From the four aspects of residency training plan,the actual clinical teaching arrangement,clinical operation skill training and examination system,we compared the pros and cons of neurological resident training systems in two famous hospitals in Australia and China,aiming to provide useful suggestions to improve the current neurological resident training system.

Objective To explore the association of dietary behavior of children with Tourette syndrome (TS) and tic symptoms.Methods 207 TS children and their 264 corresponding controls,who visited our hospital during the period of November 2008 to October 2010,were investigated with children' s dietary behavior questionnaire,under the guidance of professional staff,and the TS tic symptom severity was also evaluated according to The Yale Global Tic Severity Scale (YGTSS).Kruskal-Wallis H rank-sum test was applied for univariate analysis and multinominal logistic regression for further multivariate analysis,with values of odds ratio (OR) and population attributable risk (PAR) obtained to demonstrate the relation strength between dietary behavior and tic symptom severity.Results Results of univariate analysis showed that western fast meal,barbecues,cream food,cold food,and spicy food were related to TS tic symptom severity (P＜0.05).Results of multivariate analysis demonstrated that western fast meal,fruits and vegetables,cream food and spicy food were risk factors for mild TS compared with control group,with OR and 95％ CI of 3.282 (1.922,5.064),2.239 (1.298,3.861),2.341 (1.355,4.046),2.118 (1.327,3.380) and their corresponding PAR of 0.306,0.464,0.169,0.250 respectively.As to moderate and severe TS,the risk factors included western fast meal,fruits and vegetables,and spicy food,with their respective OR and 95％ CI of 2.581 (1.322,5.038),2.364 (1.166,4.795),1.822 (1.014,2.272) and PAR of 0.234,0.487,0.197.Conclusion Dietary behavior,especially western fast meal,fruits and vegetables,cream food and spicy food,are considered to be associated with TS tic symptom severity.Therefore it' s obligatory to rectify undesirable dietary behaviors for TS children.

Child, Preschool ; Cysts ; Diagnostic Errors ; Humans ; Leiomyoma ; diagnosis ; Male ; Nose Neoplasms ; diagnosis ; Vestibular Diseases

Background:The efficacy of standard triple therapy for eradication of Helicobacter pylori(Hp)is decreasing in recent years,and bismuth-containing quadruple regimen becomes the first-line therapy for Hp infection. However,the application of bismuth has some limitations. Aims:To investigate the efficacy of proton pump inhibitor(PPI)-based standard triple therapy combined with teprenone for Hp eradication. Methods:A total of 155 Hp-infected chronic gastritis patients were enrolled from Jan. 2013 to Dec. 2014 at Aerospace Center Hospital,and were randomly assigned into standard triple therapy group,bismuth-containing quadruple therapy group and teprenone-containing quadruple therapy group. Patients in standard triple therapy group were given rabeprazole sodium 20 mg + amoxicillin and clavulanate potassium 914 mg +clarithromycin 500 mg bid for 10 days. Patients in bismuth-containing quadruple therapy group were given standard triple therapy combined with bismuth potassium citrate 0. 6 g bid for 10 days. Patients in teprenone-containing quadruple therapy group were given standard triple therapy combined with teprenone 50 mg bid for 10 days. Symptoms of patients were evaluated before and after eradication therapy. Four weeks after the end of therapy,13 C-urea breath test( UBT)was reexamined to assess the status of Hp infection. Results:One hundred and fifty-two patients completed the treatment course. By ITT analysis,the eradication rates of standard triple therapy group,bismuth-containing quadruple therapy group and teprenone-containing quadruple therapy group were 69. 8%(37 / 53),86. 5% (45 / 52)and 88. 0% (44 / 50), respectively;by PP analysis,the eradication rates of the three groups were 71. 2%(37 / 52),88. 2% (45 / 51)and 89. 8%(44 / 49),respectively. Eradication rates analyzed by ITT and PP in bismuth-containing quadruple therapy group and teprenone-containing quadruple therapy group were significantly higher than those in standard triple therapy group(P <0. 05),but no statistically significant difference was found between these two groups( P > 0. 05). Relieving rates of abdominal pain,abdominal distention and belching in bismuth-containing quadruple therapy group and teprenone-containing quadruple therapy group were higher than those in standard triple therapy group,but statistically significant difference was only found in relieving of abdominal pain between teprenone-containing quadruple therapy group and standard triple therapy group(88. 9% vs. 70. 3% ,P < 0. 05). Adverse effects included transient and mild nausea,diarrhea and black stool, etc. Conclusions:Teprenone-containing quadruple regimen are effective for Hp eradication and symptoms relieving with no severe adverse effects,the efficacy is comparable with bismuth-containing quadruple regimen.

