Recognition of abnormal changes in echocardiographic videos by an artificial intelligence assisted diagnosis model based on 3D CNN / 中华心血管病杂志

Objective: To investigate the diagnostic efficiency and clinical application value of an artificial intelligence-assisted diagnosis model based on a three-dimensional convolutional neural network (3D CNN) on echocardiographic videos of patients with hypertensive heart disease, chronic renal failure (CRF) and hypothyroidism with cardiac involvement. Methods: This study is a retrospective study. The patients with hypertensive heart disease, CRF and hypothyroidism with cardiac involvement, who admitted in Henan Provincial People's Hospital from April 2019 to October 2021, were enrolled. Patients were divided into hypertension group, CRF group, and hypothyroidism group. Additionally, a simple random sampling method was used to select control healthy individuals, who underwent physical examination at the same period. The echocardiographic video data of enrolled participants were analyzed. The video data in each group was divided into a training set and an independent testing set in a ratio of 5 to 1. The temporal and spatial characteristics of videos were extracted using an inflated 3D convolutional network (I3D). The artificial intelligence assisted diagnosis model was trained and tested. There was no case overlapped between the training and validation sets. A model was established according to cases or videos based on video data from 3 different views (single apical four chamber (A4C) view, single parasternal left ventricular long-axis (PLAX) view and all views). The statistical analysis of diagnostic performance was completed to calculate sensitivity, specificity and area under the ROC curve (AUC). The time required for the artificial intelligence and ultrasound physicians to process cases was compared. Results: A total of 730 subjects aged (41.9±12.7) years were enrolled, including 362 males (49.6%), and 17 703 videos were collected. There were 212 cases in the hypertensive group, 210 cases in the CRF group, 105 cases in the hypothyroidism group, and 203 cases in the normal control group. The diagnostic performance of the model predicted by cases based on single PLAX view and all views data was excellent: (1) in the hypertensive group, the sensitivity, specificity and AUC of models based on all views data were 97%, 89% and 0.93, respectively, while those of models based on a single PLAX view were 94%, 95%, and 0.94, respectively; (2) in the CRF group, the sensitivity, specificity and AUC of models based on all views data were 97%, 95% and 0.96, respectively, while those of models based on a single PLAX view were 97%, 89%, and 0.93, respectively; (3) in the hypothyroidism group, the sensitivity, specificity and AUC of models based on all views data were 64%, 100% and 0.82, respectively, while those of models based on a single PLAX view were 82%, 89%, and 0.86, respectively. The time required for the 3D CNN model to measure and analyze the echocardiographic videos of each subject was significantly shorter than that for the ultrasound physicians ((23.96±6.65)s vs. (958.25±266.17)s, P<0.001). Conclusions: The artificial intelligence assisted diagnosis model based on 3D CNN can extract the dynamic temporal and spatial characteristics of echocardiographic videos jointly, and quickly and efficiently identify hypertensive heart disease and cardiac changes caused by CRF and hypothyroidism.

Clinical efficacy of combined therapy in children with stage 4 neuroblastoma / 中国当代儿科杂志

OBJECTIVES@#To study the early clinical efficacy of combined therapy of stage 4 neuroblastoma.@*METHODS@#A retrospective analysis was performed on the medical data and follow-up data of 14 children with stage 4 neuroblastoma who were diagnosed in Hong Kong University-Shenzhen Hospital from January 2016 to June 2021.@*RESULTS@#The median age of onset was 3 years and 7.5 months in these 14 children. Among these children, 9 had positive results of bone marrow biopsy, 4 had N-Myc gene amplification, 13 had an increase in neuron-specific enolase, and 7 had an increase in vanilmandelic acid in urine. Based on the results of pathological examination, differentiated type was observed in 6 children, undifferentiated type in one child, mixed type, in one child and poorly differentiated type in 6 children. Of all the children, 10 received chemotherapy with the N7 regimen (including 2 children receiving arsenic trioxide in addition) and 4 received chemotherapy with the Rapid COJEC regimen. Thirteen children underwent surgery, 14 received hematopoietic stem cell transplantation, and 10 received radiotherapy. A total of 8 children received Ch14.18/CHO immunotherapy, among whom 1 child discontinued due to anaphylactic shock during immunotherapy, and the other 7 children completed Ch14.18/CHO treatment without serious adverse events, among whom 1 child was treated with Lu177 Dotatate 3 times after recurrence and is still undergoing chemotherapy at present. The median follow-up time was 45 months for all the 14 children. Four children experienced recurrence within 2 years, and the 2-year overall survival rate was 100%; 4 children experienced recurrence within 3 years, and 7 achieved disease-free survival within 3 years.@*CONCLUSIONS@#Multidisciplinary combined therapy is recommended for children with stage 4 neuroblastoma and can help them achieve better survival and prognosis.

