Objective To evaluate the impact of optimizing the stroke green channel on the efficiency of acute ischemic stroke management in a county hospital. Methods A retrospective analysis of the emergency stroke green channel treatment data from Sixian People’s Hospital from May 2020 to April 2021 (before optimization of the green channel) and from May 2021 to April 2022 (after optimization of the green channel) was conducted. The rates of intravenous thrombolysis (IVT) and mechanical thrombectomy (MT) patients, as well as door-to-needle time (DNT), door-to-puncture time (DPT), and the modified Rankin scale (mRS) scores of patients three months post-treatment before and after the optimization of the stroke green channel were compared. Results Within one year before and after optimization of the green channel, the number of acute visits for ischemic stroke was 3 143 and 2 623, respectively. Before optimization, 84 and 51 underwent IVT and MT, respectively. After optimization of the green channel, the ratios of patients underwent IVT (n＝215) and MT (n＝103) significantly increased, and both DNT and DPT were significantly shortened (P＜0.000 1); the proportion of MT patients with an mRS score of 0-2 at 3 months post-discharge significantly increased (46/99 vs 13/46, P＝0.038). Conclusion After optimizing the green channel at Sixian People’s Hospital, the efficiency of stroke treatment has significantly improved, and the patients’ prognosis improved.

Objective To propose a motion performance-based adaptive assistance strategy to balance the differences in movement intensity caused by varying motor abilities in dual-person upper limb rehabilitation training. Methods A competitive interactive task suitable for dual-person rehabilitation training was designed.Two kinematic evaluation metrics were introduced,and fuzzy logic was applied to comprehensively assess the patients'motor performance.An adaptive control system framework was constructed to dynamically adjust the robot's assistance level through a difference-based adaptive step-size piecewise function.Four healthy persons were recruited ran-domly to test the system. Results The proposed strategy could adaptively adjust the level of assistance based on the participants'motor perfor-mance,balancing the differences in motor abilities between them and enabling both parties to engage at a similar competitive level. Conclusion The motion performance-based adaptive assistance strategy and adaptive control system framework may bal-ance the skill levels between participants with different motor abilities,avoiding the imbalance of training intensi-ty during dual-person interactive rehabilitation.

Objective:To explore the impact of artificial intelligence compressed sensing technology (CS-AI) on image quality in three-dimensional proton density weighted imaging (3D PDWI) of the unilateral hip joint.Methods:High-resolution unilateral hip imaging was conducted on 67 healthy volunteers at West China Hospital of Sichuan University from January to July 2023. Imaging was performed by using CS-AI 3D PDWI sequence with acceleration factors (AF) of 4, 6, 8, and 10, respectively. According to the AF, all subjects were divided into 4 groups: CS-AI 4, CS-AI 6, CS-AI 8 and CS-AI 10, with CS-AI 4 serving as a reference. Recording the scan time, the signal and noise intensity of the femoral head, muscle, and subcutaneous fat were measured by a senior radiologist and the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were then calculated. Additionally, two observers provided ratings for overall image quality and artifacts in the 4 groups, and statistical analysis was performed using the Friedman rank-sum test.Results:The acquisition times for CS-AI 4, CS-AI 6, CS-AI 8, and CS-AI 10 were 5 min 49 s, 3 min 54 s, 2 min 56 s and 2 min 22 s, respectively. Compared to CS-AI 4, the scanning time for CS-AI 6, CS-AI 8, CS-AI 10 were reduced by 32.95%, 50.14%, 59.31%, respectively. The objective evaluation revealed that the SNR and CNR of the femoral head and muscle in groups CS-AI 6, CS-AI 8, and CS-AI 10 were slightly lower than those in group CS-AI 4 ( P<0.05), and the differences were statistically significant. However, no statistically significant differences were found among the 3 groups ( P>0.05). The subjective evaluation indicated that the overall image quality scores of group CS-AI 8 [3 (3,4)] did not significantly differ from those of group CS-AI 4 and CS-AI 6( P>0.05); The mean scores of group CS-AI 4 and CS-AI 6 were 4 (4, 4); Scores of group CS-AI 10 was 3(3, 3), which statistically significant differ from those of the other groups ( P<0.05). The artifacts rating for groups CS-AI 4, CS-AI 6, CS-AI 8 and CS-AI 10 were 4 (4, 4), 4 (4, 4), 3 (3, 4), and 2 (2, 3) respectively. When AF was set to 10, the images exhibited the most severe artifacts ( P<0.05). For other AF values, artifact ratings did not differ significantly ( P>0.05). Conclusion:The CS-AI 3D-PDWI sequence with acceleration factor 8 can acquire high-resolution images of the unilateral hip joint that meet clinical diagnostic requirements while reducing scanning time.

