Impact of sinonasal anatomic changes after endoscopic anterior skull base surgery on nasal airflow and air conditioning: a computational fluid dynamics study / 中华耳鼻咽喉头颈外科杂志

Objective: To analyze the impact of the sinonasal anatomic changes after endonasal endoscopic anterior skull base surgery on the nasal airflow and heating and humidification by computational fluid dynamics (CFD), and to explore the correlation between the postoperative CFD parameters and the subjective symptoms of the patients. Methods: The clinical data in the Rhinology Department of the First Affiliated Hospital of Zhengzhou University from 2016 to 2021 were retrospectively analyzed. The patients received the endoscopic resection of the anterior skull base tumor were selected as the case group, and the adults whose CT scans had no sinonasal abnormalities were chosen as the control group. The CFD simulation was performed on the sinonasal models after reconstructed from the patients' sinus CT images during the post-surgical follow-up. All the patients were asked to complete the Empty Nose Syndrome 6-Item Questionnaire (ENS6Q) to assess the subjective symptoms. The comparison between two independent groups and the correlation analysis were carried out by using the Mann-Whitney U test and the Spearman correlation test in the SPSS 26.0 software. Results: Nineteen patients (including 8 males and 11 females, from 22 to 67 years old) in the case group and 2 patients (a male of 38 years old and a female of 45 years old) in the control group were enrolled in this study. After the anterior skull base surgery, the high-speed airflow moved to the upper part of the nasal cavity, and the lowest temperature shifted upwards on the choana. Comparing with the control group, the ratio of nasal mucosal surface area to nasal ventilation volume in the case group decreased [0.41 (0.40, 0.41) mm-1 vs 0.32 (0.30, 0.38) mm-1; Z=-2.04, P=0.041], the air flow in the upper and middle part of the nasal cavity increased [61.14 (59.78, 62.51)% vs 78.07 (76.22, 94.43)%; Z=-2.28, P=0.023], the nasal resistance decreased [0.024 (0.022, 0.026) Pa·s/ml vs 0.016 (0.009, 0.018) Pa·s/ml; Z=-2.29, P=0.022], the lowest temperature in the middle of the nasal cavity decreased [28.29 (27.23, 29.35)℃ vs 25.06 (24.07, 25.50)℃; Z=-2.28, P=0.023], the nasal heating efficiency decreased [98.74 (97.95, 99.52)% vs 82.16 (80.24, 86.91)%; Z=-2.28, P=0.023], the lowest relative humidity decreased [(79.62 (76.55, 82.69)% vs 73.28 (71.27, 75.05)%; Z=-2.28, P=0.023], and the nasal humidification efficiency decreased [99.50 (97.69, 101.30)% vs 86.09 (79.33, 87.16)%; Z=-2.28, P=0.023]. The ENS6Q total scores of all patients in the case group were less than 11 points. There was a moderate negative correlation between the proportion of the inferior airflow in the post-surgical nasal cavity negatively and the ENS6Q total scores (rs=-0.50, P=0.029). Conclusions: The sinonasal anatomic changes after the endoscopic anterior skull base surgery alter the nasal airflow patterns, reducing the efficiency of nasal heating and humidification. However, the post-surgical occurrence tendency of the empty nose syndrome is weak.

Research progress on the mechanism of pain related neural pathways above the spinal cord / 生理学报

Pain is a multi-dimensional emotional experience, and pain sensation and pain emotion are the two main components. As for pain, previous studies only focused on a certain link of the pain transmission pathway or a certain key brain region, and there is a lack of evidence that connectivity of brain regions is involved in pain or pain regulation in the overall state. The establishment of new experimental tools and techniques has brought light to the study of neural pathways of pain sensation and pain emotion. In this paper, the structure and functional basis of the neural pathways involved in the formation of pain sensation and the regulation of pain emotion in the nervous system above the spinal cord level, including thalamus, amygdala, midbrain periaqueductal gray (PAG), parabrachial nucleus (PB) and medial prefrontal cortex (mPFC), are reviewed in recent years, providing clues for the in-depth study of pain.

