Syncope is a common emergency condition,which can cause harmful danger to the physical and mental health,quality of living and learning of children.Even,syncope -related body traumatic injuries and anxiety and depression often occur in these children,and some have a high risk of sudden death.So,early diagnosis is of great sig-nificance.Head -up tilt table test is considered the gold standard for the diagnosis of syncope,it plays a significant role in diagnosis,differential diagnosis,treatment and evaluation of therapeutic effects.

Objective: To investigate the occurrence of suspected adverse events following immunization (AEFI) in Wuyi County, Zheijang Province from 2018 to 2021, so as to provide insights into safety assessment of vaccination. Methods The AEFI data in Wuyi County from 2018 to 2021 were collected from the AEFI Information Management System and Immunization Information Management System of National Immunization Information Management System in China. The reported incidence of AEFI and epidemiological characteristics of cases with AEFI were analyzed in Wuyi County from 2018 to 2021 using a descriptive epidemiological method. Methods: The AEFI data in Wuyi County from 2018 to 2021 were collected from the AEFI Information Management System and Immunization Information Management System of National Immunization Information Management System in China. The reported incidence of AEFI and epidemiological characteristics of cases with AEFI were analyzed in Wuyi County from 2018 to 2021 using a descriptive epidemiological method. Results: A total of 870 007 vaccine doses had been administered in Wuyi County from 2018 to 2021, and a total of 482 AEFI were reported, with annual mean reported incidence of 55.40/105. The incidence of AEFI associated with vaccines included in the national immunization program was significantly higher than those not included in the national immunization program (67.75/105 vs. 44.00/105; χ2=20.334, P<0.001). There were 435 individuals with general reactions (50.00/105 incidence), with high fever, local redness and swelling and solid nodes; 39 cases with abnormal reactions (4.48/105 incidence), including 87.18% allergic reactions; 7 cases with coincident syndrome and one case with psychogenic reaction; however, no vaccine quality or vaccination events were reported. The five vaccines with the greatest incidence of AEFI included 13-valent pneumococcal polysaccharide conjugate vaccine (269.11/105), diphtheria and tetanus toxoids and acellular pertussis, inactivated poliovirus and Haemophilus b conjugate vaccine (204.23/105), 23-valent pneumococcal polysaccharide vaccine (175.85/105), tetanus, diphtheria, acellular pertussis vaccine (128.39/105) and combined live vaccine for measles, mumps and rubella (124.36/105). The reported incidence rates of AEFI were 10.89/105, 49.88/105, 56.07/105 and 57.78/105 following oral, intradermal, subcutaneous and intramuscular administrations, respectively. In addition, AEFI were predominantly found to occur in patients at ages of 0 to <2 years (333 cases, 69.09%), and AEFI predominantly occurred <1 day following immunization (336 cases, 69.71%). Conclusions General reactions were predominant types of AEFI following vaccination in Wuyi County from 2018 to 2021, and the reported incidence of AEFI associated with vaccines included in the national immunization program was significantly higher than those not included in the national immunization program. AEFI mainly occurred among children under 2 years of age.

Objective To observe the therapeutic efficacy of Tiao Shen Tong Luo (regulating mind and unblocking collaterals) needling plus hyperbaric oxygen in treating leukoaraiosis (LA) coupled with mild cognitive impairment (MCI). Method Totally 112 patients with LA and MCI were randomized into a treatment group and a control group. In addition to the basic treatment, the treatment group was intervened by Tiao Shen Tong Luo needling plus hyperbaric oxygen, while the control group was given hyperbaric oxygen. The scales and event-related potential (P300) were evaluated and compared before and after the intervention. Result The scales scores and P300 were significantly changed in both groups after the treatment, and the therapeutic efficacy was higher in the treatment group than in the control group (P<0.05). Conclusion In addition to the basic treatment, Tiao Shen Tong Luo needling plus hyperbaric oxygen can produce a significant efficacy in treating LA couple with MCI.

Objective To observe the efficacy of Botulinum toxin type A(BTXA)injection in Meige's syndrome and facial wrinkles and exp lore the method of reducing the side e ffect of BTXAand weaken facial wrink les.Methods Ninety-nine patients were evaluate d on the therapeutic efficacy of single and multiple topical facial in-jection with BTXA.Results The effective rates of patients with blepharospasm were 98.4%,oromandi bular dystonia 90.9%,blepharospasm and o romandibular dystonia 95.8%,respectively.The therapeutic effect for each disease lasted(16.9?8.4)weeks?(12.6?5.4)weeks and(13.5?5.7)weeks,respectively.Facial wrinkl es of all patients has got weakened and seemed much smooth and flattend.The rec overy rate approached to 100%.The local side effects were transient an d mild,and disappeared spontaneously.Conclusions The treatment of Meige's syndrome and facial wrinkles with BTXA could produce a significant impro vement,and is safe.Strictly observ e the procedures of injection,and use adequate dose of BTXA,the side effects o f BTXA can be decreased.

