Objective To investigate the effect of combination of rope-assisted proprioceptive neuromuscular facilitation(PNF)training and rope-assisted brain-computer interface(BCI)training on upper limb function in stroke patients with hemiplegia. Methods From March,2022 to February,2023,96 inpatients with stroke hemiplegia from the Second Affiliated Hospital of Guangxi Medical University were randomly divided into conventional group(n=32),PNF group(n=32)and combined group(n=32).All the groups received routine rehabilitation treatment.The conventional group re-ceived upper limb PNF training,the PNF group received upper limb rope-assisted PNF training,and the com-bined group received both upper limb rope-assisted PNF training and upper limb rope-assisted BCI training,for four weeks.They were assessed with Functiongal Test for the Hemiplegic Upper Extremity-Hong Kong version(FTHUE-HK),Fugl-Meyer Assessment-Upper Extremities(FMA-UE)and modified Barthel Index(MBI)before and after treatment. Results The intra-group effect(F>341.219,P<0.001),inter-group effect(F>21.705,P<0.001)and interaction effect(F>3.171,P<0.05)were significant in the scores of FTHUE-HK and MBI.The intra-group effect(F=520.472,P<0.001)and inter-group effect(F=41.939,P<0.001)were significant in the scores of FMA-UE,and the interaction effect was not(P>0.05).After treatment,the FTHUE-HK,FMA-UE and MBI scores were the best in the combined group(P<0.05). Conclusion The combination of rope-assisted PNF training with rope-assisted BCI device training could further improve the motor function of the upper limbs in stroke patients with hemiplegia,and enhance their activities of daily liv-ing.

Objectives:To systematically evaluate the risk factors associated with postoperative epidural hematoma in patients undergoing cervical spinal surgery.Methods:PubMed,Embase,the Cochrane Library,Web of Science,CNKI,Wanfang databases,VIP databases and CBM were searched by computer for retro-spective or prospective studies on epidural hematoma in patients undergoing cervical spine surgery published since the inception of the databases to April 2023.Two reviewers screened the literatures according to the inclusion and exclusion criteria,and NOS scale was used to evaluate the quality of the literature included.The basic information of the study,including age,gender and body mass index(BMI),as well as the factors related to the occurrence of epidural hematoma after cervical spine surgery,such as surgical segment,whether combined with posterior longitudinal ligament ossification,operative time,diabetes,hypertension,smoking,use of non-steroidal anti-inflammatory drugs and laboratory related indicators were extracted.The risk of bias analysis of the included studies was performed using funnel plots,and meta-analysis was performed using RevMan 5.4 software.Results:A total of 12 literatures were included,and the NOS quality scores of the in-cluded literatures were all 6-8 points,of which,11 were of high quality and 1 was of medium quality.Meta-analysis showed that male[odds ratio(OR)=2.84,95％confidence interval(CI)(1.73,4.67),P＜0.0001],BMI＞24kg/m2[OR=8.50,95％CI(2.56,25.24),P=0.0005],multiple surgical segments(≥2)[OR=2.26,95％CI(1.42,3.594),P=0.0005],operative time＞2h[OR=1.46,95％CI(1.08,1.97),P=0.01],preoperative administration of non-steroidal anti-inflammatory drugs[OR=3.60,95％CI(1.00,12.99),P=0.05]were the risk factors for epidural hematoma after cervical spine surgery.The results of the funnel plot were used to test the publication bias of the surgical segment and intraoperative blood loss,which were the most influential factors in the literature,and the results showed that there was no publication bias in the surgical segment,while there was partial publication bias in the intraoperative blood loss.Conclusions:Male,BMI＞24kg/m2,multi-segment surgery(sur-gical segment ≥2),operative time＞2h,and preoperative administration of nonsteroidal anti-inflammatory drugs are the risk factors for SEH after cervical spine surgery.

