Objective To observe the curative effect of botulinum toxin A(BTX-A)repeated intramuscular injection for treatment of serious spastic cerebral palsy.Methods Thirty cases with serious spastic cerebral palsy received local repeated intramuscular injection. The interval time was 3 months. The dose of BTX-A was 4 U/kg.The muscle tone was assessed with the modified ashworth scale and range of motion with physical rating scale(PRS).The indexes were evaluated before injection and 3 months after the second injection. Paired-samples t-test was used in the statistic analysis.Result The muscle tone and PRS had remarkable improvement after second therapy with BTX-A(P

Adolescent ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Hepatitis B ; epidemiology ; immunology ; prevention & control ; Humans ; Infant ; Infant, Newborn ; Male

Animals ; Fatigue ; prevention & control ; Female ; Gardenia ; chemistry ; Hypoxia ; prevention & control ; Male ; Mice ; Mice, Inbred Strains ; Plant Extracts ; pharmacology ; Thuja ; chemistry ; Ziziphus ; chemistry

OBJECTIVE To investigate the effect of phosphotyrosine interaction domain containing 1 (PID1, NYGGF4) onpromotion of IR and HCC, and explore its underlying mechanisms. METHODS Lentivirus were used to mediate the knockdown of PID1 in HFD induced IR mouse model as well as ob/ob mice. Intraperitoneal glucose and insulin tolerance were performed 4 weeks after lentivirus injection. Hydrodynamics-based transfection was applied to induce the liver specific overexpression of PID1. Flow cytometry was exerted to detect the proportion and function of immune cells.qRT-PCR and Western blot were used to detect the expression of downstream pathways of PID1. Liquid chromatography-mass spectrometry (LC-MS) and co-immunoprecipitation (Co-IP) were conducted to identify proteins interacting with PID1.Chromatin immunoprecipitation(ChIP)was operated to measure the modification of H3K4me3 of PID1 promoter.RESULTS PID1 restriction improved insulin resistance,hyperglycemia and fatty liver. Conversely, hepatic knockdown of PID1 attenuated liver xenografted tumor growth. Moreover,PID1 liver-specific protooncogenes via hydrodynamics-based transfection established a primary hepatocellular carcinoma mouse model,induced an immunosuppressive environment,with the reduction of CD3+,CD4+,CD8+T cells,retarded maturation of dendritic cells(DCs),pronounced differentiation of regulatory T cells(Tregs),and recruitment of MDSC.In addition,PID1 overexpression activated prolifer-ation related genes, promoted anti-inflammatory genes, suppressed pro-inflammatory genes, induced glycolysis and lipid metabolism genes to facilitate tumorigenesis in liver. Importantly, PID1 exerted its tumor-promoting function through binding to epidermal growth factor receptor(EGFR)and activation of downstream KRAS/ERK pathway.As such,PID1 exist trimethylation of histone H3 at lysine 4(H3K4me3) modification and IR up-regulated the expression of PID1 by activation the H3K4me3 modification. CONCLUSION PID1 is a new gene that exerts both liver cancer-promoting and insulin resistance inducing function.IR accelerates liver cancer development and progression partially dependent on the activation of PID1.

Objective To evaluate the effects of pacing in right ventricular septum (RVS) on hemodynamics among atrioventricular sequential dual chamber pacing Methods Twenty patients with high grade or complete atrioventricular block received permanent dual chamber pacemaker ( DDD ),were randomized into right ventricular septum pacing group (RVS)and right ventricular apex pacing group (RVA)according to the ventricular leads position.The QRS duration of the ECG,the left ventricular ejection (LVEF),the interventricular mechanical delay( IVMD )and the plasma levels of brain natriuretic peptide (BNP)were compared before and after operations.Results Compared with the preoperation,the mean QRS duration ( ( 187.00 ± 15.67 ) ms and (94.00 ±9.17 ) ms),the IV MD ( (43.20 ± 6.79 ) ms and ( 15.00 ± 4.08 ) ms ),the level of BNP ( ( 89.70 ± 8.30) ng/L and (40.00 ± 4.73 ) ng/L) increased( P ＜ 0.05 ) and LVEF decreased significantly ( (53.70 ± 1.34) % and (58.60 ±1.65 )% ,P ＜ 0.05 ) in RVA group,but didn't change in RVS group (P ＞ 0.05 ).After three months following up,the mean QRS duration and the IVMD in RVS group( (119.00 ±7.38 )ms,(19.00 ±4.59)ms) were shorter than that of RVA group( ( 187.00 ± 15.67) ms,(43.20 ± 6.79) ms) ( P ＜ 0.05 ),the LVEF was higher and the plasma level of BNP was lower than that of RVA group ( (57.00 ± 2.00) % and ( 53.70 ± 1.34) %,(44.20 ± 9.18 ) ng/Land ( 89.70 ±8.30) ng/L,P ＜0.05).Conclusions The RVS pacing could keep the normal ventricular activation sequence and biventricular contraction synchrony farthest without side effects on hemodynamics in comparison with the RVA pacing.The RVS pacing is more approaching physiological rhythm than the RVA pacing.

