Early Enteral Nutrition and Sepsis-Associated Acute Kidney Injury: A Propensity Score Matched Cohort Study Based on the MIMIC-III Database

Purpose@#We aimed to analyze the optimal timing of enteral nutrition (EN) in the treatment of sepsis and its effect on sepsis-associated acute kidney injury (SA-AKI.) Materials and Methods: The MIMIC-III database was employed to identify patients with sepsis who had received EN. With AKI as the primary outcome variable, receiver operating characteristic (ROC) curves were utilized to calculate the optimal cut-off time of early EN (EEN). Propensity score matching (PSM) was employed to control confounding effects. Logistic regressions and propensity score-based inverse probability of treatment weighting were utilized to assess the robustness of our findings. Comparisons within the EEN group were performed. @*Results@#2364 patients were included in our study. With 53 hours after intensive care units (ICU) admission as the cut-off time of EEN according to the ROC curve, 1212 patients were assigned to the EEN group and the other 1152 to the delayed EN group. The risk of SA-AKI was reduced in the EEN group (odds ratio 0.319, 95% confidence interval 0.245–0.413, p<0.001). The EEN patients received fewer volumes (mL) of intravenous fluid (IVF) during their ICU stay (3750 mL vs. 5513.23 mL, p<0.001). The mediating effect of IVF was significant (p<0.001 for the average causal mediation effect). No significant differences were found within the EEN group (0–48 hours vs. 48–53 hours), except that patients initiating EN within 48 hours spent fewer days in ICU and hospital. @*Conclusion@#EEN is associated with decreased risk of SA-AKI, and this beneficial effect may be proportionally mediated by IVF volume.

Percutaneous foraminal endoscopy for the treatment of lumbar lateral recess stenosis in elderly / 中国骨伤

OBJECTIVE@#To investigate the clinical efficacy and safety of percutaneous foraminal endoscopy in the treatment of lumbar lateral recess stenosis in elderly.@*METHODS@#The clinical data of 31 elderly patients with lumbar lateral recess stenosis treated by percutaneous foraminal endoscopic decompression from March 2018 to August 2019 were retrospectively analyzed. Including 16 males and 15 females, aged from 65 to 81 years with an average of (71.13±5.20) years, the course of disease ranged from 3 months to 7 years with an average of (14.36±6.52) months. Visual analogue scale (VAS) and Oswestry disability index (ODI) were used to assess clinical symptom and functional status before operation and 1, 6, 12 months after operation. At the final follow-up, the modified Macnab standard was used to evaluate clinical efficacy.@*RESULTS@#All patients were completed the operation successfully. The operation time was from 75 to 120 min with an average of (97.84±11.22 ) min. All 31 patients were followed up from 12 to 28 months with an average of (17.29±5.56) months. Postoperative lumbago-leg pain VAS and ODI were significantly improved at 1, 6, and 12 months(P<0.01). At the final follow-up, according to the modified Macnab standard to evaluate the effect, 23 got excellent results, 5 good, 3 fair. One patient had severe adhesions between peripheral tissues and nerve root, and postoperative sensory abnormalities in the lower extremities were treated conservatively with traditional Chinese medicine and neurotrophic drugs, which recovered at 2 weeks after surgery. No complications such as nerve root injury and infection occurred.@*CONCLUSION@#The intervertebral foraminal endoscopy technique, which is performed under local anesthesia for a short period of operation, ensures adequate decompression while minimizing complications, and is a safe and effective surgical procedure for elderly patients with lumbar lateral recess stenosis.

Influence of family support on the physical activities and motor skills of children and adolescents / 中国学校卫生

