Objective:To explore the changes of gait flexibility and stability in patients with Parkinson's disease (PD) 2 years after deep brain stimulation (DBS).Methods:Twenty PD patients accepted DBS in Department of Neurosurgery, Tianjin Huanhu Hospital from October 2019 to November 2021 were enrolled. Motor symptoms were evaluated by Movement Disorder Society-unified Parkinson's disease rating scale III (MDS-UPDRS-III) at preoperative medication-off state, postoperative medication-off state, and postoperative medication-on state. Mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA) were used to assess the cognition and 39-item Parkinson's disease questionnaire (PDQ-39) was used to evaluate the quality of life at preoperative medication-on state and postoperative medication-on state. A three-dimensional gait analyzer was used to record the gait parameters during Instrumented Stand and Walk test (ISAW) at preoperative medication-off state, postoperative medication-off state, and postoperative medication-on state. Differences in motor symptom scores, cognitive scores, quality of life scores, as well as changes in gait flexibility and stability were compared before and after DBS.Results:(1) The MDS-UPDRS-Ⅲ scores at preoperative medication-off state, postoperative medication-off state, and postoperative medication-on state ([45.30±12.57], [24.95±10.74], [15.80±7.19]) were decreased successively, with significant differences ( P<0.05).(2) Compared with those before surgery, PD patients had significantly lower levodopa equivalent daily dose (LEDD), total scores of PDQ-39, and scores of question 9 "degree of concern about falling" in PDQ-39 at 2 years after DBS ([711.84±343.99] mg/d vs. [549.30±301.08] mg/d, 47.00[30.00, 64.00] vs. 13.50[7.75, 27.00], 2.00[0.00, 3.00] vs. 0.00[0.00, 1.75], P<0.05). (3) Compared with that at preoperative medication-off state, the arm swing velocity at postoperative medication-on state statistically increased in PD patients ( P<0.05); compared with those at preoperative medication-off state, the arm swing range and turning speed at postoperative medication-off and medication-on states significantly increased in PD patients ( P<0.05); compared with that at preoperative medication-off state, the turning duration at postoperative medication-off state statistically decreased in PD patients ( P<0.05). Compared with that at preoperative medication-off state, the range of motion of the trunk in the horizontal plane at postoperative medication-off and medication-on states increased significantly in PD patients ( P<0.05); compared with that at preoperative medication-off state, the range of motion in the sagittal plane of the lumbar, coronal plane of the trunk, and sagittal plane of the trunk all increased significantly in PD patients at postoperative medication-on state ( P<0.05); the mean velocity and root mean square acceleration at postoperative medication-on state increased significantly in PD patients compared with that at preoperative medication-off state ( P<0.05); conversely, the swing frequency at postoperative medication-off state decreased significantly in PD patients compared with that at preoperative medication-off state ( P<0.05). Conclusion:Two years after DBS, PD patients exhibit obviously improved gait, with enhanced flexibility, and dynamic and static stability.

Objective To analyze the epidemic characteristics and causes of post-exposure immunization failure of rabies in Hubei Province from 2015 to 2021, and to provide evidence for the prevention and control of rabies in Hubei Province. Methods The investigation data of rabies cases in Hubei Province from 2015 to 2021 were collected, and descriptive epidemiological methods were used for data analysis. Results A total of 127 cases of rabies were reported in Hubei Province from 2015 to 2021, with an average annual incidence of 0.31/million, showing a downward trend. The male to female ratio was 1.70:1. Farmers accounted for 82.67% of the total cases, and the 50-79 years old group accounted for 75.59%. The incidence was mainly concentrated in Xiangyang, Shiyan, Yichang and Jingmen, accounting for 77.17%. Most of the cases were concentrated in summer and autumn. Exposure of grade Ⅱand Ⅲ accounted for 24.79% and 75.21%, respectively. Hands, lower limbs below knee, head, arms and lower limbs above knee accounted for 46.15%, 25.21%, 9.40%, 8.55% and 7.69% of the exposed parts, respectively. Dogs, cats and wild animals accounted for 95.73%, 3.42% and 0.85% of the exposed animals, respectively. Stray animals, domesticated animals, neighbors' animals and wild animals accounted for 41.88%, 37.61%, 19.66% and 0.85% of animal sources, respectively. Neither the neighbors’ animals nor domesticated animals were vaccinated against veterinary rabies virus. After exposure, 8.55% of patients went to medical institutions for standard treatment of wounds, 9.40% were vaccinated with human rabies vaccine, and 4.55% of patients with grade III exposure were injected with rabies virus immunoglobulin. The incubation period within 6 months, from 6 months to 1 year, and over 1 year accounted for 72.22%, 14.74%, and 12.04%, respectively. The exposure degree (Z=-1.98, P < 0.05), exposure site (χ²=10.91, P < 0.05) and wound treatment (χ²=15.73, P < 0.05) had statistically significant effects on the incubation period. Among the 11 cases of post-exposure immunization failure, all were grade Ⅲ exposure, 63.63% were exposed to the head and face, 81.81% were not fully vaccinated with human rabies virus vaccine, 63.63% were not immunized with immunoglobulin, and 27.27% were inappropriate wound treatment. Conclusion The key to rabies prevention and control is to standardize dog management, strengthen rabies education, standardize post-exposure wound treatment, timely vaccinate against rabies virus, and inject rabies virus immunoglobulin when necessary.