Arthroscopic repair of partial articular supraspinatus tendon avulsion lesions by conversion to full-thickness tears through a small incision / 中华创伤杂志(英文版)

PURPOSE@#To assess the clinical efficacy of converting partial articular supraspinatus tendon avulsion (PASTA) lesions to full-thickness tears through a small local incision of the bursal-side supraspinatus tendon followed by repair.@*METHODS@#We retrospectively analyzed 41 patients with Ellman grade 3 PASTA lesions and an average age of (54.7 ± 11.4) years from March 2013 to July 2017. Patients without regular conservative treatment and concomitant with other shoulder pathologies or previous shoulder surgery were excluded from the study. The tears were confirmed via arthroscopy, and a polydioxanone suture was placed to indicate the position of each tear. A small incision of approximately 6 mm was made using a plasma scalpel on the bursal-side supraspinatus tendon around the positioned suture to convert the partial tear into a full-thickness tear. The torn rotator cuff was sutured through the full thickness using a suture passer after inserting a 4.5-mm double-loaded suture anchor. Data were analyzed using a paired Student's t-test with statistical significance defined as p <0.05.@*RESULTS@#At the final follow-up of 2 years, the pain-free shoulder joint range of motion and visual analog scale score were significantly improved compared to those before surgery (p < 0.001). The postoperative American Shoulder and Elbow Surgeons shoulder score was (90.6 ± 6.2), which was significantly higher than the preoperative score of (47.9 ± 8.3) (p < 0.001). The University of California at Los Angeles shoulder rating scale score increased from (14.7 ± 4.1) prior to surgery to (32.6 ± 3.4) points after surgery (p < 0.001). No patient had joint stiffness.@*CONCLUSION@#This modified tear completion repair, by conversion to full-thickness tears through a small incision, has less damage to the supraspinatus tendon on the side of the bursa compared to traditional tear completion repair in the treatment of PASTA lesions. This surgical method is a simple and effective treatment that can effectively alleviate pain and improve shoulder joint function.

Analysis of the efficacy and compliance of conventional immunotherapy and rush immunotherapy in patients with allergic rhinitis / 临床耳鼻咽喉头颈外科杂志

To analyze the efficacy and compliance of conventional immunotherapy(CIT)and rush immunotherapy(RIT)in patients with allergic rhinitis.This trial was a prospective study involved 404 patients with persistent AR who were allergic to house dust mite.328 patients were assigned to the conventional immunotherapy reaching the maintenance dose within 14 weeks,and 76 patients were assigned to the rush immunotherapy reaching the maintenance dose within 1 week.The visual analog scale(VAS)score and the patients' compliance were recorded during treatment and follow-up.After CIT and RIT,the VAS score were significantly reduced in each group,but the decrement of VAS score of RIT group was more evident than that of CIT in half ayear(<0.05).After 5 years follow-up,the VAS score of two groups was also significantly reduced.The rate of treatment continuation of CIT group in 1 year,2 years and 3 years were 18.5%,39.0% and 57.3%,higher than RIT group(11.8%,26.3%,42.1%),respectively.Both CIT and RIT were beneficial for allergic rhinitis patients,and the clinical efficacy lasts for at least 5 years.But RIT has the superiority of faster onset and better compliance.

