Efficacy of noninvasive high-frequency oscillatory ventilation versus nasal intermittent positive pressure ventilation as post-extubation respiratory support in preterm infants: a Meta analysis / 中国当代儿科杂志

OBJECTIVES@#To systematically evaluate the efficacy and safety of noninvasive high-frequency oscillatory ventilation (NHFOV) versus nasal intermittent positive pressure ventilation (NIPPV) as post-extubation respiratory support in preterm infants.@*METHODS@#China National Knowledge Infrastructure, Wanfang Data, Chinese Journal Full-text Database, China Biology Medicine disc, PubMed, Web of Science, and the Cochrane Library were searched for articles on NHFOV and NIPPV as post-extubation respiratory support in preterm infants published up to August 31, 2022. RevMan 5.4 software and Stata 17.0 software were used for a Meta analysis to compare related indices between the NHFOV and NIPPV groups, including reintubation rate within 72 hours after extubation, partial pressure of carbon dioxide (PCO2) at 6-24 hours after switch to noninvasive assisted ventilation, and the incidence rates of bronchopulmonary dysplasia (BPD), air leak, nasal damage, periventricular leukomalacia (PVL), intraventricular hemorrhage (IVH), and retinopathy of prematurity (ROP).@*RESULTS@#A total of 9 randomized controlled trials were included. The Meta analysis showed that compared with the NIPPV group, the NHFOV group had significantly lower reintubation rate within 72 hours after extubation (RR=0.67, 95%CI: 0.52-0.88, P=0.003) and PCO2 at 6-24 hours after switch to noninvasive assisted ventilation (MD=-4.12, 95%CI: -6.12 to -2.13, P<0.001). There was no significant difference between the two groups in the incidence rates of complications such as BPD, air leak, nasal damage, PVL, IVH, and ROP (P>0.05).@*CONCLUSIONS@#Compared with NIPPV, NHFOV can effectively remove CO2 and reduce the risk of reintubation, without increasing the incidence of complications such as BPD, air leak, nasal damage, PVL, and IVH, and therefore, it can be used as a sequential respiratory support mode for preterm infants after extubation.

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.

Cancer screening and its association with core knowledge of cancer in community residents / 公共卫生与预防医学

Objective To understand the situation of cancer screening of community residents and its association with the knowledge of cancer core knowledge, and to provide reference for the formulation of secondary cancer prevention measures. Methods A cross-sectional survey was conducted among 2 037 residents aged 18-79 who lived in Bao 'an District, Shenzhen. Multivariate Logistic regression analysis was used to investigate the relationship between core knowledge and cancer screening behavior after adjusting for age, gender, education, marriage, occupation and smoking. Results The cancer screening rate of community residents was 28.10%, and the screening rate of middle-aged and elderly people aged 40-79 was 33.50 %.The proportion of “not very well understanding”, “partial understanding” and “basic understanding” of the core knowledge of cancer were 43.91%, 42.33% and 13.76%, respectively, which was higher than that of the non-participants. Multivariate analysis showed that the women, the higher the level of education of college/university or above and the higher the level of knowledge of cancer prevention core knowledge, the higher the probability of participating in cancer screening was OR (95%CI ) : 2.40 (1.86-3.12), 1.65 (1.29-2.10), 1.38 (1.18 - 1.62), respectively. Conclusion The proportion of cancer screening in community residents needs to be improved, and the degree of core knowledge of cancer is closely related to cancer screening behavior. It is suggested to increase the publicity and education of the core knowledge of cancer, and at the same time, carry out the health education of secondary cancer prevention for the key population such as men and people with low education level, so as to improve the proportion of “early detection, early diagnosis and early treatment” of cancer.