Systematic analysis of MYB transcription factors related to the geniposide biosynthesis in Gardenia jasminoides Ellis based on whole genome / 药学学报

MYB transcription factors are involved in the regulation of various secondary metabolites biosynthesis. Gardenia jasminoides Ellis is the commonly used Chinese herbal medicine, and its main active ingredient is geniposide. Here, leaves and flower buds at different developmental stages of G. jasminoides were used to explore MYB transcription factors related to geniposide biosynthesis based on genome and transcriptome analysis. Transcriptome data analysis showed that, different from the expression of the common pathway genes for terpenoid biosynthesis, the expression level of genes in the specific pathway of geniposide biosynthesis was significantly higher in flower buds than in leaves, which was the same as the organ accumulation pattern of this component. And the promoter regions of geraniol synthase, iridoid synthase and geniposidic acid methyltransferase involved in the specific pathway all contained multiple MYB-binding sites. A total of 105 MYB transcription factors were obtained by annotating the coding genes of G. jasminoides, which were divided into 68 1R-MYB, 33 R2R3-MYB, 3 3R-MYB and 1 atypical MYB transcription factor according to the number of conserved domain. Based on the analysis of phylogenetic tree and quantitative real-time PCR, three candidate MYB transcription factors related to geniposide biosynthesis were selected, including potential positive regulation factor GjMYB23 and negative regulation factors GjMYB31 and GjMYB73. The results of this study will lay a foundation for searching the regulation of geniposide biosynthesis and further analysis of the quality formation mechanism of G. jasminoides, so as to promote the breeding of excellent varieties of G. jasminoides.

Clinical observation of acupuncture treatment for children with accommodative myopia / 针灸推拿医学（英文版）

Objective:To observe the effect of acupuncture in the treatment of accommodative myopia in children.Methods:A total of 76 children with accommodative myopia who met the inclusion criteria were divided into a control group or a test group according to the random number table method,with 38 cases in each group.The control group was given education on eye hygiene,and the test group was treated with acupuncture twice a week for 2 months in addition to the intervention used in the control group.The patient's uncorrected visual acuity(UCVA),refraction,and axial length(AL)were measured before treatment and 1 month and 2 months after treatment.Results:After 1 month of treatment,there was no significant difference in the UCVA between the two groups(P＞0.05);after 2 months of treatment,the UCVA of the test group was better than that of the control group(P＜0.05).After 1 and 2 months of treatment,the refraction of the two groups was significantly different from that before treatment(P＜0.01),but there was no significant difference between the two groups(P＞0.05).After 1 and 2 months of treatment,the AL in the control group was increased compared with that before treatment(P＜0.05),while there was no significant change in the test group(P＞0.05),and there was no significant difference between the two groups(P＞0.05).Conclusion:Acupuncture treatment can improve UCVA in children with accommodative myopia.

Clinical study of acupuncture plus Dang Gui Bu Xue Qu Feng Tang for benign essential blepharospasm / 针灸推拿医学（英文版）