Identification of Mutations in Myocilin and Beta-1,4-galactosyltransferase 3 Genes in a Chinese Family with Primary Open-angle Glaucoma / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Glaucoma is a major cause of irreversible blindness worldwide. There is evidence showing that a subset of the disease is genetically determined. In this study, we screened for mutations in chromosome 1q-linked open-angle glaucoma (GLC1A) in a Chinese family with primary open-angle glaucoma (POAG).</p><p><b>METHODS</b>A total of 23 members from five generations of a family were enrolled and underwent thorough ophthalmologic examinations. In addition, 200 unrelated healthy Chinese controls were also recruited as normal control. GLC1A gene was amplified by polymerase chain reaction, and DNA sequencing was performed to screen for mutations.</p><p><b>RESULTS</b>Six members were diagnosed as POAG, with severe clinical manifestations, and history of high intraocular pressures. The mean age of disease onset was 26.3 years. However, the others were asymptomatic. In six affected and three asymptomatic members, gene sequencing revealed a mutation c.C1456T in exon 3 of myocilin gene (MYOC). Furthermore, we also identified a novel mutation c.G322A in beta-1,4-galactosyltransferase 3 (B4GALT3) gene in all six affected and three asymptomatic members, which was not reported previously in POAG patients. The two newly identified variants were absent in other family members as well as controls.</p><p><b>CONCLUSION</b>The mutations c.1456C < T (p.L486F) in MYOC and c.322G < A (p.V108I) in B4GALT3 are likely responsible for the pathogenesis of POAG in this family.</p>

Indoor Allergen Levels and Household Distributions in Nine Cities Across China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>Chinese allergic subjects have high levels of sensitization to house dust mite (HDM) and other indoor allergens. This study quantifies common indoor allergen levels in Chinese households.</p><p><b>METHODS</b>Dust samples were collected from nine cities. Major allergens Der p 1 and Der f 1 from Dermatophagoides pteronyssinus and D. farinae, and specific antigens of Blomia tropicalis, Tyrophagus putrescentiae, Acarus siro, and cockroach species Blattella germanica and Periplaneta americana were measured by ELISA.</p><p><b>RESULTS</b>HDM allergens were found in dust samples from bedding in 95% of the Chinese households. The median levels varied from <0.006 to 9.2 µg/g of dust, depending on the city. The percentages of households having HDM allergen levels associated with the risk of developing allergy sensitization and asthma were 65% and 25%, respectively. Specific antigens of the storage mite and cockroach were only found in samples from the southern and tropical regions of China. Levels of mite allergens were generally higher in samples from bedding compared to samples from the living room, even for storage mites, whereas levels of cockroach antigens were higher in the living room samples.</p><p><b>CONCLUSION</b>HDM allergens are present in bedding dust samples from most Chinese households. Cities in southern and central China have relatively high levels of HDM major allergens compared to cities in northern and western China. Antigens of storage mites and cockroaches are not as common as HDM allergens.</p>

Microsatellite Development and Potential Application in Authentication, Conservation, and Genetic Improvement of Chinese Medicinal Plants / 中草药·英文版

Medicinal plants are popular and widely used as a major source of herbal drugs and pharmaceutical compounds. Ever-growing demands make medicinal plants faced to several problems including efficacy and safety to meet business requirements, conservation, and artificially assisted breeding. As a powerful molecular tool, microsatellites offer the great potentials for various purposes in plants. This review provides a scenario of microsatellites in medicinal plants including development from genomic or expressed sequence tag libraries, cross-species transferability, genotyping, and potential applications. We emphasized on the authentication of medicinal plants by microsatellite markers.

Effects of IL-17 on expression of GRO-α and IL-8 in fibroblasts from nasal polyps / 华中科技大学学报（医学）（英德文版）

Recent studies indicated that interleukin (IL)-17, growth-related oncogene (GRO)-α and IL-8 play an important role in the pathogenesis of nasal polyps. However, the effects of the increased amount of IL-17 and the production of GRO-α and IL-8 in human nasal polyp fibroblasts are not completely understood. This study aimed to determine the effects of the increased IL-17 on the changes of GRO-α and IL-8 expression in human nasal polyp fibroblasts and further investigate the mechanism of neutrophil infiltration in nasal polyps. Nasal polyp fibroblasts were isolated from six cases of human nasal polyps, and the cells were stimulated with five different concentrations of IL-17. Real-time fluorescence quantitative polymerase chain reaction (RT-PCR) was used to detect the mRNA expression of GRO-α and IL-8. The mRNA of GRO-α and IL-8 was expressed in unstimulated controls and remarkably increased by stimulation with IL-17. Moreover, the levels of GRO-α and IL-8 produced by fibroblasts were increased gradually with the increases in IL-17 concentrations. The present study showed that nasal fibroblasts can produce GRO-α and IL-8, and their production is remarkably enhanced by IL-17 stimulation, thereby clarifying the mechanism of the IL-17 mediated neutrophil infiltration in nasal polyps. These findings might provide a rationale for using IL-17 inhibitors as a treatment for nasal inflammatory diseases such as nasal polyps.

