Objective To explore the value of brain MR three-dimensional arterial spin labeling(3D-ASL),diffusion weighted imaging(DWI)combined with MGMT gene detection in the differential diagnosis of postoperative recurrence and pseudoprogression of high-grade glioma.Methods A total of 30 patients with high-grade glioma were selected,and all patients were divided into pseudoprogression group and recurrence group according to pathological results.The differences in average relative cerebral blood flow(rCBF)and average relative apparent diffusion coefficient(rADC)were compared between recurrence groups and pseudoprogression groups.Results The rCBF in the enhanced center and edge areas in the recurrence group was significantly higher than those in the pseudoprogression group,and the rADC was significantly lower than that in the pseudoprogression group,and the difference was statistically significant(P<0.05).There were correlations between the postoperative recurrence and pseudoprogression of high-grade glioma and the promoter situation of methylation of MGMT gene.Conclusion Brain MR 3D-ASL,DWI combined with MGMT gene detection has important clinical value in the differential diagnosis of postoperative recurrence and pseudoprogression of high-grade glioma.

Objective To detect the expression level of 4-aminobutyrate aminotransferase(ABAT)in bone marrow of patients with myelodysplastic syndrome(MDS),and analyze its influence on clinicopathological features and prognosis of patients.Methods From January 2016 to March 2020,92 patients with MDS and 30 patients with acute myeloid leukemia(AML)from the First Affiliated Hospital of Xingtai Medical College were retrospectively collected.Meanwhile,30 patients with immunothrombocytopenia who did not develop MDS or other clonal diseases of the blood system during a 3-year follow-up were collected as control group.Real-time quantitative fluorescent PCR(qRT-PCR)was used to detect the relative expression level and methylation level of ABAT mRNA of all patients,and the relative expression level and methylation level of ABAT mRNA among different clinical characteristics of MDS patients were compared.Multivariate logistic regression analysis was used to analyze the risk factors affecting the adverse prognosis of MDS.The clinical value of detecting ABAT methylation level in predicting poor prognosis of MDS patients was analyzed by receiver operating characteristic(ROC)curve.Kaplan-Meier method was used to calculate the 3-year survival rate between groups with different ABAT mRNA relative expression levels and methylation levels,and log-rank test was used for their comparison.Results The expression level of ABAT mRNA in MDS group(0.42±0.08)was lower than that in control group(0.56±0.15)and AML group(0.52±0.10),while the methylation level of ABAT(32.51±5.32)was higher than that of AML group(26.21±4.58)and control group(10.25±4.31),and the differences were significant(t=4.251,4.562;10.415,8.326,all P<0.001).The methylation level of ABAT in high-risk patients(42.65±5.32)was higher than that in low-risk patients(25.63±4.16),intermediate-risk-1 patients(30.59±2.51)and intermediate-risk-2 patients(33.25±3.69)by IPSS risk grade,and the differences were significant(t=8.329,7.077,15.874,all P<0.001).Poor Karyotype analysis result[OR(95%CI):4.973(1.524～8.581),P=0.004],high IPSS risk grade[OR(95%CI):8.542(2.365～14.521),P<0.001]and ABAT hypermethylation level[OR(95%CI):6.178(1.589～13.021),P<0.001]were the risk factors affecting the poor prognosis of MDS.The cut-offvalue of ABAT methylation level to predict the poor prognosis of MDS were 30.54,and the area under the curve(AUC),the sensitivity and specificity were 0.92,0.874 and 0.851,respectively.The 3-year survival rate of the high ABAT methylation group(>30.54)was 66.67%,which was lower than that of the low ABAT methylation group(≤30.54)was 93.18%,with significant difference(Log-rank x2=9.814,P=0.002).Conclusion The ABAT methylation levels in MDS bone marrow increase,which is a risk factor affecting the poor prognosis of patients.ABAT basal level>30.54 is expected to become a factors predicting the poor prognosis of patients.

