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The mechanisms of radiotherapy (RT) in cancer treatment are both by immunity and non-immunity pathways. According to different absorbed doses, the immune modulating effect of RT comprises of tumor microenvironment modulating effect, immune-modulatory effect as well as immune-ablative effect. RT could improve the therapeutic efficacy of immunotherapy, while immunotherapy could enlarge the immunity activating effect induced by RT in turn. Therefore, RT is emerging as a valuable partner of cancer immunotherapy. RT regimens have a vital impact on immunity within tumor microenvironment. Stereotactic body RT (SBRT) has obvious advantages regarding interferon production and abscopal effect. At present, potentially sub-ablative RT regimen of 8 Gy plus 3 fractionations is the most widely used SBRT. Several novel RT regimens, such as hybrid fractionation, singular site irradiation and multisite irradiation, have been designed to maximize the immune induction effect and improve the combination efficacy with immunotherapy in metastatic malignancies. In this review, the latest advances in the immune effect of RT were discussed and novel SBRT regimens were proposed, aiming to provide reference for enhancing the efficacy of radio-immunotherapy or immuno-radiotherapy in clinical practice.
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Objective:To investigate the changes and clinical significance of multiple cytokine levels in exhaled breath condensate (EBC) in patients undergoing tracheotomy with severe inhalation injury.Methods:A prospective study was conducted. A total of 32 patients with severe burn combined with severe inhalation injury admitted to the department of burns and plastic surgery of Affiliated Suzhou Hospital of Nanjing Medical University from May 2021 to August 2022 were enrolled. Twenty healthy volunteers from the same period were served as controls. EBC of patients at 12 hours after burn and the samples of healthy controls were collected. The levels of 27 cytokines in EBC, including tumor necrosis factor-α (TNF-α) and interleukins (IL-1β, IL-6, IL-8, IL-10, and IL-17), were determined by liquid phase chip technology. Meanwhile, plasma of patients at 12 hours after burn and the plasma of volunteers were collected, and the levels of inflammatory cytokines were detected by liquid chip technology, and the differences between the levels in plasma and those in EBC were analyzed. Plasma and EBC of patients with aspiration injury were collected at 12 hours and 3, 7, 14 and 21 days after burn, and TNF-α levels were determined by enzyme-linked immunosorbent assay (ELISA).Results:Finally, 32 patients were enrolled, and the total burned area was (40±16)% of total body surface area (TBSA). The time of admission was (4.2±2.3) hours after injury. ① Twenty-seven cytokines in EBC: 18 kinds of cytokines including macrophage inflammatory protein-1β (MIP-1β), IL-6, IL-5, IL-2, IL-1β, IL-8, IL-10, IL-15, IL-9, interferon-γ (IFN-γ), IL-1 receptor antagonist (IL-1ra), TNF-α, chemotactic factor for eosinophil (Eotaxin), basic fibroblast growth factor (bFGF), platelet derived growth factor-BB (PDGF-BB), interferon-inducible protein-10 (IP-10), monocyte chemoattractant protein-1 (MCP-1), granulocyte colony-stimulating factor (G-CSF) were significantly increased in patients with severe aspiration injury compared with health controls. Eotaxin was not detected in EBC of healthy controls. Five cytokines, granulocyte-macrophage colony-stimulating factor (GM-CSF), chemokine ligand 5 (CCL5/RANTES), IL-13, IL-4 and MIP-1α, were not detected in EBC of severe inhalation injury patients and healthy controls. Vascular endothelial growth factor (VEGF) and IL-12 p70 in EBC of severe aspiration injury patients were slightly decreased as compared with healthy controls, while IL-7 and IL-17 were slightly increased, but the differences were not statistically significant. ② Six inflammatory cytokines in plasma: the levels of IL-6 and IL-8 in the severe aspiration injury group were significantly increased as compared with healthy controls [IL-6 (ng/L): 18.51 (10.87, 26.21) vs. 0.22 (0.10, 0.36), IL-8 (ng/L): 10.75 (8.58, 18.79) vs. 1.06 (0.81, 2.14), both P < 0.01]. The plasma levels of TNF-α, IL-1β and IL-10 were slightly increased in patients with severe aspiration injury as compared with healthy controls, and IL-17 was slightly decreased, but the difference was not statistically significant. In the EBC collected during the same period, five inflammatory cytokines, including