objective: To improve the repair technique of secondary nasal deformity following surgical treatment in the patients with bilateral cleft lip. Methods: 12 cases were treated with the operation technique: bilateral vermilion flaps were inserted into prolabial for the enlongation of upper lip and "V Y incision suture" principle was employed to repaire the nasal deformity. Results: Satisfactory results were achieved in all the 12 cases. Conclusion: The technique is feasible in the reconstruction of Cupid's bow, philtrum and correction of nasal and labia deformities.

Objective: To investigate the distribution features of somatosensory cortical evoked potential map with augmented blocking of the sensation transmission along meridians.Method: The EEG-4400 electro-encephalogram (EEG) and ND-1 brain electrical activity mapping were adopted on 11 volunteers with remarkable sensation transmission along meridians, showing that the sensation can transmit to head and face after stimulating the points below the knee joints. Also, special observation was made on accurate location of somatosensory cortical evoked potential map in 10 people without sensation transmission.Result: Observation on 11 volunteers with remarkable transmission along the Three Foot-yang Meridians showed that they presented with concurrent high potential reactions in somatosensory cortical lower limbs and face without blocking the augmented sensation transmission along the meridians; however, when mechanical pressure was exerted to block the sensation transmission,only one reaction in the lower limbs occurred in the somatosensory cortical evoked map and the other one in the face disappeared. Conclusion: Peripheral tissue evoking is the decisive factor for transmission along the meridians.

Objective:To investigate the clinical significance of dynamic analysis of plasma brain natriuretic peptide in patients with dilated cardiomyopathy with chronic heart failure.Methods:Ninety patients with dilated cardiomyopathy with chronic heart failure admitted into our hospital firom March 2012 to March 2016 were divided into group A (20 cases),group B (38 cases),and group C (32 cases) according to the NYHA grading.The plasma BNP levels and LVEF,LA,LVEDD,and LVESD in the three groups were detected and compared.The correlation of plasma BNP and cardiac function and ultrasonic cardiogram indexes were analyzed.And the capability of plasma BNP and LVEF in diagnosis of patients were analyzed and compared.Results:The plasma BNP level in group C was markedly higher than that of group A and group B (P＜0.05),and that in group B was much higher than that of group A (P＜0.05).And LA in group C was significantly higher than that of group A (P＜0.05),while differences in LVEF,LVEDD,and LVESD were not obvious (P＞0.05).The plasma BNP was positively correlated to NYHA grading,but had no significant correlation with the LVEF,LVEDD,LVESD,and LA (P＞0.05).Based on results of receiver operating characteristic curve analysis,plasma BNP =523.5 pg/mL was the threshold value for identification of patients with NYHA Ⅲ and Ⅳ (AUC=0.901,P＜0.001),while LVEF had not the capability (AUC=0.392,P=0.276).Conclusion:Detection of plasma BNP level had important clinical significance on diagnosis,screening and cardiac functional grading of patients with dilated cardiomyopathy with chronic heart failure.

BACKGROUND: Optical coherence tomography(OCT) is a new type of noncontactable, noninjurious retinal tomographic technique. Minor serous detachment in retinal neuroepithelial layer can be resoluted and shown by it. The range of inferior fluid of retinal neuroepithelail layer or pigment epithelial layer can also be quantitatively measured to evaluate the recovery of vision.OBJECTIVE: To study the applicative value of OPT in evaluating the relation of vision and neuroepithelial layer in idiopathic central serous chorioretinopathy(ICSC) and its prognosis.DESIGN: Single sample study.SETTING: Ophthalmologic center in a university hospital.PARTICIPANTS: Patients with ICSC who were primarily diagnosed from January 1999 to June 2003 in the Ophthalmologic Center of the Medical College of Jinan University were included. There were 32 males and 8 females, with an average of(36.2 ± 5.6) years old.INTERVENTIONS: Zeiss-Humphrey OCT imaging meter was used for the examination. The maximal range and height of detachment in the serous detachment region of ICSC were measured respectively, and average value and standard deviation were then calculated.MAIN OUTCOME MEASURES: Vision and the maximal range and height of serous detachment.RESULTS: Local detachment of retinal neuroepithelial layer in the center of macula retina was shown in the OCT images of the 40 eases(41 eyes) with ICSC. Detachment ranged from 705 to 5 720 μm[an average of (3 051 ± 1 338) μm], with the height from 55 to 491 μm[an average of (270 ± 114) μm] . Four eyes were complicated with serous detachment of pigment epithelial layer. And it was suggested by statistical analysis that the range and height of detachment were related with vision.CONCLUSION: OCT, as an objective noninjurious retinal tomography, its high resolution has important value and special predominee in the diagnosis, quantitative analysis and the detection and follow-up of optical functional assessment during the course of the ICSC.