Medication Rules of Clinical Prescriptions Containing Citri Sarcodactylis Fructus Based on Data Mining / 中国实验方剂学杂志

ObjectiveTo reveal the medication rules of the clinical prescriptions containing Citri Sarcodactylis Fructus， and to provide a basis for the modern clinical application of Citri Sarcodactylis Fructus， the development of health products and the research and development of new drugs. MethodThe clinical prescriptions containing Citri Sarcodactylis Fructus were retrieved from CNKI， Wanfang Data， and VIP， and then a basic database of prescriptions was established via the traditional Chinese medicine inheritance auxiliary platform （V2.5）， IBM SPSS V20， and Excel （Microsoft Office 2016）. The frequency and association rules of the medicines in prescriptions （compatible medicines） and the corresponding syndromes were then mined. ResultThe prescriptions were screened according to the inclusion and exclusion criteria. A total of 458 clinical prescriptions containing Citri Sarcodactylis Fructus were collected， involving 388 Chinese medicines， and the total frequency of medicines reached 6 199. The core compatible medicines （frequency > 130） of Citri Sarcodactylis Fructus included Poria （frequency of 222）， Atractylodis Macrocephalae Rhizoma （217）， Paeoniae Radix Alba （196）， Bupleuri Radix （159）， and Citri Reticulatae Pericarpium （142）. The Citri Sarcodactylis Fructus-compatible medicines with frequency > 49 were selected for further analysis， which included 34 medicines with the cumulative frequency of 3 131 （50.51% of the total frequency）. These medicines mainly have the functions of tonifying Qi， invigorating Qi， tonifying blood， alleviating edema and promoting urination， promoting digestion， and activating blood and relieving pain. They are mainly warm， cold， or mild-natured， taste bitter， sweet， or acrid， and have the tropism in the spleen， liver， stomach， or lung meridians. The association rule analysis demonstrated that 14 medicine combinations were commonly used， and the core combinations were Poria-Citri Sarcodactylis Fructus， Atractylodis Macrocephalae Rhizoma-Citri Sarcodactylis Fructus， Paeoniae Radix Alba-Citri Sarcodactylis Fructus， Bupleuri Radix-Citri Sarcodactylis Fructus， Atractylodis Macrocephalae Rhizoma-Poria-Citri Sarcodactylis Fructus， and Citri Reticulatae Pericarpium-Citri Sarcodactylis Fructus. The clinical prescriptions containing Citri Sarcodactylis Fructus were mainly used to treat 52 diseases corresponding to 11 types of traditional Chinese medicine （TCM） syndromes. Three representative syndrome types， including spleen and stomach syndromes， Qi-blood-body fluid syndromes， and gynecological syndromes were selected for further association rule analysis. In the treatment of spleen and stomach syndromes， the core compatible drugs were Atractylodis Macrocephalae Rhizoma， Poria， Paeoniae Radix Alba， Bupleuri Radix， Citri Reticulatae Pericarpium， and Pinelliae Ehizoma， which， together with Citri Sarcodactylis Fructus， formed 25 commonly used medicine combinations （16 combinations composed of 2 medicines and 9 combinations composed of 3 medicines）. In the treatment of Qi-blood-body fluid syndromes， the core compatible drugs were Poria， Paeoniae Radix Alba， Atractylodis Macrocephalae Rhizoma， Astragali Radix， Hordei Fructus Germinatus， and Bupleuri Radix， which， together with Citri Sarcodactylis Fructus， formed 23 common medicine combinations （17 combinations composed of 2 medicines， 5 combinations composed of 3 medicines， and 1 combination composed of 4 medicines）. In the treatment of gynecological syndromes， the core compatible medicines were Atractylodis Macrocephalae Rhizoma， Paeoniae Radix Alba， Angelicae Sinensis Radix， Astragali Radix， Cyperi Rhizoma， and Poria， which constituted 25 common medicine combinations （15 combinations composed of 2 medicines and 10 combinations composed of 3 medicines）. ConclusionWe employed the traditional Chinese medicine（TCM） inheritance auxiliary platform to explore the compatibility of Citri Sarcodactylis Fructus-containing clinical prescriptions and the corresponding TCM syndromes， which intuitively showcased the medication rules of Citri Sarcodactylis Fructus. Specifically， Citri Sarcodactylis Fructus was mainly combined with the medicines for tonifying Qi， invigorating Qi， tonifying blood， alleviating edema and promoting urination， promoting digestion， and activating blood and relieving pain to treat different TCM syndromes. While soothing liver， regulating Qi， harmonizing stomach， and relieving pain， the combinations tonify and activate blood， invigorate spleen， and resolve dampness. The findings are of great significance to the rational application of Citri Sarcodactylis Fructus， the development of health food， and the research of new drugs and will bolster the development of Chinese medicine industry.