TNF-α, IL-1β, IL-6, IL-8 and IL-10, in patients with severe inhalation injury were significantly increased as compared with healthy controls [TNF-α (ng/L): 16.42 (12.57, 19.21) vs. 7.34 (6.11, 8.69), IL-1β (ng/L): 15.57 (10.53, 20.25) vs. 0.99 (0.67, 1.41), IL-6 (ng/L): 13.36 (9.76, 16.54) vs. 0.70 (0.42, 0.85), IL-8 (ng/L): 1 059.29 (906.91, 1 462.37) vs. 10.36 (8.40, 12.37), IL-10 (ng/L): 2.69 (1.54, 3.33) vs. 1.54 (1.18, 2.06), all P < 0.05]. ③ Dynamic changes of TNF-α in plasma and EBC: the level of TNF-α in EBC of patients with severe aspiration injury was lower than that in plasma. Plasma TNF-α level was increased gradually with the extension of time after injury, and was significantly higher than that of healthy controls on day 3 [ng/L: 30.38 (24.32, 39.19) vs. 22.94 (17.15, 30.74), P < 0.05], and reached the peak on day 14, then fell back. The level of TNF-α in EBC at 12 hours after injury was significantly higher than that in healthy controls [ng/L: 15.34 (11.75, 18.14) vs. 6.99 (6.53, 7.84), P < 0.01], and reached the peak on 3 days after injury, and then gradually decreased. Conclusion:There are changes in the expression of multiple cytokines in EBC of patients with severe inhalation injury, and the changes of many inflammatory cytokines including TNF-α are more sensitive than those in plasma, which can be used to monitor and evaluate the condition of patients with inhalation injury.
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Radiotherapy is an important treatment method for malignant tumors. Radiation resistance is the main obstacle to the therapeutic effect of radiotherapy. Cellular metabolic reprogramming is one of the main features of cancer, and it may have an important effect on the therapeutic effect of radiotherapy. Glutamine is closely related to tumor cell biosynthesis and growth. It affects radiotherapy sensitivity by producing antioxidants through decomposition. In addition, the expression patterns and functions of two isoenzymes of glutamine, namely, glutaminase (GLS) and glutaminase 2 (GLS2), are different and have an important influence on the sensitivity of radiotherapy. The utilization of glutamine metabolism in the tumor microenvironment has great research value to improve the efficacy of radiotherapy. This review describes the metabolic characteristics of glutamine in malignant tumors and the sensitization effect of glutamine inhibitors on the efficacy of radiotherapy.
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【Objective】 Coronary no-reflow during percutaneous conranary intervention (PCI) often results in the failure of ischemic myocardial reperfusion and major adverse cardiovascular events (MACE). The present study sought to evaluate whether the GRACE risk score can predict coronary no-reflow in STEMI patients undergoing PCI. 【Methods】 We consecutively recruited 1 118 patients with STEMI who were admitted to Gansu Provincial People’s Hospital and The First Affiliated Hospital of Xi’an Jiaotong University from January 2009 to December 2011. Main demographic data, cardiovascular risk factors, blood lipid and other biochemical indicators were recorded. Coronary angiography was performed by a radial artery approach using the standard Judkins technique. Coronary no-reflow was evaluated by at least two independent experienced cardiologists. The GRACE risk score was calculated with a computer program. All the cases were followed up by medical records, face-to-face interviews or telephone calls. Finally, we analyzed the predictive value of the GRACE risk score for coronary non-reflow and MACE in STEMI patients undergoing PCI. 【Results】 During a median period of 36 months, 58 of the 1 118 patients (5.2%) were lost to follow-up. Of the remaining 1 060 patients, 118 (11.1%) had no-reflow and 147 (13.9%) had MACE. The GRACE score was higher in patients with no-reflow than those without no-reflow. Multivariate logistic regression established that the GRACE score was an independent predictor for coronary no-reflow (OR=1.034; P=0.002). And multivariate Cox analysis showed the GRACE score was an independent predictor of MACE. The area under the ROC curve for coronary no-reflow and MACE was 0.719 and 0.697, respectively. Kaplan-Meier analysis showed that the probability of rehospitalization for heart failure, reinfarction, all-cause death and cumulative cardiovascular events increased with the increase of the GRACE risk score. 【Conclusion】 The GRACE risk score is a readily available predictive scoring system for coronary no-reflow and MACE in STEMI patients.
