Objective:To summarize the clinical manifestations, neuroelectrophysiological characteristics and prognoses of Movan syndrome (MoS), and provide references for early diagnoses and prognoses.Methods:A retrospective analysis was performed. The clinical data, such as clinical symptoms, treatments and prognoses, laboratory test results and electrophysiological test results, of 13 patients with confirmed MoS in Department of Neurology, He'nan Provincial People's Hospital from January 2018 to October 2023 were collected.Results:Ten male MoS patients and 3 female ones were included. Main clinical manifestations of 13 patients with MoS included myokymia, pain, numbness of limbs, itching all over the body, hyperhidrosis, urinary and defecation disorder, tachycardia, insomnia, anxiety and depression. Ten patients completed the autoimmune encephalitis antibody detection: 3 only had positive anti-contactin-associated protein-like 2 (CASPR2) antibody, 2 only had positive anti-leucine-rich glioma-inactivated protein1 (LGI1) antibody, and 2 had both positive anti-CASPR2 antibody and anti-LGI1 antibody. Eleven patients completed tumor screening and 4 tumors (thymoma [ n=2], lung squamous cell carcinoma [ n=1] and adrenal non-Hodgkin's lymphoma [ n=1]) were noted. Ten patients completed electrocardiogram, including 3 patients with resting tachycardia and 2 patients with ST segment elevation. All patients completed the electromyographic examination; 12 patients showed abnormal motor unit potential, including myokymia potential, fasciculation potential and neuromyotonic potential; F-wave and/or M-wave post-discharge potentials were found in all patients. Follow up was performed for 1-12 months; in 9 non-tumor patients, 5 were improved in 6 patients accepted immunotherapy and one was improved in 3 patients received symptomatic treatment; in 4 tumor patients, only one was improved in 3 received immunotherapy. Conclusion:Myokymia, pain, urinary and defecation disorder, and severe insomnia are typical symptoms for MoS patients; serum anti-CASPR2/LGI1 antibody and electromyography results provide evidences for MoS diagnosis; early immunotherapy can improve the MoS prognosis, and MoS patients combined with tumors have poor clinical prognosis.

Objective:To investigate the knowledge, attitudes, and practices (KAP) of pulse oximetry among pediatric healthcare providers in China and analyze the factor influencing the KAP.Methods:A self-developed questionnaire was used for an online research on the KAP of 11 849 pediatric healthcare providers from 31 provinces, autonomous regions, and municipalities of China from March 11 to 14, 2022.The factors influencing the KAP of pulse oximetry among pediatric healthcare providers were examined by Logistic regression. Results:The scores of KAP, of pulse oximetry were 5.57±0.96, 11.24±1.25 and 11.19±4.54, respectively.The corresponding scoring rates were 69.61%, 74.95%, and 55.99%, respectively. Logistic regression results showed that the gender and working years of pediatric healthcare providers, the region they were located, and whether their medical institution was equipped with pulse oximeters were the main factors affecting the knowledge score (all P<0.05). Main factors influencing the attitude score of pediatric healthcare providers included their knowledge score, gender, educational background, working years, region, medical institution level, and whether the medical institution was equipped with pulse oximeters (all P<0.05). For the practice score, the main influencing factors were the knowledge score, gender, age, and whether the medi-cal institution was equipped with pulse oximeters (all P<0.05). Conclusions:Chinese pediatric healthcare providers need to further improve their knowledge about and attitudes towards pulse oximetry.Pulse oximeters are evidently under-used.It is urgent to formulate policies or guidelines, strengthen education and training, improve knowledge and attitudes, equip more institutions with pulse oximeters, and popularize their application in medical institutions.

