BACKGROUND:Traumatic spinal cord injury primarily relies on scale assessment and imaging examinations in clinical practice.However,there are limitations in predicting the prognosis of the injury.Therefore,the use of metabolomics technology for biomarker screening is significant for estimating the extent of damage,injury and recovery,as well as developing new therapies. OBJECTIVE:To characterize the metabolic features of patients with traumatic spinal cord injury using metabolomics technology and explore potential biomarkers and disrupted metabolic pathways. METHODS:Serum and urine samples were collected from 20 patients with traumatic spinal cord injury(observation group)and 10 healthy subjects(control group).Metabolites were analyzed and multivariate statistical analysis was then performed for data processing to screen differential metabolites.Metabolic pathway enrichment was performed using MetaboAnalyst software.Logistic regression was applied to construct a biomarker combination model,and its relationship with the American Spinal Injury Association grading was analyzed. RESULTS AND CONCLUSION:Significant differences in 160 and 73 metabolites were detected in the serum and urine samples of the two groups,respectively.Pathway enrichment analysis showed evident disturbances in lipid metabolism after traumatic spinal cord injury,including sphingolipid,arachidonic acid,α-linolenic acid,and arachidonic acid metabolism,as well as glycerophospholipid and inositol phosphate biosynthesis.The combination of two identified biomarkers,telmisartan and quercetin glycoside,showed a correlation with the American Spinal Injury Association grading in both serum and urine levels.Thus,metabolomics technology provides assistance in further understanding the pathological mechanisms of traumatic spinal cord injury and screening therapeutic targets.The identified metabolic biomarker combination may serve as a reference for assessing the severity of traumatic spinal cord injury.

Objective:To investigate the level of functional fitness of elderly hypertensive patients in the community and to analyze its influencing factors.Methods:A cross-sectional survey was used from November 2021 to September 2022, questionnaire survey and Senior Functional Fitness Test (SFT) were conducted on 189 elderly hypertensive patients in the community by convenience sampling method, multiple linear regression was used to analyze the influencing factors of SFT in elderly hypertensive patients in the community.Results:Totally 189 cases of community-aged hypertensive patients completed the investigation, 88 cases were male and 101 were female. The total SFT score of community-aged hypertensive patients was (58.61 ± 16.07). Single factor analysis showed that there were significant differences in SFT scores among patients with different gender, age and education ( t=-2.57, F=6.24, 7.54, all P<0.05). Multifactorial analysis revealed that age ( t=-5.55), gender ( t=2.63), and literacy ( t=5.69) were influential factors in the total SFT scores of community-dwelling elderly hypertensive patients (all P<0.05). Conclusions:Age, gender, and literacy level are the main factors affecting the total SFT scores of elderly hypertensive patients in the community, and community caregivers should pay close attention to the above elderly hypertensive population.

Pancreatic cancer(PC)is one of the deadliest malignant tumors worldwide,known as the'king of cancers'due to its insidious onset,high malignancy,and high mortality rate.PC is highly malignant and pro-gresses rapidly,but its onset is insidious with atypical early symptoms,making it difficult to detect early lesions through conventional imaging studies.It is usually only discovered when symptoms like jaundice,abdominal and back pain occur.Surgical resection is currently the only curative option for PC.However,due to the difficulty in early diagnosis,the majority of patients are already in the middle to late stages at the time of diagnosis,missing the opportunity for surgery.Studies have confirmed that the progression of pancreatic cancer is relatively slow,with the initial tumor cells requiring at least 15 years to gain metastatic ability.Therefore,timely detection of pancreatic cancer through tumor markers could significantly improve the survival rate of patients.The most widely used and diagnostically valuable tumor marker in clinical practice is Carbohydrate antigen 199(CA199).However,due to about 3%～7%of pancreatic cancer patients being Lewis antigen-negative blood types and not expressing CA19-9,its sensitivity is only 79%～81%,which does not provide good efficacy for the diagnosis of pancreatic cancer.Pan-creatic juice,as a fluid near the tumor,has attracted much attention as a good source of tumor-related biomarkers.Many studies have confirmed the accuracy of using proteins,DNA,and exosomes in pancreatic juice for the diag-nosis of pancreatic cancer,showing great prospects for pancreatic juice as a source of tumor markers for the diagnosis of pancreatic cancer.Therefore,this thesis reviews the efficacy of pancreatic juice as a specimen for the diagnosis of pancreatic cancer.

