The prevalence and associated factors of functional constipation among primary and middle school students in Shaanxi Province / 中国学校卫生

Objective@#To understand the prevalence and associated factors of functional constipation(FC) among primary and middle school students in Shaanxi Province, in order to provide a basis for preventing FC in students.@*Methods@#A stratified cluster random sampling method was used to conduct a questionnaire survey on 9 133 primary and middle school students aged 10-18 in eight primary and secondary schools in Shaanxi Province from March to September,2017. Chi square test and multivariate Logistic regression were used to analyze the associated factors of FC among primary and middle school students in Shaanxi Province.@*Results@#There were a total of 364 students meeting the FC Rome IV diagnostic criteria, with a prevalence rate of 3.99%. Among them, there were 155 male students with a prevalence rate of 3.43%, and 209 female students with a prevalence rate of 4.53%. Univariate analysis showed that gender, breastfeeding, separation from parents, long term school meals, types of staple foods, breakfast frequency, cold foods eating frequency, spicy foods eating frequency, fried food eating frequency, pickled food eating frequency, desserts eating frequency, vegetables eating frequency were related to FC, and the differences were statistically significant ( χ 2=7.30,18.75, 20.89,35.54,22.43,16.05,21.31,13.97,10.33,23.96,16.25,17.74, P <0.05). Multivariate Logistic regression analysis showed that female, non breastfeeding, separation from parents, long term school meals, low consumption of staple food/staple food dominated by rice, and never eating vegetables were positively correlated with FC( OR =1.37,1.96,1.52,2.07,1.76,1.58,2.31, P < 0.05 ).@*Conclusions@#The prevalence of functional constipation is higher in primary and middle school students. Attention should be paid to factors related to students dietary habits and food classification to prevent the occurrence of FC in primary and middle school students.

Predictive factors of autogenous arteriovenous fistula maturation and preliminary study on assisted maturation intervention timing / 中华肾脏病杂志

Objective:To analyze the predictive factors of autogenous arteriovenous fistula (AVF) maturation and tentatively discuss the intervention timing of assisted maturation.Methods:It was a retrospective study. The data of patients with newly established AVF and regular follow-up in Haidian Hospital, the Third Hospital of Peking University from August 1, 2018 to March 31, 2022 were analyzed. The patients were divided into mature group and immature group based on whether they met clinical maturity or ultrasonic maturity criteria 3 months after AVF establishment.The general data, preoperative laboratory examination and postoperative ultrasonic examination parameters were compared between the two groups. Logistic regression analysis model was used to analyze the related factors of AVF maturation, and receiver operating characteristic curve (ROC curve) was drawn to evaluate the predictive value of each factor for AVF maturation and intervention timing.Results:A total of 568 patients were included, with age of (56.86±13.82) years old, 339 males (59.68%), and 229 females (40.32%). There were 380 patients in the maturation group and 188 patients in the immature group. The total rate of AVF maturation was 66.90% (380/568). The anastomosis diameter ( t=9.732, P < 0.001), ln(anastomosis artery diameter)( t=10.116, P < 0.001), anastomosis vein diameter ( t=13.961, P < 0.001), ln(brachial artery diameter)( t=9.362, P < 0.001) and brachial artery blood flow ( t=16.542, P < 0.001) of postoperation one month, and anastomosis diameter ( t=7.356, P < 0.001), anastomosis artery diameter ( t=11.117, P < 0.001), anastomosis vein diameter ( t=12.332, P < 0.001), ln(brachial artery diameter) ( t=7.956, P < 0.001) and brachial artery blood flow ( t=13.803, P < 0.001) of postoperation three months in the mature group were significantly higher than those in the immature group. Logistic regression analysis models showed anastomosis vein diameter at 1 month after surgery ( OR=0.577, 95% CI 0.342-0.975, P=0.040), brachial arterial blood flow at 1 month after surgery ( OR=0.988, 95% CI 0.996-1.000, P=0.043) and brachial arterial blood flow at 3 months after surgery ( OR=0.997, 95% CI 0.995-0.999, P=0.002) were the independent relevant factors of AVF maturation. When the anastomosis vein diameter ≥ 3.90 mm at 1 month after AVF surgery ( AUC=0.842, 95% CI 0.809-0.871, P < 0.001), the blood flow of brachial artery ≥ 446.90 ml/min at 1 month after AVF surgery ( AUC=0.880, 95% CI 0.850-0.906, P < 0.001), the critical value of the combined index of anastomotic vein diameter and blood flow of brachial artery at 1 month after fitting ≥ 0.44 ( AUC=0.889, 95% CI 0.860-0.914, P < 0.001) and brachial arterial blood flow ≥ 595.00 ml/min ( AUC=0.857, 95% CI 0.822-0.888, P < 0.001), the unassisted maturation of AVF could be predicted. Conclusions:The anastomosis vein diameter ≥ 3.90 mm at 1 month after AVF surgery, and the blood flow of brachial artery ≥ 446.90 ml/min at 3 months after AVF surgery, or the critical value of combined index of both after fitting ≥ 0.44 can predict the unassisted maturation of AVF, and one month after surgery may be the opportunity for early intervention to promote maturation.

