Objective:To investigate the causes, characteristics and treatment of maxillofacial trauma in children. Methods: A retrospective analysis of 470 consecutive maxillofacial records of the patients not older than 14 years was conducted. Data regarding age, gender, cause, anatomic site and treatment were reviewed. Results:Most of the patients were mals(335 cases, 71.3% ), with a male and female ratio of approximately 2. 5;1 of the injuries, 28. 5% were due to accidental falls, 17.0% traffic accidents and 10.0% sharp implementt cutting. Injuries of soft tissue often occurred on gingiva, cheek, lip and chin. Mandibuir fratures were the most common (55.1% ) of all bone fractures. Conservative therapy, such as closed reduction surgery, maxillomandibular fixation, was usually performed. Conclusion: ①Boys are more tendent to be victims of maxillofacial trauma than girls. ②Falls are the first cause of child victims. ③Gingiva, chin, lip, check and mandible are the most commonly injuried sites.

OBJECTIVETo present a new method for correction of prominent malar complex by L-shaped osteotomy through an intraoral incision.

METHODSBased on the anatomical characteristics of the malar complex, we designed a new L-shaped osteotomy for malar eminence reduction. The procedure includes oblique incision of the upper part of the mala, vertical incision of the anterior part of the mala and "greenstick" fracture of the zygomatic arches. According to the severity of malar prominence, we resect part of the anterior-inferior part of the mala and lower the malar complex.

RESULTSThis method was used in 39 patients with prominent malar complex. Of them, 32 were symmetrical and 7 were unsymmetrical. All the patients obtained good results.

CONCLUSIONL-shaped osteotomy for correction of prominent malar complex is a relatively ideal surgical method with the advantages of simpler manipulation, fewer complications, better result, and ensuring the intactness of the structural characteristics of the malar complex.

Adult ; Female ; Humans ; Male ; Osteotomy ; methods ; Surgery, Plastic ; methods ; Treatment Outcome ; Zygoma ; surgery

Objective:To evaluate the prognostic value of different critical care scoring systems in 28-day survival rate of patients with heat stroke.Methods:A retrospective analysis was conducted on the clinical data of 71 patients with heat stroke admitted to the department of emergency medicine of Beijing Luhe Hospital. Capital Medical University from July 2015 to September 2018. The general information and the worst values of vital signs and related pathophysiological indicators within 24 hours were collected and the sequential organ failure assessment (SOFA) , multiple organ dysfunction (MODS) , simplified acute physiological scoreⅡ (SAPS Ⅱ) and acute physiology and chronic health evaluationⅡ (APACHE Ⅱ) were calculated. The patients were divided into the survival group ( n=45) and the non-survival group ( n=26) according to 28-day prognosis, and the clinical data and scores of the two groups were compared.The ROC curve was drawn to analyze the evaluation value of each scoring system on the survival rate of patients at 28-day. Kaplan-Meier method was used to plot the survival curve of patients. Results:There were no significant differences in age, sex, vital signs and laboratory parameters between two groups ( P>0.05) . In non-survival patients, SOFA, SAPS Ⅱ, APACHE Ⅱ scores were significantly elevated in the survival group ( P<0.05) . ROC curve analysis showed that the area under ROC curve (AUC) of SOFA score for predicting 28-day survival rate was the highest, which was significantly higher than the APACHE Ⅱ, SAPS Ⅱ, MODS score. When the best cut-off value of SOFA score was 9.0, the sensitivity was 84.6%, and the specificity was 71.1%. Kaplan-Meier survival analysis showed that 28-day survival rate after hospital discharge in patients with SOFA score<9 ( n=27) was significantly higher than that in patients with SOFA score ≥9.0 (χ 2=1.0, P<0.01) . Conclusion:SOFA, APACHE Ⅱ, SAPS Ⅱ on admission have been proved to have good prognostic ability to predict 28-day prognosis in heat stroke patients. Among them, SOFA score system has more accurate prediction value.