Efficacy and safety of the combination of agomelatine and low-dose olanzapine in 184 cases of postprandial distress syndrome with depression, anxiety and sleep disorders / 中华消化杂志

Objective:To observe the efficacy and safety of the combination of agomelatine and low-dose olanzapine (AO) in the treatment of postprandial distress syndrome (PDS) with depression, anxiety and sleep disorders.Methods:From April 2019 to September 2020, PDS patients with depression, anxiety and sleep disorders in Tianjin Medical University General Hospital were selected and divided into AO group and flupentixol-melitracen (FM) group. Patients of the AO group were given oral agomelatine 25 mg and AO 1.70 mg (both once per day), and the patients of FM group were given oral FM 10.5 mg (once per day), and all patients took itopride 50 mg (three times per day) at the same time. The total treatment course was eight weeks. Nepean dyspepsia index-symptom (NDIS), patient health questionnaire-9 (PHQ-9), generalized anxiety disorder-7 (GAD-7) and Pittsburgh sleep quality index (PSQI) were used to evaluate the gastrointestinal symptoms, depression, anxiety and sleep disorders before treatment and two, four and eight weeks after treatment, respectively. The efficacy was evaluated according to the changes of scores of gastrointestinal symptoms before and after treatment. The adverse effects after medication were recorded. Independent sample t test and chi-square test were used for statistical analysis. Results:A total of 184 PDS patients with depression, anxiety and sleep disorders were enrolled, including 98 patients in AO group and 86 patients in FM group. At two, four and eight weeks after treatment, NDIS, PHQ-9, GAD-7 and PSQI scores of AO group and FM group were all lower than those of each group before treatment (AO group: 13.73±0.53, 10.13±0.44 and 7.87±0.31 vs. 27.08±0.84; 6.04±0.35, 4.70±0.31 and 3.81±0.22 vs. 10.04±0.50; 6.36±0.30, 5.29±0.28 and 4.21±0.19 vs. 10.71±0.51; 6.64±0.37, 5.27±0.35 and 4.09±0.30 vs. 11.14±0.42; FM group: 15.33±0.58, 11.58±0.50 and 9.80±0.35 vs. 25.10±0.79; 6.79±0.35, 5.71±0.32 and 4.86±0.30 vs. 9.11±0.46; 7.27±0.31, 6.51±0.32 and 5.21±0.27 vs. 9.79±0.44; 8.01±0.33, 6.76±0.32 and 5.78±0.32 vs. 10.44±0.32), and the differences were statistically significant (AO group: tNDIS=13.470, 17.930 and 21.530, tPHQ-9=6.488, 8.991 and 11.300, tGAD-7=7.361, 9.315 and 11.031, tPSQI=7.088, 9.736 and 12.550. FM group: tNDIS=9.921, 14.400 and 17.640, tPHQ-9=4.032, 6.106 and 7.781, tGAD-7=4.638, 5.993 and 8.840, tPSQI=5.289, 8.199 and 10.310, all P<0.05). At two, four and eight weeks after treatment, NDIS, GAD-7 and PSQI scores of AO group were all lower than those of the FM group during the same period (NDIS: 13.73±0.53 vs. 15.33±0.58, 10.13±0.44 vs. 11.58±0.50, 7.87±0.31 vs. 9.80±0.35; GAD-7: 6.36±0.30 vs. 7.27±0.31, 5.29±0.28 vs. 6.51±0.32, 4.21±0.19 vs. 5.21±0.27; PSQI: 6.64±0.37 vs. 8.01±0.33, 5.27±0.35 vs. 6.76±0.32, 4.09±0.30 vs. 5.78±0.32), and the differences were statistically significant ( tNDIS=2.018, 2.225 and 4.156, tGAD-7=2.097, 2.869 and 2.536, tPSQI=1.951, 2.359 and 3.099, all P<0.05). At eight weeks after treatment, the total effective rate of the AO group was higher than that of the FM group (94.9%, 93/98 vs. 84.9%, 73/86), and the difference was statistically significant ( χ2=5.205, P=0.026). The incidence of adverse reactions of constipation and somnolence of the AO group were both lower than those of the FM group (2.0%, 2/98 vs. 9.3%, 8/86 and 1.0%, 1/98 vs. 8.1%, 7/86, respectively), and the differences were statistically significant ( χ2=4.699 and 5.582, P=0.047 and 0.027). Conclusion:AO may be a treatment option for PDS with depression, anxiety and sleep disorders.

