Objective To investigate the effects of transcranial direct current stimulation(tDCS)combined with resistance training on the performance of college students completing pull-ups,and explore the potential mechanisms underlying the effects of training intervention from the perspective of neuromuscular activity control.Methods A total of 25 male college student volunteers were randomly divided into the tDCS combined with resistance training group(experiment group)and resistance training group(control group).Twelve subjects in the control group received a lat pull-down strength training intervention lasting for 8 weeks,with 4 sets of 12 movement repetitions each,3 times per week.Thirteen subjects in the experimental group received a 20-minute tDCS before the lat pull-up resistance training intervention.Lat pull-down isometric maximal voluntary contraction(MVC)force,lat pull-down maximal repetitions under 80％one-repetition maximum(1RM)loading,and conventional pull-up exercise were tested before and after the training intervention.Surface electromyography(sEMG)signals of the main exertion muscles of the upper limb were recorded during the pull-up exercise test.Results After the training intervention,the number of pull-ups completed by the experimental group and control group increased by 1.74 times and 1.42 times,respectively.Subjects in both groups showed significant improvements in their MVC and lat pull-down maximal repetitions under 80％1RM loading.However,there were no statistical differences in these indicators between groups.Activation levels of the agonist muscles brachioradialis,posterior deltoid,and pectoralis major were significantly decreased after the training compared to those before training for both groups.In addition,the coactivation level of the antagonist triceps brachii muscle in the experimental group significantly decreased from 0.50±0.22 to 0.37±0.09 after the training,while there was no significant change in the control group before and after the intervention.Conclusions Eight-week tDCS combined with resistance training and resistance training alone can significantly improve the pull-up performance of college students,which may be related to the fact that both types of training can significantly improve the active muscle contraction capacity.Combined with resistance training,tDCS is more effective in decreasing the coactivation level of triceps brachii during pull-ups and increasing the contraction efficiency of elbow joint muscles.

Objective To explore the relationship between plasma amyloid-β(Aβ)and cognitive impairment.Methods A total of all villagers(aged 40 years and above)from two villages of Xi'an,China,were enrolled.A validated Chinese version of the Mini-Mental State Examination and neuropsychological battery were used to assess cognition.Levels of fasting plasma Aβ1-42 and Aβ1-40 were tested using commercial enzyme-linked immunosorbent assay(ELISA).Relationship between plasma Aβ and cognitive impairment was analyzed using Logistic regression analysis.Results Of the 1 314 enrolled subjects,1 180(89.80％)had normal cognition,85(6.47％)had suspected cognitive impairment,and 49(3.73％)had probable cognitive impairment.Univariate analysis showed that plasma Aβ1-42/Aβ1-40 ratio was higher in the suspected cognitive impairment group than in the probable cognitive impairment group(P＜0.05)and normal cognitive group(P＜0.05);plasma Aβ1-42 level in the suspected cognitive impairment group was higher than that in normal cognitive group(P＜0.05).The level of Aβ1-40 did not differ between the three groups.After correcting for confounding factors(including age,gender,degree of education,cognitive impairment risk factors,habits of living)in the multivariate Logistic regression analysis,the results were consistent with those in the univariate analysis.Conclusion Levels of plasma Aβ1-42 and Aβ1-42/Aβ1-40 ratio were elevated in patients with suspected cognitive impairment,indicating that elevated plasma Aβ1-42 and Aβ1-42/Aβ1-40 ratio may be more pronounced in early stage of cognitive impairment.They may be early biomarkers for cognitive impairment,which can help identify and intervene the disease earlier.

