Effect and influence factors of cardiopulmonary resuscitation in children with congenital heart disease in pediatric intensive care unit / 中华儿科杂志

Objective: To investigate the prognostic factors of children with congenital heart disease (CHD) who had undergone cardiopulmonary resuscitation (CPR) in pediatric intensive care unit (PICU) in China. Methods: From November 2017 to October 2018, this retrospective multi-center study was conducted in 11 hospitals in China. It contained data from 281 cases who had undergone CPR and all of the subjects were divided into CHD group and non-CHD group. The general condition, duration of CPR, epinephrine doses during resuscitation, recovery of spontaneous circulation (ROSC), discharge survival rate and pediatric cerebral performance category in viable children at discharge were compared. According to whether malignant arrhythmia is the direct cause of cardiopulmonary arrest or not, children in CHD and non-CHD groups were divided into 2 subgroups: arrhythmia and non-arrhythmia, and the ROSC and survival rate to discharge were compared. Data in both groups were analyzed by t-test, chi-square analysis or ANOVA, and logistic regression were used to analyze the prognostic factors for ROSC and survival to discharge after cardiac arrest (CA). Results: The incidence of CA in PICU was 3.2% (372/11 588), and the implementation rate of CPR was 75.5% (281/372). There were 144 males and 137 females with median age of 32.8 (5.6, 42.7) months in all 281 CPA cases who received CPR. CHD group had 56 cases while non-CHD had 225 cases, with the percentage of 19.9% (56/281) and 80.1% (225/281) respectively. The proportion of female in CHD group was 60.7% (34/56) which was higher than that in non-CHD group (45.8%, 103/225) (χ2=4.00, P=0.045). There were no differences in ROSC and rate of survival to discharge between the two groups (P>0.05). The ROSC rate of children with arthythmid in CHD group was 70.0% (28/40), higher than 6/16 for non-arrhythmic children (χ2=5.06, P=0.024). At discharge, the pediatric cerebral performance category scores (1-3 scores) of CHD and non-CHD child were 50.9% (26/51) and 44.9% (92/205) respectively. Logistic regression analysis indicated that the independent prognostic factors of ROSC and survival to discharge in children with CHD were CPR duration (odds ratio (OR)=0.95, 0.97; 95%CI: 0.92~0.97, 0.95~0.99; both P<0.05) and epinephrine dosage (OR=0.87 and 0.79, 95%CI: 0.76-1.00 and 0.69-0.89, respectively; both P<0.05). Conclusions: There is no difference between CHD and non-CHD children in ROSC and survival rate of survival to discharge was low. The epinephrine dosage and the duration of CPR are related to the ROSC and survival to discharge of children with CHD.

Analysis of the predictive value of serum Nesfatin-1 combined with the Status Epilepticus Severity Score in the short-term prognosis of children with status epilepticus / 中华实用儿科临床杂志

