Animals ; Macaca mulatta ; Optic Disk ; Glaucoma ; Craniocerebral Trauma ; Intraocular Pressure ; Low Tension Glaucoma

Objective:Migraine and tremor share some genetic mutation sites,and clinical studies have also confirmed their correlation.This study aims to explore the clinical and electrophysiological characteristics of migraine patients with concomitant tremor,and to analyze the relevant influential factors of tremor occurrence. Methods:We retrospectively analyzed the clinical data of 217 migraine patients who visited the Third Affiliated Hospital of Qiqihar Medical University from June 2022 to October 2023.The Clinical Rating Scale for Tremor(CRST),Numerical Rating Scale(NRS),Generalized Anxiety Disorder-7(GAD-7),and Patient Health Questionnaire-9(PHQ-9)were respectively used to assess the tremor symptoms,degree of headache,anxiety,and depression of patients.All patients underwent routine head MR scanning and electromyography examination,and were divided into a migraine with tremor group and a migraine without tremor group based on the electromyogram examination. Results:The migraine with tremor group and the migraine without tremor group were included 52 patients(23.96%)and 165 patients(76.04%),respectively.Compared with the migraine without tremor group,the migraine with tremor group had a longer course and duration of headache,higher frequency of headache attacks,higher NRS score,GAD-7 score,and PHQ-9 score,and fewer weekly physical exercises.The differences were statistically significant(all P<0.05).There were no statistically significant differences in the presence or absence of prodromal headache and white matter hyperintensities(WMHs)between the 2 groups(both P>0.05).The evaluation results of the CRST showed that out of 217 migraine patients,39 patients(17.97%)were accompanied by tremors.The electromyographic results showed that all 52 migraine patients with tremors had upper limb tremors,including 28 migraine patients with postural tremors and 24 migraine patients with static tremors.Compared with the migraine patients with static tremors,the migraine patients with postural tremors had lower average frequency,peak frequency,and headache onset frequency(all P<0.05).Multiple linear regression analysis showed that frequency of physical exercise,duration of illness,frequency of headache attacks,NRS score,GAD-7 score,and PHQ-9 score were risk factors for migraine patients with concomitant tremors(all P<0.05). Conclusion:Patients with migraine mainly experience upper limb postural tremors.Reduced physical exercise,long course of disease,long duration of headache,frequent headache attacks,severe headache,anxiety,and depression are risk factors for migraine patients with concomitant tremors.

OBJECTIVE This study aimed to investigate the effects of Buyang Huanwu Decoction(BYHWD)on delaying vascu-lar aging and explore whether the underlying mechanism is associated with microRNA-665(miR-665)/DNA damage-regulated autoph-agy modulator1(DRAM1)-mediated autophagy.METHODS Male SD rats with natural aging were randomly divided into the aging group,BYHWD low,medium,high dosage groups(9.25,18.5,37.0 g·kg-1)and resveratrol group(80 mg·kg-1),with a young group set as well.The rats in each group were dissected and the blood vessels were collected.ELISA was used to assess senescence as-sociated β-galactosidase(SA-β-Gal)activity and advanced glycation end products(AGEs)level in vascular tissues.HE,Masson,and EVG staining were performed to observe the morphological structure of the vascular tissues.The qPCR was performed to detect the expression of miR-665 in vascular tissues.Bioinformatics analysis and dual-luciferase reporter gene experiments were used to validate the targeting relationship between miR-665 and DRAM1.Transmission electron microscope was used to observe the autophagosome.Western blot was performed to determine the protein expression of p16,DRAM1 and autophagy-related proteins Bec-lin1,p62 and LC3.Immunohistochemistry was used to detect the protein expression of DRAM1 in vascular tissues.RESULTS Com-pared to the young group,the aging group showed increased SA-β-Gal activity,AGEs level and p16 protein expression(P<0.01),disordered arrangement of vascular tissues,thickened media,increased collagen fibers,fractured and disorganized elastic fibers.The expression of miR-665 was upregulated(P<0.01).The number of autophagosomes was reduced.The protein expression of Beclin1 and LC3Ⅱ/Ⅰ downregulated(P<0.01),while the protein expression of p62 was upregulated(P<0.01).In addition,the protein ex-pression of DRAM1 was downregulated in vascular tissues(P<0.01).Compared to the aging group,intervention with BYHWD and resveratrol reduced SA-β-Gal activity(P<0.01),AGEs level and p16 protein expression(P<0.05,P<0.01),improved vascular morphology and elastic fiber structure,reduced collagen fibers.High dose BYHWD significantly downregulated miR-665 expression(P<0.01),increased the number of autophagosomes.Different doses of BYHWD significantly upregulated protein expression of Bec-lin1(P<0.05,P<0.01),medium and high doses of BYHWD significantly upregulated protein expression of LC3Ⅱ/Ⅰ(P<0.01),and downregulated protein expression of p62(P<0.01).High dose BYHWD significantly upregulated protein expression of DRAM1 in vascular tissues of aging rats(P<0.05).Bioinformatics analysis revealed the presence of specific complementary binding sites between the sequences of miR-665 and DRAM1.Dual-luciferase reporter assays confirmed that miR-665 targeted DRAM1 gene and negatively regulated DRAM1 protein expression.CONCLUSION BYHWD may promote the protein expression of DRAM1 by inhibiting the ex-pression of miR-665,thereby promoting vascular autophagy and delaying vascular aging.

