Changes in corneal biomechanics after small incision lenticule extraction and femtosecond laser-assisted laser in situ keratomileusis evaluated by corneal visualization Scheimpflug technology / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To evaluate the changes in corneal biomechanics of patients with moderate refractive error after receiving small-incision lenticule extraction(SMILE)and femtosecond laser-assisted laser in situ keratomileusis(FS-LASIK)using the corneal visualization Scheimpflug technology(Corvis ST).METHODS:Prospective cohort study. A total of 65 moderate myopia patients(65 eyes)who were scheduled to undergo refractive surgery at the Ophthalmic Refractive Surgery Center of the Ningxia Eye Hospital from November 2020 to November 2021 were included in the study, and there were 30 eyes in the SMILE group and 35 eyes in the FS-LASIK group. The changes in corneal biomechanical parameters, including integrated radius(IR), inverse concave radius(ICR), deformation amplitude ratio 2mm(DAR2), stiffness parameter at first applanation(SP-A1), ambrosio relational thickness(ARTh)and the central curvature radius at highest concavity(HC-Radius)were observed by Corvis ST between both groups preoperatively and 1 and 3mo postoperatively.RESULTS: There were no statistical significance in biomechanical parameters between two groups of patients 1 and 3mo postoperatively(P>0.05). IR, ICR and DAR2 of each groups of patients 1 and 3mo postoperatively were significantly increased than those preoperatively, and SP-A1, ARTh and HC-Radius were significantly decreased than those preoperatively(all P<0.05). The biomechanical parameters at 1mo and 3mo postoperatively showed no statistical significance(P>0.05). In addition, a positive correlation was found between central corneal thickness(CCT)and ARTh and SP-A1 of the two groups of patients at 3mo postoperatively(FS-LASIK group: r=0.727, 0.819, SMLIE group: r=0.683, 0.434, all P<0.05), while a negative correlation was found between CCT and IR and ICR at 3mo postoperatively.(FS-LASIK group: r=-0.697, -0.622, SMLIE group: r=-0.447, -0.491, all P<0.05).CONCLUSION:For patients with moderate myopia, both SMILE and FS-LASIK can reduce corneal biomechanical stability. Both surgeries showed no significant differences in the effect on biomechanical, and the biomechanical has been stabilized at 1mo postoperatively. A correlation was found between postoperative CCT and ARTh, SP-A1, IR and ICR.

Effects of repetitive transcranial magnetic stimulation on balance function in stroke patients / 中华物理医学与康复杂志

Objective:To explore the effects of repetitive transcranial magnetic stimulation on balance function in stroke patients.Methods:A total of 238 patients randomized to a rTMS group and a control group by using the random number table at the ratio of 1∶1. Patients in the rTMS group were treated with low-frequency rTMS delivered to the contralateral M1 area, while those in the control group were treated with sham rTMS. The intervention was administered 5 times a week for 4 weeks. Both groups were also treated with conventional physical therapies in addition to rTMS. At one day before the intervention, two days and six weeks after the intervention, Fugl-Meyer Balance Scale, Berg Balance Scale and Modified Barthel index were employed to evaluate the functional outcome of all the patients.Results:After intervention, the scores of Fugl-Meyer Balance Scale, Berg Balance Scale and Modified Barthel index in both groups were significantly improved, and the rTMS group improved significantly more than control group ( P<0.05). When compare to the control group, the rTMS group improved to a significantly greater extent with regard to all the outcomes measures p after intervention and at follow-up ( P<0.05). Conclusion:rTMS is beneficial to the recovery of balance function in patients with stroke.

Effects of transaxillary approach endoscopic and traditional open radical thyroidectomy on the levels of inflammatory factors in patients with thyroid cancer / 中国医师进修杂志

