ObjectiveTo explore the impact of autonomic nerve function on motor function in patients with post-stroke depression (PSD) from the perspective of regional homogeneity (ReHo). MethodsFrom January to December, 2020, a total of 60 inpatients and outpatients with cerebral infarction in the Affiliated Brain Hospital of Nanjing Medical University were divided into control group (n = 30) and PSD group (n = 30). Two groups were assessed using Fugl-Meyer Assessment (FMA), modified Barthel Index (MBI) and Hamilton Depression Scale (HAMD). Heart rate variability (HRV) was measured. Ten patients in each group were selected randomly to undergo resting state functional magnetic resonance imaging (rs-fMRI) to calculate ReHo. ResultsAll HRV indices were lower in PSD group than in the control group (|t| > 2.092, P < 0.05). In PSD group, FMA and MBI scores showed positive correlations with 24-hour standard deviation of normal-to-normal R-R intervals (SDNN), the root mean square of successive differences between normal heartbeats over 24 hours (RMSSD), the percentage of differences between adjacent normal R-R intervals over 24 hours that were greater than 50 ms (PNN50), total power (TP), very low frequency power (VLF) and low frequency power (LF) (r > 0.394, P < 0.05), and showed negative correlations with HAMD scores (|r| > 0.919, P < 0.001). HAMD scores in PSD group were negatively correlated with SDNN, RMSSD, PNN50, TP and VLF (|r| > 0.769, P < 0.001). Compared with the control group, the ReHo increased in PSD group in the right rectus gyrus (142 voxels, t = 6.575), the left medial and paracingulate gyri (204 voxels, t = 4.925) (GRF correction, P_-Voxel < 0.005，P_-Cluster < 0.05); and reduced in the right cerebellum (191 voxels, t = -6.487), the left middle temporal gyrus (140 voxels, t = -5.516), and the left precentral gyrus (119 voxels, t = -4.764) (GRF correction, P_-Voxel < 0.005，P_-Cluster < 0.05) in PSD group. ConclusionAutonomic nerve function is related to motor dysfunction in patients with PSD. The modulation of emotional, cognitive and motor brain regions by the autonomic nervous system may play a role in influencing the motor function in patients with PSD.

Objective:This study aims to investigate the effects of Zhibao Sanbian Pills on learning and memory ability and explore its mechanism.Methods:Cognitive decline and memory impairment in mice was induced by scopolamine. Morris water maze test, platform jumping test and dark avoidance test were used to evaluate the learning and memory ability of mice. TCMSP, TCMID database and literature search were used to search the chemical components of Zhibao Sanbian Pills. The potential active components were screened through ADMETlab 2.0. The targets were predicted by Swiss Target Prediction. GO function and KEGG pathway enrichment analysis were conducted through the Metascape database, and a PPI network was constructed for MCODE module analysis.Results:Compared with the model group, the latency of water maze test in the high-dose group of Zhibao Sanbian Pills was shortened ( P<0.05), and the time of platform quadrant and the number of crossing increased ( P<0.05). 863 active components and 401 potential targets of Zhibao Sanbian Pills were collected. The enrichment analysis of MCODE, GO and KEGG pathways found that the action pathways of Zhibao Sanbian Pills to improve cognitive impairment involve neuroactive ligand receptor pathway, calcium signal pathway, Rap1 signal pathway, PI3K-Akt signal pathway, MAPK signal transduction pathway, 5-hydroxytryptamine receptor pathway, etc. Conclusion:Zhibao Sanbian Pills have the potential to improve the learning and memory ability of mice, which may be realized through MAPK signaling pathway and other neural related signaling pathways.

Objective　 : To evaluate the implementation, application, and problems and suggestions of the Radiation Shield- ing Requirements in Room of Radiotherapy Installations—Part 1: General Principle (GBZ/T 201.1—2007) through a survey of relevant personnel in radiation health technical service institutions, and to provide a scientific basis for further revision and implementation of this standard. Methods: A questionnaire survey was conducted among randomly selected per- sonnel in radiation health technical services across China, which mainly investigated the awareness, training, application, and revision suggestions related to the GBZ/T 201.1—2007. The results were aggregated and analyzed. Results: A total of 184 evaluation questionnaires on the GBZ/T 201.1—2007 were collected from technical service staff in 25 provinces. Among the responders, 64.1% thought that the standard had been widely applied; 91.8% thought that the standard could meet work needs; only 54.3% ever received relevant training on the standard; 68.5% used the standard once or more per year; 33.7% thought that the standard needed to be revised. Conclusion The personnel in radiation health technical services have a high awareness rate of the GBZ/T 201.1—2007 and its contents, but their familiarity with and application of the standard need to be improved. Relevant departments should strengthen the training and promotion of the standard, and part of the standard should be revised.

