Purpose To investigate the clinicopathologic features,molecular changes,treatment and prognosis of pulmo-nary artery intimal sarcoma.Methods Ten cases of pulmonary artery intimal sarcoma were collected and the clinical features analyzed,by using HE,immunohistochemistry EnVision meth-od,FISH,and review of relevant literature.Results There were 4 males and 6 females,with a male to female ratio of 1∶1.5.The patients were 33-75 years old with an average age of 55.7 years.The main clinical symptoms were chest tightness,shortness of breath(6/10),chest pain(5/10)and cough(3/10),hemoptysis(2/10),syncope(1/10),heart murmur(1/10).1 patient had a history of bilateral breast cancer,bilateral papillary thyroid carcinoma and invasive lung adenocarcinoma,1 patient had bilateral breast cancer and 1 patient had pulmonary embolism and cardiac myxoma.Preoperative imaging showed pulmonary embolism or lung tumor.Histological morphology showed that the tumor cells were fusiform or epithelioid,with ob-vious atypia.Some tumors differentiated into rhabdomyosarco-ma,angiosarcoma and leiomyosarcoma,and giant cells were seen in 2 cases.The tumor lacked specific immune markers,and the tumor cells expressed vimentin,Fli-1,SMA,MyogD1,Myoglobin,BCL-2,ERG,etc.Ki-67 proliferation index was a-bout 30％-70％.Fluorescence in situ hybridization was used to detect MDM2(4/5)and CDK4(1/1).All cases received surgical treatment,7 cases were followed up from 1 month to 17 months,and 4 cases of them had recurrence or distant metasta-sis.Conclusion Pulmonary artery intimal sarcoma is rare,without specific immune markers and with complicated gene changes.There is no standard treatment,and the prognosis is poor.

Objective:To explore the efficacy and compliance of e-aid cognitive behavioral therapy (eCBTI) in patients with situational insomnia among different age groups.Methods:A total of 194 patients with situational insomnia were recruited via a campaign of the " Prevention and Protection Handbook Against Epidemic" from March to April 2020 in Guangzhou, China.Participants were divided into two groups according to age: under 35 years old ( n=87) and 35 years old and above ( n=107). They all received one-week eCBTI intervention.Insomnia severity index (ISI), Pre-sleep arousal scale (PSAS) and Hospital anxiety and depression scale (HADS) were used to evaluate the severity of insomnia for all participants pre- and post-intervention.The change of each scale within the group and the reduction rate of each scale between groups were compared using t test and one-way ANOVA. Results:(1) Intervention efficacy: in the <35-year-old group, compared with baseline, the scores of ISI scale ((9.2±4.1), (14.8±5.1)), PSAS cognitive arousal subscale ((18.5±8.4), (23.5±6.6)), PSAS((34.3±15.8), (40.3±10.7)), HADS depression subscale ((5.8±3.6), (8.5±4.6)) and HADS anxiety subscale((7.1±3.9), (9.5±4.5) )were statistically significant after eCBTI intervention ( t= 2.88-8.80, all P<0.01), but there was no significant difference in score of PSAS body subscale ((15.8±7.8), (16.8±5.7)). In ≥35-year-old group, compared with baseline, the scores of ISI scale ((9.7±4.2), (14.4±4.3)), HADS depression subscale ((4.6±2.2), (6.6±3.5))and PSAS cognitive arousal subscale ((16.9 ±8.5), (20.0±5.8))were significantly different after intervention ( t= 2.90-6.86, all P<0.01), meanwhile the scores of PSAS body subscale ((14.3±8.0), (13.9±5.2)), PSAS((32.2±16.5), (33.9±9.2)), HADS anxiety subscale((6.1±3.2), (7.0±3.5)) were not statistically significant (all P>0.05). There was no significant difference in the score reduction rate between the two groups before and after intervention (all P>0.05). (2) Compliance: 86 cases dropped out, and the dropout rate was 61.3%.Totally 75 cases (38.7%) completed the 7-day treatment, and 119 cases (61.3%) completed the treatment within 1-6 days.Further study found that there was statistically significant difference in the reduction rate of ISI total score among the three groups with excellent, good and poor compliance ( F=5.655, P=0.004). Conclusion:eCBTI has a good effect on situational insomnia in different age groups, and there is no difference in treatment compliance.

