Objective:To discuss the effect of the force feedback perceptual rehabilitation training on finger motor function of the patients with finger motor dysfunction after stroke,and to provide the basis for the clinical application and promotion of the force feedback perceptual rehabilitation training.Methods:A total of 86 patients with hand dysfunction after stroke were randomly divided into experimental group(n=43)and control group(n=43),and 3 cases in each group fell off from the experiment,and 80 cases were ultimately completed.On this basis,the patients in two groups received the conventional rehabilitation training for 40 min.The patients in control group received the conventional hand function training for 20 min,while the patients in experimental group received the force feedback perception rehabilitation training for 20 min,once per day,5 days per week,for a total of 6 weeks.The hand function recovery of the patients were evaluated before and after treatment by Action Research Arm Test(ARAT),grip strength,modified Ashworth scale(MAS),total active motion(TAM),Fugl-Meyer motor function assessment-upper limb(FMA-UL)finger motor part score,and Barthel index(BI).Results:Before treatment,there were no statistically significant differences in ARAT total score,grip strength,MAS grade,TAM,FMA-UL finger motor part score,and BI score of the patients between two groups(P＞0.05).After treated for 6 weeks,the ARAT scores,grip strengths,TAM,FMA-UL finger motor part scores,and BI scores of the patients in two groups were all increased than those before treatment(P＜0.05),while the MAS grades of the patients had no significant differences(P＞0.05).After treated for 6 weeks,compared with control group,the grasp score and grip score in ARAT score,and the difference of total ARAT score of the patients in experimental group were increased(P＜0.05),the TAM after treatment and the differences of grip strength,TAM,and FMA-UL finger motor part score of the patients before and after treatment were increased(P＜0.05),while the pinch scores and gross movement scores in ARAT score,MAS grades,and the differences of BI score before and after treatment had no significant differences(P＞0.05).Conclusion:Force feedback perceptual rehabilitation training is helpful in improving the finger motor function of the patients with finger motor dysfunction after stroke.

Background Epidemiological evidence indicates an association of particulate matter with depression and cognitive performance. From 2013 to 2017, China implemented the Air Pollution Prevention and Control Action Plan to reduce particulate matter concentration. There are few studies on the relationship between the decrease of particulate matter concentration and the improvement of mental health in middle-aged and elderly people. Objective To analyze the relationship between the decrease of city-level particulate matter concentration and the improvement of depression and cognitive function in the middle-aged and elderly population after the implementation of the Air Pollution Prevention and Control Action Plan. Methods Using the China Health and Retirement Longitudinal Study (CHARLS) data in 2011 and 2018, this study applied longitudinal data clustering technology to group cities based on the actual response of each city to the policy (the dynamic change trajectory of PM_2.5 in each city during the study period); the higher the degree of response, the greater the reduction of PM_2.5 concentration in the city. We assigned participants to three groups with different degrees of response to the policy, including low-response group A as the control group, medium-response intervention group B, and high-response intervention group C. A difference-in-differences (DID) model was used to estimate the influence of PM_2.5 decline on the depression and cognitive function among middle-aged and elderly people in China by considering potential individual and city-level time-varying confounders. Depression was measured using the 10-item Center for the Epidemiological Studies of Depression Scale (CES-D10) (10 questions, total score range 0-30) with higher score representing higher severity of depression. Cognitive function was evaluated with reference to the international cognitive function test questionnaire for the middle-aged and the elderly which was further categorized into two dimensions of memory and cognitive status and included 31 questions with a score range of 0-31; the higher the score, the better the cognitive function. Samples with relatively complete outcomes were selected for analysis, including 10729 people in depression analysis and 4510 people in cognitive analysis. Results The longitudinal clustering results indicated that the urban groups with the highest decline of PM_2.5 concentrations (high-response group C) had the highest baseline PM_2.5 concentrations, mainly in Beijing-Tianjin-Hebei region, Chengdu-Chongqing metropolitan area, and Wuhan metropolitan area. In 2011, no significant differences were observed in depression and cognitive function among the three groups of middle-aged and elderly populations (Kruskal Wallis test: P_depression=0.864, P_cognition=0.239). Significant differences were found in depression and cognitive function in both low-response group A and medium-response group B in 2018 compared to 2011 (paired Wilcox test, all P<0.001). However, in the high-response group C, there was no significant difference in depression in 2018 compared to 2011 (P=0.195), while a significant difference was detected in cognitive function (P=0.006). As PM_2.5 concentrations decreased, the DID model showed that the depression of the middle-aged and elderly people in the high-response group C decreased by 7.55% (95%CI: 2.83%-12.03%), and the cognitive function improved by 2.70% (95%CI: 0.25%-5.22%) compared with the low-response group A. However, no intervention effect was observed in group B with moderate response level compared with group A with low response level. Conclusion After the implementation of the Air Pollution Prevention and Control Action Plan policy, the decrease of PM_2.5 concentration has an ameliorative effect on the depression and cognitive function of middle-aged and elderly people in China. Given the aging population and the increasing burden of mental-related diseases in China, the promotion of environmental air pollution control has important public health implications.

