Objective To analyze the clinical features of overlap syndromes(OS),I.e.,chronic obstructive pulmonary disease(COPD)complicated with obstructive sleep apnea hypoventilation syndrome (OSAHS).MethodsFrequency of episodes of acute exacerbation,severity,quality of life,exercise endurance,complications and three-year survival rate were investigated in eight patients with OS and 10 patients with pure COPD.Results Both quality of life and exercise endurance in OS group were lower than those in COPD group(P＜0.05).Annual frequency of acute exacerbation episodes and severity were more and three-year survival rate was lower in OS group than those in COPD group(P＜0.05).Complications of hypertension,diabetes,erythrocythemia,respiratory failure and heart failure were all more frequent in OS group than those in COPD group.Among all the above clinical features,increased frequency of acute exacerbation episodes was the most significant.Conclusions OS is clinically more severe than pure COPD,so more attention should be paid to it.Survival for patients with OS can not extended by nocturnal oxygen therapy alone,which may be beneficial when combined with biphasic positive airway pressure(BiPAP)or continuous positive airway pressure(CPAP)ventilation.

To investigate an approach of treatment for atrial fibrillation with discrete ablation lesion, 12 dogs with experimental atrial fibrillation underwent radiofrequency catheter ablation. Atrial lesion was made at the most vulnerable site. The results showed that in 10 of 12 dogs persistent fibrillation could be ablated. There was no significant change in sinus heart rate, P wave duration, and corrected sinoatrial node recovery time (cSNRT). The results suggested that paroxysmal atrial fibrillation could be eliminated by point ablation of the lesion, and that trigger activity might be involved in the mechanism of atrial fibrillation.

Objective: To systematically evaluate the influencing factors for repeated implantation failure (RIF) after in vitro fertilization-embryo transfer (IVF-ET) in China, so as to provide the evidence for prevention of RIF. Methods: Literature on influencing factors for RIF in China were retrieved from CNKI, Wanfang Data, VIP, China Medical Literature Service System, PubMed, Web of Science, Cochrane Library and Embase from inception to September, 2024. A meta-analysis was performed using RevMan 5.3 and Stata 14.0 softwares. Literature were excluded one by one for sensitivity analysis. Publication bias was evaluated using Egger's test. Results: Initially 4 836 relevant articles were retrieved, and 12 of them were finally included, with a total sample size of 11 554 individuals. There were 10 case-control studies, 1 cohort study, and 1 cross-sectional study; and 10 high-quality studies and 2 medium-quality studies. The meta-analysis showed that factors including advanced age (OR=1.121, 95%CI: 1.035-1.215), prolonged infertility duration (OR=1.237, 95%CI: 1.091-1.403), abnormal hysteroscopy findings (OR=2.205, 95%CI: 1.119-4.348), positive anti-nuclear antibody (ANA) (OR=2.393, 95%CI: 1.473-3.886), and positive anti-beta2 glycoprotein Ⅰ antibody (β2-GPⅠ-Ab) (OR=2.824, 95%CI: 1.987-4.013) were associated with an increased risk of RIF; while factors including the large number of embryos transferred (OR=0.309, 95%CI: 0.098-0.973), thicker endometrium (OR=0.601, 95%CI: 0.556-0.650), and higher granulocyte colony-stimulating factor (G-CSF) levels (OR=0.657, 95%CI: 0.511-0.845) were associated with a reduced risk of RIF. Conclusion IVF-ET RIF is associated with age, infertility duration, number of embryos transferred, endometrial thickness, hysteroscopy findings, G-CSF levels, ANA and β2-GPⅠ-Ab.