Studies on the mechanism of inhibitory effect of lithium chloride on the proliferation of human Tenon capsule fibroblasts / 中华实验眼科杂志

Objective:To investigate the effect of lithium chloride (LiCl) on the gap junctional intercellular communication (GJIC) in human Tenon capsule fibroblasts (HTFs) and its underlying mechanism.Methods:The Tenon capsule tissue of a patient who underwent strabismus surgery in Dezhou People's Hospital in April 2019 was collected and cut into tissue blocks of dimensions 1 mm×1 mm×1 mm.Primary culture and subculture were carried out, and the 4th-generation HTFs were taken for experiment.HTFs were divided into the control group and LiCl treatment group and were cultured with cell medium without or with 80 mmol/L LiCl for another 48 hours according to grouping.The cell scratch and dye labeling technique were used to label the coupling index and evaluate the GJIC function.The expression and localization of Cx43 in HTFs were detected by immunofluorescence staining.The expression levels of Cx43 mRNA and protein were detected by real-time fluorescence quantitative PCR and Western blot, respectively.The study protocol was approved by an Ethics Committee of Dezhou People's Hospital (No.2019-023). Written informed consent was obtained from the subject.Results:The cultured spindle-shaped HTFs grew adhering to the wall showing radial monolayer or vortexlike, and the cytoplasm was vimentin positive.Results of dye tracer experiment of cell scratch showed that the cell coupling index of LiCl treatment group was 9.04±0.53, which was significantly higher than 4.94±0.39 of the control group ( t=-18.79, P<0.01). Immunofluorescence staining showed that the Cx43 fluorescence was dotted in the cell membrane between adjacent cells in the control group, and Cx43 staining was obviously enhanced in the LiCl treatment group.The results of real-time fluorescence quantitative PCR showed that with relative expression level of Cx43 mRNA in the control group set to 1, the relative expression level of Cx43 in the LiCl treatment group was significantly increased to 1.97±0.23, showing a statistical significance between them ( t=-14.426, P<0.01). Western blot showed that the relative expression level of Cx43 protein was 0.871±0.057 in the LiCl treatment group, which was significantly higher than 0.446±0.028 in the control group ( t=-11.682, P<0.01). Conclusions:LiCl can enhance the GJIC function between HTFs by upregulating the expression levels of Cx43 mRNA and protein, suggesting that the enhanced GJIC function by LiCl may be one of the mechanisms of its inhibition on HTFs proliferation.

Advance in Role of Mitochondrial Quality Control in Exercise for Sarcopenia (review) / 中国康复理论与实践

Sarcopenia is a process in which skeletal muscle mass and strength are gradually declining, resulting a main health challenge for the old adults. Mitochondria can maintain the integrity of structure and function of skeletal muscle by improving biosynthesis, antioxidant defense, fusion/fission dynamics and mitophagy. Mitochondrial dysfunction is a important factor leading to the complex etiology of sarcopenia. Exercise can regulate mitochondrial quality control pathways by activating mitochondrial biogenesis and mitophagy to maintain optimal mitochondrial function, thereby delaying and preventing the onset and progression of sarcopenia.

Genotypes and phenotypes of nine Uygur children with osteogenesis imperfecta in Xinjiang / 中华儿科杂志

Objective@#To explore the genotypes and phenotypes of osteogenesis imperfecta (OI) in Xinjiang Uygur children.@*Methods@#The history of nine Uygur children with OI who were hospitalized in First Affiliated Hospital of Xinjiang Medical University from January 2013 to December 2017 were retrospectively reviewed. They were classified into 4 types according to the classical Sillence classification. The genes associated with OI were detected, and the pathogenic variation was assessed by InterVar and Alamut software according to the American College of Medical Genetics and Genomics (ACMG) recommendations. The phenotypes of children with different genotypes were further analyzed.@*Results@#Nine cases aged 3 years and 6 monthes to 15 years were all clinically diagnosed as OI, the clinical manifes tations were repeated fractures, skeletal deformities,short stature, blue sclera, abnormol hearing, hypoplasia of dentin, and relaxation of Joint ligaments, among whom 6 was type Ⅲ OI, 3 were type Ⅳ OI. Nine mutations in 3 genes (COL1A1, COL1A2, and SERPINF1) were detected, and 5 of them were first reported and were all pathogenic variations.@*Conclusions@#The cinical phenotypes of osteogenesis imperfecta in Xinjiang Uygur are complex and varied, but all of them have fractures and skeletal deformities. Genotype is different from that reported at China and abroad, and the SERPINF1 gene may have a higher incidence in Uyghur population. The genetic heterogeneity and unique gene variation pedigree of Uyghur osteogenesis imperfecta defects further provide a basis for the correlation between genotype and phenotype of osteogenesis defects.

