Objective:To seek the possibility of using internally installed curved mandibular distractor to repair the partial mandibular curved defect.Methods:A curved mandibular defect was sectioned in each of 3 adult dogs.The distractor designed by our own group based on the steel ball conducted force was implanted.After 7 days of latency,the distraction was performed at the rate of 0.5 mm × 2 times per day,followed by 3 months consolidation period.The osteogenesis was evaluated by general observation,X-ray examination and HE staining.Results:No complication was observed after operation and during distraction.The new bone healed well into a curved shape.The X-ray examination revealed that the transport disc moved along with the predesigned rail curve.HE staining clearly showed neo bone formulation zone between the mature trabecular and connective tissue.Conclusion:The internal distractor based on the steel ball conducted force can realize the curved distraction osteogenesis of posteriormandibular.

Objective To explore unexplained syncope (UPS) morbidity of elementary and middle school students in Changsha city.Methods Four thousand two hundred and fifteen students aged 5 to 18 years from six fulltime elementary or middle schools were randomly selected and the survey was conducted by giving them 4 215 copies of questionnaires and they were categorized into 3 groups:key school group(n =1 062),normal school group(n =1 310) and peasant laborer dependent's school group (n =1 349).Three thousand seven hundred and twenty-one copies of returning questionnaires (88.28％) were collected.Results 1.Morbidity:among 3 721 students there were 738 students(19.83％) who had once or more symptom of UPS.And the morbidity of middle school students was higher than elementary school students (28.87％ vs 7.96％,x2 =252.11,P ＜ 0.01).The morbidity of key school students was higher than normal school and peasant laborer dependent's school students (25.99％ vs 16.34％ vs 18.38％,x2 =40.93,P ＜ 0.01).2.Onset age:the onset age of UPS was 6-18 (14.23 ± 2.70) years old.3.Gender difference:for the middle school group,the morbidity of female students was higher than male students(31.34％ vs 26.49％,x2 =6.06,P ＜ 0.05).But for the elementary school group (male 9.04％ vs female 6.68 ％,x2 =2.85,P ＞ 0.05) and the total secondary school students (male 18.67％ vs female 21.12％,x2 =3.51,P ＞ 0.05),there was no significant difference between genders.Conclusions The UPS morbidity of students in Changsha is 19.83％.There are differences in age,school and gender.

Objective To evaluate the value of diffusion tensor imaging (DTI)in diagnosing MCI.Methods DTI and conventional MRI were performed in 26 patients with MCI and 26 age-matched normal control subjects (NC).FA were measured in the 10 select-ed white matter regions,included bilateral frontal lobe,temporal lobe,parietal lobe,parahippocampal gyrus and cingulate gyrus,in the patients with MCI (n=26)and NC (n=26).FA of each ROI (region of interest)between the patients and controls were com-pared by using independent sample t-test.The correlation between the FA values and the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA)scores was analyzed by using Spearman correlation analysis.Results Compared with NC,the FA values of the right frontal lobe,temporal lobe white matter and bilateral cingulate gyrus in the patients were significant-ly reduced (P <0.05).FA values of the left temporal lobe,right frontal lobe and bilateral parahippocampal gyrus were significant correlated with MoCA scores,and FA values of the bilateral parahippocampal gyrus were significant correlated with MMSE scores (P <0.05).Conclusion DTI can be used as a diagnosis index of MCI.It has important value in early intervention and improving the quality of life of patients to early diagnosing MCI.

Objective To discuss the treatment experience of adrenocorticotropic hormone independent macronodular adrenal hyperplasia (AIMAH).Methods The clinical data of 24 cases of AIMAH from August 1972 to December 2016 were retrospectively analyzed.The cases included 10 males and 14 females with a mean age of 43 (range 26 to 59) years.16 patients presented with typical Cushing syndrome (CS) and 8 patients had weight gain, hypertension or diabetes mellitus without any sign of CS.The circadian rhythm of serum cortisol was abnormal.Low and high dose dexamethasone suppression tests failed to suppress cortisol secretion.The preoperative CT scan showed bilateral enlargement of the adrenal glands with multiple macmnodules.14 patients underwent open surgery, including 5 cases of unilateral adrenalectomy, 6 cases of adrenalectomy combined with contralateral subtotal adrenalectomy and 3 cases of bilateral adrenalectomy simuhaneously.6 patients underwent conventional laparoscopic adrenalectomy,including 2 cases of unilateral adrenalectomy, 2 cases of adrenalectomy combined with contralateral subtotal adrenalectomy and 2 cases of bilateral adrenalectomy.4 patients underwent robot-assisted laparoscopic bilateral adrenalectomy.Results The postoperative pathological examination showed that all patients had bilateral adrenal macronodular or adenomatoid hyperplasia.During the mean follow-up of 68 months (range 3 to 192 months), the clinical symptoms of CS disappeared after surgery in all cases.7 patients who received unilateral adrenalectomy had urinary free cortisol and serum cortisol within normal ranges and no further enlargement of the contralateral gland was noticed.Among the 3 patients who received bilateral adrenalectomy simultaneously, 1 case died of adrenal crisis on the seventh day post-operation.The remaining 2 cases presented with adrenal insufficiency but returned to normal after glucocorticoid replacement therapy.Nelson's syndrome was not observed in other patients.Conclusions The use of bilateral adrenalectomy to treat AIMAH may involve risk.Unilateral adrenalectomy is recommended for an alternative treatment for AIMAH.Controlateral adrenalectomy with lifelong corticosteroid replacement or contralateral subtotal adrenalectomy may be performed if the symptoms have not improved or recurred after unilateral adrenalectomy.