Objective:To investigate the efficacy and mechanism of Jasminoside in dextran sodium sulfate (DSS) -induced ulcerative colitis (UC) mice.Methods:Eighteen C57BL/6 mice were randomly divided into control group, UC group and UC+Jasminoside group, with six mice in each group. The mice in UC group and UC+Jasminoside group freely drank 3%DSS solution for 7 days to induce UC mouse model. The mice in control group freely drank the water without DSS. During the modeling period, the mice in the UC+Jasminoside group were given Jasminoside at a dose of 20 mg/ (kg·d) by gavage for 7 consecutive days, meanwhile the mice in control group and UC group were given equal volumes of distilled water by gavage. The change of body weight and disease activity index (DAI) of the mice were observed daily, and the length of the colon was measured 7 days after the intervention. HE staining was used to observe the inflammatory changes of the colon, and Western blot was used to measure the expression of anti-apoptotic proteins (Bcl-2 and Bcl-xl), caveolin-1 (CAV-1), inducible nitric oxide synthase (iNOS), tight junction proteins (Occludin and Claudin-1). The differences in the above indicators among the mice in three groups were analyzed statistically.Results:All the mice survived. Compared with the control group, the body weight was lower, DAI score was higher, colon was shorter, whose differences were all statistically significant (all P<0.05), and inflammatory infiltration of colon tissue was more severe in mice of UC group. Compared with the UC group, body weight was higher, DAI score was lower, colon was longer, whose differences were all statistically significant (all P<0.05), and inflammatory infiltration of colon tissue was alleviated in mice of UC+Jasminoside group. Western blot results showed that compared with control group, the expression of Bcl-2, Bcl-xl, CAV-1, Occludin and Claudin-1 was significantly lower and the expression of iNOS was significantly higher in the colon tissues of mice in UC group, and the differences were statistically significant (all P<0.05). The expression of Bcl-2, Bcl-xl, CAV-1, Occludin and Claudin-1 in the colon tissues of mice in UC+Jasminoside group was significantly higher than those in UC group, while the expression of iNOS was lower, and the differences were statistically significant (all P<0.05) . Conclusion:Jasminoside can alleviate the symptoms of UC model mice, and its mechanism of action may be related to upregulating the expression of anti-apoptotic proteins and protecting the intestinal mucosal barrier through CAV-1/iNOS pathway.