Objective:To explore the suitable prostate cancer screening mode under the medical community for primary hospitals.Methods:From April 2021 to April 2022, a total of 16007 male population ≥50 years from 9 branches of the medical community of the second hospital of Yinzhou participated in this study. They were divided into four groups according to age with group 1 of 50-59 years old, group 2 of 60-69 years old, group 3 of 70-79 years old, and group 4 of 80 years old and above. Serum tPSA was added to the routine physical examination, and the screening positive patients were referred to the referral hospital for further diagnosis and treatment under the mode of medical community. We proposed multi-parametric MRI (mpMRI) for those with serum PSA ≥4 ng/ml and suspicious lesions should be scored according to PI-RADS V2. The ultrasound-guided transperineal targeted prostate biopsy was performed for those with PI-RADS ≥3 and those with PI-RADS < 3 but tPSA ≥10 ng/ml. The tPSA follow-up examinations were performed every 6 months for tPSA < 10 ng/ml and PI-RADS < 3 points and once a year for tPSA < 4 ng/ml.Results:Among the 16 007 male population ≥50 years, 2 007(12.54%) were found serum PSA ≥4 ng/ml, and 634(31.59%)were referred to the referral hospital through the medical community system. Combining tPSA and mpMRI, 271 patients underwent ultrasound-guided transperineal targeted prostate biopsy. Among them, 162 were finally diagnosed with PCa, with a biopsy positive rate of 59.78%. The detection rate of PCa in all the subjects was 1.01%. According to the pathological grade, 5(3.08%) were in ISUP group 1, 95(58.64%) in ISUP group 2-3, and 62(38.27%) in ISUP group 4-5. There were 102(62.96%), 39(24.07%) and 21(12.96%) with localized, locally advanced or metastatic PCa, respectively. The levels of tPSA in the four groups were (1.13±1.44)ng/ml, (1.77±3.45)ng/ml, (3.27±17.58)ng/ml, and (4.26±11.48)ng/ml, respectively, with statistically significant differences ( P<0.01). The positive number of biopsy in each group was 1 case(0.06%), 56 cases(0.79%), 81 cases(1.36%) and 24 cases(1.82%) respectively, with statistically significant differences ( P<0.01). The number of ISUP 4-5 grades in each group was 0, 17(30.35%), 29(35.80%), and 16(66.67%) respectively, with statistically significant differences ( P<0.01). Conclusions:Based on the medical community system, according to the tPSA screening results of the primary hospitals, it is feasible and effective to refer suspicious patients to the referral hospitals for mpMRI examination, and screen prostate cancer by ultrasound-guided transperineal prostate fusion biopsy.

Objective:To investigate the effects of computerized cognitive remediation therapy (CCRT) combined with social skill training on the improvement of negative symptoms of schizophrenia.Methods:A total of 102 schizophrenic patients who received treatment in Shanxi Province Social Welfare Kangning Psychiatry Hospital from March 2019 to June 2021 were included in this study. They were randomly divided into an intervention group and a control group ( n = 51/group). During the intervention process, because of the reasons such as midway discharge, only 93 patients were included in the final analysis, consisting of 47 patients in the intervention group and 46 patients in the control group. All patients received social skills training. Patients in the intervention group received 8-week CCRT. The Positive and Negative Syndrome Scale and Social Skills Checklist were used to evaluate curative effect in the two groups. Results:After treatment, total score of the Positive and Negative Syndrome Scale and the score of negative symptoms in the intervention group were (46.36 ± 9.33) points and (11.15 ± 3.53) points, respectively, which were significantly lower than (51.06 ± 10.26) points and (16.42 ± 4.75) points in the control group ( t = 2.07, 5.41, both P < 0.05). The total score of Social Skills Checklist, conflict resolution ability score and relationship building ability score in the intervention group were (16.05 ± 6.85) points, (3.36 ± 1.65) points and (3.14 ± 1.83) points, respectively, which were significantly lower than (21.08 ± 8.24) points, (5.92 ± 2.35) points and (6.75 ± 2.51) points, respectively ( t = 2.87, 5.34, 7.00, all P < 0.01). Conclusion:CCRT combined with social skill training can effectively improve the negative symptoms of patients with schizophrenia.