Objective: To evaluate the therapeutic efficacy of acupuncture plus Dang Gui Bu Xue Qu Feng Tang for benign essential blepharospasm (BEB). Methods: A prospective randomized controlled trial was performed. A total of 105 participants were randomized 1:1:1 into an acupuncture group, a herbal medicine group and an acupuncture plus herbal medicine group. Participants in the acupuncture group received manual acupuncture treatment, twice a week. Participants in the herbal medicine group received Dang Gui Bu Xue Qu Feng Tang, oral administration, once a day. Participants in the acupuncture plus herbal medicine group received both treatments. The therapeutic effects of the three groups were evaluated after four weeks of treatment. The primary outcome was the Jankovic rating scale (JRS) score, and the secondary outcome was the blepharospasm disability index (BSDI) score. Results: After four weeks of treatment, the JRS total scores significantly decreased in all three groups versus baseline (P<0.05). A greater reduction in the JRS total score was reported in participants in the acupuncture plus herbal medicine group (P<0.05), but there was no significant difference between the acupuncture group and the herbal medicine group (P>0.05). The acupuncture plus herbal medicine group had a greater decrease in the JRS severity score than the herbal medicine group (P<0.05). The reduction in the JRS frequency score was not significantly different among the three groups (P>0.05). The BSDI scores significantly decreased in all three groups versus baseline (P<0.05), but the reduction in the BSDI score was insignificantly different among the three groups (P>0.05). Conclusion: It is effective in the treatment of BEB either to use acupuncture and Dang Gui Bu Xue Qu Feng Tang alone or in combination. The combination therapy shows a more significant effect than either of the treatment alone.

Clinical efficacy of electroacupuncture in controlling myopia in children and its influence on retinal blood flow / 针灸推拿医学（英文版）

Objective: To observe the clinical efficacy of electroacupuncture (EA) in controlling myopia in children and its effect on retinal blood flow. Methods: Sixty-eight myopic children were randomly divided into an observation group and a control group, with 34 cases in each group. The control group was given auricular acupressure treatment alone, and the observation group was treated with EA once a week in addition to the treatment used in the control group. The spherical equivalent refraction (SER) and axial length (AL) were measured at baseline, and after 3 months and 6 months of treatment. Optical coherence tomography angiography was used to measure the vessel density (VD) and perfusion density (PD) in the surface layer of the retina. Results: After 3 months and 6 months of treatment, the changes in SER between the two groups were not statistically significant (P>0.05). After 3 months of treatment, the changes in AL between the two groups were not statistically significant (P>0.05); after 6 months of treatment, the change amount of AL in the observation group was smaller than that in the control group (P<0.05); after 3 months and 6 months of treatment, the changes in VD and PD in the surface layer of the retina in the observation group were significantly greater than those in the control group (P<0.01). Conclusion: EA treatment once a week for 6 months can delay the increase of AL and improve the retinal surface blood flow in myopic children.

Analysis of the Marketing Approval of Pediatric Drugs in the United States and Its Enlightenment to Pedia tric Drug Use Guarantee in China / 中国药房

OBJECTIVE：To provide sugge stions for improving the variety of pediatric drugs and ensuring the safety of pediatric drug use in China. METHODS ：The historical evolution of laws and regulations on the marketing approval of pediatric drugs in the United States and the implementation results of relevant policies were summarized. Combined with the current situation of the development of pediatric drugs in China ，some suggestions were put forward to ensure the accessibility and safety of pediatric drug use in China. RESULTS & CONCLUSIONS ：Since 1994，the United States had issued a series of laws and regulations to encourage the development of pediatric drugs. At present ，the marketing approval of pediatric drugs were mainly based on the two laws of Best Pediatric Drug Act（BPCA）and Pediatric Research Equality Act （PREA）. From 1998 to 2019，the amount of supplements of pediatric drug information in drug instructions of the United States showed a fluctuating growth. As of April 2020，854 kinds of drugs had been modified in pediatric instructions ，792 of which had been carried out post marketing pediatric clinical research ，and the problem of incomplete pediatric instructions had also been greatly improved. At present ，China’s policies on pediatric drugs mainly included encouraging R&D innovation ，giving priority to review and approval ，and strengthening R&D technical guidance. Although certain achievements had been made ，there were still some problems ，such as imperfect policies and regulations ，and great difficulties carrying out pediatric drug clinical trials. It is suggested that our country should draw lessons from the American regulations on pediatric drugs ，pediatric research and the catalogue of pediatric drugs ，and establish a system and catalogue of ped iatric drug use suitable for China ’s national conditions ，so as to improve the effectiveness ，safety and accessibilityof pediatric drugs.

