ObjectiveThis study aims to investigate the effects of different sizes of seedlings and melatonin treatment on physiological and biochemical indicators and bolting-related gene expression in Angelica sinensis， find substances related to early bolting， and elucidate the inhibitory mechanism of melatonin on bolting. MethodsSpectrophotometry was used to detect the related enzyme activities of A. sinensis leaves. The contents of endogenous hormones and polyamines were detected using ultra-high performance liquid chromatography-tandem mass spectrometry. Real-time polymerase chain reaction （Real-time PCR） was used to detect the expression levels of bolting-related genes. Inter-group differential indicator analysis， orthogonal partial least squares discriminant analysis， and principal component analysis were comprehensively applied to identify factors related to early bolting. ResultsEndogenous jasmonic acid and melatonin were identified as the most important factors affecting early bolting. Secondly， the activity of antioxidant enzymes， abscisic acid content， gibberellin content， and the expression levels of CO3， HD3A， and FD genes had important effects on the bolting process. Compared with small seedlings， exogenous melatonin treatment mainly inhibited early bolting by increasing endogenous melatonin content， reducing gibberellin content， and decreasing the expression levels of SOC1 and FD genes. ConclusionExogenous melatonin can inhibit early bolting in A. sinensis by regulating its physiological， biochemical， and gene expression levels.

ObjectiveThis study aims to investigate the effects of different sizes of seedlings and melatonin treatment on physiological and biochemical indicators and bolting-related gene expression in Angelica sinensis， find substances related to early bolting， and elucidate the inhibitory mechanism of melatonin on bolting. MethodsSpectrophotometry was used to detect the related enzyme activities of A. sinensis leaves. The contents of endogenous hormones and polyamines were detected using ultra-high performance liquid chromatography-tandem mass spectrometry. Real-time polymerase chain reaction （Real-time PCR） was used to detect the expression levels of bolting-related genes. Inter-group differential indicator analysis， orthogonal partial least squares discriminant analysis， and principal component analysis were comprehensively applied to identify factors related to early bolting. ResultsEndogenous jasmonic acid and melatonin were identified as the most important factors affecting early bolting. Secondly， the activity of antioxidant enzymes， abscisic acid content， gibberellin content， and the expression levels of CO3， HD3A， and FD genes had important effects on the bolting process. Compared with small seedlings， exogenous melatonin treatment mainly inhibited early bolting by increasing endogenous melatonin content， reducing gibberellin content， and decreasing the expression levels of SOC1 and FD genes. ConclusionExogenous melatonin can inhibit early bolting in A. sinensis by regulating its physiological， biochemical， and gene expression levels.

Objective To explore the inter-rater and within-rater reliability of the 30 categories of the International Classification of Functioning Disability,and Health(ICF)dysfunction set(ICF generic-30 set)in clinical function assessment,to provide a basis for its clinical application.Methods Ninety patients from the Neurorehabilitation Department of the First People's Hospital of Suqian City were enrolled in this study.All patients were evaluated by the same functional evaluator's ICF dysfunction combination at the two time points of admission and discharge for the internal reliability analysis of the evaluator.Thirty patients in the neurorehabilitation department were randomly selected to be evaluated by two ICF function evaluators at the same time to conduct test-retest reliability analysis among evaluators.The internal consistency of the Cronbach's α coefficient test scale,and the intra-group correlation coefficient(ICC)test inter-rater reliability and within-rater reliability.Results The Cronbach's α coefficients of the combination of ICF dysfunction,physical function and activity,and participation in the two subscales were 0.941,0.717,and 0.942,respectively.The inter-rater reliability analysis showed that the ICC of the total score of the scale and the total scores of physical function and activity and participation in the two subscales were 0.998,0.971,0.999(P<0.01),and the inter-rater reliability good;the internal reliability analysis of the evaluator showed that the total score of the scale and the total scores of physical function and activity and participation in the two subscales were 0.988,0.917,0.991(P<0.01),except that b640 sexual function is not applicable,and b130 energy Harmony drive function ICC is 0.558,b280 pain ICC is 0.409,ICC of other combination items is 0.838-0.986(P<0.01),the evaluator's internal reliability is good;90 patients'ICF dysfunction combination scale has 30 categories.The comparison between admission and discharge was statistically significant except that b640 was not applicable for sexual function(P<0.05).Conclusion The combination of ICF dysfunction has good internal consistency and inter-evaluator and intra-evaluator reliability in the functional evaluation of patients in neurorehabilitation department.

