Objective To study the effects of dual-hemispheric transcranial direct current stimulation(Dual-tDCS)on upper limb motor function in chronic-phase stroke patients to provide theoretical references for neural mechanisms-based treatment of upper limb dysfunction.Methods Totally 24 chronic-phase stroke patients with upper limb motor dysfunction were selected from some hospital and divided into an experimental group(n=13)and a control group(n=11)the random number table.The control group was treated with tDCS pseudo-stimulation combined with conventional rehabilitation,while the experimental group was given with Dual-tDCS combined with conventional rehabilitation.The patient activities were assessed before and after treatment with Fugl-Meyer assessment upper limb scale(FMA-UL)and activities of daily living(ADL)scale.The changes of primary motor cortex(M1 area)and whole brain functional connectivity(FC)were compared before and after treatment.SPSS 24.0 statistical software was used for data analysis.Results After treatment,the two groups both had the FAM-UL and ADL scores increased significantly,and the experimental group had the scores statistically higher than those of the control group,and the differences were all statistically significant(P＜0.05).In the control group,the analysis on M1 area and whole brain FC after treatment indicated the FC decreased from M1 area at the unaffected side to midoccipital gyrus at the affected side and lingual gyrus and healthy angular gyrus at the unaffected side;there were no brain areas with changed FC found(P＜0.01).In the experimental group,the FC was lowered from M1 area at the unaffected side to cerebellum and cerebellar vermis at the unaffected side,while raised to precentral gyrus at the affected side(P＜0.01);the FC ascended from M1 area at the affected side to cerebellum and middle temporal gyrus at the affected side,while declined to precentral gyrus at the unaffected side(P＜0.01).Conclusion The neuromodulatory effect of Dual-tDCS on the brain improves FC in motor and non-motor-related brain areas in chronic-phase stroke patients,and may contribute to rehabilitation of upper limb motor dysfunction in chronic-phase stroke.[Chinese Medical Equipment Journal,2024,45(2):67-73]

Objectives: To construct a nomogram for prediction of intrahepatic cholangiocarcinoma (ICC) lymph node metastasis based on inflammation-related markers,and to conduct its clinical verification. Methods: Clinical and pathological data of 858 ICC patients who underwent radical resection were retrospectively collected at 10 domestic tertiary hospitals in China from January 2010 to December 2018. Among the 508 patients who underwent lymph node dissection,207 cases had complete variable clinical data for constructing the nomogram,including 84 males,123 females,109 patients≥60 years old,98 patients<60 years old and 69 patients were pathologically diagnosed with positive lymph nodes after surgery. Receiver operating characteristic curve was drawn to calculate the accuracy of preoperative imaging examinations to determine lymph node status,and the difference in overall survival time was compared by Log-rank test. Partial regression squares and statistically significant preoperative variables were screened by backward stepwise regression analysis. R software was applied to construct a nomogram,clinical decision curve and clinical influence curve,and Bootstrap method was used for internal verification. Moreover,retrospectively collecting clinical information of 107 ICC patients with intraoperative lymph node dissection admitted to 9 tertiary hospitals in China from January 2019 to June 2021 was for external verification to verify the accuracy of the nomogram. 80 patients with complete clinical data but without lymph node dissection were divided into lymph node metastasis high-risk group and low-risk group according to the score of the nomogram among the 858 patients. Log-rank test was used to compare the overall survival of patients with or without lymph node metastasis diagnosed by pathology. Results: The area under the curve of preoperative imaging examinations for lymph node status assessment of 440 patients was 0.615,with a false negative rate of 62.8% (113/180) and a false positive rate of 14.2% (37/260). The median survival time of 207 patients used to construct a nomogram with positive or negative postoperative pathological lymph node metastases was 18.5 months and 27.1 months,respectively (P<0.05). Five variables related to lymph node metastasis were screened out by backward stepwise regression analysis,which were combined calculi,neutrophil/lymphocyte ratio,albumin,liver capsule invasion and systemic immune inflammation index,according to which a nomogram was constructed with concordance index(C-index) of 0.737 (95%CI: 0.667 to 0.806). The C-index of external verification was 0.674 (95%CI:0.569 to 0.779). The calibration prediction curve was in good agreement with the reference curve. The results of the clinical decision curve showed that when the risk threshold of high lymph node metastasis in the nomogram was set to about 0.32,the maximum net benefit could be obtained by 0.11,and the cost/benefit ratio was 1∶2. The results of clinical influence curve showed that when the risk threshold of high lymph node metastasis in the nomogram was set to about 0.6,the probability of correctly predicting lymph node metastasis could reach more than 90%. There was no significant difference in overall survival time between patients with high/low risk of lymph node metastasis assessed by the nomogram and those with pathologically confirmed lymph node metastasis or without lymph node metastasis (Log-rank test:P=0.082 and 0.510,respectively). Conclusion: The prediction accuracy of preoperative nomogram for ICC lymph node metastasis based on inflammation-related markers is satisfactory,which can be used as a supplementary method for preoperative diagnosis of lymph node metastasis and is helpful for clinicians to make personalized decision of lymph node dissection for patients with ICC.

