Objective To observe the clinical effect of brachial plexus anesthesia shoulder manipulation solution combined with individualized treatment in treatment of periarthritis of shoulder.Methods 80 patients with periarthritis of shoulder were randomly divided into control group and observation group,40 cases in each group.The control group was given brachial plexus anesthesia shoulder manipulation solution,and the observation group was given brachial plexus anesthesia shoulder manipulation solution combined with individualized treatment.Joint function score and cure rate were compared before and after treatment in the two groups.Results The joint function score [(93.68 ±3.74)] and cure rate (62.50%) of the observation group were significantly higher than those in the control group[(79.35 ±3.21),35.00%] after 2 months treatment (t =1.57,3.86,χ2 =6.05,all P <0.05). Conclusion Brachial plexus anesthesia shoulder manipulation solution with individualized treatment has obvious effect in treatment of periarthritis of shoulder,and can effectively restore joint function in patients.

objective To investigate the relationship between serum iron,ferritin(SF),transferrin(TRF)and coronary artery stenosis asd well to find the possible cause of coronary heart disease,Methods All the 315 pailents underwent coronary angiography.Serum iron,SF and TBF were measured.All patients were divlded into three groups according to the Gensini score.The distribution of serum iron,SF,TRF in the three groups underwent analysis of variance and the relationship between serum iron,SF,TRF and the Gensini score were further investigated by means of multiple linear regression analysis.Results The analysis of one-way variance showed that serum iron,SF and TRF/SF Were associated with the Gensini score(coefficient correlation=6.162,7.191 and 4.380,P<0.05).Muhiple linear regression analysis adjusted for many risk factors for coronary heart disease showed that SF had independent association with the Gensini score.(r=0.240.P<0.01).Conclusion Ferritin is independ-ently associated with coronary artery stenosis.

Objective To investigate the clinical value of a newly designed surgical therapy for familial polyposis coli by severing the superior mesenteric artery&vein in order to make a complete lysis of the mesentery and an ileum pouch and the anal anastomosis within the entire muscular sheath of the rectum.Methods Six patients with familial polyposis coli(5 males and 1 female,aged 24-36 years)were admitted and underwent the procedure which was consisted of:(1)An incision was made in the left middle and lower parts of the rectus abdominis;(2)The greater omentum was retained and the large intestine was removed;(3)At the juncture of the sigmoid colon and the rectum,the muscular sheath was dissociated 0.5cm,the mucous membrane of the rectum was stripped in a revolving manner,the nourishing artery and vein in the membrane were exposed,and clamped and cut in sequence up to the anocutaneoue line;(4)The rectal mucous membrane was completely removed;(5)Under the right colonic artery,the superior mesenteric artery and vein were severed;(6)An N-,J-or W-shaped pouch was made in the ileum accordingly:(7)An anastomosis of the ileum pouch and the anal canal was made within the entire muscular sheath of the rectum,and a drainage was placed;(8)The mesostenium was fixed on the fight posterior abdomen,the small intestines were spread out to the right side,and the mesostenium was covered on the coarse surface of the colon bed:(9)A tube was placed in the left lower abdomen for a vacuum aspiration for 2 days after operation,combined with the suction drainage,to eliminate the pelvic effusions;and(10)The abdomen was closed.Results Patients were able to discriminate stools and flatus 3-7 days after operation.and the formed stools occurred 7-10 days after operation.Five patients were followed-up for 3-17 years,with averagely one defecation a day,with no night defecation and seepage.Urination was normal;In another one patient who underwent the procedure 4 months ago the defecation was twice a day,with no night defecation.All the 6 patients had normal autonomic nerve function and sexual function as well as normal defecation and urination,with no recurrence of polyposis coli or infection.The small bowel functions well with no ischemia related symptoms.Conclusion Cutting the superior mesenteric artery and vein and then making anastomosis of the ileum pouch and the anal canal within the muscular sheath of the rectum is a new surgical approach to familial polyposis coli.It is safe and significantly improves the patients' life quality.

abnormality from cardiomyopathy and endocardial fibroelastosis. Some pediatric patients have overlapped characteristics of both infant and adult type.

