Effects of professional rehabilitation training on the recovery of neurological function in young stroke patients

Young stroke patients have a strong desire to return to the society, but few studies have been conducted on their rehabilitation training items, intensity, and prognosis. We analyzed clinical data of young and middle-aged/older stroke patients hospitalized in the Department of Neurological Rehabilitation, China Rehabilitation Research Center, Capital Medical University, China from February 2014 to May 2015. Results demonstrated that hemorrhagic stroke （59.6%） was the primary stroke type found in the young group, while ischemic stroke （60.0%） was the main type detected in the middle-aged/older group. Compared with older stroke patients, education level and incidence of hyperhomocysteinemia were higher in younger stroke patients, whereas, incidences of hypertension, diabetes, and heart disease were lower. The average length of hospital stay was longer in the young group than in the middle-aged/older group. The main risk factors observed in the young stroke patients were hypertension, drinking, smoking, hyperlipidemia, hyperhomocysteinemia, diabetes, previous history of stroke, and heart disease. The most accepted rehabilitation program consisted of physiotherapy, occupational therapy, speech therapy, acupuncture and moxibustion. Average rehabilitation training time was 2.5 hours/day. Barthel Index and modified Rankin Scale scores were increased at discharge. Six months after discharge, the degree of occupational and economic satisfaction declined, and there were no changes in family life satisfaction. The degrees of other life satisfaction （such as friendship） improved. The degree of disability and functional status improved significantly in young stroke patients after professional rehabilitation, but the number of patients who returned to society within 6 months after stroke was still small.

A clinical study on the treatment of obese polycystic ovary syndrome by electroacupuncture combined with moving cupping

Objective:Effect analysis of electroacupuncture combined with recircupping in treatment of obese polycystic ovary syndrome.Methods: From October 2016 to September 2018, 68 obese PCOS patients were diagnosed and treated in the department of gynaecology, affiliated hospital of shaanxi university of traditional Chinese medicine.Treatment group given cupping and tired walking tank with metformin therapy, the control group only oral metformin treatment, after continuous treatment of three menstrual cycles, observation comprehensive curative effect of two groups before and after treatment, TCM syndrome score, body weight, body mass index (BMI), waist hip ratio (WHR), sex hormone [luteinizing hormone (LH), testosterone (T)], blood sugar [fasting plasma glucose (FPG), fasting insulin (FINS), insulin resistance index (HOMA IR)] and blood lipid [triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), total cholesterol (TC)] metabolic index, on two groups of curative effect are compared and discussed. Results:The total effective rate (83.33%) of the treatment group was higher than that of the control group (66.67%)(P<0.05).After treatment, TCM syndrome score of the two groups decreased significantly(P<0.01).The treatment group was significantly improved compared with the control group (P<0.01).Body weight, BMI, WHR of the two groups decreased significantly after treatment (P<0.01).The treatment group was better than the control group (P<0.05).After treatment, the LH and T values of the two groups decreased significantly (P<0.01).There was no significant difference in T value between the two groups (P>0.05), but the efficacy of LH in the treatment group was better than that in the control group (P<0.01).The levels of FINS, HOMA-IR and FPG in the two groups were significantly decreased after treatment (P<0.01).There was no significant difference in FPG between the two groups (P > 0.05), but the improvement of FINS and HOMA-IR in the treatment group was better than that in the control group (P< 0.01).After treatment, TG, LDL-C and TC levels in the two groups decreased (P< 0.01), while HDL-C levels in the treatment group increased (P< 0.01).There was no significant difference in HDL-C, LDL-C and TC between the two groups (P>0.05), but the efficacy of TG in the treatment group was better than that in the control group (P< 0.01).Conclusion: The curative effect of electroacupuncture and moving cupping combined with metformin is better than that of metformin alone, should be widely used.

