Objective:To study positive rates and typing of oligoclonal bands (OCB) in patients with neurological disorders, and to reveal the clinical significance and applicational value of OCB test.Methods:A retrospective analysis was performed on the detection results of 3 217 patients with neurological disorders who undertook both serum and cerebrospinal fluid OCBs in the First Hospital of Peking University from January 2012 to August 2022. According to the final diagnosis, the patients were divided into 13 groups including multiple sclerosis (479 cases), neuromyelitis optica spectrum disorders (935 cases), autoimmune encephalitis (192 cases), viral encephalitis (94 cases), nervous system complication after HSCT (232 cases), Guillain-Barré syndrome (644 cases), chronic inflammatory demyelinating polyneuropathy (157 cases), etc. Cerebrospinal fluid and serum OCBs were detected using isoelectric focusing electrophoresis combining immunofixation, then classified into Ⅰ-Ⅴ types according to the morphology. Consequently, positive rates and types were analyzed for each group. χ2 test was used for comparison between groups. Results:The positive rates of cerebrospinal fluid OCB in multiple sclerosis, nervous system complication after hematopoietic stem cell transplantation (HSCT), autoimmune encephalitis, viral encephalitis, neuromyelitis optica spectrum disorders, Guillain-Barré syndrome and chronic inflammatory demyelinating polyneuropathy were respectively 66.8% (320/479), 48.7% (113/232), 46.4%(89/192), 19.1% (18/94), 17.6% (165/935), 9.9% (64/644), 5.1% (8/157). For patients with multiple sclerosis, neuromyelitis optica spectrum disorders, viral encephalitis, and autoimmune encephalitis, Type Ⅱ bands took the majority of cerebrospinal fluid OCB-positive cases with the rates of 94.1% (301/320), 78.7% (70/89), 77.8% (14/18), and 77.6% (128/165) respectively, indicating intrathecal IgG synthesis; for patients with nervous system complication after HSCT, Guillain-Barré syndrome and chronic inflammatory demyelinating polyneuropathy, type Ⅳ bands took the majority of cerebrospinal fluid OCB-positive cases with the rates of 94.7% (107/113), 82.8% (53/64) and 100% (8/8), indicating no obvious intrathecal IgG synthesis. The positive rates of cerebrospinal fluid oligoclonal bands were significantly different among all groups (χ 2=1 268.31, P<0.001). Conclusion:The positive rates of cerebrospinal fluid oligoclonal bands are different among different neurological disorders, in which the positive rate of cerebrospinal fluid OCB is higher with type Ⅱ bands as the majority type in multiple sclerosis, which indicates that the detection and typing of cerebrospinal fluid OCB are helpful for the diagnosis of various neurological diseases, especially for multiple sclerosis.

Objective:To explore the diagnostic value of quantitative analysis of contrast-enhanced ultrasound for deep venous thrombosis of lower extremity after total hip arthroplasty.Methods:A total of 150 patients suspected of deep venous thrombosis of lower extremity undergoing total hip arthroplasty treatment in Jiaozhou Central Hospital of Qingdao from June 2021 to June 2022 were selected. Color Doppler ultrasound diagnostic instrument was used to examine the deep vein vessels of the lower limbs of patients, and quantitative analysis of contrast-enhanced ultrasound was performed to record the color Doppler detection results of patients. Quantitative parameters of contrast-enhanced ultrasound including time to peak (TIP), derived peak intensity (DPI), slope of ascending branch of curve (C) were compared between patients with deep vein thrombosis of lower extremities and normal patients. According to the onset time of symptoms of lower extremity thrombus group, patients were divided into acute stage, subacute stage and chronic stage, and the thrombus elasticity score and thrombus strain ratio among the three subgroups were compared.Results:Angiography results showed that 82 patients were diagnosed with deep vein thrombosis of lower extremities. The Kappa = 0.904, sensitivity was 95.00%, specificity was 91.43%, accuracy was 93.33%, positive prediction rate was 92.68%, and negative prediction rate was 94.12% by using contrast-enhanced ultrasonography and angiography in the diagnosis of deep vein thrombosis of lower extremity. The Kappa = 0.616, the sensitivity was 77.55%, specificity was 88.46%, accuracy was 81.33%, positive prediction rate was 92.68%, negative prediction rate was 67.65% by using ultrasonography and angiography in the diagnosis of deep venous thrombosis of lower extremities. The TIP level in patients with deep venous thrombosis of lower limbs was higher than that in normal patients, the DPI and C levels were lower than that in normal patients: (40.21 ± 12.34) s vs. (13.50 ± 4.59) s, (- 32.27 ± 7.56) dB vs. (- 11.33 ± 3.07) dB, (1.88 ± 0.40) dB/s vs. (4.75 ± 1.34) dB/s, there were statistical differences ( P<0.05). There were 28 cases of acute stage thrombosis, 22 cases of subacute stage thrombosis, and 32 cases of chronic stage thrombosis. There were statistically significant differences in thrombus elasticity score and thrombus strain ratio among patients with lower extremity thrombosis at different periods. Thrombus elasticity score and thrombus strain ratio of patients with acute stage thrombus were the lowest. Conclusions:Quantitative analysis of contrast-enhanced ultrasound has good consistency in the diagnosis of lower extremity deep vein thrombosis after total hip arthroplasty, and has certain clinical significance for staging diagnosis of lower extremity deep vein thrombosis.

