Objective To explore unexplained syncope (UPS) morbidity of elementary and middle school students in Changsha city.Methods Four thousand two hundred and fifteen students aged 5 to 18 years from six fulltime elementary or middle schools were randomly selected and the survey was conducted by giving them 4 215 copies of questionnaires and they were categorized into 3 groups:key school group(n =1 062),normal school group(n =1 310) and peasant laborer dependent's school group (n =1 349).Three thousand seven hundred and twenty-one copies of returning questionnaires (88.28％) were collected.Results 1.Morbidity:among 3 721 students there were 738 students(19.83％) who had once or more symptom of UPS.And the morbidity of middle school students was higher than elementary school students (28.87％ vs 7.96％,x2 =252.11,P ＜ 0.01).The morbidity of key school students was higher than normal school and peasant laborer dependent's school students (25.99％ vs 16.34％ vs 18.38％,x2 =40.93,P ＜ 0.01).2.Onset age:the onset age of UPS was 6-18 (14.23 ± 2.70) years old.3.Gender difference:for the middle school group,the morbidity of female students was higher than male students(31.34％ vs 26.49％,x2 =6.06,P ＜ 0.05).But for the elementary school group (male 9.04％ vs female 6.68 ％,x2 =2.85,P ＞ 0.05) and the total secondary school students (male 18.67％ vs female 21.12％,x2 =3.51,P ＞ 0.05),there was no significant difference between genders.Conclusions The UPS morbidity of students in Changsha is 19.83％.There are differences in age,school and gender.

Objective To evaluate the value of diffusion tensor imaging (DTI)in diagnosing MCI.Methods DTI and conventional MRI were performed in 26 patients with MCI and 26 age-matched normal control subjects (NC).FA were measured in the 10 select-ed white matter regions,included bilateral frontal lobe,temporal lobe,parietal lobe,parahippocampal gyrus and cingulate gyrus,in the patients with MCI (n=26)and NC (n=26).FA of each ROI (region of interest)between the patients and controls were com-pared by using independent sample t-test.The correlation between the FA values and the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA)scores was analyzed by using Spearman correlation analysis.Results Compared with NC,the FA values of the right frontal lobe,temporal lobe white matter and bilateral cingulate gyrus in the patients were significant-ly reduced (P <0.05).FA values of the left temporal lobe,right frontal lobe and bilateral parahippocampal gyrus were significant correlated with MoCA scores,and FA values of the bilateral parahippocampal gyrus were significant correlated with MMSE scores (P <0.05).Conclusion DTI can be used as a diagnosis index of MCI.It has important value in early intervention and improving the quality of life of patients to early diagnosing MCI.

Objective:To seek the possibility of using internally installed curved mandibular distractor to repair the partial mandibular curved defect.Methods:A curved mandibular defect was sectioned in each of 3 adult dogs.The distractor designed by our own group based on the steel ball conducted force was implanted.After 7 days of latency,the distraction was performed at the rate of 0.5 mm × 2 times per day,followed by 3 months consolidation period.The osteogenesis was evaluated by general observation,X-ray examination and HE staining.Results:No complication was observed after operation and during distraction.The new bone healed well into a curved shape.The X-ray examination revealed that the transport disc moved along with the predesigned rail curve.HE staining clearly showed neo bone formulation zone between the mature trabecular and connective tissue.Conclusion:The internal distractor based on the steel ball conducted force can realize the curved distraction osteogenesis of posteriormandibular.

Objective To discuss the treatment experience of adrenocorticotropic hormone independent macronodular adrenal hyperplasia (AIMAH).Methods The clinical data of 24 cases of AIMAH from August 1972 to December 2016 were retrospectively analyzed.The cases included 10 males and 14 females with a mean age of 43 (range 26 to 59) years.16 patients presented with typical Cushing syndrome (CS) and 8 patients had weight gain, hypertension or diabetes mellitus without any sign of CS.The circadian rhythm of serum cortisol was abnormal.Low and high dose dexamethasone suppression tests failed to suppress cortisol secretion.The preoperative CT scan showed bilateral enlargement of the adrenal glands with multiple macmnodules.14 patients underwent open surgery, including 5 cases of unilateral adrenalectomy, 6 cases of adrenalectomy combined with contralateral subtotal adrenalectomy and 3 cases of bilateral adrenalectomy simuhaneously.6 patients underwent conventional laparoscopic adrenalectomy,including 2 cases of unilateral adrenalectomy, 2 cases of adrenalectomy combined with contralateral subtotal adrenalectomy and 2 cases of bilateral adrenalectomy.4 patients underwent robot-assisted laparoscopic bilateral adrenalectomy.Results The postoperative pathological examination showed that all patients had bilateral adrenal macronodular or adenomatoid hyperplasia.During the mean follow-up of 68 months (range 3 to 192 months), the clinical symptoms of CS disappeared after surgery in all cases.7 patients who received unilateral adrenalectomy had urinary free cortisol and serum cortisol within normal ranges and no further enlargement of the contralateral gland was noticed.Among the 3 patients who received bilateral adrenalectomy simultaneously, 1 case died of adrenal crisis on the seventh day post-operation.The remaining 2 cases presented with adrenal insufficiency but returned to normal after glucocorticoid replacement therapy.Nelson's syndrome was not observed in other patients.Conclusions The use of bilateral adrenalectomy to treat AIMAH may involve risk.Unilateral adrenalectomy is recommended for an alternative treatment for AIMAH.Controlateral adrenalectomy with lifelong corticosteroid replacement or contralateral subtotal adrenalectomy may be performed if the symptoms have not improved or recurred after unilateral adrenalectomy.

