Integral theory-guided laparoscopic pelvic floor/ligament repair in the treatment of women's internal rectal prolapse / 中华普通外科杂志

Objective:To compare the clinical efficacy of laparoscopic integral pelvic floor/ligament repair (IPFLR) combined with a procedure for prolapse and hemorrhoids (PPH) and that laparoscopic IPFLR alone in the treatment of internal rectal prolapse (IRP) in women.Methods:Patients were divided into groups A in which 63 patients undergoing laparoscopic IPFLR alone, and group B of 67 patients reciving laparoscopic IPFLR combined with PPH. The degree of internal rectal prolapse (DIRP), Wexner constipation scale (WCS) score, Wexner incontinence scale (WIS) score, and Gastrointestinal Quality of Life Index (GIQLI) score were compared between these two groups and in each group those before surgery and 6 months, 2 years, and 5 years after surgery.Results:The number of bowel movements , DIRP, WCS score, WIS score, and GIQLI score before surgery were not significantly different between the two groups (all P>0.05). The DIRP, WCS score, WIS score, and GIQLI score in each group 6 months, 2 years, and 5 years after surgery in both two groups were significantly better than those before surgery (all P<0.001). The DIRP, WCS score, WIS score, and GIQLI score in group B were significantly better than those in group A at 6 months, 2 years, and 5 years after surgery (all P<0.05) except DIRP at 2 years after surgery (all P<0.05). There was a significant difference in the recurrence rate of IRP between the two groups when evaluated at 5 years after surgery ( P=0.001). Conclusions:Integral theory-guided laparoscopic IPFLR combined with PPH has a higher cure rate and a better clinical efficacy than laparoscopic IPFLR alone.

Investigation of P300 evoked by Stroop Color Word Task in children with emotional neglect / 四川精神卫生

ObjectiveTo investigate the P300 evoked by Stroop Color Word Task in children with emotional neglect, and to explore their implication for inhibition control. MethodsA cluster sampling was conducted for the first grade students of a middle school in Sanmenxia City, Henan Province. The students from 3 classes were assessed by standard Raven reasoning test and Child Neglect Scale (CNS), and a total of 147 eligible students were screened out. Children were divided into the emotional neglect group (n=40) and the control group (n=40) according to the 27% before and after the score of CNS emotional neglect factor. Both groups completed the Stroop Color word task, and EEG data were collected to compare the response time, accuracy, amplitude and latency of P300 between the two groups. ResultsThe CNS total score and the scores of safety neglect, communication neglect, physical neglect and emotional neglect factors in the emotional neglect group were significantly higher than those in control group (t=15.003, 4.301, 11.495, 4.803, 23.957, P<0.01). The average reaction time in the incongruent task of emotional neglect group was significantly longer than that in the control group [(879.02±101.52) ms vs. (756.93±113.91) ms, t=5.061, P<0.01]. Under incongruent task, the average amplitude of P300 in emotional neglect group was lower than that of the control group [(3.97±1.12) μV vs. (8.71±1.24) μV, t=-17.976, P<0.01]. The average latency of P300 of emotional neglect group was longer than that of the control group [(361.81±39.69) ms vs. (301.35±33.67) ms, t=7.346, P<0.01]. ConclusionUnder incongruent task, children with emotional neglect had longer response time, longer latency and lower amplitude of P300， which suggested that children with affective neglect may have inhibition and control disorder.

Clinicopathological characteristics of papillary thyroid carcinoma in obese children and adolescents / 中华普通外科杂志

Objective:To analyze the clinicopathological characteristics of papillary thyroid carcinoma (PTC) in obese children and adolescents.Methods:From Jan 2012 to Dec 2015, 59 school-age PTC children and adolescents admitted to Tianjin First Central Hospital and Tianjin Medical University Tumor Hospital were recruited for retrospective case-control study. By using the chi-square test, the clinicopathological characteristics of obese children and adolescents with papillary thyroid carcinoma were analyzed. Kaplan-Meier method was used to analyze the factors significantly related to the recurrence.Results:Compared with patients of normal weight, overweight and obese patients were older (χ 2=4.250, P=0.039), and had multifocal tumors (χ 2=5.281, P=0.022) and higher recurernce rate (χ 2=4.861, P=0.027) .Compared with normal-weight children and adolescents with PTC, overweight or obese children and adolescents with PTC significantly had higher recurrence rate (χ 2=4.466, P=0.035); In addition, tumor diameters >1 cm (χ 2=5.453, P=0.020) and patients with multifocal tumors (χ 2=7.218, P=0.007) were also more likely to suffer recurrence. Conclusion:Among children and adolescent patients with papillary thyroid cancer, obesity is significantly related to multifocal tumors and higher recurernce rate.

