Objective To investigate the application value of 320-slice wide-detector multi-phase left at-rial appendage computed tomography angiography(LAA-CTA)with pulmonary artery(PA)monitoring in the preoperative evaluation of left atrial appendage closure.Methods A retrospective analysis was conducted on the clinical data of 110 patients who underwent LAA-CTA before left atrial appendage closure.Among them,47 patients underwent single-phase enhanced scanning with superior vena cava(SVC)monitoring(con-trol group),and 63 patients underwent multi-phase enhanced scanning with pulmonary artery monitoring(study group).The differences in imaging effects of the left atrial appendage under different monitoring points and phase imaging methods were compared,as well as the accuracy of comparing with the diagnostic results of transesophageal ultrasound(TEE),and the differences in the presentation of thrombus,perithrombus,and hypoperfusion areas in the left atrial appendage.Results The study group could comprehensively display the multi-phase CT value changes of different components(thrombus,peri-thrombotic viscosity,normal blood)within the left atrial appendage cavity,and its evaluation of lesion size and progression was superior to that of the control group.Using TEE as the gold standard,the study group demonstrated better diagnostic ac-curacy for different components and normal regions within the left atrial appendage cavity compared to the control group(P<0.001).Additionally,the study group improved the detection rate of peri-thrombotic vis-cosity,clearly delineated thrombus boundaries,and enhanced diagnostic accuracy(P<0.001).Conclusion Multi-phase LAA-CTA with pulmonary artery monitoring can effectively evaluate the morphological dimensions,thrombus,and peri-thrombotic CT manifestations of the left atrial appendage.It is simple to operate,with an accuracy rate close to the gold standard,providing reliable imaging evidence for preoperative evaluation of left atrial appendage closure.

Objective:To explore the chain mediation effects of psychological resilience and fear of falling on family function and rehabilitation exercise adherence among stroke patients of different genders.Methods:Totally 298 stroke patients from Xinxiang Central Hospital between January and December 2023 were selected by convenience sampling. Participants were assessed using the Family Assessment Device (FAD), Connor-Davidson Resilience Scale (CD-RISC), Fear of Falling Questionnaire-Reversed (FFQ-R), and Exercise Adherence Questionnaire (EAQ). The SPSS PROCESS macro was utilized to test the chain mediation effects.Results:Male stroke patients had higher total FAD scores, communication, and family role dimension scores, total CD-RISC scores, resilience and self-reliance dimension scores, and EAQ scores, including adherence to physical exercise and exercise supervision, compared to female patients ( P<0.05). However, female patients scored higher in emotional response and emotional involvement dimensions of FAD, total FFQ-R, and all dimensions of FFQ-R, as well as adherence to seeking timely advice of EAQ ( P<0.05). Mediation analysis showed that in male stroke patients, family function had no significant direct effect on rehabilitation exercise adherence (95% CI: -0.055 - 0.096), with psychological resilience and fear of falling playing a fully mediating role; the total mediation effect was 0.113, accounting for 84.96% of the total effect. In female stroke patients, family function had a significant direct effect on rehabilitation exercise adherence, with an effect of 0.110, accounting for 42.80% of the total effect. In addition, psychological resilience and fear of falling partially mediated the relationship between family function and rehabilitation exercise adherence, with a total mediation effect of 0.147, accounting for 57.20% of the total effect. Conclusions:The levels of family function, psychological resilience, fear of falling, and rehabilitation exercise adherence, as well as the mechanisms linking these factors, differ by gender in stroke patients. In male stroke patients, psychological resilience and fear of falling fully mediate the relationship between family function and rehabilitation exercise adherence. In female stroke patients, family function influences rehabilitation exercise adherence through both direct effects and the partial mediating effects of psychological resilience and fear of falling.