Objective:To Investigate comprehensive predictive ability of first-trimester complete blood count combined with maternal characteristics for gestational diabetes mellitus (GDM).Methods:From May 2015 to July 2018, 1 412 pregnant women were retrospectively screened at the Fifth People′s Hospital of Shanghai, Fudan University. We recruited 258 women who developed GDM and 1 154 women who had normal glucose level during pregnancy. At the first visit, clinical data and complete blood count result were obtained. GDM prediction models were established through logistic regression analysis of GDM related risk factors and the prediction abilities of each model were compared.Results:Logistic regression analyses identified age, pre-pregnancy body mass index, previous GDM history, family history of diabetes mellitus, the neutrophil-to-lymphocyte ratio, leukocyte, neutrophil, and monocyte counts were significantly independent predictors of GDM. In the entire cohort, the predictive ability of neutrophil and monocyte counts together with maternal basal characteristics model for the development of GDM [areas under the receiver operating characteristic curve (AUC-ROC)=0.809, integrated discrimination improvement (IDI)=0.056, P=0.001] was the best among various models (basal characteristics model, AUC-ROC=0.753; Monocyte count+ basal characteristics model, AUC-ROC=0.764; neutrophil count + basal characteristics model, AUC-ROC=0.775). Similar results obtained by the same way in all pregnant women without previous GDM history. Conclusion:It could improve the prediction of GDM with model incorporated maternal characteristics and first-trimester neutrophil and monocyte counts.

This study aims to review the research progress on the effects of repetitive transcranial magnetic stimulation （rTMS） on cognitive function in generalized anxiety disorder （GAD） with the view of providing references for clinical application. As a common chronic mental disorder， GAD affects the cognitive function， the quality of life and social function of patients. Although first-line treatment is safe and effective for the majority of patients， its effect of improving cognitive function is unclear. As a non-invasive and safe physiotherapy technology， rTMS is expected to provide a new option for the clinical treatment of GAD patients. This review focuses on the characteristics of cognitive function of GAD， the current status of first-line therapy and the treatment of rTMS.

Objective: To evaluate the tolerability and short-term efficacy of chemo-radiotherapy in 125 patients with stage ⅡB-ⅣA esophageal carcinoma after radical resection. Methods: We retrospectively evaluated the rate of completion, toxicity and survival of patients undergoing adjuvant concurrent chemo-radiotherapy after radical resection of esophageal carcinoma from January 2004 to December 2014 in our institution. The survival rate was determined by the Kaplan-Meier method and analyzed using the log-rank test. Multivariate prognostic analysis was performed using the Cox proportional hazard model. Results: 122 patients received more than 50 Gy dose (97.6%). A total of 52 patients received more than 5 weeks chemo-radiotherapy (41.6%), while 73 patients underwent only 1-4 weeks (58.4%). The median following up was 48.4 months. 8 patients lost follow up (6.4%). The 1-year and 3-year overall survival rate were 91.6% and 57.0%, respectively, with a median survival time of 64.4 months. The 1-year and 3-year disease free survival rate were 73.2% and 54.3%, respectively, with a median disease free survival time of 59.1 months. The most common acute complications associated with chemo-radiotherapy were myelosuppression, radiation esophagitis and radiation dermatitis, the majority of which were Grade 1-2. Of the 125 patients, there were 59 cases of recurrence, including 23 cases with local regional recurrence, 26 cases with hematogenous metastasis, and 8 cases with mixed recurrence. Univariate analysis showed that the numbers of concurrent chemotherapy was associated with the overall survival (P=0.006). But receiving more than 5 weeks was not the prognostic factor compared to 1 to 4 weeks chemotherapy (P=0.231). Multivariate analysis showed that only the numbers of concurrent chemotherapy was an independent prognostic factor (P=0.010). Conclusions Postoperative radiotherapy concurrent with weekly chemotherapy could improve the overall survival and decrease the recurrence for stage ⅡB-ⅣA esophageal carcinoma after radical resection. However, the completion rate of chemotherapy was low, so it was necessary to explore reasonable regimens to improve the completion rate and carry out prospective randomized controlled trial.