Objective:To explore the risk factors of acute renal injury (AKI) in exertional heat radiation disease (EHS) .Methods:In november 2019, the clinical data of 69 EHS patients admitted from July 2015 to September 2019 were reviewed. The general data, laboratory indexes, Glasgow score (GCS) at admission, 24-hour acute physiology and chronic health score Ⅱ (APACHE Ⅱ) , exposure time rate and physical labor intensity were collected. According to the occurrence of AKI, the patients were divided into AKI group and non-AKI group, 31 and 38 in each group. The differences of general data and laboratory indexes between the two groups were compared, and the t and Mann-Whitney U test were used to compare the two groups. The enumeration data are expressed by examples and constituent ratio (%) . Independent sample χ 2 test is used for inter-group comparison, and multiple test is used for multi-sample comparison. The correlation was analyzed by linear regression. Risk factors were analyzed by Logistic regression analysis. Results:At discharge, 31 of 69 EHS patients developed AKI. Compared with the non-AKI group, the heart rate, white blood cell count, lactic acid, D-dimer and myoglobin were higher; MAP, platelet count and PH were lower in the AKI group. The difference was statistically significant ( P<0.05) . APACHE Ⅱ score, core temperature, time to drop to 38.5 ℃, contact time rate, platelet count, pH, lactic acid, D-dimer and myoglobin were all correlated with creatinine ( r=0.57, 0.42, 0.80, 0.78, 0.57, 0.43, 0.51, 0.55, 0.79) . APACHE Ⅱ score, time to drop to 38.5C, Lac and MYO are the risk factors of AKI in EHS patients. Multivariate Logistic regression analysis showed that the time required to drop to 38.5C was an independent risk factor for the occurrence of AKI. Conclusion:AKI is a serious complication of EHS. EHS complicated with AKI, should be identified early and effective intervention measures should be taken.

Objective:To evaluate the prognostic value of different critical care scoring systems in 28-day survival rate of patients with heat stroke.Methods:A retrospective analysis was conducted on the clinical data of 71 patients with heat stroke admitted to the department of emergency medicine of Beijing Luhe Hospital. Capital Medical University from July 2015 to September 2018. The general information and the worst values of vital signs and related pathophysiological indicators within 24 hours were collected and the sequential organ failure assessment (SOFA) , multiple organ dysfunction (MODS) , simplified acute physiological scoreⅡ (SAPS Ⅱ) and acute physiology and chronic health evaluationⅡ (APACHE Ⅱ) were calculated. The patients were divided into the survival group ( n=45) and the non-survival group ( n=26) according to 28-day prognosis, and the clinical data and scores of the two groups were compared.The ROC curve was drawn to analyze the evaluation value of each scoring system on the survival rate of patients at 28-day. Kaplan-Meier method was used to plot the survival curve of patients. Results:There were no significant differences in age, sex, vital signs and laboratory parameters between two groups ( P>0.05) . In non-survival patients, SOFA, SAPS Ⅱ, APACHE Ⅱ scores were significantly elevated in the survival group ( P<0.05) . ROC curve analysis showed that the area under ROC curve (AUC) of SOFA score for predicting 28-day survival rate was the highest, which was significantly higher than the APACHE Ⅱ, SAPS Ⅱ, MODS score. When the best cut-off value of SOFA score was 9.0, the sensitivity was 84.6%, and the specificity was 71.1%. Kaplan-Meier survival analysis showed that 28-day survival rate after hospital discharge in patients with SOFA score<9 ( n=27) was significantly higher than that in patients with SOFA score ≥9.0 (χ 2=1.0, P<0.01) . Conclusion:SOFA, APACHE Ⅱ, SAPS Ⅱ on admission have been proved to have good prognostic ability to predict 28-day prognosis in heat stroke patients. Among them, SOFA score system has more accurate prediction value.

Objective:To explore the risk factors of acute renal injury (AKI) in exertional heat radiation disease (EHS) .Methods:In november 2019, the clinical data of 69 EHS patients admitted from July 2015 to September 2019 were reviewed. The general data, laboratory indexes, Glasgow score (GCS) at admission, 24-hour acute physiology and chronic health score Ⅱ (APACHE Ⅱ) , exposure time rate and physical labor intensity were collected. According to the occurrence of AKI, the patients were divided into AKI group and non-AKI group, 31 and 38 in each group. The differences of general data and laboratory indexes between the two groups were compared, and the t and Mann-Whitney U test were used to compare the two groups. The enumeration data are expressed by examples and constituent ratio (%) . Independent sample χ 2 test is used for inter-group comparison, and multiple test is used for multi-sample comparison. The correlation was analyzed by linear regression. Risk factors were analyzed by Logistic regression analysis. Results:At discharge, 31 of 69 EHS patients developed AKI. Compared with the non-AKI group, the heart rate, white blood cell count, lactic acid, D-dimer and myoglobin were higher; MAP, platelet count and PH were lower in the AKI group. The difference was statistically significant ( P<0.05) . APACHE Ⅱ score, core temperature, time to drop to 38.5 ℃, contact time rate, platelet count, pH, lactic acid, D-dimer and myoglobin were all correlated with creatinine ( r=0.57, 0.42, 0.80, 0.78, 0.57, 0.43, 0.51, 0.55, 0.79) . APACHE Ⅱ score, time to drop to 38.5C, Lac and MYO are the risk factors of AKI in EHS patients. Multivariate Logistic regression analysis showed that the time required to drop to 38.5C was an independent risk factor for the occurrence of AKI. Conclusion:AKI is a serious complication of EHS. EHS complicated with AKI, should be identified early and effective intervention measures should be taken.