Objective:To investigate the level of serum vascular endothelial growth factor (VEGF) and its correlation with clinical symptoms in patients with first-episode drug-naive schizophrenia patients of different genders.Methods:From January 2016 to October 2019, a total of 81 first-episode drug-naive schizophrenia patients(patient group, 41 male, 40 female) and 64 healthy controls (control group, 40 male, 24 female) were included in this study.The serum level of VEGF was detected with flow cytometric bear array (CBA). Positive and negative symptom scale (PANSS) was used to evaluate the relevant clinical symptoms of patients.SPSS 22.0 software was used for statistical analysis.Independent sample t-test and nonparametric test were used for comparison between groups.The relationship between VEGF and clinical variables was analyzed by Pearson correlation analysis and Spearman correlation analysis. Results:The level of serum VEGF in the patient group was significantly lower than that in the control group(148.08(75.89, 208.61)pg/mL, 179.94(99.14, 318.41)pg/mL, Z=-2.20, P=0.028). The total PANSS score((82.71±17.30), (73.45±16.36), t=2.473, P=0.016)and cognitive score((7.88±3.36), (6.23±2.81), t=2.402, P=0.019) in male patients were higher than those in female patients.There was a negative correlation between VEGF level and PANSS negative symptom score in the patient group( r=-0.228, P=0.041), as well as significant negtive correlation between VEGF level and cognitive score in male patients( r=-0.425, P=0.007). Conclusion:The level of serum VEGF is reduced in first-episode patients with schizophrenia, which influences their negative symptom. Moreover, the decline in serum VEGF level is implicated in cognitive impairments in male patients with first-episode schizophrenia.

Objective:To evaluate the clinical efficacy of neck pricking combined with oral pricking in the treatment of dysphagia after stroke.Methods:Seventy-four patients with post-stroke dysphagia who met the inclusion criteria were randomly divided into the treatment group (acupuncture + rehabilitation training group) and the control group (rehabilitation training group) according to random number table method, 37 cases for each group. Both groups of patients were given conventional drug therapy and rehabilitation of Chinese and Western medicine. On this basis, the control group used swallowing rehabilitation training. The treatment group used acupuncture combined with neck pricking and oral pricking based on swallowing rehabilitation training. Both groups were treated for 3 weeks. Before and after the treatment, three different traits of sputum (liquid, mushy and paste) videofluoroscopic swallowing study (VFSS) were observed for each patient, and the swallowing conditions were observed. The primary outcome measures were the oral swallowing scale score, the pharyngeal swallowing scale score, the Rosenbek infiltration/aspiration scale score, and the standard swallowing function rating scale (SSA). The improvement in swallowing function and aspiration was compared between the two groups.Results:After treatment, the SSA score of the treatment group (25.05 ± 5.27 vs. 28.66 ± 5.33, t=2.884) was lower than that of the control group ( P<0.05). Compared with the same group before treatment, treatment group and control group of oral stage VFSS liquid ( t=5.199, 5.413), mushy ( t=4.761, 4.824) and pasty ( t=5.295, 4.428) scores, throat stage liquid ( t=4.986, 3.919), mushy ( t=4.789, 4.170) and pasty ( t=4.136, 3.673) scores were increased ( P<0.01), but there was no statistically significant difference between the groups ( P>0.05). After treatment, Rosenbek's leakage-aspiration degree classification was significantly reduced ( Z values were 4.224, 2.956, all Ps<0.01), but there was no statistically significant difference between the groups ( P>0.05). The total effective rate was 89.2% (33/37) in the treatment group and 74.3% (26/35) in the control group. There was no statistically significant difference between the two groups ( Z=1.125, P=0.261). Conclusions:Neck pricking combined with oral pricking and rehabilitation training for stroke dysphagia is better than simple rehabilitation training, and could significantly improve swallowing-feeding function, which could be promoted in clinical rehabilitation.

Objective: To explore the correlation between serum high density lipoprotein (HDL) levels and cognitive function in patients with bipolar disorder. Methods: A total of 99 patients with bipolar disorder were enrolled from the inpatient of Suzhou Guangji Hospital.Serum HDL levels were measured by enzymatic colourimetry.Cognitive function was assessed by the repeatable battery for the assessment of neuropsychological status (RBANS). The relationship between serum high density lipoprotein and cognitive function was analyzed by correlation analysis and stepwise multiple regression analysis. Results: Serum HDL levels ((1.39±0.55)mmol/L)were positively correlated with the RBANS total score (68.92±12.48)(r=0.238, P=0.034) and language score(80.59±15.97) (r=0.239, P=0.033) in patients with bipolar disorder.Stepwise multiple regression analysis showed that serum HDL level was the influencing factor of total score of RBANS(β=4.791, t=2.151, P=0.035)and speech function(β=7.363, t=2.247, P=0.027). Conclusion Serum HDL levels can influence cognitive function, especially speech function in patients with bipolar disorder.