Objective:To analyze the predictive value of serum Nesfatin-1 combined with the Status Epilepticus Severity Scale (STESS) score on the short-term prognosis of children with status epilepticus (SE).Methods:A clinical data of 145 children with SE who were admitted to the Children′s Hospital Affiliated to Zhengzhou University, Henan Children′s Hospital, Zhengzhou Children′s Hospital, from January 2016 to January 2020 were analyzed retrospectively.After admission, the serum levels of Nesfatin-1 and the STESS score were measured.According to the Glasgow Outcome Scale (GOS) score at discharge, children with SE were divided into poor prognosis group (<5 scores) and good prognosis group (5 scores). Univariate and multivariate Logisitc regression analyses were performed to analyze influence of the serum Nesfatin-1 level and STESS score on the short-term prognosis of children with SE.Receiver operating characteristic (ROC) curve was depicted to evaluate the predictive value of serum Nesfatin-1 level combined with STESS score in the short-term prognosis of children with SE. Results:Twenty-five cases out of 145 (17.24%) children with SE were discharged with a GOS score of <5 (poor prognosis group), 120 cases were in the good prognosis group.In the poor prognosis group, the overall attack (88.00% vs.66.67%), attack time of SE > 1 h (76.00% vs.27.50%), admission to child intensive care unit(PICU) (76.00% vs.37.50%), implementation of endotracheal intubation (16.00% vs.5.00%), abnormal electroencephalogram(EEG) results (73.91% vs.41.03%), abnormal proportion of head imaging results (82.61% vs.29.49%), serum Nesfatin-1 level[(3.65±1.45) μg/L vs.(2.20±0.77) μg/L] and STESS score[(3.01±0.75) points vs.(1.80±0.60) points] were significantly higher than those in the good prognosis group (all P<0.05). Logistic regression analysis showed that the attack time of SE > 1 h, admission to PICU, abnormal EEG, abnormal proportion of head imaging results, serum Nesfatin-1 level and STESS score were independent risk factors for the poor short-term prognosis of children with SE ( OR=4.217, 3.456, 2.626, 4.109, 3.040 and 2.012, respectively, all P<0.001). The cut-off value of serum Nesfatin-1 level and STESS score was 3.01 μg/L and 2.38 points, respectively.The Youden index and AUC of the combination of serum Nesfatin-1 level and STESS scores were 0.736 and 0.921 (95% CI: 0.861-0.959), respectively, which were better than those of single detection of either serum Nesfatin-1 level [Youden index 0.447; AUC 0.795(95% CI: 0.720-0.858)] or STESS scores [Youden index 0.562; AUC 0.859(95% CI: 0.792-0.911)]. Conclusions:The abnormal increases in serum Nesfatin-1 level and STESS score are risk factors for poor prognosis of SE in children, and their combination has a high predictive value for the poor short-term prognosis.

Incidence of acute cholecystitis underwent cholecystectomy in incidence dialysis patients: a nationwide population-based cohort study in Korea

Patients on dialysis have numerous gastrointestinal problems related to uremia, which may represent concealed cholecystitis. We investigated the incidence and risk of acute cholecystitis in dialysis patients and used national health insurance data to identify acute cholecystitis in Korea. Methods: The Korean National Health Insurance Database was used, with excerpted data from the insurance claim of the International Classification of Diseases code of dialysis and acute cholecystitis treated with cholecystectomy. We included all patients who commenced dialysis between 2004 and 2013 and selected the same number of controls via propensity score matching. Results: A total of 59,999 dialysis and control patients were analyzed; of these, 3,940 dialysis patients (6.6%) and 647 controls (1.1%) developed acute cholecystitis. The overall incidence of acute cholecystitis was 8.04-fold higher in dialysis patients than in controls (95% confidence interval, 7.40–8.76). The acute cholecystitis incidence rate (incidence rate ratio, 23.13) was especially high in the oldest group of dialysis patients (aged ≥80 years) compared with that of controls. Dialysis was a significant risk factor for acute cholecystitis (adjusted hazard ratio, 8.94; 95% confidence interval, 8.19–9.76). Acute cholecystitis developed in 3,558 of 54,103 hemodialysis patients (6.6%) and in 382 of 5,896 patients (6.5%) undergoing peritoneal dialysis. Conclusion: Patients undergoing dialysis had a higher incidence and risk of acute cholecystitis than the general population. The possibility of a gallbladder disorder developing in patients with gastrointestinal problems should be considered in the dialysis clinic.

Mortality and trend of chronic non-communicable diseases in Yichang in 2015-2020 / 公共卫生与预防医学

