Objective To explore the microstructural changes in white matter(WM)fibers of patients with post-stroke depression(PSD)by using automated fiber quantification(AFQ)and the relationship between changes in fibers and the Hamilton depression scale(HAMD).Methods The HAMD and MRI data were collected from stroke patients with a single anterior circulation infarction at 1-month follow-up.AFQ was used to extract the main fibers and calculate the fractional anisotropy(FA)of each node in each fiber.The difference of node FA in each fiber between groups and correlations between altered node FA and HAMD were then evaluated.Results Data were collected from 8 patients with PSD and 18 patients without PSD(non-PSD).Compared with that in non-PSD,the node FA in the callosum,left inferior longitudinal fasciculus,and uncinate fasciculus were significantly decreased in patients with PSD(P<0.05).The altered node FA values in the corpus callosum forceps minor(r=-0.418,P=0.047)and left uncinate fasciculus(r=-0.467,P=0.029)were negatively related to HAMD in patients with PSD.Conclusions AFQ can precisely measure the segmental microstructural damage of nerve fiber bundles in patients with PSD,of which segmental microstructural damage of the corpus callosum forceps and hook tracts is associated with the severity of depression.

Bronchiectasis has the characteristics of long course,gradual aggravation,easy recurrence and difficult to treat.The characteristics are similar to those arouse by incubative pathogenic factors.Based on the theory of incubative pathogenic factors,this disease is often related to the incubative pathogenic factors in the body's areas with deficient healthy qi,which occur at regular times.The etiology can be external,congenital,or internal.Treatment should focus on different characteristics of incubative pathogenic factors.Attention should be paid to clearing and dispersing in external pathogenic factors,while attention should be paid to supporting and promoting healthy qi in congenital pathogenic factors,and do not forget to remove internal pathogenic factors.

Objective:To retrospectively analyze the clinical characteristics of 193 Chinese patients with McCune-Albright syndrome (MAS).Methods:By using keywords " McCune-Albright syndrome", " Albright syndrome", or " fibrous dysplasia " as the search terms, 193 cases of MAS reported in China from January 1990 to November 2022 from the Wanfang data, CNKI, VIP, PubMed, and Embase databases were obtained, and their clinical data was retrospectively analyzed. Intergroup comparisons were carried out by using t test, Mann-Whitney U test, and χ2 test. Results:The 193 MAS patients had included 42 males and 151 females, with the median first-visit age of females being younger than males. The typical triad group had accounted for 46.1% of patients, and the middle first-visit and diagnosis age was younger than the atypical group. The primary reason for first-visit in males of MAS was fibrous dysplasia (FD), whilst that in females of MAS was peripheral precocious puberty (PPP). FD has occurred in 84.5% of the patients, with an average age of onset age being 6.1 years old, and 90% was ≤ 16 years of age. Endocrine hyperfunction was found in 79.3% of the patients, with a higher proportion in females compared with males ( P<0.05). Pituitary involvement was seen in 21.8% of the patients, and the incidence of craniofacial FD and cranial nerve compression was significantly higher in those with elevated growth hormone (GH) than without ( P<0.05). Café-au-Lait Spots were noted in 86.5% of the patients, and 28.3% (28/99) had located on the different side of FD. Conclusion:Most MAS patients had atypical manifestations and multi-systemic involvement. It is more common and occurs earlier in females. The most common reasons for initial diagnosis in male and female patients were FD and PPP, respectively. Patients with elevated GH should be examined for cranial nerve compression.

