Research results and mechanism of sodium glucose cotransporter 2 inhibitors in the treatment of heart failure / 中国医师杂志

Sodium glucose cotransporter 2 inhibitor (SGLT2i) emerged as a new hypoglycemic agent, which can inhibit glucose reabsorption and thus play a hypoglycemic role. Recent studies have shown that SGLT2i not only lowers blood glucose, but also has a protective effect on the cardiovascular system, which may benefit patients with heart failure.The specific mechanism of action is still not fully elucidated. This paper aims to summarize the latest research results of SGLT2i in the treatment of heart failure, and analyze the possible mechanisms for clinical guidance.

Constructing a predictive risk score for the needs of coronary care unit care in patients with ST-segment elevation myocardial infarction / 中国医师进修杂志

Objective:To construct a risk prediction score for the needs of coronary care unit (CCU) care in stable condition acute ST-segment elevation myocardial infarction (STEMI) patients who receive percutaneous coronary intervention (PCI) treatment.Methods:The clinical data of 805 STEMI patients who accepted PCI in the First Hospital of Jilin University from November 2017 to October 2018 were retrospectively analyzed. Among the patients, 654 patients from November 2017 to July 2018 were served as the modeling group, the patients with needs of CCU had 125 cases, and the patients without needs of CCU had 529 cases; 151 patients from August 2018 to October 2018 were served as the validation group, the patients with needs of CCU had 28 cases, and the patients without needs of CCU had 123 cases. Binary Logistic regression analysis was used to establish the risk prediction model and determine the score standards. The critical value was determined according to the best Youden index of receiver operating characteristic (ROC) curve.Results:Among 805 patients with STEMI, 153 cases (19.01%) had the needs of CCU, and the most common reason was pump failure (heart failure and cardiogenic shock, 113 cases). In the modeling group, age (60 to 74 years old, OR = 1.513, 95% CI 0.945 to 2.424, P = 0.085; ≥75 years old, OR = 2.740, 95% CI 1.371 to 5.478, P = 0.004), total ischemic time>4 h ( OR = 1.701, 95% CI 1.022 to 2.831, P = 0.041), admission shock index ≥0.8 ( OR = 1.910, 95% CI 1.178 to 3.099, P = 0.009), multi-vessel disease ( OR = 2.090, 95% CI 1.272 to 3.432, P = 0.004), preoperative diseased vessels thrombolysis in myocardial ischemia (TIMI) blood flow grade 0 ( OR = 2.099, 95% CI 1.313 to 3.353, P = 0.002), acute anterior myocardial infarction ( OR = 3.696, 95% CI 2.347 to 5.819, P<0.001) and previous history of stroke ( OR = 3.927, 95% CI 2.057 to 7.500, P<0.001) were independent risk factors for CCU needs in STEMI patients undergoing PCI. The scoring criteria were as followings: age<60 years old was given 0 score, 60 to 74 years old 1 score, ≥75 years old 2 score; total ischemic time>4 h in 1 score, admission shock index ≥0.8 2 scores, multi-vessel disease 2 scores, preoperative diseased vessels TIMI blood flow grade 0 2 scores, acute anterior myocardial infarction 3 scores, previous history of stroke 3 scores, and the total score was 15 scores. The patients with 0 to 6 scores were low-risk, and the patients with 7 to 15 scores were high-risk. ROC curve analysis result showed that, in modeling group, the area under curve (AUC) of risk prediction score for predicting the needs of CCU in STEMI patients was 0.740 (95% CI 0.692 to 0.788, P = 0.580); in validation group, the AUC of risk prediction score for predicting the needs of CCU in STEMI patients was 0.755 (95% CI 0.658 to 0.853, P = 0.755). Conclusions:A predictive risk score based on seven risk factors such as age, total ischemic time, admission shock index, multi-vessel disease, preoperative diseased vessels TIMI blood flow grade, acute anterior myocardial infarction and previous history of stroke is constructed in order to predict the needs of CCU in STEMI patients with stable condition who receive PCI treatment. It can be used to help doctors to identify high-risk patients before the admission to CCU, thus providing simple and practical clinical tool for rational allocation of limited CCU resources.

