Objective To study the changes of heart rate variability (HRV) and the effects of treatment with nasal continuous positive airway pressure (nCPAP) in elderly patients with sleep apnea/ hypopnea syndrome (SAHS). Methods SAHS patients and controls were examined by polysomnography(PSG) and dynamic cardiograph(DCG). Mean RR interval(Mean RRi), standard deviation of RR interval (SDRRi), low frequency(LF), high frequency(HF) and their ratio(LF/HF) were calculated. Results When compared with controls(847.9?113.8)ms vs (45.7?16.2) ms, there was significantly decrease in the Mean RRi and SDRRi in moderate, severe elderly patients and non-elderly SAHS patients(764.3?131.0)ms, (709.4?101.8)ms, (759.5?80.0)ms and (37.5?12.2)ms, (31.5?9.6)ms, (41.4?10.6)ms. There was statistical differences in LF, HF, and LF/HF between elderly and non-elderly severe SAHS (P

AIM: To determine the HPLC fingerprint of ultramicro decoction piece of Fructus gardeniae. METHODS: Chromatographic conditions were as follows: column: Hypersil BDS C_ 18 (4.6 mm?200 mm,5 ?m), mobile phase: acetonitrile-water (10∶90), column tempemture: 25 ℃,flow rate: 1 mL?min -1 , wavelength: 238 nm, and inject volume: 10 ?L. RESULTS: The fingerprint of ultramicro Fructus gardeniae was established and 7 common peaks in the fingerprint were indicated. CONCLUSION: It can nearly completely reflect intrinsic quality of ultramicro decoction piece of Fructus gardenian.

Objective To investigate the difference of vacuum sealing drainage (VSD) on the effect of one-stage skin graft and second-stage sugery after scar release.Methods A total of 42 patients who wanted to undergo scar release and skin graft was randomly divided to control group (n =21) and VSD treatment group (n =21).The control group implemented skin graft immdiately after scar release while VSD treatment group were treated with VSD for 3 days after scar release and then implemented skin graft.The rate of subcutaneous blood stasis and the survival rate of skin graft were observed at 7 days after skin graft.The condition of grafted skin contracture and hyperplasia after half a year was also observed.Results The incidcnce of subcutaneous blood stasis was significantly lower in the VSD group than that in the control group (P ＜ 0.05).The survival rate of skin grafts was significantly higher in the VSD group than that of the control group (P ＜ 0.05).The score of Vancouver scar was significantly lower in the VSD group than that in the control group (P ＜ 0.05).Conclusions VSD treatment of second-stage sugery after scar release can reduce the occurrence of subcutaneous blood stasis,promotc skin graft survival,reduce postoperative skin graft contracture and improve the prognosis of patients compared to one-stage skin graft.

Objective To analyze the distribution and clinical characteristics of gastrointestinal virus infection in infants with acute diarrhea.Methods Stool samples and clinical data were collected from 900 infants (≤5 years old) with acute diarrhea in outpatient department of Beilun District People' s Hospital during July 2012 and July 2013.Specimens were tested for 5 gastrointestinal virus including group A/B/C rotavirus (RV),adenovirus (AdV),astrovirus (AstV),sapovirus (SV) and norovirus (NV) by the multiplex PCR assay.Chi-square test was performed to compare the positive rates of virus infection among children with different genders and ages.Results Among 900 stool samples,369 were positive of gastrointestinal virus,of which 291 were positive for single virus and 78 for mixed virus.In single virus infection,NV was detected with the highest positive rate of 19.4％ (4.9％ for G Ⅰ and 14.6％ for G Ⅱ),followed by RV-A (8.2％),SV (2.9％),AstV (1.0％) and AdV (0.8％).RV-B and C type were not found.In 78 cases with mixed infections,RV-A plus NV infection was the most common one with a prevalent rate of 5.8％.The positive rate in age group ≤2 years old was 51.0％,which was significantly higher than that of age group ＞ 2-5 years old (22.1％,x2 =70.404,P ＜ 0.01).In 369 children with positive gastrointestinal virus,fever was present in 24.1％,and vomit in 35.2％ of children.Fever,vomit and fever plus vomit was more common symptoms in children with mixed infections (x2 =17.878,21.869 and 14.155,P ＜ 0.01).Conclusion NV and RV-A are the most common pathogens in infants with acute diarrhea in Beilun district,especially in children younger than 2 years old.