Objective To evaluate the tolerability and short?term efficacy of chemo?radiotherapy in 125 patients with stageⅡB?ⅣA esophageal carcinoma after radical resection. Methods We retrospectively evaluated the rate of completion, toxicity and survival of patients undergoing adjuvant concurrent chemo?radiotherapy after radical resection of esophageal carcinoma from January 2004 to December 2014 in our institution. The survival rate was determined by the Kaplan?Meier method and analyzed using the log?rank test. Multivariate prognostic analysis was performed using the Cox proportional hazard model. Results 122 patients received more than 50 Gy dose (97.6%). A total of 52 patients received more than 5 weeks chemo? radiotherapy (41.6%), while 73 patients underwent only 1?4 weeks (58.4%). The median following up was 48.4 months. 8 patients lost follow up ( 6.4%). The 1?year and 3?year overall survival rate were 91.6%and 57.0%, respectively, with a median survival time of 64.4 months. The 1?year and 3?year disease free survival rate were 73.2% and 54.3%, respectively, with a median disease free survival time of 59.1 months. The most common acute complications associated with chemo?radiotherapy were myelosuppression, radiation esophagitis and radiation dermatitis, the majority of which were Grade 1?2. Of the 125 patients, there were 59 cases of recurrence, including 23 cases with local regional recurrence, 26 cases with hematogenous metastasis, and 8 cases with mixed recurrence. Univariate analysis showed that the numbers of concurrent chemotherapy was associated with the overall survival (P＝0.006). But receiving more than 5 weeks was not the prognostic factor compared to 1 to 4 weeks chemotherapy (P＝0.231). Multivariate analysis showed that only the numbers of concurrent chemotherapy was an independent prognostic factor ( P ＝ 0.010 ). Conclusions Postoperative radiotherapy concurrent with weekly chemotherapy could improve the overall survival and decrease the recurrence for stage ⅡB?ⅣA esophageal carcinoma after radical resection. However, the completion rate of chemotherapy was low, so it was necessary to explore reasonable regimens to improve the completion rate and carry out prospective randomized controlled trial.

Objective To evaluate the tolerability and short?term efficacy of chemo?radiotherapy in 125 patients with stageⅡB?ⅣA esophageal carcinoma after radical resection. Methods We retrospectively evaluated the rate of completion, toxicity and survival of patients undergoing adjuvant concurrent chemo?radiotherapy after radical resection of esophageal carcinoma from January 2004 to December 2014 in our institution. The survival rate was determined by the Kaplan?Meier method and analyzed using the log?rank test. Multivariate prognostic analysis was performed using the Cox proportional hazard model. Results 122 patients received more than 50 Gy dose (97.6%). A total of 52 patients received more than 5 weeks chemo? radiotherapy (41.6%), while 73 patients underwent only 1?4 weeks (58.4%). The median following up was 48.4 months. 8 patients lost follow up ( 6.4%). The 1?year and 3?year overall survival rate were 91.6%and 57.0%, respectively, with a median survival time of 64.4 months. The 1?year and 3?year disease free survival rate were 73.2% and 54.3%, respectively, with a median disease free survival time of 59.1 months. The most common acute complications associated with chemo?radiotherapy were myelosuppression, radiation esophagitis and radiation dermatitis, the majority of which were Grade 1?2. Of the 125 patients, there were 59 cases of recurrence, including 23 cases with local regional recurrence, 26 cases with hematogenous metastasis, and 8 cases with mixed recurrence. Univariate analysis showed that the numbers of concurrent chemotherapy was associated with the overall survival (P＝0.006). But receiving more than 5 weeks was not the prognostic factor compared to 1 to 4 weeks chemotherapy (P＝0.231). Multivariate analysis showed that only the numbers of concurrent chemotherapy was an independent prognostic factor ( P ＝ 0.010 ). Conclusions Postoperative radiotherapy concurrent with weekly chemotherapy could improve the overall survival and decrease the recurrence for stage ⅡB?ⅣA esophageal carcinoma after radical resection. However, the completion rate of chemotherapy was low, so it was necessary to explore reasonable regimens to improve the completion rate and carry out prospective randomized controlled trial.