Objective:To investigate the effects of transaxillary endoscopic and traditional open radical thyroidectomy on the levels of inflammatory factors in patients with thyroid cancer.Methods:The clinical data of 102 thyroid cancer patients underwent radical thyroidectomy from October 2019 to October 2021 in Xinjiang Medical University Hospital of Chinese Medicine were retrospectively analyzed. Among them, 50 cases underwent transaxillary approach endoscopic radical thyroidectomy (study group), and 52 cases underwent open radical thyroidectomy (control group). The operation related indexes were compared between two groups, including operation time, intraoperative blood loss, postoperative drainage, lymph node clearance and hospital stay; the pain scores 1, 3 and 7 d after operation were recorded; the levels of interleukin-6 (IL-6), interleukin-10 (IL-10), galectin-3 (Gal-3) and tumor necrosis factor-α (TNF-α) before operation and 1 d after operation were measured by enzyme-linked immunosorbent assay; the postoperative complications were recorded, including hoarseness, limb numbness, cough after drinking water and hypocalcemia; and the cosmetic satisfaction was followed up 3 months after discharge, and the recurrence was observed by CT 6 months after discharge.Results:The operation time in study group was significantly longer than that in control group: (88.69 ± 15.16) min vs. (61.47 ± 15.48) min, while the intraoperative blood loss, postoperative drainage and hospital stay were significantly lower in control group: (51.21 ± 10.06) ml vs. (85.46 ± 11.37) ml, (98.29 ± 30.61) ml vs. (117.47 ± 30.25) ml and (5.35 ± 0.54) d vs. (7.72 ± 0.61) d, and there were statistical differences ( P<0.01); there was no statistical difference in lymph node clearance between two groups ( P>0.05). The pain score 1 and 3 d after operation in study group was significantly lower than that in control group: (5.13 ± 1.07) scores vs. (7.87 ± 1.46) scores and (4.22 ± 1.35) scores vs. (6.42 ± 1.28) scores, and there were statistical differences ( P<0.05); there was no statistical difference in pain score 7 d after operation between two groups ( P>0.05). There were no statistical differences in IL-6, IL-10, TNF-α and Gal-3 between two groups ( P>0.05); the IL-6, IL-10, TNF-α and Gal-3 1 d after operation in study group were significantly lower than those in control group: (26.27 ± 3.14) ng/L vs. (29.22 ± 4.52) ng/L, (7.54 ± 2.31) ng/L vs. (10.92 ± 2.54) ng/L, (14.98 ± 3.76) μg/L vs. (23.65 ± 2.46) μg/L and (3.54 ± 0.48) μg/L vs. (4.48 ± 0.63) μg/L, and there were statistical differences ( P<0.01). There was no statistical difference in the incidence of total complications between two groups ( χ2 = 1.73, P>0.05). The total satisfaction rate in study group was significantly higher than that in control group: 94.0% (47/50) vs. 78.8% (41/52), and there was statistical difference ( χ2 = 4.94, P<0.05). The patients were followed up for 6 months after discharge, and there was no recurrence. Conclusions:The transaxillary approach endoscopic radical thyroidectomy can reduce intraoperative blood loss, length of stay, postoperative drainage, postoperative pain, and to some extent inhibit inflammatory response. It can improve the postoperative cosmetic satisfaction, reduce the incidence of postoperative complications, and does not increase the recurrence rate

Research on the Collaborative Education Mode of Curriculum Ideology and Politics based on "Great Medical Sincerity" and Ideological and Political Courses / 中国医学伦理学

Promoting the collaborative education of curriculum ideology and politics and ideological and political courses is a realistic choice to implement the fundamental task of morality education. The methods, to solve the outstanding problems such as the "uncoordinated" between the two curriculum systems of curriculum ideology and politics and ideological and political courses in medical colleges, the "insignificant" effect of collaborative education between professional course teachers and ideological and political course teachers, and the "insufficient" embodiment of the concept of collaborative education in the medical talent training scheme, are related to the quality of talent training in medical colleges and universities. The collaborative education mode of curriculum ideology and politics based on "great medical sincerity" and ideological and political courses have been formed in the practice and exploration. With "great medical sincerity" as the link, with "two supports" and "four focus points" to build a platform mutually integrated two curriculum; with "three platforms" as the support to improve the collaborative education ability of professional teachers and ideological and political teachers; with "five entry strategy" to promote the implementation of the collaborative education concept. This mode has greatly reversed the "insufficient" phenomenon of collaborative education of curriculum ideology and politics and ideological and political courses in medical colleges.

Expression and Prognostic Value of Metabolism-related Genes in Pediatric Acute Lymphoblastic Leukemia / 中国实验血液学杂志

OBJECTIVE@#To analyze the expression and prognostic value of metabolism-related genes in pediatric acute lymphoblastic leukemia (ALL), and explore the potential prognostic biomarkers or therapeutic targets.@*METHODS@#Transcriptome data from 84 children with B-cell ALL at the time of diagnosis and prior to any treatment were used to analyze the differential gene expression. A prognostic scoring system based on the expression of the metabolism-related genes was constructed using Cox and Lasso regression methods. The prognostic value of the scoring system was further assessed by multivariate Cox regression analysis. Gene set enrichment analysis was carried out by using GSEA software.@*RESULTS@#Among the 933 metabolism-related genes, 14 up-regulated genes and 17 down-regulated genes were identified as differentially expressed genes. In addition, 8 up-regulated genes (ASS1, CKM, PTGES, ADCY5, HNMT, PHGDH, CYP4F3, AADAT) and 4 down-regulated genes (GDA, DHRS9, IDO2, UGT2B4) were selected to establish a novel prognostic scoring system. Patients in the high-risk group showed poorer survival significantly than patients in the low-risk group (P<0.05). The prognostic scoring system was still shown to be an independent prognostic factor for the survival of children with ALL after the clinical characteristics, such as gender, age, white blood cell count at initial diagnosis, cytogenetics and molecular genetics were included (HR=8.906, 95%CI: 3.114-25.470). GSEA results showed that 6 metabolism-related pathways (amino sugar and nucleotide sugar metabolism, arginine and proline metabolism, fructose and mannose metabolism, glyoxylate and dicarboxylate metabolism, pyrimidine metabolism, selenoamino acid metabolism) were enriched in the high-risk group.@*CONCLUSION@#The abnormal metabolism-related gene expression is associated with the clinical outcome of children with ALL, and these results provide potential novel prognostic biomarkers and treatment targets for pediatric ALL.