Evaluation of the protective effect of foam dressings on intraoperative acquired pressure injuries based on propensity score matching / 中国实用护理杂志

Objective:To evaluate the protective effect of foam dressing in preventing intraoperative acquired pressure injury (IAPI), and to provide reference basis for prevention and treatment of IAPI during clinical operation.Methods:The clinical data of 455 surgical patients admitted to Xinhua Hospital Affiliated to Shanghai Jiao Tong University from October 2020 to January 2021 were retrospectively collected. According to whether foam dressing was used at the compression site during operation, the patients were divided into dressing group (101 cases) and control group (354 cases). The two groups were matched with age, body mass index, preoperative Braden and cerebrovascular disease as covariates, and were finally divided into 89 patients in the dressing group and 162 patients in the control group. Logistic regression analysis and stratified analysis were used to comprehensively evaluate the actual effect of foam dressing on the occurrence of IAPI in the surgical patients.Results:Among the 251 patients, there were 14 (15.7%) cases with IAPI in the dressing group and 13 (8.0%) cases in the control group, and the difference was not statistically significant ( χ2=3.41, P>0.05). Among the patients in the prone position, compared to the control group, the dressing group can effectively reduce the risk of IAPI in surgical patients by 77% ( OR=0.23, 95% CI 0.05-0.98, P<0.05). There was no interaction between foam dressing and intraoperative surgical characteristics ( P>0.05). Conclusions:Foam dressing plays a protective role in preventing the occurrence of IAPI in patients undergoing surgery in the prone position. There was no significant protective effect of intraoperative foam dressing in patients with other surgical characteristics.

Clinical value of combined detection of serum IgG, TBX21 and miR-335 in diagnosis of lupus nephritis / 国际生物医学工程杂志

Objective:To investigate the clinical value of combined detection of serum immunoglobulin G (IgG), T-frame protein 21 (TBX21), and microRNA-335 (miR-335) in the diagnosis of lupus nephritis (LN).Methods:Ninety-five patients with LN treated in our hospital from January 2021 to January 2023 were selected as the observation group, while ninety-five healthy individuals were selected as the control group. Based on the systemic lupus erythematosus disease activity index (SLEDAI) score at admission, the LN patients were divided into two subgroups: the active LN group (51 cases, SLEDAI score > 4) and the stable LN group (44 cases, SLEDAI score = 0 - 4). The levels of serum IgG, TBX21, and miR-335 were compared between the two groups, and the levels of serum IgG, TBX21, miR-335, blood urea nitrogen (BUN), serum creatinine (Scr), complement C3, complement C4, and SLEDAI score were compared between the two groups. The correlations of serum IgG, PTX3, and miR-335 levels with BUN, Scr, complement C3, complement C4, and SLEDAI scores were analyzed. The diagnostic value of serum IgG, TBX21, and miR-335 in LN was evaluated.Results:Compared with the control group, the levels of serum IgG, TBX21, and miR-335 in the observation group were higher on admission (all P < 0.05). The serum levels of IgG, TBX21, and miR-335 in patients with the active stage were higher than those in patients with the stable stage on admission (all P < 0.05). On admission, the BUN, Scr, and SLEDAI scores of patients in the active stage were higher than those in the stable stage, and the levels of complement C3 and C4 were lower than those in the stable stage (all P < 0.05). The levels of serum IgG, TBX21, and miR-335 on admission were positively correlated with BUN, Scr, and SLEDAI scores and negatively correlated with complement C3 and C4 levels (all P < 0.05). The area under the curve (AUC) of the combination of serum IgG, TBX21, and miR-335 levels in the diagnosis of LN was greater than that of single detection ( P < 0.05). Conclusions:Serum IgG, TBX21, and miR-335 are closely related to disease activity and can be used as reference indicators for the diagnosis and prediction of LN in clinical practice, enabling the development of early targeted treatment plans.