A study on relationship between variation of P gene region and genotyping of Lamivudine-resistant hepatitis B virus / 预防医学

Objective To analyze hepatitis B virus( HBV)genotype and the correlation between variation of P gene region and genotyping of Lamivudine-resistant HBV,in order to provide molecular virology basis for anti-virus individualized treatment to different HBV genotypes. Methods Serum markers and HBV DNA of 187 Lamivudine -resistant chronic HBV patients were detected by ELISA and fluorescent quantitative polymerase chain reaction. Moreover,DNA Star and viral genotyping tool were used. Results Of the 187 cases infected with HBV genotype B and C,51 cases were B gene (27. 27%),134 cases were C gene(71. 66%),and 2 cases were mixed infections(1. 07%). HBeAg levels were significantly different between genotype B and C(P<0. 05). P gene mutation results showed that genotype B dominated by YMDD mutation alone and genotype C dominated by YMDD and rtL180M mutation. Conclusion The main HBV genotype of this study is genotype C,and different genotypes may determine the variation patterns of P region which associated with resistance.

Effects of IL-17 on expression of GRO-α and IL-8 in fibroblasts from nasal polyps / 华中科技大学学报（医学）（英德文版）

Recent studies indicated that interleukin (IL)-17, growth-related oncogene (GRO)-α and IL-8 play an important role in the pathogenesis of nasal polyps. However, the effects of the increased amount of IL-17 and the production of GRO-α and IL-8 in human nasal polyp fibroblasts are not completely understood. This study aimed to determine the effects of the increased IL-17 on the changes of GRO-α and IL-8 expression in human nasal polyp fibroblasts and further investigate the mechanism of neutrophil infiltration in nasal polyps. Nasal polyp fibroblasts were isolated from six cases of human nasal polyps, and the cells were stimulated with five different concentrations of IL-17. Real-time fluorescence quantitative polymerase chain reaction (RT-PCR) was used to detect the mRNA expression of GRO-α and IL-8. The mRNA of GRO-α and IL-8 was expressed in unstimulated controls and remarkably increased by stimulation with IL-17. Moreover, the levels of GRO-α and IL-8 produced by fibroblasts were increased gradually with the increases in IL-17 concentrations. The present study showed that nasal fibroblasts can produce GRO-α and IL-8, and their production is remarkably enhanced by IL-17 stimulation, thereby clarifying the mechanism of the IL-17 mediated neutrophil infiltration in nasal polyps. These findings might provide a rationale for using IL-17 inhibitors as a treatment for nasal inflammatory diseases such as nasal polyps.

Comparison between pavlik harness and bryant traction for femoral shaft fractures in infants / 中国骨伤

<p><b>OBJECTIVE</b>To compare clinical effects between Pavlik harness and Bryant traction in treating femoral shaft fractures in infants,including the time of hospitalization, expense of treatment, complications,time of bone union.</p><p><b>METHODS</b>From May 2005 to August 2010,the clinical data of 42 infants with femoral shaft fractures were retrospectively analyzed. Among the patients, 23 cases were treated with Pavlik harness(Pavlik harness group),there were 14 males and 9 females,ranging in age from 1 to 12 months with an average of (5.5+/-2.4) months,including upper 1/3 segment of 16 cases and middle segment of 7 cases; transverse fracture of 18 cases and oblique fracture of 5 cases. The other 19 patients were treated with Bryant traction (Bryant traction group),there were 15 males and 4 females,ranging in age from 2 to 12 months with an average of (6.7+/-2.8) months,including upper 1/3 segment of 13 cases and middle segment of 6 cases;transverse fracture of 12 cases and oblique fracture of 7 cases. The time of hospitalization,expense of treatment,complications,time of bone union were analyzed in the patients.</p><p><b>RESULTS</b>All patients were followed up with an average of 25.3 months (ranging from 19 to 30) in Pavlik harness group and 23.7 months (ranging from 17 to 28) in Bryant traction group. Time of hospitalization, expense of treatment in Pavlik harness group were respectively (0.4+/-0.7) d, (2147.7+/-64.9) yuan; and in Bryant traction group were respectively(27.1+/-2.2) d, (2741.3+/-227.6) yuan;there was significant difference between two groups(P<0.05). No complication was found in Pavlik harness group and 8 cases complicated with skin hydroa in Bryant traction group, there was significant difference between two groups (P<0.05). Time of bone union,difference of both lower extremities in Pavlik harness group were respectively (4.1+/-0.3)weeks, (6.3+/-4.1) mm;and in Bryant traction group were respectively (3.9+/-0.3) weeks, (7.6 +/-4.3) mm; 20 cases got bone healing in Pavlik harness group and 18 cases got bone healing in Bryant traction group;there was no significant difference between two groups (P>0.05).</p><p><b>CONCLUSION</b>Compared with Bryant traction method,Pavlik harness method has obvious advantages in time of hospitalization, expense of treatment, complications in treating femoral shaft fractures in infants.</p>