Objective To investigate the effect of electroacupuncture on nutritional obese mice through TLR5-gut microbio-ta pathway,and the underlying mechanism.Methods A total of 60 SPF C57BL/6 mice were selected.Among them,10 blank mice were assigned to normal group,and the nutritive obesity model was established in the other 50 mice,which was induced by high-fat diet.Twenty nutritive obesity model mice were screened and randomly divided into model group and electroacupuncture group,with 10 mice in each group.The electroacupuncture group was needled at Zhongwan,Tianshu,Guanyuan and Fenglong points.And after obtaining Qi,electroacupuncture treatment was conducted on those mice for 21 days continuously.The change in differences of general indexes(body weight,Lee's index),tissue indexes(perirenal adipose-tissue mass),serum indexes[cho-lesterol(CHO),triglyceride(TG),high-density lipoprotein(HDL-C),low-density lipoprotein(LDL-C),blood glucose),molecular indexes[leptin(LEP),adiponectin(ADPN),interleukin-6(IL-6),interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α),lipopo-lysaccharide-binding protein(LBP)and cholecystokinin(CCK)]were observed.TLR5 protein distribution was detected by immu-nohistochemical reaction,and TLR5 gene expression was detected by RT-PCR.Structural differences of intestinal flora was ana-lyzed by second generation 16S rDNA gene sequencing technology.Results The body weight,Lee's index,fat mass around kid-ney,serum contents of CHO,TG,HDL-C,the contents of LEP and FFA in fat tissue,and contents of IL-6,IL-1β,TNF-α,LBP in intestinal mucosa tissue of model group were significantly higher than that of the normal group,and the content of adipocyto-kine ADP was significantly lower.After electroacupuncture treatment,those indicators were significantly improved.The protein distribution and gene expression of TLR5 in the intestinal mucosa of the model group were significantly higher than those of the normal group,and were significantly down-regulated after electroacupuncture intervention.The number of intestinal flora spe-cies in the model group was significantly lower than those in the normal group,and were significantly increased after electroacu-puncture intervention.Proportions of Bacteroidia,Gammaproteobacteria,Eggerthellacrae and Sutterellaceae were significantly increased,while proportions of Bacilli,Clostridia,Clostridiaceae and Actinobacteria were significantly decreased.Changes in gut flora were significantly reversed after electroacupuncture intervention.Conclusion Electroacupuncture has a satisfying effect in treatment of nutritional obesity.It can regulate the distribution and expression of TLR5 protein in intestinal mucosa by balancing the structure of intestinal flora,reduce the chronic inflammatory reaction of intestinal mucosa,promote lipid metabo-lism of the body,and achieve the purpose of weight loss and lipid reduction.

