Objective To observe the intervention effect of premature pathological jaundice treated with conventional blue light phototherapy combined with acupoint massage plus body massage. Methods Ninety premature infants with pathological jaundice were randomized into control group 1, control group 2 and observation group, 30 cases in each group. The control group 1 was given blue light phototherapy plus oral use of vitamin B2, the control group 2 was given body massage based on the treatment for the control group 1, and observation group was given acupoint massage based on the treatment for the control group 2, the treatment for the three groups lasting for 7 continuous days. Before and after treatment, the levels of transcutaneous bilirubin (TCB), serum total bilirubin (TB), and serum direct bilirubin (DB) were observed, and then the therapeutic effects on jaundice in the three groups were compared. Results After treatment, the overall therapeutic effect and the daily decline of TCB, TB and DB in the observation group were superior to those in the two control groups, the difference being significant (P < 0.05 or P < 0.01). In the control group 2, the post-treatment average decline of TB and the decline of TCB on treatment day 4-7 were superior to those in the control group 1, the difference being significant(P<0.05). Conclusion Acupoint massage plus body massage is effective and safe for the treatment of pathological jaundice in premature infants, and the therapy being simple and practical.

Objective To compare the effects of salmeterol and fluticasone propionate combined montelukastin the treatment of patients with bronchial asthma.Methods Ninety-eight bronchial asthma patients from April 2014 to March 2016 in the Fourth People's Hospital Sichuan Province were selected anddivided into observation group and control group with 49 patients in each group according to the above principles by prospective study.The control group was given salmeterol treatment,and the observation group was added given montelukast treatment based on the control group.The treatment days were 15 d recorded the prognosis of the two groups.Results The total effective rates of the observation group and the control group were 95.9％ and 81.6％ respectively,the total effective rate of the observation group was significantly higher than that of the control group (P ＜ 0.05).The FEV1 and FVC values after treatment in the observation group and control group were significantly higher than before treatment (P ＜ 0.05),while the FEV1 and FVC values in the observation group after treatment were significantly higher than those in the control group (P ＜ 0.05).The scores of ACT scale after treatment of two groups were obviously higher than before treatment,and the score of observation group was statistically higher than control group after treatment (P ＜ 0.05).During treatment,there was no statistical significance on adverse reaction between two groups.Conclusion Salmeterol and fluticasone propionate combined montelukast in the treatment of patients with bronchial asthma can promote the improvement of lung function,so as to improve the quality of life and clinical treatment.

Objective:Anti-synthase syndrome (ASS) is a rare autoimmune disease. To increase the understanding of the disease and reduce the rate of miss diagnosis.Methods:The clinical data of 8 patients with positive anti-synthase antibody afterprimary Sj?gren's syndrome (pSS) were retrospectively analyzed and descriptive statistical analysis was carried out.Results:The diagnosis of Sjogren's syndrome (SS) was in accordance with the revised European criteriaof SS issued by the US-Europe consensus Group in 2002 or the classification criteria of American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) SS in 2016, and the diagnostic ASS was in accordance with the diagnostic criteria of Conners in 2010 or Solomon in 2011. Eight(100%) patients had a history of interstitial lung disease, and 7 (88%) patients had fever (oral temperature >38.5 ℃). All patients were positive for anti-Ro-52 antibody, 4 patients were positive for anti-PL-7 antibody, 2 patients were positive for anti-EJ antibody, 1 patient was positive for both anti-PL-7 antibody and anti-EJ antibody, and 1 patient was positive for anti-PL-12.Conclusion:pSS patients with severe interstitial lung disease or high fever of unknown causes should be screened for anti-synthase antibodies and the possibility of ASS.

OBJECTIVETo evaluate the efficacy and safety of slow anti-epileptic drug (AED) taper protocol and a rescue benzodiazepine protocol in video-electroencephalography (video-EEG) monitoring for presurgical evaluation of epilepsy.

METHODSSixty-two of 109 patients with refractory focal epilepsy underwent pre-surgical video-EEG monitoring with a slow AEDs taper protocol and a rescue benzodiazepine protocol. Seizures were recorded by video-EEG in 56 patients. The time to the first seizure, duration of monitoring, incidence of 4-h and 24-h seizure clustering, secondarily generalized tonic-clonic seizures (sGTCS), status epilepticus, falls and cardiac asystole were evaluated.

RESULTSA total of 191 seizures were recorded in the 56 cases, and the diagnostic efficiency of video-EEG was 90.3%. The mean time to the first seizure was 2.4 days and the time to conclude video-EEG monitoring averaged 6.8 days. Eight (12.9%) patients had 4-h clusters and 24 (38.7%) had 24-h clusters. Seizure clusters were more frequent in extra temporal epilepsy than in temporal lobe epilepsy. While 19 sGTCS were recorded in 15 patients (26.8%), status epilepticus did not occur and no seizure was complicated by cardiac asystole. Epileptic falls with no significant injuries occurred in 4 patients.

