Analysis of a child with CLN1 neuronal ceroid lipofuscinosis in conjunct with Hereditary hyperferinemia cataract syndrome / 中华医学遗传学杂志

OBJECTIVE@#To analyze the clinical data and genetic characteristics of a child with CLN1 neuronal ceroid lipofuscinosis in conjunct with Hereditary hyperferritinemia cataract syndrome (HHCS).@*METHODS@#A child who was admitted to the PICU of the First Affiliated Hospital of Zhengzhou University in November 2020 was selected as the study subject. Clinical data of the child was collected. Genetic testing was carried out for the child, and the result was analyzed in the light of literature review to explore the clinical and genetic characteristics to facilitate early identification.@*RESULTS@#The patient, a 3-year-old male, had mainly presented with visual impairment, progressive cognitive and motor regression, and epilepsy. Cranial magnetic resonance imaging revealed deepened sulci in bilateral cerebral hemispheres, and delayed myelination. The activity of palmitoyl protein thioesterase was low (8.4 nmol/g/min, reference range: 132.2 ~ 301.4 nmol/g/min), whilst serum ferritin was increased (2417.70 ng/mL, reference range: 30 ~ 400 ng/ml). Fundoscopy has revealed retinal pigment degeneration. Whole exome sequencing revealed that he has harbored c.280A>C and c.124-124+3delG compound heterozygous variants of the PPT1 gene, which were respectively inherited from his father and mother. Neither variant has been reported previously. The child has also harbored a heterozygous c.-160A>G variant of the FTL gene, which was inherited from his father. Based on the clinical phenotype and results of genetic testing, the child was diagnosed as CLN1 and HHCS.@*CONCLUSION@#The compound heterozygous variants of the PPT1 gene probably underlay the disorders in this child. For children with CLN1 and rapidly progressing visual impairment, ophthalmological examination should be recommended, and detailed family history should be taken For those suspected for HHCS, genetic testing should be performed to confirm the diagnosis.

BGB-A445, a novel non-ligand-blocking agonistic anti-OX40 antibody, exhibits superior immune activation and antitumor effects in preclinical models / 医学前沿

OX40 is a costimulatory receptor that is expressed primarily on activated CD4+, CD8+, and regulatory T cells. The ligation of OX40 to its sole ligand OX40L potentiates T cell expansion, differentiation, and activation and also promotes dendritic cells to mature to enhance their cytokine production. Therefore, the use of agonistic anti-OX40 antibodies for cancer immunotherapy has gained great interest. However, most of the agonistic anti-OX40 antibodies in the clinic are OX40L-competitive and show limited efficacy. Here, we discovered that BGB-A445, a non-ligand-competitive agonistic anti-OX40 antibody currently under clinical investigation, induced optimal T cell activation without impairing dendritic cell function. In addition, BGB-A445 dose-dependently and significantly depleted regulatory T cells in vitro and in vivo via antibody-dependent cellular cytotoxicity. In the MC38 syngeneic model established in humanized OX40 knock-in mice, BGB-A445 demonstrated robust and dose-dependent antitumor efficacy, whereas the ligand-competitive anti-OX40 antibody showed antitumor efficacy characterized by a hook effect. Furthermore, BGB-A445 demonstrated a strong combination antitumor effect with an anti-PD-1 antibody. Taken together, our findings show that BGB-A445, which does not block OX40-OX40L interaction in contrast to clinical-stage anti-OX40 antibodies, shows superior immune-stimulating effects and antitumor efficacy and thus warrants further clinical investigation.