ObjectiveTo explore the correlation among knee hyperextension angle, lower limb joints kinematics parameters and the activation of main muscles of lower limb in stroke hemiplegic patients with knee hyperextension during walking. MethodsFrom August, 2020 to September, 2021, 24 stroke hemiplegic patients with knee hyperextension and 24 healthy subjects matched with sex, age, height and body mass with knee hyperextension were analyzed with three-dimensional gait analysis system and the wireless surface electromyography acquisition system, to record the range of motion of pelvis, hip, knee and ankle joints in sagittal plane, and the activation of bilateral gluteus maximus, biceps femoris, vastus medialis and gastrocnemius medialis. ResultsAs the maximum of knee hyperextension, range of motion of the joints in sagittal plane and the activation of the muscles were different between the patients and the healthy subjects during the single-support phase of walking (|t| > 3.080, P < 0.01), and the maximum of knee hyperextension correlated with the activation of gluteus maximus in the patients (r = -0.532, P < 0.01), and the range of motion of ankle plantar flexion in both the patients and the healthy subjects (r > 0.686, P < 0.001). ConclusionThe correction for knee hyperextension gait in stroke hemiplegic patients may not only need to pay attention to knee joint control, but also need further treatment of ankle control and hip muscle function.

Objective:To explore clustered epidemic of COVID-19 in Liaocheng city and analyze infection status and chain of transmission of the cases.Methods:A joint investigation team of emergency response for COVID-19 epidemic by CDC professional workers of Liaocheng city and district at two levels on January 30, 2020. According to a indicator case from ZH supermarkets, close contacts and related subjects were tracked and screened on February 1, including ZH supermarket employees, family members having contact history with related cases during January 13-26, supermarket clients during January 16-30 and family members of related cases. an epidemiological investigation was carried on and their swab of nose/throat were collected and were sent to Liaocheng CDC laboratory, real-time fluorescence quantitative RT-PCR was used to detect nucleic acids of SARS-CoV-2.Results:a total of 8 437 people were screened during January 30 to February 9, 2020 (120 employees of supermarket, 93 family members, and 8224 clients of supermarket). The epidemic was caused by ZH cases and brought clustered cases in four families. A total 25 cases of SARS-CoV-2 infection, the total infection rate of subjects was 0.30% (25/8 437) with 22 confirmed cases (0.26%, 22/8 437) and 3 asymptomatic patients (0.04%, 3/8 437), asymptomatic patients accounted for 12.00% (3/25) of all infection cases. The infection rates of supermarket employees, family members of confirmed cases and supermarket clients were 9.17% (11/120), 12.90% (12/93) and 0.02% (2/8 224).Conclusions:This was a cluster epidemic caused by one imported case of COVID-19 in a supermarket of Liaocheng city. Prevention and control of cluster epidemic should be focused on chain of community transmission and family cluster cases. It must also be an attention for transmission risk of asymptomatic patients.

Objective To explore the clinical efficacy of internal fixation with dynamic anterior plate-screw system for quadrilateral area(DAPSQ) in the treatment of complex acetabular fractures involving the quadrilateral surface.Methods Between January 2005 and January 2017,a series of 143 patients with complex quadrilateral surface fracture of the acetabulum were treated at Department of Orthopaedics,General Hospital of Central Theater Command.They were 86 males 57 females,with a mean age 46.6 years (range,from 19 to 77 years).By the Letournel-Judet classification,there were 38 anterior column plus posterior hemitransverse fractures,26 T-shaped fractures and 79 double column fractures.They were all closed.The delay from injury to surgery averaged 9.6 days(range,from 3 to 21 days).All the cases were treated with DAPSQ internal fixation via the ilioinguinal approach.Their operation time,intraoperative bleeding volume,quality of fracture reduction,hip function and complications were recorded.Results The operation time for this series ranged from 2.5 to 5.0 hours,averaging 3.8 hours.The intraoperative blood bleeding ranged from 400 to 2,500 mL,with an average of 680 mL.By the Matta criteria for fracture reduction,76 cases were rated as excellent,51 as good and 16 as poor,giving an excellent and good rate of 88.8％.The 143 patients were followed up from 4 months to 10 years (mean,4.1 years).The clinical fracture union was achieved after 2 to 4 months (mean,3 months).By the modified Merle d'Aubigné & Postel criteria,the affected hips scored 9 to 18 points (mean,16.3 points) at the final follow-ups,with 64 excellent,52 good,19 fair and 8 poor cases,giving an excellent and good rate of 81.1％.The postoperative complications included lesion of lateral femoral cutaneous nerve in 7 cases,urinary tract infection in 15 ones,traumatic osteoarthritis in 20 ones 5 of whom had to receive total hip arthroplasty,and heterotopic ossification (Brooker Grade Ⅰ) in 5 ones.Conclusion Internal fixation with DAPSQ is safe and effective for the treatment of complex acetabular fractures involving the quadrilateral surface.

