Objective To investigate the clinical efficacy of bilateral decompressive craniotomy for treating the patients with double hedge severe craniocerebral injury (DHSCBI).Methods Sixty patients with DHSCBI were divided by random digits table method into treatment group and control group with 30 cases each.The treatment group was treated with bilateral decompressive craniotomy,while the control group was treated with traditional unilateral craniotomy.The acute brain swelling,incisional hernia,intracranial pressure of postoperative 1,3,7 d were observed and recorded.The patients were followed up for 3 months to evaluate the clinical efficacy.Results The incidence of acute brain swelling and incisional hernia in treatment group were 13.3％ (4/30) and 20.0％ (6/30),respectively,which were significantly lower than those in control group [56.7％ (17/30) and 63.3％ (19/30)] (P ＜0.01 ).The intracranial pressure of postoperative 1,3,7 d in treatment group [(21.34 ±3.05),(18.43 ±2.63),(15.52 ±2.21) mm Hg(1mm Hg =0.133 kPa)] were significantly lower than those in control group[ (31.21 ± 4.46),(29.13 ±4.16),(24.97 ±3.57) mm Hg] (P ＜0.05).The clinical efficacy in treatment group [53.3％ (16/30)] was significantly higher than that in control group [23.3％ (7/30)] (P ＜ 0.05 ).The mortality rate in treatment group [16.7％ (5/30)] was significantly lower than that in control group [40.0％(12/30)] (P ＜0.05).Conclusions Compared with traditional unilateral craniotomy,bilateral decompressive craniotomy can reduce the incidence of acute brain swelling and incisional hernia of DHSCBI patients,and have better prognosis.It is worthy of clinical application.

Objective To investigate the pathogenesis of hepatorenal syndrome(HRS),especially the role of the vasoconstrictor that and vasodilator that played in the process.Methods The patients were divided into two groups for observation:The patients of chronic hepatitis with HRS were observational group,the patients of chronic hepatitis without hepatorenal syndrome were control group.Immunoenzyme technique was used for detecting the quantity of renin、atrial natruretic polypeptide、nitric oxide and endothelin in blood and ascites of all patients in two groups respectively.Then we compared the data of the two groups.Results Compared with those of the control group,rennin and endothelin in blood and ascites of the observational group increased significantly(P

Objective:To explore the possible role and clinical significance of Th1 and Th2 class cytokines in the pathogenesis of re-current aphthous ulcer (RAU).Methods:35 cases with RAU,25 of minor RAU(MiRAU)and 1 0 of major RAU(MaRAU),were enrolled and 24 healthy subjects served as the controls.The expression levels of Th1 type cytokines (IFN-γ,TNF-α,IL-2)and Th2 type cytokines (IL-4,IL-6,IL-1 0)in the serum of peripheral blood were investigated by flow cytometry CBA methods and their rela-tionship with the clinical features of RAU was analyzed by SPSS 1 1 .5.Results:The expression level of IL-4 and IL-1 0 in MiRAU group was higher than that in the controls(P <0.05),and the expression level of IFN-γ,IL-4 and IL-1 0 in MaRAU group was higher than that in the controls(P <0.05).The expression level of IFN-γand IL-1 0 in MaRAU was higher than that in MiRAU.There was a positive correlation between the levels of IFN-γ,IL-4,IL-1 0 and the severity of RAU.Conclusion:Predominant Th2 immune re-sponse plays a role in RAU,and the level of IFN-γ,IL-4 and IL-1 0 is correlated with the severity of RAU.

ObjectiveTo investgate the effects of pyruvate sodium on energy metabolism of erythrocytes in dog blood during circulation in cardiopulmonary bypass machine.MethodsTen healthy adult mongrel dogs of both sexes weighing 12-18 kg were anesthetized with intraperitoneal 2.5％ pentobarbital 25 mg/kg.Femoral artery was cannulated and 500 ml of blood was collected from femoral artery in each dog.Blood samples from the 10 dogs were divided into 2 equal parts (250 ml each).Each part was mixed with 250 ml lactated Ringer's solution (group C) or 250 ml pyruvate sodium (group P).Flow rate of 4 L/min was employed and blood temperature was kept at 30-32 ℃ during circulation in cardiopulmonary bypass machine.The blood sanples were collected before (baseline value,T1 ) and at 30,60,90,120 min of circulation (T2-5) for determination of ATP,ADP and AMP concentrations in RBC.ResultsThe ATP and AMP concentrations were significantly higher at T2-5,while ADP concentration was higher in group P than in group C.ConclusionPyruvate sodium can improve energy metabolism of erythrocytes in dog blood druing circulation in cardiopulmary bypass machine.