Purpose To investigate the mutations of ID3,TCF3 and MYC genes in Chinese Burkitt lymphoma and discuss their significance.Methods Total DNA was extracted from tumor tissues of 32 patients with Burkitt lymphoma,then the DNA was amplified by polymerase chain reaction (PCR),and the products of PCR were sequenced directly with Sanger sequencing methods.Results The mutation rates of ID3 and TCF3 genes were 35.5％ (11/31) and 18.8％ (6/32) respectively.The mutation rate of MYC was 50％.The mutation rates of MYC exon 1,MYC exon 2 and MYC exon 3 were 3.3％ (1/30),50％ (15/30) and 7.7％ (2/26) respectively.Conclusion Recurrent mutations of the ID3,TCF3 and MYC genes in Chinese Burkitt lymphoma were identified by Sanger sequencing.For TCF3 gene,a novel mutation c.2202G ＞ C p.L569V was found in three cases.In two cases,a novel mutation of c.1070A ＞G p.G182D was found in MYC gene.

Nine pediatric patients (4 females,5 males) with huge hemangioma of head and neck complicated with Kasabach-Merritt phenomenon,aged 15-135 days,undergoing elective radical resection for huge hemangioma of head and neck,were selected from June 2012 to June 2016 in our hospital.Two pediatric patients were sensitive to preoperative hormone treatment,the platelet count almost increased to the normal value,7 pediatric patients were not sensitive to preoperative hormone treatment,and the increase in platelet count was not obvious.When the platelet count ＜ 40× 109/L,platelet was infused at 12 h before operation until the platelet count ＞ 100× 109/L.Two pediatric patients with larger haemangioma in maxillofacial region kept spontaneous breathing,and anesthesia was induced by inhaling high-concentration of sevoflurane.Anesthesia was induced with intravenous midazolam,sufentanil and cisatracurium in the other seven pediatric patients.Pediatric patients were mechanically ventilated in pressure-controlled mode after endotracheal intubation with airway pressure of 9-12 cmH2O.All pediatric patients inhaled sevoflurane,and anesthesia was maintained by infusing remifentanil.Heart rate and systolic blood pressure were maintained within the normal range during operation.Fluid and blood products were infused according to the blood loss,urine volume,physiological requirement and central venous pressure,etc.Pediatric patients were transferred to pediatric intensive care unit (PICU) at the end of operation,and the endotracheal tube was removed after the patients were completely awake.One pediatric patient developed pulmonary infection after operation,was discharged from PICU on day 7 after operation,then cured and discharged from hospital after healing on day 20 after operation.The other eight pediatric patients were discharged from PICU on day 2 after operation,then cured and discharged from hospital on days 5-10 after operation.After a followup period of 1 yr,the pediatric patients recovered well,the platelet count was normal,and the tumor recurrence was not found.

Objective To investigate the protective effect of permissive hypercapnia in infants undergoing one-lung ventilation(OLV). Methods A total of 64 infants were randomly divided into Group N(normocapnia group,n=32)and Group H(hypercapnia group,n=32).Arterial blood gas samples were collected at four differ-ent time points:10 minutes after intubation(T1),30 and 60 minutes after artificial pneumothorax(T2,T3),and 30 minutes after being sent to post anesthesia care unit(T4)while vital signs(HR,MAP,SpO2and temperature) and ventilation parameters(Ppeak,Vt,PEEP,RR,MVV,and FiO2)were recorded simultaneously;OI was calcu-lated by corresponding equation. Bronchoalveolar lavage fluid(BALF)was collected before and after surgery for the measurement of RAGE. Results Compared with those at T1,MAP and PaO2were significantly lower but Ppeak was obviously higher in group N,while HR,Ppeakas well as PaCO2were increased(P<0.05)and Vt,MVV,pH, PaO2as well as lactic acid were decreased in group H(P < 0.05)at T2and T3. Compared with those in group N, MAP,HR as well as PaCO2were higher while Ppeak,Vt,MVV,pH,and lactic acid were lower in group H at T2 and T3(P<0.05).There was a significant increase of RAGE in both groups after surgery and it was much higher in group N when compared with that in group H after surgery(P<0.05). Conclusion PHC not only has advantages in improving tissue oxygenation,but also has the potential of lung protection for infants undergoing OLV.

