Objective To investigate the clinical features of patients with multiple sclerosis (MS) and restless legs syndrome (RLS) and to further examine relevant factors that may contribute to the co-occurrence of MS and RLS.Methods Seventy MS patients were recruited in the present study.The RLS screen was further performed in MS patients based on the diagnostic criteria for RLS.MS patients with RLS were designated as the case group and MS patients without RLS served as the control group.The clinical data including age of MS onset,MS duration and clinical disability by the expanded disability status scale (EDSS) were analyzed.Results There were 12 MS patients with RLS in total 70 MS patients and the incidence rate was 17.1％.The average age of MS onset in the RLS group was (47.6 ± 10.0) years,and (40.1 ± 10.4 ) years in the control group.The difference of average age of MS onset was found to be significant (t =2.29,P =0.030).The average history of MS in the RLS group was ( 12.6 ± 6.8 ) years,and ( 8.2 ± 6.6) years in the control group ( t =2.10,P =0.039).The average EDSS of the RLS group was 4.5 ±2.5,and 2.5 ±2.0 in the control group (t =3.02,P =0.004).There was no significant association between RLSRS and EDSS in MS patients with RLS (P =0.15).Conclusion The incidence rate of RLS in MS patients was high.Among patients with MS,RLS was associated with older age,longer MS duration,and more severe disability.

Objective:To summarize the clinical experience of changing the membranous pulmonary system during extracorporeal membrane oxygenation(ECMO) in infants after congenital heart disease opration with cardiopulmonary bypass.Methods:From January to September in 2019, 6 cases of congenital heart disease with cardio-pulmonary bypass in our hospital were analyzed retrospectively, whose membrane obstruction occurred during ECMO treatment and replaced successfully.The hemodynamics and blood gas before and after replacement of ECMO system were observed, and the experience was summarized.Results:Six patients(3 males and 3 females), aging from 1 to 3 months and weighing from 3.0 to 4.9 kg, were received VA-ECMO adjuvant therapy.The ECMO system replacement process was smooth and took 175-209 s. The hemodynamic of the children was stable.The ECMO support time was 134-249 h. After the improvement of cardiac systolic function, all children were successfully withdrawn and survived.Conclusion:The improved method of liquid replacement in ECMO system can make full use of the blood components in the original system and avoid the loss of blood tangible components.According to the plan of rapid replacement, the risk of replacement will not be increased.

Objective To evaluate the effects of processing banked suspended red blood cells (RBCs) with cell saver before priming on perioperative systemic inflammatory responses of infants undergoing cardiac surgery under cardiopulmonary bypass (CPB).Methods Forty pediatric patients of both sexes,aged 3 months-2 yr,weighing 5-13 kg,of American Society of Anesthesiologists physical status Ⅱ-Ⅳ,undergoing repair of atrial or ventricular septal defect under CPB,were divided into control group (group C,n =20) and processing group (group P,n =20) using a random number table.Banked suspended RBCs were primed directly after being added to CPB circuit in group C.Banked suspended RBCs were washed with cell saver and then primed after being added to CPB circuit in group P.At 5 min before skin incision,at 30 min after the start of CPB,at 10 min after aortic unclamping,immediately after the end of CPB and at 6,12 and 24 h after the end of CPB (T1.7),blood samples were collected from the radial artery for determination of the concentrations of tumor necrosis factor,interleukin-1β (IL-1β),IL-6,IL-8,IL-10 and neutrophil elastase in plasma by enzyme-linked immunosorbent assay.Blood samples were taken from the radial artery at T1 and T4.7 for measurement of blood routine and plasma acute phase reactive protein concentrations.Results Compared with group C,the concentrations of tumor necrosis factor,IL-1β,IL-6,IL-8 and neutrophil elastase in plasma were significantly decreased at T6,7,the total number of white blood cells,neutrophil count and concentration of plasma acute phase reactive protein were decreased at T7,and duration of stay in intensive care unit was shortened in group P (P＜0.05).Conclusion Processing banked suspended RBCs with cell saver before priming can reduce perioperative systcmic inflammatory responses of infants undergoing cardiac surgery under CPB.