ObjectiveTo investigate the effect of combination of proprioceptive neuromuscular facilitation (PNF) rope training and repetitive transcranial magnetic stimulation (rTMS) on upper limb motor function of stroke patients with hemiplegia. MethodsFrom March, 2021 to February, 2022, 90 stroke inpatients with hemiplegia in the Department of Rehabilitation Medicine, the Second Affiliated Hospital of Guangxi Medical University were divided into control group (n = 30), rope group (n = 30) and combination group (n = 30) randomly. All the groups received routine rehabilitation, while the control group received routine PNF training, the rope group received PNF rope training, and the combination group received PNF rope training and rTMS, for four weeks. They were assessed with Functional Test for the Hemiplegic Upper Extremity-Hong Kong version (FTHUE-HK), Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and modified Barthel Index (MBI) before and after treatment. ResultsThe scores of FTHUE-HK, FMA-UE and MBI increased in all the three groups after treatment (t > 2.167, P < 0.05), and they were more in the combination group than in the rope group (P < 0.05), and in the rope group than in the control group (P < 0.05). ConclusionThe combination of PNF rope training and rTMS is more effective on motor function of upper limbs of stroke patients with hemiplegia than PNF training alone.

Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia seen in clinical settings, which has been associated with substantial rates of mortality and morbidity. However, clinically available drugs have limited efficacy and adverse effects. We aimed to investigate the mechanisms of action of andrographolide (Andr) with respect to AF. We used network pharmacology approaches to investigate the possible therapeutic effect of Andr. To define the role of Andr in AF, HL-1 cells were pro-treated with Andr for 1 h before rapid electronic stimulation (RES) and rabbits were pro-treated for 1 d before rapid atrial pacing (RAP). Apoptosis, myofibril degradation, oxidative stress, and inflammation were determined. RNA sequencing (RNA-seq) was performed to investigate the relevant mechanism. Andr treatment attenuated RAP-induced atrial electrophysiological changes, inflammation, oxidative damage, and apoptosis both in vivo and in vitro. RNA-seq indicated that oxidative phosphorylation played an important role. Transmission electron microscopy and adenosine triphosphate (ATP) content assay respectively validated the morphological and functional changes in mitochondria. The translocation of nuclear factor erythroid 2-related factor 2 (Nrf2) to the nucleus and the molecular docking suggested that Andr might exert a therapeutic effect by influencing the Keap1-Nrf2 complex. In conclusions, this study revealed that Andr is a potential preventive therapeutic drug toward AF via activating the translocation of Nrf2 to the nucleus and the upregulation of heme oxygenase-1 (HO-1) to promote mitochondrial bioenergetics.
Animals ; Rabbits ; Atrial Fibrillation/metabolism* ; Kelch-Like ECH-Associated Protein 1/metabolism* ; Signal Transduction ; NF-E2-Related Factor 2/pharmacology* ; Molecular Docking Simulation ; Oxidative Stress ; Energy Metabolism ; Mitochondria/metabolism* ; Inflammation/metabolism* ; Heme Oxygenase-1

Objective:To investigate the risk factors of low anterior resection syndrome (LARS)after low anterior resection of rectal cancer (Dixon).Methods:This retrospective study was conducted in Peking University First Hospital and Traditional Chinese Medicine Hospital of Shanxi Provice from Jan 2012 to Jun 2019. A cohort of 504 patients with rectal cancer was enrolled in the study. All the patients underwent anterior resection. The relationship between clinical-pathological data were analyzed retrospectively. Univariate analysis using χ 2 test. Logistic regression analysis was used to screen the influencing factors of LARS, and the Nomogram method was used to score each factors. Results:Univariate analysis showed that BMI≥28 kg/m 2(χ 2=9.450, P=0.002), the distance from the lower edge of the tumors to the anus <6 cm (χ 2=12.070, P=0.001), high ligation of the inferior mesenteric artery (IMA) (χ 2=8.279, P=0.004), preoperative neoadjuvant therapy (χ 2=11.230, P=0.001), postoperative anastomotic leakage (χ 2=11.840, P=0.001) were associated with severe LARS.Multivariate analysis showed that the distance from the lower edge of the tumors to the anus <6 cm ( OR=1.861, 95% CI: 1.289-2.688, P=0.001), BMI≥28 kg/m 2 ( OR=1.747, 95% CI: 1.022-2.987, P=0.041), high IMA ligation ( OR=1.688, 95% CI: 1.157-2.463, P=0.007), preoperative neoadjuvant therapy ( OR=2.719, 95% CI: 1.343-5.505, P=0.005) were independent risk factors for LARS. Nomogram model showed that the total factor ranged from 2 to 212, and the corresponding risk rate ranged from 30% to 80%. The patients with higher score have greater risk for severe LARS. The area under the predictive power curve of Nomogram model (AUC) was 0.749 (95% CI: 0.705-0.793, P<0.001). Conclusion:Lower tumor location, obesity, preoperative neoadjuvant therapy, high IMA ligation and postoperative anastomotic leakage increase the risk of severe LARS.

