In the aftermath of the pandemic,the government is accelerating the development of top-tier medical resources to broaden the supply and deliver superior healthcare services.However,during this transitional phase,hospitals are experiencing operational challenges due to concurrent construction activities.Notably,a shortage of parking facilities and increased traffic con-gestion continue to impactmedial consultation experience of patients.This paper tries to explore strategies and methods for dynam-ic parking management during hospital campus expansions,offering insights for other medical institutions into grappling with pa-tient parking issues.

Objective Using event-related potentials(ERPs),to study the effect and mechanism of negative emotion accumulation hepatic insufficiency on working memory in normal people.Methods Fifty subjects in each of the emotionally stable group and emotionally unstable group were given two load tasks(0-back and 1-back)in the N-back paradigm,the reaction time and correct rate were recorded,and the ERPs components N200 and P300 were detected.The latency and amplitude of P300 were analyzed statistically.Results ①Compared with the emotionally stable group,the emotionally unstable group had a longer reaction time(P<0.05).②Compared with the emotionally stable group,the subjects in the emotionally unstable group had prolonged N200 latency,decreased P300 amplitude significantly(P<0.05),and P300 latency had a tendency to extend(P<0.1).Conclusion Long-term accumulation of negative emotions and liver failure in normal people have the performance of decreased working memory,which may be related to the reduction of attention resource allocation and the impairment of cognitive processing function.

As the most common active brain-computer interaction paradigm, motor imagery brain-computer interface (MI-BCI) suffers from the bottleneck problems of small instruction set and low accuracy, and its information transmission rate (ITR) and practical application are severely limited. In this study, we designed 6-class imagination actions, collected electroencephalogram (EEG) signals from 19 subjects, and studied the effect of collaborative brain-computer interface (cBCI) collaboration strategy on MI-BCI classification performance, the effects of changes in different group sizes and fusion strategies on group multi-classification performance are compared. The results showed that the most suitable group size was 4 people, and the best fusion strategy was decision fusion. In this condition, the classification accuracy of the group reached 77%, which was higher than that of the feature fusion strategy under the same group size (77.31%
Brain ; Brain-Computer Interfaces ; Electroencephalography ; Humans ; Imagery, Psychotherapy ; Imagination

Stroke is one of the most serious diseases that threaten human life and health. It is a major cause of death and disability in the clinic. New strategies for motor rehabilitation after stroke are undergoing exploration. We aimed to develop a novel artificial neural rehabilitation system, which integrates brain-computer interface (BCI) and functional electrical stimulation (FES) technologies, for limb motor function recovery after stroke. We conducted clinical trials (including controlled trials) in 32 patients with chronic stroke. Patients were randomly divided into the BCI-FES group and the neuromuscular electrical stimulation (NMES) group. The changes in outcome measures during intervention were compared between groups, and the trends of ERD values based on EEG were analyzed for BCI-FES group. Results showed that the increase in Fugl Meyer Assessment of the Upper Extremity (FMA-UE) and Kendall Manual Muscle Testing (Kendall MMT) scores of the BCI-FES group was significantly higher than that in the sham group, which indicated the practicality and superiority of the BCI-FES system in clinical practice. The change in the laterality coefficient (LC) values based on μ-ERD (ΔLC
Electric Stimulation ; Electric Stimulation Therapy ; Electroencephalography ; Humans ; Recovery of Function ; Stroke/therapy* ; Stroke Rehabilitation