Objective:To explore the curative efficacy of Dingke Decoction in the treatment of post infectious cough based on the the real-world clinical data.Methods:Retrospective cohort study was conducted. 245 patients with cough after infection in the hospital of Jingan Chinese Medical Hospital from July 2021 to July 2022 were set as study objects. The fact that whether the patients with Dingke Decoction or not were divided into control group (90 cases, without Dingke Decoction) and treatment group (155 cases, with Dingke Decoction). By using propensity nearest neighbor 1:1 matching to balance the confounding factors before treatment, 56 cases were successfully matched in both groups. The control group was treated symptomatically according to the actual clinical situation, while the treatment group was treated with modified Dingke Decoction on the basis of symptomatic treatment in the control group. The treatment for both groups lasted for 2 weeks. TCM symptom scores and cough severity score were evaluated using the Leicester Cough Quality of Life Questionnaire (LCQ) before and after treatment. Levels of tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) were detected through ELISA; adverse reactions during the treatment were recorded, and the clinical efficacy was evaluated.Results:The total effective rate of the treatment group was 91.07% (51/56), while that of the control group was 76.79% (43/56), with a statistically significant difference between the two groups ( χ2=4.24, P=0.040). The daytime cough symptom score (1.03 ± 0.67 vs. 1.20 ± 0.66, t=7.40) and nighttime cough symptom score (0.74 ± 0.62 vs. 1.26 ± 0.54, t=6.27) in the treatment group were lower than those in the control group after treatment ( P<0.001). After treatment, the LCQ physiological (5.30 ± 0.79 vs. 4.78 ± 1.09, t=-2.44), psychological (5.33 ± 0.92 vs. 4.70 ± 1.12, t=-2.39), and social (5.23 ± 0.94 vs. 4.60 ± 0.81, t=-2.86) scores in the treatment group were higher than those in the control group ( P<0.05). After treatment, he treatment group serum IL-6 [(14.29 ± 3.94) ng/L vs. (19.99 ± 5.17) ng/L, t=4.80] and TNF-α [(36.23 ± 7.83) ng/L vs. (42.44 ± 7.63) ng/L, t=3.11] were lower than those in the control group ( P<0.01). The incidence of adverse reactions in the control group was 8.92% (5/56) and 5.36% (3/56), respectively, without statistical significance ( χ2=0.54, P=0.716). Conclusion:Based on the real-world research method, medicine Dingke Decoction can improve the clinical efficacy and the quality life of post infectious cough patients, and the mechanism may be related to reducing airway inflammation response.

Objective:To explore the teaching experience of clinical teaching teachers in master of integrated traditional Chinese and western medicine nursing, so as to provide a reference for improving the training quality of master of integrated Chinese and western medicine nursing.Methods:From March to May 2022, a total of 14 clinical teaching teachers of integrated traditional Chinese and western medicine nursing in the First Affiliated Hospital of Hunan University of were enrolled using the objective sampling method and investigated by the semi-structured face-to-face interview. Content analysis was used to analyze the interview results.Results:Five themes were extracted, namely, the practice ability of nursing graduate students needs to be improved, the evaluation methods of clinical practice ability of graduate students need to be more diversified, teaching benefits teachers as well as students; difficulties of teaching (conflicts between teachers' clinical work and teaching, unclear orientation of postgraduate clinical practice learning) , hope to get support (improve scientific research ability, improve theoretical knowledge of traditional Chinese medicine, guarantee the clinical practice and study time of graduate students) .Conclusions:A variety of practice approaches should be provided for the training in master of integrated traditional Chinese and western medicine nursing graduate students, to improve students' clinical practice ability and professional identity, strengthen clinical teacher training, improve teachers' ability, and continuously improve the clinical practice training model and the quality of talent training for nursing graduate students.

Objective:To investigate the clinical effect and safety of camrelizumab combined with induction chemotherapy followed by concurrent chemoradiotherapy for patients with locally advanced nasopharyngeal carcinoma (NPC).Methods:A total of 24 patients with stage Ⅲ-IV A NPC were recruited prospectively to receive two cycles of camrelizumab combined with induction chemotherapy (docetaxel 75 mg/m 2+ cisplatin 25 mg/m 2 for three consecutive days) followed by concurrent chemoradiotherapy (prescription doses: 6 996 cGy in 33 fractions for PGTV and PGTV nd, 6 006 cGy in 33 fractions for PTV 1, 5 096 cGy in 28 fractions for PTV 2, and concurrent cisplatin chemotherapy with a dose of 75 mg/m 2). The short-term efficacy and adverse reactions were evaluated. Results:After induction therapy, nasopharyngeal lesions showed an objective response rate (ORR) of 91.6%, including 45.8% of complete response (CR) and 45.8% of partial response (PR); cervical lymph nodes showed an ORR of 95.8% (CR: 4.2%; PR: 91.6%). Seventeen patients accepted a reexamination under a nasopharyngoscope, and the biting biopsy result indicated that 13 patients among them had complete pathologic response. After concurrent chemoradiotherapy, nasopharyngeal lesions and cervical lymph nodes showed CR rates of 83.3% and 91.7% and PR rates of 16.7% and 8.3%, respectively. After the induction therapy, 13 patients with stage IV A NPC had ORR (PR) rates of 92.4% and 92.4%, respectively, at nasopharyngeal lesions and cervical lymph nodes. After concurrent chemoradiotherapy, the patients with stage IV A NPC had CR rates of 84.6% and 92.3% and PR rates of 15.4% and 7.7%, respectively, at nasopharyngeal lesions and cervical lymph nodes. Major adverse reactions include leukopenia, granulopenia, anemia, radioactive acute oropharyngeal mucositis and dermatitis, digestive tract reaction, fatigue, hypothyroidism, aminotransferase elevation, and reactive capillary hyperplasia. Conclusions:Camrelizumab combined with induction chemotherapy followed by concurrent chemoradiotherapy can achieve high short-term efficacy for patients with locally advanced nasopharyngeal carcinoma, without increasing the incidence of adverse reactions. Its long-term efficacy deserves further research.