OBJECTIVES: Tubulointerstitial diseases is one of the common causes of renal dysfunction. Some rare pathological types are easy to be misdiagnosed and missedly diagnosed because of their low prevalence and relatively insufficient understanding, which affects the treatment and prognosis of patients. This study aims to explore clinical manifestations and pathological characteristics of several rare tubulointerstitial diseases, and therefore to improve their diagnosis and treatment. METHODS: A total of 9 363 patients diagnosed by renal biopsy in the Department of Nephrology, Second Xiangya Hospital, Central South University from November 2011 to September 2021 were selected. Six cases of light chain cast nephropathy (LCCN), 2 cases of light chain proximal tubulopathy (LCPT), 1 case of LCCN with LCPT, 4 cases of genetic tubulointerstitial disease, and 6 cases of non-genetic related tubulointerstitial lesion were screened out, and their clinical manifestations and renal biopsy pathological results were collected, compared, and analyzed. RESULTS: Patients with LCCN presented with mild to moderate anemia, microscopic hematuria, and mild to moderate proteinuria. Compared with patients with LCPT, proteinuria and anemia were more prominent in patients with LCCN. Five patients with LCCN and 2 patients with LCPT had elevated serum free kappa light chain. Five patients with LCCN presented clinically with acute kidney injury (AKI). Two patients with LCPT and 1 patient with LCCN and LCPT showed CKD combined with AKI, and 1 LCPT patient presented with typical Fanconi syndrome (FS). Five patients with LCCN, 2 patients with LCPT, and 1 patient with LCCN and LCPT were diagnosed with multiple myeloma. Five patients with LCCN had kappa light chain restriction in tubules on immunofluorescence and a "fractured" protein casts with pale periodic acid-Schiff (PAS) staining on light microscopy. Immunohistochemical staining of 2 LCPT patients showed strongly positive kappa light chain staining in the proximal tubular epithelial cells. And monoclonal light chain crystals in crystalline LCPT and abnormal lysosomes and different morphological inclusion bodies in noncrystalline LCPT were observed under the electron microscope. Six patients with LCCN were mainly treated by chemotherapy. Renal function was deteriorated in 1 patient, was stable in 4 patients, and was improved in 1 patient. Two patients with LCPT improved their renal function after chemotherapy. Four patients with genetic tubulointerstitial disease were clinically presented as CKD, mostly mild proteinuria, with or without microscopic hematuria, and also presented with hyperuricemia, urine glucose under normal blood glucose, anemia, polycystic kidneys. Only 1 case had a clear family history, and the diagnosis was mainly based on renal pathological characteristics and genetic testing. Compared with patients with non-genetic related tubulointerstitial lesion, patients with genetic tubulointerstitial disease had an earlier age of onset, higher blood uric acid, lower Hb and estiated glomemlar fitration (eGFR), and less edema and hypertension. Renal pathology of genetic tubulointerstitial disease presented tubular atrophy and interstitial fibrosis, abnormal tubular dilation, glomerular capsuledilation, and glomerular capillary loop shrinkage. Glomerular dysplasia and varying degrees of glomerular sclerosis were observed. Genetic tubulointerstitial disease patients were mainly treated with enteral dialysis, hypouricemic and hypoglycemic treatment. Two genetic tubulointerstitial disease patients had significantly deteriorated renal function, and 2 patients had stable renal function. CONCLUSIONS Patients with AKI or FS, who present serum immunofixation electrophoresis and/or serum free kappa light chain abnormalities, should be alert to LCCN or LCPT. Renal biopsy is a critical detection for diagnosis of LCCN and LCPT. Chemotherapy and stem cell transplantation could delay progression of renal function in patients with LCCN and LCPT. If the non-atrophic area of the renal interstitium presents glomerular capsule dilatation, glomerular capillary loop shrinkage, and abnormal tubular dilatation under the light microscopy, genetic tubulointerstitial disease might be considered, which should be traced to family history and can be diagnosed by genetic testing.
Humans ; Hematuria ; Immunoglobulin Light Chains/analysis* ; Multiple Myeloma ; Proteinuria ; Nephritis, Interstitial ; Acute Kidney Injury ; Anemia ; Renal Insufficiency, Chronic

Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) has become a widely used method in the field of microbial identification. Its obvious advantages including rapidity, great accuracy and high throughput attract many researchers to investigate its potential for usage in other microbiological fields. Currently, several studies have reported MALDI-TOF MS-based analysis of bacterial resistance to antibiotics, which can identify the specific heterogeneous spectrum peaks related to drug resistance through simple visual analysis of the spectrum or more complex analysis of the entire spectrum using informatics methods and statistical approaches. Therefore, MALDI-TOF MS has become a potential tool for detecting antibiotic resistance in bacteria. This review mainly summarized the progress in MALDI-TOF MS-based analysis of bacterial resistance to antibiotics.

