Burden of epilepsy in China and its provinces, 1990 to 2019: findings from the Global Burden of Disease Study 2019 / 中华医学杂志(英文版)

BACKGROUND@#Epilepsy accounts for a significant portion of the global disease burden. However, little is known about the disease burden of epilepsy in China and its provinces.@*METHODS@#We assessed the burden of epilepsy in China and its provinces, municipalities, and autonomous regions from 1990 to 2019. Burden was measured as incidence, prevalence, deaths, years lived with disability, years of life lost, and disability-adjusted life years (DALYs), by age, sex, year, and province. We used the Socio-Demographic Index (SDI) to determine the association between the provincial development level and age-standardized DALY rates of epilepsy from 1990 to 2019.@*RESULTS@#In 2019, epilepsy caused 1367.51 thousand (95% uncertainty interval [UI]: 979.92-1837.61 thousand) DALYs, and the age-standardized DALY rate was 99.77 (95% UI: 71.33-133.52)/100,000. The age-standardized incidence and prevalence rates for epilepsy in China were 24.65/100,000 and 219.69/100,000, increased by 45.00% (95% UI: 8.03-98.74%) and 35.72% (95% UI: 0.47-86.19%) compared with that in 1990, respectively. From 1990 to 2019, the proportion of DALY caused by epilepsy in the age group under 25 years steadily decreased. The proportion of DALYs caused by epilepsy in people aged 50 years and over increased from 9.45% and 10.22% in 1990 to 29.01% and 32.72% for male and female individuals in 2019, respectively. The highest age-standardized mortality rates were seen in Tibet (4.26 [95% UI: 1.43-5.66]/100,000), Qinghai (1.80 [95% UI: 1.15-2.36]/100,000), and Yunnan (1.30 [95% UI: 0.88-1.62]/100,000), and the lowest mortality rates were in Guangdong (0.48 [95% UI: 0.39-0.64]/100,000), Zhejiang (0.56 [95% UI: 0.44-0.70]/100,000), and Shanghai (0.57 [95% UI: 0.41-0.73]/100,000). The age-standardized DALY rates across the country and in provinces, municipalities, and autonomous regions generally decreased as their SDI increased.@*CONCLUSIONS@#The disease burden of epilepsy is still heavy in China, especially in the western provinces. The incidence and prevalence of epilepsy increased between 1990 and 2019, and the burden of epilepsy in the elderly increases gradually. This study provides evidence on epilepsy prevention and care of different regions in China.

Analysis of Suitable Processing Time of Rehmanniae Radix Praeparata Processed with Amomi Fructus and Citri Reticulatae Pericarpium Based on UPLC-Q-TOF-MS / 中国实验方剂学杂志

ObjectiveTo investigate the relative content changes of differential metabolites and reducing sugars during the processing process of Rehmanniae Radix Praeparata （RRP） processed with Amomi Fructus （AF） and Citri Reticulatae Pericarpium （CRP）， and to lay the foundation for revealing the processing principle of this characteristic variety. MethodThe samples of the 0-54 h processing process of RRP processed with AF and CRP were taken as the research object， and their secondary metabolites were detected by ultra performance liquid chromatography tandem quadrupole time-of-flight mass spectrometry （UPLC-Q-TOF-MS）. The 0.1% formic acid aqueous solution （A）-acetonitrile （B） was used as the mobile phase for gradient elution （0-1 min， 1%-3%B； 1-10 min， 3%-9%B； 10-15 min， 9%-12%B； 15-22 min， 12%-18%B； 22-31 min， 18%-24%B； 31-35 min， 24%-100%B； 35-36 min， 100%-5%B； 36-40 min， 5%-1%B； 40-45 min， 1%B）， column temperature was 40 ℃， injection volume was 3 μL， flow rate was 0.3 mL·min-1. Electrospray ionization （ESI） was used to scan and collect MS data in the negative ion mode， the scanning range was m/z 50-1 250. Data analysis was carried out using PeakView 1.2 software， and the chemical composition of RRP processed with AF and CRP was identified by combining the literature information and chemical composition databases. The MS data were normalized by MarkerView 1.2， and then the multivariate statistical analysis was applied to screen the differential metabolites， and the changes of the relative contents of the differential metabolites with different processing times was analyzed， finally， correlation analysis was performed between the differential metabolites， the change of the reducing sugar content was combined to determine the most suitable processing time of RRP processed with AF and CRP. ResultA total of 121 compounds were identified from RRP processed with AF and CRP at different processing times， and 12 differential metabolites were screened out by multivariate statistical analysis， including catalpol， hesperidin， isoacteoside， acteoside， narirutin， echinacoside， isomartynoside， decaffeoylacteoside， 6-O-E-feruloylajugol， dihydroxy-7-O-neohesperidin， jionoside D， and rehmapicroside. With the prolongation of processing time， the relative contents of these 12 differential metabolites and reducing sugars changed slightly at 52-54 h. ConclusionUPLC-Q-TOF-MS can comprehensively and accurately identify the chemical constituents of RRP processed with AF and CRP at different processing times， and the suitable processing time of 52-54 h is determined according to the content changes of different metabolites and reducing sugars， which provides a basis for revealing the scientific connotation of the processing principle of this variety.