The role and mechanism of SIRT1 gene in depression / 生理学报

As a kind of mental illness, depression produces great difficulties in clinical diagnosis and treatment, and has a high disability rate. It is urgent to clarify the mechanism of depression to find potential therapeutic targets and effective clinical treatment methods. As a deacetylase, silent mating type information regulator 2 homolog 1 (SIRT1) is involved in many biological processes such as cell aging, cancer, and cardiovascular disease. In recent years, more and more studies have found that SIRT1 gene plays an important role in the pathogenesis of depression, but the mechanism is still unclear. Therefore, this review mainly summarizes the relevant research progress on the role and mechanism of SIRT1 gene in the hippocampus, prefrontal cortex, amygdala, hypothalamic suprachiasmatic nucleus, and nucleus accumbens in depression, in order to provide new ideas for exploring the mechanism and prevention of depression.

Expression and significance of EPO and HIF-1α in serum and aqueous humor of patients with acute anterior uveitis / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To detect the expression of erythropoietin(EPO)and hypoxia-inducible factor-1α(HIF-1α)in serum and aqueous humor of patients with acute anterior uveitis(AAU), and to explore their clinical significance. <p>METHODS: From January 2018 to December 2020, 60 patients with AAU in our hospital were prospectively selected as the research objects, and 60 patients with proliferative vitreoretinopathy in the same period were taken as control(control group). The serum and aqueous humor of two groups were collected, enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of EPO and HIF-1α in serum and aqueous humor; the self-rating anxiety scale(SAS)and the self-rating depression scale(SDS)were used to evaluate the AAU patients, and the severity of the disease was scored; Pearson method was used to analyze the correlation between SAS score, SDS score and levels of EPO and HIF-1α in serum and aqueous humor, and the correlation between levels of EPO and HIF-1α in the serum and aqueous humor. Spearman was used to analyze the correlation between the disease severity score of AAU patients and the levels of EPO and HIF-1α in serum and aqueous humor. <p>RESULTS: Compared with the control group, the levels of EPO and HIF-1α in the serum and aqueous humor of the study group were higher(<i>P</i><0.01). Among AAU patients, 23 were negative of SAS score and 37 were positive, and 29 were negative of SDS score and 31 were positive. Compared with patients with negative SAS score, the level of HIF-1α in serum and the level of EPO in the aqueous humor were higher in patients with positive SAS score(<i>P</i><0.05); compared with patients with negative SDS score, the level of EPO in serum and the levels of EPO and HIF-1α in aqueous humor were higher in patients with positive SDS score(<i>P</i><0.01). There were 26 mild patients and 34 severe patients with AAU. Compared with mild patients with AAU, the levels of EPO and HIF-1α in serum and aqueous humor were increased in severe patients(<i>P</i><0.01). Pearson analysis showed that the SAS and SDS scores of AAU patients were not significantly correlated with the levels of EPO and HIF-1α in serum and aqueous humor(<i>P</i>>0.05), there was a positive correlation between EPO and HIF-1α in serum(<i>P</i><0.05), and between EPO and HIF-1α in aqueous humor(<i>P</i><0.05). Spearman analysis showed that the disease severity score of AAU patients was positively correlated with the levels of EPO and HIF-1α in serum and aqueous humor(<i>P</i><0.05). <p>CONCLUSION: EPO and HIF-1α are highly expressed in serum and aqueous humor of AAU patients, and they are closely related. The two are closely related to the disease severity score, and should be paid attention to clinically.