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Objective:To summarize the clinical experience of treating patients with severe acute organic fluorine poisoning using extracorporeal membrane oxygenation (ECMO).Methods:In January 2021, an acute mass organic fluorine gas poisoning incident occurred in Quzhou, Zhejiang Province. The clinical data of 4 severe patients with acute poisoning of organic fluorine treated by ECMO in our hospital were retrospectively analyzed, and the epidemiological characteristics, clinical symptoms, signs, the abnormal laboratory studies/examinations, and treatments of this kind poisoning patients, especially, the treatment pattern, support time, complications, and outcomes of ECMO were collected and analyzed.Results:All the 4 patients were male, with an average age of (52±9) years, and all of them came to the emergency department complaining chest tightness, cough and pharyngeal discomfort 6 h after exposure by inhalation. The patient’s condition progressed rapidly with severe acute respiratory failure and circulatory failure as the prominent manifestations. The mechanical ventilations were performed (13.0±4.8) h after poisoning, and ECMO treatment was performed (15.5±5.3) h after poisoning. Among them, 2 patients were treated using venoarterial (VA) ECMO, and 2 patients using venovenous (VV) ECMO, but 1 patient was converted to VA-ECMO 8 h later. The duration of ECMO support for the patients was (8.8±3.6) d. The duration of mechanical ventilation was (23.0±28.7) d and stay in intensive care unit was (42.0±55.4) d. Among them, one patient was transferred to a specialized rehabilitation hospital after the amputation surgery due to lower limb necrosis after VA-ECMO support, and the remaining 3 patients were discharged after recovery.Conclusions:ECMO support might have the irreplaceable value in the treatment of patients with severe acute organic fluorine poisoning, and should be considered as one of the reserves of regional health care system in dealing with public health emergencies.
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Objective:To investigate the expression of miRNA-21 in serum of patients with multiple myeloma (MM) and its significance.Methods:The data of 55 MM patients and 20 healthy controls in the Second Hospital of Hebei Medical University from July 2019 to June 2020 were retrospectively analyzed. Among the MM patients, 20 cases were diagnosed without treatment, 15 cases were in complete remission (CR), and 20 cases were clinically relapsed. Blood samples were collected from all subjects, and the relative expression levels of miRNA-21 were detected by real-time quantitative polymerase chain reaction (qRT-PCR), and the correlation of miRNA-21 expression with β 2-macroglobulin (β 2-MG), creatinine, hemoglobin, albumin, t(4;14) mutation, 13q14 mutation and prognosis were analyzed. The MM cell line LP-1 was selected, and normal bone marrow CD138-positive plasma cells were sorted by immunomagnetic beads as control cells. The relative expression levels of miRNA-21 in the two groups of cells were detected by qRT-PCR. Results:The serum relative expression level of miRNA-21 in MM group was higher than that in healthy control group (1.50±0.10 vs. 1.03±0.06, t = 7.04, P = 0.002). The serum expressions of miRNA-21 in newly diagnosed untreated MM patients and relapsed/refractory MM patients were high (1.50±0.10 and 3.13±0.32), and compared with the healthy control group, the differences were statistically significant ( t values were 7.04 and 10.22, both P < 0.05). The relative expression level of miRNA-21 in MM patients with complete remission (CR) was 1.27±0.25, which had no significant difference compared with the healthy control group ( t = 1.76, P = 0.152). The serum expression level of miRNA-21 in MM patients with high β 2-MG, high creatinine, low hemoglobin, low albumin, t(4;14) mutation, 13q14 mutation, non-remission and recurrence was significantly increased (all P < 0.05). The relative expression level of miRNA-21 in LP-1 cell line was higher than that in control cells (1.56±0.05 vs. 1.00±0.06), and the difference was statistically significant ( t = 11.73, P < 0.01). Conclusions:The miRNA-21 may be a molecular marker to assist in the diagnosis and efficacy evaluation of MM.
