Objective To investigate the characteristics of corneal nerve fibers in patients with Parkinson disease （PD） and varying degrees of autonomic dysfunction by using corneal confocal microscopy （CCM）. Methods A total of 70 patients with PD and 31 healthy controls were recruited. CCM was performed for all the patients enrolled， and according to the score of the Scale for Outcomes in Parkinson Disease for Autonomic Symptoms， the patients with PD were divided into mild autonomic dysfunction group and moderate to severe autonomic dysfunction group. CCM parameters and clinical data were compared between the two groups and the healthy control group. The receiver operating characteristic （ROC） curve analysis was used to quantify the efficacy of CCM parameters in the diagnosis of PD with varying degrees of autonomic dysfunction. Results The PD patients with mild autonomic dysfunction and those with moderate to severe autonomic dysfunction had significantly lower CNFD and CNFL than the healthy control group（P<0.05）.In addition， the ROC curve analysis showed that CNFD among CCM parameters had a higher diagnostic value in distinguishing PD patients with moderate to severe autonomic nervous dysfunction from the healthy population， with an area under the ROC curve of 0.8224. Conclusion CCM can be used as an effective and objective detection method to investigate the characteristics of corneal nerve fibers in PD with varying degrees of autonomic dysfunction，which supplements the current research on the application of CCM technique in PD with small fiber neuropathy.
Parkinson Disease

Objective To investigate the relationship between serum inflammatory cytokines levels and Parkinson disease (PD) with pain. Methods A total of 90 PD patients and 88 healthy controls were selected. Serum inflammatory cytokines were detected by multiplex microsphere flow immunofluorescence luminescence assay. Motor symptoms (UPDRS-Ⅲ),stages of disease (H-Y stage) and pain symptoms (KPPS score) were assessed. The relationship between inflammatory cytokines and PD with pain and the diagnostic value of serum IL-1β for PD with pain were analyzed. Results Compared to the HC group,the levels of serum IL-1β,IL-6 and IL-17 were significantly higher in the PD group (P<0.01). Serum IL-1β levels were higher in the PD with pain group than in the PD without pain group (P<0.001). Serum IL-1β levels in PD patients were positively correlated with KPPS scores (r=0.371,P<0.001). Binary logistic regression analysis showed that higher serum IL-1β level was a risk factor for PD with pain (P=0.001). The ROC curve showed that the area under the curve for serum IL-1β diagnosis of PD with pain was 0.741.Conclusion Serum IL-1β level in PD patients is associated with pain symptoms and may be a biological marker for the diagnosis of PD with pain.

Objective:To explore the effect of the course ideology and politics teaching model based on the Context-Content-Course (3C) model in the nursing experimental class of endocrine diseases for nursing undergraduates.Methods:From March 2021 to June 2021,168 undergraduates from Class 1 of Chongqing Medical University in Grade 2018 were selected as the experimental group and 163 undergraduates from Class 3 of Nursing as the control group .Taking the humanistic care ability as the entry point of the course ideology and politics education, the experimental group carried out teaching and implement humanistic care education using course ideology and politics teaching mode based on the 3C model; the control group used traditional methods to carry out humanistic care education. After the course, the humanistic care ability, professional self-efficacy, and emotional intelligence of the two groups were compared.Results:After the implementation of the new teaching model, the total scores of humanistic care ability, occupational self-efficacy, and emotional intelligence of the students in the experimental group were 147.55 ± 15.95, 110.13 ± 9.26, and 76.24 ± 8.78, respectively, while those in the control group were 121.16 ± 18.44, 90.45 ± 9.49, and 61.67 ± 12.33, respectively; and the differences of the scores between two groups were statistically significant ( t=13.73, 18.80, 12.24, all P<0.01). Conclusions:The application of the course ideology and politics teaching model based on the 3C model in the nursing experimental class of endocrine diseases is helpful to improve the humanistic care ability, professional self-efficacy, and emotional intelligence of nursing students′ and is conducive to cultivating the comprehensive humanistic qualities of nursing students. It is ansignificant manifestation of accurate course ideology and politics education.