Gynura divaricata polysaccharide was extracted from Gynura divaricata with the method of microwave-assisted extraction. Based on the results of single factor experiments, the extraction process was optimized by response surface analysis. The results indicated that the influencing factors during extraction were: liquid-solid ratio, microwave time, and microwave power, among which the influence of liquid-solid ratio was the most significant. The optimal conditions were as follows: liquid-solid ratio of 45∶1(mL/g), microwave power of 390 W, microwave time of 22 min. Under optimal extraction conditions, the extraction rate of Gynura divaricata polysaccharide was 15. 36%, which was pretty close to the predicted result. The optimized response surface methodology had some practical value for the process.

OBJECTIVE: To investigate the effect of calmodulin (CaM) and its mutants on binding to voltage-gated Na channel isoleucine-glutamine domain (Na1.2 IQ). METHODS: The cDNA of Na1.2 IQ was constructed by PCR technique, CaM mutants CaM, CaM and CaM were constructed with Quickchange site-directed mutagenesis kit (QIAGEN). The binding of Na1.2 IQ to CaM and CaM mutants under calcium and calcium free conditions were detected by pull-down assay. RESULTS: Na1.2 IQ and CaM were bound to each other at different calcium concentrations, while GST alone did not bind to CaM. The binding affinity of CaM and Na1.2 IQ at [Ca]-free was greater than that at 100 nmol/L [Ca] ( < 0.05). In the absence of calcium, the binding amount of CaM wild-type to Na1.2 IQ was greater than that of its mutant, and the binding affinity of CaM to Na1.2 IQ was the weakest among the three mutants ( < 0.05). CONCLUSIONS The binding ability of CaM and CaM mutants to Na1.2 IQ is Ca-dependent. This study has revealed a new mechanism of Na1.2 regulated by CaM, which would be useful for the study of ion channel related diseases.
Calcium ; metabolism ; Calmodulin ; genetics ; metabolism ; Mutation ; NAV1.2 Voltage-Gated Sodium Channel ; metabolism ; Protein Binding ; genetics

Objective: To investigate the prognostic value of arterial blood lactate for patients with cardiogenic shock receiving extracorporeal membrane oxygenation(ECMO). Methods: A retrospective analysis was conducted. Twenty-three patients diagnosed with cardiogenic shock receiving veno-arterial(V-A) ECMO admitted to department of Emergency Intensive Care Unit(EICU) of Beijing Luhe Hospital Affiliated to Capital Medical University from January 2017 to December 2018 were enrolled. Results: There were 10 cases in the survival group and 13 cases in the death group. Compared with survival group, APACHE-Ⅱ score was higher, CRRT applied higher percentage, PH and oxygenation index was worse in the death group(P<0.05). The lactate of the death group was significantly higher than that of the survival group at initial time at EICU, 1 h before ECMO and 0h before ECMO(P<0.05). During the ECMO operation, lactate levels in the death group at 8 h and 12 h were significantly higher than those in the survival group(P<0.05). There was no statistically significant difference in lactate clearance rate between the two groups before and after ECMO operation in each observation period(P>0.05). On the 2nd day of ECMO operation, CRRT usage time was shorter and daily liquid balance was more negative in the survival group(P<0.05). APACHE-Ⅱscore, initial lactate at EICU, lactate at ECMO 8 h and lactate at ECMO 12 h had predictive value for 30-day death of patients. The area under ROC curve(AUC) of initial lactate at EICU was 0.845, and 95% confidence interval(95%CI)=0.653-1.000. The AUC of ECMO 8 h lactate was 0.836, 95%CI: 0.634-1.000. The AUC of ECMO 12 h lactate was 0.873, 95%CI: 0.697-1.000. The AUC of APACHE-Ⅱscore was 0.891, 95%CI: 0.717-1.000. The sensitivity and specificity of prognosis prediction were 72.7% and 100% when lactate was more than 7.3 mmol/L at the time of admission into EICU as the optimal critical value. Conclusion Arterial blood lactate could be used as an important marker for evaluating the prognosis of cardiogenic shock patients on ECMO. The value of lactate clearance rate may be affected by combined CRRT.