BACKGROUND:Currently, neural stem celltransplantation can be performed through three main approaches:local lesions, blood circulation, and cerebrospinal fluid.
OBJECTIVE:To review the transplantation of neural stem cells or neural precursor cells via the cerebrospinal fluid in the treatment of central nervous system diseases.
METHODS:A computer-based search of PubMed and CHKD databases was performed to retrieve articles concerning transplantation of neural stem cells via the cerebrospinal fluid, and its application and therapeutic mechanism in the treatment of central nervous system diseases in both animal experiment and clinic study published from 2000 to 2009.
RESULTS AND CONCLUSION:It is suitable for neural stem cellsurvival, proliferation, and differentiation in the cerebrospinal fluid. Transplantation of neural stem cells via the cerebrospinal fluid is effective and feasible to treat central nervous system diseases. However, some problems have not been solved, such as the source of neural stem cells, the optimal time window and celldose, the safety and the long-term effect. Further studies are needed to pave the way for the intrathecal injection of neural stem cells in the treatment of central nervous system diseases.

Objective:To understand main problems existing in the construction of advanced stroke centers in China and put forward solutions, for reference in promoting the standardization construction of advanced stroke centers and improving the efficiency of acute stroke treatment.Methods:The data were derived from relevant data of on-site export guidance in the construction of advanced stroke centers at 175 tertiary hospitals from 2020 to 2021, and the scores of on-site evaluation indicators for the establishment of stroke centers and their formal approval were compared and analyzed. Based on on-site investigation and expert consultation, the common problems existing in the construction of advanced stroke centers were summarized. All data were analyzed by descriptive analysis, the scores of on-site evaluation indicators were expressed by ± s, and paired t test was used for comparison between groups. Results:Compared with the total score(693.04±72.06) of on-site evaluation at the stage of project launch, the total score(747.94±78.10) of on-site evaluation for formal approval of stroke centers of 70 hospitals was higher, and the difference was significant( P<0.01). There were seven common problems in the construction of stroke centers in 175 hospitals, including insufficient attention paid by hospitals, lack of effective performance incentive policies, imperfect treatment procedures and medical norms, and so on. Conclusions:Experts on-site guidance plays an important role in the construction of stroke centers in China. At present, there were still problems to tackle in the construction of stroke centers in hospitals. In order to promote the standardized construction of stroke centers in China and improve the efficiency of stroke treatment, the authors suggest fuorther strengthening the importance attached by hospital leadership and the coordination and organization of functional departments, establishing stroke center models conforming to the actual situation of the hospital, seting up the post of brain and heart health manager, and improving the regional prevention and treatment level of acute stroke.