Objective To explore the plantar pressure and surface electromyography (sEMG) parameters during human stair walking, so as to provide theoretical support for foot structure design of dynamic walker, selection of power element and distribution of installation location. Methods Ten healthy young males were recruited to perform stair walking trials, respectively. The motion capture system, plantar pressure system and surface myoelectricity acquisition system were used to collect plantar peak pressure, trajectory of COP(center of pressure) and sEMG parameters of lower limb muscles at the same time. Results Compared with level walking, the percentage of stance time in the whole gait cycle increased during stair walking. The peak pressure of forefoot area increased during stair ascent, while the peak pressure of toe area decreased during stair descent. During stair walking, rectus femoris, biceps femoris, medialis and lateralis gastrocnemius played a main role in maintaining the stability of human body. Conclusions The plantar pressure distribution should be fully considered for foot structure design of dynamic walker and the function of main muscles should be considered for selection of power element and distribution of installation location.

A number of studies have indicated that disorders of consciousness result from multifocal injuries as well as from the impaired functional and anatomical connectivity between various anterior forebrain regions. However, the specific causal mechanism linking these regions remains unclear. In this study, we used spectral dynamic causal modeling to assess how the effective connections (ECs) between various regions differ between individuals. Next, we used connectome-based predictive modeling to evaluate the performance of the ECs in predicting the clinical scores of DOC patients. We found increased ECs from the striatum to the globus pallidus as well as from the globus pallidus to the posterior cingulate cortex, and decreased ECs from the globus pallidus to the thalamus and from the medial prefrontal cortex to the striatum in DOC patients as compared to healthy controls. Prediction of the patients' outcome was effective using the negative ECs as features. In summary, the present study highlights a key role of the thalamo-basal ganglia-cortical loop in DOCs and supports the anterior forebrain mesocircuit hypothesis. Furthermore, EC could be potentially used to assess the consciousness level.
Adult ; Bayes Theorem ; Connectome ; Consciousness Disorders ; diagnostic imaging ; physiopathology ; Female ; Humans ; Machine Learning ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neural Pathways ; diagnostic imaging ; physiopathology ; Prognosis ; Prosencephalon ; diagnostic imaging ; physiopathology ; Young Adult

[ ABSTRACT] AIM:To investigate whether kaempferol protects against acute lung injury induced by swine -origin influenza A H9N2 virus via down-regulation of NF-κB signaling pathway .METHODS:BALB/c mice were used to estab-lish the animal model of acute lung injury by nasal inoculation of swine-origin influenza A H9N2 virus.After the interven-tion with kaempferol , the pulmonary edema was evaluated by determining the lung wet weight /dry weight ( W/D) ratio, the pathological changes of the lung tissues were observed , the concentrations of TNF-α, IL-1βand IL-6 in the bronchoalveolar lavage fluid (BALF) were measured, and superoxide dismutase (SOD) activity, myeloperoxidase (MPO) activity and MDA content in the homogenate of the lung tissues were detected .NF-κB P65 levels were determined by Western blot , and the NF-κB P65 and NF-κB P50 nuclear translocation in the nuclear extracts from mouse lung tissue homogenate was detec-ted by ELISA .RESULTS:Treatment with kaempferol decreased the morality of infected mice , and significantly prolonged the survival time of the infected mice .Kaempferol also relieved the pathological changes of the lung tissues , the lung W/D ratio and the lung index in swine-origin influenza A H9N2 virus-infected mice.Treatment with kaempferol significantly de-creased the infiltration of inflammatory cells including macrophages , lymphocytes and neutrophils in the BALF .The levels of TNF-α, IL-6, IL-1βand MDA and the activity of MPO were also decreased .Treatment with kaempferol also significantly increased the SOD activity .NF-κB P65 levels were decreased , and the NF-κB P65 and NF-κB P50 nuclear translocation in the nuclear extracts from the mouse lung tissue homogenate were also decreased by treatment with kaempferol .CONCLU-SION:The protective effect of kaempferol on the mice with acute lung injury induced by swine -origin influenza A H9N2 vi-rus is related to suppression of the oxidative stress and inflammatory responses by down-regulation of NF-κB signaling path-way.