Development of acute kidney injury prognostic model for critically ill patients based on MIMIC-Ⅲ database / 中华危重病急救医学

Objective:To investigate the risk factors affecting the prognosis of patients with acute kidney injury (AKI) in the intensive care unit (ICU) based on the Medical Information Mart for Intensive Care Ⅲ (MIMIC-Ⅲ) database, and to establish a prognostic model for AKI.Methods:Patients (aged ≥ 18 years) with acute renal failure, admitted to the ICU for the first time, and had complete hospital records (the RIFLE diagnostic criteria were used in the database, and the diagnosis was expressed as AKI in this article) were screened from MIMIC-Ⅲ database according to diagnostic codes. Patients were divided into two groups based on survival state at discharge, and the general information, underlying diseases, injury factors, vital signs and laboratory indicators within 24 hours after AKI, related intervention and prognostic indicators were analyzed. Univariate and multivariate Logistic regression analysis were used to determine the risk factors affecting mortality in patients with AKI and established a prediction model. The receiver operator characteristic curve (ROC curve) was used to analyze the predictive value of the prediction model for the prognosis of AKI patients.Results:There were 4 554 patients with AKI included and 862 died, with mortality of 18.93%. Univariate Logistic regression analysis was performed for factors that might be associated with death in AKI patients, and the results showed that age, hypertension, lymphoma, metastatic carcinoma, vancomycin, aspirin, coagulation abnormalities, cardiac arrest, sepsis or septic shock, invasive mechanical ventilation, white blood cell count (WBC), platelet count (PLT), K +, blood urea nitrogen (BUN), total bilirubin (TBil), renal replacement therapy (RRT) and length of stay (LOS) were independent risk factors [odds ratio ( OR) and 95% confidence interval (95% CI) were 1.002 (1.001-1.003), 0.764 (0.618-0.819), 1.749 (1.112-2.752), 2.606 (1.968-3.451), 1.779 (1.529-2.071), 0.689 (0.563-0.842), 1.871 (1.590-2.201), 2.468 (1.209-5.036), 2.610 (2.226-3.060), 2.154 (1.853-2.505), 1.105 (1.009-1.021), 0.998 (0.997-0.998), 1.132 (1.057-1.212), 1.008 (1.006-1.011), 1.061 (1.049-1.073), 2.142 (1.793-2.997), 0.805 (0.778-1.113), all P < 0.05]. Further binary Logistic regression analysis showed that lymphoma, metastatic cancer, vancomycin, cardiac arrest, sepsis or septic shock, coagulation dysfunction, invasive mechanical ventilation, increased BUN, increased TBil, increased or decreased blood K + and increased WBC were independent risk factors for death [β values were 0.636, 1.005, 0.207, 0.894, 0.787, 0.346, 0.686, 0.006, 0.051, 0.085, and 0.009; OR and 95% CI were 1.889 (1.177-3.031), 2.733 (2.027-3.683), 1.229 (1.040-1.453), 2.445 (1.165-5.133), 2.197 (1.850-2.610), 1.413 (1.183-1.689), 1.987 (1.688-2.338), 1.006 (1.003-1.009), 1.052 (1.039-1.065), 1.089 (1.008-1.176), and 1.009 (1.004-1.015), respectively, all P < 0.05]. The Hosmer-Lemeshow test showed that the AKI prognostic model was able to fit the observed data well ( P = 0.604). ROC curve analysis showed that the area under ROC curve (AUC) of the AKI prognostic model was 0.716 (95% CI was 0.697-0.735), when the cut-off value was 0.320, the sensitivity was 71.9%, the specificity was 60.1%, the positive likelihood ratio was 1.80, and the negative likelihood ratio was 0.47. Conclusion:The prognostic prediction model of AKI in critically ill patients established and based on the MIMIC-Ⅲ database may have practical significance for prognostic risk assessment of AKI and later intervention.

