Analysis of etiology and cytokines of benign infantile convulsions with mild gastroenteritis / 中国小儿急救医学

Objective:To investigate the pathogenic distribution of benign infantile convulsions with mild gastroenteritis(BICE)and explore the relevance of serum cytokines and BICE.Methods:Eighty BICE infants admitted in Inner Mongolia Maternal and Child Health Hospital from January 2017 to December 2019 were selected as BICE group, and 80 mild gastroenteritis infants without convulsion attack were selected as control group during the same period.Fluorometric real-time PCR was used to detect the pathogen of enterovirus.Serum cytokines including interleukin(IL)-6, tumor necrosis factor(TNF)-α, IL-8 and soluble interleukin-2 receptor(SIL-2R)were detected by using chemiluminescence method.The relevance of frequency and duration of convulsion in infants with BICE and the indicators above were analyzed.Results:Rotavirus infection was the main cause of BICE during the study period in this region.Among 80 cases in the BICE group, rotavirus positive infants accounted for 38.8%(31/80) and norovirus positive infants accounted for 10.0%(8/80). The levels of IL-6, IL-8 and SIL-2R in the BICE group were prominently higher than those in the control group( P<0.05); the difference of TNF-α level between two groups had no statistical significance( P>0.05). The levels of IL-6, TNF -α, IL-8, SIL-2R in the group with convulsion attack times ≥ 2 and convulsion duration ≥5 min were higher than those in the group with convulsion attack times<2 and convulsion duration<5 min( P<0.05). The frequency and duration of convulsions were positively correlated with the levels of IL-6, TNF -α, IL-8 and SIL-2R( P<0.05). Conclusion:Rotavirus is the main pathogen of BICE in this region.There is immunologic imbalance in children with BICE, especially the changes of IL-6 and SIL-2R levels, which may provide effective cytological and experimental data evidence for judging progression and prognosis of the disease.

Homogenization and optimization strategy for standard process of intensity-modulated radiotherapy for nasopharyngeal carcinoma / 中华放射肿瘤学杂志

Radiotherapy is the most common treatment for nasopharyngeal carcinoma, and the radiotherapy technique is essential for the prognosis of nasopharyngeal carcinoma. Due to the complexity of the structure of the intensity-modulated device and the accuracy of the clinical requirements of radiotherapy, it is inevitable that higher requirements will be imposed on the process of intensity-modulated radiotherapy. Currently, gaps exist in the radiotherapy equipment and personnel qualification among radiotherapy units, and thus the homogenization in the radiotherapy remains to be strengthened in China. With the application of radiotherapy information management system, digital medicine and artificial intelligence technologies in the field of radiotherapy, the original process fails to meet the application needs of the new precise radiotherapy technology. Therefore, this process is designed based on the existing radiotherapy procedures for nasopharyngeal carcinoma in combination with the latest developments in the field of radiotherapy, aiming to establish a novel standard process recommendation, ensuring the standardization and homogenization of radiotherapy and achieve the individualized intensity-modulated radiotherapy for nasopharyngeal carcinoma patients.

Etiology and serum inflammatory factors of mild gastroenteritis with benign convulsion in infants / 中国医师杂志