Objective To analyze the level, constituent ratio, and change trend of death caused by chronic non-communicable diseases （NCDs）in Yichang from 2015 to 2020. Methods The death monitoring data of residents in Yichang from 2015 to 2020 were collected from the National Mortality Surveillance System, and the crude mortality rate, standardized mortality rate and death composition ratio of Yichang residents in different seasons, genders, ages and regions were analyzed. The standardized mortality was calculated using the data of the sixth national census in 2010. The Joinpoint regression model (Joinpoint Regression Program 4.9.0.0 software) was used to analyze the trend of time variation. The annual change percentage (APC), and 95% CI were calculated. Results In 2020, the age-standardized mortality of NCDs in Yichang was 399.20 per 100 000. From 2015 to 2020, the age-standardized mortality rate of chronic diseases among residents in Yichang showed a significant downward trend (APC=-3.42%, P<0.05). The standardized mortality of NCDs decreased rapidly in urban areas (APC=-3.52%, P<0.05）and in women（APC=-4.23%, P<0.05）. The standardized mortality of NCDs in most groups (except age 40-year-old and 70-year-old groups) decreased significantly (APC=-12.31%∽-3.13%, P<0.05). The standardized mortality of NCDs in the first and fourth quarters decreased year by year（APC=-3.83%, -4.02%, P<0.05）. The constituent ratio of death caused by NCDs in urban areas and in female residents in Yichang declined slowly (APC=-0.39%, -0.54%, P<0.05）. After the outbreak of infectious diseases in 2020, the crude mortality in the first quarter changed from an upward trend in the past 5 years（APC=3.71%, P<0.05） to no statistical significance, and the rude mortality in 2020 was lower than all other years. The constituent ratios of deaths from NCDson the way to the hospital and deaths in the elderly care service institutions changed from no statistical significance in the past to a downward trend (APC=-14.65%, P<0.05) and an upward trend (APC=8.03% , P<0.05), respectively. Conclusions From 2015 to 2020, the age-standardized mortality rate of chronic non-communicable diseases among residents in Yichang has decreased, and the proportion of urban and female deaths has declined. Epidemic situation of infectious disease has changed the time trend of mortality of NCDs in stages, and partially affected the choice of place of death. It is recommended to implement the whole population strategy for the prevention and control of NCDs, focusing on rural and male residents, and optimize the management of chronic diseases.

Design of Gas Detection System Based on STM32 Infusion Set / 中国医疗器械杂志

Aiming at the low efficiency and low quality detection level of the manual infusion set, a gas detection system for infusion set based on STM32 single-chip microcomputer was designed. The detection system includes hardware system design and software system design. The hardware system is based on the STM32F103 single-chip microcomputer. It mainly designs the gas pressure sensor acquisition circuit and the multi-way solenoid valve control circuit. The software system uses a C ++ real-time operating system to ensure system monitoring's real-time performance and validity. Test data is transmitted to the upper computer and displayed via USB serial communication. The experiment proves that the infusion set gas detection system can perform gas detection on the infusion set. The system has the characteristics of stability and high accuracy. The relative error of the experimental measurement is within ±5%, and the detection efficiency is better than manual detection.

Biological function of protein tyrosine phosphatase H-type receptor and its progress in tumor / 中南大学学报(医学版)

Protein tyrosine phosphatase H-type receptor (PTPRH) gene encodes a gastric cancer associated protein, which exerts its biological function through tyrosine phosphorylation in the post-translational COOH- terminal region. PTPRH is abnormally expressed in a variety of tumors, and its biological function is closely related to the occurrence, development and prognosis of tumors.

Swimming Exercise Ameliorates Symptoms of MOG-Induced Experimental Autoimmune Encephalomyelitis by Inhibiting Inflammation and Demyelination in Rats / 대한배뇨장애요실금학회지