Objective To observe the value of ultrasound-guided intra-articular injection of hypertonic glucose(HG)for treating knee osteoarthritis in plateau area.Methods Ninety-one patients with knee osteoarthritis in plateau area(124 affected knee joints)were enrolled.The knee joints were divided into 20％HG group(n=67),25％HG group(n=42)or sodium hyaluronate group(n=15)based on the medication.Clinical and ultrasound scores were compared before and after treatment,and the efficacy of injection of HG was evaluated.Results At the 12th and 48th weeks after treatment,visual analog scale(VAS)scores decreased in all 3 groups(all P＜0.05),and Lysholm scores of 20％HG group and 25％HG group increased compared to those before treatment(all P＜0.05).The difference of Lysholm score before and in the 12th week after treatment,and of VAS score before and in the 48th week after treatment of 25％HG group were higher than those of 20％HG group(both P＜0.05).The joint exudation score of 20％HG group decreased in the 48th week after treatment compared to that before treatment(P＜0.05),and the synovial blood flow score decreased in the 12th and 48th weeks after treatment compared to those before treatment(both P＜0.05).The joint exudation score of 25％HG group decreased in the 48th week after treatment compared to that before treatment(P＜0.05),and the synovial hyperplasia and synovial blood flow score decreased in the 12th and 48th weeks after treatment compared to before treatment(all P＜0.05).The joint exudation score of sodium hyaluronate group decreased in the 48th week after treatment compared to that before treatment(P＜0.05),and the synovial hyperplasia score decreased in the 12th and 48th weeks after treatment compared to that before treatment(both P＜0.05).Conclusion Ultrasound-guided intra-articular injection of HG,esp.25％HG,had certain value for treating knee osteoarthritis in plateau area.

Objective:To investigate the correlation between cytokeratin 19 fragment(CYFRA21-1), modified ultrasound B-line and connective tissue disease associated with interstitial lung disease (CTD-ILD).Methods:The data of 112 patients with CTD hospitalized in the Department of Rheumatology and Immunology of the Second Hospital of Fujian Medical University from September 2019 to December 2021 were retrospectively collected. Sixty patients in the CTD-ILD group and 52 patients in the connective tissue disease without interstitial lung disease (CTD-noILD) group were included. The t-test and χ2 test were used to compare the demographic characteristics and tumor-associated antigens of the two groups of patients. Modified ultrasound score and HRCT Warrick score were evaluated by Pearson correlation analysis. In addition, the relationship between CYFRA21-1, modified ultrasound score and Warrick score were evaluated, and the diagnostic efficacy of CYFRA21-1 and modified ultrasound of CTD-ILD was evaluated and analyzed by binary logistic regression analysis. Results:Patients in the CTD-ILD group had higher CYFRA21-1 concentrations than the CTD-no-ILD group[5.74(4.25, 9.79) ng/ml vs. 2.79(2.21, 3.23) ng/ml, Z=45.94, P<0.001], patients in the CTD-ILD group had higher modified ultrasound scores than the CTD-no-ILD group [44.5(36.5, 60.0) vs. 5.0 (3.2, 6.8), P<0.001]. Modified ultrasound score was positively correlated with Warrick score ( r=0.93, P<0.001) and CYRFA21-1 was positively correlated with modified ultrasound score ( r=0.39, P=0.042). The sensitivity of CYFRA21-1 in determining CTD-ILD was 81.7% and the specificity was 92.3% [ AUC (95% CI)=0.88(0.81, 0.95), P<0.001], the sensitivity of modified ultrasound B-line to determine CTD-ILD was 96.4% and the specificity was 92.9% [ AUC (95% CI)=0.99 (0.97, 1.00), P<0.001]. History of smoking[ OR(95% CI)=9.26(1.11, 77.12), P=0.040] and elevated CYFRA21-1 concentration[ OR(95% CI)=19.40(4.89, 76.95), P<0.001] were risk factors for CTD-ILD. Conclusion:CYFRA21-1 is expected to be a serum marker indicating concomitant ILD in patients with CTD. Modified ultrasound B-line to determine concomitant ILD in CTD patients has good diagnostic utility and can reflect the severity of pulmonary fibrosis in CTD-ILD patients.

