Objective To evaluate the clinical validity of physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) in aged patients undergoing thoracic surgery. Methods Physiological and operative severity scores were kept in 206 aged patients undergoing thoracic surgery, in which peritoneal soiling was converted to pleura soiling. The physiological score and the operative risk score were compared between the groups with or without the postoperative complications. The mortality and morbidity rates were calculated. Actual mortality and morbidity rates were compared with the rates predicted by POSSUM. Results Among 206 patients, there were postoperative complications in 97 patients. The physiological score and the operative severity score were significantly higher in the group in whom complications occurred compared with those without complications (19.3?0.7 vs 15.1?0.6 for physiological score, P

UNLABELLEDTo evaluate the effects of preadjusted bracket base shape, the morphology of tooth surface where bracket locates, and the suitability relevant to location of bracket on the preadjusted edgewise appliance technique. 1 vertical curve and 3 horizontal curves of the clinical crown surface of anterior teeth and bicuspid teeth were measured with the precise contour instrument on the 60 plaster models of the subjects who have normal occlusion in Sichuan province. It was found that variation of identical curve exists at the different heights between the teeth and between the individuals; the surface of the central zone of tooth-crown gradually protrudes from incisors to bicuspid teeth in the vertical direction, and the mesial contour of cuspid is more prominent than the distal in the horizontal direction.

CONCLUSIONThe 4 mm X 3 mm contour of the vestibular central zone of identical tooth-crown in different individuals is fairly stable; it is suitable for the location of preadjusted brackets. The vertical shifts of brackets could change the preadjusted torque value and the design of cuspid bracket should have the distinction between mesial and distal shape.

Objective To investigate the effects of alpha lipoic acid on patients with diabetic retinopathy (DR),explore the possible mechanisms,and provide experimental evidence for the treatment of DR with lipoic acid.Methods Totally 75 DR patients were randomly divided into control group and treatment group.Patients in control group received the standard hypoglycemic treatment,antihypertensive therapy,and other comprehensive treatment.Patients from the treatment group were treated with alpha lipoic acid 600 mg + 250 ml 0.9％ sodium chloride injection additionally,avoiding light intravenous therapy,for a total of 4 weeks.Before and after treatment,fundus fluorescein angiography and visual inspection were detected in two groups.In addition,serum level of asymmetric dimethylarginine (ADMA) were detected with high performance liquid chromatography,serum lipid peroxidation product malondialdehyde (MDA) content and superoxide dismutase (SOD) activity were detected to reflect the in vivo oxidative stress before and after treatment in two groups.Results Compared to the control group,visual acuity was improved significantly (P ＜ 0.05),and total efficiency of ocular lesions-improved was increased significantly (84.21％ vs 40.54％,x2 =15.28,P ＜ 0.01).Serum levels of endogenous inhibitor of nitric oxide synthase ADMA [(0.32 ±0.13) μmol/L vs (0.51 ± 0.26) μmol/L,P ＜ 0.05] and MDA [(3.22 ± 0.90) nmol/L vs (5.13 ± 0.42) nmol/ml,P ＜ 0.05] were significantly decreased,while SOD levels [(72.68 ± 1.31) U/ml vs (53.16 ± 1.54) U/ml,P ＜0.05] were significantly increased in DR patients after alpha lipoic acid treatment.Conclusions Alpha lipoic acid had some therapeutic effects for DR patients,which mainly lied in the improvement of visual acuity and eye disease,might be related to the decrease of oxidative stress and serum level of endogenous nitric oxide synthase (NOS) inhibitor ADMA.

Objective To evaluate US, CT and 99mTc-MIBI in the localization of hyperfunctioning parathyroid tumors. Methods Among the 47 patients with primary hyperparathyroidism 45 underwent ultrasound, 47 did CT scan and 36 did double phase imagings. Results Forty-six adenomas, 2 adenocarcinomas and 2 hyperplastic glands were removed from 47 patients. The results showed that the sensitivities were 43%,78%,92% for B-utrasound; CT and isotope imaing respectively.The specificities were 96%,97%,100%;and the accuracies were 82%,92%,98%. There was significant difference between 99mTc- MIBI and CT (? 2=6.627,? 2=4.884,P