Clinical characteristics of a severe bubionic plague patient / 中华地方病学杂志

Objective:To understand the clinical manifestations and prognosis of severe bubonic plague, and to explore the treatment experience of severe bubonic plague.Methods:A retrospective analysis was conducted on the clinical data and treatment of a case of severe bubonic plague admitted to Huade County on November 11, 2019.Results:The case of bubonic plague was a 55-year-old male, and outbreak after hunting the hare at the foci. The clinical manifestations included fever, fatigue, left armpit skin hard, swelling, heat and pain, distinctness of lymph node enlargement in later stage, hiccups and pleural effusion. Laboratory tests showed diffuse intravascular coagulation (DIC), sepsis and multiple organ dysfunctions. Bubonic plague was confirmed by positive culture of Yersinia pestis and positive phage lysis test on the 3rd day after admission. After platelet, plasma, fluid resuscitation and streptomycin combined with moxixacin, DIC and multiple organ functions were restored to normal and the hard swelling subsided. The course of treatment lasted for 19 days, the body temperature returned to normal and the patient recovered. Conclusions:This patient is a severe case of bubonic plague characterized with lymphangitis, skin sclerosis and abnormal coagulation. Timely identification, evaluation, early and combined treatment is the key to successful treatment.

Mechanism of insulin-like growth factor 2 regulating human ovarian granulosa cell proliferation through the phosphatidylinositol 3-kinase/ protein kinase B signaling pathway / 解剖学报

Objective To explore the effect and mechanism of insulin-like growth factor 2 ( IGF2 ) on the proliferation of human ovarian granulosa cells ( KGN ). Methods KGN cells cultured in vitro and treated with different concentrations of IGF2 were divided into control group and IGF2 group (25 μg/L, 50 μg/L, 100 μg/L), and then cells were divided into control group, 100 μg/L IGF2 group, LY294002 group, and IGF2 +LY294002 group after intervened the phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt) signaling pathway with LY294002. MTS and 5-ethynyl-2'- deoxyuridine (EdU) method was used to detect the effect of IGF2 on KGN cell proliferation, and enzyme linked immunosorbent assay was used to detect the contents of estrogen and progesterone in cell culture supernatant. The expressions of insulin like growth factor 1 receptor (IGF1R), protein kinase B (Akt), phosphorylated protein kinase B(p-Akt) and CYP19A1 protein in each group were detected by Western blotting. Results With the concentration gradient of IGF2, the proliferation rate of KGN cells and the secretion of estrogen and progesterone gradually increased. The cell proliferation rate and hormone level in the group treated with lOOfig/L IGF2 were the highest (P<0.01), while the PI3K/Akt signaling pathway was inhibited, and the cell proliferation rate and hormone secretion decreased significantly (P<0.01). The protein expression levels of IGF1R, p-Akt and CYP19A1 in different concentration groups increased significantly (P<0.05). While the expression of the above proteins were affected by intervened the PI3K/Akt signaling pathway. Compared with the control group, the protein expression of IGF1R and p-Akt increased significantly in IGF2 group and IGF2 +LY294002 group(P<0.01), CYP19A1 increased significantly in IGF2 group(P<0.01), the protein expression of p-Akt and CYP19A1 decreased significantly in LY294002 group (P<0.05), there was no significant difference in the protein expression of IGF 1R. Compared with the IGF2 group, the protein expression of p-Akt and CYP19A1 decreased in IGF2 +LY294002 group (P<0.01), there was no statistically significant difference in the protein expression of IGF1R, and the expression levels of IGF1R, p-Akt and CYP19A1 were significantly reduced in LY294002 group (P<0.01). Conclusion IGF2 may promote the proliferation and secretion of human ovarian granulosa cells through the PI3K/Akt signaling pathway mediated by IGF1R.