[Objective]To comprehensively compare the feasibility of three different treatment strategies consisting of low-dose chemotherapy(LDC),surgery and surgery with adjuvant low-dose chemotherapy(SLDC)for children with solitary bone lesions of eosinophilic granuloma(SBL-EG).[Methods]We retrospectively reviewed the records of 149 pediatric patients with SBL-EG at our institutions from 2002 to 2014. Our study included 86 patients who received LDC ,33 patients who received surgery and 30 patients who received SLDC. The duration of hospital stay ,time to symptom relief,recovery time,cost,complications and relapse-free sur-vival(RFS)of each strategy were analyzed.[Results]Hospital stay,time to symptom relief,recovery time and cost in the LDC group were significantly shorter or less than those in the surgery or SLDC group (P < 0.05). No statistically significant differences were observed in the above-mentioned factors between the surgery and SLDC groups (P > 0.05). Chemotherapy-related adverse events in the LDC and SLDC groups included nausea(8.62%),aminotransferase elevation(7.76%),slight hair loss(4.31%), immunity decline (21.55%),growth retardation (10.34%) and moon face (7.76%). LDC and SLDC treatment resulted in a significantly longer RFS (147 months and 126 months ,respectively) than surgery alone (114 months)(P = 0.005 and 0.019 , respectively). However ,there was no statistically significant difference in RFS between the LDC and SLDC groups (P = 0.732).[Conclusions]Compared with surgery or SLDC,LDC appears to promote more rapid recovery,less invasion,increase safety and eco-nomic treatment strategy for pediatric patients with SBL-EG.

Objective To compare the sensitivity and diagnostic features of mammogram (MG) and magnetic resonance imaging (MRI) on diagnosis of breast ductal carcinoma in situ (DCIS) with or without microinvasion (DCIS-MI).Methods From Jan 2012 to Nov 2013,results of MG and MRI from 72 cases of DCIS or DCIS-MI were retrospectively analyzed.Results The sensitivity of MG was 52.8％ (38/72).The sensitivity of MRI was 87.5％ (63/72),among those 76.2％ (48/63)lesions presented as non-mass-like enhancement.Sensitivity of MRI was significantly higher in DCIS-MI than DCIS (84.6％ vs 100％,P =0.027).Logistic regression analysis showed calcifications was an independent factor influencing the sensitivity of MG (OR =23.785,P ＜ 0.001).Conclusions The sensitivity of MRI is higher than MG for the diagnosis of DCIS and DCIS-MI.

Objective: To explore the impact of teacher student relationship and peer relationship on externalizing behaviors among migrant children, and to investigate the mediating role of school attitude. Methods: A longitudinal follow up study was designed among 378 migrant children from Hubei, Guizhou and Chongqing city with the teacher student relationship, peer relationship questionnaire, school attitude and the externalizing behavior collected through questionnaire survey. Results: After controlling covariates and baseline (T1) externalized problem behaviors, baseline (T1) teacher student relationship and peer relationship negatively predicted externalizing behavior at T3 ( β teacher student =-0.12, P =0.08; β classmate =-0.20, P <0.01), The mediating effect of school attitude at T2 on the association between externalizing behaviors with teacherstudent relationship (-0.11) and peer relationship(-0.05). Conclusion Teacher student relationship and peer relationship affect externalizing behaviors among migrant children through school attitude. High quality teacher student relationship and peer relationship might help to reduce externalizing behaviors among migrant children.