Eight new C-diterpenoid alkaloid arabinosides, named aconicarmichosides E-L (-), were isolated from an aqueous extract of the lateral roots of (Fu Zi). Their structures were determined by spectroscopic and chemical methods including 2D NMR experiments and acid hydrolysis. Compounds -, together with the previously reported four neoline 14--arabinosides from the same plant, represent the only examples of glycosidic diterpenoid alkaloids so far. At a dose of 1.0 mg/kg (i.p.), as compared with the black control, compounds , , and - exhibited analgesic effects with >65.6% inhibitions against acetic acid-induced writhing of mice. Structure-activity relationship was also discussed.

Objective To explore the changes and clinical significance of serum syndecan-1 and MMP-9 levels in patients with different stages of endometriosis (EMS).Method 89 patients diagnosed as EMS and meeting criterions were collected from Jul.2014 to Aug.2016 in our hospital,including 20 cases of stage Ⅰ,27 cases of stage Ⅱ,28 cases of stage Ⅲ,and 19 cases of stage Ⅳ.At the same time,42 healthy women in our hospital were selected as control group.General information of the two groups was comparable.The serum syndecan-1 and MMP-9 levels of EMS group and the control group were detected by ELISA in fasting state.Results The serum syndecan-1 and MMP-9 levels of EMS group were higher than those of the control group(P＜0.05).The serum syndecan-1 and MMP-9 levels increased significantly with the increase of EMS stage (P＜0.05).The serum syndecan-1 and MMP-9 levels of EMS group had no significant difference at proliferative phase and secretory phase (P＞0.05).The levels of serum syndecan-1 (r=0.832,P=0.000) and MMP-9 (r=0.764,P=0.000) were positively correlated with EMS stage.There was a positive correlation between serum syndecan-1 and MMP-9 (r=0.684,P=0.000).Conclusion Serum soluble syndecan-1 and MMP-9 show high levels in patients with EMS,and the serum levels are not related to the menstrual cycle.They may be involved in the pathogenesis and progression of EMS through synergistic effects.

Objective To summarize the characteristics of deltoid ligament rupture and explore the feasibility and shortterm clinical outcomes of targeted suture anchor repair technique according to the rupture site.Methods From May 2011 to October 2014,19 cases of complete deltoid ligament rupture (17 males and 2 females) were recruited in this study,with an average age of 34.15± 1.23 years (ranged from 15 to 60 years).According to Lauge-Hansen classification,there were 7 cases of pronation external rotation grade ⅣV injury,including 3 cases of Maisonnuve fracture;1 case of pronation abduction type Ⅲ degree injury,1 case of pronation abduction grade ⅣV injury;and 10 cases of supination external rotation grade ⅣV injury.According to AO / OTA classification,there were 9 cases of 43B type injury and 10 cases of 43C type injury.According to the rupture site of deltoid ligament,the targeted suture anchor repair surgery was operated respectively.Early mobilization with the help of hinged ankle brace was encouraged.The evaluation at last follow-up was based on the American Orthopedic and Ankle Association (AOFAS) criteria of ankle and hindfoot,and the visual analogue scale (VAS) scoring system.Results Nineteen patients were all followed up for 24 to 48 months,with an average of 30.42±5.11 months.Fourteen cases (73.7％,14/19) with talus end avulsion were treated by double suture anchor in the talus,with continuous locking suture of the avulsed end.Four cases (21.1％,4/19) with middle part rupture were treated by double suture anchor in the talus,with the sutures crossing three bone tunnels at the medial malleolus.One case (5.3％,1/19) with medial malleolus end avulsion was treated by single suture anchor at the medial malleolus,with continuous locking suture of the avulsed end.At the last follow-up,the AOFAS score was ranged from 70 points to 96 points,with an average of 90.53 points,and excellent in 16 cases,good in 2 cases,fair in 1 case,excellent and good rate was 94.7％.The VAS score was ranged from 0 to 2 points,with an average of 0.42 point.No wide medical clear space was detected.But traumatic arthritis was happened in 2 patients.Conclusion The targeted suture anchor repair technique according to the rupture site was a save technique in treating deltoid ligament rupture,which is conducive to early postoperative functional exercise,with excellent short-term clinical outcomes and few complications.