Objectives Comparative analysis on epidemiological characteristics of measles in Minhang District before and after Large scale supplementary immunization activities of measles containing vaccine(MCV) in 2010. Methods Measles incidence data of MCV-SIA in 2010 and the first five years before 2010 (from January 1, 2005 to December 31, 2009), the next five years (from January 1, 2011 to December 31, 2015) and the second five years (from January 1, 2016 to December 31, 2020) after were collected. Descriptive epidemiological method was used for comparative analysis. Results The incidence rate of measles in Minhang District, Shanghai after MCV-SIA in 2010 showed a significant downward trend, The average annual incidence (per 100 0000) in the first 5 years before 2010 was 155.96, SIA was 30.08,The next five years was 29.52, The second five years was 2.84,There was statistical difference in the annual incidence rate between the four groups.（χ²=3165.821，P<0.01）. The annual incidence rate between registered residence and non registered residence population were not statistically different after second SIA years after the SIA（χ²=1.646，P=0.223）The proportion of 8-month-old children under the age of MCV decreased from 15.46% in the first five years of MCV-sia to 5.88%,In the second five years after MCV-sia, the proportion of 10-14 age group increased from 7.81% to 13.83%, The susceptible population of measles before MCV-SIA was less than 8 month old and under the age of MCV initial immunization, no migrant workers with no history of immunization and adults with registered residence. Once there is a source of infection, it is easy to cause the spread of the epidemic. After MCV-SIA, foreign students in international schools and nonworking population became the focus of measles. Of the 95 cases in which measles virus genotypes were available in the next five years, 2 (2.11%) were A genotype, and 93 (97.89%)were the indigenous H1 genotype ; Of the 7 cases in which measles virus genotypes were available in the second five years,7 (100%)were the indigenous H1 genotype . Conclusions After MCV-SIA, the comprehensive measles prevention and control measures can effectively control the incidence and prevalence of measles in Minhang District. But circulation of the indigenous H1 genotype was not interrupted, the work of normalization measures to eliminate measles also needs to cooperate with many departments to strengthen the prevention and control measures of measles in foreign schools and the nonworking population.

Objective: To explore the impact of the personal rehabilitation treatment on life quality and curative offect of the schizophrenia patients. Methods: A total of 84 patients with chronic schizophrenia in Shanxi Rongjun Corelle Hospital from December 2016 January 2018 were randomly divided into intervention group and control group on the basis of random number table, the two groups received psychiatric routine therapy nursing and general entertainment therapy, and the intervention group received 8 weeks of individualized rehabilitation therapy on this basis.The Schizophrenics Quality of Life Scale(SQLS) and Positive and Negative Symptoms Scale(PANSS) were respectively used to evaluate the effect of the two groups before and after intervention. Results: After 8 weeks of systematic social skills training, the scores of negative symptoms, general psychopathology and total PANSS score in the intervention group were (14.65±3.68)points, (24.21±3.23)points, (52.83±7.12)points, respectively, which in the control group were (21.82±4.25)points, (28.08±4.56)points, (60.67±9.52)points, respectively, the differences between the two groups were statistically significant(t=5.18, 3.35, 3.92, all P<0.01), while the positive symptom score had no statistically significant difference between the two gorups (P>0.05). The PANSS scores and total score in the intervention group after intervention had statistically significant differences compared with those before intervention (t=2.17, 5.98, 3.86, 4.13, all P<0.05). After the intervention training, the psychosocial score, motivation and energy score, symptoms and adverse reactions score, and total score of SQLS in the intervention group were (32.64±7.32)points, (39.45±10.87)points, (18.16±10.48)points, (90.34±24.17)points, which in the control group were (35.32±10.64)points, (43.82±12.43)points, (21.05±11.52)points, (98.25±32.29)points, respectively, and the differences between the two groups were statistically significant (t=2.46, 3.51, 3.12, 3.96, all P<0.05). The SQLS scores and total score in the intervention group after intervention had statistically significant differences compared with those before intervention(t=3.94, 4.72, 3.87, 5.01, all P<0.01). Conclusion The personal rehabilitation treatment can greatly promote the curative offect of patients with chronic schizophrenia, improve their life qualities.

Objective To investigate the treatment strategies and clinical effects in treatment of floating knee in children.Methods A retrospective case series study was made on 26 cases of floating knee treated from July 2005 to June 2015.There were 22 males and four females, aged from 2-14 years (mean, 7.6 years).According to the Letts classification of the floating knee, ten cases were with type A, four with type B, two with type C, eight with type D, and two with type E.Closed fractures were noted in 16 cases and open fractures in 10 cases.According to the Gustilo classification of open fractures, one was with type ⅢA, six with type ⅢB, and three with type ⅢC.One case was amputated from the distal of the femur, eight cases were treated by traction and plaster caster, and 17 cases were treated by reduction and fixation of both femoral and tibil fractures.Wound healing, fracture union, Karsstrom criteria for functional outcome and complications were detected.Results All patients were followed up for mean 2.8 years (range, 1-6 years).One case of Gustilo type ⅢA and six cases of Gustilo type ⅢB open fractures had wound healing after one-stage debridement.Two cases of Gustilo type ⅢC showed wound healing after second-stage skin grafting.One case of Gustilo type ⅢC had amputation wound infection and was cured after a second debridement and dress change.Two had delayed union and there was no nonunion.According to the Karlstrom criteria, the excellent and good rate of functional outcome was 25% and 83% respectively in nonoperative and operative population (P<0.05).Malunion was found in four cases, genu vagum in three and overgrowth of 10-20 mm in seven.There was no premature closure of epiphysis.Conclusion Femur and tibia immobilization of floating knee in children is effective for bone union and functional recovery.