A multicenter retrospective study on survival rate and complications of very preterm infants / 中国当代儿科杂志

OBJECTIVES@#To study the survival rate and the incidence of complications of very preterm infants and the factors influencing the survival rate and the incidence of complications.@*METHODS@#The medical data of the very preterm infants with a gestational age of <32 weeks and who were admitted to the Department of Neonatology in 11 hospitals of Jiangsu Province in China from January 2018 to December 2019 were retrospectively reviewed. Their survival rate and the incidence of serious complications were analyzed. A multivariate logistic regression analysis was used to evaluate the risk factors for death and serious complications in very preterm infants.@*RESULTS@#A total of 2 339 very preterm infants were enrolled, among whom 2 010 (85.93%) survived and 1 507 (64.43%) survived without serious complications. The groups with a gestational age of 22-25@*CONCLUSIONS@#The survival rate is closely associated with gestational age in very preterm infants. A low 1-minute Apgar score (≤3) may increase the risk of death in very preterm infants, while high gestational age, high birth weight, and prenatal use of glucocorticoids are associated with the reduced risk of death. A low 5-minute Apgar score (≤3) and maternal chorioamnionitis may increase the risk of serious complications in these infants, while high gestational age and high birth weight may reduce the risk of serious complications.

Clinical features of preterm infants with a birth weight less than 1 500 g undergoing different intensities of resuscitation: a multicenter retrospective analysis / 中国当代儿科杂志

OBJECTIVE@#To evaluate the clinical features of preterm infants with a birth weight less than 1 500 g undergoing different intensities of resuscitation.@*METHODS@#A retrospective analysis was performed for the preterm infants with a birth weight less than 1 500 g and a gestational age less than 32 weeks who were treated in the neonatal intensive care unit of 20 hospitals in Jiangsu, China from January 2018 to December 2019. According to the intensity of resuscitation in the delivery room, the infants were divided into three groups:non-tracheal intubation (@*RESULTS@#Compared with the non-tracheal intubation group, the tracheal intubation and ECPR groups had significantly lower rates of cesarean section and use of antenatal corticosteroid (@*CONCLUSIONS@#For preterm infants with a birth weight less than 1 500 g, the higher intensity of resuscitation in the delivery room is related to lower rate of antenatal corticosteroid therapy, lower gestational age, and lower birth weight. The infants undergoing tracheal intubation or ECRP in the delivery room have an increased incidence rate of adverse clinical outcomes. This suggests that it is important to improve the quality of perinatal management and delivery room resuscitation to improve the prognosis of the infants.

Concern and influencing factors of freshman knowledge in Sichuan university / 中国学校卫生

Objective@#To understand the concern of freshmen with different characteristics on sexual knowledge in Sichuan province and to provide evidence for comprenensive sex education in colleges.@*Methods@#A survey was conducted among 2 532 freshmen from 13 universities in Sichuan Province in September 2018. Attention to specific sexual knowledge among students with different characteristics was analyzed.@*Results@#Sexual knowledge that the freshmen concerned included partner communication (39.25%~55.10%), STD and AIDS (37.78%~44.85%) and gender equality (33.33%~43.34%). Logistic regression results showed that male students payed more attention to partner communication(OR=0.77,95%CI=0.65-0.91), masturbation (OR=0.36，95%CI=0.27-0.47) and sexual minorities (OR=0.61,95%CI=0.41-0.90), while female students payed more attention to gender equality (OR=1.31,95%CI=1.10-1.57), sexual harassment and violence (OR=1.65,95%CI=1.37-1.98). Rural students pay. more attention to partner communication (OR=0.79,95%CI=0.65-0.94), while urban students pay. more attention to masturbation (OR=1.50,95%CI=1.08-2.08), sexual harassment and sexual violence (OR=1.30,95%CI=1.07-1.58). Students who had sex were more concerned about contraception and unwanted pregnancy than those who had not (OR=0.53,95%CI=0.39-0.72). Sexual minority students were more concerned about topic of sexual minorities than heterosexual students (OR=3.50,95%CI=2.30-5.33).@*Conclusion@#College freshmen with different characteristics varied in their concern on sexual knowledge, which is related to their needs. It is suggested that schools set up comprehensive education courses according to the needs of students, the content of sex education knowledge can be focused, and carry out comprehensive and targeted sex education.

