Objective To develop a sandplay analysis evaluation matrix for children with tic disor?ders. Methods 113 children were chosen as the study subjects . Based on the grounded theory,the open coding,correlated coding and core coding were carried out on coding elements for sandplay process to gain the third?level,second?level and first?level evaluation codes. The reliability and validity of the codes were tested.Results The sandplay analysis evaluation matrix for children with tic disorders was established inclu?ding 48 third?level,17 second?level and 3 first?level evaluation codes. The codes were proved to be reliable and valid through the comparison and conditional coding with query. Conclusion The sandplay analysis e?valuation matrix for children with tic disorders,which is established based on the grounded theory,is reliable and operable. It can be used as a tool to assess the psychological or behavioral problems of children with tic disorders dynamically.

Objective To characterize 15 months later the quality of life (QOL) and depression of those with spinal cord injury (SCI) suffered during the Wenchuan earthquake,and to identify the influence factors.MethodsA sample of 27 individuals who sustained SCI during the Wenchuan earthquake were surveyed using face- to-face interviews.QOL was measured using the brief version of the World Health Organization's Quality of Life Assessment instrument.Depression was measured using the patient health questionnaire depression module 9.Stepwise multiple linear regression was employed to determine the factors most closely related with QOL and depression. ResultsStepwise linear regression showed a significant correlation of overall QOL with literacy and age.The younger or illiterate victims showed a lower overall QOL.General health was also associated with ability in the activities of daily living and with pain.Victims with better daily ability and less pain may have had better general health.Depression correlated with literacy and secondary condition.Illiterate patients or patients influenced more by a secondary condition displayed more serious depression than the others.Additionally,social participation was significantly associated with the physical health,psychological health and social relationships domains of QOL.ConclusionThe QOL of long-term SCI victims caused by the earthquake is closely related to age,literacy,pain,participation and physical independence.Depression is associated with illiteracy and secondary conditions.Attention should be paid to these correlations in designing long-term rehabilitation strategies.

OBJECTIVE:To systematically evaluate the efficacy and safety of prostaglandin E1 combined with hydration for the prevention of contrast-induced nephropathy(CIN)and provide evidence-based reference for the clinical treatment. METHODS:The PubMed,Medline (Ovid),EMbase (Ovid),Cochrane Library,VIP,CJFD and WanFang database were retrieved to collect the randomized controlled trails(RCT)of prostaglandin E1 combined with hydration for the prevention of CIN. After information collec-tion and methodology quality evaluation,the Meta-analysis was performed using Rev Man 5.3 software. RESULTS:12 RCTs involv-ing 1 732 patients were included. The results of Meta-analysis showed that the incidence of CIN in test group was significantly low-er than control group[RR=0.40,95%CI(0.30,0.53),P<0.001],the incidence of phlebitis was higher than control group [RR=10.18,95%CI(1.37,75.67),P=0.02] and there was no significant difference in the need rate of renal replacement between test group and control group[RR=0.44,95%CI(0.12,1.61),P=0.21]. CONCLUSIONS:Intravenous prostaglandin E1 combined with hydration can effectively reduce the incidence of CIN. Occurance of phlebitis should be paid attention to. Due to the limited quality and sample of included studies,it remains to be further verified by high-quality and large-sample RCT.

There are a lot of feasibility studies, using sentinel lymph node biopsy SLNB instead of Alex lymph node dissection (ALND), having got a conseusus that SLNB is a safe and useful method in the treatment of breast cancer. But in clinical practice, there are much false negative rate (FNR) which need to be carefully dealt with for SLNB. In order to diminish the FNR, how many nodes should be the perfect number to lower the FNR? If positive detection was found in the SLN, should ALND always be needed? And when micro metastasis was found in the post operation HE staining? Does it need further treatment? We make a review to discuss those matters.