Purpose@#Multiple sclerosis is an autoimmune disease that affects the central nerve system, resulting in cumulative loss of motor function. Multiple sclerosis is induced through multiple mechanisms and is caused by inflammation and demyelination. This study aims to evaluate the neuroprotective effect of swimming exercise in experimental autoimmune encephalomyelitis (EAE) rats, an animal model of multiple sclerosis. @*Methods@#EAE was induced by an intradermal injection of 50-μg purified myelin oligodendrocyte glycoprotein 33–55 (MOG33-55) dissolved in 200-μL saline at the base of the tail. The rats in the swimming exercise group were made to swim for 30 minutes once pert a day for 26 consecutive days, starting 5 days after induction of EAE. To compare the effect of swimming exercise with interferon-β, a drug for multiple sclerosis, interferon-β was injected intraperitoneally into rats of the EAE-induced and interferon-β-treated group during the exercise period. @*Results@#Injection of MOG33-55 caused weight loss, decreased clinical disability score, and increased level of pro-inflammatory cytokines and inflammatory mediators in the lumbar spinal cord. Loss of motor function and weakness increased demyelination score. Swimming exercise suppressed demyelination and expression of pro-inflammatory cytokines and inflammatory mediators. These changes promoted recovery of EAE symptoms such as body weight loss, motor dysfunction, and weakness. Swimming exercise caused the same level of improvement as interferon-β treatment. @*Conclusions@#The results of this experiment suggest the possibility of swimming exercise in urological diseases that are difficult to treat. Swimming exercises can be considered for relief of symptom in incurable multiple sclerosis.

Inflammatory Bowel Disease and Vitamin D / 대한소화기학회지

Vitamin D contributes to bone metabolism and acts as an immune modulator for both innate and adaptive immunity. The serum level of vitamin D has been associated with inflammatory diseases, such as inflammatory bowel disease (IBD). In epidemiologic studies, IBD patients have been shown to have low levels of vitamin D. The suboptimal circulating levels of vitamin D in IBD patients may be caused by low exposure to sunlight, dietary malabsorption, and the impaired conversion of active metabolites (1,25[OH] 2D). Recent studies have demonstrated that vitamin D deficiency in IBD can increase the chance of disease recurrence, IBD-related hospitalization or surgery, and deterioration of quality of life. Supplementation with vitamin D is therefore thought to reduce the risk of flare-ups and the improvement of the quality of life in IBD patients. This review aims to summarize the latest knowledge on the effects of vitamin D deficiency on IBD and the possible benefits of vitamin D supplementation in IBD patients.

Inflammatory Bowel Disease and Vitamin D / 대한소화기학회지

Vitamin D contributes to bone metabolism and acts as an immune modulator for both innate and adaptive immunity. The serum level of vitamin D has been associated with inflammatory diseases, such as inflammatory bowel disease (IBD). In epidemiologic studies, IBD patients have been shown to have low levels of vitamin D. The suboptimal circulating levels of vitamin D in IBD patients may be caused by low exposure to sunlight, dietary malabsorption, and the impaired conversion of active metabolites (1,25[OH] 2D). Recent studies have demonstrated that vitamin D deficiency in IBD can increase the chance of disease recurrence, IBD-related hospitalization or surgery, and deterioration of quality of life. Supplementation with vitamin D is therefore thought to reduce the risk of flare-ups and the improvement of the quality of life in IBD patients. This review aims to summarize the latest knowledge on the effects of vitamin D deficiency on IBD and the possible benefits of vitamin D supplementation in IBD patients.

Current surgical practices of robotic-assisted tissue repair and reconstruction / 中华创伤杂志(英文版)

This paper systematically reviewed and analyzed the recent publications of robotic-assisted surgeries in the field of tissue repair and reconstruction. Surgical robots can elevate skin flap more accurately and shorten the time of tissue harvest. In addition, robotic-assisted surgery has the advantage of minimal tissue trauma and thus forms minimal scar. The utilization of surgical robots reduces the occurrence of complications after oral radical tumor resection while achieving cosmetic sutures. Robotic-assisted radical mastectomy could radically remove invasive breast cancer lesions and achieve breast reconstruction in the first stage through the small incisions in the operation areas. Surgical robots enable precise microvascular anastomosis and reduce tissue edema in the surgical field. Robotic-assisted technology can help appropriately locate the target tissues at different angles during sinus and skull base surgeries and accurately place tissues during urethroplasty. The robotic-assisted technology provides a new platform for surgical innovation in the field of tissue repair and reconstruction. However, the uncertainty in the survival rate after tumor radical surgery, the increase of operating time, and the high costs are barriers for its clinical application in tissue repair and reconstructive surgery. Nevertheless, robotic-assisted technology has already demonstrated an impact on the field of tissue repair and reconstruction in a meaningful way.