Pulmonary dysfunction and risk factors in residents of a rural community / 中国基层医药

Objective:To observe the changes of pulmonary function and its influential factors in residents of a rural community and investigate the prevention and control measures.Methods:A survey was made in residents from a rural community in Qingdao who received public health services from September 2017 to December 2019. The demographic data, behavioral and medical history information were collected. Forced vital capacity and forced expiratory volume in one second were measured. The factors that affect lung function were analyzed using univariate analysis and multivariate analysis.Results:This survey involved 5184 residents consisting of 2199 (42.4%) males and 2985 (57.6%) females. 1322 (25.5%) residents had pulmonary dysfunction. Univariate analysis showed that residents aged ≥ 60 years had a higher risk for developing pulmonary dysfunction than residents aged < 60 years (26.1% vs. 14.3%, χ2 = 19.34, P < 0.001), and male residents had a higher risk for developing pulmonary dysfunction than female residents (32.9% vs. 20.0%, χ2 = 110.74, P < 0.001). With the increase in body mass, the incidence of pulmonary dysfunction gradually decreased. The proportion of residents with pulmonary dysfunction with low body mass was higher than that in residents with normal body mass and high body mass (43.4% vs. 27.8% or 22.8%, χ2 = 8.86, 17.63, P = 0.003, < 0.001). The proportion of residents with pulmonary dysfunction was higher in those with a history of chronic bronchitis, bronchial asthma, or obstructive pulmonary disease than in those without such a history (68.3% vs. 23.2%) χ2 = 263.33, P < 0.001). The proportion of residents with pulmonary dysfunction was significantly higher in smokers, whether or not had quit smoking than in non-smokers (35.1%, 36.3% vs. 22.8%, χ2 = 48.83, 86.46, both P < 0.001). The proportion of residents with the normal pulmonary function was not related to the exposure history of dust and chemical poisons and the family history of respiratory diseases ( χ2 = 0.38, 2.29, P = 0.535, 0.130). Multivariate analysis showed that age ≥ 60 years, male sex, low body mass, smoking, and a history of respiratory system diseases were the independent risk factors for pulmonary dysfunction. Among smokers, the number of cigarettes smoked was higher in smokers with pulmonary dysfunction than those with normal pulmonary function ( t = -2.39, P = 0.009). Conclusion:There are many risk factors for pulmonary dysfunction. Primary medical service institutes should carry out pulmonary function testing and formulate targeted prevention strategies, which help realize early detection and treatment of chronic obstructive pulmonary disease.

Immunotherapy Advances in Small Cell Lung Cancer / 中国肺癌杂志

Small cell lung cancer (SCLC) is a "refractory cancer" characterized by rapid growth and extensive early metastasis. About 70% of patients are already in the extensive stage at the time of diagnosis. Despite the high response rate to platinum-contained first-line chemotherapy, almost all patients subsequently experienced inevitable recurrence and had poor response to second-line treatment. The high mutation load and immunogenicity of SCLC suggest that immunotherapy may be effective for SCLC patients. Over the past few years, several clinical trials have evaluated the efficacy of checkpoint inhibitors [mainly cytotoxic T lymphocyte-associated antigen-4 (CTLA-4) and programmed death 1 (PD-1)/programmed death ligand-1 (PD-L1) inhibitors] in SCLC patients and demonstrated promising survival prospects. This article reviewed the clinical studies of immune checkpoint inhibitors (ICIs) in the first-line, maintenance and second or more line treatment of SCLC. Besides, predictive biomarkers were discussed to select suitable patients for immunotherapy effectively.

