0.05).The symptom of peripheral neuropathy emerged 1 w after poisoning,the numbers of gait abnormal were 3,4 and 4 respectively in groups A,B and C,and there were no significant difference among those groups.It showed that the necrosis of segments of muscle fibers and macrophages infiltration scattering distribution were observated in the necrosis area and muscular interstition.At the end of 3 w,4 w and 8 w,there were significant differences in the area of muscular necrosis between group A and C(P

Objective To evaluate the effect of Bortezomib in the treatment of secondary plasma cell leukemia in serum M protein and clinical efficacy.Methods20 cases of patients with secondary plasma cell leukemia were randomly divided into the control group and treatment group, 9 cases in the control group,11 cases in the treatment group.The control group was given Prednisolone acetate tablets 60mg/(m2·d),oral, d1~d4 + Melphalan tablets, 8mg/(m2·d),oral, d1~d4+Thalidomide 100~200mg/d, oral, bedtime;on the basis of the control group, the experimental group was treated with Bortezomib for Injection, 1.3mg/(m2·d), intravenous injection, d1、d4、d8、d11.Before and after treatment, compared between the two groups of patients with the ratio of bone marrow plasma cells, serum monoclonicity Immunoglobulin A (IgA), monoclonicity immunoglobulin G (IgG) levels, efficiency of treatment and safety.ResultsAfter treatment, compared with the control group,the plasma cell ratio, the serum levels of IgA and IgG were lower in the experimental group (P<0.05);the treatment efficiency of the experimental group (54.55%) was significantly higher than that of the control group (11.11%), the results were statistically significant.ConclusionThe Bortezomib can significantly reduce the ratio of bone marrow plasma cells and the serum levels of monoclonicity IgA、IgG in patients with secondary plasma cell leukemia, improve clinical efficacy, and the safety was high.

Objective:To examine the potential influence factors of abdominal aortic aneurysm (AAA).Methods:A 1∶2 pair-matched, case-control study was conducted from July 2011 to December 2012 .A pair was composed of one AAA patient recruited from the Vascular Surgery Department , Chinese PLA General Hospital and two gender-and age-matched non-AAA subjects , one from the same hospital and the other from the community in Fangshan District in Beijing .Demographic data , medical history and the lifestyle of each subject were collected .Moreover , all the participants underwent abdominal ultra-sound or computed tomography ( CT ) and peripheral venous blood samples were obtained .Results:There were 155 case/control pairs .The multivariate conditional logistic regression model confirmed that suffering from hypertension conferred a 1.98-fold (95%CI 1.12-3.18) increased likelihood of AAA. Smoking was a strong independent risk factor of AAA , with odds ratios ( 95% confidence intervals ) of 5.23 (2.44-11.23).Dyslipidemia(OR=2.61,95%CI 1.45-4.70), a higher level of serum hs-CRP (OR=2.43,95%CI 1.37-4.31) and homocysteine (OR=2.73,95%CI 1.61-4.65) were all asso-ciated with AAA.Conclusion: Hypertension and smoking are the risk factors of AAA .Dyslipidemia, hsCRP and Hcy are associated with AAA .