Objective:⑴ To understand the pathogen distribution of mild gastroenteritis with benign infantile convulsion (BICE). ⑵ To analyze the levels of serum interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), peripheral blood leukocyte count (WBC) and hemoglobin (Hb) in children with BICE, and to explore whether they are related to the convulsion of BICE.Methods:From May 2017 to May 2018, 30 BICE children in the Department of Pediatrics of Inner Mongolia Autonomous Region Maternal and Child Health Hospital were selected as the observation group, while 30 mild gastroenteritis children without convulsion attack were selected as the control group. The detection of enterovirus uses colloidal gold method or fluorescence polymerase chain reaction (PCR) method. Serum IL-6 and TNF-α were detected by chemiluminescence. The levels of serum inflammatory factors, WBC and Hb were compared between the control group and the observation group, as well as between the children with different seizure times and duration.Results:⑴ The onset of BICE group was mainly in autumn and winter. The incidence rate of control group in summer was higher than that in BICE group, with statistically significant difference ( P<0.05). ⑵ In BICE group, rotavirus, norovirus and Coxsackie virus were 46.67%, 6.67% and 10%, respectively. ⑶ The levels of serum [IL-6 (16.37±11.97)pg/ml] and [TNF-α (11.96±7.10)pg/ml] in BICE group were higher than those in control group [IL-6 (10.30±6.95)pg/ml, TNF-α (6.95±4.97)pg/ml], with statistically significant difference ( P=0.019, P=0.003). ⑷ The levels of serum [IL-6 (24.83±14.34)pg/ml] and [TNF-α (16.93±6.73)pg/ml] in children with convulsion ≥ 2 times were higher than those in children with convulsion < 2 times [IL-6 (11.48±6.91)pg/ml, TNF-α (9.07±5.66)pg/ml], with statistically significant difference ( P=0.013, P=0.002). The levels of serum [IL-6 (27.84±14.42)pg/ml] and [TNF-α (18.00±6.74)pg/ml] in children with convulsion duration ≥ 5 min were higher than those in children with convulsion duration <5 min [IL-6: (12.20±7.76)pg/ml, TNF-α: (9.75±5.95)pg/ml], with statistically significant difference ( P=0.001, P=0.003). ⑸ Compared with the control group, there was no significant difference in WBC and Hb content of blood routine test in BICE group ( P>0.05). Conclusions:⑴ Rotavirus infection is the main pathogen of BICE in this region. ⑵ Children with BICE have a certain degree of immune regulation dysfunction. IL-6 and TNF-α may participate in the convulsion process of BICE. The higher the levels of serum IL-6 and TNF-α, the more severe the convulsion degree in children. ⑶ This study shows that WBC number and Hb content in blood routine have nothing to do with the occurrence of BICE.

Clinical efficacy of pancreaticoduodenectomy using anterior approach in situ technique for pancreatic head cancer / 中华消化外科杂志