Risk factors for surgical-site infections after radical gastrectomy for gastric cancer: a study in China / 中华医学杂志(英文版)

BACKGROUND@#About 10% of patients get a surgical-site infection (SSI) after radical gastrectomy for gastric cancer, but SSI remains controversial among surgeons. The aim of this study was to explore the risk factors for SSIs after radical gastrectomy in patients with gastric cancer to guide clinical therapies and reduce the incidence of SSI.@*METHODS@#The study was a retrospective cohort study in patients who underwent radical gastrectomy for gastric cancer. SSI was defined in accordance with the National Nosocomial Infection Surveillance System. We evaluated patient-related and peri-operative variables that could be risk factors for SSIs. The Chi-squared test and logistic regression analysis were used to assess the association between these risk factors and SSI.@*RESULTS@#Among the 590 patients, 386 were men and 204 were women. The mean age was 56.6 (28-82) years and 14.2% (84/590) of these patients had an SSI. Among them, incisional SSI was observed in 23 patients (3.9%) and organ/space SSI in 61 patients (10.3%). Multivariate logistic regression analysis identified sex (odds ratios [ORs] = 2.548, and 95% confidence interval [CI]: 1.268-5.122, P = 0.009), total gastrectomy (OR = 2.327, 95% CI: 1.352-4.004, P = 0.002), albumin level (day 3 after surgery) <30 g/L (OR = 1.868, 95% CI: 1.066-3.274, P = 0.029), and post-operative total parenteral nutrition (OR = 2.318, 95% CI: 1.026-5.237, P = 0.043) as independent risk factors for SSI.@*CONCLUSIONS@#SSI was common among patients after radical gastrectomy for gastric cancer. The method supporting post-operative nutrition and the duration of prophylactic antibiotics may be important modifiable influencing factors for SSI.

Clinical application of bridge-link combined fixation system for adult mid-shaft clavicle fractures / 中国骨伤

OBJECTIVE@#To explore clinical efficacy of bridge-link combined fixation system for adult mid-shaft clavicle fractures.@*METHODS@#From January 2016 to August 2016, 28 patients with mid-shaft clavicle fractures were treated by bridge-link combined fixation system, including 15 males and 13 females, aged from 27 to 82 years old with an average of(48.50±15.34) years old; the courses of disease was for 13 to 15 months with an average of (14.17±0.77) months. Fracture healing time and complication were observed, postoperative and postoperative Constant function score of shoulder joint at 1, 3 and 13 months and were compared.@*RESULTS@#All patients were followed up for 13 to 15 months with an average of (14.17±0.77) months. Twenty-eight patients achieved clinical fracture healing without infection, bone un-union, delayed union, breakage of internal fixation and re-fracture after removing of the internal fixation occurred. Fracture healing time ranged from 2.5 to 4 months with (3.05±0.44) months. Postoperative Constant score at 1, 3 and 13 months were 76.57±4.70, 90.75±3.62, 96.07±2.40 respectively, and had significant difference compared with before operation(58.36±4.98).@*CONCLUSIONS@#Bridge-link combined fixation system could be used as a new internal fixation for adult mid-shaft clavicle fractures, which has advantages of rapid recovery, less complications, and could reduce incidence of breakage of internal fixation, osteoporosis, re-fractures after removing the internal fixation.

Effect of Rosuvastatin on fasting plasma glucose after coronary stent implantation in elderly patients / 中华老年医学杂志

Objective@#To investigate the effect of Rosuvastatin on fasting plasma glucose after coronary stent implantation in elderly patients with non-diabetes mellitus.@*Methods@#A total of 216 non-diabetic elderly patients undergoing coronary stent implantation in our hospital from November 2015 to April 2018 were enrolled, with a follow-up in the cardiovascular department after discharge from the Hospital.The demographic data, follow-up time, and laboratory results at hospital admission and the last outpatient visit were collected retrospectively.@*Results@#At the end of follow-up, Fasting plasma glucose(FPG)was increased in 191 patients with normal baseline FPG level as compared with the baseline level(t=-3.783, P=0.000). The incidence of new-onset diabetes was higher in the pre-diabetes group than in the normal blood glucose group(24.0% vs.2.6%, χ2=16.72, P=0.000).@*Conclusions@#Rosuvastatin increases fasting blood glucose levels in elderly non-diabetic patients after coronary stent implantation.Pre-diabetes may increase the risk for rosuvastatin-associated new-onset diabetes.