Relationship between acute kidney injury after interventional therapy and short-term prognosis in patients with acute coronary syndrome / 医学研究生学报

ObjectivePercutaneous coronary intervention (PCI) may cause acute kidney injury (AKI) in some patients with acute coronary syndrome (ACS), leading to persistent renal dysfunction. This study aimed to investigate the relationship between acute kidney injury after PCI and short-term prognosis in patients with ACS.MethodsData of 333 patients with ACS who underwent PCI in our hospital were included. According to whether the serum creatinine level was increased above 25% during 1st to 3rd day after PCI than the preoperative, patients was divided into AKI group (n=38) and non-AKI group (n=295). Risk factors for AKI in patients with ACS after PCI were analyzed. Adverse cardiovascular events and survival rates between the two groups were compared. Univariate and multivariate analysis were performed to determine the risk factors on short-term survival after surgery.ResultsAge, diabetes, preoperative renal insufficiency, left ventricular ejection fraction (LVEF), contrast dose and count of lesion coronary artery were independent risk factors for AKI after PCI (P<0.05). Within 1 year after surgery, the total incidence of cardiovascular adverse events in the AKI group and the non-AKI group were 28.9% and 5.8%, respectively, and the difference was statistically significant(χ2=20.582, P=0.000). The patients were followed up for 2.9 to 17.2 months with a median follow up of 8.6 months. The 6-month cumulative survival rate of AKI group and non-AKI group were 94.1% and 99.6%, respectively. The 1 year cumulative survival rate was 84.2% and 96.1%, respectively. The difference in overall survival rate between the two groups was statistically significant(χ2=9.216, P=0.002). Short-term survival after PCI was associated with AKI(χ2=20.582, P=0.000), LVEF (χ2=9.055, P=0.003), count of lesion coronary artery (χ2=5.749, P=0.016) and preoperative Killip grading(χ2=4.823, P=0.028). AKI and LVEF were independent predictors of short-term survival after PCI (P<0.05).ConclusionAKI in patients with ACS after PCI has a poorer short-term prognosis, which can be used as an important factor in disease assessment and risk stratification.

Analysis of immune regulation and prognosis of chronic hepatitis B virus infection / 公共卫生与预防医学

Objective To investigate the immune regulation and prognosis of hepatitis B virus (HBV) infection in infected patients, and to analyze the relationship between immune regulation and clinical outcome. Methods The data of 633 cases of HBV infection in Huhhot from January 2015 to December 2018 were retrospectively analyzed. At the same time, healthy people from the Affiliated Hospital of Inner Mongolia Medical University were selected as the control group. Immune cell regulatory factors and lymphocyte subsets in blood of HBV infected and healthy people were tested. The results of one-year clinical outcomes were calculated. The relationship between immune cell regulatory factors and lymphocytes and the clinical outcomes of patients was analyzed by multiple logistics regression. Results The levels of CD4+T cells, CD8+T cells, NK cells, IL-2, and IL-12 in the blood of patients with HBV infection were significantly lower than those in the control group, and decreased as the patients’ clinical outcome deteriorated (P0.05). Low CD4+ T cells, low CD8+ T cells, low NK cells, low IL-2, low IL-12, high IL- 4 and high IL-10 were independent risk factors leading to the deterioration of clinical outcomes (P<0.05). Conclusion The immune regulation of patients with HBV infection is in a state of suppression, which is an independent factor affecting the clinical outcome of patients.

Clinical Analysis of Serum Calcium Level in 86 Cases of Newly Diagnosed Multiple Myeloma / 中国实验血液学杂志

OBJECTIVE@#To investigate the serum calcium level in 86 patients with newly diagnosed multiple myeloma (MM) and its correlation with clinical features.@*METHODS@#The clinical data of 86 patients with newly diagnosed multiple myeloma in our hospital from 2009 to 2016 were retrospectively analyed. Clinical data of sex, age, hemoglobin, albumin, globulin, creatinine, uric acid, serum phosphorus, β2-microglobulin, immunophenotyping and disease staging were collected. After the serum calcium level was corrected, the patients were grouped into low serum calcium (2.60 mmol/L). The correlation between the clinical characteristics and the serum calcium level was analysed, the clinical characteristics between the low and non-low calcium group were compared.@*RESULTS@#The number of cases in low, normal and high serum cnlcium groups before correction was 58 (67.4%), 18 (20.9%) and 10 (11.6%) respactively, while the number of cases in 3 group after correction was 34 (39.5%), 36 (41.9%) and 16 (18.6%) respectively. The age, globulin, creatinine, uric acid and serum phosphorus levels were positively correlated with serum calcium level in patients with multiple myeloma, while the sex, hemoglobin,albumin and β2-microglobulin levels did not correlated with serum calcium level. There was significant difference in the age, globulin, creatinine and serum phosphorus between low calcium and non-low calcium group (P0.05).@*CONCLUSION@#Multiple myeloma patients suffered from both hypercalcemia and hypocalcemia, and the incidence of hypocalcemia is not low. The levels of serum calcium in patients with multiple myeloma correlate with age, globulin, creatinine, uric acid, serum phosphorus level and other factors, thus it is necessary to correct the level of ionized calcium with physiological activity.