Application of rectus muscle transplantation optimization for refractory single eye insufficiency / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the application of rectusmuscle transplantation optimization in the treatment of refractory supraventricular insufficiency in one eye caused by double supraventricular paralysis with inferior rectus restriction and high original vertical strabismus. <p>METHODS: Retrospective analysis was performed on 6 cases of double superior muscle palsy admitted to our hospital from January 2015 to January 2019. After the failure of conservative treatment, rectus muscle transplantation optimization was adopted to observe the improvement of preoperative and postoperative eye position, vertical strabismus, motor function of upper and lower rotation of paralytic eye, as well as the improvement of pseudo ptosis and compensated head position. <p>RESULTS: After the restriction was lifted, rectusmuscle transplantation optimization was performed. The original <i>in situ</i> vertical strabismus degree before surgery, one month and six months after surgery were(49.83 ± 6.55)PD,(2.67±2.07)PD, and(1.83±2.40)PD. There was a significant difference in vertical strabismus before and after 1mo and 6mo of operation(<i>P</i><0.001). There was no significant difference in the comparison of vertical strabismus between 1mo and 6mo of operation(<i>P</i>=0.899). All patients had the orthotopic position in postoperative position, and the paralysis function of the paralyzed eyes improved significantly after the operation; Pseudopterygoptosis in four cases and compensatory head position in two cases before operation were significantly improved after operation. <p>CONCLUSION: Optimization of rectus muscle transplantation is suitable for unilateral superior rotation deficiency with limitation of inferior rectus, which can effectively improve the superior rotation function of affected eye with stable curative effect.

Regulatory roles of microRNAs in sarcopenia and exercise intervention / 生理学报

Sarcopenia is an age-related degenerative disease, in which skeletal muscle mass and function are reduced during aging process. Physical intervention is one of the most effective strategies available for the treatment of sarcopenia. Studies have shown that microRNAs (miRNAs), as important regulators of gene expression, play an important role in maintaining the homeostasis of senescent skeletal muscle cells by regulating skeletal muscle cell development (proliferation and differentiation), mitochondrial biogenesis, protein synthesis and degradation, inflammatory response and metabolic pathways. Furthermore, exercise can combat age-related changes in muscle mass, composition and function, which is associated with the changes in the expression and biological functions of miRNAs in skeletal muscle cells. In this article, we systematically review the regulatory mechanisms of miRNAs in skeletal muscle aging, and discuss the regulatory roles and molecular targets of exercise-mediated miRNAs in muscular atrophy during aging process, which may provide novel insights into the prevention and treatment of sarcopenia.

Secondary metabolites from Corynespora cassiicola J9, an endophytic fungus associated with Blumea balsamifera (L.) DC / 药学学报

Chemical investigation on the rice culture of Corynespora cassiicola J9, an endophyte inhabiting in Blumea balsamifera (L.) DC. resulted in isolation of eight compounds, including a new depsidone derivative, corynether C (1), and seven analogues, corynether B (2), corynetherlactone A (3), corynether A (4), diaryl ether (5), corynesidone C (6), corynesidone D (7), and corynesidone A (8). Their structures were deduced based on 1D and 2D NMR spectroscopy, and HR-ESI-MS data. All of the isolated compounds were evaluated for inhibitory activities against Lissorhoptrus oryzophilus Kuschel by the leaf spray assay. Unfortunately, none of them showed inhibitory effects.