Objective:To explore the mechanism of Ma-Xing Shi-Gan decoction combined with Xiao-Chai-Hu decoction (hereinafter referred to as " Sanyang combined treatment" ) in alleviating colon injury in mice infected with influenza virus by transcriptome sequencing technique.Methods:The mouse model of colonic injury caused by influenza virus was induced by intranasal drip of influenza A virus H1N1 suspension. The mice were divided into Control group, Model group, and Sanyang combined treatment (SCT) group. Model group and SCT group were fed with PBS and Ma-Xing Shi-Gan decoction combined with Xiao-Chai-Hu decoction respectively. Seven days later, the colon tissues of each group were taken, the colon length and pathological damage were observed, and the transcriptome was sequenced to screen the significantly different genes between the SCT group and model group for Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Set Enrichment Analysis(GSEA).Results:After the therapy with SCT, the length of the colon of mice was significantly improved and the pathological injury of the colon was reduced. There are 92 differentially expressed genes between the SCT group and the model group. GO analysis indicated that the differential genes were enriched in biological processes such as regulation of cytokine and chemokine production, inflammatory response, defense response, immune response, regulation of NF-κB inducing kinase(NIK)/Nuclear factor-κB(NF-κB) signal and Mitogen-activated protein kinase(MAPK) cascade, as well as cell components related to intestinal barrier such as brush border membrane, brush border and microvilli. KEGG analysis indicated that the differential genes were enriched in Toll-like receptor signaling pathway, intestinal immune network for IgA production, complement and coagulation cascade, and Peroxisome proliferator-activated receptor(PPAR) signaling pathway. GSEA indicated that the intestinal immune network for IgA production, PPAR signaling pathway, propionic acid metabolism and butyrate metabolism were significantly up-regulated after the intervention with SCT, while apoptosis and MAPK signaling pathway were significantly down-regulated.Conclusions:Sanyang combined therapy can protect the intestinal tract of mice infected with influenza virus mainly through immunity, inflammation and metabolism pathways.

Objective:To explore the characteristics and influencing factors of blood carnitine metabolism in premature infants.Methods:A retrospective analysis of 37 037 neonates with negative results of genetic metabolic disease screening at Guangxi Newborn Disease Screening Center from 2018 to 2021, of which 34 517 normal full-term infants were the control group and 2 520 preterm infants were the research group.According to gestational age, the preterm infants were further divided into three groups: extremely preterm group( n=232), moderately preterm group( n=324)and late preterm group( n=1 964). According to birth weight, they were divided into three groups: very low birth weight group( n=188), low birth weight group( n=1 276)and normal birth weight group( n=1 056). According to blood collection time, they were divided into three groups: 3~7 days group( n=1 990), 8~14 days group( n=342) and 15~28 days group( n=188). Tandem mass spectrometry was used to detect the levels of 31 carnitines in dried blood spots and analyze the differences in the levels of metabolic indicators in each group. Results:Carnitine levels in preterm infants are most affected by gestational age.Adjusting the physiological and pathological conditions of premature infants and other related factors, grouped by gestational age, there were differences in the levels of 31 carnitines among the groups(all P<0.05), the smaller the gestational age, the greater the difference in carnitine levels; grouped by blood collection time, there were statistically significant differences in carnitine levels between preterm infants with different blood collection age groups and full-term 3~7 days groups(all P<0.05), and showing age-related; there are differences among 31 carnitines grouped by body weight(all P<0.05), the smaller the body weight, the greater the difference in carnitine levels.Combined with the analysis of gestational age, birth weight and blood collection date, 17 indicators including C0, C2, C3, C4, C6DC, C10, C10∶1, C12, C12∶1, C14, C14∶1, C14OH, C16, C16∶1, C18, C18∶1 and C18∶1OH are important biomarkers of carnitine metabolism in premature infants. Conclusion:Carnitine in premature newborns has different metabolic differences at different gestational ages, birth weights and blood collection ages, which provides a strong basis for establishing reference standards and interpretation of preterm infants in the laboratory in this region, and provides reasonable and effective early diagnosis and treatment for clinical practice.Meanwhile, it provides an optimized program for timely detection of carnitine deficiency and carnitine supplementation to improve nutrition of premature infants.