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Objective:To analyze the status of extracorporeal membrane oxygenation (ECMO) for poisoned patients in China, and prognosis, complications and risk factors for death in poisoned patients supported with ECMO.Methods:The data of adult poisoned patients registered in Chinese Society of Extracorporeal Life Support (CSECLS) database were collected. Patients were divided into the survival group and death group according to the conditions at discharge. The type of poisoning, patient prognosis, hemodynamic parameters and complications before and after ECMO were retrospectively analyzed.Results:A total of 96 poisoned patients supported with ECMO were included in the database from 2017 to 2022, including 77 adult patients. The use of ECMO for poisoning was more common in Henan Province (28 cases, 36%), Guangdong Province (11 cases, 14%) and Zhejiang Province (9 cases, 8%). The number of adult poisoned patients registered in the database increased over time from 2017 to 2022, but the survival rate showed no significant difference ( P = 0.794). Agricultural poisoning was the most common indication (43%). Veno-arterial (V-A) ECMO was used in 60 patients (78%) and venovenous (V-V) ECMO in 27 patients (22%). Thirty-two patients (42%) survived to hospital discharge. The mean duration of ECMO support was 57 (34, 123) h, the mean duration of mechanical ventilation was 88 (33, 211) h, the mean length of hospital stay was 10 (2, 21) days, and the mean length of ICU stay was 9 (2, 18) days. Multivariate analysis showed that 24-h lactic acid level was significantly associated with mortality ( OR = 0.378, 95% CI: 0.183-0.779, P = 0.008). Conclusions:ECMO can be used as a salvage strategy to treat various types of severe poisoning. Although the application of ECMO is expanded rapidly in China, it is still necessary to optimize intervention indications and treatment timing, and adopt standardized ECMO management and monitoring strategies to improve the prognosis of patients.
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Objective This article takes a cosmetics factory in Yichang City as an example, uses a variety of methodologies to explore methods of health impact assessment and provides methodological references for future health evaluation of related public policies. Methods By analyzing the environmental assessment report of the cosmetic renovation project, an indicator system was established and expert consultation meetings were conducted to score the impact of the corresponding indicators on health. The impact of the renovation project of the factory on the factory workers, surrounding residents and the sustainable development of the environment was analyzed by means of the Kaiser model with the risk matrix and the Borda value. Results The risk values of the five influencing factors of industrial wastewater, domestic wastewater, industrial waste gas, industrial waste and noise were 5.11%, 5.43%, 10.6%, 6.71% and 7.02% respectively. All the influencing factors were in the green zone of the risk matrix. The Borda values of the five influencing factors of industrial waste water, domestic waste water, industrial waste gas, industrial waste residue and noise were 4, 5, 10, 7 and 5 respectively. Conclusion The multiple methodologies adopted in the factory renovation project are feasible, and can provide new ideas for the health impact assessment of public policies in the future.