Objective To study the clinical and electrophysiological characteristics about ictal facial dystonia of medial temporal lobe epilepsy.Method Data was collected from patients with mesial temporal lobe epilepsy originating from unilateral temporal lobe structures through preoperative evaluation at the Functional Neurology Department of the Second People's Hospital of Shenzhen between July 1,2019 and September 1,2023.All patients did not have seizures for at least 1 year after operation.The ictal symptoms of each patient were analyzed and the patients with ictal facial dystonia were selected and the clinical and electrophysiological characteristics of ictal facial dystonia were summarized.Results Nineteen of 47 patients diagnosed as mesial temporal lobe epilepsy had ictal facial dystonia,of which the electroencephalogram starting at the right side in 11 cases and at the left side in 8 cases.Fifteen patients had the symptom in the first 1/3 period of seizure.Fifteen patients had bilateral symmetrical muscle contraction.Thirteen patients showed with negative expression,5 with neutral expression,and 1 with negative or positive expression in different seizures.None of the patient had the drop of the corners of the mouth.Five patients underwent stereotactic-electroencephalogram(SEEG),including 3 patients with bilateral implantation and 2 patients with unilateral implantation.SEEG showed that the medial temporal structure,insula and orbital lobes were all involved in the onset of ictal facial dystonia.Conclusion The medial temporal lobe epilepsy often present ictal facial dystonia in the first 1/3 period of seizure,with bilaterally symmetrically facial contraction,often accompanied by negative expression,but without drop of the corners of the mouth.The lateralization value of ictal facial dystonia is limited and this symptom involves a wide brain network structure.

Objective To summarize the clinical,electrophysiological and imaging features of frontal opercular epilepsy.Methods A retrospective analysis was conducted on 5 cases with frontal opercular epilepsy,who were treated at the Department of Functional Neurology,Shenzhen Second People's Hospital from December 2020 to December 2022.Among these cases,4 cases were underwent stereotactic-EEG(SEEG)guided radiofrequency thermocoagulation.The clinical,electrophysiological,and imaging characteristics of these 5 cases were summarized.Results The 5 cases had an onset age ranging from 2 to 17 years and a disease duration ranging from 1 to 20 years.All of them experienced daily seizures,especially at night.The seizure duration was less than 30 seconds,and consciousness recovered rapidly.Among the cases,3 exhibited hypermotor seizures of typeⅠorⅡ,characterized by body turning along the horizontal body axis.Two of them experienced laughter during the seizures,while 1 showed a fearful expression.The remaining 2 cases presented with symmetric tonic seizures,involving the facial muscles.One case reported indescribable aura,and 2 cases had autonomic symptoms.During the interictal period,all 5 cases showed epileptic discharges predominantly in the frontal region on EEG,with lateralization value present in only 2 cases.During the ictal period,4 cases demonstrated general low volatility and fast activity(LVFA),while 1 case showed low-frequency rhythmic sharp and slow waves originating from the lesioned side.Four cases underwent SEEG,which revealed seizure starting from the frontal operculum and adjacent electrodes with LVFA,rapidly spreading to the insula,insular opercular,and medial frontal lobe.Positive changes were observed in the MRI of 4 cases,including 2 cases with possible cortical dysplasia,1 case with tuberous sclerosis,and 1 case with encephalomalacia foci.All 4 cases underwent SEEG guided radiofrequency thermocoagulation,resulting in seizure frequency reduction.Conclusions Frontal opercular epilepsy is mainly characterized by hypermotor seizure with body turning along the horizontal body axis or symmetric tonic seizure.These seizure may be accompanied by emotional symptom or facial muscle tonic,but aura and autonomic symptom are less common.The lateralization value of EEG is limited in frontal opercular epilepsy.SEEG indicates early involvement of the insula,insular opercular,and medial frontal lobe.