Objective:To investigate the relationship between orthostatic intolerance (OI) and body mass index (BMI), blood lipid and serum protein levels in children and adolescents.Methods:A total of 122 children and adolescents aged from 6 to 17 years old, who were diagnosed with OI at the Department of Pediatric Cardiology, the Second Hospital of Lanzhou University from April 2018 to April 2019, were selected as the subjects.While, 56 children and adolescents in the health management center were selected as the healthy control group during the same period.Subjects were divided into syncope group and non-syncope group according to whether there was syncope in clinical history.The height and body mass of all children were measured, and venous blood were taken to detect blood lipids and serum protein in the morning.Date analysis were conducted with SPSS 22.0 software.Results:(1) The level of triglyceride in the OI group was lower than that in the healthy control group[(0.98±0.45) mmol/L vs. (1.28±1.04) mmol/L], and there was statistically significant( t=2.025, P<0.05); the BMI were respectively (17.56±3.23) kg/m 2 and (16.46±2.58) kg/m 2 in syncope group and non-syncope group, whose result indicated that the BMI in syncope group was higher than that in non-syncope group( t=2.085, P<0.05). (2) The results of binary Logistic regression analysis showed that the triglyceride level was an independent risk factor for OI( OR=0.504, 95% CI: 0.272-0.931, P<0.05). (3) The receiver operating characteristic curve evaluated the predictive value of triacylgly-cerol to OI.Results showed the sensitivity and specificity of OI were respectively 72.1% and 48.2%when the triacylglycerol was 1.09 mmol/L. Conclusions:Low triglyceride level and high BMI may be susceptible factors to OI in children and adolescents.Therefore, the diet of children with OI should be highly valued by clinicians and parents.

Objective To explore the operation opportunity of cholecystectomy for senile patients with acute cholecystitis combined with underlying disease.Methods 82 elderly patients with acute cholecystitis complicated with underlying diseases underwent cholecystectomy were selected,they were divided into two groups according to the different operation time:the early operation group and the delayed operation group,41 cases in each group.The patients in early operation group were given operation in 72h,while the delayed operation group was given operation more than 72h after attack.The operation time,intraoperative blood loss,intraoperative tissue adhesions,intraoperative exudation,hospitalization time,cost of hospitalization and complications of the two groups were observed and com-pared.Results The operation time of the two groups were (45.32 ±1 2.23)min,(50.89 ±1 3.34)min,there was no significant difference (P >0.05),the intraoperative tissue adhesions of the delayed operation group was more than the early operation group,and the intraoperative hemorrhage and exudation in the early operation group were significantly higher than those of the delayed operation group (P <0.05),and the hospital stay and cost of hospitalization were sig-nificantly lower than those of the delayed operation group (P <0.05).1 case in the early operation group occurred pulmonary infection,3 cases with incision infection,the incidence of complications was 9.76%;1 case in the delayed operation group underwent laparotomy operation,2 cases in the delayed operation group had pulmonary infection,inci-sion infection in 4 cases,the incidence rate of complication was 1 4.63%,there was no significant difference between the two groups (P >0.05).Conclusion The optimal operation timing of acute cholecystitis combined with basic dis-eases in the elderly patients underwent cholecystectomy is within 72h.For patients who can not be immediately given operation due to various reasons,delayed cholecystectomy is safe and feasible.

Objective To observe the association between ambulatory blood pressure levels and blood pressure variability (BPV) with myocardial performance index (MPI) in untreated hypertensive patients.Methods From January to September 2013,a total of 81 untreated hypertensive patients were included in this study.All patients received ambulatory blood pressure monitoring and echocardiography measurements.MPI was determined in all patients by the following formula:MPI =(isovolumic contraction time + isovolumic relaxation time)/ejection time.The patients were divided into two groups according to left ventricular MPI:patients with MPI ＞ 0.47 (n =39) and patients with MPI ≤ 0.47 (n =42).The mean levels and standard deviation (SD) of 24 h,daytime and nighttime blood pressures were compared between the two groups.SD was used to express BPV.Determinants of MPI were identified by multivariate regression analysis.Results 24 h and daytime systolic blood pressure,24 h,daytime and nighttime diastolic blood pressure,as well as SD of 24 h and daytime systolic blood pressure ((130.1 ± 8.7),(134.0 ± 8.2),(89.1 ±6.3),(90.9 ±6.4),(83.1 ±9.9),(13.7 ± 3.3) and(14.2 ± 3.5) mmHg(1 mmHg =0.133 kPa),respectively) were significantly higher in patients with MPI ＞ 0.47 than those ((124.8 ± 8.7),(126.7 ±8.8),(84.5 ±7.1),(86.2 ± 7.4),(76.4 ± 7.5),(11.8 ±2.1) and(10.4 ± 1.9) mmHg,respectively) in patients with MPI≤0.47 (all P ＜ 0.05).Multivariate regression analysis showed that 24 h diastolic blood pressure (β =0.239,P =0.007) and SD of 24 h systolic blood pressure (β =0.333,P ＜0.001),left ventricular mass index and early diastolic mitral annular velocity were independently associated with MPI.Conclusion The increase of diastolic blood pressure and systolic BPV are associated with the deterioration of left ventricular function.

