Objective To evaluate the effect of TEG ( thromboelastography ) in the timing choose of CABG( coronary artery bypass grafting ) surgery for patients that receiving DAPT treatment .Methods This study is prospective analysis from November 2013 to May 2014 in Wuhan Asia Heart Hospital.The study cohort consisted of 1 201 patientswith acute coronary syndrome , theage range from 43 to 79 years (61.1 ±10 years) with 134 males and 79 females.and the patients undergo DAPT ( aspirin 100 mg/d, clopidogrel 75 mg/d) which were prepare to the coronary artery bypass grafting and then randomly divided into two groups according to the ratio of 1∶1.There were 101 patients, using perioperative TEG inspection , which conduct the choose of surgery timing according to the ADP-induced platelet-fibrin clot strength ( MAADP) after 24 h of the withdraw of DAPT.Distribute the patients into≥50 mm, 35-50 mm and <35 mm groups according to the MAADPresults, and theirCABG was complete within 1 day, 3-5 days and after 5 days respectively. The other 100 patientsacceptancoronary artery bypass grafting surgery and DAPT patients but without TEG examination as the control group , which were withdrawal the DAPT for 5 -7 days by routine before operation.The primary endpoint is 24 h chest tube drainage andkey secondary endpoint is the total number of transfused red blood cells .Recorded the mean intubation time , ICU stay times , Median length of hospital stayandrethoracotomyrates, 30-day mortality, and 30-day readmission rate at the same time.Using Fisher in the variables , t-test when two groups were compared , use ANCOVA for variable factor correction and Statistical analysis was performed using chi-square test in the calculate of results .Results The average chest drainage in TEG group and the control was 438.8 ml vs 487.8 ml(t=1.063,P=0.289),and the total amount of transfused red blood cell in both groups were 493.8 ml vs 551.6 ml(t=1.228,P=0.2227), there were no significant difference between the two groups .The total waiting time in the three categories of patients in TEG group is 294 days ( an average waiting time of 3.11 days per patient ) and was reduced 38%(3.1 days to 5 days)than the guidelines recommend.Conclusions Although the perioperative bleeding and red blood cell transfusion , the occurrence and postoperative adverse events were similar in two groups , but using thrombelastographto measure platelet function before CABG surgery can help to choose the timing of surgery and reduce the waiting time before surgery .

Objective To evaluate the dosimetric characteristics of hippocampal formation (HF) in the intensity-modulated radiotherapy (IMRT) for nasopharyngeal carcinoma (NPC).Methods Fifty-nine NPC patients underwent IMRT.Simultaneous integrated boost technology was used to determine the doses for the target areas.The dose ranges of the HF were collected by dose-volume histogram.The influence of T stage on the exposure doses ( Dmax,Dmean,D20,V10,V20,V30,and V40 ) were compared.Results The maximum dose for the HF (Dmax) ranged from 11.1 to 78.2 Gy(F =24.2,P ＜0.05) and the Dmean ranged from 3.2 to 44.6 Gy ( F =16.3,P ＜ 0.05 ).The Dmax and Dmean of the T1-2 stage patients were (40.8 ±9.4) Gy and ( 12.5 ±5.1 ) Gy,respectively,both significantly lower than those of the T3-4 stage patients [ (58.6± 14.8) Gy,(20.9± 9.3 ) Gy].The mean exposed volume of the T4 stage patients was significantly larger than that of the T1 and T2 stages patients.Conclusions In the IMRT of NPC,the HF receives rather high irradiation dose.T stage is the main factor influencing the dose,especially T3 and T4 stages deserve serious attention.

Objective: This study is to investigate the effectiveness of philtrum repairment for-microform cleft lip, using muscle tension line group reconstruction. Methods: This is a retrospective study of 19 consecutively primary microform cleft lip repairment patients, from January 2015 to December 2017. All the patients were provided muscle tension line reconstruction (group 1) or traditional muscle repairment by horizontal mattress sutures (group 2). The philtral ridge and dimple were evaluated by scores. The statistical analyses were performed using unpaired t-test by Prism 6.0 software. Results: The philtral ridge score was higher in group 1 than group 2 (4.15±0.56 vs. 2.73±0.32, P<0.01). The philtral dimple score of group 1 increased either, when compared with group 2 (2.36±0.50 vs.1.45±0.28, P=0.0004). Conclusions Functional reconstruction of philtrum, using muscle tension line group repair, has satisfactory results in philtral ridge and philtral dimple.

