Objective:To investigate the structural changes in the spinal cord in multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD) and their relationship with clinical disability.Methods:This study was cross-sectional. A retrospective analysis of clinical and imaging data from 124 patients with MS (MS group), 101 patients with aquaporin-4 antibody-positive NMOSD (NMOSD group), and 110 healthy controls (HC group) from seven medical centers were conducted from January 2018 to October 2021. All subjects underwent 3D T 1WI, and the upper cervical spinal cord cross-sectional area (MUCCA) was segmented and measured. All patients completed the expanded disability status scale (EDSS) assessments at baseline and during follow-up, as well as the baseline 25-foot walk test (T25FW) and the nine-hole peg test (NHPT). Patients were classified into EDSS progression and non-progression groups based on follow-up EDSS scores. Comparisons of MUCCA among the three groups were conducted using analysis of covariance, controlling for age and sex as covariates. Pairwise comparisons between groups were performed using the HSD test. Univariate linear regression and logistic models were employed to identify candidate predictors of baseline clinical disability status or EDSS progression in the MS and NMOSD groups. L1 regularized multivariable linear regression analysis was used to determine independent predictors of baseline clinical disability status or EDSS progression. Independent predictors were then combined to establish a logistic regression model, and the model′s performance in predicting EDSS progression was evaluated using receiver operating characteristic analysis and the area under the curve (AUC). Results:A total of 144 patients completed follow-up EDSS assessments, with a follow-up duration of 3.30 (1.10, 6.42) years, including 82 patients in the MS group and 62 patients in the NMOSD group. Controlling for sex and age as covariates, the overall difference in MUCCA among the MS, NMOSD, and HC groups was statistically significant ( P=0.001). The MUCCA in the MS group was lower than that in the HC group, with a significant difference ( t=-2.54, P=0.007); the MUCCA in the NMOSD group was also lower than that in the HC group, with a significant difference ( t=-2.80, P=0.002). However, the difference in MUCCA between the MS and NMOSD groups was not statistically significant ( t=-0.40, P=0.882). In the MS group, MUCCA was an independent predictor of baseline EDSS score (β=-0.03), baseline T25FW score (β=-0.09), and baseline NHPT score (β=-0.30). In the NMOSD group, MUCCA (β=-0.08), age (β=0.06), and baseline EDSS score (β=-0.43) were independent predictors of EDSS progression, and the logistic regression model incorporating these three factors predicted EDSS progression with an AUC of 0.82. Conclusions:Significant spinal cord atrophy occurs in patients with both MS and NMOSD. Atrophy of the upper cervical spinal cord can predict the degree of disability in MS patients and the progression of clinical disability in NMOSD patients.

Objective:To investigate the structural changes in the spinal cord in multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD) and their relationship with clinical disability.Methods:This study was cross-sectional. A retrospective analysis of clinical and imaging data from 124 patients with MS (MS group), 101 patients with aquaporin-4 antibody-positive NMOSD (NMOSD group), and 110 healthy controls (HC group) from seven medical centers were conducted from January 2018 to October 2021. All subjects underwent 3D T 1WI, and the upper cervical spinal cord cross-sectional area (MUCCA) was segmented and measured. All patients completed the expanded disability status scale (EDSS) assessments at baseline and during follow-up, as well as the baseline 25-foot walk test (T25FW) and the nine-hole peg test (NHPT). Patients were classified into EDSS progression and non-progression groups based on follow-up EDSS scores. Comparisons of MUCCA among the three groups were conducted using analysis of covariance, controlling for age and sex as covariates. Pairwise comparisons between groups were performed using the HSD test. Univariate linear regression and logistic models were employed to identify candidate predictors of baseline clinical disability status or EDSS progression in the MS and NMOSD groups. L1 regularized multivariable linear regression analysis was used to determine independent predictors of baseline clinical disability status or EDSS progression. Independent predictors were then combined to establish a logistic regression model, and the model′s performance in predicting EDSS progression was evaluated using receiver operating characteristic analysis and the area under the curve (AUC). Results:A total of 144 patients completed follow-up EDSS assessments, with a follow-up duration of 3.30 (1.10, 6.42) years, including 82 patients in the MS group and 62 patients in the NMOSD group. Controlling for sex and age as covariates, the overall difference in MUCCA among the MS, NMOSD, and HC groups was statistically significant ( P=0.001). The MUCCA in the MS group was lower than that in the HC group, with a significant difference ( t=-2.54, P=0.007); the MUCCA in the NMOSD group was also lower than that in the HC group, with a significant difference ( t=-2.80, P=0.002). However, the difference in MUCCA between the MS and NMOSD groups was not statistically significant ( t=-0.40, P=0.882). In the MS group, MUCCA was an independent predictor of baseline EDSS score (β=-0.03), baseline T25FW score (β=-0.09), and baseline NHPT score (β=-0.30). In the NMOSD group, MUCCA (β=-0.08), age (β=0.06), and baseline EDSS score (β=-0.43) were independent predictors of EDSS progression, and the logistic regression model incorporating these three factors predicted EDSS progression with an AUC of 0.82. Conclusions:Significant spinal cord atrophy occurs in patients with both MS and NMOSD. Atrophy of the upper cervical spinal cord can predict the degree of disability in MS patients and the progression of clinical disability in NMOSD patients.