Objective:To observe any effect of using the International Classification of Functioning, Disability and Health (ICF) rehabilitation set in rehabilitating the physical ability of hemiplegic stroke survivors.Methods:Ninety stroke survivors with hemiplegia were selected and randomly divided into an observation group ( n=45) and a control group ( n=45). The observation group was first assessed using the ICF and then given 60 minutes of individualized rehabilitation, 5 or 6 times a week for 4 weeks in addition to a weekly one-hour rehabilitation course. The control group were evaluated and treated traditionally. Before and after the intervention, both groups were evaluated using the Fugl-Meyer exercise assessment (FM) and functional independence assessment (FIM). Results:After the treatment the average upper and lower limb scores as well as the total FM scores had improved significantly. Those of the observation group were then significantly different from the control group′s averages.Conclusion:Basing rehabilitation on the ICF can more effectively improve the physical functioning of hemiplegic stroke survivors.

Objective: To investigate the reversibility of ischemic core defined by CT perfusion imaging in acute ischemic stroke (AIS) patients receiving intravenous thrombolysis within different time windows and influencing factors. Methods: The data of AIS patients who received intravenous thrombolysis in the Department of Neurology of Lishui People′s Hospital from May 2016 to December 2018 were retrospectively reviewed. All patients had finished multi-model CT imaging before thrombolysis and multi-model MRI examination 24-48 hours after thrombolysis. The baseline ischemic core volume (hypoperfusion area with relative cerebral blood flow (rCBF)<30%) was quantitatively assessed based on CT perfusion images using MIStar software, and the final ischemic core volume was assessed based on diffusion weighted imaging acquired 24-48 hours after thrombolysis. The reversibility of ischemic core was defined as baseline ischemic core volume-the final infarct volume ≥5 ml. Then the clinical and imaging features of the patients between reversible group and irreversible group were compared, and the predictors of ischemic core reversibility were analyzed by binary Logistic regression analysis. Results: Finally, 97 patients were enrolled in the present study, of which 64 (66%) patients achieved successful recanalization, 51 (53%) patients with reversible baseline ischemic core. For patients with recanalization, the incidence of reversibility was 76% (26/34), 71% (17/24), 2/5 and 0 (0/1) in patients with time window from onset to thrombolysis (ONT) <3.0 h, 3.0-4.5 h, 4.6-6.0 h, and >6.0 h, respectively. In the non-recanalization group, six patients were also showed with ischemic core reversibility, including 4 (4/12) in the ONT<3.0 h group and 2 (2/12) in the ONT 3.0-4.5 h group. It was found that the reversible volume was positively correlated with baseline ischemic core volume (r=0.805, P<0.001) by Spearman correlation analysis. Finally, binary Logistic regression analysis revealed that the history of hypertension, ONT and recanalization were independent predictors of reversible changes of baseline ischemic core. Conclusions The ischemic core defined by CT perfusion imaging (rCBF<30%) was considerably inaccurate for patients with ONT<6.0 h. If recanalization could be achieved within this time window, most of the patients would manifest with ischemic core reversibility, the predictors of which also included hypertension history and ONT.

