Objective:To analyze the factors influencing the ADL ability and the improvement degree of ADL ability at discharge of hospitalized patients with TBI and to establish prediction models. Method:Data of 220 patients with traumatic brain injury hospitalized in the department of neurorehabilitation,Beijing Boai hospital from september 2017 to september 2020 were retrospectively collected.They were ran-domly divided into training set and validation set according to 3:1,and descriptive analysis was conducted for all variables.BI score at discharge and BI score difference between admission and discharge were used as out-come indexes.Firstly,univariate analysis was used to screen the statistically significant influencing factors,and then multivariate logistic regression analysis was used to establish the prediction model.Receiver operating characteristic(ROC)curve,calibration curve and Hosmer-Lemeshow test were used to evaluate the differentia-tion and calibration of the model in the training set and validation set. Result:Two prediction models were established by multivariate logistic regression:①Duration of disease at ad-mission,FMB at admission and BI at admission were significant influencing factors of BI at discharge.The ar-ea under the curves of the prediction model with BI at discharge was 0.957(95％CI:0.930-0.983)and 0.917(95％CI:0.839-0.994)in the training set and validation set,respectively,showing good model differentiation.Hosmer-lemeshow test results were P=0.196 and P=0.551,respectively,indicating a good calibration degree of the model.The sensitivity,specificity,and Youden index of the logistic regression model were 91.4％(95％CI:0.833-0.959)、83.3％(95％CI:0.723-0.907)and 0.747,respectively.②The duration of disease,length of stay and age at admission significantly affected the BI difference.The areas of the established prediction mod-el under the curves of training set and validation set were 0.773(95％CI:0.702-0.844)and 0.747(95％CI:0.613-0.881),and Hosmer-Lemeshow test results were P=0.721 and P=0.274,respectively,indicating good model differentiation and calibration.The sensitivity,specificity,and Youden index of the logistic regression model were 77.2％(95％CI:0.670-0.850)、64.4％(95％CI:0.522-0.750)and 0.416,respectively. Conclusion:The established two prediction models will help rehabilitation doctors to preliminarily judge the level of functional independence at discharge and the degree of functional improvement during hospitalization according to the status of patients with TBI at admission,and provide reference for rehabilitation medical work.

ObjectiveTo review the ancient and modern literature of Huanglian Ejiaotang and learn about the historical evolution and clinical application， thereby providing a theoretical basis for the modern application of the classical prescription. MethodLiterature in the Chinese Medical Classics Database was retrieved with "Huanglian Ejiaotang" as the keyword. In China National Knowledge Infrastructure （CNKI） and PubMed， "Huanglian Ejiaotang" in Chinese and English was used as the keyword to retrieve literature. The items and modern clinical application studies related to the prescription， medicine， dosage， syndrome， and treatment of Huanglian Ejiaotang were selected and recorded. The inclusion and exclusion criteria were used to screen out literature. The information about the dynasty， book title， function， and indication was integrated to understand the history， evolution， and clinical application of Huanglian Ejiaotang. ResultFinally， 89 ancient books were included with 111 items. Huanglian Ejiaotang was initially recorded in ZHANG Zhongjing's Treatise on Cold Damage and Miscellaneous Diseases in the Han dynasty. It was composed of five herbs， namely Coptidis Rhizoma， Scutellariae Radix， Paeoniae Radix Alba， Asini Corii Colla， and egg yolk. With the change of historical dynasties， the composition， origin basis， dosage， and preparation method of Huanglian Ejiaotang all changed， but the changes in the processing were not obvious， which was basically consistent with Treatise on Cold Damage and Miscellaneous Diseases. In addition， 48 studies were included to analyze the clinical application of Huanglian Ejiaotang， which was mainly used for insomnia， anxiety， depression， diabetes， and so on. ConclusionAccording to the ancient and modern literature， the origin basis， dosage， processing， decoction， administration， and other content of Huanglian Ejiaotang are consistent with Treatise on Cold Damage and Miscellaneous Diseases. The present clinical application has expanded the usage scale of the ancient record， which promotes the innovation and development of the classic prescription and provides references for later research， development， and accurate application.

