Objective To summarize the clinical characteristics of myotonic dystrophy(DM).Methods The clinical data of 24 DM cases were analyzed retrospectively.Results 83.3%(20/24) of the patients obtained the disease during youth and it progressed slowly.79.2%(19/24) of the patients had positive family history.DM was a multisystem disease characterizing by myotonia,weakness and atrophy involved in multiple muscle groups,especially in distal limbs,neck and face.Extensors were more severe than flexors.Spontaneous myotonic discharges and myogenic damages were shown on electromyogram.Pathological examination of muscle biopsies showed increased number of central nuclei,nuclear chains and predominant atrophic typeⅠfibers in 8 cases,muscle fiber necrosis in 7 cases,fibrous structure disorder in 4 cases,sarcoplasmic masses in 3 cases,and serration of sarolemma in 2 cases.Conclusions The clinical characteristics of DM are weakness,atrophy and myotonia.Electromyogram and muscle biopsy are helpful in diagnosis of this disease.

Objective There were few studies of prediction on type 2 diabetic patients with acute pulmonary thromboembo?lism.To evaluate the performance of the Padua score, revised Geneva score and Wells PE score in the prediction value of diagnosis of type 2 diabetes mellitus with acute pulmonary thromboembolism( APTE) . Methods 151cases with suspected APTE of type 2 diabe?tes were collected from January 2013 to December 2015 by a retrospective case analysis mode. Among 151 pations,80 cases had diag?nosed with pulmonary thromboembolism.The receiver operating characteristic (ROC) curve was used to evaluate the probability of type 2 diabetic patients with APTE predicted by the Padua, the revised Geneva and the Wells PE score. We calculated the Youden Index for the cut?off point. Results The area under curve( AUC) of the ROC curve in the Padua score, revised Geneva score and Wells PE score for APTE was 0.804±0.035、0.635±0.045 and 0.705±0.043. The area under the ROC curve of the Padua score was the highest and there was a significant difference compared with the revised Geneva( P<0.016 7) . The comparison of Padua score and Wells PE for the predication value was no statistically significant difference ( P>0.016 7) . The comparison of revised Geneva score and Wells PE for the predication value was no statistically significant difference ( P>0.016 7) . The cut?off of Padua score was 3 points and Youden Index was 0.51. The cut?off of Revised Geneva was 3 points and Youden In?dex was 0.24. The cut?off of Wells PE score was 1 points and Youden Index was 0.39. Conclusion Padua score, revised Geneva score and Wells PE score in predicting diabetes patients have some ex?tent clinical value terms, which Padua score has higher predictive value than the Revised Geneva.The predictive value of Padua score and Wells PE score was equivalent.However, the predictive value of Padua score is limited.

AIM: The purpose of this study was to investigate the effects of rhBMP-2/collagen composite on bone regeneration during expansion of the interparietal suture in the rats. METHODS: 32 10-week old SD rats were divided into groups consisting of 8 rats each. They were comprised of normal control group, expansion control group and the treatment group, the two treatment groups were covered with atelo-typeⅠcollagen and rhBMP-2/collagen composite on the suture before subjected to the expansion force. The bone regeneration in the interparietal suture was estimated by histological method, the osteocalcin content was measured by radioimmonoassay and the calcium content was determined by atomic absorption spectrophotometer. RESULTS: The bone regeneration was more active in the suture after giving an expanding force than in the suture without any intervention. Even bone bridge was formed in the rhBMP-2/collagen composite group. Both the osteocalcin content and calcium content were much higher in the rhBMP-2/collagen composite group than in other three groups (P

OBJECTIVETo explore the impacts on the life quality and the effect mechanism in the patients of allergic rhinitis (AR) treated with warm acupuncture in winter and summer.

