Objective To investigate the effect of Kangaroo care(KC)on diminishing neonatal pain during heel lancing. Methods Sixty neonates were divided randomly into two equal groups:intervention group and control group,which 30 cases in each group.In the intervention group,neonates were treated with KC(neonates were put in direct and continuous skin-to-skin contact with his/her mom)from 20 mins before heel lancing to 1 mins after the end of the lancing.In the control group,neonates were treated with regular care.The differences in heart rate,blood oxygen saturation,facial pain expression,crying duration and DAN(Douleur Aigue Nouveaune)scores between two groups were compared at 7 time points from 10s before the heel lancing to 10s after the lancing. Results The results of repeated measu te at 7 time points after heel lancing.There were significant interaction effect between time and main effect(P<0.01),which showed that the heart rate of two groups were not equal at different time points.Compared with the time effects(P<0.01)which showed that two groups of neonatal heart rate of the two groups would accelerate with time extension. There were significant differences(all P<0.05)in heart rate at 7 time points between two groups and smaller heart rate varied range in intervention group.The results of repeated measures analysis for neonatal blood oxygen saturation at 7 time points after heel lancing. There were significant interaction effect between time and main effects(P<0.01),which showed that the blood oxygen saturation of two groups were not equal at different time points.Compared with the time effect(P<0.01),which showed that two groups of neonatal blood oxygen saturation would reduce with time extension.There were significant differences(all P<0.05)in blood oxygen saturation of two groups at 30s,40s and 50s after heel lancing and smaller blood oxygen saturation varied range in intervention group.The crying duration and DAN scores in intervention group were significantly reduced compared with the controls(all P<0.05).Conclusions
Heel lancing could lead to moderate to severe pain of neonates.KC could effectively diminish the neonatal pain degree caused by heel lancing.

The aim of this study was to compare the pain experience among orthodontic patients treated with self-ligating brackets SmartClip® (3M Unitek, Monrovia, California, USA) and conventional brackets Victory series® (3M Unitek, Monrovia, California, USA). We used a controlled clinical trial study design to compare 69 patients treated with self-ligating to 70 patients treated by conventional brackets. The nickel-titanium archwires 0.012-in were engaged after bonding both arches on the first day; and the visual analogue scale (VAS) was used to assess the pain experience of subjects for the first seven treatment days. The pre-treatment dental study models were assessed by the Little’s irregularity index to quantify the groups’ malalignment characteristics. The self-ligating brackets reported lower pain experience than the conventional group on the first five treatment days. However, the sixth day showed 1.75 mm higher visual analogue score than conventional brackets, with almost equal pain level on the seventh day. The group differences throughout the first week were neither clinically nor statistically significant. The pain experiences in both groups decreased steadily from the third treatment day to the end of the first week of treatment. Based on the study findings, the pain experience during initial alignment is not influenced by the brackets’ ligation type. The pain experience tends to decrease steadily from the third treatment day to the end of the first week of treatment irrespective of the bracket type used.
Orthodontic Brackets, Orthodontic Appliances

Abstract: Objective　To analyze the epidemiological characteristics of public health emergencies in Xishuangbanna Dai Autonomous Prefecture from 2012 to 2021, and to provide reference for formulating relevant prevention and control measures. Methods　The data of public health emergencies reported in Xishuangbanna from 2012 to 2021 were collected and analyzed through the China Disease Prevention and Control Information System. Results A total of 78 public health emergencies (including "Unrated" events) were reported in Xishuangbanna from 2012 to 2021. The highest 21 cases and the lowest 3 cases were reported every year. A total of 1 0374 cases were reported in 78 public health emergencies, involving a population of 1 703 049, with a morbidity of 609.14/100 000, 24 deaths, mortality of 1.41/100 000 and fatality rate of 231.35/100 000. The event level was mainly "general (level Ⅳ)" with 52 incidents, accounting for 66.67%, and 17 incidents of "major (level Ⅲ)", accounting for 21.79%. 51 cases were mainly infectious diseases, accounting for 65.39%. The peak periods for incidents were May-July and November-February of the next year; there were 39 incidents in schools, accounting for 50%, followed by 20 incidents in families, accounting for 25.64%. The top three reported cases were food poisoning (32.05%), chicken pox 17 (21.79%) and dengue fever 10 (12.82%). Among the 24 deaths in public health emergencies, 22 were caused by food poisoning. Wild bacteria poisoning and alcohol poisoning were the main causes of food poisoning, accounting for 45.83% and 37.5% of the total deaths, respectively. Conclusion Infectious diseases, especially respiratory diseases and food poisoning are the focus of the prevention and control of public health emergencies in Xishuangbanna Dai Autonomous Prefecture, of which Schools and families should be pay close attention. Plague, a Class A infectious disease, caused by the bacterium Yersinia pestis has occurred in two inter-animal outbreaks in 10 years and spread to the population, which should be of great concern.