Prognostic Model Based on Preoperative FAR and SII Versus TNM Staging System in Evaluating Prognosis of Patients with Pancreatic Cancer After Radical Resection / 肿瘤防治研究

Objective To investigate the predictive value of preoperative fibrinogen/albumin ratio (FAR) and systemic immune inflammation index (SII) on the postoperative prognosis of patients with pancreatic ductal adenocarcinoma. Methods An ROC curve was used in determining the best cutoff values of FAR and SII and then grouped. The Cox proportional hazards model was used in analyzing the prognostic factors of radical pancreatic cancer surgery, and then a Nomogram prognostic model was established. C-index, AUC, and calibration curve were used in evaluating the discrimination and calibration ability of the Nomogram. DCA curves were used in assessing the clinical validity of the Nomograms. Results The optimal cutoff values for preoperative FAR and SII were 0.095 and 532.945, respectively. FAR≥ 0.095, SII≥ 532.945, CA199≥ 450.9 U/ml, maximum tumor diameter≥ 4 cm, and the absence of postoperative chemotherapy were independent risk factors for the poor prognosis of pancreatic cancer (P<0.05). The discrimination ability, calibration ability, and clinical effectiveness of Nomogram prognostic model were better than those of the TNM staging system. Conclusion The constructed Nomogram prognostic model has higher accuracy and level of discrimination and more clinical benefits than the TNM staging prognostic model.

Analysis of Irregular Blood Group Antibody Distribution and Blood Transfusion Efficacy in Patients with Malignant Tumor / 中国实验血液学杂志

OBJECTIVE@#To investigate the distribution of irregular blood group antibodies in patients with malignant tumors, and to analyze the relationship between it and efficacy of blood transfusion in patients.@*METHODS@#5 600 patients with malignant tumors treated in Shanxi Bethune Hospital from January 2019 to December 2021 were selected as the research subjects. All patients received blood transfusion, and cross matching test was conducted before blood transfusion, irregular antibody results of patients were tested; the irregular distribution of blood group antibodies was observed, and the relationship between it and efficacy of blood transfusion in patients was analyzed.@*RESULTS@#Among 5 600 patients with malignant tumors, 96 cases were positive for irregular antibody, and the positive rate was 1.71%; the main blood group systems involved in the irregular antibody positive of 96 patients with malignant tumors were RH, MNSs and Duffy system, among which Rh blood group was the most common, and the proportion of anti-E was the highest; among the malignant tumor patients with positive blood group irregular antibody, the proportion of female was higher than that of male; the proportion of patients aged >60 years was the highest, followed by patients aged >40 and ≤50 years, and the proportion of patients aged 18-30 years was the lowest; the patients with positive blood group irregular antibody were mainly in blood system (including lymphoma), digestive system, reproductive and urinary system; the positive rate of irregular antibody of patients in the ineffective group was higher than that of patients in the effective group, the difference was statistically significant (P<0.05). Logistic regression analysis results showed that, irregular antibody positive was a risk factor for ineffective blood transfusion in patients with malignant tumor (OR>1, P<0.05).@*CONCLUSION@#The irregular blood group antibody positive of patients with malignant tumor are mostly female, and the proportion of patients aged >60 is the highest, which is mainly distributed in malignant tumors of blood system, digestive system and urogenital system, and the positive blood group irregular antibody is related to the efficacy of blood transfusion in patients.

Related factors of negative conversion time of nucleic acid in children with COVID-19 / 中华儿科杂志