Effect of Rosuvastatin on fasting plasma glucose after coronary stent implantation in elderly patients / 中华老年医学杂志

Objective To investigate the effect of Rosuvastatin on fasting plasma glucose after coronary stent implantation in elderly patients with non-diabetes mellitus.Methods A total of 216 nondiabetic elderly patients undergoing coronary stent implantation in our hospital from November 2015 to April 2018 were enrolled,with a follow-up in the cardiovascular department after discharge from the Hospital.The demographic data,follow-up time,and laboratory results at hospital admission and the last outpatient visit were collected retrospectively.Results At the end of follow-up,Fasting plasma glucose(FPG)was increased in 191 patients with normal baseline FPG level as compared with the baseline level(t =-3.783,P =0.000).The incidence of new-onset diabetes was higher in the pre-diabetes group than in the normal blood glucose group(24.0％ vs.2.6％,x2 =16.72,P =0.000).Conclusions Rosuvastatin increases fasting blood glucose levels in elderly non-diabetic patients after coronary stent implantation.Pre-diabetes may increase the risk for rosuvastatin-associated new-onset diabetes.

Progress on Detection of Metals Ions by Functional Nucleic Acids Biosensor / 分析化学

Functional nucleic acids are natural or artificialnucleic acid sequences with specific functions and special structures. Special metal ions are essential trace elements for human health, but excessive metal ions will be harmful to human health. The functional nucleic acids are widely used in the detection of metal ions because of their advantages such as easy modification, low price, high stability and strong specificity. This review describes the function of functional nucleic acid and metal ions, mainly including cutting type, link type, metal ion-mediated base pairing, click chemical type, conformation change type, and other types. Then, biosensor of functional nucleic acid combined with different signal output is introduced. Finally, the research significance and problems of functional nucleic acid in metal ion detection are discussed, and the future development direction and application prospect of functional nucleic acid biosensor are prospected.

Establishment and Application of Functional Nucleic Acid Biosensor for Detection of Mercury Ion / 分析化学

Excessive mercury ions have negative effects on individual health. So, it is of great significance to develop a method for rapid, sensitive and specific detection of Hg2+. In this study, the method for detection of Hg2+ was developed based on specific T-Hg-T mismatche and G-quadruplex. The template sequence mainly included the recognition region which could combine with Hg2+ specifically, the rich G region which could form G-quadruplex, and the speacer 18 partition zone. The target sequence mainly included 5' ends combining area and 3' end T-rich region. Templates and targets could be combined and the elongation was triggered only in the presence of Hg2+. Furthermore, the G-rich sequences were stripped off the templates and could form a single-stranded structure, because Spacer 18 had partition function. The G-quadruplex was formed with the K+and hemin, and catalyzed H2 O2-2,2-azinobis (3-ethylbenzothiozoline)-6-sulfonic acid(ABTS) reaction with color variations. The detection could be done within 35 min, and the Hg2+ concentration exhibited a linear correlation with absorbance at 414 nm within range of 20-500 nmol/ L, with a detection limit of 16. 5 nmol/ L (3σ). The recoveries of Hg2+ spiked in tap water were 98. 5％ - 103. 5％ . The method exhibited the advantages such as simple operation, low cost and short time, and operation value in emergency treatment and real-time environmental detection.

Thinking of the Implementation of Humanistic Care to the Families of Cancer Patients / 中国医学伦理学

Medical humanistic spirit should be reflected in the whole process and the all-round of medical care.However,limited to the current cognition and condition,medical humanities in clinical practice are still not comprehensive and universal.By reading the existing literature and analyzing,combining with the own work experi-ence at the same time,this paper agreed that aiming at the special disease of cancer,the humanistic practice in the treatment of nursing had its own importance and its particularity,and it should recognize the disease and confront the patients and their families from the perspective of the whole person and omni-direction,make traditional clini-cal humanities extend to the family and extend humanistic care to family members of the patients.In this practice,medical staff can cultivate the consciousness of awing the life and respecting the patient in specific operations,es-tablish the sense of integration and improve their spiritual realm,so as to continuously improve their comprehensive quality in nursing service.