Objective To investigate the effects of transcranial direct current stimulation(tDCS)combined with resistance training on the performance of college students completing pull-ups,and explore the potential mechanisms underlying the effects of training intervention from the perspective of neuromuscular activity control.Methods A total of 25 male college student volunteers were randomly divided into the tDCS combined with resistance training group(experiment group)and resistance training group(control group).Twelve subjects in the control group received a lat pull-down strength training intervention lasting for 8 weeks,with 4 sets of 12 movement repetitions each,3 times per week.Thirteen subjects in the experimental group received a 20-minute tDCS before the lat pull-up resistance training intervention.Lat pull-down isometric maximal voluntary contraction(MVC)force,lat pull-down maximal repetitions under 80％one-repetition maximum(1RM)loading,and conventional pull-up exercise were tested before and after the training intervention.Surface electromyography(sEMG)signals of the main exertion muscles of the upper limb were recorded during the pull-up exercise test.Results After the training intervention,the number of pull-ups completed by the experimental group and control group increased by 1.74 times and 1.42 times,respectively.Subjects in both groups showed significant improvements in their MVC and lat pull-down maximal repetitions under 80％1RM loading.However,there were no statistical differences in these indicators between groups.Activation levels of the agonist muscles brachioradialis,posterior deltoid,and pectoralis major were significantly decreased after the training compared to those before training for both groups.In addition,the coactivation level of the antagonist triceps brachii muscle in the experimental group significantly decreased from 0.50±0.22 to 0.37±0.09 after the training,while there was no significant change in the control group before and after the intervention.Conclusions Eight-week tDCS combined with resistance training and resistance training alone can significantly improve the pull-up performance of college students,which may be related to the fact that both types of training can significantly improve the active muscle contraction capacity.Combined with resistance training,tDCS is more effective in decreasing the coactivation level of triceps brachii during pull-ups and increasing the contraction efficiency of elbow joint muscles.

Objective To explore the relationship between plasma amyloid-β(Aβ)and cognitive impairment.Methods A total of all villagers(aged 40 years and above)from two villages of Xi'an,China,were enrolled.A validated Chinese version of the Mini-Mental State Examination and neuropsychological battery were used to assess cognition.Levels of fasting plasma Aβ1-42 and Aβ1-40 were tested using commercial enzyme-linked immunosorbent assay(ELISA).Relationship between plasma Aβ and cognitive impairment was analyzed using Logistic regression analysis.Results Of the 1 314 enrolled subjects,1 180(89.80％)had normal cognition,85(6.47％)had suspected cognitive impairment,and 49(3.73％)had probable cognitive impairment.Univariate analysis showed that plasma Aβ1-42/Aβ1-40 ratio was higher in the suspected cognitive impairment group than in the probable cognitive impairment group(P＜0.05)and normal cognitive group(P＜0.05);plasma Aβ1-42 level in the suspected cognitive impairment group was higher than that in normal cognitive group(P＜0.05).The level of Aβ1-40 did not differ between the three groups.After correcting for confounding factors(including age,gender,degree of education,cognitive impairment risk factors,habits of living)in the multivariate Logistic regression analysis,the results were consistent with those in the univariate analysis.Conclusion Levels of plasma Aβ1-42 and Aβ1-42/Aβ1-40 ratio were elevated in patients with suspected cognitive impairment,indicating that elevated plasma Aβ1-42 and Aβ1-42/Aβ1-40 ratio may be more pronounced in early stage of cognitive impairment.They may be early biomarkers for cognitive impairment,which can help identify and intervene the disease earlier.