Environmental Monitoring ; methods ; Gas Chromatography-Mass Spectrometry ; methods ; Humans ; Industry ; Volatile Organic Compounds ; analysis

Objective:To investigate the use of the reference intervals for blood cell counting and the reference of industry standard in China.Methods:Information from all laboratories was collected using online questionnaire in 18 reference intervals survey in blood cell counting in 2019. The information includes the source of the reference intervals, the verification of the reference intervals, and the upper and lower limits of the reference intervals, the method used, the instrument, the reagent and the calibrator. Microsoft Excel 2007 software was used to analyze the results of all laboratories. The median and 95% confidence interval were calculated. The distribution of the reference intervals for blood cell counting and their conformance to industry standards were analyzed.Results:2, 869 labs reported the data. The main sources were industry standards and National Guide to Clinical Laboratory Procedures. The proportion was 33.30%-35.02% and 28.55%-30.90% respectively. 49.44%-55.13% of laboratories validated the reference interval when citing industry standards. The reference interval grouping of most laboratories (89.37%-91.69%) cited in RBC, Hgb and Hct were consistent with the industry standards. We compared the upper and lower limits of the reference intervals with that given by the industry standards, when the lower limit of the reference intervals of mean corpuscular hemoglobin concentration, absolute neutrophils count, absolute basophils count, absolute monocyte count, and lymphocyte percentage were compared. The upper limit of reference intervals of neutrophils percentage as well as upper and lower limits of reference intervals of mean corpuscular volume, mean corpuscular hemoglobin, absolute eosinophil count, basophils percentage, and monocyte percentage were also compared. The median and mode were equal and consistent with industry standards. For other labs, the upper and lower limits of the reference intervals were not consistent with the reference intervals given by the industry standards.Conclusion:The use of reference intervals for blood cell counting was not the same, and the implementation of industry standards was not optimistic. A considerable number of laboratories had not verified the reference intervals, so it was necessary to promote the industry standards for reference intervals.

This paper mainly explicates the high frequency inverter circuit and its features and deliberates the question of how to prevent the short circuit of inverter.

OBJECTIVETo compare the effects of oblique insertion at anatomical points and conventional acupuncture for sacroiliac joint injury.

METHODSEighty patients were randomly divided into an observation group and a control group, 40 cases in each one. In the observation group, oblique insertion therapy at anatomical points was used, and the 9 points of equal division (anatomical points) marked by palpating the anatomical symbol were treated as the insertion acupoints. In the control group, conventional acupuncture was applied, and perpendicular insertion was adopted at Huantiao (GB 30), Zhibian (BL 54) and Weizhong (BL 40), etc. In the two groups, the! treatment was given once a day and 5 times per week. Ten treatments were made into one course and two courses were required. The clinical effects, the changes of visual analogue scale (VAS) and Oswestry dysfunctional index. (ODI) before and after treatment were observed in the two groups.

RESULTSThe total effective rate of the observation group was 90.0% (36/40), which was better than 72.5% (29/40) of the control group (P < 0.05). After treatment, the results of the VAS and ODI of the two groups were apparently declined (both P < 0.01), and those in the observation group were decreased more obviously (both P < 0.01).