Objective To assess the prognostic value of HER2 (human epidermal growth factor receptor-2) somatic mutations S310F and V777L in breast cancer patients.Methods HER2 somatic mutations S310F and V777L was screened in 338 consecutive patients with operable primary breast cancer using direct Sanger sequencing analysis.Results A total of 12 carriers of HER2 gene S310F and V777L mutations were found,10 were HER2-negative and 2 were HER2-positive.The median follow-up was 43 months (range from 1 to 61 months).4 were found with local or distant metastasis,and all were HER2-negative patients.Survival analysis found significantly lower survival rates in patients with S3 10F and V777L mutations than in non-carriers (RFS,unadjusted hazard ratio [HR]:5.89,95％ confidence interval [CI]:1.96-17.71,P ＜ 0.001;DRFS,unadjusted HR:5.53,95％ CI:1.56-19.55,P =0.003) and this difference was more manifest in the HER2-negative patients (RFS,unadjusted HR:8.93,95％ CI:2.79-28.62,P ＜ 0.001;DRFS,unadjusted HR:9.89,95％ CI:2.54-38.49,P ＜ 0.001).HER2 somatic mutations S310F and V777L are independent predictors of poor prognosis in breast cancer.Conclusion The prognosis of breast cancer patients carrying HER2 somatic mutations S310F and V777L is significantly worse than that of non-carriers,especially in HER2-negative patients.

Objective:To compare the curative effects of different venous cannulas and drainage to improve patient's whole body oxygenation during the auxiliary process of venous-arterial extracorporeal membrane oxygenation (VA-ECMO) in lung transplantation.Methods:From December 2016 to December 2019, 12 patients who were assisted by VA-ECMO in one lung transplantation in People's Hospital of Henan Province were selected as the research objects. According to the number of side holes of venous cannulas, they were divided into two groups: one group with few side holes and other group with multiple side holes. The differences in blood gas indexes among the right radial artery, left radial artery, and right internal jugular vein before and after assistance were compared, and the assistance effect was evaluated.Results:The arterial partial pressure of oxygen (PaO 2) of blood gas indexes of the right and left radial arteries in both groups were significantly higher than that before assistance [mmHg (1 mmHg = 0.133 kPa): right and left radial artery in few side holes group: 79.5±4.2 vs. 48.3±3.8 and 88.1±3.5 vs. 48.3±3.8; right and left radial artery in multiple side holes group: 67.7±5.9 vs. 48.7±3.2 and 84.0±3.8 vs. 48.7±3.2, all P < 0.05]. The arterial partial pressure of carbon dioxide (PaCO 2) of blood gas index was significantly lower than that before assistance (mmHg: 44.2±2.6 vs. 71.7±4.4 for the right radial artery and 44.7±1.4 vs. 71.7±4.4 for the left radial artery in the group with few side holes; 46.2±2.1 vs. 71.2±3.5 for the right radial artery and 44.1±1.9 vs. 71.2±3.5 for the left radial artery in the group with multiple side holes, all P < 0.05). The partial pressure of oxygen in venous blood (PvO 2) of blood gas index of ECMO system in the group with few side holes was significantly lower than that of the multiport side holes group (mmHg: 56.4±3.2 vs. 88.7±1.5, P < 0.01), and the partial pressure of carbon dioxide in venous blood (PvCO 2) was significantly higher than that of multiport side holes group (mmHg: 63.6±3.7 vs. 44.2±1.7, P < 0.01). Conclusions:When VA-ECMO is used in lung transplantation, the superior vena cava blood flow can be fully drained by using intravenous cannula with few side holes. It can effectively improve the oxygenation of the upper body of lung transplant patients, avoid the dilemma of hypoxemia in the upper body and hyperxemia in the lower body, provide more effective assistance to patients undergoing single lung transplantation, and is more meaningful for improving the oxygenation status of the whole body in patients undergoing single lung transplantation.