Objective:To explore the influence of different size related parameters of common CT scanned body parts on body-specific dose estimate (SSDE) , in order to establish rapid conversion factors for SSDE.Methods:A total of 189 clinical cases were collected from 6 common CT scanned body parts, including head, nasal bone, sinus, neck, chest, abdomen and pelvis, at Beijing Tongren Hospital, Capital Medical University from March 8 to May 10, 2021. Batch-processing of image was carried out by using Matlabcode. The axial images′area, anteroposterior (AP) dimension, lateral (LAT) dimension and average CT values were calculated. The conversion factors for estimating body-specific dose values were obtained from the real effective diameter ( De) and water equivalent diameter ( Dw) of the clinical cases, and the differences in values were compared between SSDE ED and SSDE WED. Based on the information on AP, LAT, AP + LAT, estimated De, the real De and Dw obtained in clinical practices, the SSDE rapid correction factors for adult body parts were established. The convenient conversion relation between Dw and De was obtained. Based on the correction factors for Dw, the relative errors of the correction factors for various sizes related parameters were compared. Results:The SSDE fast conversion factors for the real De of the 6 body parts were 1.01, 1.01, 1.01, 0.97, 1.28, 1.32, and those for Dw were 0.87, 0.97, 0.98, 0.99, 1.42, 1.36, respectively. The relative errors of different conversion factors ranged from 0.68% to 18.05%. The conversion factors for abdomen and pelvis had the smallest difference, and those for AP and LAT of the chest had the smallest error. The differences between CTDI vol, SSDE ED and SSDE WED in sinus, chest and abdomen were statistically significant ( tsinus=2.44, 4.23, tchest=17.67, 17.00, tabdomen and pelvis =17.93, 18.75, P<0.05) . The differences between CTDI vol and SSDE WED in head, nasal bone, were statistically significant ( t=-22.27, 2.80, P<0.05) , but not with SSDE ED ( P>0.05) . The difference between CTDI vol and SSDE ED in neck was statistically significant ( t=-3.06, P<0.05) but without statistical insignificance in camparison with SSDE WED ( P>0.05) . Conclusions:SSDE WED can be used to accurately evaluate the body-specific dose estimatates, and different size related parameters can be selected for correction in different scanned body parts. The rapid conversion factor can be easily used in clinical practice to improve the accuracy of estimated radiation dose.

Objective:To form a nursing standard for shoulder-hand syndrome (SHS) after stroke in accordance with the clinical situation by expert argumentation in the best evidence systematically retrieved and screened for SHS after stroke with the method of Delphi expert consultation.Methods:According to the level of evidence, we systematically retrieved and screened relevant guidelines, evidence summary, systematic reviews, original studies and expert consensus. Two researchers who had received Joanna Briggs Institute (JBI) evidence-based training used the Appraisal of Guidelines for Research & Evaluation (AGREE) Ⅱ, JBI quality evaluation tools for systematic reviews, randomized controlled trials/experimental studies and expert consensus to evaluate the included guidelines, systematic reviews, original studies and expert consensus. The included literature was classified and summarized, and recommendations and conclusions related to SHS after stroke were screened and extracted. According to the results of the literature summary, the first draft of the clinical nursing standard for SHS after stroke was formed. Using the Delphi method, 25 experts in related fields were selected for two rounds of expert consultation to demonstrate the contents of the first draft.Results:This study included 8 guidelines including 1 evidence summary, 2 systematic reviews, 7 original studies and 2 expert consensus. The overall quality of the guidelines was Grade B; one piece of evidence summary was of good quality and was Grade B; the overall quality of two systematic reviews was low, and the overall quality of seven original studies was average. The first draft of the clinical nursing standard for SHS after stroke included 6 content frameworks and 29 recommendations. Two rounds of expert consultation were conducted, the questionnaire response rates were 89.28% and 100%, and the expert authority coefficients were 0.864 and 0.894, respectively. The Kendell's W of important content framework and recommended in the second round of expert consultation were 0.118 ( P<0.05) and 0.188 ( P<0.001) . According to the results of the expert consultation, the clinical nursing standard for SHS after stroke was formed, including 6 content frameworks and a total of 31 recommendations. Conclusions:The clinical nursing standard for SHS after stroke is based on the best available evidence and expert argumentation, which is in line with the clinical situation in my country and can be sed in clinical nursing work.