Expression and clinical significance of LMTK3 in prostate cancer tissues / 中国免疫学杂志

Objective: To investigate the expression and clinical significance of LMTK3 in patients with prostate carcer. Methods: Immunohistochemistry was used to detect the expression of LMTK3 and ERα in 55 cases of prostate cancer tissues and 25 cases of benign prostatic hyperplasia tissues. The relationship between the expression of LMTK3 and ERα and clinicopathological parameters was evaluated by square test and Fisher exact test. The association between LMTK3 and ERα expression was analyzed with Pearson and Spearman rank correlation. Results: The results of immunohistochemistry demonstrated that the LMTK3 and ERα protein positive expression rate in 55 cases of prostate cancer tissues was 36. 36％ and 32. 73％, whereas was 64. 00％ and 56. 00％ in the benign prostatic hyperplasia, respectively, showed a significant difference of comparison within this result ( P ＜ 0. 05). The expression of LMTK3 in prostate cancer tissues was inversely related with the level of Gleason grade ( P＜0. 05), but no relation with the levels of age, TPSA, TNM stage and lymph node metastasis ( P＞0. 05). Moreover, the expression of ERα in prostate cancer tissues was oppositely related with the levels of gleason grade and TPSA ( P＜0. 05), but no relation with the levels of age, TNM stage and lymph node metastasis ( P＞0. 05). Pearson and Spearman rank correlation analysis revealed, to some extent, there was positively correlated with the two proteins ( r = 0. 296, P＜0. 05). Conclusion: The expression of LMTK3 in prostate cancer tissues was decreased compared with benign prostatic hyperplasia tissues and negatively related with the level of gleason grade. In some degree, there is a positively correlation between the LMTK3 and ERα proteins.

Dedicated to scientific research and public service: in memory of Su The Lung, a master of preventive medicine in China / 中华疾病控制杂志

Su Teh Lung(1906-1985), a famous public health scientist, medical educator and thinker, one of the founders of epidemiology in China. Through scientific experiments and field investigations, he first clarified the distribution law of Oncomelania hupensis comprehensively and proposed the method of eliminating Oncomelania hupensis, and his work has made outstanding contributions to the study of the causes and prevention of schistosomiasis in China. He advocated a comprehensive research of every link of epidemiological process with ecological research, attached importance to statistical methods and logical thinking, went deep into the field, combined with reality, and created theoretical system of epidemiology in China. He advocated truth, seek truth from facts, devoted all his life to the practice and research of epidemic prevention and control, which has a far-reaching impact on the development of preventive medicine in China and the world.

A comparative study of MoCA-B and MMSE in screening for cognitive dysfunction in patients with / 中国神经精神疾病杂志

Objective To compare Montreal cognitive assessment-basic ( MoCA-B ) and mini-mental state examination (MMSE) in screening cognitive dysfunction of acute stroke patients. Methods The cognitive function of patients (n=83) with acute stroke onset within 10 days (including new cerebral infarction and cerebral hemorrhage) were assessed using MMSE and MoCA-B. The classification of patients with cognitive impairment was compared between the two scales. The consistency of cognitive impairment and affected domains assessed by MMSE or MoCA with experts were evaluated. Results ①There were 32 cases (38.6%) with abnormal MMSE score and 40 cases (51.8%) with abnormal MoCA-B score. ②The the diagnostic consistency of MoCA-B with experts was 89.16%. The false positive of MMSE was 2.41%and the false negative (rate of missed diagnosis) was 16.87%.False positives of MoCA-B were 4.82%and false negatives (rate of missed diagnosis) were 6.02%.③Among the 51 patients with normal MMSE, 15 had abnormal MoCA-B (29.4%). There were significant differences between these two score system in executive function, verbal fluency, directivity, abstraction, delayed recall, visual perception, naming and other cognitive domains (P＜0.05). Conclusion MoCA-B scale may be more sensitive and better than MMSE scale in screening for cognitive impairment in patients with acute stroke.

