Objective:To investigate the use of apolipoprotein B (ApoB) diagnostic algorithm for hyperlipidemia typing combined with whole exome sequencing in the precise diagnosis of familial hyperlipidemia.Methods:A retrospective observational study was conducted by collecting clinical information on all patients who attended our hospital, and had their lipid levels tested from January 2023 to May 2024, including 440 patients with low-density lipoprotein cholesterol (LDL-C)>4.10 mmol/L. Family history, current lipid levels, medication use, and comorbidities were collected by telephone follow-ups. Among them, 10 patients had a family history of hyperlipidemia. Peripheral venous blood samples were collected from patients with a family history of hyperlipidemia, and whole exome sequencing was performed.Results:According to the Fredrickson typing of WHO, 10 patients (P1 to P10) could be categorized into two groups, of which only type Ⅱa could be excluded in 6 cases, and the typing could not be determined in 4 cases. The ApoB diagnostic algorithm of hyperlipidemia typing could classify patients P1 and P2 as type Ⅱa, patients P3 to P7, P9 and P10 as type Ⅱb, and patient P8 as type Ⅴ, respectively. Whole exome sequencing detected mutations in LDLR, PCSK9, C5AR2, KIF12, ALMS1, ABCG5, COL4A3, and MTTP genes.Conclusion:The ApoB diagnostic algorithm for hyperlipidemia can be used for accurate typing of hyperlipidemia, and ApoB could be recommended as a routine lipid testing parameter. The ApoB diagnostic algorithm for hyperlipidemia combined with whole exome sequencing could be used for the accurate typing of patients with familial hyperlipidemia and defining the underlying gene mutations.

Objective To explore the effect of electromyographic perception-assisted robotic training combined with paired associa-tion stimulation on upper limb function in hemiplegic patients after stroke.Methods From December,2023 to December,2024,120 hemiplegic patients after stroke in Nanjing Pukou People's Hos-pital(Liangjiang Hospital,Southeast University)were randomly assigned to control group(n=60)and experi-mental group(n=60)using random envelope method.Both groups received medication and routine rehabilita-tion training,the control group received traditional muscle strength training combined with paired associative stimulation,and the experimental group received electromyographic perception robot-assisted training combined with paired association stimulation.Fugl-Meyer Assessment-Upper Extremities(FMA-UE),modified Barthel In-dex(MBI),and modified Ashworth Scale(MAS)were conducted before and four weeks after treatment.The sur-face electromyography(sEMG)was used to detect the root mean square(RMS)and integrated electromyography(iEMG)of the biceps and triceps brachii,and to calculate the corresponding co-activation ratio(CR).Results Nine cases in the control group and four cases in the experimental group dropped down.After treatment,RMS of triceps,CR of flexion elbow,the scores of FMA-UE and MBI increased in both groups(|t|>2.219,P<0.001),and were better in the experimental group than in the control group(|t|>2.084,P<0.05);the biceps RMS and CR of elbow extension significantly increased in experimental group(|t|>3.863,P<0.001),and were better in the experimental group than in the control group(|t|>2.498,P<0.05).The MAS score of biceps improved in experi-mental group after treatment(Z=-4.097,P<0.001),and was better in the experimental group than in the con-trol group(Z=-3.459,P<0.01).Conclusion Electromyographic perception robot-assisted training combined with paired association stimulation can im-prove the upper limb motor function and the ability of daily living in hemiplegic patients after stroke.