Objective:To investigate the correlation between diabetic peripheral neuropathy (DPN) and the overall burden of cerebral small vessel disease (CSVD) in patients with type 2 diabetes.Methods:Patients with type 2 diabetes and CSVD admitted to the Departments of Neurology and Departments of Cerebrovascular Diseases of the Second Affiliated Hospital of Kunming Medical University from June 2018 to July 2021 were enrolled retrospectively. An electromyography evoked potential meter was used to detect peripheral nerves and record the nerve conduction velocity, including median nerve, ulnar nerve, posterior tibial nerve, common peroneal nerve, and sural nerve. MRI examination and CSVD overall burden score were performed on all patients. Ordinal logistic regression analysis was used to determine the independent correlation between DPN and nerve conduction velocity and the overall burden of CSVD. Results:A total of 142 patients were enrolled. Their age was 67.22±8.42 years; 65 were males (45.8%). The overall burden of CSVD: 69 patients were in 0-point group (48.6%), 32 were in 1-point group (22.5%), 19 were in 2-point group (13.4%), 12 were in 3-point group (8.5%), and 10 were in 4-point group (7%). Univariate analysis showed that there were significant differences in age, hypertension, DPN, median nerve motor conduction velocity (MCV), ulnar nerve MCV, common peroneal nerve MCV, median nerve sensory conduction velocity (SCV), ulnar nerve SCV, posterior tibial nerve SCV, common peroneal nerve SCV and sural nerve SCV among the different CSVD overall burden score groups (all P<0.05). Ordinal multi-classification logistic regression analysis showed that age (odds ratio [ OR] 1.051, 95% confidence interval [ CI]1.000-1.104; P=0.048), DPN ( OR 2.446, 95% CI 1.050-5.697; P=0.038), hypertension ( OR 3.578, 95% CI 1.627-7.867; P=0.002) were independently positively correlated with the overall burden of CSVD; common peroneal nerve SCV ( OR 0.972, 95% CI 0.946-0.998; P=0.035) and sural nerve SCV ( OR 0.940, 95% CI 0.917-0.964; P<0.001) were independently negatively correlated with the overall burden of CSVD. Conclusion:DPN is positively correlated with the overall burden of CSVD. Common peroneal nerve and sural nerve SCV are negatively correlated with the overall burden of CSVD.

With the rapid development of omics and big data technology, there have been multiple achievements with the use of pre-cision medicine for cancer treatment. Osteosarcoma, the most common primary malignant tumor of the skeletal system, primarily oc-curs in children and adolescents. Since the 1970s, surgical resection and chemotherapy have been the main treatments for osteosarco-ma; however, the survival rate for this type of cancer has been stagnant due to high genetic heterogeneity. Precision medicine can pro-vide a precise diagnosis and tailored treatments based on the patients’biological characteristics using techniques such as omics. Therefore, application of precision medicine is promising for studying osteosarcoma and improving patient survival rates. This study aims to systematically review the progress of precision medicine in advancing osteosarcoma treatment. In addition, it discusses the prospects and future direction of osteosarcoma precision treatment.

Objective To explore the accuracy of fluid responsiveness assessment by variability of peripheral arterial peak velocity and variability of inferior vena cava diameter (ΔIVC) in patients with septic shock. Methods A prospective study was conducted. The patients with septic shock undergoing mechanical ventilation (MV) admitted to intensive care unit (ICU) of Beijing Electric Power Hospital from January 2016 to December 2017 were enrolled. According to sepsis bundles of septic shock, volume expansion (VE) was conducted. The increase in cardiac index (ΔCI) after VE ≥ 10% was defined as liquid reaction positive (responsive group), ΔCI < 10% was defined as the liquid reaction negative (non-responsive group). The hemodynamic parameters [central venous pressure (CVP), intrathoracic blood volume index (ITBVI), stroke volume variation (SVV), ΔIVC, variability of carotid Doppler peak velocity (ΔCDPV), and variability of brachial artery peak velocity (ΔVpeak-BA)] before and after VE were monitored. The correlations between the hemodynamic parameters and ΔCI were explored by Pearson correlation analysis. Receiver operating characteristic (ROC) curve was plotted to analyze the predictive value of all hemodynamic parameters on fluid responsiveness. Results During the study, 74 patients with septic shock were included, of whom 9 were excluded because of peripheral artery stenosis, recurrent arrhythmia or abdominal distension influencing the ultrasound examination, and 65 patients were finally enrolled in the analysis. There were 31 patients in the responsive group and 34 in the non-responsive group. SVV, ΔIVC, ΔCDPV and ΔVpeak-BA before VE in responsive group were significantly higher than those of the non-responsive group [SVV: (12.3±2.4)% vs. (9.2±2.1)%, ΔIVC: (22.3±5.3)% vs. (15.5±3.7)%, ΔCDPV: (15.3±3.3)% vs. (10.3±2.4)%, ΔVpeak-BA: (14.5±3.3)% vs. (9.6±2.3)%, all P < 0.05]. There was no significant difference in CVP [mmHg (1 mmHg = 0.133 kPa): 7.5±2.5 vs. 8.2±2.6] or ITBVI (mL/m2: 875.2±173.2 vs. 853.2±192.0) between the responsive group and non-responsive group (both P > 0.05). There was no significant difference in hemodynamic parameter after VE between the two groups. Correlation analysis showed that SVV, ΔIVC, ΔCDPV, and ΔVpeak-BA before VE showed significant linearity correlation with ΔCI (r value was 0.832, 0.813, 0.854, and 0.814, respectively, all P < 0.05), but no correlation was found between CVP and ΔCI (r = -0.342, P > 0.05) as well as ITBVI and ΔCI (r = -0.338, P > 0.05). ROC curve analysis showed that the area under ROC curve (AUC) of SVV, ΔIVC, ΔCDPV, and ΔVpeak-BA before VE for predicting fluid responsiveness was 0.857, 0.826, 0.906, and 0.866, respectively, which was significantly higher than that of CVP (AUC = 0.611) and ITBVI (AUC = 0.679). When the optimal cut-off value of SVV for predicting fluid responsiveness was 11.5%, the sensitivity was 70.4%, and the specificity was 94.7%. When the optimal cut-off value of ΔIVC was 20.5%, the sensitivity was 60.3%, and the specificity was 89.7%. When the optimal cut-off value of ΔCDPV was 13.0%, the sensitivity was 75.2%, and the specificity was 94.9%. When the optimal cut-off value of ΔVpeak-BA was 12.7%, the sensitivity was 64.8%, and the specificity was 89.7%. Conclusions Ultrasound assessment of ΔIVC, ΔCDPV, and ΔVpeak-BA could predict fluid responsiveness in patients with septic shock receiving mechanical ventilation. ΔCDPV had the highest predictive value among these parameters.