Safety of administration of norepinephrine through peripheral vein line in patients with septic shock / 中华危重病急救医学

Objective:To analysis the risk factors and safety of administration of norepinephrine (NE) via peripheral vein line (PVL) in patients with septic shock.Methods:A single-center retrospective study was conducted. According to the Lanzhou University Second Hospital information system (HIS) and nursing adverse events report cards, patients with septic shock administrated with NE via PVL to correct the hypotension from January 1st 2015 to December 31st, 2019 were enrolled. The patients' general information, placement location of peripheral venous catheter and venousneedle type, characteristics of NE usage and patient general condition when extravasation occurred were collected. The univariate analysis and Logistic regression were used to analyze risk factors associated with extravasation. Also, the receiver operator characteristic curve (ROC curve) was drawn, and the predictive value of risk factors for extravasation was analyzed.Results:A total of 1 022 cases with NE were enrolled. After a preliminary screening, a total of 910 cases with NE were used to correct low blood pressure, including 116 cases of peripheral venous infusion. The average age was (52.91±18.69) years old, with majority of female (77 cases, 66.4%). Basic diseases were mainly chronic obstructive pulmonary disease (COPD, 100 cases, 86.2%), followed by hypertension(91 cases, 78.4%), coronary heart disease (87 cases, 75.0%), type 2 diabetes (74 cases, 63.8%) respectively, the primary disease was septic shock in 109 cases (94.0%). A total of 147 peripheral venous catheters were inserted, and the most common site of puncture was the forearm [78.9% (116/147)], followed by the hand [12.2% (18/147)] and the median cubital vein [8.8% (13/147)]. 89.9% of the needles were 20 G in diameter, and 75 cases (64.7%) were converted to central venous catheters (CVC) during subsequent treatment due to continuous infusion of NE. Six patients (5.2%) had extravasation, the median time of extravasation was 29 (23-39) hours, and the median time of NE was 23 (11-53) hours, including 2 patients with an infusion concentration of 60 mg/L and 4 patients with an infusion concentration of 120 mg/L.The infusion speed was 0.5-1.0 μg·kg -1·min -1, and the average speed of infusion was (0.75±0.04) μg·kg -1·min -1 when extravasation. Univariate and binary Logistic regression analysis showed that the risk factors related to the occurrence of extravasation included: ① patient factors: the presence of basic diseases, hypertension [odds ratio ( OR) = 3.11, 95% confidence interval (95% CI) was 3.09-3.12, P = 0.001] and edema ( OR = 1.79, 95% CI was 1.32-2.99, P = 0.032). ② Factors of infusion fluid itself: long-term (> 24 hours) infusion ( OR = 2.91, 95% CI was 1.04-5.96, P = 0.040), infusion concentration > 60 mg/L ( OR = 1.88, 95% CI was 1.32-3.99, P = 0.024), infusion speed > 0.3 μg·kg -1·min -1 ( OR = 2.43, 95% CI was 2.38-2.51, P = 0.029) and diameter of needles < 20 G ( OR = 3.11, 95% CI was 3.09-3.22, P = 0.033).③ Medical personnel factors: lack of observation and assessment ( OR = 1.09, 95% CI was 1.03-6.77, P = 0.043). The ROC curve analysis showed that: edema, long-term infusion (> 24 hours), infusion rate > 0.3 μg·kg -1·min -1and diameter of needles < 20 G had a certain predictive value for extravasation of NE through peripheral venous infusion in patients with septic shock, the area under ROC curve (AUC) was 0.610, 0.762, 0.672, 0.629, 95% CI was 0.508-0.713, 0.675-0.849, 0.571-0.772, 0.525-0.732, and P values were 0.044, 0.000, 0.002, 0.019, respectively. Conclusions:Hypertension, edema, long-term infusion (> 24 hours), infusion concentration > 60 mg/L, infusion speed > 0.3 μg·kg -1·min -1, diameter of needle < 20 G, and lack of observation and evaluation by medical staff regularly were risk factors affecting the safety of peripheral intravenous NE in patients with septic shock. Peripheral NE should be avoided in the presence of the above risk factors.