CONCLUSIONSeizure clustering is common during presurgical video-EEG monitoring, but serious adverse events are rare with a slow AED tapering and a rescue benzodiazepine protocols. These two protocols are effective and save in presurgical video-EEG monitoring for refractory focal epilepsy.

Adolescent ; Adult ; Anticonvulsants ; adverse effects ; therapeutic use ; Electroencephalography ; methods ; Epilepsy ; diagnosis ; drug therapy ; Female ; Humans ; Male ; Middle Aged ; Monitoring, Physiologic ; methods ; Substance Withdrawal Syndrome ; diagnosis ; prevention & control ; Video Recording ; Young Adult

OBJECTIVE: To measure anterior cruciate ligament (ACL) by diffusion tensor imaging (DTI), combined with ACL half quantitative measurement magnetic resonance imaging (MRI) method as the contrast, and to preliminarily investigate the feasibility of DTI for ACL. METHODS: The ACLs of 31 healthy volunteers were scanned with ordinary MRI and DTI. At ordinary MRI map, sagittal ACL-tibial angle, coronal ACL-tibial angle, Blumensaat line-ACL angle, angle of inclination of the intercondylar roof, and ACL-tibial insertion site were measured. As for DTI analysis of ACL, ACL was divide to 5 portions, namely 1(st), 2(nd), 3(rd), 4(th), 5(th), and all fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values of every portion were recorded and repeated. RESULTS: The sagittal ACL-tibial angle, coronal ACL-tibial angle, Blumensaat line-ACL angle, angle of inclination of the intercondylar roof, and ACL-tibial insertion site were 53.00°±2.46°, 52.42°±5.15°, 12.67°±5.71°, 39.41°±2.64°, (24.90±2.84)%, respectively. FA values of different portions were 0.611±0.042, 0. 618±0.051, 0.596±0.045, 0.566±0.059, and 0.497±0.072. ADC values of 1(st)-5(th) portion were (1.068±0.216), (1.128±0.268), (1.189±0.197), (1.455±0.423), and (1.779±0.384)× 10(-3) mm(2)/s. The correlation coefficient of sagittal ACL-tibial angle and the FA value of 2(nd) and 3(rd) portion was -0.568 and -0.429. The correlation coefficient of Blumensaat line-ACL angle and the FA value of 1(st) and 4(th) portion was -0.507 and -0.633. The correlation coefficient of ACL-tibial insertion site and the FA value of 4(th) portion was -0.593, all with statistical significance. FA and ADC values of all portions in both team's ACL didn't have significant difference (P>0.05), but had obvious correlation. CONCLUSION DTI can be used to effectively evaluate the orientation and connection of ACL, having good contrast virtue with ACL half quantitative MRI measurement. It may provide more profound ACL information for clinicians, and it is of great significance for the further research and large sample data base of ACL pathology.
Adolescent ; Adult ; Anterior Cruciate Ligament ; anatomy & histology ; Diffusion Tensor Imaging ; Female ; Healthy Volunteers ; Humans ; Magnetic Resonance Imaging ; Male ; Reference Values ; Young Adult

Effective referral management of health and clinical services in maternal and child health hospitals plays an important role in enhancing patients′ medical experience, improving the efficiency and quality of maternal and child health services. A tertiary grade A maternal and child health hospital has carried out a practice of health and clinical service referral management based on information technology construction. A referral information module embedded in the hospital information system has been designed and constructed, and started to be applied in outpatient clinics in July 2021. At the same time, corresponding system and process construction, as well as quality control management and continuous improvement, have been carried out. The outpatient referral rate from July to December 2021 was 2.8% (11 466/412 808), from January to June 2022 it was 5.6% (22 705/402 586), from July to December 2022 it was 5.5% (22 233/402 959), and from January to June 2023 it was 6.7% (23 373/347 898). The referral rate has continued to improve and can provide reference for the referral management of other maternal and child health institutions.

Osteoporotic vertebral compression fracture (OVCF) can lead to lower back pain and may be even accompanied by scoliosis, neurological dysfunction and other complications, which will affect the daily activities and life quality of patients. Vertebral augmentation is an effective treatment method for OVCF, but it cannot correct unbalance of bone metabolism or improve the osteoporotic status, causing complications like lower back pain, limited spinal activities and vertebral refracture. The post-operative systematic and standardized rehabilitation treatments can improve curative effect and therapeutic efficacy of anti-osteoporosis, reduce risk of vertebral refracture, increase patient compliance and improve quality of life. Since there still lack relevant clinical treatment guidelines for postoperative rehabilitation treatments following vertebral augmentation for OVCF, the current treatments are varied with uneven therapeutic effect. In order to standardize the postoperative rehabilitation treatment, the Spine Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized relevant experts to refer to relevant literature and develop the "Guideline for postoperative rehabilitation treatment following vertebral augmentation for osteoporotic vertebral compression fracture (2022 version)" based on the clinical guidelines published by the American Academy of Orthopedic Surgeons (AAOS) as well as on the principles of scientificity, practicality and advancement. The guideline provided evidence-based recommendations on 10 important issues related to postoperative rehabilitation treatments of OVCF.