Objective@#To explore the relationship between family background and parental support and adolescents physical activity and motor skills, and to provide a corresponding theoretical basis for the health promotion of children and adolescents in China.@*Methods@#From November to December 2019, 140 junior high school students aged 12-14 years in a junior high school in Shanxi Province were selected, and physical activity was recorded for 7 days using an ActiGraph GT3X+ accelerometer. The Activity Support Scale for Children (ACTS CN) was used to evaluate parents support and attitude towards children s activities and behaviors. The Canadian Agility and Movement Skill Assessment (CAMSA) was used to evaluate the motor ability development of adolescents.@*Results@#The daily participation time in moderate to vigorous physical activity (MVPA) was (40.57±13.54) and (31.65± 9.98 ) min for males and females, respectively, with a statistically significant difference ( t =4.44, P <0.05); The average motor skill scores were (10.8±1.9) and (10.1±1.9), and completion times were (17.7±2.8) and (19.1±2.5)s, respectively; regression analyses showed that mothers education, monthly household income, mothers attention to children s exercise and fathers support for club participation were all significantly associated with adolescents MVPA ( B =-0.28,-0.16,-0.16, 0.18, P <0.05). Parental provision of exercise space was significantly associated with motor ability ( r =0.17, 0.17, P <0.05).@*Conclusion@#Parents with higher levels of education have a more positive influence on their children s physical activity participation. Parental presence can contribute to a certain extent to the level of physical activity of adolescents, and a supportive environment provided from parents can positively influence the level of motor skills of adolescents.

Effect of Shenmai Injection on Long-Term Prognosis of Patients with Chronic Heart Failure: A Multicenter, Large Sample Capacity, Long-Term Follow-Up Retrospective Cohort Study / 中国结合医学杂志

OBJECTIVE@#To explore the effect of Shenmai Injection (SMI) on the long-term prognosis of patients with chronic heart failure (CHF).@*METHODS@#The Hospital Information System was used to extract data of CHF patients, and the retrospective cohort study was conducted for analysis. In non-exposed group, standardized Western medicine treatment and Chinese patent medicine or decoction were applied without combination of SMI while in the exposed group, SMI were applied for more than 7 days. Evaluation indicators are followed with New York Heart Association functional classification (NYHA classification), left ventricular ejection fraction (LVEF), N-terminal brain natriuretic peptide precursor (NT-ProBNP), cardiogenic death and heart failure (HF) readmission. Statistical analysis includes Kaplan-Meier analysis and Cox regression which are used to explore the relationship between SMI and outcome events.@*RESULTS@#A total of 1,211 eligible CHF patients were involved and finally 1,047 patients were followed up successfully. After treatment, the cases of NYHA classification decline in the exposed and non-exposed groups accounted for 64.30% and 43.45%, respectively; the improvement values of LVEF were 8.89% and 7.91%, respectively; the improvement values of NT-ProBNP were 909 pg/mL and 735 pg/mL, respectively. After exposure on SMI, the rates of cardiogenic death and HF readmission reduced from 15.43% to 10.18% and 38.93% to 32.37%. According to Kaplan-Meier analysis, the log-rank P value of SMI and cardiogenic death was 0.014, while the counterpart of SMI and HF readmission was 0.025. Cox regression analysis indicated that for cardiogenic death, age, cardiomyopathy, diabetes, and NYHA classification were risk factors while β-blockers, aldosterone receptor antagonists, Chinese patent medicine/decoction and SMI were protective factors. Likewise, for HF readmission, age, cardiomyopathy, and NYHA classification were risk factors while SMI was a protective factor.@*CONCLUSION@#Combination with SMI on the standardized Western medicine treatment can effectively reduce cardiogenic mortality and readmission rate in CHF patients, and thereby improve the long-term prognosis.

Effect of acupuncture on serum PYY and nesfatin-1 in obese patients with insulin resistance / 针灸推拿医学（英文版）

Objective: To observe the effect of acupuncture on serum peptide YY (PYY) and nesfatin-1 in obese patients with insulin resistance. Methods: Ninety-eight obese patients with insulin resistance were divided into a control group and an observation group by the random number table method, with 49 cases in each group. The control group received exercise and dietary interventions, and the observation group received additional acupuncture treatment to the exercise and dietary interventions. The body mass index (BMI), body fat percentage, fasting insulin (FINS), fasting plasma glucose (FPG), homeostasis model assessment for insulin resistance (HOMA-IR), triglyceride (TG), total cholesterol (TC), and serum PYY and nesfatin-1 levels were compared before and after treatment. The efficacy was evaluated after treatment. Results: The total effective rate was significantly higher in the observation group than in the control group (P<0.05). After treatment, the BMI, body fat percentage, and serum TG and TC levels decreased significantly in both groups (P<0.05), and were significantly lower in the observation group than those in the control group (P<0.05). The FINS, FPG, HOMA-IR, and serum PYY and nesfatin-1 levels of the control group were not significantly changed after treatment (P>0.05). The FINS, FPG and HOMA-IR of the observation group decreased significantly after treatment (P<0.05), and were lower than those in the control group (P<0.05). The serum PYY and nesfatin-1 levels of the observation group increased significantly after treatment (P<0.05), and were higher than those in the control group (P<0.05). Conclusion: Based on exercise and dietary interventions, acupuncture is effective for obese patients with insulin resistance. It can reduce the BMI, body fat percentage, blood lipids, blood glucose, and serum insulin levels and improve insulin resistance. The action may be associated with the up-regulation of serum PYY and nesfatin-1.

