BACKGROUND:Implant stability is the basic requirement of osseointegration and also one of important parameters to judge whether the implant is implanted successfully. Generaly, the implant stability is closed related to bone quality (bone hardness and bone density) in the implant zone, implant shape, diameter and length. OBJECTIVE:To continuously monitor the changing trend of implant stability during early healing period due to the utilization of osteotome technique by resonance frequency analysis. METHODS:Twenty patients with class Ⅳ defects in the posterior maxila who underwent implant restoration (4.8 mm×12 mm) from 2010 to 2011 at the Department of Stomatology, the 521 Hospital of China North Industries Group Corporation were recruited. Resonance frequency analysis was used to measure the implant stability at implant insertion, 1, 2, 3, 4, 6, 8 and 12 weeks postoperatively. RESULTS AND CONCLUSION:Al the implants achieved osseintegration uneventfuly within 12 weeks. At implant instalation, the mean implant stability quotient value was 69.66±4.75. An increase trend in implant stability quotient values was visible within 1 week, and the implant stability quotient value reached the peaked at 1 week, and then decreased to the lowest point at 2 weeks, which were significantly different from that at implant instalation (P < 0.05). In the secondary stability phase, the increasing slope of implant stability quotient values reached a plateau by the 8th week. The resonance frequency analysis can estimate the quantitative change of implant stability after applying the osteotome technique, and the osteotome technique can promote the implant initial stability.

In order to effectively manage the atrial fibrillation patients, West China Hospital has established an integrated general-specialty management model within medical consortium. This model takes the atrial fibrillation-stroke integrated management outpatient clinic as the platform, combines general practice and specialty to provide standardized care for atrial fibrillation patients. The model was characterized by primary diagnosis, two-way referral, up and down linkage, and differential management for acute and chronic conditions. This article, taking West China Hospital as an example, introduces the integrated team of cardiologists and general practitioners in the tertiary hospital with general practitioners in the community, and the preliminary accomplishment in the management of atrial fibrillation within the medical consortium. It would provide a reference for the long-range management of atrial fibrillation in other provinces and cities.

Autism spectrum disorder（ASD）is a heterogeneous group of neurodevelopmental disorders.The prevalence of ASD increases year by year.Sleep disorder is the common comorbidity of ASD.The pathogenesis is still unknown.The imbalance of excitation / inhibition（E/I）and neuroplasticity changes are the possible pathogenesis of ASD.Early childhood sleep is an important factor affecting E/I balance and neuroplasticity.ASD and sleep disorder may share common pathogenesis.Various genetic variants（such as Shank3，SynGAP，et al）and related chromosomal disease（such as 16p11.2 deletion）and their associated syndromes such as Rett syndrome，Smith-Magenis syndrome，and Angelman syndrome，ect，all manifest both ASD and sleep disorder phenotypes.In addition，melatonin，oxytocin，hypothalamic hormone，serotonin，etc，may participate in the neural pathways of sleep disorder，ASD pathology and neuroplasticity，promoting the incidence of ASD and sleep disorder.Some treatments such as supplementing with melatonin，oxytocin，zinc，iron，and dietary supplements can improve the clinical symptoms of ASD while treating sleep disorder in children with ASD.This article reviews the mechanism of comorbid sleep disorder in children with ASD to improve clinical diagnosis and treatment.

Objective:To explore the clinical characteristics of pediatric glucose transporter type 1 deficiency syndrome (GLUT1 DS), evaluate the efficacy and safety of ketogenic diet therapy (KDT).Methods:Clinical data of 19 children with GLUT1 DS admitted to Children′s Hospital of Fudan University, Tianjin Children′s Hospital, Shenzhen Children′s Hospital, Children′s Hospital of Nanjing Medical University and Jiangxi Provincial Children′s Hospital between 2015 and 2019 were collected retrospectively. The first onset symptom, main clinical manifestations, cerebrospinal fluid features and genetic testing results of patients were summarized, the efficacy and safety of ketogenic diet treatment were analyzed. Results:Among the 19 cases, 13 were males and 6 females. The age of onset was 11.0 (1.5-45.0) months,the age of diagnosis was 54.0 (2.8-132.0) months. Epilepsy was the first onset symptom of 13 cases. Different forms of tonic-clonic seizures were the most common types of epilepsy (7 cases with generalized tonic-clonic seizures, 5 cases with focal tonic or clonic seizures, 4 cases with generalized tonic seizures). Antiepileptic drugs were effective in 4 cases. Paroxysmal motor dysfunction was present in 12 cases and ataxia was the most common one. All patients had different degrees of psychomotor retardation. Among 17 patients received cerebrospinal fluid examination, cerebrospinal fluid (CSF) glucose level was lower than 2.2 mmol/L and CSF glucose/glycemic index was<0.45 in 16 cases, only 1 case presented normal CSF glucose level (2.3 mmol/L) and normal CSF glucose/glycemic index(0.47). SLC2A1 gene mutations were found in 16 patients, missense, frameshift and nonsense mutations were the common types with 5 cases, 5 cases and 3 cases respectively. All 19 patients were treated with ketogenic diet, which was effective in 18 cases in seizure control, 11 cases in dyskinesia improvement and 18 cases in cognitive function improvement. No serious side effects were reported in any stage of KDT.Conclusions:The diagnosis of GLUT1 DS is often late. It is necessary to improve the early recognition of the disease and perform CSF glucose detection and genetic testing as early as possible. The KDT is an effective and safe treatment for GLUT1 DS, but a small number of patients have not response to diet therapy.