Objective To compare the efficacy and safety of duloxetine and gabapentin in the treatment of diabetic peripheral neuritis .Methods 135 patients with diabetic peripheral neuritis were divided into the observation group(71 cases) and the control group (64 cases) according to random number table method ,and all patients received hypoglycemic therapy based on diabetes treatment principle .Furthermore,the observation group received oral duloxe-tine,while the control group was given oral gabapentin .The pain scores of all patients were evaluated using visual ana-log scale(VAS) and medical outcomes study (SF-36),and the adverse reactions were recorded during treatment . Results (1) Compared with before treatment ,both VAS scores and SF-36 scores in observation group and control group declined significantly at the end of 1st,2nd,4th week after treatment(all P<0.05),while there were no statis-tically significant differences in VAS scores and SF-36 scores between the two groups at the same time point ( all P>0.05).(2)The incidence rates of dry mouth ,drowsiness,fatigue and dizziness in observation group were significantly lower than those in control group (18.31% vs.34.38%,4.23% vs.26.56%,0.00% vs.23.44%,0.00% vs. 15.63%,χ2 =4.059,13.308,4.059,4.059,all P<0.05),while there were no statistically significant differences in incidence rates of nausea ,diarrhea and flustered between the two groups (all P<0.05).Conclusion The duloxetine and gabapentin in the treatment of diabetic peripheral neuritis have similar efficacy , but the duloxetine has better security.

Objective To investigate the diagnosis and treatment of primary presacral tumor. Methods The clinical data of 18 patients with primary presacral tumor were retrospectively analyzed. Results Preoperative diagnosis of primary presacral tumor depended on digital rectal examination, endorectal ultrasound, CT, MRI, et al. The surgical approaches of 18 cases included posterior approach (14 cases) and abdominoperineal approach (4 cases). All tumors were completely resected. Postoperative complications were rectal injury (1 case) and wound infection (2 cases), which were cured by symptomatic treatment. Postoperative pathological results showed that 15 cases had benign lesions and 3 cases had malignant lesions. Sixteen patients were followed up from 0.5 to 5.0 years, with recurrence in 2 cases and death in 2 cases. Conclusions Primary presacral tumor should be treated with operation. Sufficient preoperative examination, personalized operative planning, subtle manipulation operative procedures with an experienced multidisciplinary team, are the important points in preventing or reducing recurrence. Endorectal ultrasound plays an important role in the diagnosis and treatment of primary presacral tumor.

Objective To observe the distribution and location of TGF-?_1 in different stages of experimental lesions and to discuss its potential function. Methods Thirty Wistar rats were established experimental periapical lesions in maxillary first and second molar as experimental group while mandibular molar as control group, and they were divided into ten groups by the time(1,2,3,4,5,6,7,8,9, and 10 weeks)after pulp exposure, three rats in every group. Expression of TGF-?_1 was detected by histopathology and immunohistochemistry. Results Strong expression of TGF-?_1 was observed in acute inflammation of pulp (1st-2nd week) and periapical tissue (4th-6th week), and idisappeared in pulp aecrosis and in chronic inflammation of periapical tissue(7th week). The main cells expressing TGF-?_1 were macrophage,lymphocyte and fibroblast. Conclusion TGF-?_1 has the certain function in inflammation and prevention of experimental periapical lesions.

OBJECTIVE:To gain clear idea of influence of multiorigins of Cordyc ep s on quality and nature of this drug.METHODS:The mannitol contents in the Cordy ceps samples collected from different growing areas were determined and compared ,and their MDR(Mutual Different Rate)was analyzed.RESULTS:The MDRs among specim ens from Sichuan,Tibet and Yunnan were 0.012～0.32 and the MDRs among the Cordyc eps samples from different micro-ecological environment were 0.037～1.36.CONCLU SION:On the mannitol content in Cordyceps,the effect of the species diversity a nd the micro-ecological environment might exceed that of district and climate d ifference.

Child and adolescent mental disorders are common disorders with various symptoms,and attracting more attention due to the increasing prevalence.Mental disorders,especially the attention-deficit hyperactivity disorder (ADHD) and the autism spectrum disorder (ASD),have great influence on the development of children and adolescents.Nowadays,the biomarkers from neuroimaging such as magnetic resonance imaging (MRI) have a great importance on the diagnosis of mental disorders,and machine learning has been proved to be very powerful in the processing for neuroimages.Nowadays,many researchers are focusing on the studies of computer-aided diagnosis (CAD) based on machine learning and neuroimaging.In this review,the technical details of machine learning based CAD of child and adolescent mental disorders are briefly introduced,and the research progress in CAD of ADHD and ASD based on machine learning and structural MRI are summarized.These studies showed that many machine learning methods have been used in the diagnosis of child and adolescent mental disorders,but the relevant methods cannot be applied to clinical diagnosis.Further studies should be conducted to improve the diagnostic ability of machine learning methods from multiple perspectives,and provide an objective and reliable tool for the clinical diagnosis of child and adolescent mental disorders.

Ultrasonic estimation of fetal weight is important in the management o f labor and delivery. Lots of charts and formulas have been put forward in virtu e of regression methods. Artificial neural network, a kind of computer artificia l intelligence technology, can simulate human thinking based on neural structure and physiology. With the excellence in complex and non-linear information proce ssing, artificial neural network is fitter for the forecasting of fetal weight t han traditional regression methods.

