Objective:To study the feasibility of magnetic resonance imaging(MRI)technique with amide proton transfer(APT)in predicting the prognosis of cerebral stroke.Methods:A total of 71 patients with acute cerebral stroke who admitted to the Nanjing First Hospital,Nanjing Medical University from September 2022 to May 2023 were selected.All of them underwent the test of National Institute of Health Stroke Scale(NIHSS),and received the MRI examination with chemical exchange saturation transfer(CEST).According to the modified Rankin scale(mRS)values of 1-month follow-up,they were divided into favorable recovery group(mRS<2,44 cases)and poor group(mRS≥2,27 cases).The asymmetric magnetization transfer ratio(MTRasym)image(APT)was obtained by analyzing data with special software.And then,the difference(△APTw)of APT values between ischemic zone and contralateral normal tissue was further calculated.The △APTw values of two groups were compared and analyzed,and the Pearson correlation analysis was adopted to analyze the correlation among △APTw,NIHSS and mRS.The receiver operating characteristics(ROC)curve was drawn,and the area under curve(AUC)of ROC curve was calculated.Results:There were significant positive correlations among △APTw,NIHSS and mRS scores(R2=0.659,0.522,P<0.001),and the differences of △APTW,NIHSS and mRS scores between the favorable recovery group and poor group were significant(t=5.73,6.36,13.92,P<0.05),respectively.The AUC value was 0.886,and the sensitivity and specificity of prediction were respectively 77.8%and 95.5%.The positive and negative predictive values were respectively 91.3%and 87.5%.Conclusion:APT imaging technique has feasibility in predicting the prognosis of acute cerebral ischemic stroke.

OBJECTIVE: To assess the value of chromosomal microarray analysis (CMA) for the prenatal diagnosis of a fetus with structural anomaly detected by ultrasonography. METHODS: The fetus and its parents were subjected to chromosomal karyotyping and CMA analysis. RESULTS: The fetus was found to carry a 46,XN,t(8;11)(q21.2;q13) translocation which was inherited from its mother. CMA has found no copy number variations (CNVs) in both parents but a de novo 2.00 Mb microdeletion in the fetus at 8q13.3. CONCLUSION CMA is capable of detecting microdeletions and microduplications in fetuses with translocations detected by karyotyping analysis.
Chromosome Aberrations ; Chromosome Deletion ; Chromosomes, Human, Pair 8 ; DNA Copy Number Variations ; Female ; Fetus ; Humans ; Karyotyping ; Microarray Analysis ; Pregnancy ; Prenatal Diagnosis

Objective: To understand the longitudinal changes of refractive errors in adolescent myopia screening in the suburb of Shanghai, and to provide reference for targeted measures of myopia prevention and intervention. Methods: By using the cluster sampling method, 1 346 students were selected from two primary schools in a town in the suburb of Shanghai. Physical development indicators and refractive examination parameters of non ciliary muscle paralysis, and uncorrected visual acuity in 2017 and 2020 were collected from the Shanghai adolescent refractive development file. Longitudinal change of spherical equivalent (SE) refractive were assessed. A linear regression model was used to examine the relationship between the rate of SE change with characteristics of the students. Results: The average annual incidence of myopia was 16.36%, and the SE degrees of the left and right eyes of myopia students decreased by 225 degrees for three years. Girls (right eye Z=-4.33; left eye Z=-3.75, P<0.01), newly-onset myopia and persistent myopia (right eye Z=634.45; left eye Z=638.85, P<0.01) was a key for the rapid progress of refractive power. Conclusion The proportion of students with severe low vision is relatively high, and the apparent shifts toward more hyperopia in myopia students call for effective prevention and control programs based on changes in refractive to slow the progression of adolescent myopia.

