Objective To observe brain function changes in insomnia disorder(ID)patients and therapeutic effect of repeated transcranial magnetic stimulation(rTMS)based on resting-state functional MRI(rs-fMRI).Methods Totally 37 patients with ID(ID group)and 20 healthy subjects(control group)were prospectively enrolled.The scores of sleep condition and psychological state scales were compared between groups,also within ID group before and after rTMS treatment.Brain regions with amplitude of low frequency fluctuations(ALFF)and regional homogeneity(ReHo)being significantly different between groups were evaluated based on brain rs-fMRI,and voxel-based resting-state functional connectivity(FC)analysis was performed in the above regions and the predefined regions of interest.Results Before treatment,Pittsburgh sleep quality index(PSQI),insomnia severity index(ISI),Epworth sleepiness score(ESS),Beck depression inventory(BDI)score and Beck anxiety inventory(BAI)score in ID group were all higher than those in control group(all P＜0.05).ALFF values and ReHo of the right median cingulate and paracingulate gyrus(Cingulum_Mid_R)were lower in ID group than those in control group(all FWE correctedP＜0.05).FC between Cingulum_Mid_R and the left anterior cingulate gyrus and cingulate gyrus(Cingulum_Ant_L)decreased,so did that between the left hippocampus(Hippocampus_L)and the right frontal gyrus(Frontal_Mid_R)(all FWE corrected P＜0.05).After rTMS,PSQI,ISI and ESS scores of ID patients decreased compared to those before treatment(all P＜0.05),but no significant change of the above neuroimaging indicators was detected(all FWE corrected P＞0.05).Conclusion ID caused synchronous decrease of Cingulum_Mid_R ALFF value and ReHo,as well as weakened FC between frontal cingulate gyrus and frontal with lobe limbic system.rTMS could improve sleep and mental state of ID patients,but its impact on neuroimaging needed further investigation.

Objective To observe brain function changes in insomnia disorder(ID)patients and therapeutic effect of repeated transcranial magnetic stimulation(rTMS)based on resting-state functional MRI(rs-fMRI).Methods Totally 37 patients with ID(ID group)and 20 healthy subjects(control group)were prospectively enrolled.The scores of sleep condition and psychological state scales were compared between groups,also within ID group before and after rTMS treatment.Brain regions with amplitude of low frequency fluctuations(ALFF)and regional homogeneity(ReHo)being significantly different between groups were evaluated based on brain rs-fMRI,and voxel-based resting-state functional connectivity(FC)analysis was performed in the above regions and the predefined regions of interest.Results Before treatment,Pittsburgh sleep quality index(PSQI),insomnia severity index(ISI),Epworth sleepiness score(ESS),Beck depression inventory(BDI)score and Beck anxiety inventory(BAI)score in ID group were all higher than those in control group(all P＜0.05).ALFF values and ReHo of the right median cingulate and paracingulate gyrus(Cingulum_Mid_R)were lower in ID group than those in control group(all FWE correctedP＜0.05).FC between Cingulum_Mid_R and the left anterior cingulate gyrus and cingulate gyrus(Cingulum_Ant_L)decreased,so did that between the left hippocampus(Hippocampus_L)and the right frontal gyrus(Frontal_Mid_R)(all FWE corrected P＜0.05).After rTMS,PSQI,ISI and ESS scores of ID patients decreased compared to those before treatment(all P＜0.05),but no significant change of the above neuroimaging indicators was detected(all FWE corrected P＞0.05).Conclusion ID caused synchronous decrease of Cingulum_Mid_R ALFF value and ReHo,as well as weakened FC between frontal cingulate gyrus and frontal with lobe limbic system.rTMS could improve sleep and mental state of ID patients,but its impact on neuroimaging needed further investigation.

