OBJECTIVE: To evaluate the efficiency and safety of sodium valproate by testing the compliance of therapeutic drug monitoring (TDM) in epileptic children so as to provide a reference for rational and individual treatment. METHODS: A retrospective analysis of clinical data of children with epilepsy was performed. The patients were treated with sodium valproate or combined with other AEDs. RESULTS: A total 1 507 children were included in the study. It was found that the 49.44% of children had taken TDM only once and the children who had TDM for over 4 times merely took up 5.24%. The first time performed TDM data within therapeutic window only took up 51.63%, and 3. 58% exceeding the window as well. There were statistical difference between age, daily dosage, valproate plasma concentration and control rate among different times in TDM (P<0.001). And difference was also statistical significance between valproate plasma concentration in age groups. Comparing sodium valproate monotherapy to sodium valproate combined with other AEDs, daily dosage (P<0.001), the valproate serum concentration (P=0.001) and the rate within therapeutic window (P=0.004) were all in statistical difference. However, there was no difference in abnormal liver function rate among TDM times. CONCLUSION: Since the great difference among individuals, it need to take individual therapy based on the results of TDM and to reduce the adverse reaction so as to improve the efficiency and rational use of drugs on clinic.

Objective: To explore the prognostic value of 18F-FDG PET/CT parameters combined with clinical features in predicting prognosis of early cervical cancer patients after surgical operation. Methods: A total of 70 cervical cancer patients who underwent 18F-FDG PET/CT before operation were collected and retrospectively analyzed. Differences of metabolic parameters were compared between relapsed patients (relapse group) and non-recurrent ones (non-recurrent group). The predictive value of 18F-FDG PET/CT parameters combined with clinical features for prognosis were analyzed. Results: The mean follow-up time was (53.86±15.74) months, and recurrence of cervical cancer occurred in 11 patients (11/70, 15.71%). The peak standard uptake value (SUVpeak) was the only 18F-FDG PET/CT parameter predicting recurrence (AUC=0.672, P=0.03). Multivariate proportional hazards model (Cox) showed that lymph node metastatic status and SUVpeak were the most important predictors. Conclusion: SUVpeak and lymph node metastatic status are main indicators for evaluating prognosis of patients with early cervical cancer after surgical operation.

Acinetobacter baumannii is an important pathogen of clinical infection in critically ill patients.The clinical detection rate of Acinetobacter baumannii is increasing and the drug resistance is becoming more and more serious.The selection of antibiotics to antibiotic-resistant Acinetobacter baumannii is very limited, particularly in children with the special age and physiological characteristics, which aggravates the clinical burden.This article reviewed the status of Acinetobacter baumannii infection, especially on different diseases including pneumonia, bloodstream infections, intracranial infections and antibiotics using.

The hemodynamic characteristics of venous reflux are associated with infertility in patients with varicocele; however, an effective method for quantifying the structural distribution of the reflux is lacking. This study aimed to predict surgical outcomes using a new software for venous reflux quantification. This was a retrospective cohort study of a consecutive series of 105 patients (age range: 22-44 years) between July 2017 and September 2019. Venous reflux of the varicocele was obtained using the Valsalva maneuver during scrotal Doppler ultrasonography before microsurgical varicocelectomy. Using this software, the colored reflux signals were segmented, and the gray scale of the color pixels representing the reflux velocity was comprehensively quantified into the mean reflux velocity of the green layer (MRVG) and the reflux velocity standard deviation of the green layer (RVSDG). Spontaneous pregnancy and changes from baseline in the semen parameters were assessed during a 12-month follow-up period. Data were analyzed using logistic regression analysis. An association of the high MRVG group with impaired progressive motility (odds ratio [OR] = 2.868, 95% confidence interval [CI]: 1.133-7.265) and impaired sperm concentration (OR = 2.943, 95% CI: 1.196-7.239) was found during multivariate analysis. High MRVG (OR = 2.680, 95% CI: 1.086-6.614) and high RVSDG (OR = 2.508, 95% CI: 1.030-6.111) were found to be independent predictors of failure to achieve pregnancy following microsurgical repair. In summary, intense venous reflux is an independent predictor of impaired progressive motility, sperm concentration, and pregnancy outcomes after microsurgical varicocelectomy.
Pregnancy ; Female ; Humans ; Male ; Young Adult ; Adult ; Varicocele/surgery* ; Retrospective Studies ; Semen ; Veins/surgery* ; Sperm Count ; Infertility, Male/surgery* ; Microsurgery/methods* ; Sperm Motility

OBJECTIVE:To describe labor patterns in women undergoing vaginal birth after cesarean(VBAC)and to ex⁃amine whether the labor pattern differed due to the different time of the previous cesarean.METHODS:In a retrospective observational study at Shengjing Hospital from January 2015 to July 2017,we compared the labor duration of latent、ac⁃tive phase and second stage among 50 women undergoing VBAC,51 nulliparous women and 51 multiparous women. Ac⁃cording to whether they had an elective cesarean(20)or a cesarean after a trial of labor(27)(data of 3 women was not available)in the previous pregnancy,the VBAC women were divided into two groups and compared the labor durations.RESULTS:There was no significant difference in median labor duration of latent phase among the groups(P>0.05). The median length of the active phase was 140,170 and 80 minutes in the VBAC,nulliparous and multiparous groups,re⁃spectively,and the VBAC was significantly longer than the multiparous(P<0.001).The median length of second stage for VBAC was 23 minutes which was significantly shorter than that of nulliparous(38 minutes,P<0.001)and longer than that of multiparous(9 min,P<0.001).Between subgroups within the VBAC according to whether they had an elective cesarean or a cesarean after a trial of labor in the previous pregnancy,there were no significant differences in the median labor duration of each stage.CONCLUSION:The labor patterns of first stage in women undergoing VBAC is similar to that of nulliparous,regardless of the indication for the previous cesarean,and labor curve shows a gradual smooth transition.The labor was faster for VBAC compared to nulliparous women in second stage.These findings on labor progress in VBAC should help obstetricians to manage labor,which improves the success rate of VBAC.