Objective: To explore the related factors of negative conversion time (NCT) of nucleic acid in children with COVID-19. Methods: A retrospective cohort study was conducted. A total of 225 children who were diagnosed with COVID-19 and admitted to Changxing Branch of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from April 3rd to May 31st 2022 were enrolled in the study. The infection age, gender, viral load, basic disease, clinical symptoms and information of accompanying caregivers were retrospectively analyzed. According to age, the children were divided into<3 years of age group and 3-<18 years of age group. According to the viral nucleic acid test results, the children were divided into positive accompanying caregiver group and negative accompanying caregiver group. Comparisons between groups were performed using Mann-Whitney U test or Chi-square test. Multivariate Logistic regression analysis was used to analyze the related factors of NCT of nucleic acid in children with COVID-19. Results: Among the 225 patients (120 boys and 105 girls) of age 2.8 (1.3, 6.2) years, 119 children <3 years and 106 children 3-<18 years of age, 19 cases were diagnosed with moderate COVID-19, and the other 206 cases were diagnosed with mild COVID-19. There were 141 patients in the positive accompanying caregiver group and 84 patients in the negative accompanying caregiver group.Patients 3-<18 years of age had a shorter NCT (5 (3, 7) vs.7 (4, 9) d, Z=-4.17, P<0.001) compared with patients <3 years of age. Patients in the negative accompanying caregiver group had a shorter NCT (5 (3, 7) vs.6 (4, 9) d,Z=-2.89,P=0.004) compared with patients in the positive accompanying caregiver group. Multivariate Logistic regression analysis showed that anorexia was associated with NCT of nucleic acid (OR=3.74,95%CI 1.69-8.31, P=0.001). Conclusion: Accompanying caregiver with positive nucleic acid test may prolong NCT of nucleic acid, and decreased appetite may be associated with prolonged NCT of nucleic acid in children with COVID-19.

"Houxi (SI 3) communicating the governor vessel" verified with the infrared thermal imaging technology / 中国针灸

OBJECTIVE@#To compare the effect on facial acupoint temperature between acupuncture at Houxi (SI 3) and Dazhui (GV 14) so as to verify "Houxi (SI 3) communicating the governor vessel" based on the infrared thermal imaging technology.@*METHODS@#Thirty-five healthy subjects (5 cases dropped off) were collected and before-after study in the same subject was adopted. The subjects were successively assigned into a sham-acupuncture group, a Houxi group, a Wangu group and a Dazhui group. Sham-acupuncture at Houxi (SI 3) on the left, acupuncture at Houxi (SI 3) on the left, Wangu (SI 4) on the left and Dazhui (GV 14) were given respectively. One intervention was given and the needles were retained for 30 min in each group. 30 min before and after acupuncture, the infrared thermal images of the face were collected, and the facial temperature was compared among the following 5 acupoints, i.e. Yintang (GV 24+), Suliao (GV 25), Shuigou (GV 26), Duiduan (GV 27) and Chengjiang (CV 24).@*RESULTS@#After acupuncture, the facial temperature at Yintang (GV 24+) and Chengjiang (CV 24) was increased compared before acupuncture in the sham-acupuncture group (P<0.01, P<0.05). The facial temperature at Suliao (GV 25) in the Houxi group was reduced after acupuncture (P<0.05). In the Wangu group, the temperature at Yintang (GV 24+) was increased compared before acupuncture (P<0.01). The facial temperature was increased at Duiduan (GV 27) and Chengjiang (CV 24) compared before acupuncture in the Dazhui group (P<0.01, P<0.05). The differences of facial temperature at Chengjiang (CV 24) and Suliao (GV 25) after acupuncture were larger than before acupuncture in the Houxi group and the Dazhui group (P<0.01). In comparison with the temperature at Suliao (GV 25) of the same group, the differences of facial temperature before and after acupuncture at Yintang (GV 24+), Shuigou (GV 26), Duiduan (GV 27) and Chengjiang (CV 24) were increased in the Houxi group (P<0.01, P<0.05); while, the increase was also obtained at Yintang (GV 24+), Shuigou (GV 26), Duiduan (GV 27) and Chengjiang (CV 24) in the Dazhui group (P<0.05, P<0.01). The difference of facial temperature at Yintang (GV 24+) before and after acupuncture was increased compared with Suliao (GV 25) in the Wangu group (P<0.05).@*CONCLUSION@#Acupuncture at Houxi (SI 3) generates a similar thermal effect as Dazhui (GV 14). It regulates and dissipates the core temperature to "govern the yang qi of the whole body".

