Objective To study the effect of the toothpaste containing FE enzyme on oral care to for critically ill patients with stroke. Methods Sixty cases of critically ill stroke patients were randomly divided into the experiment group and the control group with 30 cases in each group.The toothpaste containing FE enzyme was used in experiment group for oral care,and the routine oral care was used in the control group.The two groups were compared in terms of the oral cleaning effect,dental plaque and costs for the oral care.Results The incidences of bad breath,oral uncleanness and oral infection were significantly lower than those of the control group(P<0.01 or P<0.05). The dental plaque index after oral care was significantly lower in the experiment group than that in the control group(P<0.001).The cost in the experiment group was significantly lower than that in the control group(P<0.01).Conclusion Oral care using toothpaste containing FE enzymecan not only achieve an effective oral cleaning purpose,but also reduce the cost of oral care.

Objective To explore the value of echocardiography in evaluation of pulmonary venous in total anomalous pulmonary venous connection (TAPVC).Methods Fifty-five children with TAPVC were enrolled in the study.The data of echocardiography and CT angiography were retrospectively analyzed and compared with intraoperative findings.Results Totally 55 patients with TAPVC were classified into supra-cardiac type (n=24),cardiac type (n=20),infra-cardiac type (n=7) and mixed type (n=4) according to the sites of drainage of pulmonary venous in echocardiography.In 15 patients with obstruction of pulmonary vertical vein,the sites of obstruction in the supra-cardiac type mostly presented between vertical vein and superior vena cava or innominate vein,and the sites of obstruction in the infra-cardiac presented all between vertical vein and hepatic or portal vein.In 4 patients with pulmonary vein stenosis,3 cases with local pulmonary vein stenosis were all cardiac type,which presented between individual pulmonary vein and common confluence or right atrium;1 patient with diffuse pulmonary vein stenosis was infra-cardiac type.In 9 patients of abnormal individual pulmonary vein,8 cases were not detected by echocardiography,but all were detected by CT angiography.Conclusion Echocardiography is able to make more comprehensive evaluation for the pulmonary venous drainage,obstruction,and proximal stenosis of individual pulmonary vein in TAPVC.CT angiography is superior in evaluation of abnormalities of connection and amount of individual pulmonary vein,and imaging of distal pulmonary vein.

Objective To study the surface electromyographic signal characteristics of submental and infrahyoid muscles when swallowing in patients with nasopharyngeal carcinoma (NPC) following radiotherapy.Methods Fifteen post-radiotherapy NPC patients with pharyngeal dysphagia confirmed by videofluoroscopie swallowing study (VFSS) were selected into the patient group,while another 15 healthy subjects were recruited into the healthy group.Surface electomyography (sEMG) was used to collect sEMG signals from submental muscles and infrahyoid muscles during both dry and 3 ml thick liquid swallowing,and sEMG duration,average amplitude and peak amplitude parameters were compared between the two groups.Results Compared with healthy subjects,the patient group showed significantly longer sEMG duration of submental muscles and infrahyoid muscles during dry swallowing and 3 ml thick liquid swallowing (P＜0.05).Moreover,significantly longer sEMG duration of submental muscles and infrahyoid muscles was observed when swallowing 3 ml thick liquid,compared with dry swallowing (P＜0.05).The average sEMG amplitude and peak amplitude of submental muscles and infrahyoid muscles of patients when dry swallowing and 3 ml thick liquid swallowing were both significantly higher than those of healthy subjects (P＜0.05).Conclusion Submental muscles and infrahyoid muscles manifested enhanced contractions during swallowing in NPC patients with dysphagia,which played a compensatory role after radiotherapy.

Triple positive breast cancer overexpress ER (estrogen receptor), PR and HER2 (human epidermal growth factor receptor 2, HER2), accounting for about 50%-60% of the HER2 positive breast cancer patients. Based on the data from clinical trials, the crosstalk between the ER signaling pathway and the HER2 signaling pathway in triple-positive breast cancer may weaken the efficacy of anti-HER2 therapy and endocrine therapy, and this feature has attracted widespread attention. Emerging evidence shows that while blocking HER2 signaling pathway, together with enhancing blocking of ER signaling pathway, such as anti-HER2 dual-targeting + endocrine therapy ± CDK4 / 6 inhibitors, could effectively overcome drug resistance, and improve the efficacy. Predictive biomarkers including Ki67, intrinsic subtypes, and multi-gene assay, which have the potential benefit for personalized treatment.