Exploration and Practice of Drug Abuse Monitoring in Medical Institutions / 中国药房

OBJECTIVE： To explore the method for the development and implementation of drug abuse monitoring in medical institutions， and to provide reference for drug abuse monitoring in medical institutions. METHODS： Our hospital （the affiliated hospital of Binzhou medical college） had established the corresponding drug abuse monitoring mode from the two aspects of real-time monitoring and retrospective analysis， supplemented by relevant management measures， defined the content of drug abuse monitoring in medical institutions， and finally evaluated the implementation effect through the effective reporting quantity of drug abuse information， etc. RESULTS & CONCLUSIONS： The main contents of drug abuse monitoring in our hospital included the establishment of drug abuse monitoring management group， the improvement of drug abuse monitoring system and the sorting out of drug monitoring catalogue； the real-time drug abuse monitoring mode was established through timely reporting drug abuse information by medical， nursing and pharmaceutical personnel in daily diagnosis and treatment activities； at the same time， the retrospective analysis model of drug abuse was established by analyzing the relevant drug use data regularly through the hospital information system， paying attention to the key groups of key departments， and mining drug abuse information； a series of auxiliary management measures were taken， such as strengthening training and publicity， and establishing reward and punishment mechanism. Since the monitoring work was started in 2016， the effective number of drug abuse information reported in 2016-2018 was 38， 126 and 237 respectively， and through the monitoring， it was found that the elderly women over 60 years old （69.83％） were abusing in iatrogenic sedative hypnotic drugs. The development of drug abuse monitoring in hospital can collect drug abuse status， behavior characteristics and relevant information timely and effectively， analyze local drug abuse trends， find drug abuse risks， and provide basis for drug control of narcotics and psychotropic substances supervision.

Simultaneous Determination of 6 Components in Chaihuang Tablets by HPLC-DAD / 中国药房

OBJECTIVE： To establish a method for simultaneous determination of 6 components in Chaihuang tablets， such as baicalin， wogonoside， baicalein， wogonin， saikosaponin a and saikosaponin d in Chaihuang tablets. METHODS： HPLC-DAD method was used to detect 3 batches of Chaihuang tablets from same manufacturers. The determination was performed on Agilent Eclipse XDB-C18 column with mobile phase consisted of acetonitrile-triethylamine phosphate aqueous solution （pH adjusted to 7.0， gradient elution） at flow rate of 1.0 mL/min. The detection wavelengths were set at 210 nm （saikosaponin a， saikosaponin d） and 277 nm （baicalin， wogonoside， baicalein， wogonin）. The column temperature was 30 ℃， and sample size was 5 μL. RESULTS： The linear ranges of baicalin， wogonoside， baicalein， wogonin， saikosaponin a and saikosaponin d were 0.379 5-7.590 4 μg，   0.082 96-1.659 2 μg， 0.039 39-0.787 8 μg， 0.040 72-0.814 4 μg， 0.040 45-0.809 0 μg， 0.038 63-0.772 6 μg （all r≥0.999 3）， respectively. The limits of detection were 0.008， 0.007， 0.005， 0.005， 0.020 and 0.018 μg/mL. The limits of quantitation were 0.025， 0.022， 0.015， 0.015， 0.060， 0.054 μg/mL. RSDs of precision， reproducibility and stability tests （48 h） were all lower than 1.5％ （n＝6）. Average recoveries were 98.46％， 97.06％， 100.90％， 96.13％， 96.91％， 96.57％ （RSD＜2.0％， n＝6）. CONCLUSIONS： Established method is simple， accurate and reproducible for 6 components in Chaihuang tablets， and can be used for quality control of the tablet.