Objective To explore the effect of electromyographic perception-assisted robotic training combined with paired associa-tion stimulation on upper limb function in hemiplegic patients after stroke.Methods From December,2023 to December,2024,120 hemiplegic patients after stroke in Nanjing Pukou People's Hos-pital(Liangjiang Hospital,Southeast University)were randomly assigned to control group(n=60)and experi-mental group(n=60)using random envelope method.Both groups received medication and routine rehabilita-tion training,the control group received traditional muscle strength training combined with paired associative stimulation,and the experimental group received electromyographic perception robot-assisted training combined with paired association stimulation.Fugl-Meyer Assessment-Upper Extremities(FMA-UE),modified Barthel In-dex(MBI),and modified Ashworth Scale(MAS)were conducted before and four weeks after treatment.The sur-face electromyography(sEMG)was used to detect the root mean square(RMS)and integrated electromyography(iEMG)of the biceps and triceps brachii,and to calculate the corresponding co-activation ratio(CR).Results Nine cases in the control group and four cases in the experimental group dropped down.After treatment,RMS of triceps,CR of flexion elbow,the scores of FMA-UE and MBI increased in both groups(|t|>2.219,P<0.001),and were better in the experimental group than in the control group(|t|>2.084,P<0.05);the biceps RMS and CR of elbow extension significantly increased in experimental group(|t|>3.863,P<0.001),and were better in the experimental group than in the control group(|t|>2.498,P<0.05).The MAS score of biceps improved in experi-mental group after treatment(Z=-4.097,P<0.001),and was better in the experimental group than in the con-trol group(Z=-3.459,P<0.01).Conclusion Electromyographic perception robot-assisted training combined with paired association stimulation can im-prove the upper limb motor function and the ability of daily living in hemiplegic patients after stroke.

Objective:To investigate the use of apolipoprotein B (ApoB) diagnostic algorithm for hyperlipidemia typing combined with whole exome sequencing in the precise diagnosis of familial hyperlipidemia.Methods:A retrospective observational study was conducted by collecting clinical information on all patients who attended our hospital, and had their lipid levels tested from January 2023 to May 2024, including 440 patients with low-density lipoprotein cholesterol (LDL-C)>4.10 mmol/L. Family history, current lipid levels, medication use, and comorbidities were collected by telephone follow-ups. Among them, 10 patients had a family history of hyperlipidemia. Peripheral venous blood samples were collected from patients with a family history of hyperlipidemia, and whole exome sequencing was performed.Results:According to the Fredrickson typing of WHO, 10 patients (P1 to P10) could be categorized into two groups, of which only type Ⅱa could be excluded in 6 cases, and the typing could not be determined in 4 cases. The ApoB diagnostic algorithm of hyperlipidemia typing could classify patients P1 and P2 as type Ⅱa, patients P3 to P7, P9 and P10 as type Ⅱb, and patient P8 as type Ⅴ, respectively. Whole exome sequencing detected mutations in LDLR, PCSK9, C5AR2, KIF12, ALMS1, ABCG5, COL4A3, and MTTP genes.Conclusion:The ApoB diagnostic algorithm for hyperlipidemia can be used for accurate typing of hyperlipidemia, and ApoB could be recommended as a routine lipid testing parameter. The ApoB diagnostic algorithm for hyperlipidemia combined with whole exome sequencing could be used for the accurate typing of patients with familial hyperlipidemia and defining the underlying gene mutations.

Objective To investigate the application of intra pelvic pressure(IPP)in ultramicro-channel percutaneous nephrolithotripsy.Methods From January 2022 to January 2023,60 patients with urinary calculi who needed Super mini-PCNL(SMP)in The First Hospital of Jiaxing selected as the study objects.According to random number method,the patients were divided into control group and experimental group,with 30 cases.Both groups were treated with ultra-micro channel percutaneous nephrolithotripsia,while the experimental group was monitored and regulated IPP in real time during the operation,and observed and compared clinical indicators,IPP,fever,urinary protein,renal function,hemoglobin(Hb)and adverse reactions between the two groups.Results Compared with the control group,the hospitalization time of experimental group was shortened and the stone clearance rate was increased(P<0.05).The IPP levels of experimental groups at 6min,12min,24min and 36min were lower than those of control group(P<0.05).The fever of experimental group was lower than that of control group at 2d,3d,4d and 5d after operation(P<0.05).The urinary protein level of experimental group was lower than that of control group at 1d,2d,3d and 4d after operation(P<0.05).Compared with control group,blood urea nitrogen(BUN)and serum creatinine(SCr)levels of experimental group were decreased,and Hb levels were increased(P<0.05).The incidence of adverse reactions in experimental group was lower than that in control group(P<0.05).Conclusion Monitoring and adjusting intrapelvic pressure during super-mini percutaneous nephrolithotomy is beneficial in reducing postoperative fever in patients with urolithiasis,reducing urinary protein expression and kidney function damage,and controlling the occurrence of adverse reactions.It is worth recommending.