Objective: In clinical, cephalic index is the most common method to evaluate scaphocephaly. However, cephalic index alone is not sufficient to describe the nuances of skull shape. The authors hypothesize that the location of euryon could be a valuable and practical index as the supplement of cephalic index to better describe the skull. Methods: This is a retrospective study. CT scans of 17 scaphocephaly patients and 17 normal controls were included. Eight of 17 scaphocephaly patients have 6 months postoperative CT scan. The preoperative location of euryon of scaphocephaly patients was compared to that of the controls and postoperative. The horizontal location of euryon was defined as the ratio of the distance, from the most prominent point of forehead to euryon, to anteroposterior cranial length. The vertical location of euryon was defined as the ratio of the vertical distance, from the nasion to euryon, to cranial height. Results: Both the horizontal and vertical locations of euryon of preoperative scaphocephaly patients were significantly decreased compared to normals (46.50%±4.02% vs. 50.39%±2.21%, t=3.49, P=0.0014; 35.78%±8.62% vs. 52.6%±8.08%, t=5.86, P<0.001). Both the postoperative horizontal vertical locations of euryon were significantly increased, when compared to preoperative (47.25%±4.23% vs. 44.02%±3.72%, t=2.42, P=0.045; 42.39%±9.06% vs. 35.18%±5.36%, t=2.554, P=0.0379). Conclusions The location of euryon could be a practical and valuable index to describe the nuances of skull shape.

OBJECTIVETo investigate the changes in serum hepatitis B viral load (HBV DNA) and transformer growth factor-β(1)(TGF-β1) in patients with chronic hepatitis B after entecavir treatment and evaluates the therapeutic effect of entecavir.

METHODSSixty-three patients with chronic hepatitis B were randomly assigned into entecavir group (n=33) and control group (n=30). The entecavir group consisted of 9 mild, 17 moderate, and 7 severe cases, all treated with oral entecavir (0.5 mg daily) and general hepatoprotective drugs; the control group, consisting of 13 mild, 12 moderate and 5 severe cases, was treated with the hepatoprotective drugs only. Serum HBV DNA and TGF-β(1)were determined before and at 3 and 6 months during the treatment.

RESULTSEntecavir treatment reduced serum HBV DNA load in all the cases in entecavir group, and the difference was statistically significant between the levels measured at 3 and 6 months (P<0.05). The treatment also resulted in decreased serum TGF-β(1)levels in moderate and severe cases, and the severe cases showed a significant TGF-β(1)reduction after a 6-month treatment (P<0.05).

CONCLUSIONEntecavir can lower serum HBV DNA load levels in patients with chronic hepatitis B. Entecavir is also effective to reduce serum TGF-β(1)levels in moderate and severe cases, especially in the latter.

Adult ; Aged ; Antiviral Agents ; therapeutic use ; DNA, Viral ; blood ; Guanine ; analogs & derivatives ; therapeutic use ; Hepatitis B virus ; drug effects ; Hepatitis B, Chronic ; blood ; drug therapy ; virology ; Humans ; Middle Aged ; Serum ; metabolism ; Transforming Growth Factor beta1 ; blood ; Viral Load ; Young Adult

Objective To investigate the relationship of chronic sleep deprivation and high fat diet with laryn-gopharyngeal reflux (LPRD) .Methods A total of 16 rats were randomly divided into the experimental group and control group .Modified multiplatform water surface method and high fat diet (containing 35％ fat) were used in the experimental group rats .The rats in the control group had free sleep and normal feed .The upper gastrointestinal tract pH monitoring with double detectors was used to record the changes of pH in the both rats for 10 hours .The reflux index ,the times of re-flux with pH<4 and the longest duration of reflux were selected and converted into data of 24 hours .The three indexes of the experiment group were compared to those of the control group .Results There was no animal death during the model construction .The rats in the experimental group were irritable .There was no difference of rats weight in both groups before and after the experiment(P>0 .05) .The median of reflux index ,times of reflux with pH<4 and the longest duration of reflux of pharyngeal pH 2 detector in the rats of the experimental group were 21 .07 ,27 .25 and 61 .11 ,respectively .Those of the control group were 1 .25 ,0 .95 and 8 .44 ,respectively .Above three index of the experimental group increased obviously and the difference was statistically significant when compared to those of the control (P<0 .05) .It was suggested that LPRD might appear in the experimental group rats .The median of reflux index and the times of reflux with pH < 4 of esophageal pH1 detector in the rats of the experimental group were 15 .87 and 96 .67 ,displaying an increase when compared to those of the control group (26 .25 and 5 .6) .The differ-ences were statistically significant(P<0 .05);but the median of the longest duration of reflux in pH1 detector of the experimental group rats was 26 .25 ,failing to show statistical difference compared to that of the control group (5 .6) (P>0 .05) .Conclusion Chronic sleep deprivation and high fat diet may play an important role in the pathogenesis of LPRD .This animal model may be a new vector to study LPRD .

