Objective To explore the clinical significance of two new indexes including approximate entropy of oxygen saturation (SpO2ApEn) and saturation impairment time index (SITi) in assessing the severity of hypoxemia in obstructive sleep apnea hypopnea syndrome (OSAHS) patients.In addition,to investigate the correlation betewwn new indexes and other parameters.Methods The six hour polysomnography (PSG) of 500 patients with OSAHS and snorers in our hospital was retrospectively analyzed.According to the level of apnea hypopnea index (AHI),subjects were divided into four subgroups,namely 113 healthy controls,121 mild OSAHS,118 moderate OSAHS,and 148 severe OSAHA patients.SpO2 ApEn and SITi values among the four groups were compared.the correlations between SpO2 ApEn,SITi and other parameters were analyzed,including AHI,oxygen desaturation index (ODI),the lowest oxygen saturation(LSpO2) and the duration of oxygen saturation lower than 90％ (T ＜ 90％).Next,taking AHI as the gold standard,the significance of SpO2ApEn and SITi in assessing the severity of hypoxemia in OSAHS patients was explored by ROC curve analysis.Results SpO2ApEn and SITi between two each groups were significantly different (P ＜ 0.001) and increased synchronously with AHI.Spearman correlation analysis showed that SpO2ApEn and SITi had a good correlation with AHI (correlation coefficient r =0.765,r =0.678,P ＜ 0.O1).SpO2ApEn and SITi also had a good correlation with ODI,LSpO2and T ＜ 90％.According to the ROC analysis,the Boundary values of SpO2ApEn for mild,moderate and severe OSAHS patients were 16.70,17.81,and 20.03,respectively,and the corresponding SITi values were 3.685,4.055,and 4.445.Conclusion In this study,SpO2ApEn and SITi increased synchronously with AHI,SpO2ApEn and SITi had good correlations with AHI,ODI,LSpO2and T ＜90％.SpO2ApEn and SITi have important clinical significance for assessment of hypoxia severity in OSAHS patients.

Tau is the most abundant microtubule-associated protein in the brain .If tau protein lost the normal function, the toxic effect should be showed and plays an important role in various central nervous system lesions .Hypoxic-ischemic encephalopathy ( HIE) is an important cause of mortality in the neonatal period and it is mainly characterized by neurological deficits such as cognitive limitations .However , the mechanism still needs further study , and the underlying re-lationship between tau protein and HIE lacks direct evidence .Some recent clinical study reported that tau protein expres-sion elevated in the serum of asphyxia children and had a high correlation with behavior deficient .In this review , we focus on 3 key points to provide new insights to understand the tau protein-related pathogenesis of HIE as followed:(1) tau pro-tein and its phosphorylation change during central nervous system development ;(2) comparison of tau protein expression in developing brain and adult brain under some neurological disorders;(3) potential pathological change of tau in HIE related pathological conditions , such as dysmyelination , inflammation response and glutamate metabolism .

Urinary calculus is a common disease of urinary system.With the improvement of people's living standard,the incidence rate of urinary calculus increased year by year.Compared with other methods,spiral CT has a great advantage in the diagnosis of urinary calculus.The current commonly used examinations including spiral CT plain scan,low dose spiral CT scan,CT urography,and dual source dual energy CT imaging.The advantages and characteristics of different types of CT are analyzed and compared,which is helpful for clinicians to choose the most proper examination,to make the most of the advantages of various checks,so as to improve the accuracy of diagnosis and effectiveness of treatment.

Child ; Humans ; Nephrology ; Pediatrics

Instructional system design is an important component of instruction. Chaos theory is used in instructional system design of clinical teaching. Application of butterfly effect, fractals and strange attractors theory enhances students’clinical capabilities and comprehensive ability to analyze and solve problems.

Antiphospholipid Syndrome ; diagnosis ; etiology ; therapy ; Child ; Humans ; Lupus Erythematosus, Systemic ; complications ; Male

OBJECTIVETo compare the effect on surgical indicators and functional outcome between preoperative skeletal traction and skin traction for adult femoral fracture and guide the choice of preoperative traction method of adult femoral fractures.

METHODSFrom February 2008 to September 2012, 68 patients aged greater than 18-year-old with femoral fractures were treated and randomly divided into two groups according hospitalization order,the odd with skeletal traction of tibial tubercle (group A) and the even with skin traction (group B). In group A, there were 25 males and 9 females with an average age of (36.3±9.9) years old,including 11 cases with transverse fracture, 15 cases with oblique fracture, 8 cases with spiral fracture. In group B, there 26 males and 8 females with an average age of (37.1±11.0) years old,including 10 cases with transverse fracture, 13 cases with oblique fracture,11 cases with spiral fracture. The operative time,blood loss,the number and amount of blood transfusion ,fracture healing time, hemoglobin, pain scores and functional scores between two groups were analyzed and compared. Results:All patients were followed up, the follow-up time was (33.5±6.5) months in group A, (31.3±7.5) months in groupB. In group A,the operation time was (108.8±14.2) min and the intraoperative blood loss was (383.1±117.1) ml and the postoperative blood transfusion was 14 cases and the blood transfusion was (350.0±122.5) ml and the average bone healing time was(15.0±3.3) weeks. In group B, the operation time was (111.6±12.7) min and the intraoperative blood loss was (392.0± 116.7) ml and the blood transfusion was 11 cases and the blood transfusion was(327.3±129.1) ml and the average healing time was (15.5±3.4) weeks. These obseration indicators had no significant difference between two groups. There was no significant difference between two groups in terms of Hemoglobin, the pain scores before and after traction, the femoral fractures efficacy score,knee function score and knee range.

CONCLUSIONPreoperative skeletal traction does not reduce surgery time, blood loss and pain and so on. The bone healing time and limb functional outcomes were also not significantly improved.

Adult ; Blood Loss, Surgical ; Bone and Bones ; surgery ; Dermatologic Surgical Procedures ; Female ; Femoral Fractures ; physiopathology ; surgery ; Fracture Fixation, Internal ; Fracture Healing ; Humans ; Male ; Middle Aged ; Preoperative Period ; Traction ; Young Adult

Adolescent ; Cerebellar Cortex ; metabolism ; pathology ; Cerebellar Neoplasms ; metabolism ; pathology ; surgery ; Female ; Follow-Up Studies ; Ganglioneuroma ; metabolism ; pathology ; surgery ; Humans ; Neurofilament Proteins ; metabolism ; Synaptophysin ; metabolism

4-Hydroxycoumarins ; poisoning ; Child ; Female ; Humans ; Lower Extremity ; blood supply ; Thrombosis ; etiology

Cervical Intraepithelial Neoplasia ; diagnosis ; metabolism ; pathology ; Cervix Uteri ; metabolism ; pathology ; Cyclin-Dependent Kinase Inhibitor p16 ; metabolism ; Diagnosis, Differential ; Female ; Humans ; Ki-67 Antigen ; metabolism ; Membrane Proteins ; metabolism ; Neoplasm Invasiveness ; Uterine Cervical Dysplasia ; diagnosis ; metabolism ; pathology ; Uterine Cervical Neoplasms ; diagnosis ; metabolism ; pathology