Liver-resident natural killer (LrNK) cells, as a type of newly discovered tissue-resident natural killer cells, have a strong immune killing function. During the development and progression of hepatocellular carcinoma (HCC), the function of LrNK cells is impaired and such cells may promote the progression of HCC by upregulating the expression of related immune checkpoints. Based on the latest research, this article reviews the immune function of LrNK cells and their role in the development and progression of HCC, in order to explore the application prospect of these cells in HCC immunotherapy.

Hepatocellular carcinoma (HCC) is the second leading cause of disease-related death in China and greatly threatens the health of residents. Recent studies have shown that traditional Chinese medicine plays an important role in the comprehensive treatment of HCC. Huaier granules have been recommended for the treatment of HCC, and its mechanism of action includes inhibiting angiogenesis, inhibiting the proliferation of HCC cells, inhibiting invasion and metastasis, inducing cell apoptosis, and regulating immune function. This article summarizes the research advances in the anti-HCC mechanism of Huaier granules and its application in clinical practice, in order to provide a reference for subsequent research and clinical treatment.

Objective:Analysis of nasal lymphoma CT and MRI data, summarize imaging characteristics, provide help for clinical diagnosis. Method:Retrospectively analyzed the image manifestations of 32 cases of nasal lymphoma diagnosed by surgery and pathology. Lesion locations, tumor extension, bone destruction and its density, signal characteristics, enhancement degree, the situation of adjacent tissues were evaluated. Result:NK/T cells, T cell NHL have the characteristics: the lesions to diffuse growth, widely existed in nasal breathing zone, often involving middle and inferior turbinate, local bone slightly damaged, and no obvious bony shift. Tumor of uneven density, fuzzy boundaries, mixed signalse. The characteristics of B cell NHL: the lesion originated in the front of the nasal cavity, on the surrounding adjacent tissue compression performance, local feature is swelling growth and bone have insect damage sample sample, the dotted line change, very mild osseous shift, the tumor boundary is relatively clear, lesions density is uniform, and part of the uniform tumors had signal. Conclusion:Nasal lymphoma imaging changes have its characteristics. Image change prompts the pathological classification, providing help for clinical diagnosis.

Objective To investigate the clinical effect of simultaneous surgical resection of hepatic and pancreatic lesions versus systemic chemotherapy in treatment of resectable pancreatic cancer with liver metastasis (PCLM). Methods A retrospective analysis was performed for related data of the patients with PCLM who were admitted to Shengjing Hospital of China Medical University from January 2013 to May 2020, and the patients with resectable PCLM were screened out and then divided into surgery group and chemotherapy group. The propensity score matching (PSM) method was used to reduce the impact of data bias and confounding factors. The independent samples t -test or the Mann- Whitney U test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups. The Kaplan-Meier method was used to calculate survival time, and the log-rank test was used for evaluation. The univariate and multivariate Cox regression models were used to investigate the independent risk factors for survival. Results A total of 56 patients with resectable PCLM were screened out, with 33 patients in the surgery group and 23 patients in the chemotherapy group, and there were 15 patients in each group after PSM. The surgery group had a significantly shorter median overall survival time than the chemotherapy group before PSM (6.6 months vs 10.4 months, χ 2 =4.476, P =0.034) and after PSM (6.4 months vs 10.5 months, χ 2 =4.309, P =0.038). The multivariate Cox regression analysis showed that poorly differentiated tumor (hazard ratio [ HR ]=4.945, 95% confidence interval [ CI ]: 1.980-12.348, P =0.001) and absence of postoperative chemotherapy ( HR =3.670, 95% CI : 1.437-9.376, P =0.007) were independent risk factors for poor prognosis in patients with PCLM. Conclusion Compared with chemotherapy, simultaneous surgical resection of hepatic and pancreatic lesions fails to prolong the overall survival time of patients with resectable PCLM. Patients with poorly differentiated tumor and those without postoperative chemotherapy tend to have poor prognosis.

Objective To compare broth microdilution and agar dilution methods for in vitro testing of activities of fluconazole,ketoconazole and itraconazole against clinical Malassezia isolates.Methods Broth microdilution and agar dilution methods were used to determine the minimal inhibitory concentration(MIC)of fluconazole,ketoconazole and itraconazole for 27 clinical strains(5 species)of Malassezia.Results The minimal inhibitory concentration(MIC)ranges of fluconazole,ketoconazole and itraconazole were 0.25-≥64 mg/L,≤0.03-0.5 mg/L and ≤0.03-0.125 mg/L respectively as shown by broth microdilution method,2-≥64 mg/L,≤0.03-0.5 mg/L and ≤0.03-0.25 mg/L respectively as revealed by agar dilution method.Both methods demonstrated that itraconazole possessed the strongest activity against Malassezia species,followed by ketoconazole and fluconazole.The agreement rate in MICs between the two methods was 78.8％,85.2％ and 88.9％,respectively for fluconazole,ketoconazole and itraconazole,with the intraclass correlation coefficients (ICCs)being 0.88,0.80 and 0.76 respectively.Conclusions Fluconazole,ketoconazole and itraconazole are highly active against Malassezia species in vitro,and itraconazole is the most active.Broth microdilution and agar dilution method coincide well in,and are applicable for,the antifungal susceptibility testing of Malassezia species in vitro.