Study on application of Supportan in elderly bedridden patients with enteral nutrition support / 中国中西医结合急救杂志

Objective To explore the application value of Supportan in elderly bedridden patients with enteral nutrition (EN) support. Methods Forty cases of elderly bedridden patients admitted to the Department of Intensive Care Unit (ICU) of Hangzhou First People's Hospital from January 2015 to January 2016 were enrolled, Supportan was injected through an indwelling naso-intestinal tube on the basis of routine treatment, and the changes of blood biochemical parameters of EN [serum albumin (Alb), pre-albumin (PA), total lymphocyte count (LYM)] and immune indexes (IgG, IgM, IgA) were monitored before and after EN treatment. Results Ten days after EN treatment, the serum Alb, PA, LYM, IgG, IgM were significantly higher than those before treatment, the differences being statistically significant [Alb (g/L): 30.29±1.65 vs. 28.31±1.72, PA (g/L): 0.25±0.05 vs. 0.23±0.02, LYM (×109): 1.69±0.28 vs. 1.47±0.32, IgG (g/L): 11.54±0.96 vs. 10.69±0.70, IgM (g/L): 1.21±0.19 vs. 0.95±0.13, all P < 0.05]; 20 days after EN treatment, above indexes were increased more significantly compared with those 10 days after EN treatment [Alb (g/L): 34.16±2.41 vs. 30.29±1.65, PA (g/L): 0.28±0.03 vs. 0.25±0.05, LYM (×109/L): 1.96±0.31 vs. 1.69±0.28, IgG (g/L): 14.56±0.77 vs. 11.54±0.96, IgM (g/L): 1.56±0.18 vs. 1.21±0.19, all P < 0.05], 10 days, 20 days after EN treatment, IgA shown a tendency increased, there was no statistical significant difference compared with that before treatment (g/L: 2.63±0.33, 2.67±0.11 vs. 2.61±0.27, both P > 0.05). Conclusion Supportan has important clinical significance in improving the nutritional status and immune function of elderly bedridden patients.

Influence of Wnt/beta-catenin signal transduction pathway on the differentiation of umbilical cord mesenchymal stem cells into hepatocyte-like cells / 中国组织工程研究

BACKGROUND:Umbilical cord mesenchymal stem cells can be induced to differentiate into hepatocyte-like cells in vitro and in vivo.However,the exact mechanism is still unknown. Existing studies have shown that the Wnt/β-catenin signaling pathway is closely related to this process. OBJECTIVE: To explore the effect of Wnt/β-catenin signaling pathway on the differentiation of umbilical cord mesenchymal stem cells into hepatocyte-like cells and its potential molecular mechanism. METHODS: Human umbilical cord mesenchymal stem cells were extracted from the neonatal umbilical cord by tissue adherent method. After being cultured and purified, the umbilical cord mesenchymal stem cells at passages 4-6 were divided into four groups: control group (DMEM culture group), hepatocyte-like differentiation group, activator Wnt3a group (adding 20 μg/L Wnt3a, an activator of Wnt/β-catenin signaling pathway, under the differentiation condition), and inhibitor Dkk-1 group (adding 20 μg/L Dkk-1, an inhibitor of Wnt/β-catenin signaling pathway, under the differentiation condition). Induced cells were collected respectively on days 7, 14, 21, 28. Their mRNA and protein expressions of α-fetoprotein (AFP), albumin (ALB), hepatocyte nuclear factor 4α (HNF4α) and Cytokeratin-19 (CK-19) in the cells were detected by real-time quantitative PCR and western blot respectively. Meanwhile, Periodic Acid-Schiff staining, low-density lipoprotein uptake test and indocyanine green absorption test were applied to detect the function of hepatocyte-like cells. RESULTS AND CONCLUSION: Compared with the control group, expressions of AFP and HNF4α mRNA and protein as well as ALB mRNA were significantly up-regulated in the hepatocyte-like differentiation group, activator Wnt3a group and inhibitor Dkk-1 group (P < 0.05). Whereas, there was a decrease in the CK-19 expression at mRNA and protein levels (P < 0.01) in these three groups. Compared with the hepatocyte-like differentiation group, the mRNA and protein expressions of AFP and HNF4α, and the mRNA expression of ALB were significantly down-regulated in the activator Wnt3a group (P < 0.05). Compared with hepatocyte-like differentiation group and activator Wnt3a group, the inhibitor Dkk-1 group had higher expression of AFP, HNF4α mRNA and their proteins as well as the mRNA expression of ALB (P <0.05). Findings from the Periodic Acid-Schiff staining, low-density lipoprotein uptake test and indocyanine green absorption test showed more positive cells in the inhibitor Dkk-1 group than in the hepatocyte-like differentiation group and least positive cells in the activator Wnt3a group. Overall, these findings suggest that the inhibition of Wnt/β-catenin signaling pathway promotes the differentiation of umbilical cord mesenchymal stem cells into hepatocyte-like cells;conversely,the cell differentiation can be inhibited via the Wnt/β-catenin pathway.