OBJECTIVE: To explore prevalence, risk factors and treatment of ankle sprain of young college student , in order to obtain accurate epidemiological data. METHODS: From March 2019 to May 2019, 552 college students(1 104 sides of anke joints) from Xi'an Physical Education university were enrolled in study according to inclusion and excludion standard, including 309 males and 243 females aged from 16 to 24 years old with an average of (20.9±3.7) years old. Age, gender, and body mass indes(BMI) etc were recorded. Morbidity of acute and chronic ankle sprains of physical students, treatment after the first sprain (cold compress, cast or plaster bracing and medicine), visual analogue scale (VAS) during walking were assessed through ankle sprain questionnaire;Cumberland ankle instability tool (CAIT), Maryland foot score were applied to assess ankle function. Lateral ankle ligament injury was objectively assessed by musculoskeletal ultrasonography. RESULTS: The prevalence of acute ankle sprain(AAS) was 96.20% (531/552), and the incidence of AAS was 59.96% (622/1 104). The prevalence of chronic ankle joint instability(CAI) was 16.85% (93/552), and the incidence of CAI was 8.97% (99/1 104). In the four categories of sports, college student suffered from multiple sprains in performance majors group was 22.20% (14/63), including of aerobicsand dance performance. The incidence of AAS of ball sports was 8.60%(14/163). After the first sprain, most college students(94.4%) were received cold compression, about 60% of them went to hospital;however, only 44.7% students were received standard treatmens(cast or plaster), only 35.3% of them were received hard ankle orthosis. In 552 college students, 44 students were suffered from more than 4 times of ankle sprain, and the total incidence was 7.97% (44/552). Cumberland score was 26.6±2.4, Cumberland score of students sprained ankle joint more than 4 times was (29.2±1.1), suggested it was a risk factor for ankle joint instability. VAS of students sprained ankle joint more than 4 times was higher than that of less than 4 times(P<0.05), Maryland foot score was significantly lower than that of that of <4 times(P<0.05). Musculoskeletal ultrasonography measured the thickness of anterior tibiofibular ligament(ATFL) was (2.41±0.41) mm, and the thickness of calcaneofibular ligament(CFL) was (1.92±0.21) mm, and had no statistical difference(P>0.05). CONCLUSION Ninty-four percent college students had at least once ankle sprain, ankle sprains were more common in erobics and ball sports. After the first sprain, the proportion of cast or plaster treatment was less than 50%. Sprained ankle joint more than 4 times is a risk factor, and musculoskeletal ultrasonography showed thickening of both ATFL and CFL, while no statstical difference.
Female ; Male ; Humans ; Adolescent ; Young Adult ; Adult ; Cross-Sectional Studies ; Joint Instability/epidemiology* ; Physical Education and Training ; Universities ; Ankle Injuries/therapy*