Objective To investigate the effects of normobaric hyperoxia intervention on learning and memory abilities of valproic acid(VPA) autism model rats and the morphology of pyramidal cells in hippocampus CA1 area.Methods Animal model groups of autism were obtained in male offspring of the Wistar rats that received intraperitoneal injection of 600 mg/kg VPA at the 12.5 day after pregnancy.According to the eye opening time,behavior,weaning weight and the learning and memory abilities which were evaluated by the Y electricity maze test at the 28th day after birth,40 male VPA autism model rats were randomly selected 20 only and divided into normobaric hyperoxia model group (group A,n =10),atmospheric air model group (group B,n =10).Normal control groups were obtained in male offspring of Wistar rats that received intraperitoneal injection of equivalent physiological saline at the same period pregnancy.(group C,n =10).Rats in group A were treated with oxygen for 1 h per day and lasted 1 week;group B and C were treated with normal air.The learning and memory abilities of three groups were assessed at the 35th day after birth.The immunohistochemistry methods and image analysis were used to observe the pyramidal cells of autism model rats in hippocampal CA1 region.The effect of normobaric hyperoxia therapy on pyramidal cell of autism model rats in hippocampal CA1 region were evaluated by HE staining technique.Results The trying times of group A after treatment were less than those before treatment (31.15 ± 0.99 vs 31.54 ± 0.97,t =2.739,P =0.018).The memory times were more than those before treatment (3.00± 0.58 vs 2.69 ± 0.48,t =-2.309,P =0.040).The trying times of group A after treatment were less than those in group B after treatment (P =0.016).The memory times of group A were not different from that in group B after treatment(P=0.810).The morphology of pyramidal cells in hippocampal CA1 region showed that the pyramidal cells of the autism model rats had apoptosised.The number of apoptotic cells reduced and the number of normal form cells increased after the normobaric hyperoxia intervention compared with the autism model rats.Conclusion Normobaric hyperoxia intervention can improve the learning and memory abilities of the autism model rats.The apoptosis of the pyramidal neurons in hippocampal CA1 might be reduced after the normobaric hyperoxia intervention.

Objective To investigate the clinical features of gynecological malignant tumor related multiple primary malignant neoplasms (MPMN).Methods Apply retrospective and comprehensive analysis to the clinical data of 30 patients with gynecological malignant tumor related MPMN.Results Synchronous MPMN were found in 9 patients.Their average age was 50.2 years old and their median age was 49 years old.The neoplasms were located at ovary,uterus,cervix,breast and intestine.Metachronous MPMN were found in 21 patients.Their average age was 57.7 and their median age was 57 years old.The median interval between the first and the second primary malignant neoplasm was 4.0 years.The neoplasms were located at breast,ovary,uterus,gastrointestinal tract,uterine cervix,lung etc.In 30 cases,26 of them were treated by surgical operation and further adjunctive treatment of chemotherapy and (or) radiotherapy was conducted as per the neoplasm staging and its pathological results.The rest 4 patients (first primary malignant neoplasms were excised from 3 of them and another one was not treated by surgical operation) received adjunctive treatment of chemotherapy and (or) radiotherapy.Followed ups,which varied from 6 to 60 months,were made to 29 patients and 20 out of the 29 were alive.5-year survival rate of patients with gynecological malignant tumor related MPMN was 47.8％,2-year survival rate was 73.9％,and 1-year survival rate was 88.6％.Conclusion Pay more attention to the patients with gynecological malignant tumor related MPMN,examine the high-risk patients with malignant tumor comprehensively,identify whether it is recurrence,metastasis or new growth of malignant neoplasm,and further ensure early diagnosis and proper treatment,avoiding misdiagnosis and missed diagnosis.

Objective To explore the feasibility of mechanical chest compression to establish a rat model of car?diopulmonary resuscitation ( CPR) . Methods 4?month old healthy male Sprague Dawley rats were randomly divided into control group ( n=6 ) and model group ( n=10 ) . After induction of anaesthesia with 10% chloraldurate ( 3 ml/kg, i. p. ) , tracheal intubation and left femoral artery cannulation were performed. Under electrocardiographic and artery blood pressure monitoring, tracheal obstruction ( TO) was performed to rats in model group. At 2 min after the cardiac arrest ( CA) occurred, CPRs were administered to the rats using a self?made animal chest compressor, which provided chest?com?pression at a rate of 200 bpm. Results Shortly after TO, rats in the model group had respiratory arrest, cyanosis and ar?rhythmia. Electrocardiography indicated that CA occurred within 4-5 min, with a decreased artery systolic blood pressure ( <40 mmHg) and a zero pulse pressure. Return of spontaneous circulation ( ROSC) after the CPR was successfully a?chieved in 8 rats (80%), with a transient reperfusion arrhythmia. Finally, 60% of the rats (n=6) recovered to con?sciousness and survived for 24 hrs. The serum biochemical analysis indicated that there were electrolyte disturbances, aci?dosis, impaired renal functions and increased myocardial enzyme spectrum. Pathological examination revealed cardiac rhab? domyolysis, no?reflow phenomenon in renal glomeruli, decrease of neurons and pulmonary congestion in the model group rats. Conclusions Mechanical chest compression can provide minimal cardiac output for the requirement of CPR incardiac arrestin rats. It is feasible to establish rat CPR model with the mechanical chest compression.

