An adult female patient of internal nuclear inclusion disease(NIID)with a major clinical manifestation of decreased intelligence and recurrent disturbance of consciousness was followed up for nearly 4 years.In particular,the evolution of the video-electroencephalogram(VEEG),the auxiliary diagnosis of VEEG,and the prediction value of VEEG for clinical outcome were summarized.We found that(1)the background rhythm in NIID patients evolved with the progression of the disease;(2)electroencephalogram reactivity could predict the outcome of NIID coma;(3)VEEG helped to determine whether the consciousness disturbance caused by NIID was due to non-convulsive status epilepticus,This case provides a new idea to explore the application of VEEG in NIID.

OBJECTIVE To investigate the effects of Qinxiang Qingjie oral liquid(QXQJ)on growth and development after repeated administration of 18 d to postnatal day 4(PND4)rats.METHODS The number and sex of PND2 pups were adjusted using the cross-breeding method.These pups were ran-domly divided into the normal control,QXQJ 3.45,10.35 and 28.05 g·kg-1 groups.PND4,juvenile rats were ig given QXQJ every day,while the normal control group was given pure water,once a day,for 18 d,before observation of 3 weeks was resumed.During the experiment,the general condition,body mass,growth and development,physique,bone,hematology and coagulation of the rats in each group were detected.RESULTS 18 d after continuous administration of QXQJ,there was no obvious effect on the food intake,growth and development,nerve reflex,spontaneous behavior,hematology,coagula-tion,blood biochemistry,immunity,growth hormone,histopathology and other examination indexes of juve-nile rats.From PND5,juvenile rats in the QXQJ 10.35 and 28.05 g·kg-1groups developed yellow-brown soft or loose stools and abdominal distention,but the symptoms generally recovered at PND22.The body mass,top-rump length,tail length and limb length of the juvenile rats in the 28.05 g·kg-1 group were signifi-cantly lower at PND7(P<0.05),but recovered one week after drug withdrawal.The bone mineral specific gravity and bone mineral density of the 28.05 g·kg-1 group were significantly lower than those of the normal control group at PND22(P<0.05),but there was no significant difference at PND42.CONCLU-SION QXQJ can cause such indigestion symptoms as yellow brown soft stool or loose stool and abdominal enlargement in unweaned juvenile rats,thus affecting the physical development indicators of rats,but the symptoms can recover after withdrawal of medication or withdrawal from milk.The no observed adverse effect level(NOAEL)of QXQJ administered to 4-day-old rats for 18 d is 3.45 g·kg-1.

Fear memory contextualization is critical for selecting adaptive behavior to survive. Contextual fear conditioning (CFC) is a classical model for elucidating related underlying neuronal circuits. The primary visual cortex (V1) is the primary cortical region for contextual visual inputs, but its role in CFC is poorly understood. Here, our experiments demonstrated that bilateral inactivation of V1 in mice impaired CFC retrieval, and both CFC learning and extinction increased the turnover rate of axonal boutons in V1. The frequency of neuronal Ca²⁺ activity decreased after CFC learning, while CFC extinction reversed the decrease and raised it to the naïve level. Contrary to control mice, the frequency of neuronal Ca²⁺ activity increased after CFC learning in microglia-depleted mice and was maintained after CFC extinction, indicating that microglial depletion alters CFC learning and the frequency response pattern of extinction-induced Ca²⁺ activity. These findings reveal a critical role of microglia in neocortical information processing in V1, and suggest potential approaches for cellular-based manipulation of acquired fear memory.
Mice ; Animals ; Primary Visual Cortex ; Extinction, Psychological/physiology* ; Learning/physiology* ; Fear/physiology* ; Hippocampus/physiology*

Objective:This study aims to reveal the special immune infiltrating environment and possible immune escape mechanism of giant cell tumor of bone through single-cell sequencing data.Methods:The fresh samples obtained from 4 patients with primary giant cell tumor of bone from January 2018 to December 2021 were collected, and single-cell transcriptome sequencing was performed on the 10X platform to explore the characteristics and immune environment of giant cell tumor of bone by using t-distributed stochastic neighbor embedding ( t-SNE). The main cell types and signal pathways of immune cell regulation and function in giant cell tumor of bone were observed by cell communication analysis. Results:Cell clustering, the definition of basic cell types, the classification of immune cells, and the mutual regulatory relationship between cell types were analyzed for 35 643 single-cell data from 4 giant cell tumor samples of bone. It was found that giant cell tumor of bone was composed of 9 basic cell types, in which the immune cells were mainly CD8 + T cells (51%) and the non-immune cells were mainly fibroblast like spindle stromal cells (74%). The immune infiltration of giant cell tumor of bone is dominated by cytotoxic CD8 + T cells and lacks exhausted CD8 + T cells. CD4 + T cells are characterized by high expression of immune checkpoint genes CTLA4 and TIGIT. In giant cell tumor of bone, immune cells mainly act on multinucleated osteoclast like giant cells through PARs and CCL signaling pathways, but not stromal cells. Conclusion:This study defined the main cell types of giant cell tumor of bone through single cell sequencing data, and further revealed the composition characteristics of its immune infiltration, and found that the target of its immune cells was mainly multinuclear osteoclast like giant cells, which provided effective information for further understanding the occurrence and development of giant cell tumor of bone.