Correlation between fluoride intake and serum alkaline phosphatase in pregnant women of different gestational periods in endemic fluorosis area / 中华地方病学杂志

Objective:To explore the correlation between fluoride intake and serum alkaline phosphatase (ALP) in pregnant women of different gestational periods in endemic fluorosis area.Methods:Pregnant women in Rencheng District, Jinxiang County, Jiaxiang County of Jining City and Yuncheng County of Heze City were selected in April 2020. According to the gestational weeks, pregnant women were divided into early pregnancy group (0 - 12 weeks), middle pregnancy group (13 - 27 weeks) and late pregnancy group (> 27 weeks). The levels of urinary fluoride, ALP, osteocalcin (BGP), C-terminal peptide of β-Ⅰ collagen (β-CTX) and N-terminal propeptide of type Ⅰ collagen (PINP) of pregnant women in each group were measured, and the correlation between urinary fluoride and ALP, BGP, β-CTX, and PINP in pregnant women of different gestational periods was analyzed.Results:A total of 372 pregnant women were selected, including 97 cases in early pregnancy group, 169 cases in middle pregnancy group and 106 cases in late pregnancy group. There was no significant difference in urinary fluoride level between the three groups [(1.20 ± 0.25), (1.23 ± 0.19), (1.24 ± 0.30) mg/L, P > 0.05]. There was significant difference in serum ALP among the three groups ( P < 0.05), among them, the ALP level in early pregnancy was significantly lower than those of middle pregnancy group and late pregnancy group ( P < 0.05), and the ALP level in middle pregnancy was significantly lower than that of late pregnancy group ( P < 0.05). There was no significant differences in serum β-CTX among the three groups ( P > 0.05). There were significant differences in serum BGP and PINP levels among the three groups ( P < 0.05). The serum BGP and PINP levels in late pregnancy group were significantly higher than those of early pregnancy group and middle pregnancy group ( P < 0.05), and there were no significant differences in serum BGP and PINP levels between early pregnancy group and middle pregnancy group ( P < 0.05). There was a significant positive correlation between urinary fluoride and ALP in early pregnancy group ( r = 0.364, P < 0.05), but no significant correlation between urinary fluoride and BGP, β-CTX and PINP ( r = 0.164, 0.117, 0.136, P > 0.05). There was a significant positive correlation between urinary fluoride level and ALP in middle pregnancy group ( r = 0.417, P < 0.05), but no significant correlation between urinary fluoride level and BGP, β-CTX and PINP ( r = 0.127, 0.108, 0.129, P > 0.05). There was no significant correlation between urinary fluoride level and ALP, BGP, β-CTX and PINP in late pregnancy group ( r = 0.179, 0.158, 0.184, 0.149, P > 0.05). Conclusions:The urinary fluoride level of pregnant women in endemic fluorosis area is relatively stable in gestational period. The urinary fluoride level affects the ALP secretion of pregnant women in early and middle pregnancy. It is still necessary to strengthen the measures of improving water quality and defluoridation to reduce the impact of excessive fluoride intake on pregnancy complications in endemic fluorosis area.

Mechanisms for Nogo-B mediating mitochondrial reactive oxygen species generation during vascular remodeling in mice / 中华老年医学杂志

Objective:To investigate the role of Nogo-B in mitochondrial reactive oxygen species(m-ROS)production and vascular remodeling in vascular smooth muscle cells(VSMCs), and to further clarify the molecular mechanism for Nogo-B in m-ROS production via regulating ATP synthase expression.Methods:A mouse model of vascular remodeling was established.The expression of Nogo-B in mouse smooth muscle cells was detected.Forty mice were divided into the AAV-NC+ control, AAV-NC+ angiotensin Ⅱ(AngⅡ), AAV-Nogo-B+ control and AAV-Nogo-B+ AngⅡ groups(n=10 for each group). VSMCs cultured in vitro were divided into the control group and the Nogo-B overexpression group(Ad-Nogo-B). The expression of Nogo-B in VSMCs in vitro stimulated with AngⅡ was detected.Through experiments conducted in vivo, Nogo-B was overexpressed in VSMCs, then VSMCs were stimulated with AngⅡ, and m-ROS production, tissue fibrosis and mitochondrial function were examined.The regulatory effects of Nogo-B on m-ROS production were explored.Molecular mechanisms for NoGO-B in vascular remodeling via regulating ATP synthase/m-ROS production were examined. Results:Compared with the control group, the expression of Nogo-B was decreased in VSMCs treated with AngⅡ(0.36±0.13 vs.1.00±0.13, t=8.44, P<0.05). The production of m-ROS, fibrosis and mitochondrial dysfunction were increased in VSMCs during vascular remodeling( P<0.05), while overexpression of Nogo-B significantly reduced m-ROS production, fibrosis and mitochondrial dysfunction( P<0.05). ATP synthase expression in VSMCs was positively regulated by Nogo-B.ATP synthase expression was higher in the AAV-Nogo-B+ AngⅡ group than in the AAV-NC+ AngⅡ group(0.86±0.14 vs.0.49±0.17, t=-3.97, P<0.05). The production of m-ROS was reduced by Nogo-B and was lower in the AAV-Nogo-B+ AngⅡ group than in the AAV-NC+ AngⅡ group(1.28±0.34 vs.3.26±0.57, t=7.18, P<0.05). Meanwhile, the ability of Nogo-B to mitigate the deleterious effects of oxidative stress in VSMCs could be offset by oligomycin. Conclusions:Nogo-B participates in vascular remodeling by regulating ATP synthase-mediated m-ROS production.