Design of alarm system for patients' tumble based on six-axes attitude sensor / 中国医学装备

Objective:To design an alarm system for patients'tumble based on a six-axes attitude sensor so as to monitor patients'tumble during they lied in bed of hospital or they acted in ward of hospital.Methods:The internet of things (IOT) platform with six-axes attitude sensor and Zigbee module which adopted the functions of measurement and calculation based on six-axes attitude sensor were used to compose automatic alarm system for patients'tumble in ward of hospital.Arduino was adopted as the development platform of hardware to obtain the sensors data that were worn on patients through the I2C trunk method.And through implemented preprocess and numerical value filtering for data to perform posture calculation.Results:This design has realized the recognition for patient's current position and the alarm in time for sudden event of tumble.It could assist clinical workers to achieve better care for patients.Conclusion:This design basically realizes the function of monitoring and alarm for the situation of patient's tumble, but there are some problems includes sporadic misjudgment and oversize wearing hardware.It is planned to improve the practicability of the system by improving the algorithm and hardware platform.

Regulatory Role of Exercise-induced Autophagy in Rehabilitation of Sarcopenia (review) / 中国康复理论与实践

Sarcopenia is an aging-related disease with a significant reduction in mass and strength of skeletal muscle due to the imbalance between protein synthesis and degradation. Autophagy acts as a conserved mechanism regulating the balance of protein metabolism in body and can be regulated by multiple signaling pathways such as AMP-activated protein kinase (AMPK), insulin like growth factor (IGF)/ protein kinase B (Akt)/ mammalian target of rapamycin (mTOR) and phosphatidylinositol 3 kinase (PI3K)/Akt/mTOR induced by exercise. Exercise-activated autophagy regulates skeletal muscle remodeling and homeostasis under different physiological and pathological conditions, which is the key to skeletal muscle health maintenance. This article reviewed the regulator roles and potential molecular mechanisms of varying exercise-induced autophagy in the prevention, treatment and rehabilitation of sarcopenia.

Severity grading of grade B pancreatic fistula after pancreaticoduodenectomy: A single-center study / 中国实用外科杂志

OBJECTIVE: To discuss whether grade B pancreatic fistula after pancreaticoduodenectomy(PD)can be graded according to the severity and to provide reference for accurate evaluation and treatment.METHODS: The clinical data of 343 patients underwent PD surgery in the First Affiliated Hospital of Harbin Medical University from December2012 to June 2016 were retrospectively collected,among which 72 cases followed grade B pancreatic fistula. Grade B pancreatic fistula after operation was divided into severe groups of which imaging-assisted interventional therapy was needed and mild group. The total medical cost,length of hospital stay,drainage time,ICU transfer,introperitoneal effusion,introabdominal infection,abdominal hemorrhage,biliary fistula,delayed gastric emptying,number of types and incidence of complications except pancreatic fistula,incidence of pancreatic fistula as the most serious complications,postoperative morbidity index(PMI),fistula average complication burden(ACB)were statistically analyzed between two groups.RESULTS: Univariate analysis revealed that there were significant differences between two groups in the total medical cost(84,000 yuan vs. 132,000 yuan),length of hospital stay(29.0 days vs. 42.0 days),drainage time(20.5 d vs.53.0 d),introperitonal effusion rate(41.1% vs. 87.5%),introabdominal infection rate(10.7% vs. 43.8%),abdominal hemorrhage rate(7.1% vs. 56.3%),the number of other types of complications except pancreatic fistula(1 vs. 4),pancreatic fistula as the most serious complications(53.6% vs. 87.5%),PMI(0.22±0.08 vs. 0.37±0.00),ACB(0.19±0.08 vs. 0.37±0.00),and the P-values were less than 0.05 respectively.CONCLUSION: The severity of grade B pancreatic fistula of ISGPS update classification is heterogeneous,which can be divided into mild and severe groups. It provides a reference for precise and individualized treatment for grade B pancreatic fistula.