Objective:To summarize the situation of dead newborns and their parents after parents gave up treatment, and analyze the reasons and emotional needs of parents who gave up treatment, so as to provide reference for reducing neonatal mortality and negative emotions of parents.Methods:A retrospective study was conducted to collect the data of neonates and mothers who died after giving up treatment reported in Hunan Children′s Hospital from January 2019 to December 2021. The general information, perinatal risk factors, and the incidence of in-hospital diseases were analyzed. Then, semi-structured interviews were conducted with parents of newborns who died after giving up treatment from February to December 2021. Understand why parents give up treatment and their emotional needs.Results:A total of 172 newborns died after giving up were included in the analysis, including 103 males (59.88%) and 74 premature infants (43.02%); Umbilical cord, placenta and amniotic fluid abnormalities were 21 cases (12.21%), 39 cases (22.67%) and 25 cases (14.53%), respectively. Birth asphyxia was 31 cases (18.02%), including severe asphyxia in 18 cases (10.46%); There were 21 (12.21%), 35 (20.35%) and 30 (17.44%) cases of maternal infection in the third trimester, hypertension in pregnancy and diabetes in pregnancy, respectively. The top three causes of death were septicemia (18.02%), congenital malformation (16.86%) and severe pneumonia (10.47%). The main reason why parents give up treatment was that the child′s disease was critical and irreversible, and parents had strong emotional needs for hospice care in their hearts.Conclusions:There are many high risk factors of perinatal death of newborns after giving up treatment. Sepsis is the primary cause of death, and strengthening perinatal health care is fundamental. Parents have a strong demand for hospice care, so it is of practical significance to implement family-centered hospice care model for such special newborns.

Objective:To investigate the iodine nutritional status among children aged from 8 - 10 and pregnant women in Xiamen City before and after adjustment of salt iodine concentration, and scientifically evaluate the suitability of the new standard iodized salt adjustment policy for Xiamen City.Methods:In the pre-adjustment period (2011) and the post-adjustment period (2018), cross-sectional research methods and stratified cluster sampling methods were adopted in six districts of Xiamen City. The salt samples of residents and pregnant women, urine samples of children aged from 8 - 10 and pregnant women were collected to determine the iodine level; thyroid of children aged from 8 - 10 was examined. Changes in salt iodine, urine iodine and goiter prevalence before and after adjusting iodine content of salt were compared.Results:The median of salt iodine in residents after the adjustment (23.5 mg/kg) was significantly lower than that of before (28.9 mg/kg, Z = - 10.512, P < 0.05), the median of salt iodine in pregnant women after the adjustment (23.7 mg/kg) was significantly lower than that of before (29.2 mg/kg, Z = - 12.622, P < 0.05); the consumption rate of qualified iodized salt in residents after the adjustment (95.7%, 1 196/1 250) was significantly lower than that of before (97.1%, 1 608/1 656; χ 2 = 4.250, P < 0.05); before and after adjustment of salt iodine concentration, the consumption rate of qualified iodized salt in pregnant women was 94.7% (124/131) and 95.9% (579/604), respectively. No significant difference was found when comparing the consumption rate of qualified iodized salt in pregnant women (χ 2 = 0.015, P > 0.05). There was significant difference in median urinary iodine (from 204.2 to 183.9 μg/L, detected in 652, 1 250 urine samples, respectively) of children aged 8 - 10 years ( Z = - 3.583, P < 0.05); the difference of iodine nutritional status in pregnant women before and after adjustment of salt iodine concentration(130.2, 130.8 μg/L, detected in 132, 604 urine samples, respectively) was not significant ( Z = - 1.715, P > 0.05). The thyroid goiter rate of children aged 8 - 10 years had reduced from 1.1% (14/1 239) to 0.2% (2/1 253), the difference was statistically significant (χ 2 = 9.195, P < 0.05). Conclusions:As a whole, the measure of control and prevention of iodine deficiency disorders through iodized salt is implemented well in Xiamen City. After adjustment of salt iodine concentration, the iodine status of children aged from 8 to 10 is adequate, but the pregnant women has showed iodine deficiency.