A Systematic Investigation of Complement and Coagulation-Related Protein in Autism Spectrum Disorder Using Multiple Reaction Monitoring Technology / 神经科学通报·英文版

Autism spectrum disorder (ASD) is one of the common neurodevelopmental disorders in children. Its etiology and pathogenesis are poorly understood. Previous studies have suggested potential changes in the complement and coagulation pathways in individuals with ASD. In this study, using multiple reactions monitoring proteomic technology, 16 of the 33 proteins involved in this pathway were identified as differentially-expressed proteins in plasma between children with ASD and controls. Among them, CFHR3, C4BPB, C4BPA, CFH, C9, SERPIND1, C8A, F9, and F11 were found to be altered in the plasma of children with ASD for the first time. SERPIND1 expression was positively correlated with the CARS score. Using the machine learning method, we obtained a panel composed of 12 differentially-expressed proteins with diagnostic potential for ASD. We also reviewed the proteins changed in this pathway in the brain and blood of patients with ASD. The complement and coagulation pathways may be activated in the peripheral blood of children with ASD and play a key role in the pathogenesis of ASD.

Loss of monocarboxylate transporter 1 aggravates white matter injury after experimental subarachnoid hemorrhage in rats / 医学前沿

Monocarboxylic acid transporter 1 (MCT1) maintains axonal function by transferring lactic acid from oligodendrocytes to axons. Subarachnoid hemorrhage (SAH) induces white matter injury, but the involvement of MCT1 is unclear. In this study, the SAH model of adult male Sprague-Dawley rats was used to explore the role of MCT1 in white matter injury after SAH. At 48 h after SAH, oligodendrocyte MCT1 was significantly reduced, and the exogenous overexpression of MCT1 significantly improved white matter integrity and long-term cognitive function. Motor training after SAH significantly increased the number of ITPR2

The evaluation value of three scoring systems for the prognosis of pediatric acute liver failure / 中华实用儿科临床杂志

Objective:To investigate the prognosis value of the Child-Turcotte-Pugh (CTP), pediatrics end-stage liver disease/model for end-stage liver disease(PELD/MELD) and sequential organ failure assessment (SOFA) scores in pediatric acute liver failure (PALF) at 28 th day. Methods:Fifty-four PALF patients admitted in the Pediatric Intensive Care Unit (PICU) and Infection Department of Pediatrics, Qingdao Women′s and Children′s Hospital from June 1, 2012 to June 1, 2019 were included in the study.According to the survival of PALF patients on the 28 th day, they were divided into the survival group (28 cases) and the death group (26 cases). Baseline characte-ristics and laboratory examination data of PALF patients in both groups were collected and compared.Receiver operating characteristic (ROC) curve was used to evaluate the prognostic value of CTP, PELD/MELD and SOFA scores in PALF. Results:The mortality rate of 54 PALF patients was 48.1%.Compared with the survival group, PALF patients in the death group were significantly younger than those in survival group [11.0(3.8-39.0) months vs.14.5(7.3-84.0) months]( Z=-2.145, P=0.020). In addition, CTP, PELD/MELD and SOFA scores were significantly higher in the death group than those in survival group [14.0(11.7-15.0) vs.9.0(7.0-10.0), 32.0(29.0-36.0) vs.25.0(22.0-26.0), 13.0(11.0-16.0) vs.6.0(4.0-7.0)]( Z=-5.095, -4.894, -5.502, all P<0.05). Serum lactate level, blood ammonia level, total bilirubin, direct bilirubin and international normalized ratio were significantly higher in the death group than those in survival group [3.4(2.1-5.3) mmol/L vs.1.5(0.8-2.3) mmol/L, 69.5(46.9-102.9) μmol/L vs.41.7(27.3-50.3) μmol/L, 173.0(97.0-237.2) μmol/L vs.71.9(62.0-136.9) μmol/L, 132.3(53.6-206.2)μmol/L vs.59.3(62.0-99.7) μmol/L, 2.6(1.8-3.5) vs.1.7(1.5-1.9)]( Z=-4.027, -3.220, -2.649, -2.648, -3.807, all P<0.05). Prothrombin time (PT) was significantly prolonged in the death group than that of survival group [27.5(19.2-41.9)s vs.17.8(16.9-22.2)s]( Z=-3.489, P<0.05). Compared with those of survival group, serum albumin, alanine transaminase (ALT) and alpha fetoprotein (AFP) levels were significantly lower in the death group [(30.9±1.0) g/L vs.(33.6±0.9) g/L, 379.2(163.3-880.3) U/L vs.962.5(457.0-1 657.3) U/L, 7.5(0.7-115.8) μg/L vs.22.1(7.9-91.3) μg/L]( t=2.049, Z=-2.510, -2.342, respectively, all P<0.05). The incidence of alimentary tract hemorrhage was significantly higher in the death group than that of survival group (22/26 cases vs.11/28 cases)( χ2=13.340, P<0.05). The cut-off value of CTP, PELD/MELD and SOFA scores in predicting the prognosis of PALF were 11.5, 28.5 and 10.0, respectively.Among the three scoring systems, the specificity and positive predictive value of SOFA scores remained the highest.The sensitivity and specific of a combination of three scoring systems in predicting the prognosis of PALF were 92.3% and 89.3%, respectively, and its Youden index was the highest than that of a single scoring of either CTP, PELD/MELD or SOFA ( Z=2.19, P<0.05). Conclusions:CTP, PELD/MELD and SOFA scores have high predictive value for the short-term prognosis of PALF.The combined detection of the three scoring systems can improve the forecasting efficiency of PALD.