Objective:To investigate the genetic safety of allogeneic bone marrow mesenchymal stem cells (BMSCs) transplantation in traumatic brain injury (TBI).Methods:(1) In vivo experiment: BMSCs from male SD rats were isolated and cultured. Moderate TBI models were prepared by implanting and fixing micro-drug injection cannula into the left ventricle of 12 female SD rats, and 3 d after that, striking the right cerebral cortex of the rats with pneumatic precision percussion device was performed. Four h, and 3, 6, 9, and 12 d after modeling, TBI rats were given a single/multiple BMSCs infusion (2.5×10 5/time, total volume 10 μL) by cannula; 48 and 72 h, and 10 and 14 d after modeling, brain tissues of TBI rats (3 at each time point) were prepared into paraffin specimens. Immunofluorescent staining was used to detect the microglia activation, and RNAscope ? technology was used to detect the co-localization of astrocytes, neurons, microglia and transplanted BMSCs to observe whether the allogeneic BMSCs were integrated with the host brain cells after transplantation into TBI host. (2) In vitro experiment: the frozen and revived microglial cell line BV2 was transfected with green fluorescent protein (GFP)-positive lentiviral particles, and then, BMSCs prelabeled with pHrodo RED probe and BV2 cells pretreated with lipopolysaccharide were co-cultured in a certain ratio (BV2:BMSCs=1:1, 1:2, 2:1); after 36 and 72 h of co-culture, the phagocytosis between the 2 kinds of cells was observed under confocal fluorescence inverted microscope to observe the specific action forms of microglia on BMSCs. Results:(1) In vivo experiment: 48 and 72 h, and 10 and 14 d after modeling, no colocalization of transplanted BMSCs with astrocytes or neurons was found in paraffin sections of brain tissue in TBI rats; however, 10 and 14 d after modeling, microglia in TBI rats were obviously activated and migrated to the left lateral ventricle and choroid plexus, and co-localization of microglia with transplanted BMSCs was observed. (2) In vitro experiment: phagocytosis occurred after co-culture of BV2 cells at different proportions with BMSCs for 36 and 72 h. Conclusion:After transplantation, allogeneic BMSCs do not integrate with astrocytes or neurons of the TBI host, but they could be phagocytosed by microglia, indicating that allogeneic BMSCs transplantation for TBI is genetically safe.

Objective: To develop the Adolescent Mental Health Literacy Assessment Questionnaire (AMHLAQ), and to evaluate its reliability and validity among undergraduates. Methods: On the basis of the definition of mental health literacy (MHL) and the Knowledge, Attitudes and Practices (KAP) theory, this study constructed a total of 36 items consisting of four dimensions, and scores were measured according to a five point Likert type scale. Using a cluster sampling method, a questionnaire survey was conducted among 3 826 freshmen and sophomore students from two medical schools in Anhui Province. The items were screened by performing t tests, Pearson s correlation coefficient analysis and factor analysis. The reliability and validity of the questionnaire were evaluated using indicators including homogeneity reliability, the split half reliability coefficient, and construct validity. Results: Factor analysis revealed that the AMHLAQ consisted of 22 questions grouped into four domains. The variance cumulative contribution rate was 62.213%. The reliability result showed that the Cronbach s alpha coefficient of the total questionnaire was 0.897, the split half reliability was 0.800, the Cronbach s coefficient of each dimension was 0.796 to 0.885, the split half reliability of each dimension was 0.725 to 0.846, and the indicators had a high level of reliability. Confirmatory factor analysis showed that the model fit was good ( χ 2/df =19.319, P <0.01; RMSEA=0.069). Conclusion AMHLAQ is consistent with the evaluation standard of psychometrics, has good reliability and validity, and can be used to estimate the level of MHL among undergraduates.

