The medical staff's ability to apply medical statistics is deficient at present.In order to bring up eligible students and improve the teaching quality of medical statistics,the author has advanced his thoughts and opinions on teaching contents,teaching ways and examination ways.

Objective To compare the efficacy of cardiac resynchronization therapy (CRT) on chronic heart failure (CHF) patients with different left bundle branch block (LBBB) morphologies. Methods Patients(n=45)who were treated with CRT were enrolled. According to the intrinsic ECG morphologies, patients were divided into 1)genuineLBBB group (n=32) who present negative dominant V1 and V2 lead wave (QS or rS);mid-QRS notching or slurring in at least 2 leads of Vl, V2, V5, V6, I and aVL as well as QRS duration≥140 ms in male or≥130 ms in female and 2)falseLBBB group (n=10) who meet traditional standards but fail to meet“genuine”LBBB diagnostic standard. The QRS duration, echocardiographic indi?ces and New York Heart Association (NYHA) Functional Classification were evaluated at the 12 months follow-up. CRT re?sponder was defined as patient with≥1 decrease in NYHA class and/or with≥15%reduction in left ventricular end-systolic volume (LVESV). CRT super-responder was defined as patient with≥30%reduction in LVESV. Results There was no dif?ference in basic characteristics of patients between groups. At the 12 months follow-up, 20 patients in genuine LBBB group and 6 patients infalseLBBB group were identified as responders (P>0.05). Compared with those infalseLBBB group, the responders ingenuineLBBB group showed better improvement in left ventricular ejection fraction and left ven?tricular end diastolic diameter (LVEDD) (both P<0.05). Conclusion Left bundle branch block morphology is less predic?tive for the efficacy of CRT. However, patients who show response to CRT withgenuineLBBB profile may get more bene?fits from CRT treatment than the patients withfalseLBBB profile.

Objective To evaluate the diagnostic significance of full-field digital mammography (FFDM)for atypieal breast cancer findings.Methods Seven hundred-eighteen cases with breast cancer were examined using FFDM and atypical mammographic findings were found in 134 cases.Craniocaudal (CC)view and mediolateral oblique(MLO)view were conducted for each patient.Mediolateral view or spot view Was achieved if necessary.Preoperative localization Was conducted for the patients with nonpalpable breast cancer8.Results (1)The masses with well.circumscribed margin on mammography were more common in infiltrating duetal carcinoma(22/106),mucinous carcinoma(8/10),medullary carcinoma (5/6),and increased with age and reduction of the mass density.(2)Long spieulation,architectural distortion,patchy high density were mainly found in infiltrating ductal carcinoma and 30-40(24 cases),41-50(34 cases)years old patients.Long speculation wag mainly found in 30-40 years old patients (10/30).(3)Hish homogenous density and subcutaneous edema in the entire breast and mass-like area were most ffequendy found in infiltrating ductal carcinoma at 30-40(2 cases)and 41-50(5 cases)years old.High density and subcutaneous edema were only found in dense breast(8 cases).Conclusion The atypical findings of breast cancer in foil-field digital mammography are associated with the pathological type of cancer.patient age and the gland density of the breast.

Objective To assess the effects of MRI-positive and interictal epileptic charges(IEDs) dominance on the memory of the patients with drug-resistant medial temporal lobe epilepsy (MTLE). Methods Fifty right-handed patients(age ranging from 16 to 60 years old)diagnosed as drug-resistant MTLE in our hospital with normal intelligence between September 2006 and April 2007 were investigated. All patients were classified as left MRI-positive(MRI(+)),right MRI(+),MRI(-),bilateral MR[ (+)by high-quality MR[protocol.The EEG was defined as dominant IEDs if≥75%independent IEDs was confined to one temporal lobe in all EEG recordings.Clinical memory scale was administered as memory assessment of MTLE.ANOVA and non-parametric statistics were used to analyze the data in SPSS 12.0. Results The distribution of age,sex,education,occupation,living condition,course,seizure and treat among left MRI(+),right MRI(+),MRI(-),bilateral MRI(+)groups was similar.All scores in the patients with MTLE was significantly lower than normal(P＜0.05).Right MRI(+)MTLE patients had deftcits in nonsense graphics recognition(9.42±7.46)compared to left MRI(+)and MRI(-) groups((16.26±4.43)and(18.26±5.49),F=4.281,P＜0.05).Among MRI(-)patients,left IEDs,right IEDs and bilateral IEDs groups displayed not significantly different impairment in memory. Conclusion Right MRI(+)MTLE has more severe impairment in non-verbal memory,and nonsense graphics recognition can be used to detect the deficit.