METHODSTwo hundred and forty patients of AR were randomized into a summer and winter acupuncture group, a non-summer and winter acupuncture group and a western medication group, 80 cases in each one. In the two acupuncture groups, Dazhui (GV 14), Fengmen (BL 12), Feishu (BL 13), Pishu (BL 20) and Shenshu (BL 23) were selected. In the summer and winter acupuncture group, the warm acupuncture started at the first day of the three periods of hot season and the first day of the third nine-day period after the winter solstice. The treatment was given once every two days, continuously for 15 times. Totally, 30 treatments were required a year. In the non-summer and winter acupuncture group, the warm acupuncture was applied out of the three periods of the hot season and the third nine-day period after the winter solstice. The treatment was given once every two days and 30 treatments for a year. In the western medication group, cetirizine was taken orally, continuously for 30 days as one session. In the three groups, the treatment for 1 year was taken as one session. The second session started in the next year. Totally, 2 sessions were required. The score of rhinoconjunctivitis quality of life questionnaire (RQLQ) and the level of serum immunoglobulin E (IgE) were compared in the patients' of each group before treatment and in 1 and 2 sessions of treatment.

RESULTSAfter treatment, the scores of 7 domains, named activities, common complaints, practical problems, sleep, ocular symptoms, nasal symptoms and emotions were all improved as compared with those before treatment, in the patients of the three groups (all P < 0.05). After 2 sessions treatment, the results in the summer and winter acupuncture group were better than those in the other two groups (all P < 0.05), and the results in the non-summer and winter acupuncture group were better than those in the western medication group (all P < 0.05). After treatment, serum IgE level was lower averagely than that before treatment in the three groups (all P < 0.05). After 2 sessions treatment, the result in the summer and winter acupuncture group was lower than that in the other two groups (both P < 0.05), and the result in the non-summer and winter acupuncture group was lower than that in the western medication group (P < 0.05). After treatment, the total effective rate was 92.3% (72/78) in the summer and winter acupuncture group, better than 80.5% (62/77) in the non-summer and winter acupuncture group and 69.7% (53/76) in the western medication group (both P < 0.05).

CONCLUSIONThe warm acupuncture in both summer and winter achieves the definite efficacy on AR and the effect mechanism is relevant with reducing serum IgE level.

Acupuncture Points ; Acupuncture Therapy ; instrumentation ; methods ; Adolescent ; Adult ; Female ; Humans ; Male ; Middle Aged ; Quality of Life ; Rhinitis, Allergic ; therapy ; Seasons ; Treatment Outcome ; Young Adult

Objective:To investigate whether rumination and family functioning can predict the level of depression after 1 year of follow-up in patients with first-episode depression, and whether family functioning plays a mediating role between rumination and depression level.Methods:Sixty-five patients with first-episode depression who met the enrollment requirements were included, and all subjects were assessed the 17-item Hamilton depression scale(HAMD-17), rumination response scale(RRS) and family assessment device(FAD). All subjects were followed up for 1 year, and the predictive effects of rumination and family functioning at baseline on the level of depression after 1 year of follow-up were investigated by hierarchical linear regression analysis and mediation analysis.Results:At the baseline stage, rumination, role, affective involvement (AI) and general functioning (GF) were significantly positively associated with depression level after 1 year of follow-up in patients with first-episode depression ( r=0.49, P<0.01; r=0.30, P=0.02; r=0.43, P<0.01; r=0.50, P<0.01; respectively). Rumination, AI and GF at the baseline stage predicted depression level after 1 year of follow-up ( β=0.315, t=2.954, P=0.005; β=0.261, t=2.550, P=0.013; β=0.323, t=2.952, P=0.005). Mediation analysis showed that AI and GF partially mediated the relationship between rumination at baseline and depression level at 1 year follow-up (point estimate value for AI=0.040, 95% CI=0.012-0.090); point estimate value for GF=0.066, 95% CI=0.017-0.143). Conclusions:Rumination and family functioning at baseline in first-episode depressed patients can predict the depression level at 1 year follow-up.Family functioning partly mediates the relationship between the baseline rumination and the depression level at 1 year follow-up.

Pulmonary hypertension has a high mortality rate,and although targeted therapy is available,it is still incurable,and the long-term prognosis for patients is poor.As a tyrosine kinase inhibitor,imatinib was approved for marketing in China in 2002 for the treatment of chronic myelogenous leukemia and other tumor diseases.In addition to the antitumor effects,imatinib was found to improve hemodynamics and exercise tolerance in patients with severe pulmonary arterial hypertension,but the safety was suboptimal.With the emergence of new formulations of imatinib targeted at the lungs,it is expected to become a new targeted drug for pulmonary arterial hypertension.