Association of YKL-40 in bronchoalveolar lavage fluid with airway damage in children with Mycoplasma pneumoniae pneumonia / 中国当代儿科杂志

OBJECTIVE@#To investigate the association of YKL-40 in bronchoalveolar lavage fluid (BALF) with airway damage in children with Mycoplasma pneumoniae pneumonia (MPP).@*METHODS@#A total of 60 children with MPP who were admitted to the hospital were enrolled as the MPP group, and 12 children with bronchial foreign bodies were enrolled as the control group. According to the imaging findings, the MPP group was further divided into 3 subgroups: pulmonary patchy shadow (n=34), pulmonary consolidation (n=19) and pulmonary ground-glass opacity (n=7). According to the bronchoscopic findings, the MPP group was further divided into 3 subgroups: mucosal congestion/edema (n=38), mucous secretion (n=18) and plastic bronchitis (n=4). The clinical manifestations and laboratory characteristics of the children with MPP were analyzed, the expression of YKL-40 in BALF was measured.@*RESULTS@#The MPP group had significantly higher levels of serum lactate dehydrogenase and BALF YKL-40 than the control group (P<0.05). The pulmonary consolidation subgroup had significantly higher levels of serum C-reactive protein and lactate dehydrogenase than the pulmonary patchy shadow subgroup (P<0.05), and the pulmonary consolidation and pulmonary ground-glass opacity subgroups had a significantly higher level of BALF YKL-40 than the pulmonary patchy shadow subgroup (P<0.05). The plastic bronchitis subgroup had a significantly higher level of BALF YKL-40 than the mucous secretion and mucosal congestion/edema subgroups (P<0.05). The mucous secretion and plastic bronchitis subgroups had a significantly higher proportion of children with shortness of breath than the mucosal congestion/edema subgroup (P<0.05). The plastic bronchitis subgroup had significantly higher serum levels of C-reactive protein and lactate dehydrogenase than the mucosal congestion/edema subgroup (P<0.05).@*CONCLUSIONS@#The level of BALF YKL-40 is associated with airway damage and disease severity in children with MPP.

Mutation Spectrum of FANCJ Gene in Adult Acute Myeloid Leukemia / 中国实验血液学杂志

OBJECTIVE@#To detect and analyze the mutation status of FANCJ gene in adult AML patients, so as to provide the basis for studying the mechanism of FANCJ driven AML and guiding the preventim and treatment of deseese.@*METHODS@#The cDNAs were extracted and transeripted from bone marrow cells and normal skin cells in 222 newly diagnosed AML patients. The primers were designed for FANCJ gene coding region, the mutations of FANCJ gene coding region in AML patients as well as the mutations of FANCJ gene in mucous membrane epethelia in patients were detected by PCR and sanger seguencing; the evolutionary conservation of FANCJ mutation in different organisms was analyzed by NCBI Blast online bioinformaties software.@*RESULTS@#The sequencing analysis showed that the mutations of FANCJ gene happened in 11 sites of FANCJ gene coding region, which were as followed: exon5:c.G430A:p.A144T, exon6:c.A587G:pN196S, exon9:c.C1255T:p.R419W, exon10:c.G1442A:p.G481D, exon11:c.C1609G:p.L537V, exon16:c.C2360T:p.P787L, exon17:c.C2440T:p.R814C, exon19:c.C2608T:pH870Y, exon19:c.A2686G:p.I896V, exon19:c.C2830G:p.Q944E, exon20:c.G3412A:p.D1138N. Among them, the repeatability existed in mutations of A144T, N196S, R814C, I896V and Q944E. Beside, the mutation sites of A144, R419, G381, L537, P787, H870, Q944 and D1138 were highly conserved in different organisms.@*CONCLUSION@#Among 222 adult AML patients, the mutations of FANCJ gene have been found in 26 patients, moreover, the mutation sites are relatively conserved in different organisms, and possess important fanction. The results of this study provide the basis for exploring the mexhanism of FANCJ gene driven AML and for guiding the prevantion and treatment of AML.