Influencing factors of postencephalitic epilepsy in children with viral encephalitis at acute symptomatic seizure / 中华实用儿科临床杂志

Objective:To discuss the incidence rate and influencing factors of postencephalitic epilepsy (PE) in children with viral encephalitis at acute symptomatic seizure(ASS).Methods:The data of 132 children with ASS in the First Affiliated Hospital of Zhengzhou University from September 2013 to July 2018 were retrospectively analyzed, and the patients were divided into PE group (62 cases) and non-PE group (70 cases) according to whether they had PE at final follow-up.The risk factors of PE in children with ASS were analyzed using the multivariate Logistic regre-ssion methods. Results:The incidence of PE in children with ASS was 46.97% (62/132 cases). There were statistically significant differences in terms of psychological and behavioral abnormalities[19.4%(12/62 cases) vs.2.9%(2/70 cases)], repetitive seizures (more than 5 seizures) [67.7%(42/62 cases) vs.17.1%(12/70 cases)], status epilepticus (SE) [30.6%(19/62 cases) vs.11.4%(8/70 cases)], generalized seizures [72.6%(45/62 cases) vs.88.6%(62/70 cases)], endotracheal intubation [21.0%(13/62 cases) vs.2.9%(2/70 cases)], the duration of fever [5.5(3.0, 11.0) d vs.3.0(2.0, 6.0) d], the duration in the intensive care unit (ICU) [13(5, 21) d vs.6(3, 8) d], electroencephalography epileptiform discharges [49.1%(27/55 cases) vs.6.8%(4/59 cases)], presence of subcortical involvement on neuroimaging [37.3%(22/55 cases) vs.20.3%(14/59 cases)] in children with ASS between the PE group and the non-PE group(all P<0.05). The multivariate Logistic regression analysis showed that repetitive seizures (more than 5 seizures) ( OR=5.256, 95% CI: 1.538-17.961, P=0.008), SE( OR=6.003, 95% CI: 1.411-25.539, P=0.015), electroencephalography epileptiform discharges ( OR=36.693, 95% CI: 7.031-191.485, P<0.01) and the duration in ICU ( OR=1.170, 95% CI: 1.058-1.298, P=0.002) were the risk factors for PE in children with ASS. Conclusions:The incidence rate of PE in children with ASS is high.Children with ASS are more likely to develop into PE if they have repetitive seizures (more than 5 seizures), SE, electroencephalography epileptiform discharges, and the longer duration in ICU.

Bone morphogenetic protein: a new direction in leukemia research / 白血病·淋巴瘤

The related changes of bone marrow microenvironment (especially mesenchymal stem cells and osteoblasts) would lead to the occurrence of leukemia. Bone morphogenetic protein (BMP) is considered to be the only known morphogenetic factor capable of inducing differentiation of mesenchymal stem cells into osteoblasts, and its role in regulating the occurrence and development of leukemia in the bone marrow microenvironment has been paid more attention. The studies found that acute myeloid leukemia derived-mesenchymal stem cells induced the morphologic transformation and resistance of K562-ADM through BMP. This paper reviews the related research of BMP in order to provide new targets and directions for the research and treatment of leukemia.