Wearable physiological parameter monitoring devices play an increasingly important role in daily health monitoring and disease diagnosis/treatment due to their continuous dynamic and low physiological/psychological load characteristics. After decades of development, wearable technologies have gradually matured, and research has expanded to clinical applications. This paper reviews the research progress of wearable physiological parameter monitoring technology and its clinical applications. Firstly, it introduces wearable physiological monitoring technology's research progress in terms of sensing technology and data processing and analysis. Then, it analyzes the monitoring physiological parameters and principles of current medical-grade wearable devices and proposes three specific directions of clinical application research: 1) real-time monitoring and predictive warning, 2) disease assessment and differential diagnosis, and 3) rehabilitation training and precision medicine. Finally, the challenges and response strategies of wearable physiological monitoring technology in the biomedical field are discussed, highlighting its clinical application value and clinical application mode to provide helpful reference information for the research of wearable technology-related fields.
Monitoring, Physiologic ; Wearable Electronic Devices

OBJECTIVE: To explore diagnosis and surgical treatment of symptomatic lumbar spinal epidural lipoplasia. METHODS: A retrospective analysis of 19 patients with symptomatic lumbar spinal epidural hyperplasia treated with hemilaminectomy and interbody fusion and internal fixation from February 2012 to November 2018 were performed, including 7 males and 12 females, aged from 48 to 72 years old with an average of (57.6±1.2) years old;the course of disease ranged from 6 to 60 months with an average of (18.6±5.1) months;plane requiring decompression:L RESULTS: All patients were followed up from 12 to 37 months with an average of (16.3±3.8) months. Ninteen patients were successfully completed operation, and all adipose tissues in the compressed segment of the spinal canal were removed. Operation time was from 125 to 260 min with an average of (186± 15) min, and blood bleeding was from 150 to 500 ml with an average of (280±46) ml. Two patients occurred partial incision fat liquefaction and exudate did not heal, the incision was opened to remove effusion, the dressing was changed and anti-inflammatory treatments were performed. No complications such as cauda equina injury, cerebrospinal fluid leakage, and broken nails occurred. Preopertaive VAS of back pain and leg pain were 5.3±0.7 and 6.8±0.8, respectively, while 2.1±0.4 and 2.3±0.5 respectively at 6 months after opertaion, there were statisticalsignificant difference between 6 months after operation and before operation ( CONCLUSION Patients with symptomatic lumbar spinal epidural lipoplasia undergo hemilaminectomy and internal fixation of compression segment could relieve compression of dura mater and cauda equina, and achieve good clinical results.
Back Pain ; Child, Preschool ; Female ; Humans ; Infant ; Lumbar Vertebrae/surgery* ; Male ; Retrospective Studies ; Spinal Fusion ; Treatment Outcome

Objective: To assess the association of single nucleotide polymorphisms (SNPs) in SLCO1B3 gene with prognosis of breast cancer (BC) patients treated with neoadjuvant chemotherapy of TA regimen (taxane and antharcycline drugs). Methods: 439 female BC patients were recruited and treated with neoadjuvant chemotherapy of TA regimen. A blood sample (2 ml) of peripheral blood was collected from each patient before chemotherapy. Tagging SNPs (tag-SNPs) were selected. We investigated the association of tag-SNPs with prognosis, by Sequenom Mass ARRAY system platform, characterizing tag-SNPs. The hazard ratio (HR) and 95% confidence interval (CI) for progression or death were calculated by multivariable-adjusted Cox regression model. Results: Seven tag-SNPs (rs11045689, rs200104106, rs3764006, rs3834935, rs4149117, rs7305323 and rs73241801) were selected for study. Compared with individuals carrying the rs11045689 GG genotype, individuals carrying rs11045689 AA genotype performed worse PFS and OS, with the HR (95% CI) for progression being 1.39 (1.11~1.75) and the HR (95% CI) for death being 1.38 (1.04~1.83). Compared with individuals carrying the rs73241801 CC genotype, individuals carrying rs73241801 TT genotype performed better OS (P=0.041), with the HR (95% CI) for death being 0.65 (0.44~0.94). The number of risk allele was significantly associated with PFS (P=0.012) and OS (P=0.017) of BC patients by accumulation analysis. Compared with individuals carrying one or less than one risk allele, individuals carrying four risk alleles performed worse PFS and OS, with the HR (95% CI) for progression being 1.37 (1.09~1.72) and the HR (95% CI) for death being 1.36 (1.02~1.81). Conclusion The variations of rs11045689 and rs73241801 in SLCO1B3 gene were significantly associated with prognosis of BC patients treated with neoadjuvant chemotherapy of TA regimen, which might serve as biomarkers for predicting prognosis of BC patients treated with neoadjuvant chemotherapy.