Objective:To determine the influences of structural changes after valgus impacted femoral neck fracture on hip range of motion (ROM) so as to provide evidence for clinical judgment of whether reduction is necessary or not in the internal fixation of such fractures.Methods:1. 3D reconstructions of the CT hip scans were performed for the 73 patients who had been treated at Department of Orthopaedic Surgery, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University for valgus impacted femoral neck fractures from January 2019 to April 2019.The femoral neck-shaft angle, anteversion angle, femoral offset, axial alpha angle, lateral center edge angle (LCEA), anterior center edge angle (ACEA) and center displacement were measured and compared between the affected and healthy sides to determine the influences of the fracture on the above indexes. 2. Hip motions (flexion and MIR-90°) were simulated on bilateral sides to determine the influences of structural changes after fracture on hip ROM using stepwise regression and Logistic regression. 3. The distribution of femoral-acetabular contact points on the femoral side was observed in simulation of hip flexion to detect the potential area for femoracetabular impingement (FAI) induced by the fracture displacement.Results:1. The valgus impacted femoral neck fractures had significant influences on femoral neck-shaft angle, anteversion angle, femoral offset and axial alpha angle. Compared with the healthy side, on average, the femoral neck-shaft angle increased by 5.1°, anteversion angle decreased by 6.5°, femoral offset decreased by 8.2 mm and axial alpha angle increased by 9.7° on the affected side, showing significant differences ( P<0.05).The displacements of the femoral head center averaged 9.2 mm. There was no significant difference in LCEA or ACEA between the affected and healthy sides ( P>0.05). 2. Compared with the healthy side, on average, the simulated hip flexion decreased significantly by 27.0° and the hip MIR-90° decreased significantly by 20.3° on the affected side after fracture ( P<0.05). Regression analysis showed that femoral anteversion angle, ACEA and displacement of the femoral head center had a significant influence on hip ROM, especially the anteversion angle. When the anteversion angle decreased by more than 7.1°, the hip flexion would decrease by at least 20%. 3. The points of FAI distributed more widely on the fracture side. Compared with the healthy side, the impact points extended outward and upward in hip flexion and extended inwardly in hip MIR-90° on the affected side. Conclusions:After a valgus impacted femoral neck fracture, if the femoral anteversion angle has been decreased by more than 7.1°, the hip ROM can be greatly influenced and the points of FAI can be distributed more widely. Therefore, reduction should be recommended before internal fixation of the fracture.