Research of the core items of Physical Literacy Guidelines for Children and Adolescents / 中国学校卫生

Objective@#Physical literacy is the breakthrough point and fundamental goal to achieve the integration of sports and education, sports and public health and expand the function of physical education. Studying the children and adolescents physical literacy is a common responsibility for children and adolescents health, sports and health education workers. This article was based on the latest research evidence and expert opinions in China, aiming to develop the core items of physical literacy guidelines for Chinese children and adolescents.@*Methods@#This article systematically combed the dimensions and index system of children and adolescents physical literacy through systematic literature review. After five rounds of Delphi methods, the core items were extracted.@*Results@#The core items included four interrelated dimensions of body, emotion, behavior, and cognition, which were specifically composed of four components: physical ability, emotional experience, physical activity related behaviors, and knowledge understanding and application ability.@*Conclusion@#Children and adolescents are the key periods, sensitive periods, and window periods to cultivate physical literacy. The core items can provide framework recommendations for further refining guidelines. More empirical studies should be carried out in the future, in order to accumulate enough evidences and further to improve Physical Literacy guidelines, better to guide physical literacy promotion.

A review about the application of phonetic methods in deciding the jaws relation of complete denture / 华西口腔医学杂志

Speech could be used, because it was a neuromuscular movement without teeth contact. The method was stable, however it was used more in vertical relation deciding. More study was needed in the horizontal relation deciding. This article was to explain why and how to use phonetic method to decide jaws relation, through literature review.

Epidemiological characteristics of injury caused by fall in the elderly aged ≥60 years in Guang- zhou in 2014-2018 / 中华疾病控制杂志

@#Objective To explore the epidemiological characteristics and influencing factors of fall of elderly aged ≥ 60 years in Guangzhou from 2014 to 2018 ，so as to provide evidence for effective prevention and control measures． Methods Data on fall of the elderly was collected from the first diagno- sis in injury surveillance hospitals in Guangzhou from 2014 to 2018，and distribution description and epi- demiological analysis were adopted． Ｒesults 9 503 cases of fall of the elderly were reported in 5 injury surveillance hospitals，accounting for 49．41% of injuries in the elderly，and had occupied the first place in the cause of injury in 5 consecutive years． The sex ratio of men to women was 1 ∶ 1．67． Most of the patients had a primary or junior school degree，high rate in October-December，mainly occurred at home when doing leisure activities or life activities． The fall mainly led to injuries of head or lower extremities， contributed to contusion /bruise or fracture． And most of them were mild and moderate injury． Logistic re- gression showed that female，old age，high educational level，December to February，at home，walking， leisure activities and life activities were risk factors for falling among the elderly in Guangzhou ( all P ＜ 0．001) ． Conclusions Fall is the primary cause of injuries to the elderly in Guangzhou，especially the elderly female population． The targeted prevention and intervention measures should be developed ac- cording to their distribution characteristics．

Relationship between fundamental movement skills and physical fitness in children / 中国学校卫生

Objective@#To investigate the relationship between fundamental movement skills(FMS) and physical-related fitness(PF) in 5-6 aged children in Beijing and to provide the corresponding theoretical basis for the further development of the scien tific research work of children sports activities.@*Methods@#M-ABC-2(Movement Assessment Battery for Children-2)was used to assess FMS of the children aged 5-6 in 3 kindergartens of Beijing; “National Physical Fitness test Standards Manual-Preschool Part” was used as the standard for assessment of children’s PF; Canonical Correlation Analysis was used to analyze the relationship between FMS and PF.@*Results@#A total of 107 children’s complete data were obtained. The overall development level of 5-6 yearold children’s physical fitness could positively predict their the manual dexterity (B=0.24, P<0.05); In the test of individual PF, the muscle strength and balance ability exhibited by the tennis throwing and walking balance wood were also strongly correlated with the manual dexterity (r=0.43, P<0.01), and the standing long jump and the continuous jump of both feet also showed a positive correlation with the manual dexterity (r=0.35, P<0.05).@*Conclusion@#There is a certain relationship between the PF and FMS of children aged 5-6. The development of coordination and stability will play a positive role in promoting the development of their FMS. At the same time, parents and teachers should pay attention to the development of children's fine motor skills to promote their overall healthy growth.