Objective To investigate visual impairment students' quality of life and its influencing factors in Braille learning class at Quanzhou Special School. Methods November, 2020, 52 students (aged seven to 26) with the best corrected distance visual acuity of the better eye above 0.02 were investigated with near visual acuity, contrast sensitivity and Chinese-version Low Vision Quality of Life Questionnaire (CLVQOL). The subjects were divided into second grade blindness group, first grade low vision group and second grade low vision group according to the best corrected distance visual acuity of the better eye. Results There were significant differences in distance visual acuity (Z = 45.671, P < 0.001), near visual acuity (Z = 24.972, P < 0.001), and contrast sensitivity (CS) ( Z = 13.285, P = 0.001) among three groups. There was a correlation between near visual acuity and distance visual acuity (r = 0.74, P < 0.001), CS to distance visual acuity (r = -0.58, P < 0.001) and near visual acuity (r = -0.57, P < 0.001), score of CLVQOL and CS (r = 0.44, P < 0.001). There were significant differences in the total score (Z = 10.145, P = 0.006), distance visual acuity subscale (Z = 13.586, P = 0.001), psychological adjustment subscale (Z = 7.824, P = 0.020), reading and fine work subscale (Z = 7.923, P = 0.019) of CLVQOL among the three groups. Conclusion Quality of life is different with the visual impairment for students in special school, especially the distance visual acuity, psychological adjustment and fine reading. CS correlates to the quality of life of visually impaired students, which needs to be a part of evaluation of visual function.

Objective:To analyze the characteristics of laboratory test results and multimorbidities in elderly patients with rheumatoid arthritis(RA)and thus to provide a basis for the treatment of RA in the elderly.Methods:Retrospective analysis was performed on RA patients admitted to the Second Affiliated Hospital of Nanjing Medical University from March 2018 to December 2020.Patients were divided into an elderly RA(ERA)group(≥60 years)and a non-elderly RA(NERA)group(<60 years).The prevalences of multimorbidities and laboratory results were compared between the two groups, and influencing factors of multimorbidities in ERA patients were analyzed by using binary Logistic regression.Results:There were 215 patients in this cohort, of whom 156 patients were in the ERA group and 59 patients were in the NERA group.The prevalences of comorbid hypertension, diabetes mellitus, coronary heart disease(CHD)and interstitial lung disease in the ERA group were higher than those in the NERA group( χ2=19.890, 6.977, 5.964, 7.484, all P<0.05).The disease duration in the ERA group was longer than that in the NERA group[117.5(36.0, 240.0)months vs.72.0(10.5, 123.5)months, Z=3.142, P=0.002], and the levels of serum C-reactive protein(CRP), erythrocyte sedimentation rate(ESR), urea, creatinine and cystatin C were higher than those in NERA group[9.7(3.2, 24.8)mg/L vs.3.1(3.0, 8.3)mg/L, 31.0(13.0, 53.3)mm/h vs.17.0(11.0, 31.5)mm/h, (5.38±1.54)mmol/L vs.(4.75±1.46)mmol/L, (63.82±15.33)μmol/L vs.(57.31±11.38)μmol/L, (1.23±0.42)mg/L vs.(0.90±0.23)mg/L]( Z=4.275, 2.770, t=2.714, 2.966, 5.714, all P<0.05).The levels of serum magnesium, albumin and hemoglobin were lower than those in the NERA group[(0.84±0.08)mmol/L vs.(0.86±0.06)mmol/L, (37.46±5.32)g/L vs.(40.77±4.95)g/L, (114.52±18.06)g/L vs.(124.32±16.40)g/L]( t=2.653, 4.147, 3.648, all P<0.05).Correlation analysis showed that the level of serum CRP in the ERA group was negatively correlated with serum albumin and magnesium( r=-0.449, -0.329, all P<0.05).Uric acid was positively correlated with rheumatoid factor(RF), cystatin C, urea, age and disease duration( r=0.259, 0.416, 0.210, 0.232, 0.179, all P<0.05), but negatively correlated with hemoglobin and magnesium( r=-0.262, -0.207, all P<0.05).RF was positively correlated with uric acid, urea, total cholesterol, low density lipoprotein, the 28-joint Disease Activity Score(DAS28 score), age and disease duration( r=0.259, 0.177, 0.205, 0.234, 0.248, 0.225, 0.211, all P<0.05), but negatively correlated with albumin and hemoglobin( r=-0.301, -0.182, all P<0.05).Serum magnesium was negatively correlated with CRP, ESR, urea, uric acid and cystatin C( r=-0.273, -0.192, -0.175, -0.207, -0.315, all P<0.05).These correlations were not found in the NERA group.Multivariate Logistic regression analysis showed that factors affecting hypertension in ERA patients were age, RF and albumin.Influencing factors of CHD were age, disease duration, serum magnesium and triglycerides.Factors that affect interstitial lung disease were RF, DAS28 score and albumin. Conclusions:Compared with NERA patients, ERA patients show an elevated level of systemic inflammation and poorer nutrition assessed by relevant parameters.CRP, RF and uric acid have complex correlations with serum magnesium, hemoglobin, and albumin.ERA patients have higher prevalences of multimorbidities.Age, disease duration, RF, triglycerides, DAS28 score, serum magnesium and albumin affect the occurrence of multimorbidities in ERA patients.