Objective To determine the influence factors for limb salvage of bone fracture patients with hyperpotassemia caused by Wenchuan earthquake,to discuss the clinical symptom and to improve the clinical treatment. Methods The clinical symptom, drug therapy, limb incision decompression, hemodialysis, and limb salvage of hyperpotassemia caused by earthquake were analyzed by logistic regression. Results All the 37 patients received drug therapy: 9 patients received incision and decompression singlely,8 received hemodialysis singlely,and the other 20 received decompression and hemodialysis simultaneously. The concentration of potassium decreased from (6.25 ± 0.91) mmol/L to (4.47±0.65) mmol/L,with significant difference (P＜0.05).Five patients with Gustilo III grade open injury received amputation at the concentration of potassium of (6.13±(0.78)) mmol/L, while the concentration of potassium for the other 32 patients was (6.25±0.31) (mmol/L). There was no significant difference between them(P>0.05). Logistic regression analysis found the time of compression, the time before incision and decompression, and the time before hemodialysis were the main factors to affect limb salvage. The OR value of these factors was 4.394, 3.793 and 5.432;while the P value was 0.013, 0.047, and 0.015, respectively. Conclusion Decreasing the time of compression, appropriate incision and decompression, and hemodialysis help improve the result of limb salvage in hyperpotassemia patients with bone fracture caused by earthquake.

To evaluate the application of self-reinforced ploy-DL-lactide (SR-PDLLA) absorbable screws in the treatment of spongy bone and intra-articular fractures, the internal fixation with SR-PDLLA absorbable screw was performed on 58 cases,of which 25 were medial malleolus fractures, 14 condyle of humerus fractures, 9 tibial plateau fractures, 7 ulnar olecranon fractures, and 3 lateral malleolus fractures. Observations were made on the orthopaedic operation sites and overall conditions frequently and radiography was performed for periodic analysis. The results showed that SR-PDLLA absorbable screws were particularly effective and reliable, they had good biocompatibility in the treatment of spongy bone and intra-articular fractures and could be used safely in clinical practice.
Absorbable Implants ; Adolescent ; Adult ; Ankle Injuries ; surgery ; Bone Screws ; Child ; Female ; Fracture Fixation, Internal ; Fractures, Bone ; surgery ; Humans ; Humeral Fractures ; surgery ; Internal Fixators ; Lactic Acid ; chemistry ; Male ; Middle Aged ; Polyesters ; Polymers ; chemistry

Objective To evaluate the contraception efficacy, mode of bleeding, side effects and other positive effects of drospirenone-ethinylestradiol (Yasmin) in healthy Chinese women. Methods This was a multicenter, randomized, control study of 768 healthy Chinese women who consulted about contraception. The subjects were randomized into Yasmin group (30 μg ethinylestradiol plus 3 mg drospirenone, 573 cases) or desogestrel group (30 μg ethinylestradiol plus 150 μg desogestrel, 195 cases) with the ratio of 3: 1. Each individual was treated for 13 cycles. Further visits were required at cycle 4, cycle 7, cycle 10 and cycle 13 of treatment. Weight, height, body mass index were evaluated at each visit. The menstrual distress questionnaire (MDQ) was given to the women at baseline, visit 3 (cycle 7) and visit 5 (after cycle 13). Results The values of basal features were similar between two groups (P> 0.05). The Pearl index (method failure) of Yasmin was 0. 208/hundred women year which was lower than that of desogestrel (0. 601/hundred women year). The mode of bleeding was similar between two groups after trial without showing any significant difference. According to MDQ subscale, the improvement of water retention and increasing appetite during inter-menstrual period and water retention and general well-being during menstrual period in the Yasmin group ( -0. 297, -0. 057, 0. 033, 0. 150 respectively) was more obvious than that in the desogestrel group ( - 0. 108, 0. 023, 0. 231, - 0. 023 respectively) with a significant difference (P < 0. 05 ). Some other values which improved in beth two groups, especially the improvement of breast tenderness and pain and skin abnormality in Yasmin group (18.0%, 89/494; 12. 6%, 62/494) was more distinct than that in desogestrel group (11.3%, 19/168; 5.4%, 9/168). The mean weight increased in desogestrel group (0. 57 kg) while it decreased in Yasmin group ( -0. 28 kg) with a significant difference (P < 0. 01 ). Conclusions Both Yasmin and desogestrel have good efficacy on contraception and similar modes of menstrual bleeding. Yasmin is better than desogestrel in terms of weight control and premenstrual syndrome of oral contraceptive.

【Objective】 To make transfusion management strategies for patients with history of blood transfusion and/or pregnancy by following up a patient with delayed hemolytic transfusion reactions(DHTR) caused by unexpected antibody produced after blood transfusion. 【Methods】 ABO, Rh, MN and Kidd blood group test, direct antiglobulin test, unexpected antibody screening, antibody identification, antibody titer detection, and cross-matching test were performed on a patient with DHTR. Meanwhile, suitable red blood cells were screened for subsequent treatment. 【Results】 The patient′s blood group was B, RhD(+ ) and CCDee, the antibody screening test and cross-matching test were negative before the first transfusion. After eight days, hemoglobin of the patient decreased to 57 g/L and the laboratory results indicated delayed hemolysis, the antibody screening was positive, and the antibody identification result was anti-M, as RBCs of the patient received typed as M+ N+. After the patient received M antigen negative RBCs, the laboratory test results still indicated delayed serologic transfusion reaction. A new antibody arose and was identified as anti-Jk^a while RBCs transfused were M-N+ and Jk(a+ b-). Afterwards, it was effective for the patient to receive B, RhD(+ ), M-N+ and Jk(a-b+ ) RBCs. 【Conclusion】 Most of the homologous antibodies produced by patients after blood transfusion will disappear within a few years. When patients undergo another transfusion, DHTR may occur because of anamnestic reaction. Establishing a transfusion management document and creating a card for patients who have already produced RBC alloantibodies can greatly reduce the occurrence of DHTR by informing doctors and staff when the next transfusion is needed.