Objective:To investigate the efficacy and mechanism of Jasminoside in dextran sodium sulfate (DSS) -induced ulcerative colitis (UC) mice.Methods:Eighteen C57BL/6 mice were randomly divided into control group, UC group and UC+Jasminoside group, with six mice in each group. The mice in UC group and UC+Jasminoside group freely drank 3%DSS solution for 7 days to induce UC mouse model. The mice in control group freely drank the water without DSS. During the modeling period, the mice in the UC+Jasminoside group were given Jasminoside at a dose of 20 mg/ (kg·d) by gavage for 7 consecutive days, meanwhile the mice in control group and UC group were given equal volumes of distilled water by gavage. The change of body weight and disease activity index (DAI) of the mice were observed daily, and the length of the colon was measured 7 days after the intervention. HE staining was used to observe the inflammatory changes of the colon, and Western blot was used to measure the expression of anti-apoptotic proteins (Bcl-2 and Bcl-xl), caveolin-1 (CAV-1), inducible nitric oxide synthase (iNOS), tight junction proteins (Occludin and Claudin-1). The differences in the above indicators among the mice in three groups were analyzed statistically.Results:All the mice survived. Compared with the control group, the body weight was lower, DAI score was higher, colon was shorter, whose differences were all statistically significant (all P<0.05), and inflammatory infiltration of colon tissue was more severe in mice of UC group. Compared with the UC group, body weight was higher, DAI score was lower, colon was longer, whose differences were all statistically significant (all P<0.05), and inflammatory infiltration of colon tissue was alleviated in mice of UC+Jasminoside group. Western blot results showed that compared with control group, the expression of Bcl-2, Bcl-xl, CAV-1, Occludin and Claudin-1 was significantly lower and the expression of iNOS was significantly higher in the colon tissues of mice in UC group, and the differences were statistically significant (all P<0.05). The expression of Bcl-2, Bcl-xl, CAV-1, Occludin and Claudin-1 in the colon tissues of mice in UC+Jasminoside group was significantly higher than those in UC group, while the expression of iNOS was lower, and the differences were statistically significant (all P<0.05) . Conclusion:Jasminoside can alleviate the symptoms of UC model mice, and its mechanism of action may be related to upregulating the expression of anti-apoptotic proteins and protecting the intestinal mucosal barrier through CAV-1/iNOS pathway.

Objective:To investigate the effect and mechanism of bone marrow mesenchymal stem cell (BMSC)-derived exosomal microRNA-1297 (miR-1297) on hippocampal neuron damage in depressed rats.Methods:BMSCs and BMSCs-derived exosomes were prepared and identified. Rats were first injected with corticosterone to establish the model of depression, and then injected with BMSCs-derived exosomes. Superoxide dismutase (SOD), malondialdehyde (MDA), lactate dehydrogenase (LDH), TNF-α and IL-1β in rat serum samples, hippocampal tissues and neurons were detected. Expression of miR-1297 in hippocampal tissues and neurons was detected by RT-qPCR. A rat hippocampal neuron injury model was established to investigate the role of BMSC-derived exosomes and miR-1297 in neuronal apoptosis and proliferation. The targeting relationship between miR-1297 and connective tissue growth factor (CTGF) was analyzed using dual luciferase reporter genes.Results:In the hippocampus of depressed rats, the expression of miR-1297 was low, while the expression of CTGF was elevated. Exosomes derived from BMSCs can inhibit the expression of CTGF by up-regulating the level of miR-1297, thereby inhibiting neuronal cell apoptosis in the hippocampus of depressed rats, while increasing the level of SOD, and reducing inflammatory damage, and ultimately improving the behavioral function of depressed rats.Conclusions:Depressed rats showed decreased expression of miR-1297 and increased expression of CTGF. BMSC-derived exosomes inhibited CTGF expression through up-regulating miR-1297, thereby improving hippocampal neuron damage in rats with depression.

Objective To evaluate the auditory and verbal abilities of cochlear implantees using question_naires ,to explore basic rules of the development of auditory and verbal abilities ,and to analyze their relationships with some influencing factors .Methods A retrospective analysis of 107 cases of pre-lingually deaf children with cochlear implantation was conducted with Infant-Toddler Meaningful Auditory Integration Scale/Meaningful Audi_tory Integration Scale (IT -MAIS/MAIS) ,categories of auditory performance (CAP) and speech intelligibility rat_ing (SIR) for the evaluation of auditory and verbal abilities .An analysis was performed to assess influencing fac_tors ,such as postoperative time ,age at implantation ,physical age at follow -up ,time with hearing aids before im_plantation .SAS 9 .1 .3 was used in statistical analysis .ResuIts A total of 107 pre-lingually deaf children (48 males and 59 females) participated in this study .The postoperative time ranged from 0 to 49 months ,with an average of 9 .0 ± 10 .9 months .The results showed the postoperative time and age at implantation had significant influences on the scores of IT -MAIS/MAIS ,and postoperative time and physical age at follow -up had significant influences on the scores of CAP/SIR (P<0 .05) ,and hearing aids (HA) usage before implantation had no significant influences on these three questionnaires (P>0 .05) .ConcIusion The ages at implantation ,postoperative time and physical age had significant influences on the auditory and verbal abilities of pre-lingually deaf children with cochlear implanta_tion .Further studies are needed to explore their relationships with hearing aids usage before implantation .