Antimyoclonic Effect of Levetiracetam and Clonazepam Combined Treatment on Myoclonic Epilepsy with Ragged-Red Fiber Syndrome with m.8344A>G Mutation / 中华医学杂志(英文版)

<p><b>Background</b>Treatment of myoclonic seizures in myoclonic epilepsy with ragged-red fibers (MERRFs) has been empirical and ineffective. Guideline on this disease is not available. Additional trials must be conducted to find more suitable treatments for it. In this study, the antimyoclonic effects of monotherapies, including levetiracetam (LEV), clonazepam (CZP), valproic acid (VPA), and topiramate (TPM) compared to combination therapy group with LEV and CZP on MERRF, were evaluated to find a more advantageous approach on the treatment of myoclonic seizures.</p><p><b>Methods</b>Treatments of myoclonic seizures with VPA, LEV, CZP, and TPM were reported as monotherapies in 17 MERRF patients from Qilu Hospital between 2003 and 2016, who were diagnosed through clinical data and genetic testing. After 1-4 months of follow-up (mean: 82.9 ± 28.1 days), 12 patients that exhibited poor responses to monotherapy were given a combined treatment consisting of LEV and CZP subsequently. The follow-up period was 4-144 months (mean: 66.3 ± 45.3 months), the effective rates of monotherapy group (17 patients) and combination therapy group (12 patients) were analyzed by Chi-square test.</p><p><b>Results</b>The m.8344 A>G mutation was detected in all patients. There were four patients with partial response (4/17, two in the CZP group and two in the LEV group), ten patients with stable disease (10/17, six in the CZP group, three in the LEV group, and one in the TPM group), and three patients with progressive disease (3/18, two in the VPA group and one in the TPM group). Twelve of the patients with LEV combined with CZP showed a positive effect and good tolerance (12/12), eight of them demonstrated improved cognition and coordination. There was a significant difference between the monotherapy group and combination therapy group in the efficacy of antimyoclonic seizures (χ = 13.7, P < 0.001).</p><p><b>Conclusions</b>LEV in combination with CZP is an efficient and safe treatment for myoclonic seizures in patients with this disease exhibiting the m.8344A>G mutation.</p>

Effects of body-shade resin layer thickness on the color of polyetheretherketone-Crea.lign restorations / 华西口腔医学杂志