Application and reflection of mind map in pediatric surgery practice teaching / 中华医学教育探索杂志

Based on the current situation of pediatric surgery practice teaching in Qilu Hospital of Shandong University, 10 mind maps of common clinical diseases made by Imindmap 11 were applied to the practice teaching and teaching assessment through WeChat public platform. Mind map not only revealed the relationship between related disciplines and reappeared the clinical thinking process, but also greatly improved the enthusiasm and efficiency of interns' learning, and trained their innovative spirit and practical ability. At the same time, as a formative evaluation method, mind map facilitates teachers to evaluate and improves teaching activities. What’s more, it effectively improves the quality of teaching, and is worth promoting in clinical teaching.

Effect of laparoscopic rectopexy with Douglas pouch repair and the procedure for prolapse and hemorrhoids for complete rectal prolapse / 中华普通外科杂志

Objective:To evaluate treatment of laparoscopic rectopexy with Douglas pouch repair plus the procedure for prolapse and hemorrhoids (PPH) for complete rectal prolapse (CRP).Methods:A total of 36 CRP patients treated by laparoscopic rectopexy associated with the procedure for PPH at No. 989 Hospital of PLA between Oct 2014 and June 2017 were retrospectively analyzed.Results:Operations were successful in all these 36 cases.One patient developed left post-op hydronephrosis and no other major complications were observed , such as intra-abdominal hemorrhage, infection. 2 of 36 patients developed recurrent prolapse. The constipation score and incontinence score at the 12th month after operation were significantly different from those before operation[(5.97±1.36) vs.(10.92±1.96), t=17.39, P<0.05; (6.28±1.49) vs.(10.81±2.16), t=16.32, P<0.05]. The constipation score and incontinence score at the 24th month after operation were significantly different from those before operation[(5.81±1.28) vs.(10.92±1.96), t=15.36, P<0.05 ; (6.03±1.67) vs.(10.81±2.16), t=14.64, P<0.05]. But there was no significant difference on the 12th and 24th month after surgery ( t=0.85, P>0.05 and t=1.12, P>0.05). Conclusions:Laparoscopic rectopexy with Douglas pouch repair plus the procedure for PPH for CRP is a effective treatment.

Application of a risk stratification-based model for prediction of acute kidney injury combined with hemoperfusion in patients with sepsis: a prospective, observational, pilot study / 中华危重病急救医学