Autoimmune hemolytic anemia after allogeneic hematopoietic stem cell transplantation: report of one case and review of literature / 白血病·淋巴瘤

Objective@#To summarize the clinical characteristics and treatment experiences of autoimmune hemolytic anemia (AIHA) after allogeneic hematopoietic stem cell transplantation (allo-HSCT).@*Methods@#The clinical data of the patient with AIHA after allogeneic HSCT in Hematology Department of the First Affiliated Hospital of Soochow University was analyzed, and the literatures were reviewed.@*Results@#After receiving 2 years of allo-HSCT, one young male patient with severe aplastic anemia showed AIHA in the absence of obvious incentives. The patient healed with the treatments of glucocorticoid, intravenous injection of gamma globulin, plasma exchange combined with injection of CD20 monoclonal antibody. Through the literature review, it showed that AIHA patients after HSCT had a good response to regimens containing rituximab, while adult and malignant patients with post-HSCT AIHA had a higher mortality. Poor response to rituximab was one of the greatest risk factors for poor prognosis.@*Conclusion@#AIHA is not sensitive to hormone with a low treatment response, which is a risk factor for the increased mortality of allo-HSCT patients.

The clinical value of dynamic electrocardiogram and the NLR in the diagnosis on Kawasaki disease combined with changes of coronary artery for children / 中国医学装备

Objective: To investigate the clinical value of ambulatory electrocardiogram and the neutrophils to lymphocytes ratio (NLR) in the diagnosis on Kawasaki disease combined with changes of coronary artery for children. Methods: 80 children with Kawasaki disease were enrolled in the research. According to the combined situation of coronary artery disease, all of children with combined coronary artery disease were divided in observation group (48 cases) and the children without combined coronary artery disease were divided in control group (32 cases). All of children received the examinations of dynamic electrocardiogram, routine electrocardiogram, ultrasound cardiogram scan and blood routine detection within 15d of occurring disease. And the amounts of neutrophil and lymphocyte, and change of dynamic electrocardiogram of all of children were recorded and analyzed. And then the amounts of neutrophil and lymphocyte and the NLR of the two groups were further compared. Results: The sinus tachycardia, atrioventricular block, abnormal average heart rate and the proportions of total abnormal number of observation group were significantly higher than that of control group, and the difference of total number of ambulatory electrocardiographic abnormality between the two groups were significant (x2=20.112, P<0.05). The results of ambulatory electrocardiogram for Kawasaki disease combined with abnormal coronary artery were significantly higher than that of control group (x2=17.778, P<0.05). Compared with control group, the coronary artery ectasia was more larger, the amount of neutrophils would be more greater in observation group, and the difference between the two groups was significant (t=-3.464, P<0.05). Besides, the difference of NLR between patients with mild ectasia of observation group and patients of control group was significantly (t=2.976, P<0.05). Conclusion: Dynamic electrocardiogram and the NLR have important significance in the diagnosis for children with Kawasaki disease combined with the change of coronary artery.