Effect of neonatal immunization with different dosage allergen on the immunity of mice when grown up / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the effect of neonatal immunization with different dosage allergen on the immunity of mice when grown.</p><p><b>METHODS</b>Fifty neonatal BALB/c mice were divided into 4 groups randomly and subcutaneous injected with different dosage of ovalbumin (OVA) on day 1, 8 and 15 after born [NS group(10): injected with saline alone; NS + AL group (10): injected with saline and AL(OH)3; small dosage (SD) group (15): injected with 10 microg OVA and AL(OH)3; large dosage (LD) group (15): injected with 1000 microg OVA and AL(OH)3]. The mice were then challenged using caudal vein injection on 5 weeks old (NS group and NS + AL group were challenged with saline, SD group and LD group were challenged with 100 microg OVA). The blood was collected 1 week later to examine OVA specific IgE, IgG1 and IgG2a. Mononuclear cells were drawn from the spleen and cultured. Concentration of IL-4, IFN-r, IL-10 was examined in the cultural supernatant. Flow cytometry was used to test the expression of CD4+ IL-4+, CD4+ IFN-gamma+, CD4 IL-10 cells.</p><p><b>RESULTS</b>It was found that concentration of OVA specific IgE (OVA-sIgE) in SD group (0.33 +/- 0.18) was significantly higher than that of NS (0.07 +/- 0.01) and NS + AL (0.09 +/- 0.04) group (t value was -3.46 and -3.21, all P < 0.01), and LD group (0.17 +/- 0.10) as well (t = 2.58, P < 0.05). The concentration of OVA-sIgE was higher in LD group than that of NS group (t = -2.53, P < 0.05), but similar with that of NS + AL group (t = -2.04, P > 0.05). Both the concentration of OVA-sIgG1 and sIgG2a was higher in SD and LD group than that of NS and NS + AL group (all P < 0.05). The concentration of IL-4, IFN-gamma and IL-10 in the cultural supernatant of spleen mononuclear was all higher in SD group than that of NS and NS + AL group (all P < 0.01). The ratio of IFN-gamma/IL-4 was significantly lower in SD group than that of NS and NS + AL group (t value was 2.14, 3.44, all P < 0.05), while the same ratio was higher in LD group than that of NS and NS + AL group (t value was -2.14, -1.61, all P < 0.05). Ratio of CD4+ IL-4+ cells was significant lower in LD group than that of SD group (P < 0.05), while it was not different with that of NS and NS + AL group (P > 0. 05).</p><p><b>CONCLUSION</b>Neonatal immunization with low dosage OVA could generate a specific immunity with Th2 direction, while with large dosage OVA could generate a specific immunity with Th1 direction.</p>

Selection of optimal occlusal thickness and shoulder thickness in mandibular first molar all-ceramic crown: a three-dimensional finite element analysis / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the effect of different occlusal thickness and shoulder finish line depth on stress distribution of all-ceramic crowns and to select optimal occlusal thickness and shoulder finish line depth using continuous variation of parameters.</p><p><b>METHODS</b>This analysis was performed using mandibular first molar finite element model. The range of occlusal thickness was set from 1 mm to 3 mm, and that of shoulder finish line depth was from 0.4 mm to 1.2 mm. Load of 225 N was applied perpendicularly to the occlusal surface of the tooth at all buccal cusps to simulate functional occlusal force. The maximum equivalent stresses in crown, cement layer, abutment, periodontal ligament, alveolar bone were calculated, and the sensitivities of stresses to the variables were also evaluated.</p><p><b>RESULTS</b>The maximum equivalent stresses in crown, cement layer and abutment decreased as occlusal thickness and shoulder finish line depth were increased, while no obvious change were found in maximum equivalent stresses in periodontal ligament and alveolar bone. When occlusal thickness exceeded 1.87 mm and shoulder finish line depth exceeded 0.66 mm, the tangent slope rate of the maximum equivalent stress response curves ranged from -1 to 1. Data indicated that occlusal thickness played a more important role in reducing maximum equivalent stress in cement layer than finish line depth did, and shoulder finish line depth was a more effective parameter in reducing maximum equivalent stress in crown and abutment than occlusal thickness was.</p><p><b>CONCLUSIONS</b>Occlusal thickness exceeding 1.87 mm and shoulder finish line depth exceeding 0.66 mm are optimal design for ceramic crown on mandibular first molar from biomechanical point of view.</p>