【Objective】 To compare and study the characteristics of blood donors with and without adverse reactions to apheresis platelet donation(ARAPD), and to study the influencing factors of blood donors participating in blood donation again, so as to provide basis for putting forward scientific and reasonable countermeasures and retaining blood donors to the greatest extent. 【Methods】 157 679 platelet donors from Tianjin Blood Center from December 26, 2015 to December 25, 2020 were selected and divided into ARAPD group(n=168) and non-ARAPD group (n=157 511). Such characteristics as sex, age, height, weight, blood type, educational background, first-time donation or not, platelet count, hematocrit, phlebotomy time, circulating blood volume and anticoagulant dosage of the two groups were analyzed. Chi-square test was used to identify the high-risk population with poor blood donation response. Multivariate binary logistic regression was used to study the influencing factors of blood donors returning. 【Results】 The age, height and weight of ARAPD group were lower than those of the non-ARAPD group, and the proportion of first-time blood donors, the proportion of women and phlebotomy time were higher than those of non-ARAPD group. There was little difference between the two groups in circulating blood volume, anticoagulant dosage, pre- and post-donation platelet count and hematocrit. Logistic regression analysis showed that the influencing factors of ARAPD were age, educational background, first-time donation or not and phlebotomy time, among which age and first-time donation or not were positively correlated, education and phlebotomy time were negatively correlated (P<0.05). 【Conclusion】 Female, low age, low height and weight, and less blood donation are the basic characteristics of high-risk people with ARAPD. Low age, high education, first-time blood donation and long phlebotomy time are the influencing factors that lead to donor lapsing. Therefore, countermeasures are put forward based on the above results.

Objective:To investigate the clinical value of early gastroscopy for patients with hypopharyngeal cancer.Methods:A total of 231 cases of hypopharyngeal cancer diagnosed and treated in the First Affiliated Hospital of Xiamen University from January 2010 to December 2014 were included in the retrospective analysis. The 5-year survival rate of hypopharyngeal cancer and patients accompanied with synchronous esophageal cancer (including early and advanced esophageal cancer), as well as the detection rate of synchronous esophageal cancer by gastroscopy and systemic PET-CT examination were statistically analyzed.Results:The 5-year survival rate of hypopharyngeal cancer was 38.96% (90/231). The 5-year survival rates of 62 patients accompanied with synchronous esophageal cancer and 169 patients without were 27.42% (17/62) and 43.20% (73/169), respectively, with statistic difference ( χ2=4.747, P=0.029). The 5-year survival rate of 49 patients accompanied with synchronous early esophageal cancer was 30.69% (17/49). Among the 13 patients with synchronous progressive esophageal cancer, none had a survival period of 5 years, which was significantly different compared with the patients with synchronous early esophageal cancer ( P=0.013). The detection rates of synchronous esophageal carcinoma by gastroscopy and by systemic PET-CT were 26.84% (62/231) and 14.29% (33/231), respectively, with statistic difference ( χ2=11.14, P<0.01). The detection rates of synchronous early esophageal carcinoma by gastroscopy and by systemic PET-CT were 21.21% (49/231) and 8.66% (20/231), respectively, and the difference was also statistically significant ( χ2=14.328, P<0.01). Conclusion:Hypopharyngeal cancer accompanied with synchronous esophageal cancer is of high risk, which affects the survival rate of patients. Early gastroscopy in hypopharyngeal cancer patients can significantly improve the detection rate of synchronous esophageal cancer, which helps to design individualized regimen to improve the survival rate of patients.