BackgroundSleep disorder can adversely affect human physical and mental health， with important implications for socioeconomic development. And higher vocational college students are subject to various pressures and stimuli exerted by academic studies， job seeking and family socioeconomic status， which may contribute to the onset insomnia symptom or sleep disorder. ObjectiveTo discuss the sleep status and influencing factors among higher vocational college students， and to provide references for improving their sleep status. MethodsIn January and February， 2022， a stratified random sampling method was utilized to enroll 3 300 students from five higher vocational colleges in Wenjiang district of Chengdu city. All the participants were assessed using Insomnia Severity Index （ISI）， Patient Health Questionnaire Depression Scale-9 item （PHQ-9） and Generalized Anxiety Disorder Scale-7 （GAD-7）. Pearson correlation analysis was conducted to test the correlation of ISI with PHQ-9 and GAD-7 scores， and the Logistic regression analysis was performed to identify the influencing factors of insomnia symptom in higher vocational college students. ResultInsomnia symptom was detected in 81.90% （2 497 / 3 300） of higher vocational college students. The detection rate of insomnia symptom among vocational college students yielded statistical difference in terms of gender， family socioeconomic status， being an only child or having siblings， degree of psychological pressure exerted by academic studies or job seeking， amount of hours spent on Internet per day， frequency of physical exercise， and the presence or absence of anxiety symptom and depression symptom （χ²=21.032， 22.172， 8.983， 75.939， 36.781， 32.350， 54.512， 86.561， P<0.01 or 0.05）. Among higher vocational college students， ISI score was positively correlated with GAD-7 and PHQ-9 scores （r=0.620， 0.714， P<0.01）， and GAD-7 score was positively correlated with PHQ-9 score （r=0.824， P<0.01）. Gender， family socioeconomic status， degree of psychological pressure exerted by academic studies or job seeking， amount of hours spent on Internet per day， frequency of physical exercise， and the presence or absence of anxiety symptom and depression symptom were effective factors in predicting the insomnia symptom in higher vocational college students （P<0.01 or 0.05）. ConclusionFemale gender， average and below average family socioeconomic status， moderate-to-severe degree of psychological pressure exerted by academic studies or job seeking， spending 2~5 h， 5~7 h or >7 h on Internet per day， inadequate physical exercise and presence of depressive symptom are the risk factors for insomnia symptom in higher vocational college students.［Funded by Sichuan Provincial Primary Health Development Research Center in 2022， North Sichuan Medical College （number， SWFZ22-C-89）］

Objective:To analyze the occurrence of early hypotony after the intravitreal injection of anti-vascular endothelial growth factor (VEGF) and its risk factors.Methods:A case-control study was performed.One hundred and twenty-seven eyes of 127 patients with fundus vascular disease who received intravitreal injections of anti-VEGF drugs were enrolled in Henan Provincial People's Hospital from January 2020 to January 2022.Of the 127 patients, there were 71 males and 56 females, with an average age of (61.85±11.53) years and a mean intraocular pressure of (15.28±3.71)mmHg (1 mmHg=0.133 kPa). All subjects were intravitreally injected with 0.05 ml of anti-VEGF drugs, including 56 cases receiving ranibizumab, 38 cases receiving conbercept and 33 cases receiving aflibercept.The intraocular pressure was measured with a non-contact tonometer at 30 minutes, 1 hour and 2 hours after the injection.The cases were grouped as hypotony group or non-hypotony group according to the intraocular pressure of subjects was less than 10 mmHg or not.The differences in sex, age, distribution of left eye and right eye, disease type, intraocular pressure before injection, injection frequency, lens status, drug type, injection timing, injection site, with or without high myopia, with or without a history of glaucoma or ocular hypertension, and with or without a history of vitreoretinal surgery were analyzed to investigate the factors with a P-value <0.05, which were used as the independent variable and the occurrence of hypotony as the dependent variable in logistic regression analysis to explore the risk factors for hypotony.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Henan Eye Hospital (No.HNEEC-2022-42). Results:Hopotony occurred in 8 eyes within 2 hours after the injection.There were significant differences in intraocular pressure at different time points before and after injection between the hypotony and non-hypotony groups ( Fgroup=62.177, P<0.001; Ftime=25.128, P<0.001). The intraocular pressure of the hypotony group at 30 minutes, 1 hour and 2 hours after injection were lower than before injection, and the intraocular pressure of the non-hypotony group was higher at 30 minutes after injection than before injection (all at P<0.05). The average reduction of intraocular pressure of the hypotony group was 7.88, 7.63 and 7.23 mmHg at 30 minutes, 1 hour and 2 hours after the injection, and the intraocular pressure returned to baseline level at 1 day after injection.There was no significant difference in sex, distribution of left and right eyes, disease type, pre-injection intraocular pressure, injection frequency, lens status, drug type, injection timing, injection site, with or without a history of high myopia and with or without a history of glaucoma or ocular hypertension between the two groups.There were significant differences in age and with or without a history of vitreoretinal surgery between the two groups ( t=8.265, P<0.001; χ2=6.907, P=0.035). Multivariate logistic regression analysis showed younger patients and having a history of vitreoretinal surgery were the risk factors for early hypotony after anti-VEGF intravitreal injection (odds ratio=88.563, P<0.001; odds ratio=20.991, P=0.009). Conclusions:Patients with younger age and having a history of vitreoretinal surgery are susceptible to early hypotony after anti-VEGF intravitreal injection.