Analysis on the complications after rhinoplasty by barbed sutures / 中华整形外科杂志

Objective@#To investigate the complications and related etiologies after thread rhinoplasty.@*Methods@#From January 2017 to January 2018, 21 cases with postoperative complications after thread rhinoplasty were reviewed. The complications included thread exposure at gum (n=5), thread exposure at nose (n=2), compromised blood supply (n=5), infection (n=6), and ulceration (n=3). The medical history and clinical symptoms were analyzed.@*Results@#7 patients with thread exposure have recovered. The localized hyperpigmentation was left on patients with compromised blood supply. The skin of the infection cases basically returned to normal. The hyperpigmentation and local scar left on the rest of patients. The causes of these complications are complex, including the threads buried plane, the threads textures, skin tension, surgical manipulation, the early rejection, and the chronic inflammation, etc.@*Conclusions@#Patients, with complications after thread rhinoplasty, could obtain a better outcome, if timely operation and comprehensive treatment were provided.

Design and research of the medical logistics system based on automated guided vehicles / 中华医院管理杂志

Based on the applicability analysis of various medical logistics systems, the design and research of medical logistics system based on automated guided vehicle ( AGV) are discussed in depth in such aspects as requirement analysis, system architecture and the function of the upper software platform. According to the implementation environment of specific projects, the relationship between the professional lines is coordinated and the building information modeling technology is used to assist in the professional cooperative work of the building structure. The establishment of medical logistics system based on AGV can effectively make up for the deficiency of other mainstream logistics methods, achieve efficient and speedy logistics, and further improve the quality of hospital service.

Expression and clinical significance of long noncodi ng RNA AJ227913 in patients with gouty arthritis / 中华风湿病学杂志

Objective To investigate the role of long noncoding RNA-AJ227913 in the pathogenesis of primary gout arthritis (GA). Methods The subjects were divided into three groups:30 acute gout patients (AGA), 30 non-acute gout patients (NAGA), 30 healthy controlsand 30 hyperuricemia patients (HUA). Real-time quantitative polymerase chain reaction (RT-qPCR) was employed to examine the expression of AJ227913 in peripheral blood mononuclear cells(PBMCs) from four groups. 100 μg/ml monosodium urate (MSU) was used to stimulate the peripheral blood of NAGA and healthy controls patients. Then the expression ofAJ227913 was detected by RT-qPCR. Kruskal-Wallis test, Mann-Whitney test, Spearman correlations were used for statistical analysis. Results The expression level of AJ227913 in the AGA group (0.0557 ±0.0156) was higher than that in the NAGA group (0.0223±0.018) and healthy controls group (0.0038±0.0013). There was significant difference between the NAGA group and healthy controls group (P>0.05). Compared with the control group, the expression of AJ227913 in NAGA group which were stimulated by MSU was significantly increased. The Spearman correlation analysis found that the AJ227913 expression levels in GA groups were correlated with UREA (r=0.608, P<0.01), CREA (r=0.337, P<0.05), CYSC (r=0.422, P<0.01). Conclusion Altered expression of AJ227913 may be involved in the inflammatory process of GA and the balance of uricacid.

Altered expression of miR-223 might be involved in regulation of inflammation in primary gout patients / 中华风湿病学杂志

Objective To investigate the role of miR-223 in the pathogenesis of acute gouty inflammation.Methods The subjects were divided into 3 groups:65 acute gout patients (AG),50 inter-critical gout patients (IG),and 45 healthy controls (HC).The peripheral blood mononuclear cells (PBMCs) and the clinical laboratory parameters were all collected.The expression of miR-223 in the PBMCs was detected using realtime fluorescent quantitative polymerase chain reaction (RT-qPCR) (TaqMan probe).The PBMCs of 5 healthy people were stimulated with monosodium urate (MSU) (100 μg/ml) for 12 h,and then,miR-223,NLRP3 mRNA and IL-1β production were all measured using RT-qPCR and ELISA respectively.All data were analyzed by SPSS 17.0 statistical software,Wilcoxon rank sum test,t test and Spearman's correlations analysis were used for statistical analysis.Results ① The expression of miR-223 in AG and IG groups was both significantly decreased than that in the HC group (8±17 vs 26±76,P＜0.05;9±17 vs 26±76,P＜0.05;respectively),AG group was significantly decreased than that in the IG group [8(17) vs 9(17),Z=11.387,P＜0.01].② After stimulated with MSU in healthy controls,IL-1β production and NLRP3 mRNA were both significantly increased [(86±5) pg/ml vs (13±6) pg/ml,t=21.042,P＜0.01;5.2±0.4 vs 1.2±0.4,t=14.640,P＜0.01;respectively],while the expression of miR-223 was significantly decreased (0.34±0.20 vs 1.05±0.24,t=-5.164,P＜0.01).Conclusion The data suggests that miR-223 might be involved in the patho-genesis of spontaneous regulation,but further study is needed to discover the exact mechanism.