Objective:To evaluate the efficacy and safety of a risk stratification-based model for prediction of acute kidney injury (AKI) combined with hemoperfusion (HP) in the treatment of patients with sepsis.Methods:A prospective, observational, pilot trial was conducted. The patients who met the Sepsis-3 diagnostic criteria admitted to intensive care unit of Lanzhou University Second Hospital from May to December in 2019 were enrolled as the research objects. Through the AKI early warning model established by the research group in the early stage, AKI risk > 30% was defined as AKI high risk. Patients with AKI high risk were enrolled in the observation group, and the remaining patients were enrolled in the control group. All patients were given conventional treatment, including the search and treatment of original infection sites, the use of antibiotics and main organ function support. Patients in the observation group were combined with HP treatment on the basis of conventional treatment, 2.5 hours per day for 3 days. The baseline data of gender, age, infection site, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, sequential organ failure assessment (SOFA) score, mean arterial pressure (MAP) and serum creatinine (SCr) were recorded. The inflammatory indexes such as interleukin-6 (IL-6), lipopolysaccharide (LPS) and procalcitonin (PCT) were detected at ICU admission, 24 hours and 72 hours after ICU admission, and the length of ICU stay, ICU mortality and bleeding were recorded.Results:Among the 49 patients with sepsis enrolled in this study, the main diagnosis was pneumonia, and Gram-negative (G -) bacilli were the main pathogenic bacteria [61.2% (30/49)]. Among them, 30 patients with AKI risk > 30% were in the observation group, and the remaining 19 patients were in the control group. There was no significant difference in gender, age, infection site, APACHE Ⅱ score, SOFA score, MAP or other baseline data between the two groups, but the baseline value of SCr in the observation group was significantly higher than that in the control group (μmol/L: 112.2±34.4 vs. 93.4±13.0, P < 0.05). At ICU admission, there was no significant difference in IL-6, LPS or PCT between the two groups. However, with the extension of ICU time, the inflammatory indexes of the two groups showed a downward trend. At 24 hours after ICU admission, there was no significant difference in IL-6, LPS or PCT between the two groups. At 72 hours after ICU admission, IL-6 in the experimental group decreased significantly as compared with the control group (ng/L: 90.9±38.1 vs. 119.1±41.9, P < 0.05), but there was no significant difference in LPS or PCT between the two groups. The length of ICU stay in the experimental group was significantly shorter than that in the control group (days: 9.77±2.76 vs. 12.47±3.85, P < 0.01), but there was no significant difference in the ICU mortality between the experimental group and control group (20.0% vs. 21.1%, P > 0.05). None of the 49 patients had severe bleeding events. Conclusions:The application of a risk stratification-based model for prediction of AKI combined with HP in septic patients is feasible both in theory and in clinical practice, and shortens the length of ICU stay, but fails to effectively remove inflammatory mediators or reduce sepsis mortality. A large sample, multicenter, randomized controlled study is still needed for further verification.

The effect of laparoscopic rectopexy with Douglas pouch repair combined with procedure for prolapse and hemorrhoids (PPH) based on pelvic anatomy for rectal internal mucosal prolapse / 中华普通外科杂志

Objective To evaluate the effect of laparoscopic rectopexy with Douglas pouch repair combined with procedure for prolapse and hemorrhoids (PPH) based on pelvic anatomy for rectal internal mucosal prolapse.Methods From Mar 2009 to Sep 2011.37 patients (group A) received taparoscopic rectopexy with Douglas pouch repair based on pelvic anatomy,and group B (n =41) received laparoscopic rectopexy with Douglas pouch repair combined with PPH.Constipation level,degree of internal prolapse,relapse and postoperative complications were assessed in 5 years after operation.Results 5 years after operation,the relief of constipation and the improvement of internal prolapse in group B were better than in group A [(-0.4 ± 0.9) cm vs.(-1.0 ± 1.1) cm,t =2.370,P =0.020].The recurrence rate in group B was statistically lower than that in group A (10％ vs.30％,x2 =4.995,P =0.025).Grade Ⅰ to Grade Ⅲ complications between the two groups was not statistically different (11％ vs.12％,x2 =0.037,P =0.848).Conclusions The effect of laparoscopic rectopexy with Douglas pouch repair combined with PPH based on pelvic anatomy for rectal internal mucosal prolapse was superior to laparoscopic rectopexy with Douglas pouch repair.

Safety and efficacy of 177Lu-PSMA-617 therapy in metastatic castration-resistant prostate cancer / 中华核医学与分子影像杂志

Objective To investigate the safety and efficacy of 177Lu-prostate specific membrane antigen (PSMA)-617 in the treatment of metastatic castration-resistant prostate cancer (mCRPC).Methods From August 2017 to September 2018,11 patients(average age 70.6 years) with mCRPC who underwent 177Lu-PSMA-617 therapy in Nanjing First Hospital were studied.All patients underwent 68Ga-PSMA-11 PET/CT before therapy to assess the tumor radioactive uptake.Blood routine examination and renal function test results were documented before and after therapy to assess the safety.The efficacy was reflected by the changes of prostate specific antigen (PSA) levels and maximum standardized uptake value (SUVmax) on 68Ga-PSMA-11 PET/CT imaging.Paired t test and Wilcoxon's sign rank test were used to analyze the data.Results No acute side effects were observed after therapy of 177Lu-PSMA-617.There were no statistically significant differences after therapy in WBC counts,RBC counts,and PLT,as well as Hb levels (t values:-0.28-1.11,all P＞ 0.05).No kidney toxicity was found.The PSA level after 177Lu-PSMA-617 therapy was significantly lower than that before therapy (80.70 (14.29,1 538.00) μg/L vs 604.60 (88.41,3 980.00) μg/L;u =59,P =0.023).Of the 11 patients,only 2 had elevated PSA levels and disease progression,while the other 9 patients had varying decreases,of which 2/11 decreased by ＞30％ and 7/11 decreased by ＞50％.After therapy,SUVmax of metastatic lesions and metastatic lymph nodes were decreased in 9 and 2 patients respectively.Conclusions 177Lu-PSMA-617 has a good therapeutic value for mCRPC.It is safe and has no obvious side effects.