Objective:To investigate the effects of total-body PET/CT imaging with short acquisition time on image quality and lesion detectability in lungs and parenchymal organs.Methods:Sixty patients (31 males, 29 females, age (61.1±11.8) years) with pulmonary nodules (PN) and 53 patients (29 males, 24 females, age (56.7±17.2) years) with parenchymal organ lesions (POL) who underwent total-body PET/CT imaging in the First Affiliated Hospital of Shandong First Medical University between October 2021 and April 2022 were retrospectively analyzed. The acquisition time with PET was 600 s, and the reconstructed images were divided into 6 groups based on different duration (30, 60, 120, 180, 300 and 600 s), namely G30, G60, G120, G180, G300 and G600 groups. The subjective analysis was carried out with the 5-point Likert scale in 3 aspects: the overall impression of image quality, noise, and lesion conspicuity. The objective analysis indicators included the SUV mean of the mediastinal blood pool (MBP); the SUV mean, standard deviation (SD) and signal-to-noise ratio (SNR) of the liver; SUV max and target-to-background ratio (TBR) of the lesions. Differences of the indicators among 6 groups were analyzed by Friedman test with Bonferroni correction. G600 served as the reference for the other 5 groups to test their lesion detectability. Results:The subjective image quality of different groups for PN and that of G120, G180, G300 groups for POL could meet the needs of clinical diagnosis in terms of the overall image quality, noise, and lesion conspicuity (all scores>3). There was no significant difference in the SUV mean of MBP among different time groups (median for PN: 1.52-1.56, median for POL: 1.35-1.47; χ2 values: 10.23, 11.02, both P>0.05). Difference was not found in SUV mean of the liver either (median for PN: 2.51-2.56, median for POL: 2.33-2.40; χ2 values: 8.35, 8.93, both P>0.05). The liver SD significantly increased along with the shortened acquisition time ( χ2 values: 400.99, 400.00, both P<0.001; z values: from -16.90 to -3.15, all P<0.003). The SNR significantly decreased along with the shortened acquisition time ( χ2 values: 397.32, 400.00, both P<0.001; z values: 2.98-16.90, all P<0.003). The SUV max (median for PN: 3.55-4.01, median for POL: 5.77-6.08; χ2 values: 8.58, 3.02, both P>0.05) and TBR (median for PN: 2.42-2.81, median for POL: 2.36-2.45; χ2 values: 9.83, 3.69, both P>0.05) of lesion were not significantly different among 6 groups. Taking G600 group as a reference, the lesion detection rates were 100% in G30 group and other 4 groups for PN (81/81) and in G120, G180, G300 groups for POL (80/80). Conclusion:Total-body PET/CT imaging with acquisition time of 30 s for lungs and that with acquisition time of 120 s for parenchymal organs are feasible for clinical use, with the PET image quality and lesion detectability maintained.

Objective:To investigate the clinical features of direct and indirect carotid cavernous fistulas (CCFs).Methods:Patients with CCF treated in the Affiliated Hospital of Xuzhou Medical University from January 2010 to August 2020 were enrolled retrospectively. Relevant clinical data were collected, including the main clinical manifestations, neuroimaging features, and treatment methods. The clinical features of direct and indirect CCFs were compared.Results:A total of 31 patients were enrolled in the study, 29 (93.5%) had ocular symptoms, of which conjunctival hyperemia and edema ( n=24, 77.4%), exophthalmos ( n=19, 61.3%) and orbital murmur ( n=18, 58.1%) were most common. There were 23 patients (74.2%) in direct CCF group and 8 (25.8%) in indirect CCF group. The former had more history of head trauma (78.2% vs. 12.5%; P=0.002), more flow volume (high-flow CCFs: 100% vs. 37.5%; P<0.001) and more likely to cause orbital murmur (69.6% vs. 25.0%; P=0.043). Endovascular embolization was safe and effective. The common methods of endovascular embolization were EVAL glue combined with coil embolization ( n=18, 66.7%) and detachable balloon embolization alone ( n=6, 22.2%). Conclusion:Ocular manifestations are most prominent in patients with CCFs. Direct CCF is more common, usually with a history of head trauma, and the clinical and imaging features are more typical. Interventional embolization is the preferred treatment option for patients with CCF.