Objective To investigate the relationship between serum levels of nuclear factor E2-related fac-tor 2(Nrf2),advanced oxidation protein products(AOPP)and blood lipid,liver fibrosis in patients with non-alcoholic steatohepatitis(NASH).Methods A total of 104 patients with NASH in Bishan Hospital Affiliated to Chongqing Medical University were selected as the study group,and 90 healthy people were selected as the control group.The serum levels of Nrf2 and AOPP in each group were detected and compared.Pearson or Spearman correlation analysis was used to analyze the relationship between serum Nrf2,AOPP levels and blood lipid,liver fibrosis in patients with NASH.Receiver operating characteristic(ROC)curve was used to e-valuate the diagnostic value of serum Nrf2,AOPP levels for NASH.Results The levels of triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),Nrf2 and AOPP in the study group were higher than those in the control group(P＜0.05),and the level of high density lipoprotein cholesterol(HDL-C)was significantly lower than that in the control group(P＜0.05).The serum levels of Nrf2 and AOPP in severe group were higher than those in moderate group and mild group(P＜0.05),and the serum levels of Nrf2 and AOPP in moderate group were higher than those in mild group(P＜0.05).Correlation analysis showed that serum Nrf2 and AOPP levels in NASH patients were positively correlated with TG,TC,LDL-C and the degree of liver fibrosis(P＜0.05),and negatively correlated with HDL-C(P＜0.05).The area under the curve(AUC)of serum Nrf2 for NASH diagnosis was 0.830(95％CI 0.780-0.880).The AUC of serum AOPP in the diagnosis of NASH was 0.866(95％CI 0.816-0.916).The AUC of the combined diagnosis of NASH was 0.925(95％CI 0.875-0.975).Conclusion The serum levels of Nrf2 and AOPP are increased in NASH patients,and they are closely related to blood lipids and liver fibrosis,which are expected to be effective indicators for the diagnosis of NASH.

Objective To evaluate the expression differences of C-reactive protein(CRP),procalcitonin(PCT)and cytokines[interferon-γ(IFN-γ),tumor necrosis factor-α(TNF-α),interleukin(IL)-10,IL-6,IL-4,IL-2,IL-17 A,and IFN-γ/IL-10]in human immunodeficiency virus(HIV)infection,tuberculosis(TB)infec-tion and HIV/TB co-infection in order to provide evidence for early clinical diagnosis of HIV/TB co-infection.Methods Medical records and clinical information of 103 patients with HIV(HIV group),42 patients with TB(TB group)and 67 patients with HIV/TB co-infection(HIV/TB group)were collected from January 2021 to September 2022.CRP,PCT and cytokines were detected in all patients,and their expression differ-ences among the three groups were analyzed.Receiver operating characteristic(ROC)curves were drawn and screening ability was evaluated.Results Compared with HIV group and TB group,CRP,PCT,IFN-γ,IL-10,IL-6 levels and IFN-γ/IL-10 in HIV/TB group were increased,with statistical significance(P＜0.001).Bon-ferroni correction results showed that CRP,PCT,IFN-γ,IL-6 levels and IFN-γ/IL-10 were significantly differ-ent between HIV and HIV/TB groups(all P＜0.001).ROC curve analysis showed that the area under the curve of CRP,PCT,IFN-γ,IL-6 and IFN-γ/IL-10 combined detection was 0.826,which was higher than that of single detection.Conclusion CRP,PCT,IFN-γ,IL-6,IFN-γ/IL-10 combined detection can help the early screening of HIV infection and HIV/TB co-infection.

AIM: To analyze the research status and future development trends of intermittent exotropia(IXT)by bibliometric study.METHODS: Bibliometrics methods were used and the related literatures in the Web of Science Core Collection(WoSCC)database from 2003 to 2022 were retrieved. CiteSpace6.2.R2 software was used to conduct visualized analysis of publications of one year, countries, institutions, journals, authors, references and keywords.RESULTS: A total of 620 literatures on IXT were retrieved from 2003 to 2022, and there has been a progressive increase in the number of publications. South Korea and the United States, Mayo Clinc and Holmes JM were the most productive and impactful country, institution and author, respectively. The Journal of American Association for Pediatric Ophthalmology and Strabismus(J AAPOS)published the most manuscripts(78 publications). The keywords with the strongest citation burst were surgery, epidemiology, alignment and recurrence.CONCLUSION: Visualized analysis conducted by CiteSpace software could objectively show the quantity changes and distribution of literatures on IXT from 2003 to 2022. Furthermore, the research hotspot of IXT has gradually shifted from surgery and epidemiology to fusion and recurrence.