Detection and Analysis of T Lymphocyte Subsets and B Lymphocytes in Patients with Acute Leukemia / 中国实验血液学杂志

OBJECTIVE@#To investigate the changes of T lymphocyte subsets, B lymphocyte and NK cells in peripheral blood of patients with acute leukemia at different periods and their significance.@*METHODS@#The peripheral T lymphocyte subsets and B lymphocyte of 95 patients with acute leukemia [(43 cases of acute lymphoblastic leukemia (ALL), 52 cases of acute myeloid leukemia (AML)] and 50 normal people were detected by flow cytometry respectively.@*RESULTS@#The positive rate of CD3, CD3CD4, CD3CD8, NK cells and CD4/CD8 in the patients with newly diagnosed acute leukemia were significantly lower than those in normal controls (P<0.05) , but increased obviously after complete remission. The positive rate of Treg cells in the patients with newly diagnosed leukemia group was significantly higher than that in normal controls (P<0.01) , but decreased obviously after complete remission. Positive rate of CD3CD19 cells in the patients with newly diagnosed acute myeloid leukemia was significantly lower , but higher in the patients with newly diagnosed acute lymphoblastic leukemia than that in normal controls with statistical significant difference (P<0.05) , and increased obviously in the patients with acute myeloid leukemia (P<0.05) after complete remission , but decreased in the patients with acute lymphoblastic leukemia (P<0.01) after complete remission or no-remission.@*CONCLUSION@#Changes of T lymphocyte subsets, B lymphocytes and NK cells in the patients with newly diagnosed acute leukemia are significant, thus the detection of T lymphocyte cell subsets, B lymphocytes and NK cells can provide some evidences. for evaluation of the disease severity, curative efficiency and prognosis of patients with acute leukemia.

Etiological analysis of 61 286 hospitalized specimens from a tertiary hospital over 5 years / 中华危重病急救医学

Objective To investigate the detection and distribution of hospitalized specimens from a tertiary hospital over 5 years. Methods Specimens of sputum, urine, blood, secretions and puncture fluid were collected from patients admitted to the Harrison International Peace Hospital from November 2013 to November 2018. The origin of specimens, the distribution of departments and the distribution of pathogenic bacteria isolated were analyzed retrospectively. Results A total of 61 286 specimens were sent for examination during the 5 years. The top 5 specimens were sputum culture (n = 18 302, 29.9%), sputum smear (n = 11 253, 18.4%), blood culture (n = 9 713, 15.8%), urine culture (n = 6 448, 10.5%) and secretion culture (n = 6 133, 10.0%), accounting for 84.6% (51 849/61 286). Sputum specimens accounted for 48.2% (29 555/61 286) with the largest proportion. The number of specimens from medical wards was much higher than that from surgical wards (specimens: 25 468 vs. 10 521), respiratory medicine, department of critical care medicine and emergency intensive care unit (EICU) were important sources of pathogenic specimens in the hospital, accounting for 29.8% (18 243/61 286) in total. The average positive rate of all specimens was 23.5% (14 424/61 286). The positive rates of sputum culture and urine culture were 29.7% (5 428/18 302) and 35.4% (2 281/6 448), respectively, while the positive rate of blood culture was only 6.6% (643/9 713). Escherichia coli was the most common pathogen in all specimens except for sputum culture and fecal culture. Escherichia coli [40.6% (926/2 281)], Klebsiella pneumoniae [9.2% (210/2 281)], Pseudomonas aeruginosa [8.2% (188/2 281)], Enterococcus faecalis (group D) [6.6% (151/2 281)] and Candida albicans [3.2% (73/2 281)] were the most common pathogens in urine culture. Klebsiella pneumoniae [24.1% (1 309/5 428)], Acinetobacter baumannii [21.3% (1 154/5 428)], Pseudomonas aeruginosa [15.1% (818/5 428)], Escherichia coli [6.5% (351/5 428)] and Maltose oligotrophomonas maltose [5.8% (316/5 428)] were the most common pathogens in sputum culture. Escherichia coli [36.5% (235/643)], Klebsiella pneumoniae [10.9% (70/643)], Pseudomonas aeruginosa [4.8% (31/643)], Staphylococcus epidermidis [3.4% (22/643)] and Staphylococcus humanis [3.3% (21/643)] were the most common pathogens in blood culture. Conclusion Specimens sent for examination by inpatients are mainly from internal medicine wards, mainly from sputum, blood and urine, and the detected pathogens are mainly Gram-negative bacteria.