Applicationof"blendsign"onCTpredictingearlyhaematomaexpansioninacuteintracerebralhaemorrhage / 实用放射学杂志

Objective Toinvestigatethevalueof"blendsign"onCTtopredictearlyhaematomaexpansioninacuteintracerebral haemorrhage(ICH).Methods SeventyGninepatientswithacuteICH whounderwentbaselineCTscanwithin6hourswereenrolled retrospectively.TheywerealsorecheckedwithCTscanin24hours.Allpatientsweredividedintoearlyhaematomaexpansiongroup and nonGhae m ato m a expansion group according to the change of hae m orrhage volu m e.M ultivariable L o g istic regression analysis w as usedtodetermineindependentriskfactorsofearlyhaematomaexpansion.Results Therewere28cases (35.4%)withhaematoma expansionin79patients."Blendsign"wasobservedin23patientsonbaselineCTscan,16of23 (69.6%)patientsappearedhaematoma expansion.Thesensitivity,specificity,positivepredictivevalue,negativepredictivevalueof"blendsign"forpredictingearlyhaematoma expansion w ere 57.1%,86.2%,69.6%,78.6%.M ultivariable L o g istic regression analysis sho w ed baseline hae m orrhage volu m e and"blendsign"wereindependentlyassociatedwithhaematomaexpansion.Conclusion "Blendsign"canbeusedtopredicthematoma expansioninacuteICH,whichishelpfultoidentifyhighriskpatientswithearlyhaematomaexpansiontomakethetreatmentmore promptlyandaccurately.

Research status of sleep disorders in children / 中华实用儿科临床杂志

Good sleep plays a key role in children's physical growth,mental development and personality matu-rity.Sleep disorders are common and most easily neglected problems in children.Early sleep problems of children can sustain from childhood to adulthood,not only have relevance to the children's physical,cognitive and behavioral development,but also to be the high risk factors of the adult obesity,hypertension,depression,anxiety and other chronic diseases.A deep study of sleep disorders in children is very important for the protection of children's physical and men-tal health.This article reviews the etiology,classification,diagnosis and treatment of sleep disorders in children.

Identification and treatment of impulsive control disorder in children / 中华实用儿科临床杂志

Children impulse control disorder (CICD)is a kind of psychological disorder occurred in childhood. The early recognition and intervention in children with CICD have important significance for the healthy growth of chil-dren. Now,the classification,etiology,epidemiology,clinical features,differential diagnosis and treatment of CICD are reviewed in order to improve the recognition and treatment level of CICD.

Genetic analysis and prenatal diagnosis for patients with non-syndromic hearing impairment / 天津医药

Objective To explore the genetic pathogen of patients with non-syndromic hearing impairment and to provide prenatal diagnosis for the families of hereditary deafness. Methods Mutation screening of GJB2, SLC26A4, GJB3 and mitochondrial 12 S rRNA genes was performed in 208 patients with non-syndromic hearing impairment by gene chip. Then direct sequencing was used in 41 patients who were found one mutation of GJB2 or SLC26A4 gene. And prenatal diagnosis was carried out in two families by direct sequencing. Results Eighty-six patients (41.35％) were found at least one mutation by gene chip. Among them, 40 patients were found to carry two mutations and 46 patients were found to carry one mutation. The most frequent mutation was 235delC, which was found in 46 patients. And 12 cases were found the second mutation through direct sequencing. A total of 52 (25.00％) patients were detected two mutations. Prenatal diagnosis showed that one fetus carried compound mutations of 299-300delAT and 235delC, and another one carried heterozygous mutation of IVS7-2A>G. Conclusion Patients with non-syndromic hearing impairment can be accurately diagnosed by gene chip and Sanger sequencing. The prenatal diagnosis is primary means for high-risk fetuses.

