Objective To explore the utility of videofluoroscopy in observing swallowing dysfunction after severe traumatic brain injury (TBI). Methods Videoflouroscopic studies of swallowing (VFSSs) were performed on 40 patients with severe TBI as well as 40 healthy matched controls.Information about penetration and aspiration was collected,and oral delay time (ODT),oral transit time (OTT),pharyngeal delay time (PDT),pharyngeal transit time (PTT) and the maximum vertical and anterior movement of hyoid bone were measured. Results Seventeen of the healthy controls (42.5％) displayed mild penetration,though none had severe penetration or aspiration.Among the severe TBI patients,5 ( 12.5％ ) displayed mild penetration,12 (30.0％) showed severe penetration and 17 (42.5％) subjects had aspiration.The 3ml liquid swallowing parameters of the severe TBI group were ODT ( 0.86 ± 0.37) s,OTT (0.73 ± 0.28 ) s,PDT ( 0.50 ± 0.35 ) s and PTT(0.61 ± 0.11 ) s.The maximum vertical hyoid bone movement in this group averaged (0.98 ± 0.38) cm,and maximum anterior movement was (0.37 ±0.37) cm.The healthy controls and severe TBI patients showed significant differences in terms of all six measures.Conclusion Dysphagia was found to be frequent among severe TBI patients,commonly occurring in the oral and pharyngeal phases.Videoflouroscopy may be helpful for identifying the main features of dysphagia and formulating better rehabilitation strategies.

Objective To study the clinical significance of vires infection and serum interleukin-2 (IL-2)Ievels in recurrent childhood idiopathic thrombocytopenic purpura(ITP).Methods The cytomegalovirus(CMV),epstein-Barrvirus(EBV)-adenovirus(ADV),herpesvirus(HSV)antibodies ISM and IL-2 levels were determined in the serum of 4 childhood with recurrent childhood ITP as well as in 40 normal controls with ELISA and RIA.Re-sults The CMV-lgM positive cases were 18,EBV-IgM were 14-ADV-IgM were 5,HSV-lgM were 3.In the controls,those were 3,2,1,and 0 respectively(P<0.05 or P<0.01).The serum IL-2(0.35±0.12)μg/L levels were sig-nificantly lower than those in the controls[(0.61±0.17)μ/L,P<0.05].Conclusion DNA virus antibodies and IL-2 levels can reflect virus infection and immune condition of diseases in recurrent childhood ITP.It is impor-rant to comprehend the mechanism of recurrent childhood ITP for guiding clinical treatment.

Data is the basis and soul of clinical trials. To obtain accurate data, strict and standard data management is essential, which can be effectively supported by quality control in statistical analysis. In this paper, we briefly introduce the concept of the quality control in clinical trials, and describe its contents and methods. We hope that this work will be helpful to the application of statistical quality control in data management of clinical trials.
Clinical Trials as Topic ; standards ; Data Collection ; standards ; Quality Control ; Statistics as Topic

OBJECTIVE:To investigate the characteristics of serious ADR in psychiatric hospital,and to provide reference for effective and safe use of drugs in the clinic. METHODS:114 cases of serious ADR in our hospital from 2004 to 2015 were ana-lyzed retrospectively in terms of general information,primary disease,route of administration,dosage form,drug types,organs or systems involved in ADR and clinical manifestations,top 5 ADR-inducing drugs and main clinical manifestations,etc. RESULTS:Of 114 serious ADR cases,the number of female was more than that of male(71/43). Patients aged 21-30 years old took up the greatest proprotion(35 cases,30.70%). The main involved primary disease was schizophrenia(54 cases,47.37%). Oral adminis-tration-induced ADR was most common(103 cases,90.35%). The main involved drugs were antipsychotics,occupying the great-est proportion(75 cases,65.79%). Digestive system involved was the most common(53 cases,42.74%), Olanzapine tablets had the highest incidence of serious ADR (23 cases,18.55%),the main clinical manifestation were both abnormal liver function. There were 8 cases of new serious ADR (7.02%). Most of the ADR can be cured after drug withdrawal or countermeasures,no death case was found. CONCLUSIONS:Psychiatric drugs can induce serious ADR as treat psychiatric disease,among which the in-cidence of ADR induced by Olanzapine tablets is the highest and mainly manifestes digestive system symptoms. It is suggested to strengthen serious ADR monitoring to promote the safe use of drugs.

OBJECTIVE:To provide suggestions for the government decision of payment price of medicare drugs. METHODS:Investigation was conducted for the beginning of payment price policy of medicare drugs,effect of the implementation of policy in other countries and the encountered problems. The payment pricing mechanism was explored based on the combination of new medi-cal reform with theoretical analysis and empirical research. RESULTS:The reform of payment pricing mechanism of medicare drugs will have effect on current drug price,especially for R&D oriented pharmaceutical industries. The policy can decrease drug expendi-ture in medicare expenditure,and it is not sure whether it can decrease total medicare expenditure. CONCLUSIONS:It is suggest-ed to notice the related measures and government should keep balance between drug availability and encouraging R&D innovation.