Changes of homocysteine,renal function and serum lipid levels in renal transplantation / 国际检验医学杂志

Objective To discuss the application and significance of homocysteine (Hcy),renal function and serum lipid levels in renal transplantation,by testing those from patients after renal transplantation.Methods Hcy,creatinine (Cr),urea nitrogen (BUN),uric acid (UA),total cholesterol (TC),triglyceride (TG),low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) were detected in transplantation group(n=63) and control group(n=60).Serum Hcy,Cr and BUN of transplantation group were continuously monitored before and 1,3,7,14 days after operation,and the relationship between Hcy and renal function before and after renal transplantation were compared.Results Compared with control group,Hcy,Cr and BUN in transplantation group all increased and the difference between two groups was statistically significant (P0.05).Conclusion Hcy,Cr and BUN can be used as monitoring indicators of efficacy after renal transplantation,also which can be used to observe the incidence and severity of hyperlipidemia.

Application of serum IgG4 and IgE in children with allergic asthma and rhinallergosis / 国际检验医学杂志

Objective To detect serum IgG4 and IgE levels in children with allergic asthma and rhinallergosis to provide an im-portant laboratory evidence for its diagnosis ,treatment and prevention.Methods The serum IgG4 and IgE levels were detected in 118 children patients with allergic asthma ,167 children patients with rhinallergosis and 150 healthy children(control group) under-going physical examination in the same period.Results The levels of serum IgG4 and IgE in the allergic asthma group and rhinal-lergosis group were significantly higher than those in the control group ,the difference was statistically significant (P0.05).Conclusion Serum IgG4 and IgE have a certain clinical significance in the occurrence ,treatment and surveillance of allergic asthma and rhinallergosis in children.

Characteristics of smooth pursuit eye-movement in subjects at clinical high risk for psychosis / 中国神经精神疾病杂志

Objective To investigate the eye-movement features of smooth pursuit in subjects at clinical high risk for psychosis.Methods sixty subjects at clinical high risk for psychosis and sixty healthy controls were recruited.The smooth pursuit tasks were assessed in both horizontal (0.4 Hz) and Lissajous (0.2 or 0.4 Hz) condition.The Wechsler Memory Scale-third edition and spatial span subtest were used to assess working memory.The difference of the smooth pursuit performance between the two groups and the relationship between smooth pursuit and working memory were analyzed.Results Subjects at clinical high risk for psychosis showed significantly lower Horizontal components for pursuit gain [Lissajous 0.2 Hz task (0.82±0.12) vs.(0.89±0.09),Lissajous 0.4 Hz task (0.78±0.13) vs.(0.84±0.14)],lower vertical components for pursuit gain [Lissajous 0.2 Hz task (0.80±0.14) vs.(0.86±0.12),Lissajous 0.4 Hz task (0.71±0.15)vs.(0.77±0.16)] and higher mean positional error [Lissajous 0.2 Hz task (37.00±19.10) vs.(30.45± 16.18),Lissajous 0.4 Hz task (44.18±19.70) vs.(37.61±16.26)] compared to healthy controls (P＜0.05).There was a significant correlation between pursuit gain and performance on Spatial Span (Horizontal components:r=0.361,P=0.005;vertical components:r=0.327,P=0.01 1) in the Subjects at clinical high risk for psychosis.Conclusions Subjects at clinical high risk for psychosis showed deficits in smooth pursuit,and the deficits were related to the working memory.