Objective To investigate the efficacy of dopamine producing cells (DPCs) derived from human umbilical cord-derived mesenchymal stem cells (hUC-MSCs) in treatment in model rats with Parkinson’s disease (PD). Methods The cultured hUC-MSCs were induced into DPCs in vitro. The dopamine (DA) and glial cell line-derived neurotrophic factor (GDNF) expression levels were detected by ELISA to identify the DPCs. The PD rat model was established by injecting 6-OHDA into the right substantia nigra (SN). A total of 60 successfulled PD model rats were randomized into hUC-MSCs-DPCs group (5 × 105 hUC-MSCs-DPCs were transplanted into right striatum, n=20), hUC-MSCs group (5 × 105 hUC-MSCs were transplanted, n=20) and control group (same volume PBS, n=20). All the transplanted cells were labeled with CM-Dil. The apomorphine induced rotation behavior was assessed at 4, 8 and 12 weeks after cell transplantation. The rats were executed after 12 weeks. The immunofluorescence staining was used to detect the tyrosine hydroxylase (TH) expression level, and FLUORO-JADE? C staining was used to test the apoptotic neurons in brain of rats. Results The hUC-MSCs-DPCs were induced successfully in vitro, which showed a high expression level of DA and GDNF. Furthermore, at 4, 8 and 12 weeks after cell transplantation, the rotation behavior was improved, and expression levels of GDNF were significantly higher in hUC-MSCs-DPCs group than those of hUC-MSCs group and control group (P<0.05). In addition, we found that most of the transplanted TH+hUC-MSCs-DPCs at the right striatum and a few cells around both the left and the right substantia nigra at 12 weeks after transplantation. The apoptotic neurons were decreased after cell transplantation in hUC-MSCs-DPCs group than that of control group (P<0.05). Conclusion The hUC-MSCs-DPCs can improve the rotational behavior induced by apomorphine in PD model rats, which may be involved in improving levels of DA and GDNF in damaged striatum and protecting neurons.

OBJECTIVE:To observe the effects of insulin glargine in type 2 diabetes mellitus patients with poor glucose con-trol by rosiglitazone and metformin. METHODS:A total of 90 patients with type 2 diabetes mellitus with poor glucose control by rosiglitazone and metformin admitted to our hospital from Aug. 2013 to Dec. 2015 were divided into control group and observation group according to random number table,with 45 cases in each group. Control group was given Acarbose tablets 50 mg orally be-fore meal,tid,with maximal dose of 300 mg/d. Observation group was given Insulin glargine injection subcutaneously,qd,with initial dose of 0.15 u/kg,adjusted according to blood glucose monitoring,with maximal dose of 40 u/d. Both group were treated for 24 weeks. The levels of fasting blood glucose,2 h postprandial blood glucose,HbA1c,fasting C peptide and 2 h postprandial C peptide were compared between 2 groups before and after treatment. The time of blood glucose reaching target and the occur-rence of adverse events were recorded,and the incidence of adverse events was calculated. RESULTS:Before treatment,there was no statistical significance in above indexes between 2 groups(P>0.05). After treatment,The levels of fasting blood glucose and 2 h postprandial blood glucose in 2 groups were significantly lower than before treatment,and the levels of fasting C peptide,2 h postprandial C peptide and HbA1c were significantly higher than before treatment;except for fasting blood glucose,above indexes of observation group were significantly better than those of control group,with statistical significance (P<0.05). The time of blood glucose reaching target in observation group was significantly shorter than control group,the incidence of nocturnal hypogly-cemia,severe hypoglycemia,edema and gastrointestinal reactions and total adverse events in observation group were significantly lower than control group,with statistical significance(P<0.05). CONCLUSIONS:The application of insulin glargine in type 2 di-abetes mellitus patients with poor glucose control by rosiglitazone and metformin can effectively reduce the levels of blood glucose and HbA1c,and improve islet function with good safety.

Objective To investigate the changes of visual acuity,fundus changes,and serum vitamin D concentration in diabetic retinopathy patients treated with metformin,and to evaluate its clinical efficacy.Methods Totally 80 cases (160 eyes) patients with background diabetic retinopathy were included in the study,and were divided into observation group (metformin + Pancreatic Kininogenase Enteric-coated Tablets) and control group (Pancreatic Kininogenase Enteric-coated Tablets) according to the different treatment methods used for 3 months.Fundus fluorescein angiography was used to evaluate the improvement of the fundus lesions.The serum levels of vitamin D were measured with electrochemiluminescence immunoassay (ECLIA).Results After 3 months of treatment,serum vitamin D concentration of the observation group increased,and the differences were statistically significant (P ＜ 0.05) when compared to before treatment.However,3 months after treatment,serum vitamin D levels of the control group increased slightly,but the difference was not statistically significant (P ＞ 0.05).The total effective rate of fundus improvement in the observation group and the control group was 70％ and 55％,respectively.There was significant difference between the two groups in the improvement of fundus (P ＜ O.05).Conclusions Metformin has an adjunctive effect on background diabetic retinopathy,and the increase of serum vitamin D may be one of the mechanisms of metformin in improving diabetic retinopathy.