Objective:To explore the predictive value of a radiomics model based on preoperative contrast enhanced MRI in the assessment of the isocitrate dedydrogenase 1 (IDH 1) genotype in high-grade glioma.Methods:A retrospective analysis was performed on a dataset including 182 patients with high-grade glioma confirmed by surgical pathology between December 2012 and January 2018 in the Affiliated Hospital of Qingdao University. There were 79 patients with IDH1-mutant glioma (45 cases with WHO grade Ⅲ, 34 with WHO grade Ⅳ) and 103 with IDH 1 wild-type glioma (33 cases with WHO grade Ⅲ, 70 cases with WHO grade Ⅳ). All patients had complete preoperative brain contrast enhanced MRI.The cases were divided into a training dataset and a validation dataset at a ratio of 7∶3 using stratified random sampling. Radiomic features were initially extracted using A.K (Analysis Kit, GE healthcare) software, and were selected and excluded using Kruskal-Wallis and Spearman analyses. Using R softwear " GLM" function, the Lasso-logistic model was finally conducted to obtain the optimized subset of the feature to build the radiomics model, and the model was then tested with cross-validation. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the performance of the model in differentiating IDH1-mutant type and wild-type gliomas.Results:The radiomics model showed good performance in IDH genotype differentiation in both the training dataset (AUC 0.870, 95% CI: 0.754 to 0.855, accuracy rate 79.8%, sensitivity 85.5%, specificity 75.4%, positive predictive value 0.734, negative predictive value 0.867) and the validation dataset (AUC 0.860, 95% CI: 0.690 to 0.913, accuracy rate 78.9%, sensitivity 91.3%, specificity 69.0%, positive predictive value 0.700, negative predictive value 0.909).Conclusion:The radiomics model based on the preoperative enhanced MR can provide a way to predict the IDH1 genotype in high-grade gliomas.

BACKGROUND AND PURPOSE: This study investigated the contribution of white-matter hyperintensities (WMH) and lacunar infarcts (LI) to the risk of Alzheimer's disease (AD) in an elderly cohort in China. METHODS: Older adults who were initially cognitively normal were examined with MRI at baseline, and followed for 5 years. WMH were classified as mild, moderate, or severe, and LI were classified into a few LI (1 to 3) or many LI (≥4). Cognitive function was assessed using the Mini Mental State Examination and the Activities of Daily Living scale. RESULTS: Among the 2,626 subjects, 357 developed AD by the end of the 5-year follow-up period. After adjusting for age and other potential confounders, having only WMH, having only LI, and having both WMH and LI were associated with an increased risk of developing AD compared with having neither WMH nor LI. Moderate and severe WMH were associated with an increased risk of developing AD compared with no WMH. Furthermore, patients with many LI had an increased risk of developing AD compared with no LI. CONCLUSIONS: Having moderate or severe WMH and many LI were associated with an increased risk of developing AD, with this being particularly striking when both WMH and LI were present.
Activities of Daily Living ; Adult ; Aged* ; Alzheimer Disease* ; China* ; Cognition ; Cohort Studies ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Strikes, Employee ; Stroke, Lacunar*