Objective To investigate the clinical efficacy and safety of microcatheter assisted trabeculectomy on the treatment of childhood glaucoma.Methods A prospective case series method was performed.Sixteen childhood glaucoma with 22 eyes were enrolled in Henan Eye Hospital and Zhengzhou Second People's Hospital from December 2016 to August 2017.Nine males with 12 eyes and 7 females with 10 eyes were included,and the age ranged from 6 months to 8 years (median 4 years).All the subjects underwent microcatheter assisted trabeculectomy.The intraocular pressure changes were observed preoperation and 7 days,1 month and 6 months after surgery,and the postoperative complications were analyzed.This study was approved by the Ethics Committee of Henan Eye Hospital (2018KS-01) and Zhengzhou Secord People's Hospital (No.20161202001),and adhered to the tenets of the Declaration of Helsinki.Written informed consent was obtained from each guardia prior to any medical examination.Results Twenty eyes of 14 patients underwent microcatheter assisted trabeculectomy,the success rate was 90.91％.Twelve eyes were operated with full incision (incision range was 360°),8 eyes were performed with subtotal incision (incision range was 180°-330°),while the microcatheter could not pass over 90° in 2 eyes and was switch to traditional Harms knife trabeculotomy-trabeculectomy intraoperatively.The intraocular pressures of the 20 eyes that underwent microcatheter assisted trabeculectomy preoperation,7 days,1 month and 6 months after surgery were (26.55 ±4.38),(20.48 ± 3.62),(13.71 ± 6.35) and (12.67 ± 5.37) mmHg,respectively.The intraocular pressures in patients at different time points were statistically significant (F=112.771,P＜0.001).At the last follow-up,the intraocular pressures of 18 eyes were controlled.Among them,16 eyes achieved completely controlled intraocular pressure while 2 eyes returned to normal intraocular pressure after using ocular hypotensive drugs.The intraocular pressure of 2 eyes increased again after operation,and the intraocular pressure could not be controlled after combined use of anti-hypertensive drugs.All patients had no serious complications during and after the operation.Different degrees of anterior chamber hemorrhage occurred in 16 eyes during the surgery,and all the hemorrhages were absorbed within 1 week after surgery.Conclusions For children with glaucoma,microcatheter assisted trabeculectomy can achieve good intraocular pressure reduction effect without serious complications.

[Abstrca t] Objective BRCA 1 ( breast cancer susceptibility gene 1) and RAP80 ( receptor-associated protein 80) play key roles in predicting chemosensitivity of platinum and taxanes .A randomized trial was carried out to compare non-selected cisplatin-based chemotherapy with therapy customized according to BRCA1 and RAP80 expression.Methods Advanced stage NSCLC patients whose tumor specimen was sufficient for molecular analysis were randomized (1∶3) to the control or experimental arm.Patients in the control arm received docetaxel/cisplatin; in the experimental arm , patients with low RAP 80 expression received gemcitabine/cisplatin ( Arm 1 ) , those with intermediate/high RAP 80 expression and low/intermediate BRCA 1expression received docetaxel/cisplatin ( Arm 2 ) , and those with intermediate/high RAP80 expression and high BRCA1 expression received docetaxel alone (Arm 3).The primary end point was progression-free survival (PFS).Results 226 patients were screened and 124 were randomized in this trial.ORR in the four subgroups was 22.6%, 48.4%, 30.3%and 19.2%, respectively (P=0.08);PFS was 4.74, 5.59, 3.78 and 2.73 months, respectively (P=0.55); and OS was 10.82, 14.44, 10.86 and 10.86 months, respectively (P=0.84).The common adverse effects included neutropenia , nausea, anemia and fatigue.Conclusions No statistically significant difference of ORR , PFS or OS is observed in the experimental arms compared with the control arm .Patients with low RAP 80 mRNA levels have a trend of better survival and higher response rate to gemcitabine /cisplatin chemotherapy .

[Abstrca t] Objective BRCA 1 ( breast cancer susceptibility gene 1) and RAP80 ( receptor-associated protein 80) play key roles in predicting chemosensitivity of platinum and taxanes .A randomized trial was carried out to compare non-selected cisplatin-based chemotherapy with therapy customized according to BRCA1 and RAP80 expression.Methods Advanced stage NSCLC patients whose tumor specimen was sufficient for molecular analysis were randomized (1∶3) to the control or experimental arm.Patients in the control arm received docetaxel/cisplatin; in the experimental arm , patients with low RAP 80 expression received gemcitabine/cisplatin ( Arm 1 ) , those with intermediate/high RAP 80 expression and low/intermediate BRCA 1expression received docetaxel/cisplatin ( Arm 2 ) , and those with intermediate/high RAP80 expression and high BRCA1 expression received docetaxel alone (Arm 3).The primary end point was progression-free survival (PFS).Results 226 patients were screened and 124 were randomized in this trial.ORR in the four subgroups was 22.6%, 48.4%, 30.3%and 19.2%, respectively (P=0.08);PFS was 4.74, 5.59, 3.78 and 2.73 months, respectively (P=0.55); and OS was 10.82, 14.44, 10.86 and 10.86 months, respectively (P=0.84).The common adverse effects included neutropenia , nausea, anemia and fatigue.Conclusions No statistically significant difference of ORR , PFS or OS is observed in the experimental arms compared with the control arm .Patients with low RAP 80 mRNA levels have a trend of better survival and higher response rate to gemcitabine /cisplatin chemotherapy .