Objective:To compare the efficacy of pars plana vitrectomy (PPV) combined with human amniotic membrane (hAM) plugging technique or internal limiting membrane (ILM) flap insertion technique for high myopia macular hole retinal detachment (MHRD).Methods:A non-randomized controlled clinical study was performed.Sixteen eyes of 15 patients with high myopia MHRD treated in the Ninth People's Hospital of Shanghai Jiao Tong University School of Medicine from July 2020 to August 2021 were included.All patients underwent PPV and were divided into hAM plug group (7 eyes of 7 patients) and the ILM insertion group (9 eyes of 8 patients) based on the different plugging materials.The best corrected visual acuity (BCVA) and intraocular pressure were measured before surgery and at 1 week, 1, 3, and 6 months postoperative, respectively.Slit-lamp microscopy combined with lenses, scanning laser ophthalmoscope and optical coherence tomography (OCT) were used to examine the fundus, the macular hole closure and retinal reposition.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine (No.SH9H-2021-T322-2). Written informed consent was obtained from each subject.Results:The retinal reattachment was achieved in 6 eyes in the hAM plug group and all 9 eyes in the ILM insertion group after initial surgery.The macular hole closure was observed in 5 eyes in the hAM plug group and 8 eyes in the ILM insertion group after initial surgery, and there was no statistical difference in the macular hole closure rate between the two groups ( P>0.05). There were significant differences in the overall comparison of BCVA between the two groups over time ( Ftime=4.420, P<0.05). Postoperative BCVA at different time points was better than preoperative BCVA in each group, but the differences were not significant (all at P>0.05). There was no significant difference in the overall comparison of BCVA between the two groups ( Fgroup=0.183, P>0.05). Two eyes in the hAM plug group and 4 eyes in the ILM insertion group developed transient ocular hypertension, which returned to normal after 1 week of treatment. Conclusions:Both PPV combined with hAM plugging technique and ILM insertion technique are safe and effective for the treatment of MHRD in high myopia.The hAM plugging technique can not only achieve anatomical reduction but also functional recovery of the retina even in complicated fundus conditions.

Objective:To explore the construction of a competency-oriented off-campus practice training system for master of public health (MPH).Methods:Through literature review and analysis on domestic and foreign MPH degree training models, a comprehensive and feasible MPH off-campus practice training system was designed innovatively.Results:The construction of a "4+N+Comprehensive Evaluation" practice system for MPH programs with a practice duration of more than 2 years has been explored by high-level public health talent training demonstration base of Sun Yat-sen University-Guangzhou CDC. "4" represents practice-based teaching, professional practice, participation in public health project management, and research for the training of MPH in terms of theory, practice, management and research anility of public health. "N" represents expanded practice to train MPH with comprehensive competence and professional spirit," and comprehensive evaluation is used to assess the training effect.Conclusion:A competency MPH off-campus practice system of "4+N+Comprehensive Evaluation" has been established for the training of high-level public health professionals in new era.

Objective:To explore the effects of hyperbaric oxygen (HBO) combined with electroacupuncture on the myelin inhibitory associated proteins (Nogo-A and NgR receptor) in rats with spinal cord injury.Methods:A total of 84 female SD rats were randomly divided into four groups, namely, model group, HBO group, electroacupuncture group, and combined treatment group. After successful modeling, the model group did not receive intervention, and the other groups were treated accordingly. Samples were collected on the 3, 7, and 14 d after the injury for evaluating the injured rats with Basso, Beattie, Bresnahan (BBB) Locomotor Rating Scale, and performing the HE staining and related gene detection on them.Results:After the injury on the 3, 7, and 14 d, the BBB scores of the HBO group, the electroacupuncture group, and the combined treatment group were significantly higher than those of the model group ( P<0.01), and the scores of the combined treatment group were higher than those of the HBO group and the electroacupuncture group, but there was no significant difference between the score of the HBO group and that of the electroacupuncture group. After the injury on the 3, 7, and 14 d, Nogo-A mRNA expression levels in the HBO group, the electroacupuncture group, and the combined treatment group were all lower than those in the model group ( P<0.05). After the injury on the 7 d and 14 d, the expression levels of NgR mRNA in the HBO group (0.49±0.53, 0.52±0.47), the electroacupuncture group (0.53±0.58, 0.58±0.36), and the combined treatment group (0.16±0.13, 0.20±0.13) were all lower than those in the model group (1.33±1.26, 1.03±0.30) ( P<0.05). Moreover, the Nogo-A and NgR mRNA expression levels in the combined treatment group were lower than those in the HBO group and the electroacupuncture group, while the difference between the HBO group and the electroacupuncture group was not statistically significant ( P>0.05). Conclusion:Compared with monotherapy, the combined treatment of spinal cord injury in rats can inhibit the expressions of Nogo-A and NgR mRNA better, reduce cell injury, and promote the growth of spinal cord fiber bundle and the recovery of motor function.