Monochorionic monoamniotic twins discordant for anencephaly: a case report / 中华围产医学杂志

We reported a case of monochorionic monoamniotic twins discordant for anencephaly diagnosed by second-trimester ultrasonography at the First Affiliated Hospital of Fujian Medical University.Ultrasound at seven weeks of gestation showed only one gestational sac with an embryo inside.Another 12 gestational weeks' ultrasound scan performed at another hospital found one gestational sac and one fetus (crown-rump length was 6.11 cm and nuchal translucency was 0.11 cm) in the upper-middle uterine cavity.The ultrasound examination at 22+6 gestational weeks identified one placenta and two fetuses without obvious diaphragm echo in between.Although no structural abnormality was observed in one fetus,frog-like eyes,absence of skull image and brain tissue echo were presented in the other fetus.The patient was transferred to a higher level hospital and was successfully performed radiofrequency ablation for selective reduction at 23+4 weeks of gestation.At 35 weeks,a premature live boy and an anencephalic stillbirth fetus were born vaginally after premature rupture of membranes.The baby boy was healthy at follow-up at four months old.

Changes and significance of serum intestinal fatty acid binding protein in children with traumatic brain injury complicated with gastrointestinal dysfunction / 中国小儿急救医学

Objective To study the changes and significance of serum intestinal fatty acid binding protein (IFABP) in children with traumatic brain injury(TBI) complicaled with acute gastrointestinal injury (AGI). Methods A total of 95 children suffering from TBI hospitalized in the PICU of the First Affiliated Hospital of Zhengzhou University from January 2017 to March 2018 were enrolled in the study. According to the modified Glasgow coma score combined with clinical classification criteria for acute closed head injury, the cases were devided into mild(43 cases),moderate (23 cases),and severe(29 cases). Children were gra-ded according to AGI (AGI Ⅰ42 cases,AGI Ⅱ 30 cases,AGI Ⅲ 13 cases,and AGI Ⅳ 10 cases). Thirty healthy children who underwent physical examination at outpatient service were enrolled as the control group. Blood samples were collected at the time of admission and on the 3rd day after admission. Serum IFABP was detected by ELISA,and the differences of serum IFABP concentrations were compared among groups. The correlations between IFABP with TBI classification and AGI grade were analyzed. The receiver operating characteristic (ROC) curve was drawn,and the predictive values of IFABP for the diagnosis of children with TBI complicated with AGI were evaluated. Results On the day of admission,the serum levels of IFABP in mild,moderate and severe brain injury group were significantly higher than that in control group (all P <0. 01). And serum IFABP concentration gradually increased with the increase of brain injury (all P < 0. 01).Serum IFABP levels in children with AGI grade Ⅰto Ⅳ were significantly higher than those in control group (all P < 0. 01). The levels of serum IFABP also increased with the increase of AGI level (all P < 0. 01). The concentration of serum IFABP was positively correlated with the grade of TBI and AGI (rs = 0. 82,P < 0. 01;rs = 0. 70,P < 0. 01). In each group,the levels of serum IFABP on the 3rd day after admission were lower than those on admission (all P < 0. 01). The ROC curve analysis showed that serum IFABP was of high diag-nostic value in children with TBI complicated with AGI,and the area under the ROC curve was 0. 88. When the cutoff value of IFABP was 431. 36 ng/ L,the sensitivity and specificity were 71. 61％ and 90. 00％ ,re-spectively. Conclusion Serum IFABP can be used as a sensitive indicator for the early diagnosis and disease assessment in children with TBI complicated with gastrointestinal dysfunction.