OBJECTIVE: To investigate the clinical results of locking compression plate combined with autologous iliac bone graft in the treatment of aseptic ulnar nonunion. METHODS: From March 2009 to July 2017, 22 patients with aseptic ulnar diaphyseal nonunion with complete follow-up data were treated with surgery, including 12 males and 10 females, aged from 16 to 58 (39.7±9.9) years old and ranging in course of disease from 10 to 192 (39.4±55.7) months. There were 15 atrophic nonunions, 5 hypertrophic nonunions and 2 synovial pseudo-articular nonunions. After debridement of the nonunion, locking compression plate was used to fix the nonunion and autogenous iliac bone graft was given. Bone healing rate, surgical complications and clinical results were evaluated. RESULTS: All the patients were followed up, and the duration ranged from 13 to 42 months, with a mean of (22.5±8.2) months, and 1 patient did not heal. Visual analogue pain scores ranged from 0 to 3 (0.9±0.9). Pronation of forearm was 47 to 86 (69.0±14.7) degrees, supination was 35 to 85 (63.0±9.4) degrees, wrist flexion was 20 to 80 (51.0±10.2) degrees, wrist flexion was 32 to 88 (71.0±11.7) degrees, elbow flexion contracture was 0 to 25 (9.0±5.6) degrees, further flexion was 105 to 150 (134.0±13.9) degrees, and grip strength was 87% on the opposite side. According to the Anderson scoring system, 8 cases were excellent, 11 were satisfied, 2 were not satisfied, and 1 was failed. CONCLUSIONS LCP combined with autologous iliac bone graft can effectively treat aseptic ulna diaphyseal nonunion.
Adolescent ; Adult ; Bone Plates ; Bone Transplantation ; Diaphyses ; Female ; Fracture Fixation, Internal ; Fractures, Ununited ; surgery ; Humans ; Ilium ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Ulna ; Young Adult

BACKGROUND:Large numbers of experimental data have confirmed that bone marrow mesenchymal stem cel s have a positive therapeutic effect on cerebral ischemia-reperfusion injury, but there are few reports about intravenous administration of bone marrow mesenchymal stem cel conditioned medium in the treatment of stroke.
OBJECTIVE:To investigate the effects of the conditioned medium of rat bone marrow mesenchymal stem cel s on the recovery of neurological function in rats after cerebral ischemia-reperfusion injury.
METHODS:The bone marrow mesenchymal stem cel s were isolated from rat bone marrow. When cel s at passage 2 or 3 reached 90%confluence, the original culture medium was removed. Then the cel s were cultured in serum-free DMEM for 18 hours. After that, the culture solution was col ected as the conditioned medium of rat bone marrow mesenchymal stem cel s. Adult rats were subjected to 2 hours of right middle cerebral artery occlusion. Ischemia-reperfusion injury rats were randomly assigned to three groups:control group, simple culture medium group and conditioned medium group, and respectively given injection of normal saline, DMEM, conditioned medium (10 mL/kg) via the tail vein at 2, 24, 48 hours after operation.
RESULTS AND CONCLUSION:There was no difference in the behavioral tests among the three groups at postoperative 2 hours (P>0.05). Compared with the control and simple culture medium group, neurological impairment was significantly improved in the conditioned medium group at postoperative 1, 3, 5 days (P<0.05), but there was no significant difference between the control and simple culture medium groups. At postoperative 5 days, brain edema was significantly eased in the conditioned medium group in comparison to the control and simple culture medium groups (P<0.05), and there was also no difference between the latter two groups (P>0.05). These results suggest that rat bone marrow mesenchymal stem cel s-conditioned medium via intravenous administration can significantly ease brain edema and improve the neurologic function after cerebral ischemia-reperfusion injury.

Aim To investigate the effect of chronic intermittent hypobaric hypoxia ( CIHH) on the paeonol induced vasomotion of isolated rat ’ s thoracic aorta rings and its underlying mechanisms. Methods Spra-gue-Dawlay ( SD ) rats were randomly divided into 2 groups: control group ( CON ) and CIHH treatment group ( CIHH) . CIHH rats were exposed to hypoxia in a hypobaric chamber simulating 5 000 m altitude, 6 hours daily for 28 days. CON rats lived in the same en-vironment as CIHH animals except hypoxia. Organ bath technique was used to observe the effect of pae-onol on isolated thoracic aorta rings of rats. Results There were no significant differences of noradrenaline ( NE )- and KCl-induced contraction in thoracic aorta rings among CIHH and CON rats;CIHH enhanced va-sodilative effects of paeonol on isolated thoracic aorta rings of rats; the vasodilative effects on CIHH rats could be partly decreased by β-receptor blocker prop-ranolol,ATP-sensitive potassium channel ( KATP ) bloc-ker glibenclamide and NO synthase inhibitor L-NAME. Paeonol significantly inhibited NE-induced intracellular and extracellular calcium-dependent contraction in CIHH rats. Paeonol didn ’ t inhibit NE-induced con-traction by intracellular calcium release and its inhibi-tory effect couldn ’ t be blocked by glibenclamide in CON. Vasodilative effects of paeonol couldn ’ t be re-versed by indomethacin, a cyclooxygenase inhibitor, in CIHH and CON rats. Conclusion CIHH significantly enhances vasodilative effects of paeonol on isolated tho-racic aorta rings of rats. Besides promoting the signa-ling pathway of paeonol in CON, CIHH significantly enhances vasodilative effects of paeonol via activating KATP and inhibiting Ca2+ release from sarcoplasmic re-ticulum.