Background Researchers are paying increasing attention to the effect of cellular senescence in vascular dysfunctional diseases,and it is hypothesized that cellular senescence may also be involved in the development of diabetes related vascular complications.The outstanding feature of cellular senescence is the upregulation of beta-galactosidase.Objective This study was to investigate the effects of high glucose on cell senescent in vitro and in vivo on bovine retinal endothelial cells (BRVECs) and mouse retina.Methods BRVECs were cultured and passaged,and the seventh generation of cells were employed in this study.The cells were divided into the control group and the high glucose culture group and cultivated using M199 medium containing 5.5 mmol/L or 25.0 mmol/L glucose,respectively.5-bromine-chlorine-4-3-indole-beta D galactose glucoside (X-Gal) staining was used to examine the expression of beta-galactosidase in the cells.Diabetic models were established in the SPF male C57BL/6J mice aged 8-10 weeks by intraperitoneal injection of streptozotocin (STZ),and the age-and gendermatched normal mice served as controls.The mouse retinas were collected and starched in the 48-well plates 3 months later.X-Gal staining was employed to calculate the positive cells.Results BRVECs grew well 24 hours after culture but showed irregular arrangement.Forty-eight hours later,the cells reached confluence with a tight connect.The ratios of positive BRVECs and total cells were (51.4±5.4) ％ and (36.6-±3.8) ％ in the high glucose culture group and the control group,with a significant difference between the two groups (t =-3.204,P =0.033).The number of positive cells for X-Gal in mouse retinas was (94.0± 15.1) /field in the diabetic group,which was higher than that in the control group ([60.0 ± 5.7]/field) (t =-2.974,P =0.041).Conclusions High glucose environment accelerates senescence of retinal cells,and high glucose induces premature cell senescence,which likely plays an important role in the pathogenesis of diabetic retinopathy.

【Objective】 To establish an ARIMA model suitable for clinical platelet demand prediction in Suzhou, which can be used as reference to predict future clinical platelet demand and provide scientific basis for platelet collection, preparation, stock management and clinical deployment for blood banks, so as to achieve the maximum balance between platelets supply and demand . 【Methods】 The data of platelet consumption in Suzhou from 2009 to 2019 were collected and analyzed by SPSS 26 software, Time series analysis method was used to establish the ARIMA model. The model was further optimized through model identification, parameter estimation and optimal model test, and then used to predict clinical platelet consumption from January to November 2020. The predicted value was compared with the actual value to verify the prediction effect of the model. 【Results】 The optimal model for the prediction of platelet clinical demand was ARIMA (0, 1, 1) (0, 1, 1) 12. The ACF autocorrelation function value and PACF partial autocorrelation function value of the residuals were within 95% CI. Meanwhile, the LJUNG BOX test was 13.982 (P>0.05), indicating that there was no autocorrelation in the residuals. The trend of the curve between the predicted and actual value was basically the same(except for February 2020), and the predicted values were within 95% CI, with the average relative error of 7.22%, which was lower than 10%, showing good prediction effect. 【Conclusion】 ARIMA model can be used for short-term prediction of clinical platelets demand in Suzhou, and can provide basis for reasonable collection, preparation and deployment of platelets.

Objective To analyze the outcomes of clinical management and rehabilitation interventions for earthquake victims with spinal cord injury. Methods Comprehensive rehabilitation intervention was conducted for 3 to 4 months with 51 earthquake victims with spinal cord injuries. The study involved their physical examination and on site interviews during hospitalization, and follow-up by telephone. Etiology, severity, complications and outcomes of rehabilitation and clinical management were analyzed. Results In 9.8% of the patients the spinal cord injury was at C7 or above, 5.9% at C8 to T6 , 68.6% at T7 to L2 , 13.7% at L3 to S2 and 2.0% at S2 or below. There were 22 complete injuries and 29 incomplete. After 4 months of training, 76.5% of the wounded reached wheelchair independence, 78.4% ambulated with an orthosis and 88.2% were partially independent in the activities of daily living.Conclusions The comprehensive rehabilitation intervention allowed most of the victims to resume an independent life. Their long-term care remains a challenge.