Effect of adjacent segmental facet joint degeneration on adjacent segment disease after lumbar fusion and fixation / 中国骨伤

OBJECTIVE@#To explore the effect of facet joint degeneration in adjacent segments on the incidence of adjacent segment disease (ASD) after lumbar fusion and fixation.@*METHODS@#A retrospective analysis was performed on 138 patients who underwent L5S1 posterior lumbar interbody fusion (PLIF) from June 2016 to June 2019. Patients were divided into a degeneration group (68 cases) and a non-degenerative group (70 cases) based on the presence or absence of L4,5 facet joint degeneration before surgery (graded using the Weishaupt standard). Age, gender, body mass index (BMI), follow-up time, and preoperative L4,5 intervertebral disc degeneration (graded using the Pfirrmann standard) were collected for both groups. Clinical outcomes were evaluated using the visual analogue scale (VAS) and Oswestry disability index (ODI) at 1 and 3 months after surgery. The incidence and time of ASD after surgery were analyzed.@*RESULTS@#There were no significant differences between the two groups in age, gender, BMI, follow-up time, or preoperative L4,5 intervertebral disc degeneration. Both groups showed significant improvement in VAS and ODI at 1 and 3 months after surgery (P<0.001), with no significant difference between the groups(P>0.05). However, there was a statistically significant difference in the incidence and timing of ASD between the groups (P<0.05). The degeneration group had 2 cases of ASD in gradeⅠdegeneration, 4 cases of ASD in gradeⅡdegeneration, and 7 cases of ASD in grade Ⅲ degeneration. There was a statistically significant difference between the number of patients with grade Ⅲ degeneration and those with gradesⅠandⅡASD (P<0.0167, Bonferroni correction).@*CONCLUSION@#Preoperative degeneration of adjacent articular processes will increase the risk of ASD after lumbar fusion fixation, whereas gradeⅢ degeneration will further increase the risk.

Successfully treated recalcitrant atopic eczema with acupoint autohemotherapy: A case report and hypothesized mechanism of the therapy / 中西医结合学报

Acupoint autohemotherapy at bilateral Zusanli (ST36) and Xuehai (SP10) was used to treat a 26-year-old female patient who had suffered from recalcitrant atopic eczema (AE) for five years. The treatment was applied at a frequency of once per week for the first month, followed by a three-month period of once every other week. At the end of treatment, the patient's AE symptoms were entirely resolved, and by the end of a six-month follow-up her immunoglobulin E level had returned to the normal range. Further, there was no relapse of AE symptoms during the six-month follow-up. Therefore, we hypothesized that after the repeated treatments the local inflammatory reaction induced by autologous blood injection triggered a local immune response, followed by a systemic immune response after the repeated treatment, finally leading to the anti-inflammation and immunomodulation effects. This case suggests that acupoint autohemotherapy could be used as an effective complementary treatment for recalcitrant AE, especially in cases where other treatments have failed. Further comparative studies are needed to corroborate the value and mechanisms of this therapy.

Application of the in-basket test in head nurse competence evaluation / 中华医院管理杂志

Objective:To evaluate the competence of head nurses by using the in-basket test for establishing a hierarchical training system for these nurses.Methods:A set of in-basket test was independently designed to evaluate the head nurses of a tertiary hospital in September 2021.Fourteen competency indicators, including positive initiative, coordination and communication ability, and leadership, problem solving ability, motivation, empowerment, attention to quality and order, etc, were selected to analyze the answers of the in-basket test and score their competency level. The measures were described by Mean±SD and M(IQR), and the counts were described by rates and percentages. The rank sum test and multiple linear regression were used to analyze the influencing factors of competency scoring of head nurses. Results:A total of 133 head nurses were tested, with a total competency scoring of 30.0(5.5). The highest indicators were talent cultivation 3.0(2.0), positive initiative 3.0(1.0), coordination and communication ability 3.0(1.0), while those with lower scores were empowerment 1.0(1.0) and motivation 1.5(1.5). The rank sum test analysis showed that age, position, job position character and working seniority were the influencing factors of competency score( P<0.05). The multiple linear regression analysis showed that, working seniorities of 16-20 years( β=0.583, P=0.013), 21-25 years( β=0.732, P=0.008), 26-30 years( β=0.632, P=0.026) were the influencing factors of competency score of head nurses. Conclusions:The in-basket test is practical to evaluate the competence of head nurses as a basis for their targeted training in the future.