Objective:To explore the relationship between proactive personality, resilience and achievement motivation of military cadets, and to explore the mediating role of resilience between proactive personality and achievement motivation, as well as the moderating effect of cadets’leading ability on this mediating role.Methods:In this study, 109 military cadets were measured with proactive personality scale, Connor-Davidson resilience scale (CD-RISC) and achievement motivation scale. SPSS 26.0 was used for descriptive statistical analysis and correlation analysis.Results:①There was a significant correlation among the total scores of proactive personality, resilience and achievement motivation ( Ps<0.01). ②Proactive personality could significantly predict the level of achievement motivation ( a=0.454, P<0.001), and resilience could significantly predict the level of achievement motivation ( b=0.231, P=0.019). ③Resilience significantly mediated the relationship between proactive personality and achievement motivation ( c′=0.3, P=0.003). ④Cadets' leading ability moderated the effect of resilience on achievement motivation (index=0.338, 95% CI: 0.057 to 0.881). The mediating effect of resilience between proactive personality and achievement motivation was significant for cadets' leaders (Effect=0.381, 95% CI: 0.085 to 1.005), but not significant for other students (Effect=0.043, 95% CI: -0.069 to 0.252). Conclusion:The proactive personality of military cadets can affect the level of achievement motivation through psychological resilience, which is also moderated by cadre identity, suggesting that military education should improve the level of achievement motivation in many ways.

Objective:To investigate the vitamin D level of pulmonary tuberculosis patients in Qinghai Province, and to explore the correlation between vitamin D level and pulmonary tuberculosis.Methods:From May to September 2020, 208 bacterial confirmed pulmonary tuberculosis patients who were admitted to The 4th People′s Hospital of Qinghai Province were enrolled as the pulmonary tuberculosis group, and 129 healthy people who underwent physical examination during the same period were enrolled as the healthy control group. Independent sample t test and chi-square test were used for statistical analysis. Results:The deficiency rate of vitamin D was 11.06%(23/208) in the pulmonary tuberculosis group, which was higher than that (3.10%(4/129)) in the healthy control group, and the difference was statistically significant ( χ2=6.840, P=0.009). The vitamin D level was (56.84±20.03) μg/L in the pulmonary tuberculosis group, which was lower than that ((67.39±17.07) μg/L) in the healthy control group, and the difference was statistically significant ( t=5.154, P<0.01). The vitamin D levels were not different between the newly treated ((56.66±20.02) μg/L)) and retreated pulmonary tuberculosis patients ((59.11±20.81) μg/L) ( t=0.468, P=0.650). The vitamin D level of simple pulmonary tuberculosis patients ((57.82±20.01) μg/L) was higher than that of pulmonary tuberculosis patients combined with other diseases ((48.08±18.46) μg/L), and the difference was statistically significant ( t=2.132, P=0.034). Conclusion:Pulmonary tuberculosis is associated with decreased vitamin D levels, and patients with pulmonary tuberculosis are more likely to suffer from decreased or deficient vitamin D, which suggests clinicians considering the vitamin D status when treating pulmonary tuberculosis patients.