OBJECTIVETo evaluate the effect of Notoginseng Radix on hepatic expression of transforming growth factor beta1 (TGF-beta1) and connective tissue growth factor (CTGF) in rats with alcoholic liver disease (ALD), in order to discuss its protective effect on alcoholic cirrhosis.

METHODFifty SD male rats were divided into the normal control group, the model group, the high-dose and low-dose Notoginseng Radix groups (3.0, 12.0 g x kg(-1)) and the magnesium isoglycyrrhizinate group (24 mg x kg(-1)), with 10 rats in each group. Apart from the control group, other groups were administered with ethanol-cornoil-pyrazole for 14 weeks to establish the alcoholic liver disease model. During the establishment of the model, the high-dose and low-dose Notoginseng Radix groups were administered with 12 g x kg(-1) x d(-1) Notoginseng Radix for 14 weeks, once everyday. Efforts were made to detect liver function, pathology with Masson staining, and the expressions of TGF-beta1, Smad3, Smad7 and CTGF mRNA.

RESULTCompared with the rats in model group, rats in Notoginseng Radix groups showed significant reduction in liver ALT, AST, collagen fiber deposition, and TGF-beta1, Smad3 and CTGF mRNA expressions in liver tissues, with the increase in the expression quantity of Smad7 mRNA. There were differences between the Notoginseng Radix groups. No significant difference was observed between the high-dose Notoginseng Radix group and the magnesium isoglycyrrhizinate group.

CONCLUSIONNotoginseng Radix can affect TGF-beta1/Smads signaling pathway and reduce the expression of CTGF.

Animals ; Connective Tissue Growth Factor ; genetics ; metabolism ; Drugs, Chinese Herbal ; administration & dosage ; Gene Expression ; drug effects ; Humans ; Liver Diseases, Alcoholic ; drug therapy ; genetics ; metabolism ; Male ; Panax notoginseng ; chemistry ; Rats ; Rats, Sprague-Dawley ; Smad3 Protein ; genetics ; metabolism ; Smad7 Protein ; genetics ; metabolism ; Transforming Growth Factor beta1 ; genetics ; metabolism

Objective To analyze the clinical manifestations and MRI characteristics of hypertrophic olivary degeneration (HOD) to improve our knowledge for this disease and reduce misdiagnosis.Methods Twelve patients with HOD,admitted to our hospital from 2009 to 2012,were chosen in our study; their clinical data,including onset age,protopathy and other clinical manifestations,and imaging data,including SE sequence axial T1WI,T2WI and FLAIR fast spin-echo imaging,were analyzed.Results The protopathy in these 12 patients included pontine hemorrhage in 5,cerebellar infarction in 3,cerebral hemorrhage in 2,midbrain infarction in 1 and surgery for cerebellar tumor in 1.The main clinical symptoms included palatal myoclonus in 7,ataxia in 6,ocular myoclonus in 5,glossolalia in 3,diplopia in 2 and extremity tremor in 2.The region of inferior olivary nucleus (ION)presented high intensity on T2WI and iso-or mild hypointensity on T1WI in all 12 patients.Bilateral ION showed high signals in 5 in FLAIR; enlargement of the ION in 11 patients were noted.Conclusions HOD is a pathological phenomenon that occurs after injury to the dentato-olivary pathway.Its hallmarks include hypertrophy of the olive with increased T2 signal intensity on magnetic resonance imaging,and it often manifests with oculopalatal myoclonus clinically.