Analysis of reliability of the strength of all-ceramic crown on mandibular first molar / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To analyze the reliability of all-ceramic crown on mandibular first molar under randomized biting force, and to explore the failure possibility of all-ceramic crown.</p><p><b>METHODS</b>Finite element (FE) models of all-ceramic crown on mandibular first molar were established using the Algor FE software. All-ceramic crown was loaded at different occlusal areas and positions with random variables of biting force, and the reliability of all-ceramic crown was analyzed.</p><p><b>RESULTS</b>The occlusal contact positions were located on the fossa, inclined surface and dental cusp. When the occlusal contact area was 0.4 mm(2), The reliability of all-ceramic crown on mandibular first molar were 100% (fossa), 99% (inclined surface), and 97% (cusp) respectively. When the occlusal contact area was 1.5 mm(2), the reliabilities of all-ceramic crown on mandibular first molar were 100% (fossa), 100% (inclined surface), and 99% (cusp) respectively. When the occlusal contact area was increased to 12.6 mm(2), the reliability of all-ceramic crown was 100%.</p><p><b>CONCLUSIONS</b>Premature occlusal contact and steep cusp inclination on all-ceramic crown on mandibular first molar will result in stress concentration and the crown will exhibit high failure probabilities. Chewing hard food is another contributing factor to the failure of all-ceramic crowns.</p>

Effect of early allergen immunization on the development of allergic rhinitis in mouse / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of early allergen exposure on later development of allergic rhinitis in mouse.</p><p><b>METHODS</b>Twenty-four BALB/c neonates were randomly divided into 4 groups (low-dose group, high-dose group, negative control group and positive control group), each group had 6 mice. The mice were administered ovalbumin (OVA) by subcutaneous injection on day 1, 5, 12 after birth (10 μg OVA in 0.05 ml saline for low-dose group, 1000 μg OVA in 0.05 ml saline for high-dose group, only saline for negative and positive control group). Then the mice were sensitized and intranasally challenged with OVA (saline without OVA was used in negative control group) after 6 weeks. Symptoms, histopathological changes of nasal mucosa were observed, OVA-IgE in serum was examined, cytokines IL-4, IL-5 and IFN-gamma were detected in the supernatant of cultured splenic mononuclear cells.</p><p><b>RESULTS</b>Compared to the positive control group, symptoms and nasal mucosa histological changes of high-dose group was indistinctive. The level of OVA-IgE and cytokines IL-4, IL-5 (x(-) +/- s) in high-dose group [(265.11 +/- 26.29), (446.39 +/- 72.83) and (171.24 +/- 15.66) pg/ml, respectively] were significantly lower than those in positive control group [(665.85 +/- 43.15), (1113.45 +/- 30.47), (255.36 +/- 30.96) pg/ml, respectively, t value were 0.000, 0.000 and 0.009, respectively, all P < 0.05]. The level of IFN-γ in high-dose group [(319.74 +/- 56.30) pg/ml] was significantly higher than those in positive control group [(170.02 +/- 14.50) pg/ml, t = 0.000, P < 0.05]. There was no significant difference of the results between the low-dose group and positive control group.</p><p><b>CONCLUSIONS</b>Neonatal immunization with high-dose OVA inhibited the future allergic rhinitis symptoms, nasal histological changes, serum OVA-IgE levels and Th1/Th2 cytokine imbalance, resulting in the protective effect.</p>