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To investigate the clinical manifestations and risk factors in patients with systemic lupus erythematosus (SLE) and cancers. From October 2010 to February 2019, 5 566 SLE patients hospitalized in the First Affiliated Hospital of Zhengzhou University were enrolled. A total of 69 cancer patients were identified, and the clinical characteristics and previous treatment were analyzed. Cervical carcinoma (21.74%, 15/69) and thyroid cancer (21.74%, 15/69) were the most common types of cancer. Most cancers were diagnosed in SLE patients with an age 40~50 years. The disease duration of SLE was from 60~120 months. SLE patients without cancers were usually diagnosed between 20~30 years with duration of symptoms less than 12 months. As to the previous treatment of SLE, the uses of glucocorticoid, cyclophosphamide, methotrexate and azathioprine were comparable between patients with cancers and without (P>0.05). However, the use of hydroxychloroquine was more frequent in SLE patients than in patients with cancers (P<0.01). Correlation analysis revealed significant correlation between disease course of SLE (OR=4.25, 95%CI 1.79~10.01,P<0.001), hydroxychloroquine (OR=0.26, 95%CI 0.12~0.59,P<0.001) and cancer risk. Long disease course may be a risk factor for SLE patients to develop cancer, whereas hydroxychloroquine could be a protective factor.
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Objective To evaluate the construction status of a healthy city in central China, and clarify the weak links and construction results in the construction of a healthy city, and to provide a basis for the relevant government departments to issue policies. Methods Healthy city construction evaluation system in this city was established according to the National Healthy City Construction Evaluation System (2018) of the National Healthy City Evaluation Office Forty-two sets of health city construction index data in 2017-2018 were collected and analyzed. The single index was calculated according to the Guidance Manual for Filling in the Healthy City Evaluation Data, and the single index data was then standardized. The Delphi method was used to consult the weights of the three-level index. Finally, the sub-index and the total index of each dimension of the city's healthy city construction were calculated based on the health index method. Results The results of the 2017-2018 healthy city construction evaluation showed that 35 of the 42 indexes participated in the evaluation, and the total-indices of the two years were 77.71 and 79.95, respectively. The two-year sub-indices of the five dimensions of health service, health culture, health environment, healthy population, and healthy society were 17.17 and 18.32, 11.39 and 12.85, 19.21 and 17.94, 13.81 and 13.81, 16.12 and 17.04, respectively. Except for the decline in the health environment dimension, the other four sub-indices and the total healthy city index showed an upward trend year by year. In the past two years, the comprehensive proportions of the corresponding weight of the five dimensions sub-indices were 95.58% in health culture, 95.47% in health service, 73.99% in health environment, 73.27% in healthy society, and 69.52% in healthy people. Conclusion After the construction of national healthy city and the pilot construction of national healthy city, a city in central China achieved its first results in five dimensions of healthy city. In 2018, among the 35 indexes participated in the evaluation in this city, 30 were positive, and 26 were better than the national/ provincial target value. However, some construction indices were still far from the standard values. The development of the five dimensions was unbalanced, and there were weak links in different degrees.
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To investigate the clinical manifestations and risk factors in patients with systemic lupus erythematosus (SLE) and cancers. From October 2010 to February 2019, 5 566 SLE patients hospitalized in the First Affiliated Hospital of Zhengzhou University were enrolled. A total of 69 cancer patients were identified, and the clinical characteristics and previous treatment were analyzed. Cervical carcinoma (21.74%, 15/69) and thyroid cancer (21.74%, 15/69) were the most common types of cancer. Most cancers were diagnosed in SLE patients with an age 40~50 years. The disease duration of SLE was from 60~120 months. SLE patients without cancers were usually diagnosed between 20~30 years with duration of symptoms less than 12 months. As to the previous treatment of SLE, the uses of glucocorticoid, cyclophosphamide, methotrexate and azathioprine were comparable between patients with cancers and without ( P>0.05). However, the use of hydroxychloroquine was more frequent in SLE patients than in patients with cancers ( P<0.01). Correlation analysis revealed significant correlation between disease course of SLE ( OR=4.25, 95% CI 1.79~10.01, P<0.001), hydroxychloroquine ( OR=0.26, 95% CI 0.12~0.59, P<0.001) and cancer risk. Long disease course may be a risk factor for SLE patients to develop cancer, whereas hydroxychloroquine could be a protective factor.