Objective:To compare the difference between serum lipoprotein(a) [Lp(a)] particle concentration and mass concentration in chronic kidney disease (CKD) patients and healthy controls, and to analyze the concentration distribution of the deviations between the two measurement methods.Methods:Serum Lp(a) particle concentration and mass concentration were respectively detected in 196 patients with CKD and 97 healthy controls from Eastern Theater General Hospital during June 2018 to December 2019. The upper limit of reference value for Lp(a) particle concentration was set as 75 nmol/L and the upper limit of reference value for mass concentration was set as 300 mg/L, the difference on the positive rates of Lp(a) particle concentration and mass concentration in each group were compared. According to the quartile of Lp(a) concentration in patients with CKD, the patients were divided into 4 groups, and the results derived from the two methods were compared among groups.Results:Serum Lp(a) particle concentration (25.7 [10.5, 75.4] nmol/L vs 19.2[8.1-50.2] nmol/L, P=0.021) and mass concentration (157[64, 432] mg/L vs 127[50-274] mg/L, P=0.023) were significantly higher in patients with CKD than those in healthy controls. The positive rate of Lp(a) particle concentration was significantly lower than that of mass concentration (25.0%[48/196] vs 37.2%[73/196], P=0.009) in CKD patients. The positive rate of Lp(a) particle concentration and mass concentration was similar in healthy controls (18.6%[18/97] vs 22.7%[22/97], P=0.478). The overestimation rate of Lp(a) mass concentration in CKD patients was significantly higher than that in healthy controls (12.8%[25/196] vs 4.1%[4/97], P=0.020). Lp(a) mass concentration of group Ⅲ in CKD patients was between 157.00-432.25 mg/L, the positive rate of Lp(a) particle concentration was significantly lower than that of mass concentration (4.1%[2/49] vs 49%[24/49], P<0.001), and the overestimation rate (44.9%[22/49]) of Lp(a) mass concentration in this group was also the highest (all P<0.001). According to the conversion factor provided by the reagent manual of Lp(a) particle concentration, the test results were converted into mass concentration. The actual mass concentration of Lp(a) in CKD patients grouped by quartile was significantly higher than that after Lp(a) particle concentration conversion (all P<0.05). Conclusions:The positive rate of serum Lp(a) particle concentration is significantly lower than that of mass concentration in CKD patients and the obvious overestimation deviation of Lp(a) mass concentration is observed in this analysis.

Objective:To evaluate the pregnancy outcomes of fetal tethered cord (TC) prenatally diagnosed by MRI.Methods:Clinical data of 38 fetuses diagnosed as having TC by MRI, including 36 singletons and two fetuses who were both one of dichorionic diamniotic twins, were retrospectively collected and analyzed in the Obstetrics and Gynecology Hospital of Fudan University from January 2015 to August 2019. According to whether conus medullaris was located above the bladder or reached the lower edge of the bladder, all cases were divided into high or low groups. Pregnancy outcomes were compared between the two groups using Fisher's exact test and Student's t-test. Results:(1) The gestational age at MRI was (25.5±4.7) weeks. Among the 38 cases, 14 (36.8%) were isolated TC, 24 (63.2%) were complicated by other anomalies. The meningocele was responsible for the most (39.5%, n=15). The results of the ultrasound were consistent with those of MRI in 24 cases (63.2%). While in the other 14 cases (36.8%), the ultrasound only showed vertebral body's abnormal morphology, after which further MRI examination revealed a tethered cord. (2) Twenty-nine women (76.3%) chose to terminate the pregnancy. One patient (2.6%) underwent fetal reduction at 23 gestational weeks (one normal twin was delivered prematurely), and one (2.6%) was lost to follow-up. Seven (18.4%) cases continued the pregnancies to delivery. The postnatal follow-up period was 8.1 months (4.0 to 54.9 months). Two infants without comorbidities showed normal growth and development. Another three cases underwent surgeries after birth, and two cases died in the neonatal period. (3) The average width of the medullary cone was (2.5±0.8) cm. There was no significant difference in the spinal cord width between the high [(2.5±0.8) cm, n=34] and low group [(2.7±1.1) cm, n=4]. Six pregnancies (17.6%) in the high group was continued to delivery, and one of the neonates died of severe hydrocephalus. One patient in the low group (1/4) was delivered, while the baby died of neonatal asphyxia. Conclusions:Fetuses with isolated TC are prone to have a good prognosis. Further study should focus on the relation between the high or low position of the conus medullaris and pregnancy outcomes.