A Metaanalysis of physical activity among Chinese children and adolescents with accelerometer data / 中国学校卫生

Objective@#To provide baseline data for the development of physical activity and health promotion strategies and public health policy among Chinese children and adolescents by systematically evaluating accelerometermeasured moderatetovigorous physical activity (MVPA) and sedentary behavior(SB).@*Methods@#The study search was carried out using China National Knowledge Infrastructure, SPORTDiscus with Full Text, and Web of Science, including studies that published from January 1, 2009 to February 28, 2019. The studies were selected by inclusion (based on PICOS principles) and exclusion criteria, and were assessed through quality assessment items based on revised STROBE statement. The information about MVPA and SB were extracted, and Comprehensive Metaanalysis Software (CMA V2) was used to pool the findings from the included studies into a Metaanalysis.@*Results@#Sixteen studies published from 2012 to 2019 were included the Metaanalysis. Sample sizes of eligible studies ranged from 96 to 2 163 participants. Metaanalysis found that Chinese children and adolescents separately spent 37.66 min/day, 539.61 min/d in MVPA and SB. Boys were more likely to have higher level of MVPA in minutes compared to the girls’(P<0.01). Children and adolescents spent more time in MVPA on weekdays than weekends(P<0.05), and also spent more SB on weekdays than weekends(P<0.05).@*Conclusion@#Chinese children and adolescents are physically inactive and live a sedentary lifestyle in general, especially among girls. MVPA and SB time among children and adolescents spent on weekdays are higher than weekends.

Association of Overlapped and Un-overlapped Comorbidities with COVID-19 Severity and Treatment Outcomes: A Retrospective Cohort Study from Nine Provinces in China / 生物医学与环境科学（英文）

Objective@#Several COVID-19 patients have overlapping comorbidities. The independent role of each component contributing to the risk of COVID-19 is unknown, and how some non-cardiometabolic comorbidities affect the risk of COVID-19 remains unclear.@*Methods@#A retrospective follow-up design was adopted. A total of 1,160 laboratory-confirmed patients were enrolled from nine provinces in China. Data on comorbidities were obtained from the patients' medical records. Multivariable logistic regression models were used to estimate the odds ratio ( @*Results@#Overall, 158 (13.6%) patients were diagnosed with severe illness and 32 (2.7%) had unfavorable outcomes. Hypertension (2.87, 1.30-6.32), type 2 diabetes (T2DM) (3.57, 2.32-5.49), cardiovascular disease (CVD) (3.78, 1.81-7.89), fatty liver disease (7.53, 1.96-28.96), hyperlipidemia (2.15, 1.26-3.67), other lung diseases (6.00, 3.01-11.96), and electrolyte imbalance (10.40, 3.00-26.10) were independently linked to increased odds of being severely ill. T2DM (6.07, 2.89-12.75), CVD (8.47, 6.03-11.89), and electrolyte imbalance (19.44, 11.47-32.96) were also strong predictors of unfavorable outcomes. Women with comorbidities were more likely to have severe disease on admission (5.46, 3.25-9.19), while men with comorbidities were more likely to have unfavorable treatment outcomes (6.58, 1.46-29.64) within two weeks.@*Conclusion@#Besides hypertension, diabetes, and CVD, fatty liver disease, hyperlipidemia, other lung diseases, and electrolyte imbalance were independent risk factors for COVID-19 severity and poor treatment outcome. Women with comorbidities were more likely to have severe disease, while men with comorbidities were more likely to have unfavorable treatment outcomes.