Objective? To construct the "Internet +" based health management model for physical examination population. Methods? From September 2016 to September 2017, we constructed the primary"Internet +" health management model by literature review. Two rounds of consultation with 25 experts were carried out with the Delphi method to construct the "Internet +" health management model for physical examination population. Results? Among two rounds of consultation, the recovery rate of questionnaire was all 100%. The expert authority coefficient (Cr) was 0.87. The final "Internet +" health management model included 3 first-level indicators, 7 second-level indicators and 26 third-level indicators. Conclusions? The "Internet +"based health management model is reliable which can be intervention for health management model of physical examination population.

Objective To study the colonization rate and antibiotic resistance of group B Streptococcus (GBS) in gravidas during late pregnancy,and to evaluate the effectiveness of GBS screening in late pregnancy and intrapartum antibiotic prophylaxis (IAP) for the prevention of neonatal early-onset GBS disease (EOGBS).Methods A retrospective study was conducted to analyze the colonization rate and antibiotic resistance pattern of GBS in 14 204 gravidas who were screened for GBS at 35-37 gestational weeks during March 2016 to March 2018 in the University of Hongkong-Shenzhen Hospital (HKU-SZH).Differences in the incidence of EOGBS before and after GBS screening and IAP were analyzed using Chi-square or Fisher's exact test.Results Among the 14 204 gravidas,2 027 cases were GBS positive with a colonization rate of 14.27％.Incidence rates of EOGBS before and after GBS screening were 0.6‰ (4/6 356) and 0.07‰ (1/14 403),respectively (Fisher's exact test,P=0.033).GBS isolates were 100％ (2 027/2 027) sensitive to penicillin and vancomycin.Resistance rates to clindamycin and erythromycin were 67.2％(1 363/2 027) and 65.7％ (1 332/2 027),respectively.Conclusions Routine GBS screening in late pregnancy and IAP can significantly decrease the incidence of EOGBS.Penicillin is the optimal choice for prevention and treatment of GBS infection.

Objective To evaluate the clinical efficacy and safety of endoscopic submucosal dissection (ESD) guided with endoscopic ultrasonography (EUS) for rectal neuroendocrine neoplasms(NENs).Methods A retrospective analysis was performed on 58 patients with rectal ENEs who underwent ESD from January 2011 to December 2015 in JiangSu Province Hospital.Manifestations of EUS, clinicopathological characteristics, proliferation activity grade, complete resection rate, complications and follow-up results of lesion were studied.Results Those treated by ESD included 58 patients with 64 lesions of rectal NENs.EUS results showed that 3 lesions originated from mucosa, 3 from muscularis mucosa and 58 from submucosa.A total of 34 lesions located within 5 cm from anus, 26 in 6-10 cm from anus and 4 more than 10 cm from anus.All 64 lesions were successfully treated by ESD.The mean maximum diameter of the lesions was 0.8 cm(0.2-3.5 cm), and the mean procedure time was 31 min(10-60 min).The complete resection rate was 93.8% (60/64).There were 4 patients with positive basal surgical margin, and two of them underwent additional surgery and two others were treated with argon plasma coagulation after rejecting surgery and ESD.Histological examination determined that 59 lesions were pathologic grade 1(G1) and 5 were pathologic grade 2(G2).Delayed bleeding occurred in 4 cases after ESD,which was managed by medicine in 1 case and endoscopic treatment in 3 cases.No perforation occurred after ESD.During a mean follow-up period of 22.9 months(3-48 months), no lymph node metastasis or distant metastasis was observed.Conclusion EUS is able to distinguish the origin of rectal NENs and aid determining the range and depth of ESD.ESD appears to be a safe, feasible and effective procedure for providing accurate histopathologica1 evaluations as well as curative treatments for rectal NENs limited to submucosa.