The Specific Application of Case Teaching Method in Medical Ethics:Taking Tumor Patients as Example / 中国医学伦理学

The ethical issues involved in the diagnosis and treatment of malignant tumors are increasing. Case teaching method is a teaching mode that has received much attention in recent years. This paper analyzed the com-mon ethical issues faced by clinical oncology at present, including tumor patients' right of informed consent, tumor patients' right of treatment option, and the hospice care for tumor patients and so on, and combined with cases, introduced the application of case teaching method in clinical oncology postgraduate ethics teaching.

Anti-aggregation Effect and Short-term Safety Evaluation of Low-dose Aspirin Therapy in the Elderly Chinese Population: a Multicenter Randomized Controlled Clinical Trial / 中国循环杂志

Objectives: This study aimed to observe the change of arachidonic acid-induced platelet aggregation rate (AA-Ag) and short-term adverse reactions after taking 50 or 100 mg/d aspirin(enteric-coated sustained-release formulation) or 100 mg/d aspirin (enteric-coated aspirin tablet)in the elderly Chinese population (aged 60 years or older). Methods: A total of 1 194 participants aged 60 or older, who should be recommended to take aspirin therapy due to medical reasons, were recruited and randomly assigned into three groups to receive enteric-coated sustained-release aspirin tablet (50 mg, once daily, group A), or 100 mg, once daily (group B) or enteric-coated aspirin tablet 100 mg once daily (group C), respectively. AA-Ag was measured after (14±3)days of aspirin treatment. Adverse events and bleeding events were recorded during the (28±3)days of follow-up. Results: The AA-Ag in group A (n=347), B (n=338) and C (n=332) post 14-day aspirin therapy were 6.65 (4.03,10.84)%, 5.89(3.22,10.03) % and 6.00(3.68,10.09) %, respectively (P>0.05). During the 28 days follow-up, the adverse events rate of group A (n=388), B (n=387) and C (n=385) was 3.87%,3.36%, and 7.95%, and the mild bleeding events rate was 3.09%, 2.33%, and 6.23%, respectively. Adverse events rate and mild bleeding events rate were significantly higher in group C than in group A and B (P<0.05). Conclusions: Compared with 100 mg-dose aspirin, 50 mg-dose aspirin achieves similar anti-platelet aggregation effect in this elderly Chinese population. The short-term adverse events and mild bleeding risk of aspirin with enteric-coated sustained-release formulation were fewer than that of enteric-coated formulation.

Clinical efficacy of LVIS stent combined with coil embolization of ruptured wide-necked intracranial aneurysms during the acute phase / 中国脑血管病杂志

Objective To investigate the safety and efficacy of LVIS stent combined with coil embolization of ruptured wide-necked intracranial aneurysms during the acute phase.Methods From May 2014 to August 2017,the clinical and imaging data of 56 patients with ruptured wide-necked intracranial aneurysm treated with LVIS stents for acute phase assisted embolization at the Department of Neurosurgery,the Affiliated Hospital of Southwest Medical University were analyzed retrospectively.All patients were treated with LVIS stent combined with coil embolization.Immediate postoperative angiography,six months after procedure,and follow-up imaging were evaluated by Raymond grade (RS grade).The clinical follow-up results were evaluated by the modified Rankin Scale (mRS) score.Results LVIS stent combined with coil embolization was performed in 56 patients with 60 aneurysms in this group.The success rate of stent release was 100％.Immediate angiography after procedure showed that the complete embolization rate of aneurysms was 80.0％ (48/60),the near complete embolization rate was 13.3 ％ (8/60),and the incomplete embolization rate was 6.7％ (4/60).Postoperative follow-up angiography at 6 monthrevealed that the complete embolization rate of aneurysms was 87.8％ (36/41),nearly complete embolization rate was 7.3％ (3/41),incomplete embolization rate was 4.9％ (2/41).Postoperative follow-up angiography at 12 months revealed that the complete embolization rate of aneurysms was 83.0％ (39/47),and near complete embolization rate was 12.8％ (6/47),and incomplete embolization rate was 4.3％ (2/47).Of the 56 patients,49 were followed up clinically and 7 were lost to follow up.The average follow-up time was 13 ± 4 months.The clinical follow-up showed that the good prognosis (mRS score 0-2) rate was 87.8％ (43/49).Intraoperative complications occurred in 7 cases,5 were intraoperative parent artery thrombosis and 2 were intraoperative aneurysm rupture.Conclusions LVIS stent combined with coil embolization of ruptured wide-necked intracranial aneurysms during the acute phase has good efficacy and safety.Its long-term efficacy remains to be confirmed by long-term follow-up.