Objective This study was conducted to assess the accuracy of [18F] fiuorodeoxyglucose-positron emission tomography/computed tomography (18FDG PET-CT) in detection of pelvic nodal metastases in endometrial cancer.Methods Patients with endometrial cancer from January 2015 to June 2017 confirmed by the postoperative pathology were retrospectively analyzed.30 patients finished PET-CT before operation.The findings on histopathology were compared with 18FDG-PET/CT findings to calculate the sensitivity,specificity,positive predictive value (PPV),negative predictive value (NPV),and accuracy of 18FDG-PET/CT.To analyze the efficacy of maximum standardized uptake (SUVmax) and lymph node maximum standardized uptake (LN-SUVmax) of PET-CT in the diagnosis of pelvic lymph node metastasis.Resuits For detection of pelvic nodes,based on patient analysis,18FDG-PET/CT had a sensitivity of 75.0％,specificity of 88.5％,PPV of 50.0％,NPV of 95.8％ and accuracy of 86.7％.Based on a nodal region analysis,18FDG-PET/CT had a sensitivity of 83.3％,specificity of 98.3％,PPV of 55.0％,NPV of 99.6％,and accuracy of 98.3％.When maximum standardized uptake values (SUVmax) ＞ 8,area under curve (AUC) =0.64,Yonden Index =0.42.When maximum standardized uptake values of lymphonodus (LN-SUVmax) ＞ 3 (AUC =0.79,Yonden Index =0.63),the sensitivity and specificity of diagnosis of lymph node metastasis were 100％,42.31％,and 75.0％,88.5％,but without statistically significant difference.Although AUC of LN-SUVmax was higher than SUVmax of primary lesion,but the difference was not statistically significant (P ＞ 0.05).Conclusions 18 FDG-PET/CT has high specificity,NPV for detection of pelvic LN metastasis area in endometrial cancer,which can provide preoperative basis for patients with endometrial cancer to avoid lymph node resection,thereby reducing the risk of early endometrial cancer surgery and improving the quality of life after surgery.We concluded that,there were no exact cutoffs of SUVmax for the prediction of lymph node metastases,neither primary lesion,nor lymph node.There is clearly a need for multicenter,large-scale trials to find out better parameters in judging metastasis of lymphnodes.

Heavy metal residue in vegetables is a big concern in the whole world.The aim of this work is to explore the effect of multivariable selection on analyzing Cd in Chinese cabbage polluted in lab by collecting the spectra of laser induced breakdown spectroscopy (LIBS) from the samples.At the same time,the actual Cd content in samples was obtained by anodic stripping voltammetry (ASV).The LIBS spectral range in partial least square (PLS) model was screened by standard normal variable transformation (SNV),first derivative (FD),second derivative (SD) and center treatment (CT) for preprocessing spectra and the optimized method was used for the analysis of interval partial least square (iPLS) and synergy interval partial least square (SiPLS).The results indicated that the method of CT was the best as a comparison with PLS,iPLS and SiPLS.And the intervals of wavelength were 214.72-215.82 nm,215.88-216.97 nm and 225.08 -226.35 nm by utilizing the optimized SiPLS.Here the root mean square error of cross validation (RMSECV) between real content and predicted ones was 1.487,the root mean squared error of prediction (RMSEP) was 1.094,the correlation coefficient (R) was 0.9942,and the average relative error (ARE) was 11.60％.The results displayed that LIBS could predict Cd in vegetables by multivariable selection of SiPLS and the accuracy could meet the requirement of rapid and green analysis of Cd in vegetables.