Objective To investigate the inhibitory effect of ursolic acid in Hippophae rhamnoides L. on hepatocyte apoptosis in rats with alcoholic liver disease based on the mitochondria-cytochrome c pathway. Methods A total of 50 specific pathogen-free male Wistar rats were divided into normal control group, alcohol model group, and low-, middle-, and high-dose ursolic acid groups using a random number table, with 10 rats in each group. The rats in the normal control group were given normal saline by gavage once a day for 8 weeks; the rats in the alcohol model group were given alcohol at increasing concentrations by gavage for 8 consecutive weeks; the rats in the low-, middle-, and high-dose ursolic acid groups were given ursolic acid at a dose of 50, 100, and 150 mg/kg, respectively, followed by an equal volume of alcohol as the model group 1 hour later. Serum liver function parameters were measured for each group; HE staining was used to observe liver histopathology; an electron microscope was used to observe hepatocyte ultrastructure; the TUNEL method was used to measure hepatocyte apoptosis; Western Blotting was used to measure the protein expression levels of cytochrome c and activated caspase-3 in hepatocyte mitochondria and cytoplasm. A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the least significant difference t -test was used for further comparison between two groups. Results Compared with the alcohol model group, the middle- and high-dose ursolic acid groups had significant reductions in the serum level of alanine aminotransferase, aspartate aminotransferase, and cholinesterase (all P < 0.05). The rats in the alcohol model group had disordered arrangement of hepatic cords with marked hepatocyte edema and fatty degeneration, while those in the middle- and high- dose ursolic acid groups had basically normal arrangement of hepatic cords and a significant improvement in hepatocyte fatty degeneration, as well as a significant increase in the number of hepatocyte mitochondria and a significant improvement in morphology. Compared with the alcohol model group, the middle- and high-dose ursolic acid groups had significantly lower hepatocyte apoptosis rate and protein expression levels of cytochrome c and caspase-3 in cytoplasm (all P < 0.05). Conclusion Ursolic acid in Hippophae rhamnoides L. can improve the liver function and histomorphology of rats with alcoholic liver disease, possibly by inhibiting the release of cytochrome c in hepatocyte mitochondria, the activation of caspase-3, and the apoptosis of hepatocytes via the mitochondria-cytochrome c pathway.

ObjectiveTo investigate the effects of an intelligent aerobic bicycle training on lower limb motor function, cardiopulmonary function and activities of daily living (ADL) in patients with ischemic stroke at different courses. MethodsFrom November, 2019 to November, 2021, 138 ischemic stroke patients were stratified-randomly divided into control group (n = 69) and experimental group (n = 69). All the patients received medication and routine rehabilitation training, and the experimental group additionally received intelligent aerobic bicycle training, for eight weeks. They were assessed with Fugl-Meyer Assessment-Lower Extremities (FMA-LE), peak oxygen uptake (VO₂peak), Six-minute Walk Test (6MWT) and modified Barthel Index (MBI) before, and four weeks and eight weeks after treatment. ResultsThe performances of FMA-LE, VO₂peak, 6MWT and MBI improved in both groups after treatment (|t| > 6.763, P < 0.001), and improved more in the experimental group than in the control group (|t| > 2.439, P < 0.05). For the patients beginning training less than one month after stroke, the performances of FMA-LE, VO₂peak and 6MWT improved more in the experimental group than in the control group (|t| > 2.036, P < 0.05); for those during one to three months, the performances of 6MWT and MBI improved more (|t| > 2.005, P < 0.05); for those during three to six months, the performances of all the tests were not significantly different (|t| < 1.303, P > 0.05). ConclusionIntelligent aerobic bicycle training may improve the lower limb motor function, cardiopulmonary function and ADL for patients with ischemic stroke, especially intervening earlier.

Objective:To explore the application value of artificial intelligence-assisted diagnosis system for TBS report in cervical cancer screening.Methods:A total of 16 317 clinical samples and related data of cervical liquid-based thin-layer cell smears, which were obtained from July 2020 to September 2020, were collected from Southern Hospital, Guangzhou Huayin Medical Inspection Center, Shenzhen Bao′an People′s Hospital(Group) and Changsha Yuan′an Biotechnology Co., Ltd. The TBS report artificial intelligence-assisted diagnosis system of cervical liquid-based thin-layer cytology jointly developed by Southern Medical University and Guangzhou F. Q. PATHOTECH Co., Ltd. based on deep learning convolution neural network was used to diagnose all clinical samples. The sensitivity,specificity and accuracy of both artificial intelligence-assisted diagnosis system and cytologists using artificial intelligence-assisted diagnosis system were analyzed based on the evaluation standard(2014 TBS). The time spent by the two methods was also compared.Results:The sensitivity of artificial intelligence-assisted diagnosis system in predicting cervical intraepithelial lesions and other lesions (including endometrial cells detected in women over 45 years old and infectious lesions) under different production methods, different cytoplasmic staining and different scanning instruments was 92.90% and 83.55% respectively, and the specificity of negative samples was 87.02%, while that of cytologists using artificial intelligence-assisted diagnosis system was 99.34%, 97.79% and 99.10%, respectively. Moreover, cytologists using artificial intelligence-assisted diagnosis system could save about 6 times of reading time than manual.Conclusions:Artificial intelligence-assisted diagnosis system for TBS report of cervical liquid-based thin-layer cytology has the advantages of high sensitivity, high specificity and strong generalization. Cytologists can significantly improve the accuracy and work efficiency of reading smears by using artificial intelligence-assisted diagnosis system.