Effect of dexmedetomidine combined with propofol on brain tissue damage in brain glioma resection

Objective:To study the effect of dexmedetomidine combined with propofol on brain tissue damage in brain glioma resection.Methods: A total of 74 patients who received brain glioma resection in our hospital between May 2014 and December 2016 were selected and randomly divided into Dex group and control group who received dexmedetomidine intervention and saline intervention before induction respectively. Serum brain tissue damage marker, PI3K/AKT/iNOS and oxidation reaction molecule contents as well as cerebral oxygen metabolism index levels were determined before anesthesia (T0), at dura mater incision (T1), immediately after recovery (T2) and 24 h after operation (T3).Results: Serum NSE, S100B, MBP, GFAP, PI3K, AKT, iNOS and MDA contents as well as AVDO2 and CERO2 levels of both groups at T2 and T3 were significantly higher than those at T0 and T1 while serum SOD and CAT contents as well as SjvO2levels were significantly lower than those at T0 and T1, and serum NSE, S100B, MBP, GFAP, PI3K, AKT, iNOS and MDA contents as well as AVDO2 and CERO2 levels of Dex group at T2 and T3 were significantly lower than those of control group while serum SOD and CAT contents as well as SjvO2 levels were significantly higher than those of control group.Conclusions: Dexmedetomidine combined with propofol can reduce the brain tissue damage in brain glioma resection.

Prevalence and risk factors for minimal hepatic encephalopathy in cirrhotic patients with different etiologies

Aims:Minimal hepatic encephalopathy(MHE)significantly affects the prognosis of patients with cirrhosis.This study was performed to determine whether there is a difference in the prevalence of MHE among patients with cirrhosis of different etiologies and whether the etiology directly influences the occurrence of MHE.Methods:This multicenter,cross-sectional study enrolled 1879 patients with confirmed cirrhosis at 40 hospitals from October 25,2021,to January 10,2023(Trial registration:https://clinicaltrials.gov/[NCT05140837]).The patients'demographics,etiologies of cirrhosis,and laboratory test results were collected.The psychometric hepatic encephalopathy score(PHES)was determined in all patients to screen for MHE.Multivariate logistic analyses were performed to identify the risk factors for MHE.Results:In total,736 patients with cirrhosis were analyzed.The prevalence of MHE was 42.0%(n=309).The primary etiology among all patients was hepatitis B virus(HBV)-related cirrhosis(71.9%[529/736]).The prevalence of MHE was significantly higher in patients with alcoholic cirrhosis(57.1%[40/70])than in those with HBV-related cirrhosis(40.6%[215/529],p=0.009)or hepatitis C virus(HCV)-related cirrhosis(38.2%[26/68],p=0.026).Age(odds ratio[OR],1.042;95%confidence interval[CI],1.024-1.059;p<0.001),duration of education(OR,0.935;95%CI,0.899-0.971;p=0.001),etiology(OR,1.740;95%CI,1.028-2.945;p=0.039),and high MELD-Na scores(OR,1.038;95%CI,1.009-1.067;p=0.009)were independent risk factors for MHE.When patients with cirrhosis of different etiologies were analyzed separately,the results showed that age(OR,1.035;95%CI,1.014-1.057;p=0.001)and duration of education(OR,0.924;95%CI,0.883-0.966;p=0.001)were risk factors for MHE among patients with HBV-related cirrhosis,whereas age(OR,1.138;95%CI,1.033-1.254;p=0.009)and creatinine concentration(OR,16.487;95%CI,1.113-244.160;p=0.042)were risk factors for MHE in patients with HCV-related cirrhosis.No risk factors for MHE were found in patients with autoimmune cirrhosis.For patients with alcoholic cirrhosis,the platelet count(OR,1.014;95%CI,1.000-1.027;p=0.045)was a risk factor for MHE.The PHES subtest results were inconsistent among patients who had MHE with cirrhosis of different etiologies.Patients with HBV-related cirrhosis performed better on Number Connection Test B and the serial dotting test than those with alcoholic cirrhosis(p=0.007 and p<0.001),better on Number Connection Test B than those with HCV-related cirrhosis(p=0.020),and better on the line tracing test than those with autoimmune cirrhosis(p=0.037).Conclusion:The etiology of cirrhosis affected the prevalence of MHE and risk factors for MHE.The domains of major cognitive impairment varied among patients with cirrhosis of different etiologies.Further studies are required to verify these findings.