Objective: To investigate the effect of single antiepileptic drugs(AEDs) and combination therapy on the effect of seizure after stroke, prognosis and recurrent seizures. Methods: From November 2013 to December 2017, 280 patients with epilepsy and epilepsy that had been included in the epilepsy course and AEDs course for>6 months in Shaoxing Central Hospital were divided into early-onset epilepsy group and late-onset epilepsy group according to the patients' condition, with 140 cases in each group.According to different AEDs treatment regimens, they were further divided into monotherapy group(valproate) and combination therapy group(valproate, oxcarbazepine combined with levetiracetam). Results: The proportion of monotherapy in the early-onset epilepsy group was significantly higher than that of the late-onset epilepsy group, and the proportion of the late-onset epilepsy group was significantly higher than that of the early-onset epilepsy group(χ²=22.857, P<0.0001). The incidence and effectiveness of epilepsy patients after single-agent and combination therapy in the early-onset epilepsy group had statistically significant differences[onset rate: 40.0%(36/90) vs.16.0%(8/50), χ²=8.591, P=0.003; effective rate: 88.9%(80/90) vs.100.0%(50/50), χ²=5.983, P=0.014]. The incidence and effectiveness of single-agent and combination therapy in the late-onset epilepsy group had statistically significant differences [seizure rate: 40.0%(20/50) vs.82.2%(74/90), χ²=25.974, P=0.000; effective rate: 64.0%(32/50) vs.87.8%(79/90), χ²=11.065, P=0.000]. Conclusion The time of post-stroke epilepsy is not related with the site, type and risk factors of stroke; early epilepsy usually manifested partial seizures and had better curative effect of AEDs, and late epilepsy usually manifested overall tonic clonic seizure; there were no obvious difference in curative effect and recurrence rate of early and late epilepsy on single and combined AEDs treatment.

Objective:To study the predictive value of hour-specific total serum bilirubin(TSB) nomogram combined with clinical risk factors in the risk of hyperbilirubinemia.Method:Perinatal clinical data of newborns born in Shanghai Pudong New Area Health Care Hospital for Women and Children, Shanghai Pudong New Area People's Hospital and Shanghai Pudong Hospital from August 2017 to July 2018 were collected in this prospective study. Transcutaneous bilirubin (TcB) was monitored before discharge from hospital. Enrolled neonates were followed up for 28 days. The patients were assigned to neonatal hyperbilirubinemia group (NHB) and non-hyperbilirubinemia group (Non-HB) according to the occurrence of hyperbilirubinemia. The predictive value of models for the risk of hyperbilirubinemia was evaluated by receiver operating characteristic (ROC) curves and Logistic regression analysis.Result:A total of 8 664 newborns were included in this study, with 1 196 cases of hyperbilirubinemia, with an incidence of 13.8%. Logistic regression analysis showed that maternal blood type O, premature rupture of membranes, male gender, gestational age 35~37 weeks, subcutaneous ecchymosis/cranial edema, and breastfeeding were independent risk factors for NHB ( P<0.05). The area under receiver operative characteristic curve (ROC) of predischarge bilirubin risk zone only was 0.874(95% CI 0.861~0.885, P<0.05)and for all independent risk factors was 0.664 (95% CI 0.647~0.680, P<0.05). The area under ROC curve was 0.891 (95% CI 0.880~0.902, P<0.05) by combining predischarge bilirubin risk zone with clinical risk factors. Conclusion:Predischarge bilirubin risk zone combined with clinical risk factors can reasonably predict neonatal hyperbilirubinemia well.

In order to effectively treat respiratory diseases, a non-invasive positive pressure ventilator system is designed, the overall structure design of the system is proposed, and the hardware construction is completed. The breathing state of the patient is identified by the threshold triggering method of the flow rate of change, and the calculation of the flow rate of change is realized by the least squares method. At the same time, the breathing parameters are calculated in real time according to the flow-time and pressure-time characteristic curves. In addition, CMV, CPAP, BiPAP and PSV ventilation modes are also implemented. Finally, the parameter measurement accuracy and ventilation mode setting tests are carried out. The results show that the calculation of key breathing parameters provided by the system meets the relevant standards, and supports the stable output of 4 ventilation modes at the same time, provides breathing treatment for patients, and meets the basic functional requirements of the ventilator.
Humans ; Ventilators, Mechanical ; Respiration