Objective To collect information from the traditional Chinese medicine(TCM)four diagnostic information of patients with coronary heart disease(CHD)and to observe the characteristics of their Chinese medicine syndrome factor at different ages,to provide an objective basis for the Chinese medicine treatment of patients with CHD at different ages.Methods The TCM Four Diagnostic Information Collection Scale for CHD developed by the group was used to collect the four diagnostic information of patients with coronary heart disease,and the syndrome elements were extracted according to the syndrome differentiation standard to observe the distribution of syndrome elements at different ages.Results CHD is located in the heart and accompanied by liver,kidney,stomach,lung and other organs.Qi deficiency is the most common syndrome factor,followed by phlegm turbidity,yin deficiency,blood stasis and qi stagnation.Among the syndrome elements of disease location,the heart and liver were the most common in the young group,and the heart and kidney were more common in the middle-aged group and the elderly group.Among the syndrome elements of disease nature,qi deficiency was more common in the young group,phlegm turbidity and qi stagnation were more common in the empirical group,and qi deficiency and phlegm turbidity were the most frequent.In the middle-aged group,qi deficiency was more common in deficiency syndrome,phlegm turbidity and blood stasis were more common in excess syndrome,and the frequency of qi deficiency and phlegm turbidity and blood stasis was the highest.In the elderly group,qi deficiency and yin deficiency were more common in deficiency syndrome,phlegm turbidity and blood stasis were more common in excess syndrome,and qi and yin deficiency combined with phlegm turbidity and blood stasis had the highest frequency.Conclusion The combination of syndrome elements in patients with CHD in different age groups has its own characteristics.The young,middle and elderly groups are all visible in the mixture of deficiency and excess,while the young group is the most common with qi deficiency and phlegm turbidity,the middle-aged group is the most common with qi deficiency and phlegm turbidity and blood stasis,and the elderly group is the most common with qi and yin deficiency and phlegm turbidity and blood stasis.With the increase of age,the complexity of the combination of syndrome elements is higher.

Objective:To explore the effect of attentional bias training on the attentional bias, psychological craving and relapse rate of alcohol dependent patients during rehabilitation.Methods:A randomized controlled trial was used to select 90 alcohol-dependent patients and randomly divide them into an intervention group and a control group. The alcohol cue pictures and neutral pictures were imported into E-Prime software at a ratio of 1∶1.The patients in the two groups were trained for eight times with attentional bias and without attentional bias by point delection paradigm. After each training, the software automatically records the response time and correct rate of the cue pictures and neutral pictures, and before intervention(T0), after 4 interventions(T4), and after 8 interventions(T8), the alcohol craving score was assessed by visual analogue scale and the relapse situation was followed up 1 month after the intervention. SPSS 24.0 software was used for statistical analysis.Repeat measure ANOVA, χ2 test and t-test were used to compare the response time, accuracy and psychological craving of the two groups. Results:Repeated measurement analysis of variance showed that there were interaction between group and time in cue-map response time, line chart accuracy and psychological craving score of the two groups ( F=5.218, 6.939, 147.14, all P<0.01). Simple effect analysis showed that there was no significant difference in cue pictures response time, cue pictures accuracy and psychological craving score between the intervention group and the control group at T0(all P>0.05), but there was significant difference at T4 and T8 (all P<0.05), and there was significant difference in neutral pictures reaction only at T8 ( P<0.05). The comparison between two groups showed that the intervention group showed a downward trend in cue pictures response, T4 and T8 were lower than T0, with statistical difference (both P<0.001), while there was no difference in the control group. In the intervention group, the correct rate of cue pictures increased, T4 and T8 were higher than T0, and there were statistical differences (both P<0.001), while there was no difference in the control group( P>0.05). The psychological craving scores of both the intervention group and the control group showed a downward trend, T4 and T8 were lower than T0, there were statistical differences (both P<0.001), but the difference between T4 and T8 in the control group remained unchanged. One month after the end of the intervention, the difference in the rate of relapse between the intervention group and the control group was marginal (11.10%, 26.70%, P=0.059). The total number of days of abstinence in the intervention group was longer than that in the control group ((28.33±4.99)d, (26.47±6.66)d, P=0.010). Conclusion:Attentional bias training can improve the mental craving and attentional bias of alcohol-dependent patients during the rehabilitation period, and the relapse rate decreased one month after the intervention.