Mean platelet volume might be an effective indicator of arterial erectile dysfunction / 亚洲男科学杂志(英文版)

The aim of our study was to investigate the role of platelet parameters including mean platelet volume (MPV) and platelet count (PC) in the pathogenesis of penile arteriogenic erectile dysfunction (ED) and to evaluate the association between the platelet parameters and arteriogenic ED. There were 244 patients with ED (based on the International Index of Erectile Function [IIEF]-5 ≤21) and 60 healthy controls (IIEF-5 >21) enrolled. All participants were asked to undergo a laboratory examination, and penile vascular function was evaluated using penile color Doppler ultrasonography (pDUS). Among these ED patients, 24 patients with no abnormality on nocturnal penile tumescence (NPT) and 84 with normal vasculature or mixed vascular abnormalities were excluded. The other patients were classified into three groups as follows: control (n = 60), arteriogenic ED (n = 99), and venous leakage (n = 37) groups. MPV and PC were significantly higher in the arteriogenic ED group compared with the venous and control groups (P < 0.05). Receiver operating characteristic curve analysis revealed that the area under the curve for MPV to predict arteriogenic ED was 0.707. MPV ≥9.65 fl was recognized as a cut-off value for potential arteriogenic ED (sensitivity: 47.5%; specificity: 91.7%). A significant inverse correlation was detected between MPV and 10-min peak systolic velocity (PSV) (r = -0.34; P < 0.001) in the arteriogenic ED group. These findings suggest that the MPV might be a powerful indicator to predict and diagnose arteriogenic ED, and MPV may be a marker for ED when using pDUS.

The earth mover's distance and Bayesian linear discriminant analysis for epileptic seizure detection in scalp EEG

Since epileptic seizure is unpredictable and paroxysmal, an automatic system for seizure detecting could be of great significance and assistance to patients and medical staff. In this paper, a novel method is proposed for multichannel patient-specific seizure detection applying the earth mover's distance (EMD) in scalp EEG. Firstly, the wavelet decomposition is executed to the original EEGs with five scales, the scale 3, 4 and 5 are selected and transformed into histograms and afterwards the distances between histograms in pairs are computed applying the earth mover's distance as effective features. Then, the EMD features are sent to the classifier based on the Bayesian linear discriminant analysis (BLDA) for classification, and an efficient postprocessing procedure is applied to improve the detection system precision, finally. To evaluate the performance of the proposed method, the CHB-MIT scalp EEG database with 958 h EEG recordings from 23 epileptic patients is used and a relatively satisfactory detection rate is achieved with the average sensitivity of 95.65% and false detection rate of 0.68/h. The good performance of this algorithm indicates the potential application for seizure monitoring in clinical practice.

Comparison of efficacy and safety between entecavir versus adefovir dipivoxil in the treatment of HBeAg positive chronic hepatitis B / 中国综合临床

Objective To compare the efficacy and safety of entecavir versus adefovir dipivoxil in the treatment of HBeAg positive chronic hepatitis B ( CHB) . Methods Ninety?six cases with HBeAg positive CHB were divided into ETV group and ADV group according to different medication. In addition to conventional treatment,ETV group received entecavir 0. 5 mg/d,ADV group received adefovir dipivoxil 10 mg/d. HBV DNA negative conversion rate,alanine aminotransferase ( ALT) recurrence rate and HBeAg negative conversion rate in 24 weeks,48 weeks and 96 weeks were compared as well as the adverse reactions and liver function in 96 weeks. Results HBV DNA negative conversion rates in ETV group were significantly higher than those in ADV group in 24 weeks,48 weeks and 96 weeks (24 weeks:64. 6％(31/48) vs. 41. 7％(20/48);48 weeks:83. 3％(40/48) vs. 52. 1％(25/48);96 weeks:97. 9％(47/48) vs. 62. 5％(30/48),χ2 =5. 06,10. 72,18. 96,P<0. 05) . ALT recurrence rates in ETV group were significantly higher than those in ADV group at 24 weeks,48 weeks ( 24weeks:77. 1％( 37/48 ) vs. 54. 2％( 26/48 );48weeks:85. 4％( 40/48 ) vs. 62. 5％( 30/48 ) ,χ2=5. 59,6. 54,P<0. 05). There was no significant difference in ALT complication rate at 96 week(χ2=0. 71,P>0. 05) . There was no significant difference in HBeAg negative conversion rate between the two groups through treatment(χ2=0. 07, 0. 22, 0. 44, P>0. 05 ) . After 96 weeks, ALT in both groups decreased significantly ( t =13. 56,11. 85,P<0. 05) ,while ALT in ETV group was significantly lower than that in ADV group ( ( 31. 8 ±8. 6) U/L vs. (38. 5±7. 5) U/L,t=4. 07,P<0. 05). AST in both groups decreased significantly(t=41. 27, 33. 68,P<0. 05),while AST in ETV group was significantly lower than that in ADV group ( (30. 3±6. 5) U/L vs.(37.6±7.1)U/L,t=5.25,P<0.05).TBIL in both groups decreased significantly(t=28.92,22.23,P<0. 05),while TBIL in ETV group was significantly lower than that in ADV group ( (13. 5±3. 3) μmol/L vs. (18. 7±3. 9) μmol/L,t=7. 05,P<0. 05). GGT in both groups decreased significantly (t=16. 99,13. 97,P<0.05),while GGT in ETV group was significantly lower than that in ADV group ( (35.6±10.4)U/L vs. (59. 7±12. 5)U/L,t=10. 27,P<0. 05). There was no significant difference in adverse reaction between the two groups (χ2=1. 96,P>0. 05) . Conclusion Entecavir has a higher rate of HBV DNA negative conversion rate, ALT recurrence rate and HBeAg negative conversion rate in the treatment of HBeAg positive CHB. It is an ideal antiviral drug.