BACKGROUNDAneurysmal bone cyst (ABC) is a benign lesion with the potential to be locally aggressive. The optimal treatment of cervical spine lesions remains controversial. This retrospective study was designed to evaluate the different treatments for primary ABCs of the cervical spine.

METHODSThis series included eight men and six women diagnosed between 2002 and 2012. A retrospective review of the hospital charts, operating room reports, office charts, and radiographs was performed. The data collected included patient age, sex, radiological features, pathology, treatment methods, outcomes, and complications from biopsies and treatments. The mean age at diagnosis was 17.5 years old with a range of 6-35 years. All patients had experienced local pain for a mean of 7.3 months (range, 0.5-18.0 months), and three patients had neurological deficits (one with radiculopathy and two with myelopathy). The Frankel classification before treatment was E in 12 cases, D in one case, and C in one case.

RESULTSFour patients received radiotherapy alone. Ten patients underwent surgery, including five total spondylectomies, two local resections, and three curettages. Three patients received preoperative selective arterial embolization, and four received adjuvant radiotherapy. The mean follow-up time was 44.5 months (range 12-96 months), and no recurrence was identified. Three patients with neurological deficits achieved complete recovery, as noted at the final follow-up examination. One patient received radiotherapy without appropriate immobilization as prescribed and developed C1-C2 subluxation with severe spinal cord compression but without myelopathy. He refused further treatment.

CONCLUSIONSThe results can be achieved by different treatments (surgical resection/curettage, selective arterial embolization, and radiotherapy) for ABC of the cervical spine. Reconstruction of stability is also important for the treatment of cervical ABC.

Adolescent ; Adult ; Bone Cysts, Aneurysmal ; therapy ; Cervical Vertebrae ; pathology ; Child ; Embolization, Therapeutic ; Female ; Humans ; Male ; Retrospective Studies ; Spinal Diseases ; therapy ; Young Adult

OBJECTIVETo investigate the effect of adrenomedullin (ADM) on renal arteriole remodeling and phosphorylation of extracellular signal-regulated protein kinases 1/2 (p-ERK1/2) in spontaneous hypertensive rats (SHR).

METHODSMale SHR (4 weeks old) were randomized into hypertensive group (SHR) and ADM-treated group (ADM) to receive subcutaneous saline and ADM injections (daily dose of 1.0 nmol/kg, 5 days a week), respectively, with age-matched Wistar-Kyota (WKY) rats as the blank control. The systolic blood pressure (SBP) was measured at the end of each week, and histological changes of the renal arterioles were observed using HE and Weigert staining; the expression of P-ERK1/2 in the arterioles was detected with immunohistochemistry and Western blotting.

RESULTSAt 16 and 24 weeks of age, the rats in both SHR and ADM groups showed significantly higher SBP levels than WKY rats (P<0.05), and at 24 weeks, SBP was significantly lower in ADM group than in SHR group (P<0.05). The intima thickness/lumen diameter (IT/LD) ratio of the renal arterioles increased in both SHR and ADM groups at 16 and 24 weeks as compared with that of WKY rats (P<0.05), and for arterioles with an outer diameter <40 µm, the IT/LD ratio was significantly lower at 24 weeks in ADM group than in SHR group (P<0.05). The renal expression of p-ERK1/2, which increased significantly in SHR and ADM groups at 16 and 24 weeks (P<0.05), was significantly lower in ADM group than in SHR group at 24 weeks (P<0.05).

CONCLUSIONSLong-term ADM treatment can control SPB elevation in SHR rats and reduce renal arteriole remodeling by inhibiting the phosphorylation of ERK1/2.