OBJECTIVE: To explore the genetic basis for a Chinese patient featuring cleidocranial dysplasia(CCD). METHODS: Genomic DNA was extracted from peripheral blood samples of the patient and his parents. Whole exome sequencing (WES) was carried out for the patient, and suspected variant was verified by Sanger sequencing. RESULTS: WES has identified a missense c.460G>T (p.Val154Phe) (GRCh37/hg19) variant of the RUNX2 gene. The variant was located in the Runt domain, a highly conserved region (PM1); it was not present in either the Genome Aggregation Database or the 1000 Genomes Project (PM2), and was predicted to have a deleterious effect on the gene product by multiple in silico prediction tools (PP3); the clinical phenotype of the patient was highly consistent with that of cleidocranial dysplasia (PP4). Furthermore, the variant was unreported in medical literature and was absent in both parents (PS2). Based on the American College of Medical Genetics and Genomics guidelines, the c.460 G>T variant of RUNX2 gene was predicted to be pathogenic (PS2+PM1+PM2+PP3+PP4). CONCLUSION The c.460G>T (p.Val154Phe) variant of the RUNX2 gene probably underlay the clinical phenotype in the patient. Above finding has enabled accurate diagnosis and expanded the spectrum of RUNX2 variants.
China ; Cleidocranial Dysplasia/genetics* ; Core Binding Factor Alpha 1 Subunit/genetics* ; Humans ; Mutation ; Whole Exome Sequencing

Objective:To explore the effect of transitional nursing on medicine-taking compliance and insight of first hospitalized female schizophrenic patients.Methods:Seventy female cases who met ICD-10 diagnostic criteria that were discharged after stable treatment were randomly divided into intervention group and control group, 35 cases for each group.The medicine-taking compliance of the two groups was evaluated by the Morisky medication adherence scale, and the treatment effect was evaluated by the Insight and Treatment Attitude Questionnaire (ITAQ).The follow-up period was two months after discharge with four assessment points.Results:The Morisky scores in intervention group at the end of 1 week[ (4.7±1.2) vs. (4.0±0.8) ], 2 weeks[ (5.1±1.2) vs. (3.8±1.1) ], 1 month[ (5.1±1.5) vs. (3.5±1.2) ]and 2 months[ (5.8±1.2) vs. (3.3±1.0) ]were higher than those in control group (F=52.74, P＜0.001).The ITAQ scores in intervention group at the end of 1 week[ (3.4±2.1) vs. (2.9±1.4) ], 2 weeks[ (5.5±3.2) vs. (3.7±2.5) ], 1 month[ (4.6±2.7) vs. (4.5±2.7) ]and 2 months[ (6.9±3.4) vs. (3.9±2.6) ]were also higher than those in control group (F=7.12, P=0.010).Conclusion:Transitional nursing can improve the medicine-taking compliance and rehabilitation effect of first hospitalized female schizophrenic patients.

Objective To investigate the effects and mechanism of evodiamine on the proliferation and apoptosis of osteosarcoma MG-63 cells.Methods MG-63 cells were cultured with evodiamine for 24 hours,and the cell proliferation was evaluated by methyl thiazolyl tetrazolium (MTT) assay.Cell cycle arrest,apoptosis and intracellular Ca2+ accumulation were evaluated by flow cytometry.BALB/C mice model of osteosarcoma was established to investigate the tumor inhibitory effect of evodiamine on human osteosarcoma.Wnt/β-catenin signaling protein expressions in osteosarcoma cells were detected by Western blotting.Results As concentration of evodiamine increasing (0.25 μmol/L,0.5 μmol/L,1.0 μmol/L,2.0 μmol/L and 4.0 μmol/L),the inhibition rate of MG-63 ceils increased [(4.18 ± 1.26)％,(15.49 ± 2.26)％,(40.55 ± 6.57)％,(49.87 ±7.69)％ and (60.42 ±8.29)％].The difference was statistically significant between 2.0 μmol/L group and the control group (t =-2.66,P ＜ 0.05).MG-63 cells were cultured with 2.0 μmol/L evodiamine for 24 hours,and the apoptotic rate was (64.67 ± 8.63) ％,the proportion of S phase cells was (85.33 ± 9.31)％,the fluorescence of Ca2+ was 97.33 ± 21.31.The corresponding data of the control group were (4.94 ± 0.81) ％,(43.67 ± 8.92) ％ and 28.67 ± 8.92,the differences were statistically significant (t =-11.90,P ＜ 0.05;t =-7.22,P ＜ 0.05;t =-6.65,P ＜ 0.05).On mice model,the tumor weight of evodiamine group and the control group was (2.15 ±0.35)g and (4.29 ±0.49)g respectively,the difference was statistically significant (t =7.95,P ＜ 0.05).Comparing with the control group (1.00 ± 0.00),evodiamine decreased the expression of β-catenin protein (0.72 ± 0.36) and increased the expressions of Bax (1.15± 0.27) and Caspase-3 (1.46 ± 0.18) protein,and the differences were statistically significant (t =-3.05,P ＜ 0.05;t =-6.42,P ＜ 0.05;t =-5.85,P ＜ 0.05).Conclusion Evodiamine inhibits proliferation and induces apoptosis of human osteosarcoma MG-63 cells by blocking Wnt/β-catenin signaling.