Effects of different doses of mivacurium chloride on muscle relaxation time- course and hemodynamics in children with different ages / 中国医师进修杂志

Objective To observe the effect of different doses of mivacurium chloride on muscle relaxation time-course and hemodynamics in children with different ages. Methods One hundred children of selective inguinal hernia repair under general anesthesia with endotracheal intubation from January 2016 to January 2017 were enrolled, and the age was 0.5 to 6.0 years. The children were divided into low age group (0.5 to 3.0 years) and high age group (3.1 to 6.0 years) according to the age, then the children were divided into low dose group (mivacurium chloride 0.20 mg/kg) and high dose group (mivacurium chloride 0.25 mg/kg) according to the doses of mivacurium chloride. Therefore, the children were divided into low age low dose group, low age high dose group, high age low dose group and high age high dose group with 25 cases each. The mean arterial pressure (MAP) and heart rates before anesthesia (T0) and 1 min (T1), 3 min (T2), 5 min (T3), 10 min (T4) after intravenous injection of mivacurium chloride were recorded. The times of first intravenous injection of mivacurium chloride to neuromuscular block 75% (ThD75), 90% (ThD90) and maximum (ThDmax) were recorded. The recovery index (RI) was recorded. The times of last intravenous injection of mivacurium chloride to onset of muscle convulsions (Th) and muscle convulsions recovery 10% (ThR10), 25% (ThR25), 75% (ThR75), 90% (ThR90) were recorded. The times of ratio of the fourth muscle twitch to the first muscle twitch (TOFR) recovery 75% (TOFR75) and 90% (TOFR90) were recorded. Results There were no statistical difference in MAP and heart rate among 4 groups (P＞0.05). The ThD75, ThD90 and ThDmax in low age low dose group were (126 ± 40), (163 ± 59) and (192 ± 49) s, those in low age high dose group were (73 ± 15), (115 ± 41) and (142 ± 37) s, those in high age low dose group were (149 ± 38), (193 ± 44) and (221 ± 47)s, and those in high age high dose group were (105 ± 32), (138 ± 35) and (167 ± 44)s. The ThD75, ThD90 and ThDmax in low age high dose group were significantly shorter than those in low age low dose group, those in high age high dose group were significantly shorter than those in high age low dose group, those in high age low dose group were significantly longer than those in low age low dose group, those in high age high dose group were significantly longer than those in low age high dose group, and there were statistical differences (P＜0.05). There were no statistical differences in Th, ThR10, ThR25, ThD75, ThD90, RI, TOFR75 and TOFR90 among low age low dose group and low age high dose group, high age low dose group and high age high dose group (P＞0.05). Conclusions In the children of 0.5 to 3.0 years, the effect of mivacurium chloride is significantly faster than that in the children of aged 3.1 to 6.0 years. Compared with 0.20 mg/kg of mivacurium chloride, 0.25 mg/kg of mivacurium chloride has less time to display muscle relaxation effect. The recovery time is not affected by age and induction dose. Mivacurium chloride has no significant effect on hemodynamics.