Objective:To evaluate the safety and clinical efficacy of transplanting a muscle flap to treat the postoperative refractory empyema with a bronchopleural fistula.Methods:From July 2015 to December 2019, the clinical data of 15 patients who suffered from postoperative refractory empyema with bronchopleural fistula was retrospectively summarized. There were 13 males and two females with a mean age of 61.7 years. Ten cases had previous posterolateral thoracotomy and four cases underwent minimally invasive surgery. After conservative and endoscopic therapy, a pedicled latissimus dorsi muscle flap, a pectoralis major muscle flap, or a free vastus lateralis myocutaneous flap was harvested from the ipsilateral local thorax or thigh and was transferred to cover the intrathoracic cavity.Results:There was no perioperative death. During a mean follow-up of 14.8 months, one patient was dead, one suffered from a recurrence of refractory empyema, and l3 patients had an uneventful course with no recurrence of refractory empyema and bronchopleural fistula. Postoperative chest computed tomography or magnetic resonance imaging showed the empyema cavity was satisfactorily covered with a pedicle or free muscle flap.Conclusions:Muscle flap transplantation is an effective alternative for treating the postoperative refractory empyema with bronchopleural fistula, which can achieve promising short-medium-term results.

Objective:To evaluate the safety and clinical efficacy of transplanting a muscle flap to treat the postoperative refractory empyema with a bronchopleural fistula.Methods:From July 2015 to December 2019, the clinical data of 15 patients who suffered from postoperative refractory empyema with bronchopleural fistula was retrospectively summarized. There were 13 males and two females with a mean age of 61.7 years. Ten cases had previous posterolateral thoracotomy and four cases underwent minimally invasive surgery. After conservative and endoscopic therapy, a pedicled latissimus dorsi muscle flap, a pectoralis major muscle flap, or a free vastus lateralis myocutaneous flap was harvested from the ipsilateral local thorax or thigh and was transferred to cover the intrathoracic cavity.Results:There was no perioperative death. During a mean follow-up of 14.8 months, one patient was dead, one suffered from a recurrence of refractory empyema, and l3 patients had an uneventful course with no recurrence of refractory empyema and bronchopleural fistula. Postoperative chest computed tomography or magnetic resonance imaging showed the empyema cavity was satisfactorily covered with a pedicle or free muscle flap.Conclusions:Muscle flap transplantation is an effective alternative for treating the postoperative refractory empyema with bronchopleural fistula, which can achieve promising short-medium-term results.

Objective:To establish a disease risk prediction model for the newborn screening system of inherited metabolic diseases by artificial intelligence technology.Methods:This was a retrospectively study. Newborn screening data ( n=5 907 547) from February 2010 to May 2019 from 31 hospitals in China and verified data ( n=3 028) from 34 hospitals of the same period were collected to establish the artificial intelligence model for the prediction of inherited metabolic diseases in neonates. The validity of the artificial intelligence disease risk prediction model was verified by 360 814 newborns ' screening data from January 2018 to September 2018 through a single-blind experiment. The effectiveness of the artificial intelligence disease risk prediction model was verified by comparing the detection rate of clinically confirmed cases, the positive rate of initial screening and the positive predictive value between the clinicians and the artificial intelligence prediction model of inherited metabolic diseases. Results:A total of 3 665 697 newborns ' screening data were collected including 3 019 cases ' positive data to establish the 16 artificial intelligence models for 32 inherited metabolic diseases. The single-blind experiment ( n=360 814) showed that 45 clinically diagnosed infants were detected by both artificial intelligence model and clinicians. A total of 2 684 cases were positive in tandem mass spectrometry screening and 1 694 cases were with high risk in artificial intelligence prediction model of inherited metabolic diseases, with the positive rates of tandem 0.74% (2 684/360 814)and 0.46% (1 694/360 814), respectively. Compared to clinicians, the positive rate of newborns was reduced by 36.89% (990/2 684) after the application of the artificial intelligence model, and the positive predictive values of clinicians and artificial intelligence prediction model of inherited metabolic diseases were 1.68% (45/2 684) and 2.66% (45/1 694) respectively. Conclusion:An accurate, fast, and the lower false positive rate auxiliary diagnosis system for neonatal inherited metabolic diseases by artificial intelligence technology has been established, which may have an important clinical value.

This paper deeply studied the definition and characteristics of clinical research programs. On such basis, the researchers utilized theoretical and comparative studies in combination of practical studies, to probe deeply into both the operating procedures and management documents of the clinical research management council.These efforts contributed to constructing a systematic, overall and feasible management system,for reference of building such a council by medical institutions.