Objective:To explore the safety and efficacy of radiofrequency in the treatment of overactive bladder(OAB).Methods:A prospective, multicenter, non-randomized controlled trial was conducted. Eligible patients were divided into test group and control group in Zhejiang Provincial People’Hospital, The First Affiliated Hospital of Wenzhou Medical University, and Sir Run Run Shaw Hospital affiliated to Zhejiang University School of Medicine from March 2019 to June 2020. Inclusion criteria: patients diagnosed with OAB, and bladder capacity>100ml. Exclusion criteria: pregnant and lactating women; patients with secondary OAB symptoms such as urinary tract obstruction; patients with uncontrolled urinary tract infection within 1 week; patients in stable stage by using other treatment methods; patients implanted with any nerve stimulator, cardiac pacemaker or implantable defibrillator; patients with malignant tumors, serious cardiovascular, cerebrovascular diseases, renal insufficiency or received BTX treatment in recent 12 months. The patients were allocated to test group and the control group in a ratio of 2∶1 according to the time sequence of the visit. The patients in the test group were treated with radiofrequency treatment. After entering the group, they were treated for 4 times at the 1st, 2nd, 7th and 8th week respectively. In the control group, the energy was turned off during the radiofrequency treatment. The patients were followed-up every week until the end of the 12th week. The treatment success rate [the average frequency of urination in 24 h was reduced more than 50% from the baseline or returned to the normal (≤8 times/day) or the average frequency of urgent urination in 24 h was reduced more than 50% from the baseline], the frequency of urination, urgent urination and nocturnal urination before and after treatment, the residual urine volume of the bladder, the quality of life (QOL) score and the occurrence of catheter related adverse events in two groups were compared.Results:114 patients were enrolled in the study, including 76 patients in the test group and 38 patients in the control group. There were no significant differences in the age [(44.2±12.8) vs. (41.7 ± 12.1) years old], male female ratio (13/63 vs. 4/34), average course of disease [2.0(1.2, 5.0) vs. 2.0 (1.0, 4.0) years], the frequency of urination[12.8 (10.6, 16.8) vs. 12.8 (10.3, 17.0) times], urgency urination [11.8(9.3, 15.8) vs. 11.8 (9.0, 17.0) times], nocturia [2.7 (1.3, 3.7) vs. 2.3(0.7, 3.3) times], residual urine volume of bladder [12.0 (3.0, 28.0) vs. 14.0 (3.7, 20.0) ml ] and the QOL score [5.0(4.0, 5.0) vs. 4.0(4.0, 5.0)]before the treatment between the two groups ( P>0.05). The treatment success rate in the test group was 76.3% (58/76), while 26.3% (10/38) in the control group, with a statistically significant difference ( P<0.01). There were significant differences between the test group and control group in the frequency of urination [9.7 (7.7, 12.0) vs. 12.9 (9.6, 15.7) times], urgent urination [7.3 (5.0, 10.0) vs. 11.7 (7.3, 15.3) times], nocturia [1.3 (0.7, 2.0) vs. 1.7 (1.0, 3.0) times] and the QOL score of the patients[3.0(1.0, 3.0) vs. 4.0(3.0, 4.5)]after the treatment(all P<0.05). The frequency of urination, urgency urination, nocturia, the residual urine volume and the QOL score in the test group were significantly improved ( P<0.05) after the treatment.The frequency of urination, nocturia, residual urine volume and the QOL score in the control group were improved ( P<0.05) after the treatment. 13 (11.4%) patients had catheter related adverse events. In the test group and the control group, there were 7 cases of macroscopic hemorrhage caused by the placement of instruments (5/76 vs. 2/38), 5 cases of acute urinary tract infection within 3 days (3/76 vs. 2/38), and 1 case of instrument breakage (catheter breakage) (0/76 vs. 1/38). There were no significant differences in the adverse events between the two groups ( P> 0.05). Conclusions:Radiofrequency treatment of OAB can effectively improve the symptoms of patients, improve the QOL of patients, and has low incidence of adverse events, with good efficacy and safety.