Objective:To explore benefit finding and its influencing factors among enterostomy patients.Methods:A total of 120 enterostomy patients were investigated with general information questionnaire, Benefit Finding Scale, Simplified Scale of Resilience and Perceived Social Support Scale.Results:The score of benefit finding among enterostomy patients was 49.44±5.86. Multiple regression analysis showed that education level, self-care, complications, resilience, perceived social support were influencing factors of benefit finding, and explained 51.1% of the variance.Conclusions:The benefit finding among enterostomy patients was grim. It is suggested that clinical staff pay more attention to the patients with low education, poor self-care and complications of stoma, and also pay more attention to the positive psychology and the social support system of patients, guide patients to pay attention to the positive significance of the disease, so as to improve the level of benefit finding.

Objective:To investigate the current situation with regard to a sense of coherence in major caregivers of enterostomy patients and analyze its relationship with self-efficacy and perceived social support.Methods:From July to December 2019, a total of 118 major caregivers of enterostomy patients were investigated using a general information questionnaire, a self-efficacy scale, and a perceived social support scale.Results:The score of sense of coherence in major caregivers of enterostomy patients was 58.40±9.17, and the average scores of all dimensions, from high to low, were “controllable sense，” “understandable sense，”and “meaningful sense.” Sense of coherence was positively correlated with self-efficacy and perceived social support ( r=0.457, P<0.01; r=0.369, P<0.01). Hierarchical multiple regression analysis showed that self-efficacy and perceived social support had a positive predictive effect on sense of coherence and explained 35.2% of the variance ( R′ 2=0.352, F=25.639, P<0.001). Conclusions:The main caregivers of enterostomy patients had a low level of sense of coherence. Self-efficacy and perceived social support have a positive effect on sense of coherence. Medical staff should take targeted measures to help caregivers improve their self-efficacy and social support system in order to improve their sense of coherence.

Model informed precision dosing (MIPD) is a new concept to guide precision dosing for individual patient by modeling and simulation based on the available information about the individual patient, medications and the disease. Compared to the empirical dosing, MIPD could improve the efficacy, safety, economics and adherence of the pharmacotherapy according to the individual's pathophysiology, genotyping and disease progression. This consensus report provides a brief account of the concept, methodology and implementation of MIPD as well as clinical decision supporting systems for MIPD. The status and future advancing of MIPD was also discussed to facilitate the appropriate application and development of MIPD in China.

Objective:To explore rumination status and its influencing factors among enterostomy patients, so as to provide references for the formulation of interventions.Methods:Using convenience sampling method, 120 patients with enterostomy who were treated and followed up in the Fifth Affiliated Hospital of Sun Yat-Sen University from July to December 2019 were selected as the research subjects. General information questionnaire, Event Related Rumination Inventory Scale, Simplified Scale of Resilience and Perceived Social Support Scale were applied in the investigation.Results:The invasive rumination score of enterostomy patients was (13.64±4.88) and the purposive rumination score was (14.90±3.72) . Multiple linear regression analysis showed that age, self-care degree of stoma, resilience and perceived social support explained 38.1% of the variance of invasive rumination ( P<0.01) . Education, occupation, resilience and perceived social support explained 41.9% of the variation of invasive rumination ( P<0.01) . Conclusions:The rumination of enterostomy patients was in the lower middle level. It is suggested that clinical staff pay more attention to the patients with low age, poor self-care ability of colostomy, low education level and unemployed state. At the same time, measures should be taken to improve the level of patients' resilience and improve their social support system, so as to promote the patients' positive psychological adjustment.