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Health related behaviors are closely related to health outcomes. This paper reviews the studies on factors for health related behaviors worldwide published in recent 15 years, and systematically summarizes the current research status of the factors for health related behaviors. The factors influencing health related behaviors are individual social demographic factors, social cognitive factors of individuals, and social environmental factors. The individual social demographic factors mainly include gender, age, marital status, economic level and educational level. The social cognitive factors of individuals mainly include self-efficacy, health belief, social support and peer influence. The social environmental factors mainly include mass media, accessibility of facilities and level of urbanization, etc.
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Objective@#To analyze the clinical characteristics and gene mutations of early-onset epileptic encephalopathy(EOEE) caused by ion channel gene mutation, to identify the etiology, to guide the treatment and to provide the basis for genetic counseling.@*Methods@#The clinical data from 17 children with EOEE caused by ion channel gene mutation and the peripheral blood of the children and their parents were collected from June 2014 to May 2018 at the Department of Neurology, Tianjin Children′s Hospital.Epilepsy gene sequencing was performed by using disease gene targeting second generation sequencing technology.The mutation of pathogenic ion channel gene was found.The confirmed mutations were verified by Sanger sequencing and the source of the mutation was identified.@*Results@#Among 17 case with EOEE, 3 cases had genetic mutation, and 14 cases had denovo mutations.Dravet syndrome was found in 8 cases (47.1%), there were SCN1A gene missense mutation in 5 cases, SCN1A gene nonsense mutation in 3 cases, KCNQ2 gene missense mutation in 1 case (5.9%) and non-specific epileptic encephalopathy in 8 cases (47.1%). SCN2A gene missense mutation, SCN4A gene missense mutation, SCN8A gene missense mutation, KCNQ2 gene missense mutation and KCNH gene missense mutation were found in suspected pathogenic mutations.There were 1 missense mutation out of 5 genes, 1 missense mutation of CACNA1A gene, 1 missense mutation of GRIN2A gene and 1 missense mutation of GRIN3A gene.Seventeen patients were treated with 2 or more antiepileptic drugs, 4 with ketogenic diet and 1 with vitamin B6 supplementation.During 11 to 96 months of follow-up, seizures were completely controlled in 3 cases (17.6%), decreased in 7 cases (41.2%) by more than 50%, and decreased in 7 cases (41.2%) by less than 50%.@*Conclusions@#The clinical phenotypes for children with unexplained EOEE are varied, and gene mutations of ion cha-nnel are most common.Some gene sites are denovo mutations which have not been reported such as missense mutation for 3 case SCN1A gene, 1 case SCN2A gene, 1 case CACNA1A gene, 1 case KCNH5 gene, and nonsense mutation for 2 case SCN1A gene, which have enriched the mutation spectrum of EOEE.
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A 37-year-old woman presented with a congenital spinal meningocele for 37 years and ruptured for 6 months. She was admitted to the Plastic Surgery Hospital of the Chinese Academy of Medical Sciences in March 2018. The diameter of the lesion was about 10 cm, with purulent secretion and malodor. The superior gluteal artery perforator propeller flap was used to reconstruct the defect after the lesion resection. Part of the wound didn’t heal and cerebrospinal fluid leaked from the wound postoperatively. The wound eventually healed after wound debridement and drainage changing. Cerebrospinal fluid retention under the flap could result in wound dehiscence and cerebrospinal fluid leakage. The author introduced the treatment process and operative method. The preliminary experience in treating cerebrospinal fluid leakage after surgical management of the spinal meningocele was also summarized.