Objective: To predict the risk of cognitive decline among elderly patients with type 2 diabetes mellitus (T2DM), so as to provide insights into the early identification of cognitive decline in elderly patients with T2DM. Methods: The elderly patients with T2DM hospitalized in the Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University were selected as subjects. General information was collected by a questionnaire survey, including demographics and nutritional status, and cognitive decline was assessed using the frailty Phenotype Scale, the Montreal Cognitive Assessment and the Clinical Dementia Rating. Multivariable logistic regression model was used to analyze the influencing factors of cognitive decline among elderly patients with T2DM. A nomogram was established, and was verified with Bootstrap resampling method and receiver operation characteristic curve. Results: A total of 270 questionnaires were sent out and 262 valid questionnaires were collected, with an effective rate of 97.04%. There were 137 males (52.29%), 146 patients at ages of 60 to 69 years (55.73%), 179 married patients (68.32%), and 85 patients with cognitive decline (32.44%). Multivariable logistic regression analysis identified gender (female, OR=3.118), age (70 to 79 years, OR=3.218; 80 years and older, OR=3.058), educational level (high school or technical secondary school, OR=0.335; junior college, OR=0.130; college and above, OR=0.300), regular exercise (OR=0.083), memory (decreased, OR=29.723), nutritional status (risk of malnutrition, OR=16.307; malnutrition, OR=39.469), activity of daily living (decreased, OR=6.804) and depressive symptoms (OR=8.609) as factors affecting cognitive decline among elderly patients with T2DM (all P<0.05). The nomogram based on the above factors fit well and indicated strong predictive ability. Conclusion Gender, age, educational level, regular exercise, memory, nutritional status, activity of daily living and depressive symptoms can effectively predict the risk of cognitive decline among elderly patients with T2DM.

Objective:To establish the norm of clinical nursing teachers' competency in tertiary first-class hospitals in northwest China.Methods:From August 2019 to February 2020, 1 077 clinical nursing teachers were selected from 12 tertiary first-class hospitals in northwest China by stratified, random and proportional sampling, and were investigated with the Clinical Nursing Teacher Competency Evaluation Scale. Descriptive statistics were carried out on the sample data, and univariate variance analysis and pairwise comparison were carried out on the multi-classification variables of age, nursing age, professional title, teaching years and the number of teachers per year. The verified data were exported to SPSS 26.0 for statistical analysis, variance analysis was used for multi-group comparison, and LSD test was used for pairwise comparison between groups.Results:①The corresponding mean norm was established by grouping the total score and the first-class index; the percentile norm was made with 5% spacing; P10, P30, P70 and P90 were selected as the grading demarcation points, and the demarcation norm was constructed. ②Factor analysis showed that there were statistical differences in personality characteristics among different ages, nursing ages and professional titles ( P<0.05), and also in professional attitudes among different nursing ages and professional titles ( P<0.05). Conclusion:The establishment of norm provides references for individuals or units to evaluate teachers' competence.

Objective:To study the clinical characteristics, diagnosis, complications and prognosis of neonatal varicella.Methods:From September 2008 to December 2019, the clinical data of hospitalized neonates with varicella in our hospital were retrospectively analyzed.Results:A total of 33 cases of neonatal varicella were reviewed, including 18 males and 15 females, 32 full-term infants and 1 premature infant. The gestational age (GA) was (38.8±1.2)w and birth weight (BW) was (3 670±247)g. The onset of the disease occurred at 14.0 (8.0,19.0)d and was diagnosed at 18.0 (11.5,23.0)d. The hospital stay duration was (8.1±3.7)(2~20)d. All mothers denied varicella history or varicella vaccination. Among the 33 infants, 29 had a history of varicella/zoster exposure. All 33 infants had typical rash and 25 had fever, body temperature (38.3±0.6) ℃ and duration (2.4±1.4) d. 13 cases were congenital varicella, 20 cases were acquired varicella. 24 cases abnormality of cardiac enzymes, 11 cases skin infection, 8 cases liver damage, 4 cases pneumonia, 6 cases granulocytopenia/agranulocytosis, 9 cases anemia, 4 cases sepsis and 1 case viral encephalitis were diagnosed. 20 infants received intravenous antiviral therapy (acyclovir), 17 were treated with antibiotics, 15 were given intravenous immunoglobulin (IVIG), 8 received both antiviral therapy and IVIG and 6 were treated with recombinant human granulocyte stimulating factor. 31 infants were cured and discharged. 2 infants were discharged after improvement of rashes. All infants reported complete recovery on telephone follow-up.Conclusions:Most neonatal varicella cases have a definite exposure history. Besides rashes, complications including pneumonia, liver damage, myocardial injury, granulocytopenia/agranulocytosis, viral encephalitis are common. Intravenous antiviral therapy with acyclovir and combined treatment of IVIG and symptomatic support can often achieve a good prognosis.