Objective: Autism spectrum disorder (ASD) is a neurodevelopmental disorder with onset in infancy. Early intervention is critical to improve the prognosis for these children. E-health interventions have tremendous potential. This review aimed to determine the status and effectiveness of family interventions for parents of children aged 0–6 years with ASD in the context of e-health. Methods: The review methodology was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. PubMed, Web of Science, and China National Knowledge Infrastructure were searched from inception to June 2022. The searches were limited to children with ASD of the age range between 0 and 6 years. We collated the available information and used descriptive statistics to analyze the synthesized data. Results: Our initial search identified 3,672 articles, of which 30 studies met the inclusion criteria. The 30 articles selected were released between 2012 and 2022. All articles are in English. Most articles reviewed were from high-income countries (27/30, 90.0%), especially from the United States (16/30, 53.3%). Four major themes emerged from the 30 studies that matched the inclusion criteria, as follows: 1) type of e-health interventions, 2) duration of interventions, 3) clinical aspects of e-health interventions, and 4) evidence for intervention effectiveness, looking into the positive, negative, and mixed findings of previous studies. Conclusion These findings suggest that a wide variety of e-health interventions may actually help support both children with ASD aged 0–6 years and their parents.

Objective To investigate the effect of anesthesia factor on lung injury in patients un?dergoing thoracoscopic radical lung cancer surgery and to evaluate efficacy of combination of thoracic para?vertebral block(TPVB)with dexmedetomidine mixed with ropivacaine and general anesthesia. Methods One hundred patients of both sexes, aged 18-64 yr, with body mass index of 18-25 kg∕m2, of American Society of Anesthesiologists physical statusⅡorⅢ, scheduled for elective thoracoscopic radical lung cancer surgery, were divided into 5 groups(n=20 each)using a random number table: general anesthesia group (group G), TPVB with ropivacaine combined with general anesthesia group(group R), intravenously in?fused dexmedetomidine combined with general anesthesia group(group Div), intravenously infused dexme?detomidine plus TPVB with ropivacaine combined with general anesthesia group(group Div+R), and TPVB with dexmedetomidine mixed with ropivacaine combined with general anesthesia group(group Dtp+R). In group R, TPVB was performed under ultrasound guidance, two?point method was selected accord?ing to the position of intercostal space at surgical incision, and 0.5% ropivacaine 10 ml was injected into each puncture site. Dexmedetomidine 0.5 μg∕kg was intravenously infused over 10 min in group Div. Dexmedetomidine was intravenously infused for TPVB in group Div+R. TPVB solution contained dexmedeto?midine 0.5 μg∕kg and ropivacaine in group Dtp+R. Anesthesia was then induced and maintained by IV in?fusion of propofol and remifentanil. The intraoperative consumption of propofol and remifentanil and develop?ment of adverse reactions such as hypoxemia, hypotension and bradycardia were recorded. Normal lung tis?sues around the tumor margin were obtained immediately after tumor resection for determination of the ex?pression of hypoxia?inducible factor 1 alpha(HIF?1α), BCL2∕adenovirus E1B 19kDa interacting protein 3 (BNIP3)and microtubule?associated protein 1 light chain 3Ⅱ(LC3Ⅱ)(by Western blot), contents of tumor necrosis factor?alpha(TNF?α)and interleukin?6(IL?6)in lung tissues(by enzyme?linked immu?nosorbent assay)and cell apoptosis(by TUNEL)and for examination of the pathological changes(with a light microscope)which were scored. Apoptosis index was calculated. Results The amount of propofol consumed was significantly lower in Div+R and Dtp+R groups than in the other three groups, and the a?mount of remifentanil consumed was significantly higher in G and Div groups than in the other three groups (P<0.05). The incidence of hypertension and tachycardia was significantly lower in R and Div groups than in group G(P<0.05). The incidence of hypotension was significantly lower in R, Div and Dtp+R groups than in group Div+R(P<0.05). The incidence of bradycardia was significantly higher in Div and Div+R groups than in group R(P<0.05). Compared with G and R groups, apoptosis index, contents of TNF?α and IL?6 and lung injury scores were significantly decreased, and the expression of HIF?1α, BNIP3 and LC3Ⅱ was up?regulated in Div, Div+R and Dtp+R groups(P<0.05). Compared with group Div, the TNF?α content and lung injury scores were significantly decreased, and the expression of HIF?1α and LC3Ⅱwas up?regulated in Div+R and Dtp+R groups, and the IL?6 content was significantly decreased in group Dtp+R(P<0.05). Conclusion Combination of TPVB with dexmedetomidine mixed with ropivacaine and general anesthesia produces better efficacy in reducing lung injury in patients undergoing thoracoscopic radi?cal lung cancer surgery.