BACKGROUND: Chronic noise exposure is one environmental hazard that is associated with genetic susceptibility factors that increase Alzheimer's disease (AD) pathogenesis. However, the comprehensive understanding of the link between chronic noise stress and AD is limited. Herein, we investigated the effects of chronic noise exposure on AD-like changes in senescence-accelerated mouse prone 8 (SAMP8). METHODS: A total of 30 male SAMP8 mice were randomly divided into the noise-exposed group, the control group, and aging group (positive controls), and mice in the exposure group were exposed to 98 dB SPL white noise for 30 consecutive days. Transcriptome analysis and AD-like neuropathology of hippocampus were examined by RNA sequencing and immunoblotting. Enzyme-linked immunosorbent assay and real-time PCR were used to further determine the differential gene expression and explore the underlying mechanisms of chronic noise exposure in relation to AD at the genome level. RESULTS: Chronic noise exposure led to amyloid beta accumulation and increased the hyperphosphorylation of tau at the Ser202 and Ser404 sites in young SAMP8 mice; similar observations were noted in aging SAMP8 mice. We identified 21 protein-coding transcripts that were differentially expressed: 6 were downregulated and 15 were upregulated after chronic noise exposure; 8 genes were related to AD. qPCR results indicated that the expression of Arc, Egr1, Egr2, Fos, Nauk1, and Per2 were significantly high in the noise exposure group. These outcomes mirrored the results of the RNA sequencing data. CONCLUSIONS These findings further revealed that chronic noise exposure exacerbated aging-like impairment in the hippocampus of the SAMP8 mice and that the protein-coding transcripts discovered in the study may be key candidate regulators involved in environment-gene interactions.

Objective: To investigate the clinical and molecular genetic features of neonatal congenital lipoid adrenal hyperplasia (CLAH) caused by mutations in steroidogenic acute regulatory protein (StAR) encoding gene. Methods: This study retrospectively analyzed the clinical data of a CLAH neonate admitted to Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University in April 2017. StAR gene was analyzed using high-throughput sequencing and Sanger sequencing. Relevant literature retrieved from databases including China National Knowledge Infrastructure (CNKI), Wanfang and PubMed were reviewed, and the reported cases with relatively complete clinical data and results of serum hormone test and StAR gene mutation analysis were collected. Results: The index patient presented with hyperpigmentation and growth retardation soon after birth. Laboratory tests revealed hyponatremia, hyperkalemia, increased serum adrenocorticotrophic hormone (263.4 pmol/L) and decreased 17-hydroxyprogesterone (0.16 ng/ml), dehydroepiandrosterone (<0.95 μmol/L), androstenedione (<1.0 nmol/L), testosterone (<0.025 ng/ml), progesterone (0.02 ng/ml) and cortisol (1.6 μg/ml). High-throughput sequencing showed that the patient carried a compound heterozygous mutation of p.Thr240fs in exon 6 and p.Gln258X in exon 7, inherited from the father and mother, respectively. Sanger sequencing confirmed the diagnosis of CLAH caused by StAR gene mutation. After steroid replacement therapy, the patient's symptoms resolved and the concentrations of electrolytes returned to normal. The neonate was followed up to two years of age and no abnormality was found in physical or neurological development. Two Chinese and 11 English publications were retrieved and altogether 96 cases of neonatal CLAH, including the index one, were reviewed and 42 of them had detailed clinical data. The most common clinical manifestations were skin pigmentation (85.7%, 36/42). Other manifestations included vomiting (35.7%, 15/42) and growth retardation (14.3%, 6/42). All patients with physical examination records had female external genitalia (100.0%, 35/35). The common laboratory abnormalities included hyponatremia (95.2%, 40/42), hyperkalemia (88.1%, 37/42), elevated serum adrenocorticotrophic hormone (100.0%, 37/37) and decreased 17-hydroxyprogesterone (90.5%, 19/21), cortisol (86.2%, 25/29), testosterone (9/10) and dehydroepiandrosterone (14/14). p.Gln258X was the most common StAR gene mutation in neonates in Eastern Asia, including China. Most cases had a good prognosis after appropriate steroid replacement. Conclusions CLAH should be considered for neonates with adrenocortical hypofunction, especially with female phenotypes and low 17-hydroxyprogesterone. Karyotyping and StAR gene analysis may be helpful in diagnosis. Timely and appropriate treatment could improve the prognosis.