Analysis of Treatment Drugs for Type 2 Diabetes Based on Complex Network / 中国药房

OBJECTIVE:To excavate the drug use rules of type 2 diabetes,and to provide reference for clinical treatment. METHODS:Clinical data of 807 patients with type 2 diabetes were collected from our hospital during Jan. 2012-Jun. 2017. Complex network and subnetworks for drug compatibility and their visual chromatograms were established by Gephi 0.9.1 software. MATLAB R2014a software was used for topic model mining. The complex network,subnetworks and the overlapping structures of community were analyzed in respects of node distance and degree centrality. Core drugs for type 2 diabetes were screened. RESULTS & CONCLUSIONS:The drug complication complex network established in the study included 119 nodes and 24 412 edges with maximum edge weight of 378. Drugs with high frequency included Insulin aspart injection,Fluvastatin sodium extended release tablets,Metformin hydrochloride tablets,Acarbose tablets,etc. Average distance of network was 1.89,and maximum distance was 4. The distance of 89.90% drugs was 1 or 2,and the links between the various drugs were close. Insulin aspart injection(0.914),Metformin hydrochloride tablets(0.887)and Voglibose tablets(0.866)were core drugs of the network. Totally 4 typical topics were excavated, including peripheral neuropathy, peripheral vascular disease, abnormal lipid metabolism and microangiopathy. Results of subnetwork analysis showed that typical topics were based on hypoglycemic therapy and supplemented by neurotrophic drugs,antihypertensive drugs,lipid regulating drugs and drugs for improvement of retinopathy. Complex network analysis showed that drug use regularity was in line with related guideline of type 2 diabetes and clinical practice. The method has practical significance of data mining in clinic.

Application of formative assessment on standardized training in pediatric residents / 中华医学教育探索杂志

Objective To explore the application effect of formative assessment on the standardized training in pediatric residents.Methods A total of 36 pediatric residents who attended the standardized training in affiliated hospital of Nantong university were randomly divided into 2 groups (18 in the experimental group and 18 in the control group) and trained in accordance with the standardized training content and standard of the national resident of pediatrics.Residents in the experimental group received formative assessment,with total score including process assessment (35％),graduation examination (50％),medicalethics (5％),reading report (5％) and work attendance (5％).While the other 18 residents in the control group received traditional assessment,with final score of graduation examination.The effectiveness of formative assessment was conducted via analysis of test score and self evaluation.The SPSS 17.0 was used for statistics,independent sample t test was used to perform inter-group comparison and Pearson correlation coefficient was used to demonstrate the correlation.P＜0.05 signifies statistically significant differences.Results In the experimental group,the process evaluation and the graduation examination were both positively related with the total score (r=0.953,r=0.966,P=0.00).In the graduation examination,the scores of clinical practice skills test and case analysis in the experimental group were both higher than those in the control group [(12.03 ± 1.51) vs.(10.83 ± 1.42),(12.03 ± 1.40) vs.(10.83 ± 1.29),P＜0.05],with statistically significant differences.The self evaluation of trainees showed that the clinical-inference and decisionmaking ability,the self-study ability,scores of attitudes and professionalism and total scores in the experimental group were higher than those in the control group,with statistically significant differences (P＜0.05).Conclusion The application of formative evaluation on the standardized training in pediatric residents is beneficial to improve the training effect and is worth popularizing.

Multi-dimensional Reflection on the Innovation and Development of TCM Culture Industry / 世界科学技术-中医药现代化

Traditional Chinese Medicine (TCM) healthcare culture presents a long history and has broad connotations.TCM healthcare culture in the new era receives increasing concerns due to its full-blown theoretical system as well as various healthcare models, which is integrated with modern science and technology and business model. This article focuses on the new opportunities and challenges to the development of Chinese medicine healthcare culture industry in the new era and based on its major features, comprehensively analyzes the innovation and development issues of TCM healthcare culture from multi-dimensions, including integration of international strategy, social needs and technology development, etc.