Manipulative reduction and splint fixation for the treatment of middle and lower segment fracture of ulnar and radius / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the outcome of manipulative reduction and splint fixation for treatment of middle and lower fractures of ulnar and radius.</p><p><b>METHODS</b>Sixty-eight patients with lower segment fractures of ulnar and radius included 46 male and 22 female, aged from 1 to 26 years. The course was from 10 min to 1 week. There were 39 cases in right and 29 in left; 45 in inferior segment and 23 in middle segment. All cases were closed fractures. According to fracture displacement, different methods of manipulation and splint or plaster splint fixation were used to reduction and fixation.</p><p><b>RESULTS</b>Sixty-eight patient were followed-up for 0.5 to 1 year (mean 8 months), the fractures were all healing. According to the effective evaluation criteria, the results were excellent in 57 cases, good in 11. X-ray film showed anatomic reduction in 38 cases, similar to anatomic reduction in 20, functional reduction in 10.</p><p><b>CONCLUSIONS</b>Manipulative reduction and splint fixation for the treatment of the ulnar and radial bone fractures is a method of simple, minimally invasive, effective and functional advantages of quick recovery.</p>

A multicenter study on treatment of autonomous nerve-mediated syncope in children with beta-receptor blocker / 中华儿科杂志

<p><b>OBJECTIVE</b>Syncope is a common pediatric emergency. Based on an epidemiologic survey in the USA, around 15% of children experienced syncopal attack, which strongly influenced the life, study and hurt the children mentally and physiologically. Therefore, exploring the therapeutic regimen has become a hot topic in the field of pediatric cardiology. The aim of this study was to examine the effect of beta receptor blocker in the treatment of children with autonomous nerve mediated syncope.</p><p><b>METHODS</b>Totally 103 children (43 males, 60 females, age 5 - 19 yrs, median 12.0 +/- 2.6 yrs) with autonomous nerve mediated syncope from Beijing, Hunan, Hubei and Shanghai, were included in this study. Forty-nine of them suffered from vasovagal syncope (VVS) and 54 suffered from postural tachycardia syndrome (POTS). They were randomly divided into treatment group accepting oral metoprolol treatment and control group accepting oral rehydration salt treatment. The frequency of syncopal episodes and the outcome of head-up tilt (HUT) test were observed. SPSS 10.0 software was used for the statistical analysis of these data.</p><p><b>RESULTS</b>The cure rate of children who suffered from VVS and POTS and took oral metoprolol was 60.61% and 68.75%, respectively, but in the control group, the cure rate was only 18.75% and 0.00%, respectively. The rate of improvement of children who suffered from VVS and POTS and were treated with oral metoprolol was 15.15% and 15.63%, respectively, and in the control group, it was 6.25% and 40.91%, respectively. The effective rates for cases of VVS and POTS treated with oral metoprolol were higher than those of cases received oral rehydration salt treatment (P < 0.01). The percentage of the change from positive HUT to negative for children with VVS and POTS who took oral metoprolol therapy was 60.61% and 68.75%, respectively, but in control group, it was only 18.75% and 9.09%, respectively (P < 0.01). There was a significant difference in the percentage of the change from positive HUT to negative between children with VVS treated with oral metoprolol and with oral rehydration salt (P < 0.01). Also, a significant difference was found in the percentage of the change from positive HUT to negative between children with POTS treated with oral metoprolol and with oral rehydration salt (P < 0.01).</p><p><b>CONCLUSION</b>beta receptor blocker is effective in the treatment of children with VVS or POTS.</p>

Forty Children with Vasovagal Syncope / 实用儿科临床杂志

Objective To explore the difference of clinical features and laboratory indexs with different vasovagal responses in(head-up) tilt test(HUT) in children with vasovagal syncope(VVS).Methods Forty consecutive children diagnosed with VVS by HUT were analyzed.The vasovagal responses were divided into vasodepressor,cardioinhibitory and mixed patterns.The distribution and different clinical features and laboratory indexs of different response patterns in the VVS were studied.Results The most common vasovagal response was vasodepressor.There was no significant difference in their clinical features,including the motivation,presymptom,frequency and duration of syncope,baseline heart rate and blood pressure,and serum electrolytes among the children with different vasovagal respon-ses.Conclusion Vosodepressor response is the most common hemodynamic pattern in vasovagal syncope in children.