Environmental Monitoring ; methods ; Gas Chromatography-Mass Spectrometry ; methods ; Humans ; Industry ; Volatile Organic Compounds ; analysis

Objective:To investigate the use of the reference intervals for blood cell counting and the reference of industry standard in China.Methods:Information from all laboratories was collected using online questionnaire in 18 reference intervals survey in blood cell counting in 2019. The information includes the source of the reference intervals, the verification of the reference intervals, and the upper and lower limits of the reference intervals, the method used, the instrument, the reagent and the calibrator. Microsoft Excel 2007 software was used to analyze the results of all laboratories. The median and 95% confidence interval were calculated. The distribution of the reference intervals for blood cell counting and their conformance to industry standards were analyzed.Results:2, 869 labs reported the data. The main sources were industry standards and National Guide to Clinical Laboratory Procedures. The proportion was 33.30%-35.02% and 28.55%-30.90% respectively. 49.44%-55.13% of laboratories validated the reference interval when citing industry standards. The reference interval grouping of most laboratories (89.37%-91.69%) cited in RBC, Hgb and Hct were consistent with the industry standards. We compared the upper and lower limits of the reference intervals with that given by the industry standards, when the lower limit of the reference intervals of mean corpuscular hemoglobin concentration, absolute neutrophils count, absolute basophils count, absolute monocyte count, and lymphocyte percentage were compared. The upper limit of reference intervals of neutrophils percentage as well as upper and lower limits of reference intervals of mean corpuscular volume, mean corpuscular hemoglobin, absolute eosinophil count, basophils percentage, and monocyte percentage were also compared. The median and mode were equal and consistent with industry standards. For other labs, the upper and lower limits of the reference intervals were not consistent with the reference intervals given by the industry standards.Conclusion:The use of reference intervals for blood cell counting was not the same, and the implementation of industry standards was not optimistic. A considerable number of laboratories had not verified the reference intervals, so it was necessary to promote the industry standards for reference intervals.

OBJECTIVETo compare the effects of oblique insertion at anatomical points and conventional acupuncture for sacroiliac joint injury.

METHODSEighty patients were randomly divided into an observation group and a control group, 40 cases in each one. In the observation group, oblique insertion therapy at anatomical points was used, and the 9 points of equal division (anatomical points) marked by palpating the anatomical symbol were treated as the insertion acupoints. In the control group, conventional acupuncture was applied, and perpendicular insertion was adopted at Huantiao (GB 30), Zhibian (BL 54) and Weizhong (BL 40), etc. In the two groups, the! treatment was given once a day and 5 times per week. Ten treatments were made into one course and two courses were required. The clinical effects, the changes of visual analogue scale (VAS) and Oswestry dysfunctional index. (ODI) before and after treatment were observed in the two groups.

RESULTSThe total effective rate of the observation group was 90.0% (36/40), which was better than 72.5% (29/40) of the control group (P < 0.05). After treatment, the results of the VAS and ODI of the two groups were apparently declined (both P < 0.01), and those in the observation group were decreased more obviously (both P < 0.01).

CONCLUSIONThe effect of oblique inser-tion at anatomical points for sacroiliac joint injury is superior to that of conventional acupuncture, which can effectively relieve pain and improve the disfunction.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Humans ; Joint Diseases ; physiopathology ; therapy ; Male ; Middle Aged ; Sacroiliac Joint ; injuries ; physiopathology ; Young Adult