Objective To understand the application of skin disinfectant in neonatal intensive care units(NICUs)nationwide.Methods From April to May 2023,application of skin disinfectant in 93 NICUs nationwide was sur-veyed with convenience sampling method by a self-designed questionnaire.Questionnaire contents included types of disinfectant,disinfection tools,cleaning and disinfection frequency,disinfectant drying status,removal of disinfec-tant,and adverse reactions caused by disinfectant.Results A total of 93 nursing units in 71 medical institutions from 25 provinces/municipalities were included in this study.In NICUs,three most commonly used disinfectants were ethanol(79.57％),iodophor(74.19％),and anerdian(62.37％).In nursing units for neonates＜2 months of age,chlorhexidine was prohibited in 28 units(30.11％),used with caution in 23 units(24.73％),allowed in 9 units(9.68％),and there was no unified requirement in 33 units(35.48％).When using ethanol,staff only wiped once in 13(17.57％)nursing units.In some nursing units,there was no unified requirements on the wiping fre-quency of disinfectant.As for the removal of residual iodine,saline was used in 29(42.03％)nursing units,ethanol in 8(11.59％),and 19(27.54％)did not have unified requirements.The adverse reactions of disinfectant mainly included rash and contact dermatitis.Disinfectants that caused adverse reactions included ethanol,iodophor,aner-dian,and chlorhexidine.Conclusion In clinical practice,unified standards for the use of neonatal skin disinfectant remain absent.Selection and use of neonatal skin disinfectant vary considerably.Neonatal skin disinfectants have common adverse reactions.It is necessary to strengthen the training of health care workers on the standardized use of disinfectant,as well as carry out large-scale and rigorous randomized controlled trial designs to provide scientific basis for the correct selection of disinfectant.

Ankylosing spondylitis (AS) combined with lower cervical fracture is often categorized into unstable fracture, with a high incidence of neurological injury and a high rate of disability and morbidity. As factors such as shoulder occlusion may affect the accuracy of X-ray imaging diagnosis, it is often easily misdiagnosed at the primary diagnosis. Non-operative treatment has complications such as bone nonunion and the possibility of secondary neurological damage, while the timing, access and choice of surgical treatment are still controversial. Currently, there are no clinical practice guidelines for the treatment of AS combined with lower cervical fracture with or without dislocation. To this end, the Spinal Trauma Group of Orthopedics Branch of Chinese Medical Doctor Association organized experts to formulate Clinical guidelines for the treatment of ankylosing spondylitis combined with lower cervical fracture in adults ( version 2024) in accordance with the principles of evidence-based medicine, scientificity and practicality, in which 11 recommendations were put forward in terms of the diagnosis, imaging evaluation, typing and treatment, etc, to provide guidance for the diagnosis and treatment of AS combined with lower cervical fracture.