OBJECTIVE:To focus on the situation of clinical pharmacists particpating in the clinical drug treatment consulta-tion in China. METHODS:With the keywords of“clinical pharmacists”,“consultation”and others,retrieved from China Hospital Knowledge Database (CHKD),Wanfang Database and China BioMedical Literature Service System (SinoMed),the situation of clinical pharmacists particpating in the clinical drug treatment consultation in China was concluded and summarized. RESULTS:A total of 186 literatures were included,invloving 114 effective literatures. 2 606 cases were clinical pharmacists particpating in the clinical drug treatment consultation,2 257 cases were all or part of adoption of clinical pharmacists’suggestions,the execution lev-el of clinicians for clinical pharmacists’consultation suggestions reached 93.02%. After carrying out the clinical pharmacists’con-sultation suggestions,patients’condition improved or cured reached 2 290 cases,with the effective rate of 94.47%. CONCLU-SIONS:Clinical pharmacists participating in the clinical consultation has certain function,however,the working method and mode need to be further explored and standarized.

Objective:To observe the flow density (FD) of macular and optic disc and area of foveal avascular zone (FAZ) in severe nonproliferative diabetic retinopathy (S-NPDR).Methods:A prospective cross-sectional study. From October 2019 to April 2020, 31 eyes of 25 S-NPDR patients (S-NPDR group) who were diagnosed in the ophthalmological examination of Jiangsu Province Hospital and 30 eyes of 30 age- and sex-matched healthy volunteers (control group) were included in this study. Optical coherence tomography angiography (OCTA) was used to scan the macular area of 6 mm×6 mm and optic disc of 4.5 mm×4.5 mm. The software automatically divides it into three concentric circles centered on the macular fovea, which were foveal area with a diameter of 1 mm, parafoveal area of 1 to 3 mm, and foveal peripheral area of 3 to 6 mm. The area around the optic disc was divided into 8 areas: nasal upper, nasal lower, inferior nasal, inferior temporal, temporal lower, temporal upper, superior temporal and superior nasal. The FD of the optic disc, the superficial capillary layer (SCP) and deep capillary layer (DCP) of the retina and FAZ area were measured. The FD and FAZ area were compared between the two groups by independent sample t test. The correlation between FAZ area and FD was analyzed by Pearson correlation. Results:In parafoveal and perifoveal area, compared with the control group, the FD of SCP ( t=6.470, 5.220; P<0.001) and DCP ( t=7.270, 7.370; P<0.001) decreased in S-NPDR group. In foveal area, there was statistically significant difference in the FD of DCP between the two groups ( t=2.250, P=0.030), while the difference in FD of SCP between the two groups was not statistically significant ( t=0.000, P=0.900). The FAZ area in S-NPDR group was larger than that in control group, and the difference was statistically significant ( t=2.390, P=0.030). The FD in the S-NPDR group was lower than that in the control group except the superior nasal, the difference was statistically significant ( t=7.520, 5.000, 4.870, 3.120, 2.360, 2.120, 5.410, 5.560, 2.640; P<0.05). Pearson correlation analysis showed that the FAZ area of S-NPDR was negatively correlated with FD of SCP ( r=-0.513, P=0.004), and had no correlation with FD of DCP ( r=0.034, P=0.859). Conclusion:The overall FD in macular area and optic disc of patients with S-NPDR decreased and the FAZ area enlarged.

Objective To assess the diagnostic yields of clinical chromosomal microarray ( CMA) testing for patients with neurodevelopmetal disorders ( NDD) , and to characterize the spectrum of pathogenic copy number variation(CNV) in NDD.Methods The study was a cross-sectional study.NDD patients from Shanghai Children′s Medical Center ( SCMC ) from April 2014 to April 2015 were recruited.DNA samples from SCMC cohort were tested on Affymetrix Cytoscan Dx microarray platform.The diagnostic yields of CMA testing were further assessed for the whole NDD cohort and each subgroup.Results A genome-wide genotype-phenotype analysis on a total of 107 NDD cases with CMA testing was conducted.Based on the SCMC clinical cohort, the overall diagnostic yield of CMA testing for NDD patients was 20.6%(22/107). Excluding one case with chromosomal aneuploid, the frequency of non-polymorphic CNVs of the rest NDD cases were 25.5%(27/106).The diagnostic yield for developmental delay/intellectual disorder(DD/ID) and autism spectrum disorder(ASD)were 26.3% (15/57) and 10.2%(4/39) respectively.DD/ID was more likely to be associated with CNV than ASD and attention-deficit/hyperactivity disorder(ADHD).Five recurrent genomic loci were significantly enriched in patients including 1q21.1-q21.2, 15q11.2-q13.1, 22q11.2, 7q11.23 and 17q11.2.Conclusion CNV is an important pathogenesis in NDD.

OBJECTIVETo compare the difference in depression relief in the treatment of depressive disorder at the acute stage between the combined therapy of acupuncture and 5-HT (5-hydroxytryptamine) selective serotonini reuptake inhibitors (SSRIs) and the single application of SSRIs and explore the impact on the imbalance of 5-HT and TH1/TH2.

METHODSNinety cases of depressive disorder at the acute stage were randomized into a combined therapy group and a medication group, 45 cases in each one. In the medication group, SSRIs were prescribed forl oral administration, once or twice a day, continuously for 4 weeks. In the combined therapy group, on the basis of treatment as the medication group, acupuncture was combined. The main acupoints were Baihui (GV 20), Yintang (GV 29), Shenting (GV 24), Fengchi (GB 20), Dazhui (GV 14) and Sishencong (EX-HN 1), once every two. days, continuously for 4 weeks. Before treatment, and after the 1st, 2nd and 4th weeks of treatment, the Hamilton depression scale (HAMD) was used to evaluate the depression severity. Separately, before and after the 4 weeks of treatment, the levels of serum 5-HT, interleukin-1 beta (IL-1β), interleukin-6 (IL-6), interleukin-4 (IL-4) and interleukin-10 (IL-10) were determined and compared with those in 45 cases of the healthy group.