Effects of A549-derived exosome on tight junction protein and cytoskeleton remodeling in lung epithelial cells BEAS-2B / 医学研究生学报

Objective A large number of studies have shown that the exosome is closely related to the occurrence and devel -opment of tumor cells , but the specific mechanism is still unknown .The study was to investigate the effects of A 549-derived exosome on tight junction protein and cytoskeleton remodeling in normal lung epithelial BEAS-2B cells. Methods A549-derived exosome were isolated by ultracentrifugation , the morphology of which was observed by transmission electron microscope .Western blot analysis was used to examine the surface markers of CD 9 and CD63.Immunofluorescence assay, western blot assay and qPCR assay were applied to detect the effects of exosome on tight junction protein ZO-1 and occludin mRNA expression in BEAS-2B cell.Phalloidin-FITC staining experiment was used to detect the effects of exosome on the cytoskeleton remodeling of BEAS-2B cells.The invasiveness of A549 to BEAS-2B was detected by Transwell invasion test . Results Typical vesicles were observed under electron microscope and exosome markers CD 9 and CD63 expression were detected.The expression levels of ZO-1, occludin pro-tain (P<0.05) and mRNA (P<0.01) were decreased in exosome-treated BEAS-2B cells, and the cytoskeleton remodelled .Transwell invasion test showed that the number of A 549 cells passing through the microporous membrane (22±4) after exosome treatment BEAS-2B was significantly higher than that of the control group (10.6±4.5) (P<0.05). Conclusion A549-derived exosome can promote the cytoskeleton remodeling of BEAS-2B cells by down-regulating the expression of ZO-1 and occludin in BEAS-2B cells, aiming to de-stroy the barrier of BEAS-2B cell to tumor cell A549.

An Analysis of Auditory Perception and Speech Ability Outcomes after Cochlear Implantation in Prelingually Deaf Children with Leukoencephalopathy / 听力学及言语疾病杂志

Objective To study the auditory perception and speech ability outcomes after cochlear implantation in prelingually deaf children with extremely severe neurosensory hearing loss and comorbid leukoencephalopathy.Methods Our study included 14 prelingually deaf children with leukoencephalopathy (confirmed by preoperative MRI scanning) who were treated with cochlear implantation in the Department of Otorhinolaryngology Head and Neck Surgery of Hainan Provincial People''s Hospital, including 8 males and 6 females of 1~6 yr with a mean age of 3.8 yr.Sixteen synchronous prelingually deaf children without central nervous system (CNS) diseases were also included as the control group, including 11 males and 5 females of 1~6 yr with a mean age of 4.4 yr.All the patients underwent pre-surgical assessments of audiology, radiology, speech ability and intelligence before cochlear implantation via transmastoid facial nerve recess approach was done, after which rehabilitation was provided at the Hainan Rehabilitation Center for Deaf Children.Categories of auditory performance (CAP) and speech intelligibility rate (SIR) were employed as the assessment criteria for the outcome of surgery, the scores of which at different timepoints after surgery were statistically compared through paired t-test between the two groups.Results All the patients gained post-surgical hearing and speech abilities to different degrees, whereas CAP and SIR scores both chronologically improved in the both groups.No statistical difference was revealed either in CAP or in SIR scores between the two groups at 6, 12 and 24 months after surgery (P>0.05).Conclusion Children with extremely severe neurosensory hearing loss can be reated with cochlear implantation even if they have comorbid leukoencephalopathy.The effects of auditory and speech rehabilitation for the same age patients with leukoencephalopathy are similar to those without leukoencephalopathy in 2 years after surgery.

Application of deferred stent implantation in patients with high thrombus burden of acute ST-segment ele-vation myocardial infarction / 实用医学杂志

Objective To study the value of deferred stent implantation in patients with high thrombus burden of acute ST-segment elevation myocardial infarction (STEMI). Methods Select 106 cases with a high thrombus burden within 12 hours of onset in patients with STEMI ,the infarct-related artery thrombus aspiration after antegrade flow of TIMI 2-3 and≤2 points of the thrombus aspiration(TS)patients were randomly divided into immediate stenting group(n = 43)and deferred stenting group(n = 40). Two groups of patients were compared with the myocardial blush grade(MBG),the incidence of slow-/no-reflow ,the incidence of compound endpoints in 6 months and the cardiac function after PCI for 6 months. Results After stenting,the MBG of deferred group was significantly higher than that of immediate group ,the incidence of slow-/no-reflow and the compound endpoints events within 6 months in deferred group was significantly lower than that in the immediate group. After PCI for 6 months,the improvement of LVEF in the deferred group was significantly higher than that in the immediate group, the left ventricular end diastolic dimension(LVEDD)in deferred group was significantly lower than that in immedi-ate group,and the differences were statistically significant(P < 0.05). Conclusions The high thrombus burden in patients with acute STEMI after thrombus aspiration ,deferred stent implantation can significantly reduce the rate of slow-/no-reflow ,improve myocardial perfusion ,reduce the incidence of compound endpoints events ,im-prove cardiac function in patients.