Objective:To investigate the predictive value of infiltrating zone contrast-enhanced ultrasound(CEUS) gradient features in Nottingham grading and pathologically true infiltration of invasive ductal carcinoma(IDC).Methods:A retrospective analysis was performed on 78 female breast cancer patients (95 masses) confirmed by surgical and pathology in the Affiliated Hospital of Jiangsu University from July 2019 to June 2022, which were divided into Grade-Ⅰ (22 masses), Grade-Ⅱ (28 masses), and Grade-Ⅲ (45 masses) according to the Nottingham histological grading system. The differences in the maximum diameter of the infiltration zone and the characteristic parameters of the gradient of the inner and outer edges of the infiltration zone among the three groups of masses were compared, and the differential gradient features among them were analyzed by multivariate ordered Logistic regression and ROC curves. The relationship between the differential gradient characteristics of the infiltration zone and the pathologically true infiltration of the mass was further explored.Results:The univariate analysis showed statistically significant differences among the three groups for peak-arrival time gradient (ΔTTP), ascending branch slope gradient (ΔRS), peak intensity gradient (ΔPI) and area gradient under the curve (ΔAUC) (all P<0.05). Multiple ordered logistic regression analysis showed that ΔTTP, ΔPI and ΔAUC had independent influences on the histologic grading of IDC (all P<0.05), and the area under the curve for the combination of the three in predicting IDC histology grades Ⅰ, Ⅱ and Ⅲ was 0.692, 0.705 and 0.765, respectively. In addition, the maximum diameter of pathologically true infiltration of the mass was positively correlated with ΔTTP ( r=0.621, P<0.05) and negatively correlated with ΔPI ( r=-0.605, P<0.05) and ΔAUC ( r=-0.719, P<0.05). Conclusions:Infiltration zone CEUS gradient features are effective in predicting the histologic grade of IDC and strongly correlate with the degree of pathologically true infiltration of the mass.

Objective To investigate the impact of influence of personality traits of nurses as second victim and negative experience of nurses in adverse event and explore the intermediary roles of stress perception in influencing mechanism of negative experience.Methods Between March and April 2023,a convenience sampling method was employed to select 560 nurses from 3 general hospitals in Taiyuan City to conduct the study.The selected nurse all had experienced adverse events within last 3 months.The survey employed a general information questionnaire,Chinese big five personality questionnaire,second victim experience and support scale and Chinese version of stress perception scale.Pearson's correlation analysis was conducted to explore the correlation between the personality traits of nurses as second victim(specifically neuroticism),negative experiences and stress perception.The mediating role of stress perception between the neuroticism of nurses as second victim and negative experiences of nurses was analysed using PROCESS plug-in with the Bootstrap method.Results All of 560 distributed questionnaires were recovered,with a 100.00%of response rate.Personality traits of nurses as second victim were ranked in descending order with rigor,agreeableness,openness,neuroticism and extroversion.Both negative experiences and stress perception had higher scores(40.25±10.64 and 30.25±5.98,respectively).Neurotic personality in nurses as second victim was positively correlated with negative experience(r=0.528,P＜0.01)and stress perception(r=0.594,P＜0.01).Negative experiences showed a positive correlation with stress perception(r=0.339,P＜0.01).Neurotic personality of nurses as second victim had a significant direct impact on negative experiences[β=0.519,95%CI:0.318-0.720].As one of the stress perception dimensions,tension played a partial mediating role between neurotic personality in nurses as second victim and negative experience[β=0.148,95%CI:0.006-0.300],and a mediating effect percentage of 22.70%.Conclusions The neurotic personality of nurses as second victim can directly affect the negative experiences,either independently or in conjunction with tension.Nursing managers and nurses as second victims can reduce the negative experiences in adverse events by addressing higher neurotic personality and alleviating tension.

Objective To investigate the clinical characteristics and prognosis of pneumococcal meningitis(PM),and drug sensitivity of Streptococcus pneumoniae(SP)isolates in Chinese children.Methods A retrospective analysis was conducted on clinical information,laboratory data,and microbiological data of 160 hospitalized children under 15 years old with PM from January 2019 to December 2020 in 33 tertiary hospitals across the country.Results Among the 160 children with PM,there were 103 males and 57 females.The age ranged from 15 days to 15 years,with 109 cases(68.1% )aged 3 months to under 3 years.SP strains were isolated from 95 cases(59.4% )in cerebrospinal fluid cultures and from 57 cases(35.6% )in blood cultures.The positive rates of SP detection by cerebrospinal fluid metagenomic next-generation sequencing and cerebrospinal fluid SP antigen testing were 40% (35/87)and 27% (21/78),respectively.Fifty-five cases(34.4% )had one or more risk factors for purulent meningitis,113 cases(70.6% )had one or more extra-cranial infectious foci,and 18 cases(11.3% )had underlying diseases.The most common clinical symptoms were fever(147 cases,91.9% ),followed by lethargy(98 cases,61.3% )and vomiting(61 cases,38.1% ).Sixty-nine cases(43.1% )experienced intracranial complications during hospitalization,with subdural effusion and/or empyema being the most common complication[43 cases(26.9% )],followed by hydrocephalus in 24 cases(15.0% ),brain abscess in 23 cases(14.4% ),and cerebral hemorrhage in 8 cases(5.0% ).Subdural effusion and/or empyema and hydrocephalus mainly occurred in children under 1 year old,with rates of 91% (39/43)and 83% (20/24),respectively.SP strains exhibited complete sensitivity to vancomycin(100% ,75/75),linezolid(100% ,56/56),and meropenem(100% ,6/6).High sensitivity rates were also observed for levofloxacin(81% ,22/27),moxifloxacin(82% ,14/17),rifampicin(96% ,25/26),and chloramphenicol(91% ,21/23).However,low sensitivity rates were found for penicillin(16% ,11/68)and clindamycin(6% ,1/17),and SP strains were completely resistant to erythromycin(100% ,31/31).The rates of discharge with cure and improvement were 22.5% (36/160)and 66.2% (106/160),respectively,while 18 cases(11.3% )had adverse outcomes.Conclusions Pediatric PM is more common in children aged 3 months to under 3 years.Intracranial complications are more frequently observed in children under 1 year old.Fever is the most common clinical manifestation of PM,and subdural effusion/emphysema and hydrocephalus are the most frequent complications.Non-culture detection methods for cerebrospinal fluid can improve pathogen detection rates.Adverse outcomes can be noted in more than 10% of PM cases.SP strains are high sensitivity to vancomycin,linezolid,meropenem,levofloxacin,moxifloxacin,rifampicin,and chloramphenicol.[Chinese Journal of Contemporary Pediatrics,2024,26(2):131-138]