Accidents or diseases may cause impairment or even loss of human motor function, among which stroke is a disease which is most likely to cause disability and seriously endangers social health. During recent years, as a new nerve regulation technology, non-invasive brain stimulation technology can achieve the application of nerve stimulation to the brain, induce and promote neuroplasticity and improve the excitability of cerebral cortex. Especially, transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation(TMS) have shown high therapeutic potential in motor rehabilitation. This paper summarizes the mechanism and progress of the research and application of tDCS and TMS in the field of neurorehabilitation. Its technical challenges and future development trends are provided as well.
Brain ; Humans ; Stroke ; Stroke Rehabilitation ; Transcranial Direct Current Stimulation ; Transcranial Magnetic Stimulation

Objective:To analyze serum levels of complement 1q (C1q) in patients with acute ischemic stroke (AIS) and transient ischemic attack (TIA), and to assess the association of serum C1q with the neurological deficit severity of AIS and the subsequent stroke risk after TIA, and to investigate the predictive and discriminative values of serum C1q for AIS and TIA.Methods:Clinical case-control study. Serum C1q levels were determined in 65 AIS, 61 TIA patients and 66 healthy controls from Jinling Hospital affiliated to Medical School of Nanjing University during January 2016 to March 2017. Their serum levels of total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, glucose, high-sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL-6) and procalcitonin (PCT) were also detected. The NIHSS scores of AIS patients and ABCD3-I scores of TIA patients were calculated. Spearman correlation analyses and stepwise linear regression analyses were performed to investigate the association of serum C1q levels with NIHSS and ABCD3-I scores. Logistic regression analyses were performed to investigate the predictive and discriminative values of serum C1q for AIS and TIA patients. Results:Compared with controls [C1q:175.50(164.00-196.50)mg/L, TG: 0.91(0.71-1.19)mmol/L, HDL-C:(1.43±0.23)mmol/L], serum levels of C1q [AIS: 199.00(180.00-218.00)mg/L; TIA: 184.00(174.50-202.75)mg/L) and TG(AIS: 1.36(0.91-2.00)mmol/L; TIA: 1.31(0.90-2.01) mmol/L] were significantly increased in AIS and TIA patients(all P<0.05), while HDL-C[AIS: (1.08±0.41) mmol/L; TIA: (1.08±0.42) mmol/L] were significantly decreased(all P<0.001). Levels of C1q, hs-CRP[AIS:4.10(2.15-15.05)mg/L; TIA:1.40(0.63-3.88)mg/L],IL-6 [AIS: 10.88(7.21-32.96) ng/L; TIA: 7.07(6.18-9.82)ng/L] and PCT [AIS: 0.06(0.04-0.11)μg/L; TIA: 0.20(0.20-0.04)μg/L] in AIS patients were significantly higher than that in TIA patients(all P<0.05). C1q levels [AIS:203.00(183.25-219.75)mg/L; TIA: 181.00(1 666.50-206.00)mg/L] in severe AIS patients (NIHSS≥6) were significantly higher than that in mild AIS patients (NIHSS<6)( P=0.031). C1q levels[AIS:197.00(180.00-219.00)mg/L; TIA: 182.00(167.50-195.50)mg/L] in high-risk TIA patients (ABCD3-I>3) were significantly higher than that in low-risk TIA patients (ABCD3-I≤3)( P=0.018). After adjusting for age, gender, other lipid/lipoprotein and glucose parameters, C1q levels in AIS patients were independently linked(adjusted R2=0.704) to TC (β=0.524, P=0.078),TG (β=0.0.439, P=0.0.017) levels and NIHSS (β=0.372, P=0.039); C1q levels in TIA patients were independently linked (adjusted R2=0.505) to TG (β=0.535, P<0.001) levels and ABCD3-I (β=0.406, P<0.001); high C1q levels were closely associated with AIS( OR=1.035, 95 %CI1.014-1.056, P=0.001) and TIA ( OR=1.023, 95 %CI1.003-1.044, P=0.025) presence, and could also clearly differentiate between AIS and TIA( OR=1.013, 95 %CI1.000-1.026, P=0.049). Conclusions:Serum C1q levels were significantly elevated in AIS and TIA patients, especially in AIS patients. Serum C1q were independently linked to NIHSS of AIS patients and ABCD3-I of TIA patients, and may be function as a novel risk biomarker for predicting and differentiating AIS and TIA.