Study on changes of ratio of serum NEFA/ALB in children with primary ne-phrotic syndrome / 中国免疫学杂志

Objective:To study on the changes of the ratio of serum NEFA/ALB in children with primary nephrotic syndrome , and to provide new indicators for the diagnosis and severity assessment of clinical PNS .Methods:The levels of serum albumin ( ALB) , free fatty acid (NEFA),urea nitrogen(BUN),uric acid(UA),creatinine(Scr),total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol ( LDL-C) ,high density lipoprotein cholesterol ( HDL-C) were quantitatively measured in 52 patients with PNS in acute stage ( acute stage group ) and 34 patients with PNS in complete remission ( remission stage group ) and 50 healthy children ( con-trol group).The lipid/lipoprotein and renal function parameters were also analyzed .Results: Compared with controls group ,the levels of serum ALB,HDL-C in acute group and remission group decreased significantly ( P<0.05 ) ,but the levels of serum NEFA/ALB,TC, TG,LDL-C,UA,BUN,Scr in acute group increased significantly ( P<0.05 ) ,the levels of serum TG ,LDL-C in acute group increased significantly (P<0.05).Compared with remission group,the levels of serum ALB in acute group decreased significantly (P<0.05), but the levels of serum NEFA/ALB,TC,TG,LDL-C,UA,BUN,Scr increased significantly (P<0.05).In PNS children,the ratio of NEFA to ALB was positively correlated with the levels of TC ,TG,LDL-C,UA,BUN (P<0.05),while negatively correlated with ALB (P<0.05).Multiple linear regression analysis showed that the ratio of NEFA to ALB had an independent association with BUN levels (β=0.045,t=1.602,P=0.003).Conclusion:In the development process of PNS disease ,serum ratio of NEFA to ALB increased in-dicates impaired kidney function or reduced kidney function ,and it can help doctor assess and judge the clinical condition .

Application of Topic Model in the Study of Type 2 Diabetes Treatment Plan / 中国药房

OBJECTIVE:To explore the application of topic model in the study of type 2 diabetes treatment plan. METHODS:Clinical data of 650 inpatients with type 2 diabetes in our hospital during Jan. 2012-Jun. 2016 were analyzed retrospectively. The data of clinical diagnosis,lab indexes and clinical drug use were exchanged,summarized and merged by MATLAB R2014a software. Latent Dirichlet allocation and author topic model were adopted to extract the typical topics with topic probability value>0.1,and the topics was described by the complications with cumulative probability value>0.5. RESULTS:A total of 62 complications words,16 abnormal laboratory indexes groups and 20 treatment plans were obtained. A total of 4 typical topics were excavated(cumulative probability values for the first few complications were 0.8786,0.8247,0.8215,0.7536;topic probability value were 0.3364,0.2773,0.2035,0.1176,respectively) and were mainly characterized by peripheral neuropathy,peripheral vascular disease,abnormal lipid metabolism and microvascular lesions;abnormal lab indexes groups met the above characteristics. The complications with high distribution rate included diabetic peripheral neuropathy (0.5787), hypertension (0.3631),atherosclerosis (0.2789),hyperlipidemia (0.4578) and diabetic retinopathy (0.3143);main drugs included Insulin aspart injection,Insulin injection,Methylcobalamin dispersible tablets,etc. CONCLUSIONS:The complications of type 2 diabetes are characterized by peripheral neuropathy,peripheral vascular disease,abnormal lipid metabolism and microvascular lesions. The medication rules with clinical significance can be extracted from the clinical data by topic model.

Relationship between serum ATGL and inflammatory factors in patients with coronary heart disease / 国际检验医学杂志