Humans ; Anemia, Aplastic ; Hemoglobinuria, Paroxysmal/complications* ; Syndrome

Male diabetic individuals present a marked impairment in fertility; however, knowledge regarding the pathogenic mechanisms and therapeutic strategies is unsatisfactory. The new hypoglycemic drug dapagliflozin has shown certain benefits, such as decreasing the risk of cardiovascular and renal events in patients with diabetes. Even so, until now, the effects and underlying mechanisms of dapagliflozin on diabetic male infertility have awaited clarification. Here, we found that dapagliflozin lowered blood glucose levels, alleviated seminiferous tubule destruction, and increased sperm concentrations and motility in leptin receptor-deficient diabetic db/db mice. Moreover, the glucagon-like peptide-1 receptor (GLP-1R) antagonist exendin (9-39) had no effect on glucose levels but reversed the protective effects of dapagliflozin on testicular structure and sperm quality in db/db mice. We also found that dapagliflozin inhibited the testicular apoptotic process by upregulating the expression of the antiapoptotic protein B-cell lymphoma 2 (BCL2) and X-linked inhibitor of apoptosis protein (XIAP) and inhibiting oxidative stress by enhancing the antioxidant status, including total antioxidant capacity, total superoxide dismutase (SOD) activity, and glutathione peroxidase (GPx) activity, as well as decreasing the level of 4-hydroxynonenal (4-HNE). Exendin (9-39) administration partially reversed these effects. Furthermore, dapagliflozin upregulated the glucagon-like peptide-1 (GLP-1) level in plasma and GLP-1R expression by promoting AKT8 virus oncogene cellular homolog (Akt) phosphorylation in testicular tissue. Exendin (9-39) partially inhibited Akt phosphorylation. These results suggest that dapagliflozin protects against diabetes-induced spermatogenic dysfunction via activation of the GLP-1R/phosphatidylinositol 3-kinase (PI3K)/Akt signaling pathway. Our results indicate the potential effects of dapagliflozin against diabetes-induced spermatogenic dysfunction.
Mice ; Animals ; Male ; Proto-Oncogene Proteins c-akt/metabolism* ; Antioxidants ; Phosphatidylinositol 3-Kinases/metabolism* ; Semen/metabolism* ; Diabetes Mellitus

OBJECTIVE: To derive the Chinese medicine (CM) syndrome classification and subgroup syndrome characteristics of ischemic stroke patients. METHODS: By extracting the CM clinical electronic medical records (EMRs) of 7,170 hospitalized patients with ischemic stroke from 2016 to 2018 at Weifang Hospital of Traditional Chinese Medicine, Shandong Province, China, a patient similarity network (PSN) was constructed based on the symptomatic phenotype of the patients. Thereafter the efficient community detection method BGLL was used to identify subgroups of patients. Finally, subgroups with a large number of cases were selected to analyze the specific manifestations of clinical symptoms and CM syndromes in each subgroup. RESULTS: Seven main subgroups of patients with specific symptom characteristics were identified, including M3, M2, M1, M5, M0, M29 and M4. M3 and M0 subgroups had prominent posterior circulatory symptoms, while M3 was associated with autonomic disorders, and M4 manifested as anxiety; M2 and M4 had motor and motor coordination disorders; M1 had sensory disorders; M5 had more obvious lung infections; M29 had a disorder of consciousness. The specificity of CM syndromes of each subgroup was as follows. M3, M2, M1, M0, M29 and M4 all had the same syndrome as wind phlegm pattern; M3 and M0 both showed hyperactivity of Gan (Liver) yang pattern; M2 and M29 had similar syndromes, which corresponded to intertwined phlegm and blood stasis pattern and phlegm-stasis obstructing meridians pattern, respectively. The manifestations of CM syndromes often appeared in a combination of 2 or more syndrome elements. The most common combination of these 7 subgroups was wind-phlegm. The 7 subgroups of CM syndrome elements were specifically manifested as pathogenic wind, pathogenic phlegm, and deficiency pathogens. CONCLUSIONS There were 7 main symptom similarity-based subgroups in ischemic stroke patients, and their specific characteristics were obvious. The main syndromes were wind phlegm pattern and hyperactivity of Gan yang pattern.
Humans ; Syndrome ; Ischemic Stroke ; Medicine, Chinese Traditional ; Liver ; Phenotype