[Objective] Based on the resting state functional magnetic resonance imaging to investigate the abnormal features of the functional connectivity of resting brain neural network in the patients with primary insomnia,by using voxel-wise whole-brain finctional networks analysis of degree centrality (DC) for imaging evidence of neural mechanisms underlying primary insomnia.[Methods] The resting state fMRI were performed in 59 PI patients and 47 age,education,and sex-matched normal healthy subjects.Analysis of DC map changes between the two patient groups and the control group were performed by two sample t test.(threshold at P ＜ 0.05).[Results] Compared with the control group,the patients with PI showed significantly reduced DC value in bilateral medial frontal gyrus (MFG),bilateral anterior cingulate gyrus (ACG),and right insula;and increased DC value in right middle temporal gyrus (MTG),and left cuneus,(CUN),P ＜ 0.05.[Conclusion]Changes of DC value occurred in some region of brain in the P[patient groups when compared with the control group.It was indicated that DC,as a novel resting-state fMRI parameter in the voxel-wise whole-brain functional networks,might be an appealing alternative approach for further study on pathologic and neuropsychological states of PI.

Objective To investigate the levels of adiponectin and the relation with insulin and tumor necrosis factor(TNF)- ? in patients with cirrhosis. Methods Adiponectin,insulin and TNF-? levels were determined in 73 patients with cirrhosis and 30 healthy controls, and were correlated with various clinical and biochemical parameters. Meanwhile Child-Pugh liver function was classified. Results Adiponectin was significantly elevated in patients with cirrhosis compared with the control. Adiponectin levels in cirrhosis was correlated positively with insulin and negatively with insulin sensitively index,and did not correlate with TNF-? and liver function.Conclusion Serum adiponectin levels in cirrhosis are significantly elevated. Adiponectin levels do not correlate with TNF-? and liver function, but exclusively insulin and insulin sensitivity index.

Abstract: Objective To analyze the epidemiological characteristics of pulmonary tuberculosis (PTB) in Ankang City from 2011 to 2021, so as to provide a scientific basis for the formulation of PTB prevention and control strategy. Methods Descriptive statistics were used to analyze the epidemiological characteristics of PTB in Ankang City from 2011 to 2021, and a time series model was established to quantitatively predict the incidence of pulmonary tuberculosis in 2023. Results The incidence rate in Ankang City showed a significant upward trend from 2011 to 2017, and a more obvious downward trend in 2017-2021 (P<0.05), and the decrease rate in 2021 was 40.36% compared with that in 2017. The proportion of etiological positivity increased from 12.5% in 2014 to over 50.00% after 2019. The incidence season was mainly concentrated in the first quarter, accounting for 28.39% of the annual incidence. High incidence areas were concentrated in the south of Ankang: Langao County, Ziyang County and Zhenping County, with 128.32/100 000, 117.07/100 000 and 110.44/100 000, respectively. Low incidence areas were located in the north of Ankang: Ningshan County, with 60.62/100 000. Farmers and students were the high incidence groups, accounting for 81.80% and 4.97% of the total cases respectively. The incidence of young children was relatively low, but cases were reported every year. The incidence rate of male was 2.39 times that of female. The age of onset increased significantly from 15 years old, and the peak incidence was in the age group of 60-<80 years old, followed by the age group of 45-<60 years old, the average annual incidence was 136.44/100 000 and 104.47/100 000, respectively. The model ARIMA(0,1,1)(0,1,1)12 predicted that the incidence of the disease generally increased from October 2022 to March 2023, then steadily decreased, and increased again in December. Conclusions The incidence of tuberculosis varies in different areas of Ankang City, and males, farmers, students and the elderly are all factors of high incidence of tuberculosis. Therefore, different prevention and control strategies should be adopted according to the characteristics of population in different areas. The number of cases in Ankang City in 2023 showed an overall downward trend, which can provide a reference for the prevention and control of PTB.