Objective To investigate the relationship between serum three triacylglycerol lipase (ATGL) and inflammatory factors in patients with coronary atherosclerotic heart disease (CHD).Methods 135 cases of CHD patients,and 50 healthy people were enrolled in the study.CHD patients were divided into stable angina pectoris (SAP) group (53 cases),unstable angina pectoris (UAP) group(46 cases) and acute myocardial infarction (AMI) group (36 cases) according to relevant diagnostic criteria.The serum levels of ATGL,tumor necrosis factor (TNF-α),interleukin-6(IL-6), interleukin-10(IL-10),1,25 dihydroxy vitamin D3[1,25(OH)2D3] were measured by ELISA, and statistical treatment was performed.Results The levels of ATGL,1,25(OH)2D3 in CHD group were lower than that in control group,and the levels of TNF-α,IL-6 and IL-10 were higher than those of control group(P<0.05).Comparison among different clinical types of CHD patients showed that ATGL,1,25 (OH)2D3 levels of AMI group were significantly lower than those of SAP group and UAP group,while TNF-α,IL-6 and IL-10 were higher than those of SAP group and UAP group(P<0.05);the levels of ATGL,1,25(OH)2D3 in UAP group were lower than those in SAP group,and TNF-α and IL-10 were higher than those in SAP group(P<0.05).Spearman correlation analysis showed that in the CHD group the serum levels of ATGL negatively correlated with TG,LDL-C,LP (a),TNF-α,IL-6,IL-10(r=-0.289,-0.227,-0.359,-0.243,-0.205,-0.337,P<0.05),while positively correlated with age,HDL-C,1,25(OH)2D3(r=0.267,0.356,0.229,P<0.05).Conclusion The ATGL levels in patients with CHD decreases with the increase of inflammatory factors,and plays a certain anti-inflammatory role in the progression of CHD.It can be used as a monitoring indicator to reflex the progress of CHD.

Oral health related life quality assessment of young children before and after dental treatment under general anesthesia / 实用口腔医学杂志

Objective:To assess the effects of dental treatment under general anesthesia on the life quality of children and their families.Methods:59 children aged 3 to 6-year-old were included.Parents were required to complete the early childhood oral health impact scales(ECOHIS) before and 1 month after dental treatment under general anesthesia.The questionnaire includes child impact section(CIS) and family impact section(FIS).Data were analyzed using SPSS version 19.0.Results:55 out of the 59 parents completed the qustionnaire.After treatment the total ECOHIS scores decreased by 51％ (P ＜ 0.001),overall child impact section scores decreased by 50％ (P ＜0.001),and family impact section scores decreased by 53％ (P ＜0.001),revealing a large effect size(ES) for the child(1.4) and family (4.0) sections of the ECOHIS.Conclusion:Dental treatment under general anesthesia for uncooperative young children with extensive dental problems can improve the quality of life of both children and their families.

Relationship between serum 25-hydroxy vitamin D with HCY andβ2-microglobulin in patients with T2DM and its clinical significance / 国际检验医学杂志

Objective To detect the serum levels of 25‐hydroxy vitamin D[25‐(OH)D] ,homocysteine(HCY) andβ2‐microglob‐ulin(β2‐MG) in the patients with type 2 diabetes mellitus (T2DM ) and to investigate the relationship between serum HCY and β2‐MG with 25‐(OH)D and its clinical significance .Methods A total of 139 cases of T2DM were selected anddivided into 3 groups , the normal albuminuria group for [urinary albumin to creatinine ratio (UACR)< 30 mg/gCr ,45 cases] ,microalbuminuria group (UACR ≥ 30 mg/gCr and < 300 mg/gCr ,48 cases) and massive proteinuria group (UACR ≥ 300 mg/gCr ,46 cases) according to the urinary albumin to creatinine ratio (UACR) .Other 45 individuals undergoing the physical examination were selected as the con‐trol group .The serum 25‐(OH)D level was measured by electrochemiluminescence .Serum HCY level was determined by the enzy‐matic method .Serum β2‐MG level was measured by the latex enhanced immune turbidity method .At the same time ,the biochemical indicators of FBG ,HbA1C ,serum calcium and phosphorus were measured .Results The serum 25‐(OH)D level was decreased with the increase of urinary albumin in the DM patients .And the serum 25‐(OH)D level in the microalbuminuria group and the massive proteinuria group was significantly decreased compared with the normal albuminuria group and the control group ,the difference was statistically significant(P<0 .01) .The serum HCY and β2‐MG levels in the microalbuminuria group and the massive proteinuria group were significantly increased compared with the healthy control group ,the difference was statistically significant (P<0 .05) . Conclusion The serum 25‐(OH)D level is decreased with the increase of urinary albumin in the diabetic patients .The serum HCY andβ2‐MG levels are increased with the increase of urinary albumin and serum 25‐(OH)D level is negatively correlated with the HCY andβ2‐MG levels .