Objective: To understand the consistency and factors influencing rural parents knowledge, attitude and practice about early childhood sex education, so as to put forward effective suggestions and countermeasures for improving childhood sex education in rural areas. Methods: A multi stage stratified sampling method was used to investigate the knowledge, attitude and practice of early childhood sex education among 1 015 parents in 16 kindergartens in rural areas of Sichuan from March to May 2019. Chi square text and multivariate Logistic regression analysis were used to analyze factors affecting the consistency of parents knowledge, attitude and practice of childhood sex education. Results: Nearly 64.9%, 85.9% and 44.7% of parents with sufficient knowledge, support, and implement of early children s sex education, respectively, and the consistency rate of knowledge, attitude and practice were 30.2%. The results of the multivariate Logistic regression analysis showed that parents aged <31 years ( OR= 5.35 , 95%CI =2.93-9.77), 31-40 years ( OR=4.82, 95%CI =2.65-8.76) and 41-50 years ( OR=2.37, 95%CI =1.10-5.11), and the mother s education level being middle school ( OR=3.67, 95%CI =1.75-7.69), secondary/high school ( OR=2.83, 95%CI =1.32-6.05) and college/bachelor s degree and above ( OR=5.44, 95%CI =2.23-12.98), sex related questions asked by child ( OR=2.00, 95%CI =1.44-2.78), having sex education in the family ( OR=5.38, 95% CI =3.82-7.59), believing that parents should be responsible for sex education for young children ( OR=2.58, 95%CI =1.40-4.74) had a higher consistency rate of knowledge, attitude and practice in early childhood sex education ( P <0.05). Conclusion In rural areas of Sichuan, although parents highly support early childhood sex education, the eligible rate of knowledge and the implementing rate are quite low, as well as the consistent rate of knowledge, attitude and practice. Relevant departments should pay attention to strengthen publicity and education, especially among older parents, low educated parents and those opposed to or not yet implementing child sex education.

Objective:The purpose of this study was to investigate the effect of voice therapy via telepractice on voice function in laryngopharyngeal reflux disease (LPRD) patients.Methods:The prospective study included 120 patients from January 2021 to July 2022 with dyspnea and LPRD diagnosed at the department of otolaryngology head and neck surgery of the First Hospital of Shanxi Medical University. These patients were then randomly divided into standard treatment group (group A), combined face-to-face voice therapy group (group B) and combined telepractice voice therapy group (group C). We collected and compared data on curative effect in patients with LPRD at the 8th week(Stage 1) and the 12th week of treatment(Stage 2) and the 6th week post-treatment(Stage 3). Statistical analysis was performed using SPSS 22.0.Results:One hundred and twenty patients with LPRD and dyspnea were included in the study (63 men, 57 women, 18-65 years old). At stage 1, there were statistically significant differences among the three groups in Voice Handicap Index(VHI), Reflux Symptom Index (RSI) and Reflux Finding Score(RFS) ( F=13.72, P<0.05; F=62.50, P<0.05; F=3.78, P<0.05). VHI and RSI in group B and C were significantly smaller than those in group A, VHI and RSI in group C were significantly smaller than those in group B, and RFS in group C was significantly smaller than that in group A and B. At stage 2, there were statistically significant differences between the three groups in Maximum Phonation Time(MPT), Dysphonia Severity Index(DSI), VHI, RSI and RFS( F=8.49, P<0.05; F=3.24, P<0.05; F=8.55, P<0.05; F=19.92, P<0.05; F=12.19, P<0.05). MPT and DSI in group B and C were significantly larger than those in group A. The scores of VHI, RSI and RFS in group B and C were significantly smaller than those in group A, and RFS in group C was significantly smaller than that in group B. At stage 3, there were statistically significant differences among the three groups in Jitter, MPT, DSI, VHI( F=3.19, P<0.05; F=19.37, P<0.05; F=43.56, P<0.05; F=11.05, P<0.05), and there were statistically significant differences among the three groups in RSI and RFS( F=25.58, P<0.05; F=11.82, P<0.05). MPT and DSI in group B and C were significantly larger than those in group A. The scores of VHI and RSI in group B and C were significantly smaller than those in group A, and RFS in group C was significantly smaller than those in group A and B. Conclusion:Telepractice can be used in patients with LPRD and dyspnea as an alternative to face-to-face voice therapy with better long-term outcomes.