Objective:To explore effects of mindfulness cognitive intervention combined with team psychological training on the sleep, mental and working status of medical staff in Neurosurgery ICU.Methods:Using the cluster sampling method, a total of 42 medical staff of Neurosurgery ICU who worked in Xiangyang Central Hospital from October 2019 to October 2020 were selected as the research objects and they were given mindfulness cognitive intervention combined with team psychological training. The scores of Chinese Perceived Stress Scale (CPSS) , Maslach Burnout Inventory Human Service Survey (MBI-HSS) , SAS, SDS, Pittsburgh Sleep Quality Index (PSQI) and satisfaction of Neurosurgical ICU patients and their families were compared before and after the intervention.Results:The scores of CPSS, SAS, SDS, PSQI and MBI-HSS of 42 Neurosurgical ICU medical staff after the intervention were lower than those before the intervention, and the differences were statistically significant ( P<0.01) . After the intervention, the satisfaction rate of ICU patients and their family members was 98.25% (336/342) , higher than 91.69% (298/325) before the intervention, and the difference was statistically significant ( P<0.01) . Conclusions:Mindfulness cognition intervention combined with team psychological training can improve the sleep, psychological and working conditions of medical staff of Neurosurgery ICU, which is worthy of clinical promotion.

Objective To investigate the relationship between MRI and pathological features of uterine carcinosarcoma(UCS).Methods 13 cases of UCS which were confirmed by surgery and pathology were collected,MRI plain scan and enhanced scan were carried on all of the patients,the pathological tissue was got after operation for conventional HE and immunohistochemical staining.The MRI representation and pathological tissue composition of all the 13 cases were analyzed and summarized.Results 8 cases were occurred in uterine body,3 cases were in the cervix and 2 were involving the uterine body and cervix at the same time.The MRI manifestations of them were enlarged uterine size with irregular masses showed,intermediate or hypointensity intensity signal on T1 weighted and hyperintensity or intermediate intensity signal on T2 weighted,necrosis and cystic lesions were showed in 5 cases,2 cases hemorrhage were displaied which showed hyperintensity signal on T1 weighted,4 cases were endometrial thickening,all of the cases were heterogeneous enhancement;the pathological showed different proportion of carcinorma and sarcoma were visible in all the 13 cases of UCS.Conclusion UCS has complex components histopathologically,including both carcinoma tissue and sarcoma tissue.The heterogeneous signal of cystic degeneration,necrosis and hemorrhage within tumor in MRI could help the diagnosis of UCS.

Objective:To assess the impact of timing of percutaneous catheter drainage (PCD) application (ANC and WON) on outcomes and complications in severe acute pancreatitis (SAP) treatment.Methods:The clinical data of 75 SAP patients treated with PCD from Jan. 1, 2018 to Dec.31, 2018 in Pancreatitis Treatment Center of Deyang People’s Hospital were retrospectively analyzed. The clinical manifestations, application period and curative effect of PCD were analyzed.Results:Among the 75 patients, 51 (68%) were ANC patients, (32%) were WON patients, 0 (0%) died, 70 (93.3%) were cured, and 5 (6.7%) underwent further surgical treatment. There was no significant difference between the average time of PCD application, or complications (such as pancreatic fistulae, catheter obstruction or falling and haemorrhage) ( P>0.05) . Conclusion:Percutaneous catheter drainage in different stages of acute necrotizing pancreatitis does not affect its safety and efficacy, and delayed use don’t have better curative effect.

Four cases of Pentalogy of Cantrell were diagnosed by prenatal ultrasonography and confirmed by autopsy after labor induction.There were 1 case of complete Pentalogy of Cantrell and 3 cases of incomplete Pentalogy.In 3 cases of incomplete Pentalogy of Cantrell,1 case presented with high umbilical cord prolapse,extraspectoral heart,partial defect of the lower part of the sternum,partial defect of the pericardium,single umbilical artery and cervical lymphatic cyst;1 case presented with high umbilical cord prolapse,extraspectoral heart,thoracic fissure and ventricular septal defect;and 1 case presented with umbilical cord,extraspectoral heart,partial inferior sternal segment defect,ventricular septal defect and bilateral clubfoot varus.In l case of complete Pentalogy of Cantrell,there were high umbilical cord bulge,extraspectoral heart,chest fissure and inferior segment defect,anterior diaphragm and pericardium defect,total forebrain deformity,right 12th ribs loss and ventricular septal defect.Ectopic heart and omphalocele are typical echographic features of Pentalogy of Cantrel and prenatal ultrasonography is of important value in early diagnosis of this congenital malformation.