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Objective To analyze the clinical characteristics and gene mutations of early －onset epileptic encephalopathy(EOEE)caused by ion channel gene mutation,to identify the etiology,to guide the treatment and to pro﹣vide the basis for genetic counseling. Methods The clinical data from 17 children with EOEE caused by ion channel gene mutation and the peripheral blood of the children and their parents were collected from June 2014 to May 2018 at the Department of Neurology,Tianjin Children′s Hospital. Epilepsy gene sequencing was performed by using disease gene targeting second generation sequencing technology. The mutation of pathogenic ion channel gene was found. The confirmed mutations were verified by Sanger sequencing and the source of the mutation was identified. Results Among 17 case with EOEE,3 cases had genetic mutation,and 14 cases had denovo mutations. Dravet syndrome was found in 8 cases(47. 1﹪),there were SCN1A gene missense mutation in 5 cases,SCN1A gene nonsense mutation in 3 cases, KCNQ2 gene missense mutation in 1 case(5. 9﹪)and non－specific epileptic encephalopathy in 8 cases(47. 1﹪). SCN2A gene missense mutation,SCN4A gene missense mutation,SCN8A gene missense mutation,KCNQ2 gene missense mutation and KCNH gene missense mutation were found in suspected pathogenic mutations. There were 1 missense mu﹣tation out of 5 genes,1 missense mutation of CACNA1A gene,1 missense mutation of GRIN2A gene and 1 missense mu﹣tation of GRIN3A gene. Seventeen patients were treated with 2 or more antiepileptic drugs,4 with ketogenic diet and 1 with vitamin B6 supplementation. During 11 to 96 months of follow－up,seizures were completely controlled in 3 cases (17. 6﹪),decreased in 7 cases(41. 2﹪)by more than 50﹪,and decreased in 7 cases(41. 2﹪)by less than 50﹪. Conclusions The clinical phenotypes for children with unexplained EOEE are varied,and gene mutations of ion cha﹣nnel are most common. Some gene sites are denovo mutations which have not been reported such as missense mutation for 3 case SCN1A gene,1 case SCN2A gene,1 case CACNA1A gene,1 case KCNH5 gene,and nonsense mutation for 2 case SCN1A gene,which have enriched the mutation spectrum of EOEE.
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Objective To explore the related factors and clinical significance of the effect of irrigation on infant with dacryocystitis. Methods A total of 318 eyes of 262 infant were treated with dacryocystitis, and their overall curative effect was observed. Single factor correlation analysis and multivariate Logistic regression were used to analyze 8 factors related to efficacy, such as age of children, length of medical history, severity of symptoms, degree of operation of nurses, degree of parental cooperation, compliance with medication, massage therapy and treatment methods. The effect of each factor on the curative effect. Results It was found that the total effective rate was 90.56 percent of the lacrimal passage in children with 318 tear channel obstruction and dacryocystitis.Single factor analysis results show that the factors influencing the curative effect of single in treatment (χ2= 88.984, P < 0.01), symptom severity (χ2=14.185,P < 0.05) length of history (χ2=18.783, P < 0.05) difference and massage therapy (χ2=10.081, P < 0.05) was statistically significant, the three factors of multiariable Logistic regression analysis results showed that the treatment (P=0.000, OR=0.148,95％ CI 0.052- 0.419) and massage therapy (P=0.012, OR=3.390, 95％ CI 1.309- 8.777) affected infant lacrimal duct flushing out main factors influencing the efficacy of tong. Conclusions The main influencing factors are the different treatment modalities, severity of symptoms the length of medical history and massage therapy in the related factors that affect the effect of infantwith dacryocystitis.
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Epilepsy is a chronic brain lesion caused by a variety of pathological factors. It is characterized by repeatability, transient and seizure, and is one of the common neurological systemic diseases in children. Seizures can induce structural changes of sleep and cause sleep disorders, and sleep disorders call induce interictal epileptiform discharges and seizures. The abnormal sleep structure of children with epilepsy is characterized by decreased total sleep time, prolonged sleep latency, prolonged latency of rapid eye movement (REM), and decreased proportion of sleep fragments and shortened sleep cycle time. Epilepsy and sleep are closely related and complex. Controlling seizures can help improve the quality of sleep. The normalization of sleep structure in children with epilepsy can help control seizures, thus improving overall quality of life and long-term prognosis.