Objective: To explore the effect of active vitamin D supplements on promoting postoperative lumbar functional rehabilitation in postmenopausal women. Methods: From January 2015 to January 2017, selecting 120 postmenopausal women patients who underwent lumbar posterior surgery with age from 50 to 80 years, randomly divided into control group and observation group, control group and observation group suffer traditional nursing and treatment, meanwhile, observation group was supplied with active vitamin D, over a follow-up period of six months, using the Visual Analogue Scale(VAS)score, Japanese Orthopedic Association Scores(JOA)score, back stretch height to assess the effect of active vitamin D supplements. Results: Back stretch height of patients in the observation group was (25.4 ± 2.6) cm, which was significantly better than (20.7 ± 2.1) cm of the control group after 6 months (t=-10.90, P<0.01); the observation group JOA score and VAS score were significantly better than the control group (JOA score: 25.8±2.0 vs. 24.6±1.8, t=-3.50, P<0.01; VAS score: 1.6±0.9 vs. 2.1±1.1, t=-3.10, P<0.01). Conclusion Active vitamin D supplements can improve the patient′s waist discomfort, enhance the muscle strength, improve the quality of life, and get better functional rehabilitation.

OBJECTIVE:To investigate the effects of NOS1AP rs12742393 A/C gene polymorphism on lipid-regulating re-sponse of rosuvastatin calcium. METHODS:Two hundred and tuirty six patients with coronary heart disease(CHD)were selected from cardiology department of our hospital during Jan. 2014-Jun. 2015,and then given rosuvastatin calcium and other symptomatic treatment for 12 weeks. Polymorphism of NOS1AP rs12742393 A/C was detected by PCR-RFLP. The levels of TG,TC,HDL-C and LDL-C were detected by photoelectric colorimetry before treatment and 4,12 weeks after treatment. The serum relationship of genotype with the level of blood lipid was analyzed. RESULTS:Among 236 CHD patients,there were 131 cases of AA genotype (55.5%),98 cases of AC genotype(41.5%) and 7 cases of CC genotype(3.0%);genotype and allele frequencies met the Har-dy-Weinberg balance(P>0.05). There were 132 patients with normal blood lipid and 104 patients with hypercholesterolemia;there was statistical significance in genotype and allele frequencies (P<0.05). Among 104 CHD patients with hypercholesterolemia be-fore treatment,there was no statistical significance in the levels of TG,TC,LDL-C and HDL-C between AA genotype and AC+CC genotype(P>0.05). 4th and 12th week after treatment,the levels of TG,TC and LDL-C in different genotypes were all de-creased significantly;4th week after treatment,the level of LDL-C in AC+CC genotype was significantly lower than AA genotype, and the change compared to before treatment was significantly more than AA genotype,with statistical significance (P<0.05). There was no statistical significance in the level of HDL-C among different genotypes compared to before treatment;there was no statistical significance in the levels of TG,TC and HDL-C 4th,12th week after treatment and their changes compared to before treatment between AA genotype and AC+CC genotype;there was no statistical significance in the level of LDL-C 12th week after treatment and their changes between AA genotype and AC+CC genotype(P>0.05). CONCLUSIONS:NOS1AP rs12742393 A/C gene polymorphism is associated with CHD complicated with hypercholesterolemia;the C allele of NOS1AP rs12742393 may strengthen the response of CHD patients with hy-percholesterolemia to rosuvastatin calcium through influencing the level of LDL-C.