Design of casualty sorting unit in tent-form field medical system / 医疗卫生装备

Object To design a casualty sorting unit with chest integrated with table in the tent-form field medical system.Methods The unit was designed with virtual prototype simulation and CAD, which took considerations on the service orientation, the types and quantity of equipment and devices as well as the requirements for packaging box's size and dimensions of the tent-form field medical system.Results The unit had a size of 1795 mm ×600 mm ×600 mm when deployed, and could be used as the field diagnostic and treatment table; the size was 800 mm ×600 mm ×600 mm when withdrawn, when the module met the requirements of the tent-form field medical system for the packaging box and could be used to hold valuable devices such as color Doppler ultrasound and ECG machine. Finite element simulation and check verified that the module had shape and stress changes due to austere force satisfy the desired requirements.Conclusion The unit gains advantages in deployment and withdrawal, materials, mechanical structure and ergonomics-based operation, accords with the requirements for modularity and multi function integrated into one decice, and enhances the efficiency of casualty sorting in the tent-form field medical system.

Study on X-ray protection module in radiodiagnosis unit of tent-form field medical system / 医疗卫生装备

Object To study on the X-ray protection module in the radiodiagnosis unit to protect X-ray technicians, other medical staffs and etc against radiation during standing and lying X-ray examinations in the tent-form field medical system.Methods A local tightness protection solution was put forward involving in lead protective materials, standing shoot rack,diagnosis couch as well as considerations on the service orientation of the tent-form field medical system and the operation mode of the X-ray tent. A protective support with fast-plug and lateral folding structure was designed based on X-ray radiation protection principle and lead equivalent calculation of the lead curtain. An X-ray protection module was developed with the lend curtain, protective support, warning sign and etc.Results The dose peaked at vertical direction, and at vertical direction the annual dose to the public 1 m away from the tent was 78.8μSv which was far lower than the limit value 1 mSv. The strength of the protective support met the requirements, and the maximum deformation of the support bar was 15 mm after the suspension of the lead curtain.Conclusion The X-ray protection module gains advantages in design, structure, operation,rapid deployment and withdrawal, handling and transport as well as protective effective according to GB 18871—2002 regulation, and thus can be used for X-ray diagnosis at peace and war time.

Study on medical technical support system in tent-form field medical system / 医疗卫生装备

Objective To develop a medical technical support module and box-type medical technical equipment so as to supply medical oxygen and water for the tent-form field medical system at field conditions.Methods The medical technical support module had its service orientation analyzed to determine its functional requirements and technical indexes, which involved in PSA oxygen generation technology with variable frequency,constant pressure and self-adaptability to altitudes as well as medical water preparation technology by integrated membrane separation. Box-type modules for medical oxygen generation and medial water preparation were trial-produced with the mode of integrated box and instruments as well as high-density polyethylene as the box material.Results The oxygen production was 1.3 Nm3/h,and the oxygen concentration was 92.7%.The flow volume of cleaning water and purified water was 433.7 and 37.2 L/h respectively at 25℃,and the water quality accorded with the relevant water quality indexes of GB 5749—2006 and the national pharmacopoeia(2010 edition). Conclusion This set of medical equipment can meet the design requirements and can effectively guarantee the medical oxygen and medical water needed for medical treatmentin field tent hospital under field conditions. [Chinese Medical Equipment Journal,2018,39(5):7-11]

Study on PSA oxygen generating technology with variable frequencies,constant pressure and self-adaptivity to altitude changes / 医疗卫生装备

Objective To provide technical support for developing portable and carrying PSA medical oxygen generators under variable altitudes. Methods Based on the operation principle of PSA technology, the effects of altitude on the performance capacity of series of PSA medical oxygen generators were analyzed. PSA oxygen generating technology was explored with an inlet system with variable frequencies and constant pressure. The problems due to the introduction of the converter were discussed during studying key technologies, and some countermeasures were put forward accordingly. Trials were executed with 1.2 Nm3/h generator taken as an example. Results The PSA medical oxygen generator developed met the requirements of corresponding standards of medical molecular sieve oxygen generator at the altitudes from 0 to 4451 m. Conclusion The PSA oxygen generator has its adaption altitude enhanced significantly.

