBI scores and in the TUGT times of the observation group were significantly better than those of the control group.Conclusion:Function-oriented training can improve the balance and the ability in the activities of daily living of stroke survivors more effectively than the routine therapy.

Objective:To explore risk factors of individually predicting delayed bleeding after endoscopic submucosal dissection (ESD) for patients with early gastrointestinal tumors, to establish Nomogram model and to propose nursing countermeasures.Methods:Data of 236 patients who received ESD in Jiangsu Taizhou People's Hospital due to early gastrointestinal tumor from December 2017 to December 2019 were retrospectively analyzed. The independent risk factors for postoperative delayed bleeding were analyzed by univariate Logistic regression and binary Logistic regression respectively and a Nomogram prediction model was established.Results:Long-term use of antithrombotic drugs ( OR=4.990) , the number of biopsies greater or equal to 3 ( OR=7.834) , accompanied by ulcers and scars ( OR=6.079) , lesion diameter greater or equal to 3 cm ( OR=5.316) , infiltration to submucosa ( OR=5.667) , intraoperative marked bleeding ( OR=5.745) and experience of surgeons ( OR=7.660) were independent risk factors for delayed bleeding after ESD in early gastrointestinal tumors ( P<0.05) . A related Nomogram prediction model was established based on the above 7 independent risk factors, and the model was verified. The H- L deviation test result was χ 2=3.753, P=0.663 and C- index was 0.907 (95% CI 0.877-0.937) , which indicated Nomogram prediction model had good accuracy and dipartite degree. Conclusions:Long-term use of antithrombotic drugs, the number of biopsies greater or equal to 3, accompanied by ulcers and scars, lesion diameter greater or equal to 3 cm, infiltration to submucosa, intraoperative marked bleeding and unskilled surgeons are independent risk factors for delayed bleeding after ESD in early gastrointestinal tumors. Nomogram model established has accurate predictive ability and dipartite degree, which is helpful for nursing staff to screen high-risk patients and formulate relevant nursing strategies.