Objective To study the effect of hypertension on motor function in Parkinson's disease (PD) patients with white matter lesion (WML).Methods Two hundred and nineteen PD patients with WML were divided into hypokinesia group (n=137) and non hypokinesia group (n=82).The patients were followed up for 1 year.The relationship of vascular risk factors with hypertension and hypokinesia was analyzed.Results The age was older,the incidence of hypertension,DM and lipidemia was higher,the SBP and DBP were higher in hypokinesia group than in non hypokinesia group (P＜0.01,P＜0.05).Logistics regression analysis showed that age,hypertension and DM were the risk factors for hypokinesia in PD patients with WML (OR =1.78,95 ％CI:1.43-2.14,OR =1.97,95 ％0 CI:1.49-2.52,OR =1.63,95 ％ CI:1.31-1.94).Further analysis showed that grade 2 and 3 hypertension were closely related the risk of hypokinesia in PD patients with WML(OR=1.62,95％CI:1.29-1.95;OR=2.19,95％CI:1.49-2.91).Conclusion Hypertension,especially grade 2 and 3 hypertension,can aggravate hypokinesia in PD patients with WML.

Objective To study the relationship between CDC25A (cell division cycle 25A) expression and the development of gastric adenocarcinoma. hTe effect of artesunate (Art) on CDC25A and gastric cancer cells were also investigated.Methods hTe CDC25A protein expression in gastric adenocarcinoma was detected by lfow cytometry assay. SGC-7901 cells were divided into four groups: control group and 30, 60, 120μmol/L Art groups. Cell apoptosis, cell cycle and CDC25A protein expression in SGC-7901 cells were determined by lfow cytometry atfer the treatment of different concentrations of Art (30, 60, 120μmol/L) for 24h, while the same volume of saline was used in the control.Results CDC25A protein expression level in gastric adenocarcinoma (419.69±21.91) was signiifcantly higher than that in normal gastric tissues (316.11±24.23,P<0.01). hTe cell apoptosis rates of 30, 60, 120μmol/L Art groups (5.48%±0.67%, 12.55%±1.17%, 23.43%±2.18%) were significantly higher than that of control group (0.87%±0.14 %,P<0.05), with an Art dose dependent manner. hTe cell proliferation indices of 30, 60, 120μmol/L Art groups (39.18%±0.53%, 35.71%±0.99%, 31.73%±1.02%) were signiifcantly lower than that of control group (44.12%±2.51%,P<0.01). hTe CDC25A protein expression levels of 30, 60, 120μmol/L Art groups (414.80±4.06, 397.86±3.61, 345.68±7.11) were significantly lower than that of control group (433.99±1.56,P<0.01).ConclusionhTe abnormally increased expression level of CDC25A may be involved in the development of gastric adenocarcinoma. Art can inhibit the growth of SGC-7901 cells by down-regulating the expression of CDC25A protein.

SUMMARY Pheochromocytomaisrareinpregn’ancy.Clinicalfeaturesofacaseofpheochromocytoma during pregnancy in the Peking University People’s Hospital was investigated and the literature reviewed to discuss the diagnosis and treatment of this disease.The patient manifested with hypertension and pro-teinuria,who was easily misdiagnosed with gestational hypertension disease.When she was transferred to our hospital,the symptoms such as,paroxysmal palpitation,dizziness,vomiting were noticed,and the possibility of pheochromocytoma was considered due to the accompanying abdominal mass.An emergent cesarean section was performed successfully due to preterm labor during the treatment of the disease.Af-ter the delivery the drug preparation continued.And the laparoscopic resection of pheochromocytoma pro-ceeded when the blood pressure was steady.The patient recovered fully after the surgery.The final diag-nosis of pheochromocytoma was confirmed with the pathology.Its diagnosis and treatment experiences could improve our understanding and treatment of secondary hypertension due to pheochromocytoma in pregnancy.