Objective To evaluate the outcomes achieved by using left internal mammary artery(LIMA) to radial artery (RA) total arterial composite grafts in minimally invasive direct coronary artery bypass grafting (MIDCAB) for patients with multiple vessel disease.Methods From January 2009 to September 2015, 39 patients(24 males) with multiple vessel disease underwent MIDCAB with LIMA-RA total arterial composite grafts without cardiopulmonary bypass in our hospital .MIDCAB was performed through a left anterior minithoracotomy .Results All patients successfully underwent MIDCAB with LIMA-RA total arterial composite grafts.No patient required to convert to strenotomy during the surgery.Mean operation time was(176.1 ± 14.1)min.Revascularization was performed for 2 target vessels in 11 cases, 3 target vessels in 25 cases and 4 target vessels in 3 cases.Mean postoperative ventilation time was(21.9 ±27.9) h.Mean ICU time was(2.8 ±2.1) days, and mean postoper-ative inhosptial time was(11.2 ±3.3)days.There was no early death in perioperation.At a follow-up of 6 to 86 months[aver-age(27.5 ±18.0) months], one patient died.The overall survival at 2 years postoperatively was(96.0 ±3.9)%.The paten-cy rate of LIMA was 100%.The overall patency rate of RA grafts at 2 years postoperatively was(91.8 ±4.0)%.Conclusion MIDCAB with LIMA-RA total arterial composite grafts is a safe and effective procedure with favorable early and mid-term out-comes for patients with multiple vessel disease .

Objective To summarize our clinical experience of surgical treatment for pediatric patients with ventricular septal defect(VSD) and mitral regurgitation(MR).Methods A retrospective study was performed including consecutive 84 patients with VSD and MR receiving mitral valvuloplasty(MVP) and VSD closure from January 2006 to January 2012 in Shanghai Xinhua Hospital.All patients were associated with pulmonary hypertension(PH,32-85 mm Hg).The diameters of ventricular septal defects were between 0.7 and 1.6 cm.Echocardiography showed that trivial MR (+) in 9 cases,mild MR (++)in 18 cases,moderate MR(+++) in 33 cases,and severe MR(++++) in 24 cases.VSD closure and MVP were performed with cardiopulmonary bypass under moderate systemic hypothermia.The results of repair were evaluated by transesophageal echocardiography (TEE) during operation.Results Intra-operative TEE results: no residual shunt of VSD,none MR in 80 cases,residual trivial MR in 4 cases.Mean Cardiopulmonary bypass (CPB) time was (84.6 ± 18.5) mins.Mean Aortic clump time was(50.8 ± 11.5) mins.Mean postoperative ventilation time was (38.7 ± 30.2) hours,and mean postoperative inhosptial time was(10.5 ±4.6) days.The in-hospital mortality was 1.2％ (1 case died).78 cases were fully followed up.There was no late death.Echocardiography showed that none MR in 62 cases,trivial MR in 10 cases,mild MR in 4 cases,moderate MR in 2 patients.The overall freedom from reoperation at 5 years was (97.4 ± 1.8) ％.Conclusion Ventricular septal defect with pulmonary hypertension need early surgical repair.MR was treated at the same time of VSD closure could effectively improve the surgical outcome of pediatric patients with ventricular septal defect and mitral regurgitation.