Objective: To identify the prevalence of sleep problems in children with autism spectrum disorder (ASD) and to explore the association with the main melatonin metabolite, 6-sulfatoxymelatonin (6-SM). Method: This was a prospective case-control study. Children with ASD were recruited from Child Development and Behavioral Research Center (CDBRC) of the Harbin Medical University and Harbin Special Education School from October 2015 to April 2017 (ASD group) . Healthy controls were selected from five kindergartens and one primary school in Harbin by the stratified cluster random sampling (control group) . The Children's Sleep Habits Questionnaire (CSHQ) was used to investigate the sleep problems of the two groups. The patients were matched in a 1∶1 ratio for the age and sex, and the urine samples of case-control pairs were collected in the morning. The level of 6-SM was measured by the enzyme linked immunosorbent assay (ELISA). The student's t test was used for comparison between the ASD group and control group, and the Pearson correlation analysis was used to determine the correlation difference. Result: A total of 212 ASD children (mean (±SD) age was (6.0±2.7) years, and 181 patients (85.4%) were male), and a total of 334 healthy children(mean (±SD) age was (5.9±2.6) years, and 272 patients (81.4%) were male) were recruited. Among them, 101 matched case-control pairs completed the collection of urine samples. According to the statistical analysis, the scores of total CSHQ, bedtime resistance, sleep onset delay, sleep duration, night waking, parasomnia, sleep disordered breathing and daytime sleepiness in children with ASD were significantly higher than those in the control group (48.2±6.2 vs. 46.6±5.4, 11.4±2.5 vs. 10.7±2.8, 1.7±0.8 vs. 1.5±0.7, 4.1±1.4 vs. 3.7±1.1, 4.2±1.5 vs. 3.8±1.1, 8.5±1.5 vs. 8.3±1.4, 3.7±1.0 vs. 3.4±0.8, 11.7±2.5 vs. 12.4±2.7, t=3.16, 3.00, 3.23, 2.76, 3.19, 1.99, 3.45,-2.72, P=0.002, 0.003, 0.001, 0.006, 0.002, 0.048, 0.001, 0.007), the level of 6-SM was significantly lower in children with ASD than that of healthy controls ((1.24±0.50) vs. (1.68±0.63)μg/h, t=-5.50, P<0.01), and the total CSHQ score was negatively correlated with the level of 6-SM (r=-0.50, P<0.01). Conclusion The children with ASD were at high risk for sleep problems, and the melatonin metabolite of ASD group was abnormal compared with that of the control group. Moreover, there was a negative correlation between the severity of sleep problems and the level of 6-SM in ASD children. The results of our study indicate that the abnormal melatonin metabolism may be one of the causes of sleep problems in children with ASD.