Objective Intracoronary administration of Tirofiban or recombinant human pro-urokinase(rhPro-UK)during primary percutaneous coronary intervention(PPCI)has been shown to improve coronary artery microcirculation perfusion.This study aims to explore the efficacy and safety of intracoronary rhPro-UK or Tirofiban in patients with ST-segment elevation myocardial infarction(STEMI)undergoing PPCI.Methods The PubMed,Ovid-MEDLINE,Embase,Web of Science,Cochrane Library,clinical trials.gov,CNKI,WANFANG,VIP,SinoMed,databases were searched for randomized controlled trials(RCTs)or cohort researches of the Intracoronary injection of rhPro-UK or Tirofiban during PPCI in STEMI patients from inception to 27th November 2023.Two reviewers independently screened literature,extracted data and assessed the risk of bias of included studies.Meta-analysis of data was performed by RevMan 5.4.Results There were 12 studies involving 1 721 patients were included,with 864 in the rhPro-UK group(experimental group)and 857 in the Tirofiban group(control group).Meta-analysis showed that compared to the control group,intracoronary rhPro-UK significantly improved postoperative myocardial blood flow perfusion,including higher proportions of thrombolysis in myocardial infarction(TIMI)grade Ⅲ and TIMI myocardial perfusion grades(TMPG)grade Ⅲ(OR 1.83,95％CI 1.36-2.46,P＜0.0001;OR 2.38.95％CI 1.22-4.66,P=0.010);And significantly lower corrected T1M1 frame count(cTFC)(MD-2.43,95％CI-2.94--1.92,P＜0.00001);ST-segment resolution(STR)≥70％was higher than that of control group(OR 1.93,95％CI 1.01-3.68,P=0.050).There was a significant reduction in major adverse cardiovascular events(MACE)one month postoperatively(OR 0.54,95％CI 0.35-0.82,P=0.004).Improving cardiac function one month after surgery,higher left ventricular ejection fraction(LVEF)(MD 1.71,95％CI 0.04-3.38,P=0.050).Reducing the size of the myocardial infarction,the postoperative peak value of CK-MB was lower than that of control group(MD-74.16,95％CI-83.59--64.74,P＜0.00001).The incidence of bleeding event was not significantly different between groups(OR 1.18,95％CI 0.64-2.16,P=0.600).Conclusions In STEMI patients undergoing PPCI,intracoronary rhPro-UK improves coronary artery microcirculation perfusion and cardiac function more effectively than Tirofiban,reducing the size of the myocardial infarction and the occurrence of MACE after PPCI 1 month,and there was no significant difference in bleeding events between the two groups.

The latest epidemiological data suggests that the situation of adult diabetes in China is severe, and metabolic diseases have become significant chronic illnesses that have a serious impact on public health and social development. After more than six years of practice, the National Metabolic Management Center(MMC) has developed distinctive approaches to manage metabolic patients and has achieved a series of positive outcomes, continuously advancing the standardized diagnosis and treatment model. In order to further improve the efficiency, based on the first edition, the second edition guideline was composed by incorporating experience of the past six years in conjunction with the latest international and domestic guidelines.