Objective To review the surgical methods and mid-term results of mitral valve repair in pediatric patients with moderate to severe mitral regurgitation (MR).Methods 132 children with moderate to severe MR,aged (18.9 ± 7.2)months,weighted(11.3 ±4.8) kg.The etiology for mitral regurgitation is congenital heart disease in 126 cases,infective endocarditis in 5 cases and Marfan syndrome in 1 case.Mitral valvuloplasty(MVP) was performed with cardiopulmonary bypass under moderate systemic hypothermia.The methods of MVP included annuloplasty,annuloplasty ring,cleft closure,reconstruction of posterior leaflet.The coucomitant cardiac anomalies were treated at the same time.The results of repair were evaluated by saline injection test and transesophageal echocardiography (TEE) during operation.Results Intra-operative TEE results: 131 cases had none to mild MR,and only one case had moderate MR.The patient underwent second repair immediately,subsequent TEE was mild.Mean cardiopulmonary bypass (CPB) time was (80.0 ± 31.1) minutes.Mean aortic clump time was (48.0 ± 17.9) minutes.The in-hospital mortality was 2.3％ (3 cases died).One died of heart failure on postoperative day 7,the other died of low cardiac output syndrome resulting on postoperative day 2.Another one was large ventricular septal defect(VSD) with pulmonary hypertension (PH),died of pulmonary infection.Mean postoperative ventilation time was (34.4 ± 31.9) hours,and mean postoperative inhosptial time was (9.0 ± 5.4) days.The average follow-up period was (40.5 ± 8.3) months (2 to 74 months).122 cases were fully followed up.Echocardiography showed that moderate MR was in 7 patients,and 3 patients had severe MR.4 patients underwent re-do mitral valve repair or mitral valve replacement.There was no late death.The overall survival rate at 5 years was 97.7％ and the overall freedom from reoperation at 5 years was 92.0％.Conclusion Pediatric patients with moderate to severe MR need early surgical treatment,the early and mid-term results were satisfactory.Individualized treatment protocol based on specific pathology was the keypoint of surgical therapy.

Objective:To reveal the abnormal topology of brain network in Alzheimer′s disease (AD), and evaluate the laterality of tau protein deposition in brains of AD patients based on 18F-APN-1607 PET brain imaging combined with graph theory. Methods:From November 2018 to January 2020, 23 clinically diagnosed AD patients (9 males, 14 females; age (61.3±10.7) years) and 13 normal controls (NC) (9 males, 4 females; age (61.6±4.5) years) who underwent 18F-APN-1607 PET imaging in Huashan Hospital, Fudan University were analyzed in this cross-sectional study. The brain network analysis method based on graph theory was used to construct the tau network of the NC group and the AD group, the network attributes (clustering coefficient, shortest path length, local efficiency, and small-worldness) were calculated, and the asymmetry index (AI) of each group to evaluate the laterality of tau protein deposition was obtained. Permutation test (1 000 times) was used to analyze the differences in brain network parameters between the NC group and the AD group. Results:The tau network of the AD group had obvious topological disorder, and the connections in the olfactory cortex and temporal lobe were weakened, while in the posterior cingulate gyrus, anterior wedge, and parietal occipital lobe, the connections were enhanced. Compared with NC group, clustering coefficient ( t values: 2.28-2.69), local efficiency ( t values: 2.34-3.06) and small-worldness ( t values: 2.26-3.32) were significantly decreased in AD group (all P<0.05) with the sparsity of 20%-50%, while the shortest path length was significantly increased ( t values: 2.13-2.85; all P<0.05). There was significant tau laterality in the posterior cingulate gyrus, superior parietal gyrus, paracentral lobule, superior temporal gyrus and middle temporal gyrus (AI: 10.5%(8.1%, 13.9%), 14.1%(7.6%, 20.3%), -12.4%(-15.7%, -7.8%), -10.8%(-15.3%, -2.1%) , -12.1%(-17.9%, -6.6%), respectively). Conclusion:The tau network analysis based on 18F-APN-1607 may be used to reveal abnormal topological changes of AD patients, and the tau deposition in the posterior cingulate gyrus, superior parietal gyrus, paracentral lobule, superior temporal gyrus and middle temporal gyrus has obvious laterality in AD patients.