BACKGROUND:Silk fibroin, as a kind of high-performance biomaterial, has been widely used to construct scaffolds in bone tissue engineering. However, whether silk fibroin itself holds osteoinductive ability has not been reported yet. OBJECTIVE:To investigate the impact of different concentrations of silk fibroin solution on the proliferation and differentiation of rat bone marrow mesenchymal stem cel s (BMSCs) in vitro. METHODS:Silk fibroin and BMSCs were respectively isolated from silkworm cocoon and rat tibia, and were identified. Then, BMSCs were cultured in different concentrations of silk fibroin solution (0.01%, 0.05%and 0.1%), and the cell proliferation and the alkaline phosphatase activity were detected at different time points. RESULTS AND CONCLUSION:FTIR spectra of the sample extracted from silkworm cocoon showed distinct absorption peaks at 1 653 (amide I), 1 530.5 (amide II) and 1 212.3 cm-1 (amide III), which could be confirmed to be silk fibroin. Thus generated BMSCs showed long fusiform or astral morphology, positive for representative markers (CD29, CD44 and CD90) relating to mesenchymal stem cells, and could differentiate into osteocytes, chondrocytes and adipocytes under specific induction conditions, which further confirmed the extracted cells were BMSCs. Compared with the control group (without silk fibroin), 0.05% silk fibroin not only significantly promoted the cell adhesion, migration and proliferation, but also enhanced the alkaline phosphatase activity (P<0.01). With the increasing of the silk fibroin concentrations, the osteodifferentiation capacity of the BMSCs was progressively improved within the range of 0-0.05%and then declined at 0.01%of silk fibroin solutions. These results suggest that silk fibroin can promote osteogenesis, thus providing scientific evidence for developing silk fibroin-based tissue-engineered scaffolds.

Objective To evaluate the efficacy of patient-controlled infraclavicular brachial plexus block for analgesia after elbow arthrolysis.Methods Eighty patients with elbow stiffness of both sexes, aged 18-64 yr, of American Society of Anesthesiologists physical status Ⅰ-Ⅲ, scheduled for elective elbow arthrolysis, were equally and randomly assigned to receive either the infraclavicular (Ⅰ group) or axillary (A group) brachial plexus block.All catheters were placed using ultrasound visualization preoperatively.When patients complained of pain in the recovery room after regaining consciousness, 0.2％ ropivacaine was injected via the catheter, 15 min later patient-controlled infraclavicular brachial plexus block was performed with 0.2％ ropivacaine (400 ml), and an electronic pump was set up with a 5 ml bolus dose, a 30 min lockout interval and background infusion at a rate of 5 ml/h.The patients underwent rehabilitation exercise everyday for 3 consecutive days starting from 24 h after operation.The catheter insertion time, successful block, and occurrence of moderate or severe pain (numeric rating scale [NRS] score ＞ 4) and greater inserting resistance (inserting resistance score＞ 1) during insertion, and the occurrence of paresthesia and vascular damage during insertion were recorded.NRS score was recorded at 24, 48 and 72 h after operation during rehabilitation exercise.The elbow articular range of motion was recorded at 72 h after operation, and the improvement in articular range of motion was calculated.The satisfaction with the improvement in articular range of motion (improvement ≥ 80％) and occurrence of complete improvement in articular range of motion (improvement=100％) were recorded.Catheter-related adverse reactions (such as oozing from the insertion site, obstruction, prolapse) and local anesthetics-related adverse reactions (nausea and vomiting, central nervous system toxicity) were recorded.Results The success rate of blockade was 100％ during insertion in both groups.Compared with group A, the catheter insertion time was significantly shortened, the incidence of moderate or severe pain and greater inserting resistance during insertion was decreased, the incidence of paresthesia and vascular damage during insertion was decreased, NRS score at 24 h after operation durig rehabilitation exercise was decreased, the incidence of complete improvement was increased (P＜0.05), and no significant change was found in the improvement in articular range of motion and satisfaction with the improvement in group I (P＞0.05).Conclusion Patient-controlled infraclavicular brachial plexus block can be safely and effectively used for analgesia after elbow arthrolysis, and it provides better efficacy than patient-controlled axillary brachial plexus block.