Modulation of transcutaneous auricular vagus nerve stimulation on default mode network in patients with primary insomnia / 中国针灸

OBJECTIVE@#To explore the modulation of transcutaneous auricular vagus nerve stimulation (taVNS) on default mode network (DMN) in patients with primary insomnia (PI).@*METHODS@#A total of 22 PI patients (one patient dropped off and two patients were excluded) were included and treated with taVNS. The bilateral auricular points of Xin (CO15) and Shen (CO10) were selected and treated with disperse-dense wave at frequency of 4 Hz/20 Hz, the intensity was based on the patient's tolerance. taVNS was given once in the morning and once in the evening for 30 minutes each time. The treatment lasted for at least 5 days a week for 4 weeks. At the same time, 16 healthy subjects matched with gender and age were recruited. The Pittsburgh sleep quality index (PSQI) score was evaluated before and after treatment in PI patients. The resting-state functional magnetic resonance imaging (rs-fMRI) data of PI patients before and after treatment and healthy subjects at baseline period were collected to observe the effect of taVNS on the functional connection (FC) between posterior cingulate cortex (PCC) and whole brain.@*RESULTS@#After treatment, the total score of PSQI in PI patients was lower than that before treatment (P<0.01). Compared with healthy subjects, the FC of the left PCC was increased either with the left orbital superior frontal gyrus or with left middle frontal gyrus (P<0.001), and the FC between right PCC and left middle frontal gyrus was increased in PI patients before treatment (P<0.001). Compared before treatment, the FC between left PCC and left middle frontal gyrus was decreased (P<0.05), and the FC of the right PCC was decreased either with the right medial prefrontal cortex or with the left middle frontal gyrus in PI patients after treatment (P<0.001, P<0.01).@*CONCLUSION@#taVNS can modulate the FC between anterior and posterior DMN, and between DMN and cognitive control network of PI patients, which may be one of the brain effect mechanisms of taVNS in the treatment of PI patients.

SOX12 Promotes Thyroid Cancer Cell Proliferation and Invasion by Regulating the Expression of POU2F1 and POU3F1

Purpose@#SOX12 is overexpressed in many cancers, and we aimed to explore the biological function and mechanism of SOX12 in thyroid cancer. @*Materials and Methods@#We first analyzed the expression of SOX12 in thyroid cancer using data in The Cancer Genome Atlas. Immunohistochemistry and qRT-PCR were performed to identify SOX12 expression in thyroid cancer tissue and cells. Thyroid cancer cells were transfected with small interfering RNA targeting SOX12, and cellular functional experiments, including CCK8, wound healing, and Transwell assays, were performed. Protein expression was examined by Western blot analysis. A xenograft model was developed to evaluate the effect of SOX12 on tumor growth in vivo. @*Results@#SOX12 expression was increased in thyroid cancer tissue and cells. SOX12 promoted cell proliferation, migration, and invasion and accelerated tumor growth in vivo. The expression of PCNA, Cyclin D1, E-cadherin, Snail, MMP-2, and MMP-9 was affected by SOX12 knockdown. Bioinformatic analysis showed that SOX12 could interact with the POU family. SOX12 knockdown inhibited the expression of POU2F1, POU2F2, POU3F1 and POU3F2, and SOX12 expression showed a positive correlation with POU2F1, POU3F1, and POU3F2 expression in clinical data. POU2F1 and POU3F1 were able to reverse the effect of SOX12 knockdown on thyroid cancer cells. @*Conclusion@#SOX12 affects the progression of thyroid cancer by regulating epithelial-mesenchymal transition and interacting with POU2F1 and POU3F1, which may be novel targets for thyroid cancer molecular therapy.

Autoimmune encephalitis initially diagnosed as mental disorders: a clinical analysis of 5 cases / 中华全科医师杂志

The clinical data of 5 patients with autoimmune encephalitis admitted to the psychiatric department of the 904th Hospital of the Joint Logistics Service Force from January 2016 to June 2020 were retrospectively analyzed. Among 5 patients, 4 had stress psychological events within one month before the onset, and 3 had precursor symptoms such as fever and vomiting. They were all characterized by rapid progress of atypical mental and behavioral abnormalities and cognitive impairment. In terms of neurological symptoms, 1 case had faciobrachial dystonic seizures (FBDS), 3 cases had seizures, 2 cases had involuntary movement, and 4 cases had autonomic dysfunction, including central hypopnea, arrhythmia, blood pressure instability and paroxysmal facial flushing. Most neurological symptoms occur within 1 month of the onset. MRI revealed abnormalities in cerebral cortex, thalamus, temporal lobe and insular lobe in 4 cases; EEG demonstrated bilateral short-range medium amplitude θ wave in 2 cases. Abnormal cerebrospinal fluid (CSF) pressure was detected in 4 cases and 2 cases had abnormal cell number CSF. Three patients had positive anti-N-methyl-D-aspartate receptor (NMDAR) antibody, one patient had positive anti-LGI1 antibody, and one patient had positive anti-γ-aminobutyric acid B receptor (GABA BR) antibody. One case was discharged automatically, the remaining 4 patients were treated with glucocorticoid or combined with gamma globulin and cyclophosphamide, antiepileptic drugs, antipsychotic drugs and other symptomatic treatment, and their symptoms were relieved. Patients were followed up for six months, there was slightly slow residual reaction in 2 cases and personality change in 1 case. Autoimmune encephalitis characterized by mental symptoms is likely to be misdiagnosed as mental disorders. Clinicians should identify symptoms different from mental disorders, taking into account of the possibility of autoimmune encephalitis, to make early diagnosis and treatment.