OBJECTIVETo explore the status of articles published in Chinese Journal of Pediatrics from 2005 to 2014.

METHODAll the articles published in Chinese Journal of Pediatrics from 2005 to 2014 were searched at Wanfang Medical Online database. The total number and citations of articles, authors, agency, single article citation, internet downloads, columns, fund and Mesh were analyzed. The end of searching period was January 2015.

RESULTFrom 2005 to 2014, 2814 articles were published in Chinese Journal of Pediatrics, 235 to 380 articles per year. A total of 1 596 articles were cited, the citation rate was 56.16%, total number of citation was 15 428. Among single article citations, of the top 20 articles, 55% (11/20) were those published in the Standard/Protocol/Guide column. Of the top 20 papers most frequently downloaded on internet, 100% were articles published in the Standard/Protocol/Guide column. During the recent 10 years, the source of the papers published in the journal covered 31 provinces, municipalities and autonomous regions. The column that published the largest number of articles was Original Article (911, 32.05%), followed by Case Report (336,11.82%) and Review (245, 8.62%). Of the total number of articles published in the journal, 747 were supported by fund, which accounted for 26%. The articles supported by national fund accounted for 8%.

CONCLUSIONArticles published in Chinese Journal of Pediatrics had high-quality and can reflect the development and research progress in pediatric medicine. It is one of the most important information resources in pediatric academic fields in China.

Objective:To study the occurrence and disappearance of gallbladder polyps in patients who underwent multiple ultrasonographic examinations, and to determine the risk factors of formation of gallbladder polyps.Methods:From January 2014 to December 2017, relevant data on patients who underwent follow-up abdominal ultrasound examinations at the Health Screening Center of Xuanwu Hospital was retrospectively analyzed, and the dynamic changes of gallbladder polyps were assessed. A comparative analysis was then conducted between those who had gallbladder polyps (the gallbladder polyps group, n=1 149) and those who had no gallbladder polyps (the control group, n=18 243). The occurrence, changes and disappearance of gallbladder polyps shown on multiple untrasonographic examinations were compared. Results:The patterns of changes of gallbladder polyps showed that the proportions of patients with gallbladder polyps which were stable in size ( n=1 149, 52.1%) were greater than those who had new appearance of gallbladder polyps ( n=797, 36.2%), and these 2 groups of patients were having higher proportions than those who had disappearance of gallbladder polyps ( n=258, 11.7%). The largest proportion of gallbladder polyps were found in middle-aged people, and new polyps were mainly found in the age group of 30.0-59.0 years. The peak of gallbladder polyps incidence was after age 60. There were significant differences in age, male, blood glucose, total cholesterol, low density lipoprotein (LDL), and diastolic blood pressure between the study and the control groups (all P<0.05). Multivariate analysis showed that age ( OR=1.152), male ( OR=1.407) and LDL ( OR=1.656) were independent risk factors of gallbladder polyp formation. Conclusions:The annual incidence of gallbladder polyps was 9.7‰. Gallbladder polyps were more commonly found in middle age, and the incidence of gallbladder polyps was increasing. Gallbladder polyps could disappear. However, with increase in initial diameter of gallbladder polyps, the probability of disappearance decreased. Age, male gender and elevated LDL were independent risk factors of gallbladder polyps formation.

Objective:To understand the current situation of smartphone addiction and mental health of medical freshmen, and conduct research on the relationship between smartphone addiction and mental health, so as to provide evidence for the prevention and intervention of smartphone addiction among medical freshmen.Methods:A stratified random sampling method was used to select 279 freshmen in the medical profession of Binzhou Medical University as the research objects, and the revised smartphone addiction scale (SAS-C) and mental health symptom self-rating checklist scale (SCL-90) were selected for testing. SPSS 19.0 was used for t test. Results:A percentage of 29.71 medical freshmen had smartphone addiction problems, which was generally above average. The SCL-90 total scores and the scores of somatization, interpersonal sensitivity, depression, anxiety, hostility, psychosis and other factors in the smartphone addiction group were significantly higher than those in non-smartphone addiction group. The total score of smartphone addiction in medical professional freshmen was significantly correlated with the total score of SCL-90. In addition to the interference factors of daily life, other factors had positive correlation with various factors of SCL-90. Interpersonal sensitivity and obsessive-compulsive symptoms had a significant predictive effect on smartphone addiction (β=0.24, 0.26, P < 0.01), which were important variables affecting mobile phone addiction of medical freshmen. Conclusion:Many medical freshmen have the problem of smartphone addiction, which may cause a series of psychological problems, especially obsessive-compulsive symptoms, interpersonal sensitivity, anxiety and psychosis.