Objective:To construct a prognostic model for severe acute pancreatitis (SAP) based on CT scores and inflammatory factors, and to evaluate its efficacy.Methods:128 patients with SAP diagnosed admitted to the First Hospital Affiliated to Hebei North College from March 2019 to December 2021 were enrolled and given Ulinastatin combined with continuous blood purification therapy. The levels of C-reactive protein (CRP), procalcitonin (PCT), interleukins (IL-6, IL-8), tumor necrosis factor-α (TNF-α), and D-dimer were measured before and on the third day of treatment. An abdominal CT was performed on the third day of treatment to assess the modified CT severity index (MCTSI) and extra-pancreatic inflammatory CT score (EPIC). Patients were divided into the survival group ( n = 94) and the death group ( n = 34) according to the 28-day survival prognosis after admission. The risk factors for the SAP prognosis were analyzed using Logistic regression, which was then used to build nomogram regression models. The value of the model was evaluated using the concordance index (C-index), calibration curves and decision curve analysis (DCA). Results:Before treatment, the levels of CRP, PCT, IL-6, IL-8 and D-dimer in the death group were higher than those in the survival group. After treatment, the levels of IL-6, IL-8 and TNF-α in the death group were higher than those in the survival group. MCTSI and EPIC scores in the survival group were lower than those in the death group. Logistic regression analysis shows that, pre-treatment CRP > 140.70 mg/L, D-dimer > 2.00 mg/L, and post-treatment IL-6 > 31.28 ng/L, IL-8 > 31.04 ng/L, TNF-α > 31.04 ng/L, and MCTSI > 8 points were all independent risk factors for SAP prognosis [odds ratios ( OR) and 95% confidence intervals (95% CI) were 8.939 (1.792-44.575), 6.369 (1.368-29.640), 8.546 (1.664-43.896), 5.239 (1.108-24.769), 4.808 (1.126-20.525), 18.569 (3.931-87.725), all P < 0.05]. Model 1 (consisting of pre-treatment CRP, D-dimer, and post-treatment IL-6, IL-8 and TNF-α) had a lower C-index than that model 2 (consisting of pre-treatment CRP, D-dimer, and post-treatment IL-6, IL-8 and TNF-α, and MCTSI; 0.988 vs. 0.995). The mean absolute error (MAE) and mean square error (MSE) of model 1 (0.034, 0.003) were higher than those of model 2 (0.017, 0.001). When the threshold probability was in the range of 0-0.66 or 0.72-1.00, the net benefit of model 1 was lower than that of model 2. When the threshold probability was in the range of 0.66-0.72, the net benefit of model 1 was higher than that of model 2. In addition, model 2 had a higher C-index than acute physiology and chronic health evaluationⅡ (APACHE Ⅱ) and bedside index of acute pancreatitis severity (BISAP, 0.995 vs. 0.833, 0.751). Model 2 had a lower MAE (0.017) and MSE (0.001) than APACHEⅡ (0.041, 0.002). Model 2 had a lower MAE than BISAP (0.025). Model 2 had a higher net benefit than both APACHEⅡ and BISAP. Conclusion:The prognostic assessment model of SAP consisting of pre-treatment CRP, D-dimer, and post-treatment IL-6, IL-8 and TNF-α, and MCTSI has high discrimination, precision and clinical application value, and is superior to APACHEⅡ and BISAP.

Objective To investigate the influencing factors of the cognitive deficits in schizophrenic patients with diabetes.Methods 578 inpatients with schizophrenia and 400 healthy adults were collected.578 schizophrenic patients were divided into schizophrenia group with type 2 diabetes (combined group,n=277) and schizophrenia without type 2 diabetes (single disease group,n=301).The cognitive function of all subjects were examined by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS).The clinical symptoms of patients with schizophrenia were measured with the Positive and Negative Syndrome Scale (PANSS).Fasting glucose,lipids,hemoglobin A1c (HbA1c) and insulin levels were measured.Results The total score and factor scores of RBANS in the combined group were lower than those in the healthy control group (total score (70.51 ± 14.43) vs (80.04 ± 15.14),immediate memory (62.65 ± 16.81) vs (75.66± 17.33),visual span(83.60±20.81) vs (87.61 ± 15.61),verbal function(85.58± 14.64) vs (93.88± 13.10),attention function (73.66± 17.52) vs (87.42±20.37),delayed memory(75.27± 17.80) vs (86.27± 15.27),all P＜0.05).The total score of RBANS,immediate memory and attention function factor were lower in the combined group than that in the single disease group ((70.51±14.43) vs (75.02±15.25),(62.65±16.81) vs (67.37±19.12),(73.66±17.52) vs (84.17±15.22),all P＜0.05).Multiple linear stepwise regression analysis showed that education,negative symptoms,positive symptoms,BMI,HbAc 1,course of disease and antipsychotic type were the influencing factors of cognitive impairment in schizophrenic patients with diabetes.Conclusion The cognitive impairment of schizophrenic patients with diabetes is more serious and affected by many factors.Targeted early intervention can help reduce cognitive impairment.