Objective:To compare the therapeutic effects of percutaneous nephrostomy and ureteral stent drainage in the treatment of infectious hydronephrosis.Methods:From June 2017 to June 2018, 92 patients with infectious hydronephrosis in the First Hospital of Jiaxing were selected.The patients' hospital number was entered into the computer and the patients were divided into group A(percutaneous nephrolithotomy and drainage treatment, 46 cases) and group B(transurethral ureteral stent drainage treatment, 46 cases) by lottery.The treatment effect and safety were compared between the two groups.Results:There were no statistically significant differences in age, male/female, duration of disease, site of renal disease, primary disease, and underlying disease between the two groups(all P>0.05). There was no statistically significant difference in the success rate of disposable catheter placement between group A and group B(97.73% vs.100.00%, χ 2=0.126, P>0.05). The efficacy of group A was significantly higher than that of group B(97.73% vs.81.40%, χ 2=4.617, P<0.05). There were no statistically significant differences in the incidence rates of bleeding, infection, drainage tube abscess and puncture abscess between the two groups(all P>0.05). Conclusion:Percutaneous nephrostomy in the treatment of infectious hydronephrosis is more effective than ureteral stent drainage.Both of two methods have high safety of treatment.Clinical treatment should be based on the specific circumstances of the patients to obtain a significant clinical effect.

Objective To observe the effect of modified electroconvulsive therapy (MECT) on au-tobiographical memory and efficacy in schizophrenic patients. Methods Seventy-four patients with schizo-phrenia were randomly divided into study group (38 cases) and control group (36 cases). The study group was treated with MECT for 10-12 times in combination with single antipsychotic drug,while the control group was treated with single antipsychotic drug. Both groups were treated for 12 weeks. All patients were assessed for autobiographical memory before treatment and at the 4th,8th and 12th week after treatment,and the effi-cacy was evaluated by the positive and negative symptom scale (PANSS). Results (1)The response time of autobiographical event memory in the study group at the 4th and 8th weekends after treatment ((2 058. 84 ±200. 06)ms,(1 883. 61±202. 17)ms)were significantly longer those at baseline((1 765. 27±203. 23)ms) and that at the same periods in the control group(( 1 787. 03 ± 192. 82),(1 762. 01± 195. 25)),and the differences were statistically significant(t=6. 346,2. 545;P<0. 05,t=5. 945,2. 630;P<0. 05),but the re-sponse time of autobiographical event memory in the study group at the 12th weekend after treatment was not statistically significant compared with that before treatment (P>0. 05). ( 2) For each time point after treat-ment,the PANSS scores of the study group and the control group were significantly lower than those at base-line (P<0. 05). The PANSS scores of the study group at each time point after treatment((62. 42±7. 22), (49. 32±5. 54),(43. 63±9. 90)) were significantly lower than those of the control group at the same periods ((71. 78±10. 19),(56. 14±5. 95),(49. 28±9. 31)),and the differences were statistically significant ( t=4. 577,5. 108,2. 525;all P<0. 05). The total effective rate of the study group ( 94. 7%) was significantly higher than that of the control group (80. 6%) (χ2=9. 287,P<0. 05). Conclusions MECT is effective in the treatment of patients with schizophrenia,and it has some damage to their autobiographical memory,but the damage is transient and reversible.

Objective To systematically review the efficacy of dexmedetomidine mixed with ropivacaine for brachial plexus block in the patients undergoing upper limb surgery.Methods Medline,PubMed,Embase,Web of Science,Weipu,Wanfang,Zhiwang databases were searched for randomized controlled trials involving the efficacy of dexmedetomidine mixed with ropivacaine for brachial plexus block in patients undergoing upper limb surgery from the date of database establishment up to July 2017,and the trials were published in Chinese or in English.Evaluation indexes included onset time and duration of sensory and motor blocks and analgesia time when used for brachial plexus block.Trials were selected and data were extracted independently by 2 investigators,and meta-analysis was conducted using the Cochrane Collaboration's RevMan 5.3 software.Results Twelve randomized controlled trials were included in our metaanalysis.Compared with control group,the onset time of sensory and motor blocks was significantly shortened,the duration of sensory and motor blocks was prolonged,and analgesia time when used for brachial plexus block was prolonged in dexmedetomidine group (P＜0.01).Conclusion Dexmedetomidine mixed with ropivacaine can be effectively used for brachial plexus block in the patients undergoing upper limb surgery.