A multi-center study of hemodynamic characteristics exhibited by children with unexplained syncope / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Syncope is common in children and adolescents, with 15% estimated to have had at least one syncopal episode by age 18. In recent years, an increasing number of children, especially girls at their school age, have developed unexplained syncope. The mechanism of an unexplained syncope exhibited by children is incompletely studied; the association between different hemodynamic patterns and clinical features is also not clear. The aim of the study was to investigate the hemodynamic patterns of children with unexplained syncope and to examine the clinical relevance.</p><p><b>METHODS</b>Two hundred and eight children [87 boys, 121 girls, aged 3 - 19 years, mean (11.66 +/- 2.72) years] were selectively recruited from May 2000 to April 2006 when they presented syncope as their main complaint at the Multi-center Network for Childhood Syncope in Beijing, Hunan Province, Hubei Province, and Shanghai of China. All of the patients underwent head-up tilt tests; data were analyzed using SPSS version 10.0 for Windows. Continuous variables were expressed as the mean +/- standard deviation. Dichotomous variables were compared through a chi(2) test. A value of P < 0.05 (two sided) was regarded as statistically significant.</p><p><b>RESULTS</b>The age distribution of children with syncope was approximately normal. Head-up tilt tests was positive in 155 children, and the incidence of positive response of the baseline head-up tilt test for diagnosing unexplained syncope was 50.48%. The sensitivity value and diagnostic value of sublingual nitroglycerin head-up tilt test were both 74.52%. The hemodynamic pattern was normal in 53 children. The 155 children, who were positive in head-up tilt tests, showed signs of postural orthostatic tachycardia syndrome (60, 28.8%), the vasoinhibitory pattern (72, 34.6%), the cardioinhibitory pattern (5, 2.4%), and the mixed pattern (18, 8.7%). The gender distribution between the two age groups (age < 12 years vs age > or = 12 years) was not different (P > 0.05). The distribution of hemodynamic patterns between the children of the two age groups (age < 12 years vs age > or = 12 years), and the children with different complaints (dizziness vs syncope) was significantly different (P < 0.05), while the distribution between the children of different sexes and different lasting time of syncope (< or = 5 minutes vs > 5 minutes) was not significantly different (P > 0.05). Different hemodynamic patterns were differentiated by differing syncope inducements, presymptoms, and complicated symptoms during and after syncope.</p><p><b>CONCLUSION</b>The tested girls were more prone when compared with the boys to have unexplained syncope, and the peak age was around twelve years old. The incidence of positive response of head-up tilt tests was also relatively higher for the girls. The distribution of hemodynamic patterns for different ages was different. For children with unexplained syncope, we should use head-up tilttests to distinguish the hemodynamic patterns in order to adopt rational therapeutic measures.</p>

Individual 3-D image prototyping models for orbital reconstruction / 中华整形外科杂志

<p><b>OBJECTIVE</b>To fabricate a rapid prototyping (RP) 3-D image models for individual reconstruction of orbital bony loss.</p><p><b>METHODS</b>The skull was placed on a helical CT scanner table and the Frankfort plane was perpendicular to the table. The CT data was obtained by a Aquilion (TOSHIBA, Japan) with 1 mm thickness section in spiral mode. By adjusting of CT threshold value and pixels in order to stack the segmental defects, we obtained an approximate 3-dimension visual model of the scanned skull using MedGraphics software. An orbital RP model based on the dataset of the 3-dimension visual model was fabricated by RP machine. Both 3-dimension visual model and RP model were measured against the skull with several anatomic landmarks to examine the accuracy of the models, and the errors were analysed.</p><p><b>RESULTS</b>Integrity precision rapid RP models of the orbital region were reconstructed. The anterior orbital rim, middle orbital section and posterior orbital section were all fabricated. Optic foramen, superior orbital fissure, infraorbital foramen, inferior orbital fissure, lacrimal sac socket and naso-lacrimal duct were shown clearly. But some fine hole and slot, such as the anterior ethmoidal foramen, posterior ethmoidal foramen and zygomaticofrontal suture were not obviously seen. The mean difference between the 3-dimension visual model and the skull was 0.10 +/- 1.02mm. For the RP and dry skull, the mean difference was 0.22 +/- 1.04mm. There were no statistical differences between them.</p><p><b>CONCLUSIONS</b>Integrity precision orbital RP models were fabricated which fulfilled the requirements of the individual reconstruction with bony orbital pathologic changes. The keys to fabricate the precision orbital RP models included a closer cooperation between the surgeon and engineer, thin CT slice in 1mm thick and an appropriated threshold value. Better results for the orbital deformities should be achieved for the contour of orbital region or eye function.</p>