Expression of thymidine kinase 1 in primary hepatic carcinoma and its value in prognostic prediction / 实用医学杂志

Objective To investigate the expressions of TK1 (thymidine kinase 1) in PHC (primary hepatic carcinoma). Methods TK1 and AFP in serum of 33 cases of PHC (primary hepatic carcinoma), 38 cases of hepatic cirrhosis,36 cases of hepatitis and 35 cases of healthy people were detected by means of Western blot—enhanced chemiluminecence and electrochemiluminescence. Results The difference of TK1 level in PHC group indicated significance when compared with that in hepatic cirrhosis group , hepatitis group and control group (U value was 436.4, 352.1, 163.6, respectively, all P 0.05). Kaplan-Meier curve analysis revealed that PHC patients with TK1≤ 2.0 pmol/L had a significantly shortened overall survival when compared with those with TK1 > 2.0 pmol/L (χ2 = 3.954,P < 0.05). Multivariable Cox regression analysis indicated that the level of TK1 and TNM stage were the independent risk factors for patients with PHC (all P <0.05). Conclusions The detection of TK1 has a certain clinical value in the diagnosis, monitoring and evaluation of the prognosis of the PHC.

Incidence of the post-operative cognitive dysfunction in elderly patients with general anesthesia combined with epidural anesthesia and patient-controlled epidural analgesia / 中南大学学报(医学版)

OBJECTIVE@#To explore the effect of general anesthesia combined with epidural anesthesia and patient-controlled epidural analgesia on the incidence of the post-operative cognitive dysfunction (POCD) in elderly patients.
@*METHODS@#A total of 100 elderly patients with gastric cancer, who underwent radical gastrectomy in Yan'an People's Hospital from March 2012 to March 2015, were randomly divided into 3 groups: a general anesthesia and patient-controlled intravenous analgesia (PCIA) (Group I, n=35), a general anesthesia combined with epidural anesthesia and PCIA (Group II, n=30), and a general anesthesia combined with epidural anesthesia and patient-controlled epidural analgesia (PCEA) (Group III, n=35). There was no significant difference in age, gender, body mass index (BMI), length of operation, American Society of Anesthesiologists (ASA) grade and Mini-Mental State Examination (MMSE) score (all P>0.05). The cognitive function was assessed at the 1st day before operation and at the 6 h, 12 h, 2 d and 6 d after operation by the Mini-Mental State Examination test (MMSE), and the incidence of POCD was compared among the 3 groups. The mean arterial pressure (MAP), blood glucose, cortisol and tumor necrosis factor α (TNF-α) content during the operation were considered. The dosage of sevoflurane (SEVO) in the operation process and the pain score at the 6, 12 and 24 h after operation were recorded.
@*RESULTS@#The incidence of POCD at 6 h was 45.71% in the Group I and 34.28% in the Group II, which were higher than that in the Group III (10.00%). The incidence of POCD at 12 h was 34.29% in the Group I and 28.57% in the Group II, which were higher than that in the Group III (3.33%). The incidence of POCD at the 2 d was 28.57% in the Group I and 17.14% in the Group II, which were higher than that in the Group III (0). The incidence of POCD at 6 d was 17.14% in the Group I and 2.85% in the Group II, which were higher than that in the Group III (0). The blood glucose, cortisol and TNF-α content were consistent with the incidence of POCD, with significant difference (all P<0.05). The amplitude of MAP in the Group II and the Group III was significantly less than that in the Group I, and the postoperative analgesia effect in the Group III was obviously better than that in the other two groups (both P<0.05).
@*CONCLUSION@#The general anesthesia combined with epidural anesthesia and patient-controlled epidural analgesia can effectively maintain the stable hemodynamic status in the patients and display inhibitory effect on postoperative cognitive dysfunction.