Objective To investigate the electrocardiographic characteristics and assess the efficiency of ra-diofrequency catheter ablation(RFCA) in ventricular arrhythmia arising from the aortic sinus of Valsalva. Methods Eighteen patients(6 males and 12 females)were selected to undergo RFCA for ventficular arrhythmia originating from the left aortic sinus of Valsava. All of them were symptomatic,but without evidence of structural heart disease. Activation mapping was performed in the endocardium of the aortic sinus of Valsalva,then ablation was performed at the site with the earliest ventricular wave in endocardium electrograms. At the same time, coronary and aortic angiog-raphy were performed to assess the anatomic relationship between the ventricular tachycardia (VT)/ventricular pre-mature contraction (VPC) origin and coronary arteries and aortic valve before the RF energy delivery. Results Eighteen patients were successfully managed, with no major complications related to the procedure. VT eliminated and VPC counts on 24-hour ECG monitoring decreased significantly after the ablation[18 474(12 399,26 812)/24h vs 4 (1,7)/24 h, Wilcoxon signed-rank test, P<0.05]. During a follow-up period of 6 monthes, there was no recur-rence. Conclusions Ventricular arrhythmia arising from the aortic sinus of Valsalva has specific electrocardiograph-ic characteristics, and it can be successfully and safely treated under the guidance of activation mapping.

With the deployment of electronic medical records systems, more and more routine clinical data are recorded electronically, which become a potential data source for new drug clinical trials. In this paper, we summarized the opportunities, challenges, obstacles and the latest development in this field.
Clinical Trials as Topic ; Data Collection ; methods ; Drug Evaluation ; Electronic Health Records

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 changes in the epidemiology and clinical characteristics of cervical cancer over the past 50 years, and explore appropriate treatment corresponding to these changes. Methods The clinical and pathological data of 1557 patients with invasive cervical cancer treated between January, 1955 and December, 2004 were retrospectively analyzed.Results and Conclusions The average age of cervical cancer onset gradually decreased over the past 50 years, from 56.27±8.45 in 1955-1964 to 43.81±8.9 years in 1995-2004, whereas the ratio of young (≤35 years old) patients rose from 3.42% to 24.91%. The ratio of early clinical stage (stages Ⅰ - Ⅱ ) and non-squamous cancer also steadily increased (P＜0.05,respectively). The tumor stage, pathological type and rate of lymph node metastasis were all significantly different among different age groups (P＜0.05). In particular, the young (≤ 35 years old) group had evidently higher ratios ofnon-squamous and advanced stage (Ⅲ- Ⅳ) cancers with a higher rate of lymphatic metastasis in comparison with other age groups (P＜0.01,respectively). Because of the changes in epidemiology and clinical characteristics of cervical cancer, it is necessary to modify the conventional treatment regimens and explore reasonable therapy corresponding to these changes. Preservation of reproductive endocrine function ought to be fully considered in cervical cancer treatment in women at childbearing age.Neoadjuvant intraarterial chemotherapy is an useful method for cervical cancer treatment at present.

Objective To evaluate the changes in the epidemiology and clinical characteristics of cervical cancer over the past 50 years, and explore appropriate treatment corresponding to these changes. Methods The clinical and pathological data of 1557 patients with invasive cervical cancer treated between January, 1955 and December, 2004 were retrospectively analyzed.Results and Conclusions The average age of cervical cancer onset gradually decreased over the past 50 years, from 56.27±8.45 in 1955-1964 to 43.81±8.9 years in 1995-2004, whereas the ratio of young (≤35 years old) patients rose from 3.42% to 24.91%. The ratio of early clinical stage (stages Ⅰ - Ⅱ ) and non-squamous cancer also steadily increased (P＜0.05,respectively). The tumor stage, pathological type and rate of lymph node metastasis were all significantly different among different age groups (P＜0.05). In particular, the young (≤ 35 years old) group had evidently higher ratios ofnon-squamous and advanced stage (Ⅲ- Ⅳ) cancers with a higher rate of lymphatic metastasis in comparison with other age groups (P＜0.01,respectively). Because of the changes in epidemiology and clinical characteristics of cervical cancer, it is necessary to modify the conventional treatment regimens and explore reasonable therapy corresponding to these changes. Preservation of reproductive endocrine function ought to be fully considered in cervical cancer treatment in women at childbearing age.Neoadjuvant intraarterial chemotherapy is an useful method for cervical cancer treatment at present.