Clinical application of intravascular ultrasound in the interventional treatment of internal carotid artery occlusion: initial experience of one case / 介入放射学杂志

Objective To discuss the clinical value of intravascular ultrasound (IVUS) in treatinginternal carotid arteries occlusion.Methods The patient was diagnosed with internal carotid artery occlusionthat was confirmed by CTA.Cerebral perfusion imaging showed that low perfusion area was consistent withischemic symptoms.Guided by IVUS,percutaneous transluminal angioplasty (PTA) was performed.By usingmicro-catheter coaxial technology,the micro guide wire was inserted in the carotid artery until it passedthrough the obstructed segment;After IVUS examination proved that the micro guide wire was in the truelumen of carotid artery,angiography through micro-catheter was carried out to confirm that the distal arterywas unobstructed;after adjusting the device position the embolism protector was placed.The plaque andlumen condition were assessed with IVUS,which was reevaluated after pre-expansion of balloon.After normaldirection blood flow was regained,the plaque stability was assessed with IVUS virtual organization sequence.Simple balloon dilatation therapy was adopted as the fibrous cap of plaque was in stable condition and thelumen stenosis rate was ＜40％.Results After balloon dilatation,the obstructed artery was reopened and theblood flow regained normal direction.IVUS examination showed that during the whole operation process thefibrous cap of plaque at the narrowed segment remained in stable condition,the lumen stenosis rate was ＜40％.Cerebral perfusion imaging revealed that after the treatment the low perfusion state was markedlyimproved.Conclusion IVUS plays an important guiding role in performing PTA for internal carotid arteryocclusion.This technique can increase the success rate of vascular recanalization and reduce the incidence ofcomplications.

Clinical outcomes of subcutaneous multiple inflammation and calluses induced by facial injection lipolysis / 中华医学美学美容杂志

Objective To explore the treatment protocols and the occurrence and developmental rule of subcutaneous multiple inflammation and indurations by facial injection lipolysis,and to summarize the treatment experience.Methods Six cases of subcutaneous indurations were females patients with facial injection lipolysis,and the lesions increased slowly after about one month.The local temperature raised and pinching pain appeared in the facial area.The other secondary post-traumatic swelling and scleroma areas were treated with piercing or cutting,spread to the surrounding tissues.Red scleroma became osmosis,by local open decompression,debridement,irrigation and drainage lasting almost 3 months.The area had burst out mucoid funicular materials gradually.Results The facial injection lipolysis caused regionally red swelling and scleroma gradually with 1 month of continuous irrigation drainage.The red scleroma area was limited with debridement again after maturation,closed incision after discharge mucus-shape substance by its organization.In the redness induration period,pathological results showed the homogeneous materials without structure could be seen in the fibrous tissue,with surrounding hyperemia,hemorrhage associated with inflammation.Festering burst period showed that local tissue presented suppurative inflammation,multiple abscesses and granuloma formation.Conclusions Conservative treatment can lead to swelling,bursting and developing into deep tissues.Surgical treatment can spread redness scleroma area and lead to a large area of skin depression,soft tissue scar and deformity.

Clinical diagnostic value of serum β-hCG and AFP in mediastinal germ cell tumor / 中华检验医学杂志