OBJECTIVE: To evaluate the verbal communication skills of post-lingual cochlear implantees with categories of auditory performance (CAP) and speech intelligibility rating(SIR), and to explore their relationships with the duration of hearing loss, the postoperative time and preoperative hearing aid usage. METHOD: A retrospective analysis was conducted on 23 cases of post-lingual patients with cochlear implantation. CAP and SIR were applied in the evaluation of verbal communication skills. IBM SPSS Statistics 19 was used in statistical analysis. RESULT: The average score of CAP was 6.13, and statistical analysis showed CAP score was not significantly correlated with the duration of hearing loss, the postoperative time or the time of wearing a hearing aid preoperatively. The average SIR score of all these post-lingual patients was 4.91. CONCLUSION It showed that CAP score was not significantly correlated with these three factors. This may due to the low accuracy of CAP or the small sample size in the present study. SIR was not suitable for the evaluation of post-lingual cochlear implantees.
Adolescent ; Adult ; Aged ; Cochlear Implantation ; Female ; Hearing ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Speech Intelligibility ; Young Adult

OBJECTIVE: To present the experience of nasal reconstruction with forehead flap. METHOD: nasal reconstruction with forehead flap were applied in eight nasal carcinoma cases after operation and 5 nasal trauma cases with defects. RESULT: These forehead flaps were alive in all patients, all incision healed in I stage, no post operative complications were found. The shapes of nose were satisfactory, there were no recurrence of tumor during 1 to 17 year follow up. CONCLUSION The method can be clinically applied for its simple procedure, reliable flap's blood supply, high survival rate and satisfied result.
Adolescent ; Adult ; Aged ; Female ; Forehead ; surgery ; Humans ; Male ; Middle Aged ; Nose ; injuries ; surgery ; Rhinoplasty ; methods ; Skin Transplantation ; Surgical Flaps ; Young Adult

BACKGROUND: It is still controversial whether antibiotic-loaded bone cement can prevent wound deep infection in the primary hip arthroplasty. OBJECTIVE: To retrospectively observe the effect of antibiotic-loaded bone cements in primary hip arthroplasty. DESIGN, TIME AND SETTING: A retrospective case analysis was performed for the patients undergoing primary hip arthroplasty at Department of Orthopedics, Peking University Third Hospital from February 2004 to January 2007. PARTICIPANTS: 227 consecutive patients (233 hips) underwent primary hip arthroplasty with the same antibiotic-loaded bone cement, including 69 male and 115 female, and 184 cases (191 hips) were followed up for 3-46 months. METHODS: Fifty-four patients over 71 years old with femoral neck fracture were treated with bipolar femoral head replacement. 130 patients underwent total hip arthroplasty. Seventeen patients with massive acetabular bone defect were reconstructed with impaction autogenous and heterogenous bone grafting plus mesh; 3 patients underwent acetabular structural bone grafting. Both acetabular and femoral side prosthesis were antibiotic-loaded bone cements (Refobacin~-Palacos~R 40 or Cemex~ Genta). MAIN OUTCOME MEASURES: Deep infection after operation. RESULTS: 227 patients (233 hips) did not develop early deep infection after surgery. 184 cases (191 hips) did not occur deep infection during the follow up. However, 15 cases developed swelling on the affected site or skin temperature increase, or pain surrounding joint, and underwent blood sedimentation and C-reactive protein examinations; 12 cases had normal blood sedimentation and 3 had increased blood sedimentation including 1 with rheumatoid, 1 with senile chronic bronchitis, and 1 with undetermined cause. All the 3 patients restored one month later. Fourteen patients had C-reactive protein within normal scope, and 1 with increased C-reactive protein caused by rheumatoid arthritis, but restored 6 weeks later. CONCLUSION: Antibiotic-loaded bone cements in primary hip arthroplasty can reduce incidence of deep infection.