OBJECTIVE：To investigate t he effects of different compatibility ratio of Gardenia jasminoides to fermented soybean on the content of genistein and total flavonoids ，and to investigate the compatibility regularity of Zhizichi decoction. METHODS：The decoction method was used to prepare the mixed decoction with different compatibility ratio of G. jasminoides to fermented soybean （2∶1，1∶1，1∶2，1∶4，m/m，the same hereinafter ）. UPLC-MS/MS method was used to determine the content of genistein in Zhizichi decoction with different compatibility ratio and corresponding fermented soybean single decoction. UV method was used to determine the content of total flavonoids in Zhizichi decoction with different compatibility ratio and corresponding gardenia single decoction and fermented soybean single decoction. RESULTS ：The established method had good linearity ， precision，repeatability，stability and accuracy. Compared with single decoction ，the content of genistein in the mixed decoction with different compatibility ratio of G. jasminoides to fermented soybean （2∶1，1∶1，1∶2，1∶4）was decreased to different extents ， while the content of total flavonoids was increased to different extents. With the increase of fermented soybean ，the content of genistein in the decoction increased at first and then decreased. When the compatibility ratios of G. jasminoides to fermented soybean were 1 ∶ 1 and 1 ∶ 2，the content of genistein in the decoction was the highest （all 0.071 μg/mL）. With the increase of fermented soybean ，the content of total flavonoids in the decoction did not change regularly ；when the ratio of G. jasminoides to fermented soybean was 1 ∶ 1，the content of total flavonoids in the decoction was the highest （1.861 μg/mL）. CONCLUSIONS ： When the compatibility ratio of G. jasminoides to fermented soybean was 1 ∶ 1，the content of flavonoids in the decoction is the highest.

Poor experience of teacher-student interaction and low user loyalty exist in MOOC (massive open online courses).Therefore,the campus open online courses (COOC),a network teaching platform,was developed to integrate traditional classroom teaching and network teaching and to build an online-offline curriculum system according to professional training scheme of school.The online-offline teaching design and learning evaluation in COOC platform was also developed.The running data of COOC platform showed that the online-offline learning evaluation model has guiding impact on students' learning attitude because it can record the students' learning process and learning effect,which can enhance students' active participation in self-directed learning.The learning evaluation model in COOC is objective and scientific,which is helpful to improve the quality of teaching and learning.

Objective To explore the role and value of neuroendoscopy-assisted microscope technique in the operation of sellar region tumor. Methods Sixty-three cases of saddle area treated by neuroendoscopy-assisted microscopy during 2015—2017 of neurosurgery in Weifang people' s hospital (neuroendoscopy-assisted microscope technique group) were collected and analyzed. Seven-six patients with sellar area treated by simple microscopic resection from 2013 to 2015(simple microscope group) were retrospectively analyzed. Tumor resection rate, postoperative complication rate and postoperative recurrence rate, the effect of operation was compared and evaluated. Results In the neuroendoscopy-assisted microscope technique group and simple microscope group, the total resection rate of tumor was 95.24％(60/63) and 80.26％(61/76), the incidence of vasospasm was 3.17％(2/63) and 13.16％(10/76), and the incidence of nerve injury was 0(0/63) and 6.58％(5/76). There were significant differences (P<0.05). The postoperative infection, cerebrospinal fluid leakage and postoperative recurrence rate between two groups had no significant differences (P>0.05). Conclusions Endoscopic microscopically assisted resection of sellar area can not only increase the total resection rate of tumor, but also reduce the incidence of complications.