Objective:To explore the clinical characteristics and treatment of a family with inherited generalized epilepsy with febrile seizures plus (GEFS + ) caused by the KCNT2 gene mutation and review the literature. Methods:Clinical data of a child with GEFS + and his family members who visited Department of Pediatric Neurology, Guangzhou Women and Children′s Medical Center in May 2019 were collected.DNA samples were collected from the peripheral blood of the proband, his parents, his elder brother, and his maternal grandparents, and genetic analysis and verification were performed using the next-generation sequencing technique.Using " KCNT2" as the key word, literature was retrieved from PubMed, China National Knowledge Infrastructure and Wanfang databases (up to August 2019). Results:The proband was a 3-year-old boy who was admitted to Guangzhou Women and Children′s Medical Center because of frequent epileptic seizures in the past 5 months.He presented with a binocular gaze and experienced 3 to 8 times of extremities myoclonic-spastic epileptic attacks every day.He had a history of 3 times of febrile seizures at the age of 2 years old.His seizures were refractory to Sodium valproate, Topiramate, Nitrazepam and Levetiracetam.His elder brother and mother had a history of childhood febrile seizures.Other members in the family had no history of convulsion.Ictal electroencephalogram showed general 1 Hz high voltage spike-slow waves.A heterozygous nonsense mutation of KCNT2 gene c. 574C>T(p.Q192X) that was never reported previously was detected in the proband, his brother, mother and maternal grandmother.Furthermore, no other family members carried the mutation at the c. 574 locus of the KCNT2 gene.No article in Chinese was found, and 2 articles in a language other than Chinese provided the complete data of 3 sporadic cases.Together with 4 cases in the family studied in this article, there were 7 cases and 4 mutation sites in KCNT2 gene.Of these mutations, there were 3 missense mutations and 1 nonsense mutation.Three sporadic patients presented with early infantile epileptic encephalopathy.The family of this study was characterized with febrile seizures and febrile seizures plus. Conclusions:A de novo mutation and phenotype of the KCNT2 gene is found in a family with GEFS + .It would expand the gene mutation spectrum and provide basis for family genetic counseling. KCNT2 mutation induced GEFS + is refractory to antiepileptic drugs.

OBJECTIVETo guide doctors in precisely positioning surgical operation, a new production method of minimally invasive implant guide template was presented.

METHODSThe mandible of patient was scanned by CT scanner, and three-dimensional jaw bone model was constructed based on CT images data The professional dental implant software Simplant was used to simulate the plant based on the three-dimensional CT model to determine the location and depth of implants. In the same time, the dental plaster models were scanned by stereo vision system to build the oral mucosa model. Next, curvature registration technology was used to fuse the oral mucosa model and the CT model, then the designed position of implant in the oral mucosa could be determined. The minimally invasive implant guide template was designed in 3-Matic software according to the design position of implant and the oral mucosa model. Finally, the template was produced by rapid prototyping.

RESULTSThe three-dimensional registration technology was useful to fuse the CT data and the dental plaster data, and the template was accurate that could provide the doctors a guidance in the actual planting without cut-off mucosa.

CONCLUSIONThe guide template which fabricated by comprehensive utilization of three-dimensional registration, Simplant simulation and rapid prototyping positioning are accurate and can achieve the minimally invasive and accuracy implant surgery, this technique is worthy of clinical use.

Atrial fibrillation, also known as atrial fibrillation, is a common cardiac arrhythmia, and its incidence increases with age. Catheter ablation is considered to be an effective means to treat atrial fibrillation and maintain sinus rhythm. The common ablation technologies are radiofrequency ablation and cryoablation. However, the existing catheter ablation technology has a "zero-sum effect", and it is difficult to control the optimal dose clinically. In this study, a new method of pulsed electric field ablation for atrial fibrillation was proposed, which effectively solved the "zero-sum effect" problem of temperature ablation. The clinical application results show that the proposed technology effectively overcomes the shortcomings of existing temperature ablation, and can form durable pulmonary vein isolation.