Objective To explore the clinical diagnostic value of serum human chorionic gonadotropin beta subunit (β-HCG) and alpha fetoprotein ( AFP) in mediastinal germ cell tumors .Methods A retrospective analysis was conducted on the patients who were definitely diagnosed as mediastinal tumors or mediastinal neoplastic lesions .A total of 133 patients were included for analysis between January 2008 and May 2014, divided into two groups.42 cases of mediastinal germ cell tumor patients were marked as case group while 91 cases of other mediastinal tumor or mediastinal neoplastic lesion patients were marked as control group ( including 31 cases of thymoma , 10 cases of mediastinal neurogenic tumor , 2 cases of intrathoracic goiter , 25 cases of mediastinal cyst , 2 cases of mediastinal lipoma , 11 cases of mediastinal lymphoma and 10 cases of thymic carcinoma ) .AFP was detected by chemiluminescence detection , and -HCG was detected by electrochemical luminescence .K-S test was performed to investigate normality of data , non-normally distributed data were described as Median ( interquartile range ) .Mann-Whitney U test was done for measurement of data between two groups .Logistic regression analysis was performed as multivariate analysis.Receiver operating characteristic curve ( ROC) was used to determine the cut-off values.Results The levels of serum AFP and β-HCG in case group were 13.26 (2.39-48.09) ng/ml and 1.99 (0.10-15.7) IU/L, respectively, significantly higher than those in control group [AFP:2.47 (1.78-3.16) ng/ml,β-HCG:0.10 (0.10-0.55) IU/L].The difference of levels of AFP and β-HCG between the case group and the control group were statistically significant ( P=0.000 ) .There were no significant difference when it comes to β-HCG between the case group and intrathoracic goiter patients in control group .Apart from it, the difference of levels of AFP and β-HCG between the case group and every single control group were statistically significant .Cut-off values of AFP and β-HCG for distinguishing mediastinal germ cell tumors from mediastinal tumors were 5.07 ng/ml and 2.32 IU/L.In this scenario, for AFP and β-HCG, sensitivity were 57.1%and 50%, specificity were 97.8%and 96.7%, accuracy were 54.9%and 46.7%, area under the curve ( AUC ) were 0.773 and 0.755, positive likelihood ratios were 26.00 and 15.17respectively.Parallel experiments contributed to increase the sensitivity to 71.4%. Predictive probability (P) =1/[1+exp ( -0.319AFP-0.253HCG+2.850)] was obtained by logistic regression model.When cut-off value of predictive probability ( P ) was 0.30, specificity, AUC, and positive likelihood ratio were increased to 98.9%, 0.835 and 65.00respectively, negative likelihood ratio was decreased to 0.29, positive predictive value and negative predictive value were increased also (96.8%and 88.2%respectively).Conclusion Serum β-HCG, AFP and predictive probability ( P ) is valuable in the diagnosis of mediastinal germ cell tumor .

Effect of Dermatix Ultra on repair of scar tissue in patients after breast plastic surgery / 中国生化药物杂志

Objective To explore clinical effect of Dermatix Ultra on repair of scar tissue in patients after breast plastic surgery .Methods 66 patients with breast conserving surgery after breast conserving surgery were selected and divided into two groups.32 cases in the control group were treated with the implementation of breast conserving surgery and breast plastic surgery , 34 cases in the treatment group were treated on the basis of the control group and combined with Dermatix Ultra.Evaluation of patient and observer scar assessment scale ( POSAS ) and visual analogue scale were compared after the treatment and satisfaction degree were compared after 6 months follow-up.Results Compared with the control group, scar evaluation in treatment group were higher(P<0.05), the color, thickness, the degree of pigmentation and the score of the pigment were higher (P<0.05), the color, softness, thickness, pain and itching were higher (P<0.05), and the patients were followed up for 6 months (P<0.05).The color, thickness, roughness and pigmentation score of OSAS in the treatment group were higher (P<0.05), Color, softness, thickness, pain and pruritus in PSAS were higher (P<0.05),after 6 months of follow-up, the satisfaction rate in patients was higher (P<0.05).Conclusion Dermatix Ultra has a good clinical effect in repair of scar tissue after the breast plastic surgery, improve the color, thickness, smoothness and pigmentation of patients after breast augmentation surgery, and improve the prognosis.

Proliferation of human adipose-derived stem cells with expended polytetrafluoroethylenee scaffold inplanted in subcutaneous tissue of rats / 中华医学美学美容杂志

Objective To observe the growth of human adipose stem cells (hADSCs) co-culture with expanded polytetrafluoroethylenee (ePTFE) scaffold in vivo.Methods hADSCs were isolated from healthy human liposuction fat.The hADSCs were seeded onto the ePTFE scaffold as Group A,while the ePTFE scaffold without hADSCs as Group B,and the two groups were randomly implanted under the back skin of 10 SD rats.The transplant compound in two groups was harvested at 4 weeks after implantation.Wet weight of transplanted compound was measured.After HE and immunofluorescence CD31 staining,blood vessel density and fibrous proliferation were observed and evaluated.Results Primary cultured hADSCs were spindle-shaped cells.The histological study found that after cultured in vivo,hADSCs could grow in the space of the ePTFE scaffold,several cells were found at the edge of the scaffolds and parts of cells had grown into the inside even the whole layer of the scaffolds.The wet weight of transplanted compound in group A (511.62±32.82) mg was significantly higher than that in group B (363.56±34.74) mg,(P＜0.05).Histological and immunofluorescence analysis showed the blood vessel density was (29.50±2.63)/HPL in group A,(12.00±2.26)/HPL in group B.Compared with group B,group A had significantly higher blood vessel density and lower fibrosis counts (P＜0.05).Conclusions hADSCs have a good biocompatibility with ePTFE scaffold.ePTFE scaffold has no negative effect on the proliferation of hADSCs.