Adrenomedullin ; pharmacology ; Animals ; Arterioles ; drug effects ; Blood Pressure ; Hypertension ; Kidney ; blood supply ; Male ; Mitogen-Activated Protein Kinase 1 ; metabolism ; Mitogen-Activated Protein Kinase 3 ; metabolism ; Rats ; Rats, Inbred SHR ; Rats, Wistar ; Vascular Remodeling

Objective To investigate the association of serum angiopoietin-1 (Ang-1) and angiopoietin-2 (Ang-2) with myocardial reperfusion in ST-segment elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (PCI). Methods A total of 103 consecutive STEMI patients who received primary PCI were enrolled in this study. The patients were divided into two groups according to ST-segment resolution (STR) at 2 h after PCI:STR ≥ 50%group (n=69) and STR<50%group (n=34). Serum concentrations of Ang-1, Ang-2 and Ang-2 to Ang-1 ratios (Ang-2/Ang-1) before and immediately after PCI, 2 h, 6 h, 24 h after PCI were compared. Predictors of poor STR were identiifed by multivariable logistic regression analysis. Results The patients with STR≥50%had significant higher serum Ang-1 levels (P < 0.05) and lower Ang-2/Ang-1 ratios (P < 0.01) from before PCI to 6 h after PCI than those with STR < 50%;Ang-1 and Ang-2/Ang-1 at 24 h after PCI, and Ang-2 at all time points were not signiifcantly different between the two groups (P>0.05). In multivariable logistic regression analysis, Ang-2/Ang-1 before PCI was independently associated with STR < 50%;Other independent predictors were pain to balloon time, infarct related artery (LAD), and TIMI flow grade<Ⅲafter PCI. Conclusions Higher Ang-2/Ang-1 is an independent predictor of poor myocardial reperfusion in STEMI patients after PCI.

Objective To study the relationship between facial skin conditions and TCM constitutional types; To provide new means and methods for guidance of skin conservation and skin health improvement from the aspect of constitutional types. Methods Totally 2241 female volunteers in nine provincial capital cities and municipalities participated in this research, and were investigated by web questionnaire. Constitutional types were determined according to the“Classification and Judgment of TCM Constitutional Types”standard issued by China Association of Chinese Medicine. Skin color, glossiness, delicate degree, moistness, firmness, resilience, uniformity and other indicators were scored. Skin conditions were classified into three groups:1-3 score group, 4-6 score group, and 7-9 score group, and the constitutional differences among each group were compared. Results Yang-deficiency and mild constitutional types accounted for the largest proportion. Yellowish skin color accounted for the largest proportion, and the next were white, dark and reddish. Yang-deficiency constitutional type accounted for the largest proportion in 1-3 score group, and the second was Qi-stagnation; Yang-deficiency and mild constitutional types accounted for the largest proportion in 4-6 score group; mild constitutional type accounted for the largest proportion in 7-9 score group. Conclusion People with mild constitutional type got highest score in every skin index, while biased constitutional types influenced the score in varied degrees. The constitutional types which influenced Chinese urban females’ facial skin index more were Yang-deficiency and Qi-stagnation constitutional types.

Background Aneurysmal bone cyst (ABC) is a benign lesion with the potential to be locally aggressive.The optimal treatment of cervical spine lesions remains controversial.This retrospective study was designed to evaluate the different treatments for primary ABCs of the cervical spine.Methods This series included eight men and six women diagnosed between 2002 and 2012.A retrospective review of the hospital charts,operating room reports,office charts,and radiographs was performed.The data collected included patient age,sex,radiological features,pathology,treatment method,outcomes,and complications from biopsies and treatments.The mean age at diagnosis was 17.5 years old with a range of 6-35 years.All patients had experienced local pain for a mean of 7.3 months (range,0.5-18.0 months),and three patients had neurological deficits (one with radiculopathy and two with myelopathy).The Frankel classification before treatment was E in 12 cases,D in one case,and C in one case.Results Four patients received radiotherapy alone.Ten patients underwent surgery,including five total spondyiectomies,two local resections,and three curettages.Three patients received preoperative selective arterial embolization,and four received adjuvant radiotherapy.The mean follow-up time was 44.5 months (range 12-96 months),and no recurrence was identified.Three patients with neurological deficits achieved complete recovery,as noted at the final follow-up examination.One patient received radiotherapy without appropriate immobilization as prescribed and developed C1-C2 subluxation with severe spinal cord compression but without myelopathy.He refused further treatment.Conclusions The results can be achieved by different treatments (surgical resection/curettage,selective arterial embolization,and radiotherapy) for ABC of the cervical spine.Reconstruction of stability is also important for the treatment of cervical ABC.