A Bayesian Stepwise Discriminant Model for Predicting Risk Factors of Preterm Premature Rupture of Membranes： A Case-control Study

Background： Preterm premature rapture of membrane （PPROM） can lead to serious consequences such as intrauterine infection, prolapse of the umbilical cord, and neonatal respiratory distress syndrome. Genital infection is a very important risk which closely related with PPROM. The preliminary study only made qualitative research on genital infection, but there was no deep and clear judgment about the effects of pathogenic bacteria. This study was to analyze the association of in fections with PPROM in pregnant women in Shaanxi, China, and to establish Bayesian stepwise discriminant analysis to predict the incidence of PPROM. Methods： In training group, the 112 pregnant women with PPROM were enrolled in the case subgroup, and 108 normal pregnant women in the control subgroup using an unmatched case-control method. The sociodemographic characteristics of these participants were collected by face-to-face interviews. Vaginal excretions fiom each participant were sampled at 28 36-6 weeks of pregnancy using a sterile swab. DNA corresponding to Chlamrdia trachomalix （CT）, Ureaplasma urealyticwn （UU）, Candida albicans, group B streptococci （GBS）, herpes simplex virus- 1 （HSV-1）, and HSV-2 were detected in each participant by real-time polymerase chain reaction. A model of Bayesian discriminant analysis was established and then verified by a mull）center validation group that included 500 participants in the case subgroup and 5（10 participants in the control subgroup from five different hospitals in the Shaanxi province, respectively. Results： The sociological characteristics were not significantly different between the case and control subgroups in both training and validation groups （all P 〉 0.05）. In training group, the infection rates of UU （11.6% vs. 3.7%）, CT （17.0% vs. 5.6%）, and GBS （22.3% vs. 6.5%） showed statistically different between the case and control subgroups （all P 〈 0.05）, Iog-transfomacd quantification of UU, CE GBS, and HSV-2 showed statistically different between the case and control subgroups （P 〈 0.05）. All etiological agents were introduced into the Bayesian stepwise discriminant model showed that UU, CT, and GBS infections were the main contributors to PPROM, with coe｜＇ficients of 0.441,3.347, and 4.126, respectively. The accuracy rates of the Bayesian stepwise discriminant analysis between the case and control subgroup were 84.1% and 86.8% in the training and validation groups, respectively. Conclusions： This study established a Bayesian stepwise discriminant model to predict the incidence of PPROM. The UU, CT, and GBS infections were discriminant factors for PPROM according to a Bayesian stepwise discriminant analysis. This model could provide a new method for the early predicting of PPROM in pregnant women.

Overexpressed long noncoding RNA CRNDE with distinct alternatively spliced isoforms in multiple cancers

Alternative splicing is a tightly regulated process that contributes to cancer development.CRNDE is a long noncoding RNA with alternative splicing and is implicated in the pathogenesis of several cancers.However,whether deregulated expression of CRNDE is common and which isoforms are mainly involved in cancers remain unclear.In this study,we report that CRNDE is aberrantly expressed in the majority of solid and hematopoietic malignancies.The investigation of CRNDE expression in normal samples revealed that CRNDE was expressed in a tissue- and cell-specific manner.Further comparison of CRNDE expression in 2938 patient samples from 15 solid and hematopoietic tumors showed that CRNDE was significantly overexpressed in 11 malignancies,including 3 reported and 8 unreported,and also implicated that the overexpressed isoforms differed in various cancer types.Furthermore,anti-cancer drugs could efficiently repress CRNDE overexpression in cancer cell lines and primary samples,and even had different impacts on the expression of CRNDE isoforms.Finally,experimental profiles of 12 alternatively spliced isoforms demonstrated that the spliced variant CRNDE-g was the most highly expressed isoform in multiple cancer types.Collectively,our results emphasize the cancer-associated feature of CRNDE and its spliced isoforms,and may provide promising targets for cancer diagnosis and therapy.