Objective To investigate the effect of improved bone plate fixation and bone grafting in the treat ment of intra-articular calcaneal fracture.Methods 80 patients with intra-articular calcaneal fractures were randomly divided into the two groups.The non-bone graft group(47 feet in 40 patients)was given improved bone plate fixation.The bone graft group(50 feet in 40 patients)was given improved bone plate fixation and bone grafting.Results The incidence rate of complication in the non-bone graft group was 25.0％ and that in the bone graft group was 19.1％.The difference between the two groups was not significant(x2 =0.21,P ＞ 0.05).Postoperative Bhler's angle and calcaneal height between the two groups had significant differences (t =14.5,16.99,all P ＜ 0.05).The excellent rate of Maryland functionality in non-bone graft group was 66.0％,which was significantly lower than 86.0％ in the bone graft group(x2 =5.38,P ＜ 0.05).The average full weight bearing time between the two groups had significant difference (t =11.17,P ＜ 0.05).Bhler's angle after 1 year and forwa rd Bhler's angle loss of the non-bone graft group had significant differences compared with the bone graft group (t =29.76,9.81,all P ＜ 0.05).Conclusion Improved bone plate fixation and bone grafting in the treatment of intra-articular calcaneal fracture can obtain better results and avoid the long-term loss of reduction.

Objective To investigate the clinical effect internal fixation combined with external fixator incision in the treatment of intra-articular fractures of the distal radius.Methods 80 cases of intra-articular distal radius fracture patients underwent cut internal fixation combined with external fixator in the treatment of orthopedic were chosen,postoperative rehabilitation exercises,fracture healing after the removal of the external fixator.All patients were followed up for 8 months to 12 months,an average of 9.2 months.Results 80 patients were intraarticular fractures healed,the time required was 4 to 10 months,an average of 6.3 months.In accordance with the assessment of functional systems Dienst wrist,51 cases wrist function were excellent,21 cases were good,the good rate was 90％ (72/80).There were no clinical fractures common complication after surgery.Conclusion Open internal fixation combined with external fixator treatment of intra-articular fractures of the distal radius fractures not only makes reduction of fracture and immobilization satisfaction,but also conducive to the wrist of early postoperative functional rehabilitation exercise.

Objective To compare the outcomes of total hip replacement and minimally invasive dynamic hip screw in treating osteoporotic femoral intertrochanterie fractures.Methods Retrospectively analyze the clinical data of 56 patients with osteoporotic femoral intertrochanteric fractures who came to our hospital from July,2008-June,2012.Twenty eight cases who accepted minimally invasive dynamic hip screw were divided into the control group while 28 cases who accepted total hip replacement were divided into the experimental group.The blood loss and postoperative drainage,operative time,situation of implant loosening,the occurrence of postoperative complications and the clinical curative effect were compared between two groups.Results The differences in operative time,blood loss,and postoperative drainage flow,limited weight-bearing after operation was statistically significant between two group[(96.37 ± 20.42)min,(529.85±73.82) ml,(7.46±1.23) dvs (66.84±18.63)min,(152.79±37.35) ml,(14.32±2.62)d,t=5.653,24.117,12.542,P＜0.05].The differences in FRS score and Harris score between twogroups was not statistically significant [(27.75±3.59),(89.84±4.17) vs (26.41±3.16),(88.68±3.92),P＞ 0.05].The incidence in internal fixation loosening varied significantly with different degree of osteoporosis in the control group (66.7％vs18.8％,x2 =4.745,P ＜ 0.05) but not in the experimental group (11.1％ vs 10.0％,P＞0.05).Complication rate of the experimental group was significantly lower than the control group (3.6％vs 28.6％,x2 =4.766,P ＜ 0.05).Conclusions For the elder patients with osteoporotic femoral intertrochanteric fractures,the selection of surgical approach should be based on the patient's individual circumstances and the degree of osteoporosis.In the same time,attention should be paid to anti-osteoporosis therapy after operation.

Objective To investigate the experiences of total hip replacement in the treatment of different types of osteoarthritis secondary to acetabular dysplasia, and evaluate its effect. Methods From January 1999 to December 2006, 37 hips in 35 cases with osteoarthritis secondary to acetabular dysplasia undergoing total hip replacement were included in this study. Preoperative Harris score was 30-64 points, with an average score of 45 points. Undergoing total hip replacement with complete release, of soft tissue, original acetabular, and no femoral osteotomy. Crowe Ⅰ , Ⅱ-type acetabular dysplasia chose conventional cementless press-fit prosthesis;Crowe Ⅲ,Ⅳ-type,chose the appropriate trumpet,Zweymüller system cementless acetabular biconical spiral surface and thin and straight SL rectangular hip stems. Results The duration of follow-up ranged from 12 to 60 months (average 24 months). No case appeared dislocation, periprosthetic fractures, femoral nerve and sciatic nerve injury and other complications, no clinical and X-ray findings of prosthesis loosening occurred. Postoperative Harris score was 60-95 points, and average was 85 points. Conclusion Adequate preoperative preparation, intraoperative complete release, is the key of the treatment and restoration of limb length.