Objective To explore the clinical effect of creatine phosphate on infantile with rotaviral enteritis and myocardial damage.Methods One hundred and twenty children with rotaviral enteritis and myocardial damage were randomly divided into the control group (n =60) and observation group (n =60).Two groups were given antiviral,rehydration,nutritional support,redressing acid-base imbalance and electrolyte disorders and other conventional treatment.The patients of the control group were given 160 mg/(kg · d) 1,6Fructose Diphosphate(1 times/d) on the basis of routine treatment,while those in the observation group were given 1.0 g creatine phosphate + 150 ml 5％ glucose injection(1 times/d) on the basis of routine treatment,both courses of two groups were 7 days.The levels of myocardial enzymes were measured and the clinical effect and adverse reactions were recorded.Results The total effective rate in observation group was 95.0％ (57/60),obviously higher than that of control group (80.0％ (48/60)) and the differences were statistically significant (x2 =6.268,P ＜ 0.05).There were no statistical significant difference in terms of myocardial enzyme between the two groups before treatment(P ＞0.05).The level of lactate dehydmgenase(LDH),creatine kinase (CK),creatine kinase isoenzyme (CK-MB) and aspartate aminotransferase (AST) of observation group were (163.8 ±18.5) U/L,(152.8±26.4) U/L,(19.4±7.8) U/Land (24.4 ±6.8) U/Lafter treatment,and (193.4 ± 22.8) U/L,(168.6 ± 32.6) U/L,(27.4 ± 9.2) U/L and (35.4 ± 9.8) U/L of control group,and the differences between the two groups were significant (t =3.484,3.228,4.278 and 4.729; P ＜ 0.05).There was no obvious adverse reaction during the treatment course.Conclusion The clinical effect of creatine phosphate on infantile with rotaviral enteritis and myocardial damage is remarkable and safe,and it is worth of clinical application.

Objective To characterize contemporary electrographic neonatal seizures by video electroencephalogram (VEEG) and to assess the value and the limitations of two-channel (C3-C4/T3-T4) amplitude-integrated electroencephalogram (aEEG) plus original EEG signals used to diagnose neonatal seizure with video EEG as a golden standard.Methods Sixty-six neonates admitted to Children's Hospital of Fudan University from January 2011 to July 2011 with clinical or suspected clinical seizure were investigated and bedside VEEG were recorded for more than 3 hours.VEEG signals were transformed into three kinds of aEEG signals by Galileo NT PMS software:one-channel aEEG (C3-C4),one-channel aEEG (C3-C4) plus original EEG,two-channel aEEG (C3-C4/T3-T4) plus original EEG.Electrical seizure activity on VEEG was signed out with respect to its occurrence,duration and localization of seizure onset; while aEEG seizure was recorded only with its occurrence.The relationship between aEEG and VEEG was analyzed by Spearman analysis.The value and the limitations of aEEG to diagnose neonatal seizure were evaluated by sensitivity,specificity,positive predictive value and negative predictive value.Results A total of 62 traces were suitable for analysis.(1) VEEG showed 39 seizure activities,among which 8 status epilepticus; and the rest 31 neonates had 352 non-status epilepticus electrical seizures,79.3％ (279/352) of which occurred over the centrotemporal region.(2) Eight cases with status epilepticus on VEEG were all diagnosed as status epilepticus on aEEG.For non-status epilepticus electrical seizures,the sensitivity of aEEG for detection of electrical seizures was as followed:49.1％ (173/352) for one-channel aEEG,54.5 ％ (192/352) for one-channel aEEG plus original EEG,81.2％ (286/353) for two-channel aEEG plus original EEG.Results from one-channel aEEG,one-channel aEEG plus original EEG and two-channel aEEG plus original EEG were all related to VEEG (ρ =0.790,0.907 and 0.953,respectively,P＜ 0.01).(3) Sensitivity of seizure detection was 66.7％ (26/39,95％ CI:0.62-0.81) for one-channel aEEG,74.4％(29/39,95％ CI:0.78-0.96) for one-channel aEEG(C3-C4) plus original EEG and 89.7％ (35/39,95％ CI:0.89-1.00) for two-channel aEEG(C3-C4/T3-T4) plus original EEG.Conclusions VEEG might help aEEG in diagnosis of neonatal seizure.two-channel aEEG (C3-C4/T3-T4) plus original EEG could significantly increase the sensitivity of neonatal seizures indentification.