OBJECTIVE@#This study aims to assess the effects of the different thicknesses of body-shade resin layers on the color of polyetheretherketone (PEEK)-Crea.lign restorations.@*METHODS@#Five PEEK specimens with the thickness of 0.6 mm were prepared. The color values of PEEK specimens were measured. Afterward, opaque-shade resin layers (0.1 mm) and body-shade resin layers (1.5 mm) were stacked with mold. The five specimens were evenly ground to a thickness of 1.4, 1.2, 1.0, 0.8, 0.6, 0.4, 0.2, and 0.0 mm in sequence. After grinding and ultrasonic cleaning, the color value was measured.@*RESULTS@#With the constant thickness of PEEK and 0.1 mm thickness of opaque-shade resin layer, the L*, a*, and b* values all showed downward trend with the increased thickness of the body-shade resin layer (1.0-1.4 mm). With the constant thickness of PEEK and 0.1 mm thickness of opaque-shade resin layer, the color difference between the adjacent groups was less than 1.5 NBS. This difference between nonadjacent groups was more than 1.5 NBS when the thickness of the body-shade resin layer reached 0.6 mm. Color difference between PEEK-Crea.lign restoration and PEEK was more than 1.5 NBS.@*CONCLUSIONS@#The thickness change in the body-shade resin layers influence the color of the PEEK-Crea.lign restorations. Using A2 shade Crea.lign, opaque-shade resin layer thickness is 0.1 and 0.6 mm thickness of body-shade resin layer can produce color which clinically acceptable.

Application of International Speech Test Signal on Acceptable Noise Level Test in Mandarin Adults with Normal Hearing / 听力学及言语疾病杂志

Objective To study the use of the international speech test signal(ISTS) on acceptable noise level (ANL)test in Mandarin adults.Methods The Mandarin test materials and ISTS were used as test materials.The ANL test was performed on 40 normal hearing adults.For each case,the most comfortable loudness(MCL)and background noise level(BNL)were obtained.MCL minus BNL equal to ANL.Results The values of ANL under the Mandarin test materials and ISTS test materials were 39.31±6.97 and 41.85±7.60 dB HL,respectively.The values of BNL were 37.59±8.45 and 39.27±8.66 dB HL,respectively.The values of ANL were 1.53±5.61 and 2.45±5.58 dB,respectively in 40 normal hearing adults.There was no significant difference in the MCL,BNL and ANL between the test materials of Mandarin and ISTS (P＞ 0.05).Conclusion International speech test signal (ISTS) can be used on ANL test in Mandarin adults with normal hearing.

The progress in surgical procedure for early stage of non-small cell lung cancer / 天津医药

Surgical treatment is important for the treatment of non-small cell lung cancer (NSCLC). In recent years, video-assisted thoracic surgery (VATS) and Robotic VATS (RVATS) have been widely used in the therapies for patients of early stage NSCLC and traditional thoracotomy is becoming less and less. Many patients with ground-glass note (GGN) can be cured by VATS and Robotic procedures, and which promotes the development of minimally invasive surgery. However, the treatment of GGN is controversial. This article makes a summary of the selection in single VATS, RVATS and lung segments for surgical procedures in NSCLC.

The Effect of Neuromuscular Electrical Stimulation on Pulmonary Function, Gait Ability, and Quality of Life in Patients with Chronic Obstructive Pulmonary Disease

PURPOSE: This study aims to investigate the changes in pulmonary function, gait ability, and quality of life when NMES is applied along with CBE and to provide basic clinical data to be used in pulmonary rehabilitation guidelines for patients with COPD to treat patients with severe COPD. METHODS: For this study, CBE and NMES of quadriceps femoris on both sides were applied to the experimental group (n=10), and only CBE was applied to the control group (n=10). For a pre-test, a 6-minute walk test was performed, and pulmonary function and health-related quality of life were measured. Moreover, an exercise program was applied to each group for 30 minutes per session, 5 times a week, for 6 weeks. After that, a post-test was conducted the same way as the pre-test. RESULTS: In the within-group comparison, there were significant differences in forced expiratory volume in one second, 6-minute walk test and health-related quality of life between the experimental group and the control group (p < 0.01)(p < 0.05). In the between-group comparison, the experimental group showed an increase in forced expiratory volume in one second and 6-minute walk test (p < 0.05) and showed a decline in health-related quality of life (p < 0.05). CONCLUSION: The 6-weeks NMES program improved health-related quality in patients with severe COPD by increasing expiratory volume by reinforcing the function of quadriceps femoris. This finding implies that NMES could be an alternative mode for improving physical functions of patients with severe COPD, who cannot participate in a breathing exercise program or are reluctant to participate.