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Objective To explore the value of OSCE system combined with intelligent network in-formation platform in clinical skills assessment of obstetrics and gynecology. Methods 112 clinical medi-cal students who participated in the practice of gynecology and obstetrics in Second Military Medical Uni-versity in 2017 were randomly divided into the experimental group (network information OSCE) and the control group (traditional OSCE). The teaching results were evaluated by the questionnaire survey of teachers and students and the examination results as well. The statistical analysis was made with the Chi-square test and the t test respectively. Results According to the questionnaire survey of two skills assessment methods, the satisfaction index of the experimental group was higher than that of the control group in both teachers and students, and the difference was statistically significant (P<0.05). The total time of examination in the experimental group was lower than that of the control group, and the difference was statistically significant (P<0.05). The final total score and the results of case analysis and clinical operation examination of experi-mental group were all higher than those of the control group, but there was no statistical difference (P>0.05). Conclusion OSCE combined with the network information system has an unparalleled advantage in the assessment of the obstetrics and gynecology department. The system will promote clinical education of ob-stetrics and gynecology and the evaluation of the clinical ability of the medical students to a new height, which deserves popularization.
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19 cases with vertical alveolar bone resoption wer examined by CBCT and treated by orthodentic therapy, the changes of alveolar ridge height, bone defect and bone mineral density were analysed. After treatment, the defect area of alveolar bone was decreased(P＜ 0. 05), the density of defect area of alveolar bone was increased(P＜ 0. 05). CBCT plays an important role in the evaluation of vertical alveolar bone absorption and reconstruction treated by orthodontic therapy.
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Objective To understand genetic mutation sites in linezolid (LZD)-sensitive and inducible resistant strains of methicillin-resistant Staphylococcus aureus (MRSA) using whole-genome sequencing,and realize mutation sites of LZD-resistant gene.Methods MRSA-MS4 with explicit genotype and whole-genome sequences was induced by LZD of different concentration gradients,LZD-resistant strain MRSA-MS4-LZD100 was obtained,minimum inhibitory concentration(MIC) was detected,domain V of 23S rRNA and ribosomal proteins L3/L4 gene in MRSAMS4-LZD100 were amplified by polymerase chain reaction (PCR),the sequenced products obtained the corresponding mutation site in contrast with the wild-type strain;Illumina PE library was constructed through paired-end sequencing by Illumina HiSeq 2000 technique,and whole genome sequencing was completed based on bioinformatics.Results MRAS-MS4-LZD100 strain was induced after 32 passages,MIC of LZD was 96 μg/mL.Sequencing of PCR products indicated the genetic variations were G2447T mutation in multiple copies of domain V of 23S rRNA gene,and Gly113Val mutation in L3 protein respectively;the whole genome of MRSA-MS4-LZD100 contained 2 744 315 bp,annotation of the whole genome found a total of 2 509 genes,11 tRNA-encoding genes and 2 entire rRNA-encoding operons.The data were submitted to the PubMed,and the GeneBank accession number JXMJ00000000 was assigned;a total of 101 SNPs and 6 Small indels were found,16 of 101SNP mutations occurred in exon,of which the variant proteins with anmino acid sequence alterations included IstB ATP binding domain-containing protein,clumping factor A,IS1272 transposase and so on;3 of 6 Small indel mutations occurred in exon,of which the variant proteins with anmino acid sequence alterations included hypothetical protein,30S ribosomal protein S1,and clumping factor A.Conclusion LZD-resistant strain MRSA-MS4-LZD100 was successfully induced by LZD;beside 23S rRNA V domain and ribosomal L3 protein,the other mutant site exist in this resistant strain,which provide some direction for subsequent study of recessive LZD resistance mechanism.