Objective To observe the effects of Ginkgo biloba extract 50 (GBE50) on hemodynamics and myocardial tissue TNF-α pathway in rats with acute blood stasis syndrome; To discuss its mechanism of action. Methods A model of acute blood stasis syndrome was established by subcutaneous injection of epinephrine hydrochloride and ice bath. Male SD rats were divided randomly into normal group, model group and GBE50 group. After medicine was administrated by gavage for 11 days, the acute blood stasis model was established. The hemodynamic changes were observed in the next day. The expressions of TNF-α, TNFR1 and TNFR2 mRNA were detected by RT-PCR. The expressions of TNF-α, TNFR1 and TNFR2 protein were tested by radioimmunoassay and immunohistochemistry. Results The hemodynamics of the model group was lower than that of the normal group. Compared with model group, GBE50 could increase mLVSP, DP and decrease t-dp/dtmax(P<0.05). The protein expressions of TNF-α, TNFR1, and TNFR2 in GBE50 group were higher than those in model group, and TNFR2 mRNA expression increased significantly in GBE50 group (P<0.05). Conclusion GBE50 can ameliorate the decline of hemodynamics of rats with acute blood stasis syndrome, and regulate the myocardial TNF-α pathway. Increasing the expression of protective receptor TNFR2 may be one of the mechanisms of protecting cardiac function.

Objective To investigate the effects of prescription of nourishing blood and stretching of stoke (PNBSS) on the levels of TXB2 and 6-Keto-PGF1αin serum of patients with acute ischemic cerebrovascular disease (AICD);To discuss its action mechanism in AICD treatment. Methods Ninety patients with AICD were randomly divided into trial group and control group, 45 cases in each group. The control group received western routine treatment, while the trail group received the western routine treatment plus PNBSS, one dose per day, for one week. Rating scale of neurologic deficit was employed to evaluate treatment effectiveness. Venous blood was collected before the treatment and on the 3rd and 7th days of treatment. Levels of TXB2 and 6-Keto-PGF1αin serum were detected respectively. Results The score of neurologic deficit of post-treatment in two groups apparently decreased compared with baseline (P<0.01), and score of neurologic deficit in trial group on 7th day was lower than that of control group (P<0.05). The total effective rate in trial group was 93.3%, which was apparently higher than that of control group (84.4%). The level of TXB2 in serum and ratio of TXB2/6-Keto-PGF1α (T/P) in two groups on 3rd and 7th days remarkably decreased compared with baseline (P<0.01), while the level of 6-Keto-PGF1α in two groups on 3rd and 7th days was higher than that of baseline (P<0.01). Meanwhile, the level of TXB2 and ratio of T/P in two groups on 7th day were apparently lower than that of 3rd day (P<0.01), and the level of 6-Keto-PGF1αon 7th day was higher than that of 3rd day (P<0.01). The level of TXB2 in serum and ratio of T/P on 3rd and 7th days in trial group were apparently lower than that of control group (P<0.01, P<0.05), while the level of 6-Keto-PGF1α on 3rd and 7th days in trial group was apparently higher than that of control group (P<0.01, P<0.05). Conclusion One of the mechanisms of PNBSS for AICD appears to inhibit overavtivity of thrombocyte, and regulate the misadjustment of ratio of T/P.

Objective To observe the effects of Najia method of midday-midnight point selection for acute ischemic stroke (AIS) model rats onthe contents of NSE and S100B protein in serum. Methods SPF SD male rats were chosen to establish the models by middle cerebral artery bolt method. Rats were divided into blank group, sham-operation group, model group, channel-point group, and Najia method group by random number table method. Blank group, sham-operation group, and model group were in the absence of treatment, while the channel-point group received acupuncture treatment according to differentiation syndrome. Najia method group used Najia method of midday-midnight point selection to conduct acupuncture treatment once a day. Improvement of neural function and cerebral infarction volume were observed. The contents of NSE and S100B protein in serum were detected. Results Compared with model group, neurological function score, infarct volume and infarct volume percentage, and the contents of NSE and S100B protein in serum decreased in Najia method group and channel-point group (P<0.05, P<0.01). The effects of Najia group were generally better than the channel-point group. Conclusion Najia method of midday-midnight point selection can decrease the content of NSE and S100B protein in serum of AIS model rats, so as to achieve the effects of neuroprotection and treatment.