Objective:To further elucidate the pathogenesis of hemifacial spasm by analyzing blinking reflex characteristics.Methods:A total of 63 patients with hemifacial spasm (hemifacial spasm group) who underwent neuroelectrophysiological evaluation in Department of Neurological Electrophysiology, Guizhou Provincial People's Hospital from January 2021 to December 2022 were included as study subjects. Additionally, 58 patients with primary trigeminal neuralgia (trigeminal neuralgia group), 8 patients with post-facial paralysis associated exercise (post-facial paralysis associated exercise group), and 20 healthy volunteers (normal group) were selected as controls. Differences in facial nerve motor conduction velocity, complex muscle action potential latency, and blinking reflex characteristics including R1 latency, R1 amplitude, R2 initiation latency, R2 amplitude, R2 terminal latency, R2' initiation latency recorded on the affected side, R2' amplitude recorded on the affected side, and R2' terminal latency recorded on the affected side were collected and compared. Severity of hemifacial spasm was graded from grade 1 to grade 4 according to Samsung Medical Center scoring system; based on microvascular decompression findings regarding responsible blood vessels contacted with the facial nerve, patients were divided into one responsible blood vessel group and two or more responsible blood vessels group; trends or differences in incidences of increased/prolonged blink reflex indexes among all groups were analyzed.Results:No significant difference in facial nerve motor conduction velocity or complex muscle action potential latency was noted among the 4 groups ( P>0.05); the hemifacial spasm group had significantly higher R1 amplitude than the trigeminal neuralgia group and post-facial paralysis associated exercise group; additionally, the hemifacial spasm group had significantly higher R2 amplitude, R2' amplitude recorded on the affected side, R2 terminal latency, and R2' terminal latency recorded on the affected side compared with the other 3 groups ( P<0.05). Among patients with varying degrees of hemifacial spasm, increased incidences of increased R1 amplitude and prolonged R2 terminal latency were noted with increased spasm degrees, enjoying significant differences ( P<0.05). No significant differences in incidences of increased R1 amplitude, increased R2 amplitude, prolonged R2 terminal latency, increased R2' amplitude recorded on the affected side or prolonged R2' terminal latency recorded on the affected side were noted between one responsible blood vessel group and two or more responsible blood vessels group ( P>0.05). Conclusion:Increased R1 amplitude and prolonged R2 latency in patients with hemifacial spasm further substantiate the pathogenesis of hyperexcitability within facial nerve nucleus.

Objective:To investigate the prevalence of estimated glomerular filtration (eGFR) and risk factors among middle-aged and elderly residents in Beijing.Methods:In August-December of 2017, 6 549 residents aged 45-79 years old were randomly selected in the study by stratified multi-stage cluster sampling method. The investigation was performed by questionnaire, physical examination and laboratory tests. The contents of questionnaire included the demographic characteristic and prevalence of chronic disease. Blood pressure was tested. Fasting venous blood was collected to test the level of total cholesterol (TC), high density lipoprotein cholesterol (HLDL), low density lipoprotein cholesterol (LDL), triglyceride (TG), fasting blood-glucose (FBG), blood creatinine (Cr) and serum uric acid (UA). The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation was used to estimate GFR(eGFR). The decreased GFR was defined as eGFR less than 60 ml/min per 1.73 m 2. The statistical software SPSS 20.0 was used for analysis. The general linear model, test of independence of rows and columns, logistic regression for complex samples were generalized. The weighted mean and weighted rate were analyzed. Results:The average level of eGFR was (100.51±0.54) ml/min per 1.73 m 2. The rate of decreased GFR was 1.28%, and it showed a higher rate in subjects aged 70-79 years-old, living in urban area, with history of cardiovascular disease, hypertension, diabetes mellitus, hyperuricemia (4.53%, 1.57%, 2.90%, 2.27%, 2.12% and 4.62%; F=30.827, 10.588, 11.466, 34.693, 6.788,51.643, all P<0.05) . Logistic regression analysis of complex sampling showed that 70-79 years old ( OR=4.435, 95 %CI:2.402-8.191), living in urban area ( OR=3.145, 95 %CI: 1.540-6.420), hypertension ( OR=4.663, 95 %CI:2.177-9.988), hyperuricemia ( OR=6.751, 95 %CI:3.363-13.553) were associated with decreased GFR (all P<0.05). Conclusion:The prevalence of the decreased eGFR among middle-aged and elderly residents in Beijing is higher than the average level in the eastern part of China. Hypertension, hyperuricemia, the old age and living in urban are risk factors of decreased GFR.