Objective To explore the clinical application value of second-generation dual-source CT combined with intelligent modulation and iterative reconstruction in emergency aortic dissection imaging.Methods A total of 40 emergency patients with clinical suspected aortic dissection were included in this study.Conventional scanning was performed in the control group,and large-pitch intelligent modulation and iterative reconstruction were performed in the test group.The mean CT value,mean noise,signal noise ratio(SNR),contrast noise ratio(CNR),effective dose,image quality and aortic root image quality were evaluated and analyzed.Results Totally 40 patients successfully completed CT aortic dissection imaging.There was no difference in image quality between the two groups (P＞ 0.05).The quality of aortic root images in the test group was better than that in the control group,and the difference was statistically significant(x2=22.556,P＜0.05).The mean CT value and mean noise of aorta in the control group were slightly higher than those in the test group.However,SNR and CNR in the test group were higher than those in the control group,and the difference was statistically significant (t =-21.042,-15.924,8.530,11.495,P＜0.05).The effective dose of the control group [(10.59±3.89)mSv] was significantly higher than that [(6.39±0.81) mSv] of the test group,the difference was statistically significant (t =-12.327,P＜0.05).Conclusions The combined intelligent modulation technique and iterative reconstruction technique with dual-source CT large pitch scanning can meet the requirements of image quality and reduce the effective dose,and can be used as a conventional imaging method for emergency CT of aortic dissection.

Objective To investigate the clinical efficacy of paclitaxel combined with three-dimensional conformal ra-diotherapy(3DCRT) for advanced non-small cell lung cancer(NSCLC) in the elderly. Methods From June 2011 to June 2013, 51 elderly patients with NSCLC were randomly divided into chemoradiotherapy group (n=26) and chemotherapy group(n=25). All patients were treated with weekly 60 mg/m2 of paclitaxel intravenously for 3 weeks, and patients in the chemoradiotherapy group were also treated with three-dimensional conformal radiation (1.8~2.0 Gy per fraction, 5 times per week, total dose of 60~66 Gy). The clinical efficacy and adverse reactions were compared between two groups. Re-sults In chemoradiotherapy group, the response rate was 84.6% and the overall efficiency rate was 96.2%, which were higher than 60.0% and 84.0% in chemotherapy group (P<0.05). In chemoradiotherapy group, the one year survival rate was 79.2%, which was higher than 61.5% in chemotherapy group (P<0.05), so did one year progression free survival rates (67.4% vs 40.0%)(P<0.05). The main side effects were gastrointestinal toxicity, radiation esophagitis and bone-marrow suppression. Conclusion Paclitaxel combined with three-dimensional conformal radiotherapy for advanced NSCLC in the elderly are safe and effective, the toxicity is tolerable.

In order to decrease the potential side-effects of human basic fibroblast growth factor (hbFGF) caused by its broadspectrum mitogenic activity, a single residue of hbFGF, the residue serine 108, was replaced with neutral alanine residue to construct a mutant of hbFGF (mhbFGF) with reduced mitogenic activity. The mutant was overexpressed in Escherichia coli BL21(DE3) by IPTG induction. The expression level of mhbFGF was about 30% of the total cellular protein. The expressed mhbFGF was purified by ionic exchange and heparin affinity chromatography from the supernatant of bacteria lysate. Measured by MTT method, the effect of mhbFGF on Balb/c 3T3 cell proliferation was much lower than that of wild-type hbFGF. The purified recombinant mhbFGF was prepared and sufficient for the following pharmacological and safety studies.