Objective:To explore influencing factors of the self-reported brief life quality satisfaction score(Brief-QoL) in patients with acromegaly and understand the persistent low Brief-QoL scores in cases achieving biochemical remission.Methods:This study included 836 acromegaly patients who were hospitalized at Peking Union Medical College Hospital between January 2012 and December 2020. We retrospectively examined how clinical characteristics, biochemical parameters, comorbidities, and symptoms influenced Brief-QoL. Among patients who achieved biochemical remission, differences in clinical symptoms and comorbidities were analyzed between the high and low quality of life groups.Results:Patients with well-controlled biochemical indicators at the last follow-up had generally high Brief-QoL. However, patients with symptoms such as headaches (47.8% in the low-score group vs 14.9% in the high-score group, P<0.001) and joint pain (69.6% in the low-score group vs 19.0% in the high-score group, P<0.001) had low Brief-QoL despite biochemical remission. Receiving combined treatment(52.4% in the low-score group vs 27.5% in the high-score group, P=0.030) and having comorbid diabetes or hyperlipidemia were significant factors leading to decreased quality of life. Conclusion:Brief-QoL is suitable for follow-up of outpatient patients. Early identification of factors affecting quality of life and timely intervention can facilitate the realization of standardized management.

To report a case of nonbullous neutrophilic lupus erythematosus. A 57-year-old male patient presented with recurrent erythematous pruritic papules and plaques on the trunk and extremities for over 10 years. Skin examination revealed scattered urticaria-like papules and plaques on the trunk and limbs, with thin scales on the edge of some lesions. Laboratory tests showed positive antinuclear antibodies at a titer of 1∶320 (granular type), anti-Sj?gren syndrome A (SSA) antibodies (++), anti-SSB antibodies (+++), anti-Ro-52 antibodies (+++), and anti-neutrophil cytoplasmic antibodies at a level of 369.09 RU/ml (reference range: 0 - 20 RU/ml). Histopathological analysis of the skin lesions on the back revealed epidermal hyperkeratosis in a basket-like shape, liquefaction degeneration of basal cells, infiltration of numerous neutrophils in the superficial dermis with karyorrhexis, perivascular infiltration of lymphocytes in the superficial and middle dermis, and extensive extracellular mucin deposition throughout the dermis. Finally, the patient was diagnosed with nonbullous neutrophilic lupus erythematosus.

Objective:To analyze the evaluation of the application effect and deficiency of nurses acting as standardized parents in the graduation examination of standardized residency training of pediatrics and further improve and promote the level of standardized parents.Methods:A questionnaire survey was used to collect the scores of nurse standardized parents by students and examiners who took part in the graduation examination of standardized residency training of pediatrics in 2021. And the self-evaluation scores of standardized parents were collected. Counting data were represented by the number of cases and composition ratio. A Chi-square test was used to compare the rates.Results:A total of 125 questionnaires from students and 37 questionnaires from nurse standardized parents were collected, and the overall satisfaction (very satisfied + satisfied) of standardized parents reached 121 (96.80%). In the three dimensions of simulation ability, compliance with question-and-answer rules, and simulated attitude, students believed that the consistency between standardized parents and actual parents in simulated altitude was lower than that in the simulation ability and compliance with question-and-answer rules ( P=0.007, P=0.001). The overall satisfaction of standardized parents (very satisfied + satisfied) reached 87.38% (388/444). There were 26 (70.27%) nurse standardized parents who had the lowest satisfaction with their own performance ability, followed by 28 (75.68%) cases of imitation ability and 30 (81.08%) cases of adaptability. Conclusions:It is feasible to adopt nurse standardized parents in the assessment of standardized residency training of pediatrics, and both students and examiners have higher satisfaction. The next step is to improve the training of nurses standardized parents in the attitude of simulation and, at the same time, enhance the training of imitation ability and adaptability, so as to further expand the construction of standardized parents.