Objective Inflammation plays a critical role in the presence , development and maintenance of atrial fibrillation ( AF) , but it remains unclear what factors induce inflammation in AF patients , especially in those with valvular heart disease ( VHD) . The aim of this paper was to investigate the role of the shedding of Syndecan -4 in left atrial inflammation in patients with valvular atrial fibrillation. Methods Sixty VHD patients scheduled for valvuloplasty or valve replacement surgery were divided into three groups of equal number:sinus rhythm (SR), paroxysmal atrial fibrillation (PaAF), and persistent atrial fibrillation (PeAF).Another 10 pa-tients with congenital heart disease but no valve damage and atrial fibrillation were included in a control group .Baseline clinical data were recorded and tissues were obtained from the left atrial appendage during operation .The expressions of iNOS , HMGB1, and Syn-decan-4 in the left atrium were detected by Western blot , and the pathological changes of the left atrial tissue observed by HE staining . Results Western blot analysis was performed to detect expression levels of proteins .The iNOS level was significantly higher in pa-tients from the paroxysmal AF group (1.61 ±0.10) and persistent AF group (1.67 ±0.08) than those from sinus group (1.06 ± 0.11) and control group (1.02 ±0.12), as was the protein level of HMGB1 (0.63 ±0.05, 0.95 ±0.10, 0.45 ±0.07 and 0.46 ± 0.06 in paroxysmal AF group, persistent AF group, sinus group and controlgroup respectively ).Inflammatory cell infiltration in-creased, while syndecan 4 was down-regulated in AF groups.All these comparisons were significant (P<0.05). Conclusion The decreased expression of Syndecan-4 and enhanced inflammatory response in the left atrial tissue indicate that the shedding of Synde-can-4 may play a role in the presence and development of inflamma-tion in the left atrium .

Objective To evaluate the influence of belly beard device and the distended bladder on the dose distribution of PTV and the dose-volume histograms(DVHs)of organs at risk(OARs)for postoperative radiation tIlerapy of rectal cancer.Methods A total of 23 patients(8 and 15)with distended bladder receiving 3-field postoperative radiation therapy were dealed with or without a special belly beard in the prone position.At the same time,15 cages with belly board were scanned with empty bladder.The volume of irradiated small bowel was calculated for doses between 5-50 Gy at 5 Gy intervals.With prescription dose in plan target volume(PTV)of 50 Gy,we compared the dose distribution,DVH of OARs,conformity index(CIPTV),the volume of irradiated small bowel and the acute toxicity under the condition of thlee different moulds.Results There was no significant difference in PTV's converge,DVHs of femoral head and CI among 3 moulds(P＞0.05).With the belly board,the high-dose volume of irradiated small bowel(V20-V52.5)was significantly decreased(P＜0.05),specially with distended bladder.However,the low dose volume(V5-V15)was slightly increased.The bladder distension significanfly decreases the volumes of the irradiated small howel at dose levels from 15-52.5 Gy(P＜0.05).Furthermore,the mean volume(V5-V30)of irradiated small bowel differed significantly between patients experiencing Grade 0.1 and ≥2 diarrhea(P＜0.05).Conclusions The combination of belly board and distended bladder was more effectively to reduce the irradiated small bowel volume among 3 moulds,so as to minimized acute diarrhea toxicity.