Objective To evaluate the influence of different load carriages during military walking on the gait of lower limbs. Methods In a randomized cross-over design, 15 healthy young males were asked to perform self-paced walking with a normal uniform under a load carriage of 0 kg, 7.5 kg, 27 kg, and 50 kg for four times. The kinematics parameters of the pelvis, knee, and ankle were evaluated by the Vicon motion capture system and AMTI force plates. Results With increasing load carriage, the stride frequency relatively improved, whereas the stride reduced and the speed was maintained on the whole. The peak left/right hip flexion and extension angle and peak knee adduction angle were obviously affected by the load carriage, whereas the movement magnitudes could be maintained. The peak varus angle of the left ankle and peak valgus angle of the right ankle were also affected. The peak force and moment of the left/right knee and ankle increased. Conclusions With increasing load carriage, overall, the movement magnitudes of lower limb joints were maintained under the given loads, whereas the lower limb loads were increased, which could increase the potential risk of lower limb injuries.

Objective:To analyze the risk factors of bronchopulmonary dysplasia(BPD)in very preterm infants(VPI), and to provide scientific basis for the prevention and treatment of BPD in VPI.Methods:A prospective multicenter study was designed to collect the clinical data of VPI in department of neonatology of 28 hospitals in 7 regions from September 2019 to December 2020.According to the continuous oxygen dependence at 28 days after birth, VPI were divided into non BPD group and BPD group, and the risk factors of BPD in VPI were analyzed.Results:A total of 2 514 cases of VPI including 1 364 cases without BPD and 1 150 cases with BPD were enrolled.The incidence of BPD was 45.7%.The smaller the gestational age and weight, the higher the incidence of BPD( P<0.001). Compared with non BPD group, the average birth age, weight and cesarean section rate in BPD group were lower, and the incidence of male infants, small for gestational age and 5-minute apgar score≤7 were higher( P<0.01). In BPD group, the incidences of neonatal respiratory distress syndrome(NRDS), hemodynamically significant patent ductus arteriosus, retinopathy of prematurity, feeding intolerance, extrauterine growth restriction, grade Ⅲ~Ⅳ intracranial hemorrhage, anemia, early-onset and late-onset sepsis, nosocomial infection, parenteral nutrition-associated cholestasis were higher( P<0.05), the use of pulmonary surfactant(PS), postnatal hormone exposure, anemia and blood transfusion were also higher, and the time of invasive and non-invasive mechanical ventilation, oxygen use and total hospital stay were longer( P<0.001). The time of starting enteral nutrition, cumulative fasting days, days of reaching total enteral nutrition, days of continuous parenteral nutrition, days of reaching 110 kcal/(kg·d) total calorie, days of reaching 110 kcal/(kg·d) oral calorie were longer and the breastfeeding rate was lower in BPD group than those in non BPD group( P<0.001). The cumulative doses of amino acid and fat emulsion during the first week of hospitalization were higher in BPD group( P<0.001). Multivariate Logistic regression analysis showed that NRDS, invasive mechanical ventilation, age of reaching total enteral nutrition, anemia and blood transfusion were the independent risk factors for BPD in VPI, and older gestational age was the protective factor for BPD. Conclusion:Strengthening perinatal management, avoiding premature delivery and severe NRDS, shortening the time of invasive mechanical ventilation, paying attention to enteral nutrition management, reaching whole intestinal feeding as soon as possible, and strictly mastering the indications of blood transfusion are very important to reduce the incidence of BPD in VPI.