Objective To determine the expression levels of serum miR-25 in the patients with non-small cell lung cancer (NSCLC),and evaluate its clinical significance in the screening of NSCLC.Methods Serum samples from 82 untreated NSCLC patients,including 4 with TNM satge Ⅰ,10 with TNM stage Ⅱ,11 with TNM stage Ⅲ,53 with TNM stage Ⅳ and 4 with unknown stage,and 82 healthy controls with matched age and gender were collected,and the levels of miR-25 in these samples were determined by quantitative reverse transcription PCR (qRT-PCR).The diagnostic value of miR-25 in NSCLC was evaluated by the receiver operating characteristic (ROC) curve.Results Serum miR-25 levels in NSCLC patients were significantly higher than that in healthy controls (0.017 ± 0.028 vs 0.004 ±0.004,t =4.098,P ＜0.01).The area under the ROC curve (AUGROC),sensitivity and specificity of miR-25 for the diagnosis of NSCLC were 0.818 (95％ CI:0.753-0.882),70.7％ and 80.7％,respectively.In addition,the AUCROC,sensitivity and specificity of serum miR-25 for the screening of stage Ⅰ/Ⅱ NSCLC were 0.852 (95％ CI:0.728-0.976),78.6％ and 87.8％,respectively.Logistic regression analysis showed that miR-25 was an independent risk factor of NSCLC (OR =10.84,95％ CI:5.07-23.19,P ＜ 0.01).Conclusion Serum miR-25 levels in NSCLC patients increase significantly,indicating that it may be a novel molecular biomarker for the screening of NSCLC.

[Objective]To investigate the effect of pantoprazole on skeletal muscle wasting in cancer cachexia and the possible mechanism.[Methods]24 male BALB/c mice were randomly divided into control group(NN),cancer cachexia group(CC),pantrop?razole treatment group(PPI). The mice in CC and PPI were inoculated subcutaneously with mouse colon adenocarcinoma C26 cells to establish a model of cancer cachexia. The mice in PPI group were gavaged with 75 mg/kg pantoprazole dissolving in physiological saline,while those in NN and CC group were gavaged with 0.1 mL/10 g physiological saline. The mice were killed 12d after treatment. The weight of gastrocnemius and tumour and the size of tumour were measured. The morphological change of skeletal muscle were evalu?ated by the method of stain with hematoxylin and eosin(H&E). The levels of IL-6 and TNF-αin serum were tested by ELISA. qRT-PCR was used to assess the expression of mRNA of Myod1 and myf5 in skeletal muscle. The protein expressions of MuRF1,MAFBx, Myod1 and myf5 were measured by Western blot.[Results]Compared with CC group ,pantoprazole can increase the weight of mice and gastrocnemius(39.8% and 24.2%,respectively),cross section area(25.4%),levels of mRNA and protein of Myod1 and myf5(P<0.05),while the levels of IL-6 and TNF-αdecreased(30.7%and 18.9%,respectively),as well as the levels of protein ex?pression of MuRF1 and MAFBx(P < 0.05).[Conclusion]Pantoprazole can attenuate the wasting of skeletal muscle,the potential mechanism may be related to the inhibition of inflammatory factors and UPS ,and up-regulation of Myod1 and myf5.