Objective:To investigate the clinical efficacy of pancreaticodudenectomy (PD) using anterior approach in situ technique for pancreatic head cancer.Methods:The retrospective cohort study was conducted. The clinicopathological data of 285 patients with pancreatic head cancer who were admitted to the First Affiliated Hospital of Kunming Medical University from January 2012 to June 2018 were collected. There were 164 males and 121 females, aged from 40 to 76 years, with an average age of 57 years. Of the 285 patients, 196 patients who underwent PD using anterior approach in situ technique were set as anterior approach group, 89 patients who underwent PD using traditional approach were set as traditional approach group. Observation indicators: (1) surgical situations; (2) postoperative situations; (3) follow-up. Follow-up was performed by outpatient examination, telephone or network interview once every 2 to 3 months to detect tumor recurrence, metastasis and survival of patients up to December 2018. The endpoint of follow-up was death of patients, and the secondary endpoint of follow-up was tumor recurrence or metastasis. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed by the t test. Measurement data with skewed distribution were represented as M (range), and comparison between groups was analyzed by the Mann-Whitney U test. Count data were represented as absolute numbers or percentages, and comparison between groups was analyzed by the chi-square test. Kaplan-Meier method was used to draw the survial curve and calculate the survival rates. Survival analysis was done by the Log-rank test. Results:(1) Surgical situations: 285 patients underwent surgery successfully. Cases with pylorus-preservaction, cases with superior mesenteric vein/ portal vein (SMV/PV) resection and reconstruction (end to end anastomosis, artificial vascular replacement, lateral wall resection and anastomosis), operation time, volume of intraoperative blood loss were 118, 37 (17, 11, 9), (303±107)minutes, 350 mL(range, 100-750 mL) in the anterior approach group, and 48, 9 (7, 1, 1), (335±103)minutes, 400 mL(range, 100-900 mL) in the traditional approach group, respectively, showing no significant difference between the two groups ( χ2=0.990, 3.474, t=0.722, Z=1.729, P>0.05). (2) Postoperative situations: the rate of R 0 resection, the number of lymph node dissected, the number of positive lymph node dissected, rate of nerve invasion, rate of vascular invasion, cases with postoperative severe complica-tions, the number of perioperative death, cases with postoperative chemotherapy were 93.88%(184/196), 12(range, 5-19), 4(range, 0-15), 45.41%(89/196), 31.12%(61/196), 28, 3, 69 in the anterior approach group, and 85.39%(76/89), 7(range, 4-17), 5(range, 0-13), 32.58%(29/89), 23.60%(21/89), 11, 2, 41 in the traditional approach group, respectively. There were significant differences in the rate of R 0 resection, the number of lymph node dissected, rate of nerve invasion between the two groups ( χ2=5.506, Z=4.637, χ2=4.149, P<0.05), while there was no significant difference in the number of positive lymph node dissected, rate of vascular invasion, cases with postoperative severe complications, the number of perioperative death, cases with postoperative chemotherapy between the two groups ( Z=0.052, χ2=1.962, 0.192, 0.001, 3.048, P>0.05). (3) Follow-up: of the 285 patients, 252 and 228 achieved the secondary endpoint and the endpoint of follow-up respectively with the follow-up time of 35 months (range, 6-58 months). There were 181 and 176 of 196 patients in the anterior approach group achieving the secondary endpoint and the endpoint of follow-up respectively with the follow-up time of 38 months (range, 6-58 months). There were 71 and 52 of 89 patients in the traditional approach group achieving the second endpoint and the endpoint of follow-up respectively with the follow-up time of 33 months (range, 7-53 months). The median tumor free survival time and median overall survival time were 31 months and 37 months in the anterior approach group, respectively, versus 24 months and 31 months in the traditional approach group. There was a significant difference in the tumor free survival between the two groups ( χ2=7.646, P<0.05), while no significant difference in the overall survival between the two groups ( χ2=3.265, P>0.05). Conclusion:PD using anterior approach in situ technique is safe and feasible for pancreatic head cancer, which can improve the rate of R 0 resection and prolong the tumor free survival time of patients.

Study on feasibility of Brainlab combined with 6-degree-of-freedom couch in radiotherapy of head and neck / 重庆医学

Objective To study the feasibility of Brainlab plus 6-degree-of-freedom(6D) couch in the radiotherapy of head and neck by using their setup error.Methods Twenty-four patients with head and neck neoplasms in our hospital during AugustOctober 2016 were taken as the examples.After positioning by technician,each Brainlab was carried out,the setup errors in 3 translation directions of left-to-right(X),head-to-foot(Y) and abdomen to-back(Z) and 3 pivoting directions of Rx,Ry and Rz were obtained after registration of positioned CT image.After adjustment,Brainlab re-scanning was conducted for getting corrected errors.Results The online correction by Brainlab plus 6D obviously reduced the setup errors.The setup errors in all directions approached to 0,in which the difference between Ry and Rz directions had no statistical significance(P＞0.05),while the difference among the X,Y,Z and RX directions was statistically significant(P＜0.05).Conclusion The online corrections of Brainlab combined with 6D considerably reduces the errors in translation and rotation directions in radiotherapy of head and neck neoplasms,thus reduces normal tissue received amount and increases the radiotherapeutic accuracy.

Clinical application of the evidence-based clinical nursing guideline for nasogastric tube feeding / 中华护理杂志

Objective To explore the effectiveness,feasibility and suitability of the guideline for nasogastric tube feeding in adult patients.Methods Based on the Ottawa Model of Research Use as framework,we screened relevant evidence from guidelines,and developed new nasogastric tube feeding nursing procedure.Nursing knowledge,the rate of compliance to new procedure and the incidence of complications of nasogastric tube feeding were used to evaluate the clinical effects of the guideline.Results Nurses' knowledge increased significantly(P＜0.05).Nurses had a high degree of implementation of the new procedure,with the rate of over 85％.Compared with the control group,the rate of complications of nasogastric tube feeing in the experimental group was lower than that in the control group.Especially,the rates of reflux and aspiration were significantly lower(P＜0.05).Both rates of tube shedding and skin damage in the intervention group were decreased significantly(P＜0.05).Conclusion The nasal feeding nursing guideline in our clinical scenarios has its effectiveness,feasibility and suitability.