Application of color Doppler ultrasound in nursing observation of flap vascular circulation after free flap transplantation / 中国实用护理杂志

Objective:To summarize the clinical application value of color Doppler ultrasound (CDU) in the nursing observation of flap vascular circulation after free flap transplantation.Methods:From September 2018 to November 2020, 18 patients with skin defect of limbs treated by free flap transplantation in the Second Affiliated Hospital of Wenzhou Medical University were monitored by skin color, skin temperature, skin tension, capillary reaction time and CDU. When the vascular circulation disorder was found, the patients should be treated with volume expansion, rehydration, local massage of the flap, anticoagulation and microcirculation improvement. Positive drainage under the flap to prevent infection, combined with hyperbaric oxygen treatment, accurate and timely exploration of vascular crisis to avoid flap necrosis.Results:Postoperatively, CDU monitoring found that 2 cases had regional vascular circulation disorder, 1 case had complete embolization of the main vessels and perforators in the flap, the flap was thinned and changed to full thickness skin grafting, the deep tissue exposed area was healed by dressing change, and 1 case had incomplete embolization of the flap′s reflowing vein. After operation, the venous crisis was relieved and the flap survived completely.Conclusions:Comprehensive observation is needed after free flap transplantation. Combined with four routine vascular circulation indexes, CDU monitoring of flap blood flow can provide more objective, accurate and detailed basis for vascular circulation status, and can accurately find the vascular circulation disorder after free flap transplantation in early stage, and understand the vascular flow status of the flap, so as to effectively avoid the continuous progress of vascular crisis, to avoid flap necrosis and improve the survival rate of flap.

Clinical and genetic characteristics of 2 cases with infantile GM1 gangliosidosis / 中华实用儿科临床杂志

Objective:To analyze clinical and genetic characteristics of 2 cases with infantile GM1 gang-liosidosis.Methods:Clinical data of 2 cases with infantile GM1 gangliosidosis in the Department of Rehabilitation, Tianjin Children′s Hospital from May 2019 to June 2019 were retrospectively analyzed.Results:The major manifestations of 2 cases included infantile onset, psychomotor retardation and retrogression, blundering face, sensitive to sound, gingival hyperplasia, abnormal eruption of teeth, hypotonia or dystonia, bone dysplasia, and skin abnormalities.Case 1 had hepatosplenomegaly, corneal opacity and multiple joint contractures.Case 2 had fundus cherry erythema and epileptic seizure.Biochemical results showed that alkaline phosphatase and aspartate transaminase significantly increased, and alanine transaminase was normal.Cranial nuclear magnetic imaging showed poor myelin sheath in the white matter in both cases, and case 1 also had symmetric signal changes in the thalamus.Whole exon sequencing showed that case 1 had deletion mutation of 3p22.3 (33137821-33138587)×1 in the exon of GLB1 gene, which has not been previously reported. Conclusions:The clinical spectrum of infantile GM1 gangliosidosis is broad.Both cases in this study have skin abnormalities, which are relatively rare.Multiple joint contractures in case 1 have not been previously reported, and considered as a new phenotype.The deletion mutation of 3p22.3 (33137821-33138587)×1 in the exon of GLB1 gene in case 1 is a newly detected mutation, which expands the genetic profile of infantile GM1 gangliosidosis.