RESULTSHAMD score was reduced in the 1st, 2nd and 4th weeks of treatment as compared with that before treatment in the combined therapy group (all P<0 01). HAMD score was reduced in the 2nd and 4th weeks of treatment as compared with that before treatment in the medication group (all P<0. 01). HAMD scores in the combined therapy group were lower than those in the medication group in the 1st, 2nd and 4th weeks of treatment (all P< 0. 01). Before treatment, in the combined therapy group and the medication group, the levels of serum 5-HT, IL-4 and IL-10 were all lower than those in the healthy group (all P<0. 01); the levels of IL-1β and IL-6 were higher than those in the healthy group (all P<0. 01). In the combined therapy group and the medication group, the levels of 5-HT, IL-4 and IL-10 in 4 weeks of treatment were all increased as compared with those before treatment (all P<0. 01), and the levels of IL-1β and IL-6 were lower than those before treatment (all P<0. 01). In the combined therapy group, the levels of IL-1β and IL-6 in 4 weeks of treatment were lower than those in the medication group, and the levels of 5-HT, IL-4 and IL-10 were higher than those in the medication group (P<0. 01, P< 0. 05).

CONCLUSIONThe combined therapy of acupuncture and SSRIs achieves much quicker and more effective re-' sult for relieving depression in the patients of depressive disorder as compared with simple oral administration of' SSRIs, and much more contributes to adjust the imbalance of serum 5-HT and TH1/TH2.

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Antidepressive Agents ; administration & dosage ; Combined Modality Therapy ; Depressive Disorder ; blood ; drug therapy ; therapy ; Female ; Humans ; Interleukin-10 ; blood ; Interleukin-1beta ; blood ; Interleukin-4 ; blood ; Interleukin-6 ; blood ; Male ; Middle Aged ; Serotonin ; blood ; Th1 Cells ; metabolism ; Th2 Cells ; metabolism ; Young Adult

This study aims to explore the clinical value of the computer-aided diagnosis (CAD) system for early detection of the pulmonary nodules on digital chest X-ray. A total of 100 cases of digital chest radiographs with pulmonary nodules of 5-20 mm diameter were selected from Pictures Archiving and Communication System (PACS) database in West China Hospital of Sichuan University were enrolled into trial group, and other 200 chest radiographs without pulmonary nodules as control group. All cases were confirmed by CT examination. Firstly, these cases were diagnosed by 5 different-seniority doctors without CAD, and after three months, these cases were re-diagnosed by the 5 doctors with CAD. Subsequently, the diagnostic results were analyzed by using SPSS statistical methods. The results showed that the sensitivity and specificity for detecting pulmonary nodules tended to be improved by using the CAD system, especially for specificity, but there was no significant difference before and after using CAD system.
China ; Diagnosis, Computer-Assisted ; Early Diagnosis ; Humans ; Lung ; pathology ; Radiographic Image Enhancement ; Radiography, Thoracic ; Thorax

Objective To investigate the correlation between atypical respiratory pathogens infection and serum total IgE levels . Methods Serum IgM level was detected in 1 913 blood samples of children with atypical respiratory infection by using indirect im‐munofluorescence assay ,including mycoplasma pneumonia(MP) ,legionella pneumophila (LP) ,rickettsia Q(QFR) ,chlamydia pneu‐monia(CPn) ,adenovirus (Adv) ,respiratory syncytial virus (RSV) ,influenza A virus (IAv) ,influenza B virus (IBv) and parainflu‐enza virus (PIV)1/2/3 .The serum total IgE level was detected by immune scatter turbidimetry .Software SPSS 17 .0 was used in data statistical analysis .Results A total of 991 out of 1 913 samples of respiratory inflected children exhibited positive(positive group) ,while 922 exhibited negative(negative group) in indirect immunofluorescence assay .650 out of the 991 positive samples (65 .59% ) contained MP infection and the combination of MP infection and other virus infections .The serum total IgE level in posi‐tive group was significantly higher than that of the negative group ,and the serum total IgE level in samples with MP infection was higher than that in samples with IBv infection ,Adv infection ,and RSV infection .In the samples in which serum total IgE level was higher than the clinical reference range (100 kU/mL) ,the infection rate of MP infection alone was 31 .29% ,which was evidently higher than that in samples of low IgE level(< 100 kU/mL ,21 .30% ) .On the other hand ,the infection rate of RSV alone was 1 .88% and the infection rate of Adv alone was 3 .13% ,which were both evidently lower than those in samples with normal serum total IgE level(both 6 .53% ) .Conclusion MP is the most common pathogen in children with atypical respiratory pathogen infec‐tion ,and can lead to higher serum total IgE levels .