Objective To investigate the recent decade (1999 to 2009) incidence of committed suicide and attempted suicide of the Jinuo nationality in Jinuo Mountain and study the clinical characteristics of it. Methods 10 610 subjects at 44 Jinuo villagers committees were investigated by the method of door-to-door inquiry under the help of clues and collected the data of larithmics and medical history. Results 32 committed suicide patients were found in total, and the average incidence rate per year in the recent decade was 30. 16/100 000. 5 attempted suicide patients were found and the average incidence rate per year in the recent decade was 4.71/100 000. Conclusion The Jinuo committed suicide incidence rate is higher than nationwide level. The attempted suicide incidence rate is lower than nationwide level.

Objective To study the surgery effect on early application of toe flap to repair thumb severe electric bum.Methods From July 2007 to October 2017,a total of 25 cases of thumb severe electric burn were repaired by thumb toe flap grafting.The function of the finger after operation was evaluated comprehensively,and the effect of 72 hours before and after the injury was compared.Results All the flaps survived and the finger function was excellent.The excellent and good rate of 25 cases was 72％.The excellent and good rate of 72 hours before and after injury were 85.7％ and 54.5％ respectively.5 cases had bad wound complications after operation.1 cases were operated within 72 hours after injury,and 4 cases were operated after 72 hours.Conclusions The early application of toe flap to repair severe electric bum thumb can maximize the recovery of function of the thumb.The earlier the operation,the fewer complications,the better the repair effect.

To analyze the prevalence of motor cognitive risk syndrome （MCRS） and the decline of motor and cognitive function in elderly patients with small vessel disease （CSVD）. Methods From June 2018 to August 2020，a total of 130 CSVD patients aged 60～80 years admitted in the seventh medical center of PLA General Hospital were included （46 of them were diagnosed with MCRs syndrome）. A series of cognitive function and motor tests were examined，including mini mental state examination （MMSE），verbal fluency test （VFT），clock drawing test （CDT），trailmaking test Part B （TMT B），single task walking （STW），dual task walking （DTW） and dualtask cost （DTC）. Univariate analysis was performed for general and clinical data. Variables with P< 0.05 were further included in the multivariate Logistic regression analysis to assess the risk factors of MCRS. Univariate analysis also was performed for the cognitive and motor function of patients with different levels of SVD. Results The incidence rate of MCRs is about 35.38% （46/130）in the study. The cognitive function of MCRS negative group was significantly better than that of MCRS positive group，VFT［（ 17.695±4.069） vs. （16.083±3.319）］，and MMSE［28（28.29） vs. 27（26，27）］. Compared with MCRS negative group，the motor function differences in DTW speed［（90.500±21.138） vs. （65.417±17.301）］mm/s and DTC［ 12.425（ 5.845，18.985） vs. 16.190（9.605，22.925）］%. The multivariate Logistic regression analysis indicated that VFT（OR= 1.876，95%CI 1.329～2.648，P< 0.01），DTC（OR=0.900，95%CI 0.823～0.985，P=0.022），DWT speed（OR= 0.869，95%CI 0.809～0.933 P< 0.01），and MMSE（OR=0.055，95%CI 0.017～0.175，P< 0.01） was an independent risk factor of MCRs. After adjusting for age，gender，education level and coexisting diseases，VFT（OR=1.961，95%CI 1.276～3.014，P=0.002），DTW speed（OR=0.861，95%CI 0.767～0.966，P< 0.01），MMSE（OR=0.032，95%CI 0.007～ 0.146，P< 0.01）and DTC（OR=0.861，95%CI 0.767～0.966，P< 0.01）were still significant. Conclusion The cognitive and motor performance in MCRS positive group is significantly worse than that in MCRS negative group in CSVD patients. VFT，MMSE and DTW are influencing factors of MCRS. DTW is more likely to cause gait disorder，which is mainly manifested by the decrease of walking speed.