Objective: To investigate the breakthrough points and methods of pharmaceutical care performed by clinical pharmacists for chemotherapy-induced Ⅳ degree myelosuppression.Methods: One advanced lung adenocarcinoma patient suffering from chemotherapy-induced Ⅳ degree myolosuppression was selected as the example, clinical pharmacists provided suggestions on the chemotherapy regimen, assisted physicians in making reasonable treatment plan and implemented comprehensive pharmaceutical care for the patient.Results: Clinical pharmacists played a positive role in the clinical treatment through the comprehensive pharmaceutical care in oncology department.Conclusion: With the professional knowledge of pharmacy, clinical pharmacists can improve the level of clinical rational drug use.

There are many noise signals in original laser induced breakdown spectroscopy (LIBS) spectra.To explore the effect of spectral pretreatment on LIBS information by different filter methods, the LIBS spectra of Pb-polluted cabbage in wavelength range of 400.45-410.98 nm was investigated and preprocessed by adjacent averaging, Savitzky-Golay (S-G) and fast Fourier transformation (FFT).Then partial least square (PLS) model was established for evaluating the spectral treatment effect.The result showed that the root mean square error of prediction (RMSEP) and average relative error of S-G method were 0.26 and 3.7%, suggesting a superior smoothing effect than other methods.Experimental results indicated that an appropriate filtering method could help to improve the spectral quality and raise the precision of model checkout.

OBJECTIVETo characterize the O3: K6 serovariant of Vibrio parahaemolyticus on virulence gene and molecular typing, and analyze the genetic relationship between O3: K6 and O3: K6 serovariants.

METHODSPFGE was performed on 115 strains of V.parahaemolyticus which were collected from the anal swab of cases of foodbrone diseases in Shenzhen during 2006-2012. According to isolation times and locations, 7 strains of O3: K6 were selected as control strains. Tdh gene, trh gene, orf8 gene were detected, GS-PCR, multi-locus sequence typing (MLST) were used to chracterize 7 strains of O3: K6 and O3: K6 serovariants.

RESULTSPFGE indicated that 58.3% (67/115) of V. parahaemolyticus strains shared a high similarity of band pattern (similarity > 80%) , which comprised of O3: K6 (44/67), O1: KUT(4/67), and O3: K6 serovariants(19/67). Among the O3: K6 serovariants, O1: K25 accounted for 7% (5/67), O4: K68 accounted for 10% (7 /67), O11: K36 accounted for 10% (7 /67). They all carried both tdh and trh gene, and 53% (10/19) was GS-PCR positive and carried orf8 gene, 26% (5/19) was both GS-PCR and orf8 gene negative, 21% (4/19) was GS-PCR negative, orf8 gene positive, 89% (17/19) was assigned to ST-3, 11% (2/19) was assigned to ST-305. Seven strains of O3: K6 was GS-PCR positive, carried orf8 gene, assigned to ST-3. ST-305 and ST-3 had differences in 2 housekeeping genes, which was dtdS gene and pntA gene. In the 305th base of dtdS gene, ST-305(147 allele profile) was T, while ST-3(4 allele profile) was C. In the 33th base of pntA gene, ST-305(93 allele profile) was T, while ST-3(29 allele profile ) was C.

CONCLUSIONO4: K68,O1: K25 and O11: K36 were highly similar in virulencec gene carriage, MLST type of O3: K6, and aslo shared a close genetic relationship with O3: K6, thus were considered as O3: K6 serovirants.

A new method has been established for simultaneous determination of anions and cations in fertilizer sample by multimodal liquid chromatography with direct conductivity detection. An Acclaim Trinity P1 column based on nanopolymer silica hybrid technology with multimodal separation functional groups reversed-phase/anion-exchange/cation-exchange was used for the analysis. The chromatographic conditions were optimized and the effect ion of eluent on retention was discussed. Eight ions ( Li+, NH+4 , K+, HCOO-, NO-2 , Cl-, NO-3 and Br-) were separated and determined simultaneously by using 25 mmol/L CH3 COONa solution containing 50% acetonitrile at pH=5. 0 as mobile phase. The flow rate was 0. 50 mL/min and the temperature was 30 ℃. Under the optimum conditions, the linear ranges of the method were in the range of 0 . 5-200 mg/L for all the ions with correlation coefficient of 0 . 9997-0 . 9999 . Whereas the detection limits (S/N=3) were in the range of 0. 16-1. 72 mg/L and the relative standard deviations (RSD, n=9) were in the range of 1 . 3-2 . 5%. The method was applied to the determination of anions and cations in the fertilizer samples with satisfied results and the recoveries were in the range of 95 . 8%-103 . 8%.