CONCLUSIONThe effect of oblique inser-tion at anatomical points for sacroiliac joint injury is superior to that of conventional acupuncture, which can effectively relieve pain and improve the disfunction.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Humans ; Joint Diseases ; physiopathology ; therapy ; Male ; Middle Aged ; Sacroiliac Joint ; injuries ; physiopathology ; Young Adult

Objective:To analyze the clinical characteristics, treatment and prognosis of mixed phenotypic acute leukemia (MPAL) in children, and to provide reference for clinical optimization of diagnosis and treatment and improve the remission rate.Methods:Based on the diagnostic criteria of the World Health Organization (WHO) in 2016, the bone marrow cell morphology, immune typing, cytogenetics, molecular biological characteristics, treatment regimen, and prognosis of 15 children with MPAL who were admitted to Children′s Hospital Affiliated to Soochow University from January 2012 to December 2020 were retrospectively analyzed.The count data were compared between groups using the χ2 test, the measurement data that conformed to the normal distribution were compared using the t test, and the measurement data that were not normally distributed were compared using the rank sum test.Survival was estimated using the Kaplan- Meier ( K- M) method and the Log- rank method was used for comparison. Results:A total of 15 children with MPAL were admitted to Children′s Hospital Affiliated to Soochow University in the past 8 years, including 8 males and 7 females, with a median age of 6.8 years.Nine patients expressed B lymphocyte and myeloid phenotype, 5 patients expressed T lymphocyte and myeloid phenotype, and 1 patient expressed B and T lymphocyte phenotype.Karyotype of 11 children was examined, and the results showed that there were 2 cases of normal karyotype, 2 complex karyotype, 6 pseudodiploid and 1 subdiploid.Fusion genes were detected in 5 children, including 3 AML- ETO positive, 1 BCR- ABL positive, and 1 MLL gene positive.Thirteen patients were in complete remission (CR) after chemotherapy, with a total CR rate of 86.6% and a 2-year over survival (OS) rate of (68.2±13.4)%.Among the 15 children, 14 received induction chemotherapy and 1 gave up treatment for personal reasons.There were 10 patients with the first choice of acute lymphoblastic leukemia (ALL) chemotherapy regimen and 1 patient receiving CR, with a total CR rate of 10%.There were 4 cases of acute myeloid leukemia (AML) with the preferred chemotherapy regimen and 3 cases with CR in the first course of treatment, and the total CR rate was 75%.One case without remission was relieved after changing ALL chemotherapy regimen.The 2-year OS rates of 8 patients with hematopoietic stem cell transplantation (HSCT) and 6 patients without HSCT were (70.0±18.2)% and (66.7±19.2)%, respectively, with no significant difference ( χ2=0.318, P=0.573). Conclusions:Children with MPAL is a rare malignant tumor, mainly characterized by the co-expression of lymphoid and myeloid antigens.Chemotherapy alone or HSCT can achieve a good prognosis in the short term, but the long-term efficacy remains to be further observed.

Objective　To explore the effect of Mp1p on host macrophages through transcriptomics combined with metabolomics. Methods Firstly, a THP-1 macrophage strain (THP-1-Mp1p+) stably expressing Mp1p was constructed using lentivirus. Secondly, using high-throughput RNA sequencing (RNA Seq) technology, the expression level of intracellular mRNA was detected in transcriptomics analysis to determine differentially expressed genes; In metabolomics analysis, metabolite identification was performed through database comparison, and pathway analysis was performed on differential metabolites to reveal potential mechanisms of action. Finally, the results of metabolomics and transcriptomics were combined for analysis, and differential metabolites and genes were analyzed to further elucidate the mechanism of action of Mp1p on macrophages. Results Transcriptome analysis showed that, compared with the negative control group, the THP-1-Mp1p+ group had a total of 1 180 differentially expressed genes (DEGs), with 345 upregulated genes and 835 downregulated genes. GO enrichment analysis of DEGs showed that there were 135 differentially expressed genes, including 105 in biological processes (BP), 28 in cellular components (CC), and 2 in molecular functions (MF). The KEGG analysis results showed that the effect of Mp1p on THP-1 macrophages was highly correlated with the TNF pathway. The metabolomic analysis found that both the blank control group and the THP-1-Mp1p+ macrophage group achieved good separation between QC samples in both positive and negative ion modes. The threshold for significant differential metabolites was set at: VIP≥1 and T-test P<0.05, resulting in the identification of 488 differential metabolites, with 230 in the positive ion mode and 258 in the negative ion mode. Pathway enrichment analysis of the identified metabolites pointed to significant enrichment in metabolic pathways. The combined analysis confirmed that the tumor necrosis factor signaling pathway, interleukin-17 signaling pathway, and NF-kappaB signaling pathway were important metabolic pathways involved. Conclusions The virulence factor Mp1p may affect host macrophages by modulating the tumor necrosis factor signaling pathway, interleukin-17 signaling pathway, and NF-kappaB signaling pathway. The findings contribute to a better understanding of the mechanisms of action of Mp1p and may offer potential directions for the selection of relevant diagnostic and therapeutic targets in the future.