Objective:To investigate the value of 3D printing technology in sphenoid ridge meningioma dissection. Methods:By using craniocerebral spiral enhanced CT scan DICOM images, the skull, vessels, and tumor were extracted, reconstructed, and assembled and integrated in the same coordinate system. Then, we constructed a 3D virtual model and a 3D-printed entity model, which was ap-plied for preoperation and postoperation. Results:Virtual models of the brains of five patients were reconstructed successfully and 3D entity models were produced. The models expressed the relationship among tumors, adjacent blood vessels, and the important posi-tion of the nerve tissue. Then, the models were applied to the reference before surgery planning and after surgery. Five cases were successfully performed. Conclusion:The use of the entity model of sphenoid ridge meningioma is important in optimizing operation plans, improving tumor resection, and reducing intraoperative bleeding.

Objective To evaluate the efficacy and safety of transurethral laser shovel type vaporresection-enucleation of the prostate (LS-VREP) based on the inter-layer of surgical capsule for the treatment of benign prostatic hyperplasia (BPH),which was less 80 g weight.Methods From September 2013 to August 2016,a retrospective study was performed including 1 369 cases of BPH patients,who were treated by 120-160 W transurethral laser (straight green-light) shovel type vapor-resection-enucleation of the prostate (LS-VREP group,n =1 008) and transurethral resection of the prostate (TURP group,n =361).The preoperative data,including average age,prostate weight,IPSS,QOL,Qmax and PVR was reviewed.There was no significant difference of the above data between the two groups (P ＞ 0.05).Operative time,changes of hemoglobin and serum sodium concentration,postoperative bladder irrigation time,catheter indwelling duration,hospital stay,pre-and 3 months post-operative IPSS,QOL,Q PVR were recorded.In addition,complications were monitored.Results Mean operation time of LS-VREP group was (46.1 ± 18.6) min,while TURP group was (48.2 ± 15.2) min,and there was no difference between the two groups (P ＞ 0.05).Post-operative mean hemoglobin concentration and serum sodium concentration of LS-VREP group decreased (1.6 ± 1.2) g/L and (1.2 ± 0.6) mmol/L respectively,while those of TURP group decreased (5.7 ± 3.6) g/L and (3.2 ± 1.2) mmol/L,and the differences were statistically significant (P ＜ 0.05).Mean post-operative catheter indwelling time,and post-operative hospital stay of LS-VREP group was (42.9 ± 12.7) h and (3.2 ± 0.6) d,while TURP group was (65.7 ± 15.4) h and (5.4 ± 1.2) d,and the differences were statistically significant (P ＜ 0.05).Comparatively IPSS,QOL,Qmax and PVR were all improved significantly in both groups at 3 months after operation (P ＜ 0.05),but no significant difference was found between the two groups (P ＞ 0.05).After three months' follow-up of post-operation,as for the complication rate,including TURS,bleeding requiring reoperation,incontinence,dysuria and erectile dysfunction,LS-VREP group (15/1 008) was less than that of TURP group (30/361,P ＜ 0.05).Conclusions The LS-VREP based on the inter-layer of surgical capsule is safe and effective for the treatment of BPH patients whose prostate weight was less than 80 g.LS-VREP showed less intraoperative bleeding,faster postoperative recovery,and high safety,which is considered a safe,effective and optimized minimally invasive surgery.

Objective To evaluate the safety and efficacy of transurethral frontfiring photoselective vaporesection for the treatment of cystitis glandularis,by comparing with the transurethral bipolar plasmakinetic resection.Methods From January 2014 to July 2016,41 patients with pathologically diagnosed cystitis glandularis in our hospital,were divided into two groups,including 22 cases underwent transurethral frontfiring photoselective vaporesection(the observation group),and the other 19 cases underwent transurethral bipolar plasmakinetic resection(the control group).All patients were regularly treated with postoperative intravesical instillation chemotherapy with pirarubicin.The clinical data of two groups were statistically analyzed to compare the differences of the safety and efficacy.Results All the surgeries were performed successfully.There were no statistical significances in perioperative data,the operation time,the decreased concentration of hemoglobin(Hb)and Na+,operative related complications, indwelling catheter duration and hospitalization duration between the two groups.The first-time cure rate and the effective rate of transurethral frontfiring photoselective vaporesection showed significantly better than those of transurethral bipolar plasmakinetic resection(P<0.05 for each).Conclusion Comparing the traditional transurethral bipolar plasmakinetic resection for the treatment of cystitis glandularis,tansurethral frontfiring photoselective vaporesection with postoperative intravesical instillation chemotherapy with pirarubicin,is a safer,simpler,and more effective method,which could be a new optional method in the conditional hospitals,deserving the worthy of clinical popularization.