Overview of standardized training programme for clinical application and quality control of pulmonary function testing in China / 中国实用内科杂志

Pulmonary function testing(PFT) is an appropriate technique for comprehensive prevention and control of chronic airway diseases. In 2015, the National Clinical Research Center for Respiratory Diseases launched the national standardized training and assessment programme on clinical application and quality control of PFT. There are four steps for the overall programme. The first step is to establish the standard and outline of standardized training for PFT. The second step is to carry out standardized training based on the established standard and outline. The third step is to conduct post-training assessment, evaluate the training effect, and certify the trainees who master the training content. The last step is to carry out quality control in those who have obtained the certification,and evaluate the application of training content in clinical practice. With the progress of the programme, clinicians' awareness of the importance of PFT will be increased, physicians' and techinicians' operate on skills and clinical application abilities of PFT will be promoted, while the qualities of PFT in China will be improved. It will be of great significance to the construction of Pulmonary and Critical Care Medicine(PCCM).

Retrospective analysis of the clinical characteristics of retinal vein occlusion in the nearby five years / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To retrospectively analyze the clinical change of retinal vein occlusion inpatients of the Second People's Hospital of Foshan in the nearby five years.<p>METHODS: The data of inpatients in the Second People's Hospital of Foshan were collected by the term “retinal vein occlusion”from 2013-01-01 to 2017-12-31. Retrospective analysis of the details for the disease.<p>RESULTS: Totally 351 patients with retinal vein occlusion were admitted and treated for 473 times in five years. Elder with systemic disease(hypertension, diabetes and renal inadequacy)was more common. The hospital days were significantly statistical difference among five years with the shortest days in 2017. The prevalence of RVO was growing year by year, especially for BRVO, with statistical difference between 2017 and the other four years(<i>P</i><0.005). Treatments for RVO were mainly including retinal laser, intravitreal injection or both combined. There was significantly statistical difference about the rate of intravitreal injection among five years(<i>P</i><0.05)with the lowest one in 2013.“1+PRN” therapeutic regimen was more tolerable for patients than “3+PRN”.<p>CONCLUSION: BRVO is growing more sharply than CRVO in the nearby five years. Retinal laser combined with“1+PRN”intravitreal injection is the main therapeutic regimen for RVO in our hospital.

The mutation characteristics of drug-resistance of Mycobacterium tuberculosis in Qinzhou,Guangxi / 国际检验医学杂志

Objective To analyze the variation characteristics of rpoB,katG,inhA,rpsL and embB related genes of Mycobacterium tuberculosis(MTB)in Qinzhou,Guangxi.Methods PCR reverse point hybridization was used to detect 5 common resistance mutants of Mycobacterium tuberculosis in 237 MTB-DNA positive sputum samples.Results Among 237 cases of tuberculosis patients,72 cases(30.38%)were resistant to the four kinds of anti-TB drugs.The resistance mutation rate of rifampin,isoniazid and streptomycin was 2.53%, 13.92%,3.80%.The top 5 gene mutation detection loci of Mycobacterium tuberculosis were-15M,S531L and 43M.Conclusion The main drug-resistant strains are isoniazid resistance,and the mutation of inhA gene were the major one in Qinzhou,Guangxi.

23-Gauge pars plana vitrectomy and scleral buckle for the treatment of proliferative rhegmatogenous retinal detachment with inferior breaks / 眼科新进展

Objective To compare the safety and efficacy of 23-Gauge pars plana vitrectomy (PPV) and PPV combined with scleral buckling-PPV (SB-PPV) in proliferative rhegmatogenous retinal detachments with inferior breaks.Methods Retrospectively nonrandomized clinical case study was conducted in 70 patients with proliferative rhegmatogenous retinal detachment associated with inferior breaks between January 2013 and December 2016,including 39 eyes receiving SB-PPV procedures as the SB-PPV group and 31 eyes undergoing PPV procedures as the PPV group.And anatomical success rate for one procedure,lens trauma rate,retinotomy rate,postoperative best corrected visual acuity (BCVA) outcome and intraocular pressure (IOP) were recorded and analyzed.Results The anatomical success rate for one procedure was 92.3％ (36/ 39) in the SB-PPV group and 74.2％ (23/31) in the PPV group,and the difference was statistically significant (P ＜ 0.035).The lens trauma rate was 2.6％ (1/39) in the SB-PPV group and 19.4％ (6/31) in PPV group,with the difference being statistically significant (P ＜0.05).The retinotomy rate was 5.1％ (2/39) in the SB-PPV group and 32.3％ (10/31) in the PPV group,and the difference approached statistically significance (P ＜0.05).There was no significant difference in the postoperative BCVA and IOP between the two groups (both P ＞ 0.05).Conclusion SB-PPV can increase the anatomical success rate for one procedure in patients with rhegmatogenous retinal detachment associated with inferior breaks,and reduce retinotomy rate and lens trauma rate.