Blood pressure and heart rate changes of 640 single dental implant surgeries / 北京大学学报(医学版)

OBJECTIVE@#To investigate the blood pressure and heart rate changes and influencing factors during single dental implant surgery.@*METHODS@#A retrospective cohort study was conducted. Six hundred and forty cases underwent single dental implant placement in Department of Prosthodontics, Peking University School and Hospital of Stomatology from January 2016 to December 2016 were recruited in this study according to the inclusion and exclusion criteria. They were divided into different groups according to the exposure factors which were patient characteristics (gender, age) and surgical procedures (immediate placement, flap elevation, bone grafting). The correlation between blood pressure and heart rate variability during single dental implant surgery and the patient characteristics and surgical procedures were analyzed.@*RESULTS@#The average systolic blood pressure variability was 9.47%±6.45% (maximum 46.04%), the average diastolic blood pressure variability was 12.18%±9.39% (maximum 88.00%), and the average heart rate variability was 10.59%±7.68% (maximum 49.12%). The effects of age and bone grafting on blood pressure variability, and of gender and immediate placement on heart rate variability, were statistically significant (P < 0.05), respectively. The incidence of abnormal intraoperative blood pressure rise was 4.69%, of which there were 4 cases (0.63%) of systolic blood pressure ≥180 mmHg and/or diastolic blood pressure ≥110 mmHg. The incidence of abnormal intraoperative heart rate rise was 6.72%. Hierarchical analysis showed a higher risk of abnormal intraoperative blood pressure rise in the elderly (≥60 years) male patients [P < 0.05, RR=3.409 (95%CI: 1.155-10.062) ] and flap elevation with bone grafting cases [P < 0.05, RR=2.382 (95%CI: 1.126-5.040)], respectively. There was no statistically significant association between abnormal heart rate rise and patient characteristics or surgical procedures (P>0.05).@*CONCLUSION@#There was a certain risk of blood pressure and heart rate variability during dental implant surgery. Elderly male patients and flap elevation with bone grafting were risk factors of abnormal intraoperative blood pressure rise.

Analysis of the relationship among maxillary anterior teeth width, anterior arch perimeter and anterior segment depth / 北京大学学报(医学版)

OBJECTIVE@#To analyze the relationship between the width of the maxillary anterior teeth and the anterior arch perimeter, to analyze the change rule of the width of the anterior teeth and the anterior arch perimeter, when altered the convexity of the anterior arch, with the width of the maxillary anterior arch keeping constant, and to provide a reliable basis for later digitized and personalized aesthetic analysis of front teeth.@*METHODS@#In the study, 61 front teeth complete and well-arranged models had been selected from the working models after the prostheses in Department of Prosthodontics, Peking University School and Hospital of Stomatology, including 22 male models and 39 female models. A photograph was taken from the occlusal surface of each model using the fixed magnification with a single lens reflex camera. The width of anterior teeth, the width of anterior arch and the convexity of anterior arch had been measured using the Photoshop software. The ratio of the width of the anterior teeth to the width of the anterior arch was calculated. Keeping the width of anterior arch unchanged, the layer free transformation function used to add or decrease the curvature of the anterior arch from 1-5 mm, each circumference of the anterior arch was measured. According to the proportion of their anterior teeth in the anterior arch perimeter, the width of each anterior teeth crown under different convexities of anterior arch was calculated. SPSS 23.0 was used to analyze the ratio of the width anterior teeth to the anterior arch perimeter and correlation between the convexity of the anterior arch and the width of the anterior teeth.@*RESULTS@#The percentages of the median length of the anterior arch in the central incisor, lateral incisor and canine were 36.2%±1.3%, 30.2%±1.5%, and 33.6%±1.4%, respectively. The proportions were normal distributions and not related to the perimeter of the anterior arch. When the width of the anterior arch was constant, there was a positive correlation between the convexity of anterior arch in the range of 5 mm and the width of anterior teeth or the front arch circumference. With each increase or decrease of 1 mm of the convexity of anterior arch, the width of the middle incisor increased or decreased by about 0.18 mm, the half circumference of the anterior arch increased or decreased by about 0.50 mm.@*CONCLUSION@#The width of the anterior teeth in the middle-distal direction remained stable in the anterior arch circumference. Within a certain range, when the width of the maxillary anterior arch remains unchanged, the width of the anterior teeth and the perimeter of the anterior teeth are positively correlated to the convexity of the anterior arch.