Objective:To explore the effects of hyperbaric oxygen (HBO) combined with electroacupuncture on the myelin inhibitory associated proteins (Nogo-A and NgR receptor) in rats with spinal cord injury.Methods:A total of 84 female SD rats were randomly divided into four groups, namely, model group, HBO group, electroacupuncture group, and combined treatment group. After successful modeling, the model group did not receive intervention, and the other groups were treated accordingly. Samples were collected on the 3, 7, and 14 d after the injury for evaluating the injured rats with Basso, Beattie, Bresnahan (BBB) Locomotor Rating Scale, and performing the HE staining and related gene detection on them.Results:After the injury on the 3, 7, and 14 d, the BBB scores of the HBO group, the electroacupuncture group, and the combined treatment group were significantly higher than those of the model group ( P<0.01), and the scores of the combined treatment group were higher than those of the HBO group and the electroacupuncture group, but there was no significant difference between the score of the HBO group and that of the electroacupuncture group. After the injury on the 3, 7, and 14 d, Nogo-A mRNA expression levels in the HBO group, the electroacupuncture group, and the combined treatment group were all lower than those in the model group ( P<0.05). After the injury on the 7 d and 14 d, the expression levels of NgR mRNA in the HBO group (0.49±0.53, 0.52±0.47), the electroacupuncture group (0.53±0.58, 0.58±0.36), and the combined treatment group (0.16±0.13, 0.20±0.13) were all lower than those in the model group (1.33±1.26, 1.03±0.30) ( P<0.05). Moreover, the Nogo-A and NgR mRNA expression levels in the combined treatment group were lower than those in the HBO group and the electroacupuncture group, while the difference between the HBO group and the electroacupuncture group was not statistically significant ( P>0.05). Conclusion:Compared with monotherapy, the combined treatment of spinal cord injury in rats can inhibit the expressions of Nogo-A and NgR mRNA better, reduce cell injury, and promote the growth of spinal cord fiber bundle and the recovery of motor function.

Objective Shkbp is also called Shkbp1,can competitively inhibit binding CIN85 and c-Cbl,thereby blocking the epidermal growth factor receptor (EGFR) endocytosis and degradation,to play a role in tumor promotion.This study aims to explore the changes in blood cell classification and T cell subsets in blood,bone marrow,and spleen in Shkbp1-deletion (Shkbp-1-/-) mice.Methods Shkbp-1-/-transgenic mice were identified by PCR genotyping.Blood cell classification was performed using an automatic classification system.Flow cytometry was used to detect the T lymphocyte subsets in the blood,bone marrow,and spleen of Shkbp-1-/-and control mice.Results Routine blood examination showed that neutrophils and eosinophils tended to increase and showing significant differences,and there was no significant difference in lymphocytes.The flow cytometry results showed that there was a decrease of CD4+CD8+ double positive cells and increase of bone marrow CD3+ and CD4+ cells in the control group.However,there was a decreasing trend of CD3+,CD4+,CD8+,and CD4+CD8+ cells in the spleen tissues.Conclusions Shkbp1 is involved in the maturation and differentiation of blood cells,and affects the number of immune cells.This study lays a foundation for the study of how Shkbp1 is involved in the differentiation of blood cells.

Objective PSGL-1 is specifically expressed in leucocytes.The aim of this study was to explore the changes of myeloid-derived suppressor cells (MDSCs) in the spleen and bone marrow in PSGL-1-deficient mice.Methods PSGL-1 -/-mice were used in the experiment.After identification of the offsprings, flow cytometry was used to test the expression of CD11b and Gr-1 in C57 and PSGL-1 -/-mice.Results Compared with the C57 mice, the expression of MDSCs was up-regulated in the PSGL-1-deficient mice ( P <0.001).Conclusion The expression of MDSCs is upregulated in PSGl-1-deficient mice.

Objective To observe the cardiac function in acute brain injury patients(ABI)and the relationship between ABI and plasma neuropeptideY(NPY),and to inspect the mechanism and find the evidences for preventing cardiac impairment caused by ABI. Methods 89 patients with acute brain injury within 24 hours after the injury were divided into severe group(n =47)and mild group(n = 42)according to Glasgow Coma Scale(GCS),and 35 normal healthy adults were selected as control group.In 24 hours and 72 hours after the brain injury,all patients were examined with echocardiography to observe cardiac structure,Doppler blood flow velocity and cardiac function,and in the same time the plasma NPY were determined by radioimmunoassay.Then the results were compared with controls. Results The parameters of cardiac function such as EF、 SV.AV、CO、CI had statistical change in 24 hours and 72hours after the brain injury between severe ABI group and mild ABI group,and it also had statistical change between severe ABI group and control group(all P <0.05),but no statistical change between mild ABI group and control group(all P ＜0.05).The level of plasma NPY in ABI patients was significantly higher than that before injury,there was statistically different change between severe ABI group and mild ABI group,and it also had statistical change between severe ABI group and control group(all P＜0.05).The parameters of cardiac function was negatively correlated with the rise of plasma NPY by pearson correlation analysis(EF:r =- 0.79,P <0.01; SV:r =- 0.71,P <0.01;AV:r=-0.67,P ＜0.01 ;E/A:r =-0.63,all P ＜0.01)and(CO:r =- 0.32,P ＜0.05;CI:r =-0.35,all P ＜0.05). Conclusion The parameters of cardiac function were significantly decreased in the patients with acute brain injury,and it was closely related with the level of plasma NPY.