Objective:To determine the clinical, pathological and imaging phenotypes of pediatric patients with anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) myopathy to explore its diagnostic strategies.Methods:The clinical features of 10 pediatric patients with anti-HMGCR myopathy in the Department of Neurology, Peking University First Hospital from July 2014 to July 2021 were collected. Muscle biopsies were performed in all patients, with histological, enzymatic histochemical and immunohistochemical staining.Results:The male to female ratio was 6∶4, the age of onset was 3-16 (8.3±3.7) years, 2 cases had subacute onset, and 8 cases experienced chronic progressive onset. All patients presented with neck and proximal muscular weakness of all limbs. Skin rash was observed in 2 cases. Serum creatine kinase was 998-27 981 U/L. The electromyography results were available from 6 cases, who experienced myogenic changes. The muscle magnetic resonance imaging was performed in 5 cases and revealed muscle edema predominantly in posterior compartment of thigh, with mild fatty infiltrate in 2 cases. An initial diagnosis was limb-girdle muscular dystrophy in 7 cases, but with subsequently negative genetic testing. Muscle biopsies revealed scattered necrotic fibers and regenerating fibers, complement deposition in sarcolemma basement-membrane areas of non-necrotic fibers and a few of lymphocyte infiltrate in all specimens. Moreover, a high frequency of major histocompatibility complex Ⅰ expression in muscle fibers was observed in 9 cases, proliferation of connective tissue of endomysium in 8 cases, muscle fiber hypertrophy in 4 cases and vacuoles in 2 cases.Conclusions:Pediatric anti-HMGCR myopathy is frequently misdiagnosed as muscular dystrophy. Systematic consideration of anti-HMGCR myopathy and testing for myositis specific antibody in children with genetically unconfirmed muscular dystrophy may help the differential diagnosis.

Objective: To monitor and analyze the epidemiological characteristics of influenza in schools and understand the disease burden of students, and to provide a scientific reference for instructing the prevention of influenza in schools. Methods: A school influenza surveillance sentinel to conduct influenza like case (ILI) surveillance and outbreak surveillance. Through network, we understood the burden of flu disease among students. Descriptive epidemiology was used to analyze influenza like case surveillance and questionnaire survey data. Results: Surveillance confirmed that from the 42th week of 2019 to the 1st week of 2020, the cumulative reported ILI of 3 school influenza surveillance sites in Jinan accounted for 7.91% (ILI%) of the total number of surveillance personnel during the same period, with the highest ILI% (24.19%) of kindergarten children, ILI% gradually decreased with the increase of grade, and teachers were the lowest. The reporting of ILI was concentrated in the 49th to 52nd week of 2019, during which the reported influenza like cases accounted for 84.81% of the total number of ILI reported during the surveillance period. Two influenza outbreaks were monitored. The pathogens were H3N2 and B (Victoria). The epidemics mainly occurred in the lower grades of elementary school. A survey of 2 297 students found that 577 people had fever and respiratory symptoms since October 2019. Among them, 85.26% of them went to the hospital, 32.75% of those who used anti influenza drugs such as oseltamivir, and 64.81% of those who used antibiotics. 42.63% received infusion therapy, 3.99% were hospitalized, and the average cost of inpatients was 6 686 yuan. The sick students were absent from school for an average of 3.77 days, and the parents of the sick children missed work for an average of 4.26 days. Conclusion Surveillance of influenza like cases in schools is an important way to proactively discover influenza epidemic trends and outbreaks, and to accurately grasp the characteristics of influenza epidemics in schools. The key populations affected by influenza are kindergarten children and lower grades of primary school students. Suffering from influenza has caused a heavy disease burden on students and children in kindergartens, and is also an important factor that causes student absenteeism and parents to miss work.

Objective To analyze the epidemiological characteristics and spatiotemporal clustering of scarlet fever in Jinan, from 2014-2019, and to provide a basis for scarlet fever prevention and control. Methods The case data of scarlet fever in Jinan during 2013-2019 were extracted from the Chinese National Notifiable Infectious Disease Reporting System. Descriptive epidemiology and spatiotemporal rearrangement scanning methods were used to analyze the epidemiological characteristics and spatiotemporal distribution of scarlet fever. The RR values of scarlet fever in different towns (streets) were calculated, and the contour map of RR value was drawn. Results A total of 9 715 cases of scarlet fever were reported in Jinan from 2014 to 2019. During this period, the number of cases and the incidence rate showed a gradual increase, with two seasonal peaks in the winter and spring each year. Spatiotemporal clustering analysis detected a total of eight spatiotemporal aggregation areas, and the strongest one was in Licheng and Lixia Districts, from March 2017 to December 2019 (RR=3.45, LLR=577.88, P<0.001). The relative risk maps in each year from 2014 to 2019 were similar, and the areas with the highest risk were located in the central area of Jinan. Conclusion From 2014 to 2019, scarlet fever is highly prevalent in the central area of Jinan, with obvious spatial and temporal clustering. There are clustering areas in the central, southwest and eastern areas of Jinan, and there was a tendency for the disease to spread to Zhangqiu in the east and Pingyin in the southwest.