Candidate genes involved in the biosynthesis of lignan in Schisandra chinensis fruit based on transcriptome and metabolomes analysis / 中国天然药物

Schisandra chinensis Turcz. (Baill.) is a plant species with fruits that have been well known in Far Eastern medicine for a long time. It has traditionally been used as a stimulating and fortifying agent in cases of physical exhaustion and to inhibit fatigue. The major bioactive compounds found in S. chinensis are lignans with a dibenzocyclooctadiene skeleton, but little is known about their biosynthesis in plants. S. chinensis is the ideal medicinal plant for studying the biosynthesis of lignans, especially the dibenzocyclooctadiene skeleton. Genomic information for this important herbal plant is unavailable. To better understand the lignan biosynthesis pathway, we generated transcriptome sequences from the fruit during ripening and performed de novo sequence assembly, yielding 136 843 unique transcripts with N50 of 1778 bp. Putative functions could be assigned to 41 824 transcripts (51.57%) based on BLAST searches against annotation databases including GO (Gene ontology) and KEGG (Kyoto Encyclopedia of Genes and Genomes). Furthermore, 22 candidate cytochrome P450 genes and 15 candidate dirigent proteins genes that were most likely involved in the lignan biosynthesis pathway were discovered based on transcriptome sequencing of S. chinensis. The genomic data obtained from S. chinensis, especially the identification of putative genes involved in the lignan biosynthesis pathway, will facilitate our understanding of lignan biosynthesis at the molecular level. The lignan metabolite profiles were analyzed by metabolomes, the accumulation patterns of 30 metabolites involved in the lignan pathway were studied. Co-expression network of lignan contents and transcriptional changes showed 355 strong correlations (correlation coefficient, R > 0.9) between 21 compounds and 153 transcripts. Furthermore, the comprehensive analysis and characterization of the genes involved in lignan pathways and the metabolite profiles of lignans are expected to provide better insight regarding the diversity of the chemical composition, synthetic characteristics, and regulatory mechanisms of this medical herb.

Colonoscopy Adherence and Related Factors Among Preliminary Screened-Positive Population in Guangzhou：A Follow-Up Study / 中山大学学报(医学科学版)

@#【Objective】To explore colonoscopy adherence and related factors among preliminary screened-positive population in Guangzhou. 【Methods】This study was a part of the Guangzhou Community-based Colorectal Cancer Screening Program. We retrospectively analyzed the 1-year follow-up data of population aged 50~74 years old and positive in preliminary colorectal cancer screening in 2015. Kaplan- Meier method was used to describe the respond time to colonoscopy examination. Cox proportional hazard model was performed to identify factors associated with colonoscopy adherence. The effect of studied factors on colonoscopy adherence was reported according to hazard ratio（HR）.【Results】 A total of 18 604 preliminary screened-positive residents were included ，among whom 4 014 completed colonoscopy examination within one year，with a colonoscopy adherence of 21.6% . Colorectal lesions were found in 2 012 cases （50.1%），of which 96（2.4%）were colorectal cancers. The adherence of 1 month，3 months and 6 months were 9.7% ，15.8% ，and 18.6% respectively. Multivariate Cox regression analysis showed that those who were female ，in older age ， unmarried/widowed/divorced，without health insurance，and had a history of chronic cholecystitis or cholecystectomy were less likely to undergo colonoscopy；while those who were fecal occult blood test- positive，had colonoscopy preferential policies，worked in government or public institution，had medical insurance for urban workers，had a history of chronic diarrhea，a history of chronic constipation，a history of mucous and/or blood stool，and a history of bad life incidents were more likely to undergo colonoscopy. 【Conclusions】 This study suggested that the colonoscopy adherence of preliminary screened- positive population in Guangzhou was low and such low adherence was associated with different factors. Community health workers should timely track the completion of colonoscopy of preliminary screened-positive residents ， and take targeted measures to promote colonoscopy adherence.