Objective To investigate the efficacy and safety of repeated botulinum toxin type A (BTX-A) treatment for Meige's syndrome in senile people. Methods Forty-eight senile patients with Meige's syndrome received BTX-A treatment for twelve times or over. The improvements of spasm were evaluated before and after the first, the sixth and the twelfth treatment according to Cohen's criteria. The onset time, effective duration and side effects were studied and compared among the three times treatments. Results The obvious effective rate of the three times treatment were all 100%. The average onset time of the three times treatments were (3.5± 1.7)days,(3.2±1.8)days and (3.3±1.9)days, and the average effective duration were (25.4±2.1)weeks,(24.6±2.3)weeks and (25.4±1.8)weeks, respectively. The incidences of side effects were 8. 3% (4/48), 6.3(3/48)%and 8.3%(4/48), respectively. All the differences were not statistically significant(P>0.05). Conclusions Repeated BTX-A treatment is an effective and safe method for Meige's syndrome in senile people.

In recent years, the systematic treatment of liver cancer has made significant progress, but surgical resection remains as main treatment to obtain long-term survival for patients with liver cancer. With the rapid development of liver surgery, the complexity of liver anatomy and surgical operation are no longer the main obstacles to liver surgery. The insufficient future liver remnant (FLR) after hepatectomy has become the main limit of liver surgery. In clinical practice, most patients with liver cancer cannot undergo one-stage radical resection and can only receive non-surgical treatment, with poor long-term prognosis. The associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) provides hope for the treatment of liver cancer patients with insufficient FLR. ALPPS can induce significant hypotrophy of the FLR in a short period of time, and the radical tumor resection rate is as high as 90% to 100%, which significantly improves the prognosis of patients. However, in the early stages of the practice, there were considerable controversies on the safety of the operation. In recent years, with the continuous advancement of technology, the safety of ALPPS has been greatly improved. The authors synthesize the latest literatures and elaborate on the latest progress of ALPPS.

[Summary] Glucose-dependent insulinotropic polypeptide ( GIP) is known to promote the release of insulin fromβcells, but this function suffers from a defect in obese patients. More and more evidences suggest that GIP is the bridge between a high-fat diet, obesity, insulin resistance, and type 2 diabetes. With the deepening of research in GIP in type 2 diabetes and obesity, GIP may provide new ideas for the treatment of type 2 diabetes and obesity.

Objective:To evaluate the biocompatibility of insulin-like growth factor I (IGF-1) gene transfected bone marrow stem cells (MSCs) with ostrich true bone ceramic (OTBC). Methods:Rat MSCs were transfected with IGF-1 gene, and positive clones were selected by G418. The expression of IGF-1 protein in the MSCs was detected by immunocytochemical technique. The IGF-1 transfected MSCs were cultured with OTBC and the morphology of the cells was observed by scanning electronic microscope(SEM) at different time point. Results:Immunohistochemical staining suggested that the IGF-1 protein was expressed in the IGF-1 transfected MSCs. The cells adhered to OTBC and stretched well after 24 h of culture. The IGF-1 transfected MSCs proliferated on the surface of OTBC with culture time.Conclusion:The OTBC has a good biocompatibility with IGF-1 transfected MSCs.

ObjectiveTo investigate the risk factors for syncope in children with orthostatic intolerance (OI).Methods The clinical data from 136 children with OI were retrospectively analyzed. The children were divided into syncope group and non-syncope group based on the existence of syncope. Results Among the 136 children, 77 children (56.62%) had syncope and 59 children (43.38%) did not have syncope. The differences in BMI, prevalence of inducement of prolonged standing, prevalence of accompanied symptoms of blurred vision/ blacking out, cold sweating and pallor, prevalence of the history of motion sickness and blood flow velocity of MCA were statistically significant between two groups (P<0.05). Conclusions Children with OI who has low BMI, inducement of prolonged standing, accompanied symptoms of blurred vision/ blacking out, cold sweating and pallor, the history of motion sickness, and fast blood flow velocity of MCA, are prone to syncope.

Objective To explore an anatomical basis for the medial plantar skin flaps and its clinical value of repairing heel defects. Methods The origin,branches,course and distribution of the medial plantar artery and the nerve of flaps were studied in 10 adult cadavers(20 legs).8 cases of homonymy and opposite side heel soft tissue defects with medial plantar skin flaps,aged 10-42 years.Free skin transplantation on the donors. Results The length of media plantar artery deep branch was (8.9±0.2)cm,gives off 3-5 cutaneous branches.Medial plantar nerve have 5-8 branches.it inchdes 3～5cutaneous branches distribute plantar skin and 2-4 plantar digital nerves distribute toes skin.The area of flaps was 4.0 cm×3.0 cm-6.0 cm×5.0 cm in the 8 flaps. 6 pedicle skin flaps were transfenrred to repair homonymy side heel soft tissue defects.2 opposite side heel soft tissue defects were repaired by 2 free flaps.All the flaps were survived. All patients were followed up one months to one year,the function and appearance of the flaps were good.Conclusion The flaps have less anatomic variation or sacrificing major vessels but have reliable blood supply and can restore good sensation after operation.They are ideal flaps for repairing heel soft tissue defects.