Analysis of the diversity and structural changes of intestinal flora in patients with sepsis / 中华急诊医学杂志

Objective:To explore the diversity and structural changes of intestinal flora in patients with sepsis.Methods:A total of 55 patients were enrolled who visited the Emergency Department of several Grade III-A hospitals from November 2015 to March 2016. Among them, 25 patients with sepsis metthe diagnostic criteria of Sepsis 3.0 and 30 patients had no sepsis. The intestinal flora from all fecal samples was sequenced by 16S rRNA sequencing technology. The diversity and structure changes of the flora were analyzed using Uparse, Qiime, R and LEfSe software.Results:There was no significant difference in sex, age, chronic underlying diseases, and the diversity of intestinal flora between the sepsis and non-sepsis groups (all P>0.05). The structure of intestinal flora was significant different between the two groups ( P<0.05). Abundances of Negativicutes, Selenomonadales, Veillonellaceae, Lachnospiraceae, Faecalibacterium, Hafnia, Lachnoclostridium, Blautia and Ruminococcus in intestinal flora from patients with sepsis were significantly reduced, but those of Bacilli, Coriobacteriia, Lactobacillales, Coriobacteriales, Clostridiaceae, Coriobacteriaceae, Clostridium_sensu_stricto, Collinsella and Collinsella_aerofaciens were significantly increased. Conclusions:There is no change in the diversity of intestinal flora between the sepsis and non-sepsis groups. There are structural changes of intestinal flora in patients with sepsis.

Proteinuria associated with hookworm infection: a case report / 中国血吸虫病防治杂志

As a common soil-borne nematode, hookworm is mainly parasitized in the intestine, and the clinical manifestations of hookworm infections mainly include gastrointestinal symptoms and iron-deficiency anemia. In addition, hookworm may be also parasitized in other organs in addition to gastrointestinal system, resulting in development of disorders in other systems. Proteinuria caused by hookworm infections is rare and easy to be misdiagnosed in clinical practices. Hereby, the diagnosis and treatment of a case of proteinuria associated with hookworm infections was reported, in order to increase the understanding of hookworm infection-associated proteinuria among clinicians.

Differences of Energy Spectrum CT Findings between Small Cell Lung Cancer with Mediastinal Lymph Node Metastasis and Mediastinal Sarcoidosis / 中国医学科学院学报

Objective To compare the differences of energy spectrum CT between small cell lung cancer(SCLC)with mediastinal lymph node metastasis and mediastinal sarcoidosis.Methods Twenty-five SCLC patients with mediastinal lymph node metastasis(SCLC group)and 26 patients with mediastinal sarcoidosis(sarcoidosis group)confirmed by bronchoscopy and biopsy in Tangshan People's Hospital from January 2018 to June 2019 were selected as the research objects.The CT value,iodine concentration,water concentration and energy spectrum curve slope under different single energy levels were compared between SCLC group and sarcoidosis group.Results The single-energy CT values of 40-80 keV segments in the arterial phase of the SCLC group were significantly higher than those in the sarcoidosis group(all P 0.05).The single-energy CT values of 40-90 keV segments in venous phase of the SCLC group were significantly higher than those of the sarcoidosis group(all P 0.05).The concentrations of iodine in the arterial phase and venous phase of the SCLC group were(11.56±4.06)μg/cm

The clinical diagnosis and treatment strategy of lumbar brucellar spondylitis / 中华骨科杂志

Lumbar brucellar spondylitis is an infectious disease caused by the invasion of brucella. The incidence has been on the rise in recent years. And it threatens people's health seriously. Early and proper diagnosis and treatment is the key to cure patients with lumbar brucella spondylitis. However, in the early stage of the disease, there are only nonspecific symptoms such as back pain, fever, and sweating. If the patient has the above symptoms and epidemiological history of direct or indirect livestock contact, and inflammatory signals of the vertebrae or intervertebral space are visible on MRI, the possibility of early infection of lumbar brucella spondylitis should be considered. It is not difficult to make the diagnosis of lumbar brucella spondylitis in the middle and late stages by taking into account the epidemiology, symptoms, signs, laboratory tests, and the imaging features such as narrowing of the intervertebral space, abnormal signals of the vertebral body and disc, bone destruction and sclerosis, "lace-like" appearance, sequestrum formation and limited paraspinal abscess. Patients in these stages often present with serious manifestations such as lumbar instability due to bone destruction, and the focus is on surgical intervention. The basic principle of surgical treatment is lesion removal combined with fixation. Intraoperative reduction of damage to bone and ligamentous structures such as the posterior ligamentous complex and strong fixation will contribute to the complete cure of the disease. By referring to the literature on lumbar brucellar spondylitis, this paper focuses on the etiology, pathogenesis, clinical manifestations, imaging features, laboratory tests and conservative and surgical treatment of the disease, aiming to provide a basis for clinical diagnosis and treatment.