Expression of LMP2A, E-Cadherin and fibronectin in nasopharyngeal carcinoma and its clinical significance / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the expression of EBV-encoded latent membrane protein 2A (LMP2A) and epithelial-mesenchymal transformation(EMT) associated markers (E-cadherin and fibronectin) in nasopharyngeal carcinoma (NPC) and its clinical significance.@*METHOD@#The expression of LMP2A, E-cad-herin and fibronectin proteins in 32 cases of chronic nasopharyngeal inflammation, 56 cases of NPC and 18 cases of NPC lymph node metastasis were examined byimmunohistochemical SP method.@*RESULT@#(1)The positive rates of LMP2A in NPC and its lymph node metastasis were significantly higher than those of chronic nasopharyngeal inflammation (89. 3%vs 37. 5%o and 77. 8% vs 37. 5%) respectively (both P 0. 05). In addition, LMP2A and E-cadherin expression were significantly correlated with T stage (both P<0. 01).@*CONCLUSION@#LMP2A and fibronectin expressions were increased in NPC, but normal expression of E-cadherin were decreased. LMP2A may promote lymph node metastasis and malignant progression of NPC by induce EMT through downregulation of E-cadherin and upregulation of fibronectin.

The current status and influencing factors of falls self-efficacy among the stroke elderly patients / 中国实用护理杂志

Objective To investigate the current status and influencing factors of falls self-efficacy among the stroke elderly patients.Methods Totally 170 elderly stroke patients were investigated using the Modified Falls Efficacy Scale (MFES),and they were tested with Berg Balance Scale (BBS) and Time Up and Go Test (TUGT).Results The average score of falls self-efficacy was 108.There were 50.6％ elderly stroke patients assigned to the group with low falls self-efficacy.Multiple Logistic regression analysis indicated that impairments of balance and mobility,severe stroke-related disability were the independent influencing factors associated with FOF,which could explain 52.0％ of variations.Conclusions Low falls self-efficacy among the stroke elderly patients is a common complaint,nurses and physicians should focus on this problem,interventions combining exercise and education of accidental falls should be taken to improve falls self-efficacy of elderly stroke patients,and prevent falls finally.

Autopsy pathological characteristics in coronary artery disease patients with or without sudden cardiac death / 中华心血管病杂志

<p><b>OBJECTIVE</b>To compare clinicopathological characteristics of coronary artery disease (CAD) patients with or without sudden coronary death (SCD) .</p><p><b>METHODS</b>A total of 145 autopsy cases with CAD were divided into SCD group (38 cases) and non-SCD group (107 cases). The difference on age, number of diseased coronary vessel, coronary atherosclerotic stage (fatty streak stage, fibrous plaque stage and atheromatous plaque stage), composite lesions of coronary artery, grade of stenosis severity, acute myocardial infarction, old myocardial infarction, hypertensive cardiomyopathy, myocardial fatty infiltration and arteriosclerosis of the arteries on the base of the brain were compared between SCD group and non-SCD group.</p><p><b>RESULTS</b>(1) Patients were older in SCD group than in non-SCD group [ (55.3 ± 14.5) years vs. (48.5 ± 13.3) years, P < 0.01]. (2) There was a significant positive correlation between coronary atherosclerotic stage and grade of coronary stenosis severity (rs = 0.79, P < 0.01) . (3) The rate of multiple vessel disease, coronary atherosclerotic stage, composite lesions of coronary artery, grade III-IV coronary artery stenosis, old myocardial infarction and arteriosclerosis of the arteries on the base of the brain were 60.5% (23/38) , 84.2% (32/38), 63.2% (24/38), 86.8% (33/38), 36.8% (14/38) and 34.2% (13/38), respectively in SCD group, which were significantly higher than those in non-SCD group [25.2% (27/107), 29.0% (31/107) , 18.7% (20/107), 19.6% (21/107), 3.7% (4/107) and 6.5% (7/107), respectively, all P < 0.01].</p><p><b>CONCLUSION</b>Coronary artery atherosclerotic lesion is severer and patients are older in SCD patients than in non-SCD patients in this coronary artery disease patient cohort.</p>