Objective: To investigate the species, concentration and seasonal trends of main airborne allergenic pollen in 4 districts and 5 counties of Hohhot City. Methods: The Department of allergy, Beijing Shijitan Hospital Affiliated to Capital Medical University conducted a cross-sectional study about monitoring the airborne allergenic pollen from August 1, 2021 to July 31, 2022 by the gravitational method in 4 districts and 5 counties of Hohhot City, which include Yuquan District, Xincheng District, Huimin District, Saihan District, Tuoketuo County, Helingeer County, Tumotezuoqi County, Wuchuan County and Qingshuihe County. Daily pollens were counted and identified by optical microscopy, and the data were analyzed. Results: The airborne allergenic pollen was collected every month all year round in 4 districts and 5 counties of Hohhot city. Through the whole year of the total quantity of pollens ranged from 24 850 to 50 154 grains per 1 000 mm² and two peaks of pollen concentration in air were observed,which happened in spring (from March to May) and in summer and autumn (from July to September). In spring, the main pollens were tree pollens, which principally distributed in Populus pollen (18.29%), Ulmus pollen (8.36%), Pinus pollen (6.20%), Cupressaceae pollen (5.23%), Betulaceae pollen (2.73%), Salix pollen (1.80%) and Quercus pollen (1.16%). In summer and autumn, the main pollens were weed pollens, which mainly included Artemisia pollen (42.73%), Chenopodiaceae pollen or Amaranthaceae pollen (7.46%), Poaceae pollen (2.26%), Humulus pollen or Cannabis pollen (0.60%). Conclusion: There were two peaks of main airborne allergenic pollen in 4 districts and 5 counties of Hohhot City. In the spring peak of pollen, the main airborne pollens were tree pollens. In the summer and autumn peak of pollen, the main airborne pollens were weed pollens. The Artemisia pollen was the most major airborne pollen in this area.
Humans ; Cross-Sectional Studies ; Pollen ; Hospitals

Objective: To investigate the species, concentration and seasonal trends of main airborne allergenic pollen in 4 districts and 5 counties of Hohhot City. Methods: The Department of allergy, Beijing Shijitan Hospital Affiliated to Capital Medical University conducted a cross-sectional study about monitoring the airborne allergenic pollen from August 1, 2021 to July 31, 2022 by the gravitational method in 4 districts and 5 counties of Hohhot City, which include Yuquan District, Xincheng District, Huimin District, Saihan District, Tuoketuo County, Helingeer County, Tumotezuoqi County, Wuchuan County and Qingshuihe County. Daily pollens were counted and identified by optical microscopy, and the data were analyzed. Results: The airborne allergenic pollen was collected every month all year round in 4 districts and 5 counties of Hohhot city. Through the whole year of the total quantity of pollens ranged from 24 850 to 50 154 grains per 1 000 mm² and two peaks of pollen concentration in air were observed,which happened in spring (from March to May) and in summer and autumn (from July to September). In spring, the main pollens were tree pollens, which principally distributed in Populus pollen (18.29%), Ulmus pollen (8.36%), Pinus pollen (6.20%), Cupressaceae pollen (5.23%), Betulaceae pollen (2.73%), Salix pollen (1.80%) and Quercus pollen (1.16%). In summer and autumn, the main pollens were weed pollens, which mainly included Artemisia pollen (42.73%), Chenopodiaceae pollen or Amaranthaceae pollen (7.46%), Poaceae pollen (2.26%), Humulus pollen or Cannabis pollen (0.60%). Conclusion: There were two peaks of main airborne allergenic pollen in 4 districts and 5 counties of Hohhot City. In the spring peak of pollen, the main airborne pollens were tree pollens. In the summer and autumn peak of pollen, the main airborne pollens were weed pollens. The Artemisia pollen was the most major airborne pollen in this area.
Humans ; Cross-Sectional Studies ; Pollen ; Hospitals