Objective To analyze clinical and genetic risk factors of refractory or relapsed acute myeloid leukemia (AML) patients,and evaluate the efficacy of reinduction of chemotherapy.Methods 296 newly diagnosed AML patients,including 89 refractory or relapsed cases,were observed with clinical characteristics.And the efficiency of different reinduction chemotherapy regimens were compared.Results Compared with the non-refractory or relapsed AML,age,complex karyotype and Fms like tyrosine kinase 3 internal tandem duplication (FLT3-ITD) gene mutations were risk factors of relapsed or refractory AML (P ＜ 0.05).Seventy-eight refractory and relapsed AML patients received reinduction therapy.The overall response rate (the complete response rate and the partial response rate) was 44.90 ％ (30/78).All reinduction regimens were divided into three categories:using the initial induction scheme or using new induction scheme including some chemotherapeutics without cross-resistance (regimen A),using the induction regimen containing medium-or high-dose cytarabine (regimen B),and using priming regimen containing of G-CSF,cytarabine,aclacinomycin or homoharringtonine (regimen C).Their overall response rate were 35.12 ％ (13/37),61.90 ％ (13/21) and 45.00 ％ (9/20),respectively,in which the overall response rate of regimen B was statistically higher than regimen A (P ＜ 0.05).Conclusions Age,complex karyotype and FLT3-ITD mutation were important causes of relapsed or refractory AML.The overall response rates were different among three different reinduction regimens.It is helpful to improve the overall response rate of reinduction therapy to use the regimen containing medium-or high-dose cytarabine,which was more suitable for young patients.For patients with poor tolerance,the priming regimen suit was more helpful to improve the overall response rate.

Objective To analyze factors contributing to the quality of life of earthquake victims with nonunion fracture in limbs after medical rehabilitation and to provide a clinical reference for future disasters.Methods Thirty-one wounded who sustained their injuries in the Sichuan earthquake completed the short form-36(SF-36)questionnaire 2 weeks before their amputation,and after 3,6 and 12 months of medical rehabilitation.The SF-36scores were compared with Sichuan population norms.Stepwise multiple linear regression was used to highlight variables which influenced their functional recovery and their physical and mental health.Results The physical and mental health composite scores of the 31 victims were significantly lower than Sichuan population norms before medical rehabilitation,but they had a significant increasing trend after 3,6 and 12 months of treatment.Their scores on all the domains remained significantly lower than Sichuan population norms at a later follow-up.Smoking,external fixations and chronic diseases were related to their recovery of physical function.Age,permanent housing,family income and casualties among family members were related to their mental health recovery.Conclusion The quality of life of patients with nonunion fracture caused by earthquake can be improved significantly through medical rehabilitation.But social factors should be considered in addition to medical rehabilitation after an earthquake.

OBJECTIVE: To analyze the role and significance of pepsin and pepsinogen in the pathogenesis of OME in children. METHOD: Pediatric patients with otitis media aged 2-8 years who enrolled in our department of the hospital from May of 2012 to December of 2012 were set as experimental group (38 cases, 48 ears) which should be underwent tympanic membrane puncture/tube insertion. Meanwhile, pediatric patients waiting for cochlear implant without otitis media (10 ears), were set as control group. Middle ear lavage fluid and plasma samples from the two groups were collected and detected using enzyme-linked immune method for pepsin and pepsinogen. RESULT: The concentrations of pepsin and pepsinogen in the middle ear lavage fluid of OME group [(48.8 ± 415.99) ng/ml and 676.32 ± 336.71)ng/ml] were significantly higher than those in the control group [(8.20 ± 4.59)ng/ml and (77.27 ± 50.33) ng/ml] (P < 0.01). Meanwhile, the concentration of pepsinogen in the middle ear lavage of OME patients was significantly higher than that of plasma (P < 0.01). The concentration of pepsin in the middle ear lavage fluid from the dry ear subgroup was lower than those in the serum ear and mucous ear subgroups (P < 0.01), but there was no significant difference about concentrations of pepsinogen among the dry ear, serum ear and mucous ear subgroups (P > 0.05). CONCLUSION Pepsin and pepsinogen in the middle ear cavity of OME patients maybe originated from laryngopharyngeal reflux (LPR), indicating that LPR is associated with the pathogenesis of OME in children.
Child ; Child, Preschool ; Ear, Middle ; metabolism ; Enzyme-Linked Immunosorbent Assay ; Humans ; Laryngopharyngeal Reflux ; physiopathology ; Otitis Media with Effusion ; metabolism ; Pepsin A ; metabolism ; Pepsinogen A ; metabolism ; Tympanic Membrane ; surgery