Clinically mild encephalitis/encephalopathy with a reversible splenial lesion of corpus callosum in a child and literature review / 中华儿科杂志

<p><b>OBJECTIVE</b>To investigate the characteristics of a new clinical-image syndrome-mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) of corpus callosum.</p><p><b>METHOD</b>The clinical and imaging features of one pediatric patient with the diagnosis of MERS were analyzed and the clinical and radiologic data of 44 MERS cases which were reported all around the world were also analyzed.</p><p><b>RESULT</b>The underlying disease of the patient before the onset was respiratory mycoplasma infection. On the second day of the disease course, the patient presented symptoms of encephalopathy. Brain MRI indicated lesions in the splenium of corpus callosum, centrum semiovate and posterior periventricular white matter. And these lesions recovered completely within 3 weeks. Most of the 44 patients diagnosed with MERS were associated with infectious diseases and completely recovered within two weeks. Symptoms included consciousness disturbance, convulsions and dysarthria. In addition to the splenium, brain MRI also showed lesions in genu of corpus callosum, centrum semiovate and white matter of frontal lobe.</p><p><b>CONCLUSION</b>The clinical presentations of MERS were sudden onset of symptoms of encephalopathy during acute inflammation. Brain MRI indicated a reversible lesion in the splenium of corpus callosum. Patients recover completely within a few days.</p>

Clinical and genetic analysis of a family with Aicardi-Goutières syndrome and literature review / 中华儿科杂志

<p><b>OBJECTIVE</b>Aicardi-Goutières syndrome (AGS) is a rare early-onset genetic encephalopathy. The aim of this study was to explore the clinical, imaging and genetic features of a family with AGS, which may contribute to definite diagnosis, genetic counseling and prenatal diagnosis of this rare disease in China. We summarized the characteristics of AGS through reviewing related references.</p><p><b>METHOD</b>Information of the proband and other family members as well as their DNA samples were collected. All the exons and exon-intron boundaries of pathogenic genes were amplified with PCR and were directly sequenced for genomic DNA. And we reviewed the reports of 252 cases.</p><p><b>RESULT</b>(1) The proband was a 6 years plus 7 months old boy. He presented with severe developmental delay and abnormal posture mainly as torsion of limbs. By physical examination he was found to have some chilblain-like skin lesions at the end of limbs and microcephaly. The CT scan of his head displayed multiple calcification, especially in the basal ganglia. The MRI of his head displayed a hypointense signal in T1-weighted (T1W) images and a hyperintense signal in T2-weighted (T2W) in cerebral white matter and cystic lesions in temporal white matter. The younger sister of the proband presented with chilblain-like skin lesions on her face and the end of limbs had no developmental delay. The CT of her head showed multiple calcification, especially in the basal ganglia. (2) Two mutations were identified in TREX1, one was a novel nonsense mutation (c.294_295insA), and the other was a known pathogenic mutation (c.868_885del). (3) The common performances of AGS included mental retardation [92% (231/252) ], dystonia [75% (189/252)], microcephaly [63% (159/252) ], chilblain [42% (106/252) ], basal ganglia calcification [100% (252/252)], brain atrophy[88% (222/252)] and cerebral white matter lesions [86% (217/252)]. TREX1 [38% (96/252) ] and RNASEH2B [23% (58/252)]are the most common pathogenic genes.</p><p><b>CONCLUSION</b>We determined pathogenic gene of these patients which is the basis of genetic counseling for this family. c.294_295insA mutation is a novel mutation not reported around the world yet.</p>