A review of behavioral visual acuity tests for rodents / 国际眼科杂志(Guoji Yanke Zazhi)

·Rodents have been used widely in the research of eye diseases to study visual function in animal models. Two methods of visual acuity testing in animals have been internationally recognized:the electrophysiological visual acuity test and the behavioral visual acuity test. Both of these methods have their advantages and limitations. The electrophysiology test (visual evoked potential) is invasive, and animals need recovery time after being implanted with electrodes. Also,the electrophysiological visual acuity test only reflects the electrical activity of a single cell or nuclei, it does not reflect the overall visual function of the animal. The widely used behavioral visual acuity test is able to compensate for these limitations. This paper gives a brief overview of the methods of the behavioral visual acuity test for rodents (rats, mice, guinea pigs,etc.).

Effect of indwelling time of lacrimal silicone drainage tube on patients with chronic dacryocystitis and its influence on patients' vision / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the effect of indwelling time of lacrimal silicone drainage tube on chronic dacryocystitis and its effect on visual acuity.?METHODS: The clinical data of 92 patients ( 110 eyes ) with chronic dacryocystitis treated with lacrimal drainage tube in our hospital from January 2013 to December 2016 were retrospectively analyzed. According to the indwelling time, the patients were divided into 6wk group (42 patients 50 eyes ) and 12wk group ( 50 patients 60 eyes). Comparison of two groups on clinical efficacy, vision, overflow symptoms, complications and recurrence was taken.?RESULTS:The effective rate was significantly higher in the 6wk group than in the 12wk group (P<0. 05). The visual acuity and incidence of epilepsy symptoms at 3mo after extubation was not signifcantly different (P<0. 05). The incidence of complication was 14. 0％ (7/50) at 3mo after extubation in 6wk group and significantly lower than that in the 12wk group which was 38. 3％ (23/60, P<0. 05). The recurrence rate was 2. 0％ (1/50) in the 6wk group, which was significantly lower than that in the 12wk group (18. 3％, 11/60;P<0. 05).?CONCLUSION: The clinical efficacy of lacrimal silicone drainage tube for 6wk and 12wk is similar to patients with chronic dacryocystitis. There is also little difference in the visual acuity of patients with dacryocystitis, but with the prolongation of the lacrimal duct drainage tube, rinse patency rate, increase the difficulty of extubation, complications and recurrence rate, the clinical situation should be based on the patient as much as possible to shorten the lacrimal duct silicone drainage tube retention time.

Advances in liver transplantation for patients with primary sclerosing cholangitis / 中华肝胆外科杂志

Primary sclerosing cholangitis (PSC) is a common autoimmune liver disease,and the diversity of its treatment methods has been hotly discussed by scholars in various countries.As the best treatment,end-stage liver transplantation (LT),due to the related diseases,such as postoperative complications greatly limits its wide application in clinical practice.Early assessment and intervention can reduce the risk of concomitant disease and reduce the occurrence of postoperative complications.In this paper,the status of LT indications,timing and related disease management,postoperative complications and other aspects of PSC patients were reviewed.

Clinical Observation of Exenatide Combined with Clomiphene Citrate in the Treatment of Polycystic Ova-ry Syndrome with Insulin Resistance / 中国药房

OBJECTIVE:To observe clinical efficacy and safety of exenatide combined with clomiphene citrate in the treatment of polycystic ovary syndrome with insulin resistance. METHODS:98 patients with polycystic ovary syndrome complicated with in-sulin resistance were randomly divided into control group (49 cases) and observation group (49 cases). Control group was given Clomiphene citrate capsule 50 mg orally,once a day,for 5 d+Metformin enteric-coated tablet with initial dose of 0.25 g orally, twice a day,adjusted to 0.50-0.75 g orally,twice a day,for 3 menstrual cycles. Observation group was given Clomiphene citrate capsule(usage and dosage same as control group)+Exenatide injection 5 μg subcutaneously,twice a day,adjusted to 10 μg subcu-taneously,twice a day,for 2 months. Clinical efficacies of 2 groups were observed as well as the levels of LH,FSH,LH/FSH and IR before and after treatment,ovulation and pregnancy of infertility patients after treatment. The occurrence of ADR was record-ed. RESULTS:Total response rate,ovulation rate and pregnancy rate of observation group were significantly higher than that of con-trol group,with statistical significance(P0.05). After treatment,the levels of LH,LH/FSH and IR in 2 groups were significantly lower than before,and the observation group was significantly lower than the control group,the levels of FSH in 2 groups was sig-nificantly higher than before,and the observation group was significantly higher than the control group,with statistical significance (P0.05). CONCUSIONS:Exenatide com-bined with clomiphene citrate shows significant therapeutic efficacy for polycystic ovary syndrome complicated with insulin resis-tance and can increase ovulation rate and pregnancy rate through improving insulin resistance,but doesn't increase the occurrence of ADR.