Effects of monocular visual field injury on binocular visual field in patients with glaucoma / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To investigate the effect of the severity of monocular visual field loss on binocular visual field loss patients with primary angle-closure glaucoma, primary open angle glaucoma and normal tension glaucoma. <p>METHODS: According to the stage of binocular monocular field loss, 30 healthy and 120 glaucoma patients participants were classified as normal, early, moderate or severe. Binocular vision was determined by integrating the field of view and Esterman binocular field assessment. The monocular and binocular visual field parameters were compared within and between groups. <p>RESULTS:For patients with one eye at normal or early stage and the other with severe stage, the mean deviation of binocular comprehensive visual field was -2.8±1.1dB and -5.5±1.9dB, respectively, and Esterman's average score were 99.1%±1.7% and 95.6%±4.7%, respectively. When both eyes developed moderate or severe injury(moderate/moderate, moderate/severe or severe/severe), the mean deviation of binocular comprehensive visual field is lower than -6dB, and the Esterman average score of moderate/moderate group and moderate/severe group was 94.2%±6.0% and 94.3%±4.9%, respectively. However, when both eyes in the stage of severe injury, the average score of Esterman's rapidly decreased from more than 90% to 68.4%±26.3%.<p>CONCLUSION: If one eye is in a normal or early stage, the binocular vision can remain relatively intact. When the binocular progression to the moderate or severe stage, the mean deviation of binocular visual field defects measured by the binocular comprehensive visual field is significant, and only when the binocular progression to the severe stage, significant Esterman binocular visual field defects are detected.

Preliminary analysis on X-ray in youth neck type of cervical spondylosis with upper crossed syndrome / 中国骨伤

OBJECTIVE@#To analyze the X-ray characteristics in youth neck type of cervical spondylosis with upper crossed syndrome(UCS).@*METHODS@#The patients who had a neck type of cervical spondylosis with or without UCS were selected from January to October 2017, 20 cases in each group, and 10 normal volunteers were chosen in the study. X-ray examination of lateral and hyperextension-hyperflexion of cervical spine were performed to observe cervical spine angle, angular displacement and adjacent vertebral body slip.@*RESULTS@#The cervical spine angle was (-0.40±9.64)° in the UCS group, significantly less than (14.35±9.01)° in the normal group and (12.34±5.65)° in the non-UCS group(0.05).@*CONCLUSIONS@#In young patients who has a neck type of cervical spondylosis with UCS, the cervical curvature prone to straighten or reverse, the upper cervical flexion and extension are limited, while the lower cervical is in a flexion.

Evaluation of the fabrication deviation of a kind of milling digital implant surgical guides / 北京大学学报(医学版)

OBJECTIVE@#To evaluate the deviation of digital implant surgical guides during fabrication process in the Organical Dental Implant (ODI) system.@*METHODS@#This study included two parts. The first part was the in vitro study. A resin block with a diagnostic template was used for the planning. After cone beam computed tomography (CBCT) scanning, a surgical guide with eight implants was virtually designed using the ODI system. The guide was milled by a 5-axial numerical controlled milling machine, and an optical scanning was taken to digitalize the guide to a standard tessellation language (STL) form. The STL data were then imported into an ODI software and registered with the original design. The deviation of the sleeves between the design and the STL was measured in the ODI software and set as the golden standard. Then the ODI examination table was used to measure the deviation of the guide during fabrication. Examiners A and B measured 10 times separately. The reliability and the validity of the examination table was calculated. The second part was the in vivo study: The deviation during fabrication of 12 guides designed and fabricated by the ODI system were measured using the examination table.@*RESULTS@#The standard deviation of the deviation measured using the examination table by examiners A and B were all below 0.40 mm (for the shell reference points) and 0.71 degree (for the angles). No significant difference was found between the two examiners for any implant sites. The result of the examination table was larger than that of the software for the shell reference point (t-test, P<0.05), but no significant difference was found for the angle deviation (t-test, P>0.05). The 45 implants positions in the 12 guides for the in vivo study were examined using the examination table. The deviations at the shell reference points were (1.06±0.29) mm (0.42-1.75 mm), and at the implant tip were (1.12±0.48) mm (0.41-2.44 mm). The angle deviations were (1.42±0.70) degree (0.29-2.96 degree).@*CONCLUSION@#Deviation is unavoidable during the fabrication process of the guides. The examination table of the ODI system is a reliable and valid tool to measure the deviation during fabrication of the ODI guides. More studies should be designed to research the relationship between the fabrication deviation and the implant insertion deviation.