Variation of matrix metalloproteinase 2 levels during Kartogenin-induced directional differentiation of human bone marrow mesenchymal stem cells / 中国组织工程研究

BACKGROUND:Kartogenin can induce chondrogenic differentiation of mesenchymal stem cel s as reported in in vitro experiments. The discovery of Kartogenin finds a novel path to cartilage repair, and it is expected to develop into a new drug to treat osteoarthritis. OBJECTIVE:To observe the inductive role of Kartogenin in the process of human bone marrow mesenchymal stem cel s differentiating into chondrocytes in vitro. METHODS:In vitro cultured human bone marrow mesenchymal stem cel s were grown to the logarithmic phase, and then divided into control group (0μmol/L Kartogenin), 1μmol/L Kartogenin group, and 10μmol/L Kartogenin group. After 72 hours of culture, cel proliferation and differentiation were observed microscopical y. Matrix metal oproteinase 2 and type II col agen levels in the cel supernatant were detected by enzyme linked immunosorbent assay and immunofluorescence staining, respectively. RESULTS AND CONCLUSION:Under the microscope, Kartogenin was shown to significantly promote the proliferation and differentiation of human bone marrow mesenchymal stem cel s. With the increase of Kartogenin concentrations, the level of type II col agen was increased, while the level of matrix metal oproteinase 2 was decreased. These findings indicate that Kartogenin can induce human bone marrow mesenchymal stem cel s to differentiate into chondrocytes, and with the increase of Kartogenin concentration, destruction of the cartilage extracel ular matrix may be inhibited.

SNP microarray analysis of retention abortion chorionic villus / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To compare villus cell culture and karyotype analysis with single nucleotide polymorphism (SNP) microarray technology for the detection of chorionic villus chromosome in patients with retention of abortion.</p><p><b>METHODS</b>Forty cases were analyzed with the two methods.</p><p><b>RESULTS</b>Chorionic villus culturing was successful in 29 cases, among which 10 were found to have an abnormal karyotypes. For the SNP microarray analysis, all 40 cases were successful, among which 16 were shown to have an abnormal molecular karyotype.</p><p><b>CONCLUSION</b>SNP microarray technology is highly accurate and specific, which is particularly suitable for the detection of chromosomal deletions or duplications, uniparental disomy, low-percentage mosaicism and other chromosomal abnormalities. It has provided an effective supplement to the conventional chorionic villus culture and karyotype analysis.</p>

Alterations of plasma glucocerabrosidase,protein phosphastase 2A and ceramide levels in patients with ischemic stroke / 中国脑血管病杂志

Objective Toanalyzethealterationsofplasmaglucocerebrosidase(GBA),protein phosphatase 2A (PP2A)and its degradation product ceramide in patients with ischemic stroke. Methods Atotalof45inpatientswithischemicstrokeattheDepartmentofNeurology,theAffiliated Hospital of Logistics College of the CAPF were enrolled from May to September 2013,and 45 age-and sex-matched healthy subjects at the Physical Examination Center collected at the same time period were used as a control group. Blood samples of the patients and healthy subjects were obtained,anticoagulated, and the plasma was separated. H50 protein chip and laser matrix-assisted laser desorption/ionization top of flymassspectrometrywereusedtotestthelevelsofplasmaceramide.Results TheplasmaGBAand PP2A activities in patients with ischemic stroke were significantly lower than those of the control group;the GBA activities of the ischemic stroke group and the control group were 2 . 4 ± 0 . 8 and 3 . 1 ± 1 . 4 U/L respectively. There was significant difference (P<0. 05);the PP2A activities of the two groups were 6. 5 ± 2. 8 and 14. 5 ± 4. 7 U/L respectively (P<0. 01). The relative level of the plasma ceramide in patients with ischemic stroke was 1. 9 ± 0. 7,and it was significantly lower than 12. 2 ± 5. 0 of the control group (P<0.01).Conclusion ThedecreasedlevelsofplasmaGBAandPP2Aactivitiesaswellasthe ceramide in patients with ischemic stroke suggested that the abnormal phosphorylation of synuclein in the blood of patients with stroke.