Effects of vitrectomy with preoperative intravitreal Conbercept for proliferative diabetic retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To analyze the clinical effects of preoperative intravitreal Conbercept combined vitrectomy for proliferative diabetic retinopathy ( PDR) patients.?METHODS:From June 2014 to May 2017, 57 patients (65 eyes) diagnosed with PDR. The patients were divided into two groups according to whether received preoperative intravitreal conbercept: intravitreal group ( 27 cases, 31 eyes), control group (30 cases, 34 eyes). Intravitreal group was treated with 0. 05mg ( 0. 05mL ) conbercept intravitreal injection 3d before vitrectomy, while control group was treated with vitrectomy alone. The overall surgical time, intraoperative bleeding, use of endodiathermy, iatrogenic retinal hole, and silicone oil, postoperative vitreous hemorrhage and the best corrected visual acuity were recorded and analyzed.?RESULTS: The average surgical time of intravitreal group was lower ( P < 0. 05 ), while intraoperative hemorrhage rate, rate of endodiathermy application, iatrogenic hiatal incidence, rate of silicone oil application, incidences of recurrent vitreous hemorrhage of intravitreal group were lower than those of control group ( all P<0. 05 ) . Intravitreal group got better postoperative best corrected visual acuity than control group (P<0. 05).?CONCLUSION: Intravitreal conbercept for proliferative diabetic retinopathy before 25G vitrectomy decreased surgical complications, reduced the surgical time and postoperative vitreous hemorrhage, and improved the potoperative best corrected visual acuity.

Effects of Dexmedetomidine Intratracheal Instillation on Quality of Emergence from General Anesthesia in Patients Undergoing Gynecologic Laparoscopic Operation / 中山大学学报(医学科学版)

[Objective]To evaluate the effects of dexmedetomidine intratracheal instillation on quality of emergence from general anesthesia in patients undergoing gynecologic laparoscopic operation. [Methods]Ninety patients of ASA I orⅡ,aged 18~64 years old,weighed 40~80 kg,scheduled for elective gynecological 1aparoscopic surgery under general anes-thesia,expected surgery time 1-2 h,requiring endotracheal extubation after surgery,were randomly divided into 3 group (n=30 each):control group(group C),exmedetomidine administered intratracheally group(group D1)and dexmedetomi-dine administered intravenously group(group D2).At the beginning of operation,2 μg/kg of dexmedetomidine were infused intratracheal through the drug injection hole of disposable enhanced Ⅲendotracheal tube in group D1 and 0.5 μg/kg of dex-medetomidine were intravenous pumped in 10 minutes in group D2,while saline was used in group C.The patients were sent to postanesthesia care unit after extubaion. MAP and HR were recorded at the time of dexmedetomidine or saline infused (T0),and 5,10,15,30 min(T2-T4)after dexmedetomidine or saline infused,immediately after extubation(T5),and 5,10,15,30 min(T6-T9)after extubation.The time of the patients to recover spontaneous breath,eye opening,extubation and direc-tional power were recorded.The cough reflex scores and sedation-agitation scale during extubation,the visual analogue scale and Ramsay sedation scale at 30 minutes after extubation were also recorded.[Results]①Compared with T0,MAP and HR increased statistically at T5~T7in group C,MAP increased statistically at T5~T6and HR increased statistically at T5~T7in group D1 and D2(P<0.05).Compared with group C,MAP and HR at T5~T7decreased statistically in group D1 and D2(P<0.05).②The scores of cough reflex,sedation-agitation scale and visual analogue scale were significantly lower in group Dl and D2 than in group C(P<0.5).③The incidence of agitation,high blood pressure and tachycardia were significantly lower in group D1 and D2 than in group C(P<0.05).[Conclusions]Either intravenous pumping or intratracheal instillation of dex-medetomidine for patients undergoing gynecological laparoscopic surgery can effectively keep stable perioperative hemody-namics,relieve cough reflex,agitation incidence and enhance the quality of emergence from general anesthesia recovery.