Three-dimensional finite element study on biomechanical effects of orthognathic surgery on the temporomandibular joint of skeletal mandibular retrusion / 中国组织工程研究

BACKGROUND:Generally,orthognathic surgery is used for skeletal mandibular retrusion.As the fulcrum of the masticatory loads on the temporomandibular joint,the mandible connects orthognathic surgery on itself with temporomandibular joint closely.However,the influence of orthognathic surgery on temporomandibular joint has not yet been fully unified.Finite element method has been widely used in the research concerning stomatology in recent years.OBJECTIVE:To establish a finite element model of temporomandibular joint and mandible with masticatory muscles before and after orthognathic surgery on the mandible and to investigate the long-term influence of orthognathic surgery on the biomechanics of temporomandibular joint.METHODS:The data of CT scan and three-dimensional reconstruction of a patient with skeletal mandibular retrusion were used to simulate surgical mandibular advancement with sagittal split ramus osteotomy,and the distance of advancement was 4,8 and 10 mm,respectively.The Von Mises stress of the condyles and articular fossae were obtained based on finite element method.RESULTS AND CONCLUSION:The finite element models of temporomandibular joint and mandible with masticatory muscles before and after orthognathic surgery of the patient with skeletal mandibular retrusion were established successfully,the stress nephograms and maximum Von Mises stress in each region of the condyles and articular fossae were obtained.To conclude,the finite element models are successfully established by Mimics,Geomagic Studio,Unigraphics NX and Workbench synthetically.The standard orthognathic surgery generally does not affect the condyle and glenoid fossa of the patient with skeletal mandibular retrusion negatively in the long-term.

Research on sleep quality and influential factors of patients with schizophrenia in rural areas in Ningxia Hui Autonomous Region / 中华行为医学与脑科学杂志

Objective To explore the sleep quality and its influencing factors among the patients with schizophrenia of Hui and Han populations in the rural areas in Ningxia Hui Autonomous Region.MethodsTotally 296 patients with schizophrenia of Hui and Han populations in the rural areas were selected from 2 counties of Wuzhong and Zhongwei in Ningxia Hui Autonomous Region by using cluster random sampling method.Self-made general information questionnaire was used to collect the demographic and clinical characteristics of the patients with schizophrenia.The Pittsburgh Sleep Quality Index(PSQI) was used to evaluate the sleep quality.Brief Psychiatric Rating Scale(BPRS),Hamilton Depression Scale(HAMD) and Hamilton Anxiety Scale(HAMA) were used to measure the psychotic symptoms,depressive symptoms and anxiety symptoms,respectively.ResultsIn the rural areas,the incidence of sleep disorder in the patients with schizophrenia of Hui and Han populations was 84.5%.The influencing factors of sleep disorder in the patients with schizophrenia in the rural areas were age(B=0.055,P=0.012,OR=1.057,95%CI:1.012-1.103),nationality(B=2.250,P<0.01,OR=9.485,95%CI:2.701-33.319),marital status(B=-1.506,P=0.003,OR=0.222,95%CI:0.081-0.605),course of disease(B=-0.003,P=0.089,OR=0.997,95%CI:0.993-1.001),the total score of HAMD(B=0.079,P=0.007,OR=1.083,95%CI:1.021-1.148)and the total score of HAMA(B=0.060,P=0.036,OR=1.061,95%CI:1.004-1.122).ConclusionSleep disorders are common and associated with multiple factors in patients with schizophrenia of Hui and Han populations in Ningxia rural area.In clinical practice,more attention should be paid to the identification and intervention of sleep disorders,so as to improve the sleep quality for the patients with schizophrenia.