Analysis of phacovitrectomy with internal limiting membrane peeling to treat foveoschisis without macular hole in ultra-high myopia / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To analyze the results of phacovitrectomy with internal limiting membrane(ILM) peeling to treat foveoschisis in ultra-high myopia.METHODS: Totally 32 eyes of 32 ultra-high myopia patients with foveoschisis were selected retrospectively.The preoperative refractive errors ranged from-12.00D to-20.00D with the mean of-15.78±2.16D.The best corrected visiual acuity(BCVA) were converted to LogMAR acuity, and the average BCVA was 4.1±0.4.Conventional phacovitrectomy with ILM peeling by ICG dying were performed.Gas tamponade were performed to end the operation.The BCVA and the foveoschisis cavity were observed by 1-9mo after the surgery, with the mean of 4.5mo.RESULTS: The foveoschisis cavity of 30 eyes were healed with BCVA increased and visual distortion alleviated distinctly (94%)(t=-7.91, P<0.05).CONCLUSION: Phacovitrectomy with ILM peeling is useful in treating foveoschisis in ultra-high myopia with visual function preserving.

A prospective observation for the patients with type 2 diabetes mellitus complicated with stroke / 预防医学

Objective To learn the stroke occurrence status and the influencing factors of the patients with type 2 diabetes,and to provide the basis for the prevention of stroke.Methods Patients with type 2 diabetes which were reported in 2011 year from the system of chronic disease monitoring information management of Zhejiang Province were selected and followed -up until October in 2014.Stroke occurrence were recorded and the influencing factors were analyzed.Results The incidence rate was 5.22％ (59/1 129),and the annual incidence was 1.56％.Fifty six cases (94.92％) were ischemic stroke.Logistic regression analysis showed that older than 65 and hypertension were risk factors for type 2 diabetes complicated with stroke.The group of 65-and 75-were associated with higher risk of stroke than 45-(OR =3.38,95％ CI:1.39-8.24;OR =7.77,2.14-28.24).Hypertensionin were the influencing factors of stroke among patients with type 2 diabetes (OR =10.92,95％ CI:5.94-20.09).Conclusion Older age and hypertension were risk factors for type 2 diabetes complicated with stroke.Therefore effective control blood pressure among older patients with type 2 diabetes should be strengthed to prevent stroke.

Cost estimates for basic public health service in Qingpu District of Shanghai / 上海预防医学

Objective To investigate the cost of public health service in Qingpu District and provide evidence for the government in funds investment.Methods On the basis of the basic public health service items of Shanghai City in 2014,the items in this research were determined by experts consultation,and then economics methods were used for the cost estimates.Results In this research,it was proved that 664 public health personnel were needed to fulfill the task of public health service stipulated by the government of Shanghai City while the actual number was 579,lacking 85 personnel.In 2013,the investment input on public health service in Qingpu District amounted to ￥8 987.75×104 while the actual need was ￥13 438.10×104 according to this research,so there was a lack of ￥4 450.36×104.Conclusion On the basis of the population and service area in Qingpu District,the number of personnel working on public health service and the investment input by the government were not adequate to accomplish the stipulated task,so the government should increase health personnel and investment input on public health service.And a compensation mechanism should be set to motivate the related work in secondary or tertiary hospitals.