Impact of Remote Ischemic Conditioning on Circulating miR-208b Level and Cardiac Function in Patients With ST Segment Elevation Myocardial Infarction Undergoing Primary Angioplasty / 中国循环杂志

Objectives: To investigate whether remote ischemic conditioning (RIC) applied to patients with ST-segment elevation myocardial infarction (STEMI) before percutaneous coronary intervention (PCI) could affect circulating miR-208b level or not. Methods:Patients diagnosed with STEMI undergoing PCI from January 2016 to July 2017 were enrolled from the Department of Cardiology, Affiliated Zhongshan Hospital of Dalian University.The patients were randomly allocated to two groups: (1) control group (n=25), PCI alone; (2) RIC group (n=50), PCI combined with RIC (three cycles of 5 min inflation and 5 min deflation of the right lower limb with blood pressure cuff performed before reperfusion). Serum miR-208b was measured before and immediately, at 24 h, and 48 h after PCI with real-time quantitative polymerase chain reaction. Results: The expression of miR-208b was significantly higher immediately post PCI than that before operation in the control group (84.1±9.0 vs 77.8±9.4; P=0.032), while it was significantly lower immediately post PCI than that before operationin RIC group (71.0±9.3 vs 77.4±8.8; P=0.028).miR-208b level was similar before PCI between the control and RIC groups (P=0.874), which was significantly reduced immediately post PCI in RIC group as compared with the control group (P=0.021).The peak value of creatine kinase isoenzyme (CK-MB) in the limb RIC group was significantly lower than that in the control group ([135.2±18.6] U/L vs [167.7±17.2] U/L; P=0.038).The area under the CK-MB curve of the RIC group was significantly smaller than that of the control group ([3 060.7±17.1] U/L vs [3 635.9±15.1] U/L); P=0.047]. The left ventricular ejection fraction (LVEF) in RIC group was significantly higher than that in the control group ([57.8±7.8]% vs [51.9±7.9]%; P=0.003) post PCI. The expression level of serum miR-208b was positively correlated with CK-MB AUC in RIC group (r=0.498, P<0.001). Conclusions: RIC of the lower limb prior to PCI could reduce miR-208b level and improve cardiac functionin STEMI patients.

Treatment of displacement-type lumbar intervertebral disc protrusion on L2-L5 with percutaneous endoscopic interlaminar discectomy / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the operative characteristic, safety, clinical effect of percutaneous endoscopic interlaminar discectomy (PEID) in treating displacement-type lumbar intervertebral disc protrusion on L₂-L₅.</p><p><b>METHODS</b>Form November 2015 to October 2016, 15 patients with displacement-type lumbar intervertebral disc protrusion were treated with percutaneous endoscopic interlaminar discectomy. There were 9 males and 6 females, aged from 19 to 63 years old with an average of 42 years. All the patients with single-segment displacement-type lumbar intervertebral disc protrusion were diagnosed by clinical and iconography data, and complicated with low back pain and single lower limbs radioactivity pain. Lesion occurred in L₄,₅ of 8 cases, L₃,₄ of 4 cases, L₂,₃ of 3 cases. The patients were divided into 4 regions according to Lee standard (displaced nucleus pulposus location on spinal canal), I region was 2 cases, II region was 3 cases, III region was 5 cases, IV region was 5 cases.Preoperative, postoperative 3 months, final follow-up, lumbago-leg pain and lumbar function were assessed by VAS, JOA scores;at final follow-up, MacNab was used to evaluate the clinical effect;postoperative 3 months, rechecked lumbar MRI to observe discectomy condition.</p><p><b>RESULTS</b>All the operations were successfully complete under local anesthesia, and no complications such as injuries of nerve root and dural sac, postoperative hemorrhage, local infection were found. Operative time was 45 to 90 min with an average of 54.8 min;and hospitalization time was 3 to 4 days with an average of 3 days. All 15 cases were followed up for 12 to 13 months with an average of 12.2 months, no recurrence was found. Preoperation, postoperative 3, 12 months, VAS scores were 8.2±1.4, 3.0±0.6, 1.7±0.5, JOA scores were 8.76±3.32, 23.61±2.14, 24.82±3.43, respectively. Postoperative VAS, JOA scores were obviously improved(<0.05). According to MacNab standard to evaluate the clinical effect, 9 cases obtained excellent results, 5 good, 1 fair.</p><p><b>CONCLUSIONS</b>PEID is a micro-trauma surgical method and has advantage of safe and effective in treating displacement-type lumbar intervertebral disc protrusion on L₂-L₅, but requires laminoplasty during operation, and under local anesthesia to operation maybe can induce neurostimulation.</p>