Objective To investigate MVD, TSP-1, TGF-?1 expression in GH-Secreting Pituitary Adenomas by immunohistochemistry, and to correlate data with clinical characteristics.Methods The protein expression of TSP-1, TGF-?1 in 48 surgical specimens (21 invasive cases; 27 non-invasive cases) of pituitary adenomas was measured using immunohistochemical method. The relationship between the expression and clinical properties was examined. MVD was measured by detecting CD34.Results Compared with the noninvasive group, no difference of expression of CD34(t=2.257; P=0.083) was observed. The expression of TSP-1 in invasive group was low. The expression of TGF-?1 was higher in invasive cases than that in noninvasive ones. The expression of TGF-?1 had positive correlations with MVD; but there was no correlation between the expression of CD34 and the invasion of pituitary adenomas. In addition, MVD count was not associated with the expression of TSP-1. Size, sex or rate of recurrence did not influence MVD and TSP-1 expression. Conclusion MVD values do not necessarily represent angiogenesis in pituitary adenomas. TGF-?1 may increase MVD, and TSP-1 does not affect MVD in pituitary adenomas and angiogenesis may be regulated by other pathway.

Background Serum cystatin C levels can be used to predict morbidity and mortality in patients with cardiovascular disease. However, the clinical relevance of serum cystatin C levels in patients with hypertensive left ventricular hypertrophy (LVH) has rarely been investigated. We designed the present study to investigate whether serum cystatin C levels are associated with cardiac structural and functional alterations in hypertensive patients. Methods We enrolled 823 hypertensive patients and classified them into two groups:those with LVH (n=287) and those without LVH (n=536). All patients underwent echocardiography and serum cystatin C testing. We analyzed the relationship be-tween serum cystatin C levels and LVH. Results Serum cystatin C levels were higher in hypertensive patients with LVH than in those without LVH (P＜0.05). Using linear correlation analysis, we found a positive correlation between serum cystatin C levels and interven-tricular septal thickness (r=0.247, P＜0.01), posterior wall thickness (r=0.216, P＜0.01), and left ventricular weight index (r=0.347, P＜0.01). When analyzed by multiple linear regression, the positive correlations remained between serum cystatin C and interventricular septal thickness (β=0.167, P＜0.05), posterior wall thickness (β=0.187, P＜0.05), and left ventricular weight index (β=0.245, P＜0.01). Con-clusion Serum cystatin C concentration is an independent marker for hypertensive LVH.

A multiplex real-time PCR was developed to detect ctxA of Vibrio cholerae, gyrB and tdh of Vibrio parahaemolyticus simultaneously. The multiplex real-time PCR were evalidated by detection for the three genes in 47 toxigenic V. cholerae O1 and O139 strains (ctxA+; O1=3, O139=44), 25 non-toxigenic V. cholerae strains (ctxA-; O1=12, O139=6, non-O1 and non-O139=7), 116 V. parahaemolyticus strains with or without tdh (73 or 43) and 9 other bacteria strains. The specificity and sensitivity of the multiplex real-time PCR in detection for the ctxA and the tdh genes in the strains tested were both 100.0%, compared to the results by routine PCRs. In the detection for V. parahaemolyticus specific gyrB using the multiplex real-time PCR, all of 116 V. parahaemolyticus strains were positive, and 9 other strains and 72 V. cholerae strains were all negative. The multiplex real-time PCR is a sensitive, specific and quick assay not only for detecting virulence genes of V. cholerae and V. parahaemolyticus but also for identifying V. parahaemolyticus at species level. In addition, two real-time PCRs for detection of V. parahaemolyticus virulence genes trh1 and trh2 were also developed.

A nicotine-degrading bacterial strain Z7 was isolated from tobacco growing soil at Zhangjiajie region in Hunan Province.The morphology,physiological and biochemical characteristics of strain Z7 were studied and the results showed that characteristics of this strain were essentially consistent with Agrobacterium radiobacter/tumefaciens.This strain degraded nicotine optimally at 30℃ and initial pH 7.0.It was able to utilize nicotine as its sole carbon source,and it could degrade 71% of nicotine under the optimized incubation conditions for 48 h.Meanwhile,the color of culture medium turned from yellowy to green and dark green,then it turned to brown.This strain might have potential applications in tobacco industry.

Objective:To investigate the causes, diagnosis and treatment of postoperative pulmonary changes in patients with thyroid cancer.Methods:Data of 378 patients with thyroid cancer surgery admitted from Oct. 1, 2019 to Jan. 31, 2020 were retrospectively analyzed. SPSS 23.0 statistical software was adopted to analyze the effect of gender, age, smoking history, BMI, operation way and the surgical approach on postoperative changes in the lungs. The two groups of counting data were compared using χ2 method. Results:Age, gender, smoking history and surgical approach had no significant influence on postoperative pulmonary change ( P>0.05) . Lung changes in patients receiving thyroid cancer plus lateral neck dissection were greater than those receiving radical thyroid cancer alone ( P=0.001) , and lung changes in patients receiving bilateral neck dissection were greater than those receiving unilateral neck dissection ( P=0.027) . The pulmonary changes in patients with underweight and obesity were greater than those in patients with normal weight and hyperreorganization ( P=0.019) . Conclusions:Lateral neck dissection and patients’ body mass index are important factors affecting the postoperative lung changes in thyroid cancer patients. Thyroid cancer patients undergoing lateral neck dissection should actively check their lung changes through chest radiographs after surgery, especially for lean and obese patients, and patients undergoing bilateral neck dissection.