Objective:To investigate the effect of Mindfulness-based stress reduction (MBSR) on perceived stress and mental state of patients with in vitro fertilization.Methods:83 cases women who were assisted reproduction with in vitro fertilization and embryo transfer (IVF-ET) in our hospital from May 2014 to December 2016 were selected as research objects.All the subjects were divided into control group and observation group according to the random number table method,with 41 cases in the control group and 42 cases in the observation group.Patients in the control group were given routine comprehensive nursing intervention,while the observation group was given MBSR intervention on the basis of the control group.The scores of self rating depression scale (SDS),self rating anxiety scale (SAS) and Chinese perceived stress scale (CPSS) before and after the intervention in the two groups were compared.Results:There was no significant difference in SDS score,SAS score and CPSS score between the two groups before intervention (P＞0.05).The scores of SDS,SAS and CPSS in observation group after intervention were (43.53± 4.89),(42.38± 4.34) and (27.53± 4.89),which were lower than (57.96± 7.30),(56.42± 5.49),(37.96± 7.30) before intervention,and the differences were statistically significant (P＜0.05).The scores ofSDS,SAS and CPSS in control group after intervention were (51.13± 5.52),(51.13± 5.52) and (31.13± 5.52),which were lower than (58.83± 7.28),(56.45± 5.51),(38.83± 7.28) before intervention,and the differences were statistically significant(P＜0.05).And those scores in were lower in observation group than in control group,the differences were statistically significant (P＜0.05).Conclusion:MBSR intervention can effectively improve the anxiety,depression and perceived stress of patients with in vitro fertilization,which is helpful in improving the success rate of IVF-ET,and it is worthy of clinical application.

Objective To investigate the clinical efficacy of open reduction and internal fixation with dynamic anterior plate-screw system for quadrilateral area ( DAPSQ ) in the treatment of elderly patients with acetabular fracture involving medial displacement of the quadrilateral surface. Methods Between January 2007 and December 2014, a series of 18 senile patients with acetabular fractures involving medial displace-ment of the quadrilateral surface were treated at our department. They were 13 men 5 women, with a mean age 67. 8 years ( range, from 61 to 78 years ) . By the Judet-Letournel classification, there were 4 anterior column fractures, 5 anterior column plus posterior hemitransverse fractures, 8 double column fractures and one T-shaped fracture. The delay from injury to surgery averaged 6. 5 days. All were treated with the technique of DAPSQ. Screw internal fixation of the quadrilateral area followed plate moulding via a single ilioinguinal ap-proach. Fixation with lag screws for the posterior column was added if necessary. Results The 18 pa-tients were followed up for 12 to 35 months ( mean, 26 months ) . By the Matta criteria for fracture reduction, 9 cases were rated as excellent, 6 as good and 3 as poor. Bone healing was achieved within 2 to 4 months( mean, 3. 5 months ) . By the modified Merle d'Aubigné & Postel criteria, the affected hips scored 9 to 18 points ( mean, 16. 3 points ) at the final follow-ups, giving 7 excellent, 7 good, 2 fair and 2 poor cases. By the Harris evaluation, the affected hips scored 58 to 98 points ( mean, 87. 6 points ) , giving 7 excellent, 8 good, one fair and 2 poor cases. The postoperative complications included urinary tract infection in one, lesion of lateral femoral cutaneous nerve in one, heterotopic ossification ( Brooker Grade Ⅰ) in one, and traumatic osteoarthritis in 5 cases 2 of whom had to receive total hip arthroplasty. Conclusion The technique of DAPSQ is suitable for the treatment of acetabular fractures involving medial displacement of the quadrilateral surface in elderly patients, because it can provide and maintain stable fixation of the fracture in the quadri-lateral area and preserve hip joint function, leading to fine outcomes.