Objective:To analyze the clinical characteristics, treatment and prognosis of mixed phenotypic acute leukemia (MPAL) in children, and to provide reference for clinical optimization of diagnosis and treatment and improve the remission rate.Methods:Based on the diagnostic criteria of the World Health Organization (WHO) in 2016, the bone marrow cell morphology, immune typing, cytogenetics, molecular biological characteristics, treatment regimen, and prognosis of 15 children with MPAL who were admitted to Children′s Hospital Affiliated to Soochow University from January 2012 to December 2020 were retrospectively analyzed.The count data were compared between groups using the χ2 test, the measurement data that conformed to the normal distribution were compared using the t test, and the measurement data that were not normally distributed were compared using the rank sum test.Survival was estimated using the Kaplan- Meier ( K- M) method and the Log- rank method was used for comparison. Results:A total of 15 children with MPAL were admitted to Children′s Hospital Affiliated to Soochow University in the past 8 years, including 8 males and 7 females, with a median age of 6.8 years.Nine patients expressed B lymphocyte and myeloid phenotype, 5 patients expressed T lymphocyte and myeloid phenotype, and 1 patient expressed B and T lymphocyte phenotype.Karyotype of 11 children was examined, and the results showed that there were 2 cases of normal karyotype, 2 complex karyotype, 6 pseudodiploid and 1 subdiploid.Fusion genes were detected in 5 children, including 3 AML- ETO positive, 1 BCR- ABL positive, and 1 MLL gene positive.Thirteen patients were in complete remission (CR) after chemotherapy, with a total CR rate of 86.6% and a 2-year over survival (OS) rate of (68.2±13.4)%.Among the 15 children, 14 received induction chemotherapy and 1 gave up treatment for personal reasons.There were 10 patients with the first choice of acute lymphoblastic leukemia (ALL) chemotherapy regimen and 1 patient receiving CR, with a total CR rate of 10%.There were 4 cases of acute myeloid leukemia (AML) with the preferred chemotherapy regimen and 3 cases with CR in the first course of treatment, and the total CR rate was 75%.One case without remission was relieved after changing ALL chemotherapy regimen.The 2-year OS rates of 8 patients with hematopoietic stem cell transplantation (HSCT) and 6 patients without HSCT were (70.0±18.2)% and (66.7±19.2)%, respectively, with no significant difference ( χ2=0.318, P=0.573). Conclusions:Children with MPAL is a rare malignant tumor, mainly characterized by the co-expression of lymphoid and myeloid antigens.Chemotherapy alone or HSCT can achieve a good prognosis in the short term, but the long-term efficacy remains to be further observed.

Fear memories are temporarily suppressed after repeated retrieval, a phenomenon known as memory extinction.How to reduce or even eliminate fear memory is the key to the treatment of fear related diseases such as post-traumatic stress disorder(PTSD). A single extinction training based on Pavlov's fear regulation task could only inhibit the expression of conditioned fear memory traces, but it could not eliminate the acquired conditioned fear memory. However, according to the reconsolidation theory based on memory, the retrieval-extinction paradigm has a more lasting effect on the erasure and rewriting of fear memory, and can effectively prevent the return of fear memory. Studies have shown that extraction-regression is closely related to a variety of neurotransmitter receptors such as glutamate receptor(GluR), dopamine receptor(DAR), L-type voltage-gated calcium channels(LVGCs) and cannabinoid. Moreover, its effect is closely related with factors such as retrieval-extinction memory stage. At present, most of the researches on extracted boundary conditions only stay at the level of behavior, with little understanding and exploration on the level of molecular mechanism. From the perspective of molecular neurobiology, with different stages of memory and different types of receptors and molecular mechanisms, this research reviewed the mechanisms of retrieval-extinction in recent years.It provided valuable signaling pathways, molecular targets and research directions for the treatment of fear-related diseases such as PTSD.

Objective:To explore the risk factors for hemophagocytic syndrome (HPS) in childhood Epstein-Barr virus (EBV)-associated infectious mononucleosis (IM).Methods:From January 2013 to December 2017, the medical charts of all children who were diagnosed with EBV-associated IM and HPS in Children′s Hospital of Soochow University were analyzed retrospectively. Statistical analyses were performed using SPSS version 22.0.Results:A total of 316 IM and 59 HPS were enrolled. The age was (4.26 ± 2.95) years old with a male-to-female ratio of 1.2∶1. In addition to the diagnostic criteria of HPS, there were significantly lower rates of fever >10 d, hepatomegaly, jaundice, alanine aminotransferase >500 U/L, aspartate aminotransferase >500 U/L, LDH >1 000 U/L, C-reactive protein >50 mg/L and hypoalbuminemia in children with EBV-associated IM compared to those with HPS, and the differences were statistically significant ( P<0.05). Multivariate Logistic regression analysis showed that fever >10 d, eyelid edema, lymphadenopathy and purulent tonsils were independent predictors of HPS in children with EBV-associated IM ( P<0.05). Hepatomegaly and fever >10 d were risk factors ( OR = 16.079 and 12.138, 95% CI 2.788 to 92.744 and 2.878 to 51.180). Eyelid edema, lymphadenopathy and purulent tonsils were protective factors ( OR = 0.087, 0.006 and 0.031; 95% CI 0.010 to 0.723, 0.001 to 0.058 and 0.007 to 0.146). Conclusions:Hepatomegaly and fever >10 d are the risk factors for hemophagocytic syndrome in childhood EBV-associated infectious mononucleosis.