Report and literature review of two cases of coma induced by beva-cizumab combined with chemotherapy / 中国肿瘤临床

Objective:The clinical features, risk factors, and outcomes of coma were analyzed in patients treated with bevacizum-ab combined with chemotherapy This study also aims to increase the awareness on the toxicity of this regimen. Methods:Two cases of coma induced by bevacizumab combined with chemotherapy were reported. Diagnosis, treatment, and relevant literature were reviewed and discussed. Results:Inadequate blood pressure (BP) control was one of the risk factors leading to coma in patients treated with this therapy. The clinical feature of these patients was reversible posterior leukoencephalopathy syndrome (RLPS). Imaging results showed no typical finding. Reinforced supportive treatment including intensive BP control showed satisfactory outcomes. Conclusion:Coma is common in patients treated with bevacizumab combined with chemotherapy. This regimen should be used cautiously in patients with a history of hypertension. BP should be monitored closely and managed promptly during the combination therapy to prevent coma. RLPS-related coma is reversible after appropriate treatment.

Values of dobutamineand and integrated backscatter in diagnosis of coronary artery disease / 吉林大学学报(医学版)

Objective To evaluate the values of integrated backscatterr (IBS) and dobutamine stress echo- cardiography (DSE) in the diagnosis of coronary artery disease(CAD).Methods Thirty-one suspected CAD patients received DSE and IBS analysis before selective coronary angiography(SCA).Using SCA results as the golden standard of the diagnosis,the diagnostic sensitivity(Se),specificity(Sp),and accuracy rate (Ac) of conventional eye-view and DSE-cyclic variation integrated backscatter (CVIB) were compared. Results The CVIB of myocardial segments perfused by stenotic coronary artery was smaller than that of segments perfused by patent coronary artery during high dose of DSE. For conventional DSE eye-view method, the Se,Sp,and Ac were 80%,72% and 77%, while that of DSE-CVIB were 90%,72% and 83%, respectively. Conclusion IBS is a valuable method in assessing the myocardial wall motion in DSE, and the combination of the two methods can improve the diagnostic accuracy rate of CAD.

Applied value of integrated backscatter in differential diagnosis of ladder cancer and clot / 吉林大学学报(医学版)

Objective To analyze quantitatively two-dimensional sonography of bladder cancer and clot with integrated backscatter(IBS) to evaluate its applied value in differential diagnosis of ladder cancer and clot.(Methods The IBS) and IBS% were measured in 32 patients with bladder cancer and 18 patients with bladder clot.(Results There were) significant differences of average image intensity(AII),peak to peak intensity(PPI) and standard deviation of image intensity(SDI) between bladder cancer and clot(P

Effect of ultrasound combined with contrast agent on efficiency of VEGF gene transferring into fibroblasts in vitro / 吉林大学学报(医学版)

0.05).The transfection efficiencies were improved significantly in the ultrasound plus contrast agent and VEGF plasmid group(MI 1.2,1.4,and 1.6) compared with pure plasmid group(P0.05);there were significant differences between ultrasound plus contrast agent and VEGF165 plasmid(MI 1.4,1.6) and ultrasound plus contrast agent and VEGF165 plasmid group(MI 1.2)(P

Effects of Xinxuetong on left ventricular function in hypertension / 吉林大学学报(医学版)

Objective:We estimated the effect of Xinxuetong on the left ventricular function in hyperten-sion. Methods :Transaortic and transmitral flow velocity was studied by pulsed Doppler echo cardiographybefore and after vein administration of Xinxuetong. Results: It was shown that Peak A, IRP andPeak A/Peak E decreased after administration of Xinxuetong. Conclusion:This study suggests that Xinx-uetong can significantly improve the diastolic function and the treatment of hypertension.