Determinants on aged population’s health expenditures in China / 中国卫生政策研究

Objective:To provide references for policy-making on the establishment of a sound healthcare sys-tem for China’s aged population. Methods:Based on the framework of The Behavioral Model of Health Services Use and data from China Health and Retirement Longitudinal Study in 2011 , the Tobit model of aged population’s health expenditures is built. Results: Self-rated health conditions, chronic disease, medical insurance, endowment insur-ance, self-rated living standard, age, gender, marital status and urban-rural character are the significant determi-nants. Conclusions:The healthcare system for China’s aged population should be built through simultaneously apply-ing disease prevention and access facilitation policies and the characteristic differences of different groups of aged pop-ulation should be taken into consideration.

Discussion on the treatment methods of pediatric obstructive sleep apnea hypopnea syndrome / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the treatment methods of pediatric obstructive sleep apnea hypopnea syndrome (OSAHS).</p><p><b>METHODS</b>A total of 386 children with OSAHS were enrolled from June 2008 to April 2011.Ninety children with adenoid and tonsil ≤ degree III (group A) were randomly divided into A1 subgroup and A2 subgroup, while 22 of 296 (group B) children aged less than 3 years old with degree IV adenoid and(or) tonsil were divided into B1 subgroup, and the other 274 of 296 children with degree IV adenoid and (or) tonsil were divided into B1 subgroup, B2 subgroup and B3 subgroup. The adenoid, tonsil size examination and nasal endoscopic examination scores were performed before treatment, 3 months and 6 months after treatment. Drug therapy included oral antibiotics, mometasone furoate as a nasal spray, leukotriene receptor antagonist (LTRAs), mucoactive medications. Conservative treatment meant drug therapy plus negative pressure of sputum aspiration.Surgical treatment meant coblation adenotonsillectomy. A1 subgroup received drug therapy for 3 months; A2 and B1 subgroup received conservative treatment for 3 months; B2 subgroup received coblation adenotonsillectomy after 3 days conservative treatment and postoperative drug therapy for 2 weeks; B3 subgroup received coblation adenotonsillectomy after 2 weeks conservative treatment and postoperative drug therapy for 3 months.</p><p><b>RESULTS</b>The adenoid and tonsil size of A2 subgroup decreased at 3 months after treatment (Wald χ² were 10.584 and 8.366, respectively, P < 0.05), no significant re-increase was found at 6 months, and no decrease was found in the A1 subgroup (P > 0.05). The nasal endoscopic examination scores decreased in both A1 and A2 subgroup at 3 months after the treatment (F = 403.420, P < 0.05), but it was found re-increase in A1 subgroup at the 6 months (P < 0.05), no significant re-increase was found in the A2 subgroup. The polysomnography (PSG) monitor of A2 subgroup was 100.0% normal at 3 months after treatment, while the A1 subgroup was only 43.2% (χ² = 36.189, P < 0.05). B2 and B3 subgroups cured after coblation adenotonsillectomy, but no decrease of the adenoid and tonsil size was found in B1 subgroup (P > 0.05). The nasal endoscopic examination scores of B1, B2 and B3 subgroups showed significant decrease after the treatment, but re-increase was found in both B1 and B2 subgroups at the 6 months (F = 1 614.244, P < 0.05), no significant re-increase was found in the B3 subgroup. The PSG monitor of B3 subgroup was 100.0% normal at 3 months after treatment, B2 subgroup 73.4%, and B1 subgroup only 57.4% (χ² = 90.846, P < 0.05).</p><p><b>CONCLUSIONS</b>The treatment method of children with OSAHS should be selected according to the age, condition of disease, and size of the adenoid and tonsil. Adenoid and tonsil ≤ degree III should select conservative treatment; while for degree IV adenoid and (or) tonsil, surgical treatment should be primary choice. Conservative treatment can reduce the risk of perioperative and adequate postoperative drug therapy can help prevent recurrence after surgery.</p>