Ictal asystole in epileptic seizure (IA) is one of the severe complications of epilepsy, which is associated with falls and traumatic injuries related to seizures. Epileptic patients with IA may require adjustment to their treatment, including antiseizure medications adjustment, evaluation for epilepsy surgery and consideration of cardiac pacemaker implantation. However, there is no consensus on treatment options for these patients. This review focuses on the mechanisms, clinical features, auxiliary examinations and the outcomes of different treatments in the IA patients. Machine learning has some application values in analyzing the long-term video electroencephalogram (EEG) results of such patients and exploring the correlated characteristics between EEG and heart rate variability, which may provide a new perspective for the research.

The treatment rules of point selection and treatment principles for treating chronic fatigue syndrome (CFS) can be divided into three categories: regulating and replenishing, invigorating original yang and regulating zang-fu organs. The mechanism of moxibustion includes improving gut microbiota imbalance, regulating immune cell imbalance and correcting endocrine dysfunction. The moxibustion methods include ginger-partitioned moxibustion, thunder-fire moxibustion, warm acupuncture, and governor moxibustion. Acupuncture points such as Shenque (RN8), Guanyuan (RN4), Qihai (RN6), Zusanli (ST36), Baihui (DU20), Yongquan (KI1) and back-shu points are often selected to exert anti-chronic fatigue effects.

Objective:To explore the clinical characteristics, diagnosis and treatment of acute leukemia patients during pregnancy.Methods:The clinical data of 16 cases with acute leukemia during pregnancy from January 2009 to December 2018 in the First Affiliated Hospital of USTC were retrospectively analyzed. The diagnosis and treatment regimens, pregnancy outcome, the early fetus and survival status of patients were also analyzed.Results:All 16 leukemia cases were confirmedly diagnosed and classified by bone marrow puncture, including 13 cases of acute myeloid leukemia (5 cases of non-acute promyelocytic leukemia and 8 cases of acute promyelocytic leukemia) and 3 cases of acute lymphoblastic leukemia. At the time of confirmed diagnosis, 6 patients were in first trimester, 6 cases in second trimester and 4 cases in late trimester. As for pregnancy outcome, 1 patient had natural birthing, 5 patients underwent cesarean operation, 9 patients underwent artificial abortion and 1 patient had spontaneous abortion. Chemotherapy was performed in 15 patients during pregnancy, 11 patients received chemotherapy for treatment of primary disease after pregnancy, 3 patients died during the treatment. During the follow-up of 13 cases, 8 patients survived and 5 patients lost follow-up.Conclusions:Early diagnosis of acute leukemia during pregnancy is very important. Bone marrow puncture should be performed timely to make clear diagnosis when blood routine result is abnormal during antenatal care. Multidisciplinary consultation should be initiated in time, and the best treatment plan should be worked out to guard against serious complications during pregnancy.

Objectives: To compare the effect of eldecalcitol and alfacalcidol on skeletal microstructure by highresolution peripheral QCT (HR-pQCT). Methods: This was a substudy of a randomized, double-blind, active comparator trial. Five female osteoporotic patients with 1-year 0.75 mg/day eldecalcitol and 5 with 1-year 1.0 mg/day alfacalcidol completed HR-pQCT scans before and after treatment were enrolled. Results: Total vBMD [1.67 ± 1.06% (mean ± SD), P ¼ 0.043 versus baseline] and trabecular vBMD (2.91 ± 1.72%, P ¼ 0.043) at the radius increased in eldecalcitol group, while total, trabecular, and cortical vBMD tended to decrease in alfacalcidol group, with a significant reduction in cortical vBMD at the tibia (0.88 ± 0.62%, P ¼ 0.043). Cortical area (1.82 ± 1.92%, P ¼ 0.043) at the radius and thickness (0.87 ± 1.12%, P ¼ 0.043) at the tibia increased in eldecalcitol group, while these parameters decreased with alfacalcidol at the tibia (1.77 ± 1.72%, P ¼ 0.043 for cortical area; 1.40 ± 2.14%, P ¼ 0.042 for cortical thickness). Trabecular thickness at the radius (1.97 ± 1.93%, P ¼ 0.042) and number at the tibia (3.09 ± 3.04%, P ¼ 0.043) increased by eldecalcitol but did not increase by alfacalcidol. Trabecular separation decreased by eldecalcitol (2.22 ± 2.43%, P ¼ 0.043) but tended to increase by alfacalcidol at the tibia. Conclusions Eldecalcitol has the greater potential to improve cortical and trabecular microstructure at the peripheral bone than alfacalcidol which needs further more studies.

Objectives: To compare the effect of eldecalcitol and alfacalcidol on skeletal microstructure by highresolution peripheral QCT (HR-pQCT). Methods: This was a substudy of a randomized, double-blind, active comparator trial. Five female osteoporotic patients with 1-year 0.75 mg/day eldecalcitol and 5 with 1-year 1.0 mg/day alfacalcidol completed HR-pQCT scans before and after treatment were enrolled. Results: Total vBMD [1.67 ± 1.06% (mean ± SD), P ¼ 0.043 versus baseline] and trabecular vBMD (2.91 ± 1.72%, P ¼ 0.043) at the radius increased in eldecalcitol group, while total, trabecular, and cortical vBMD tended to decrease in alfacalcidol group, with a significant reduction in cortical vBMD at the tibia (0.88 ± 0.62%, P ¼ 0.043). Cortical area (1.82 ± 1.92%, P ¼ 0.043) at the radius and thickness (0.87 ± 1.12%, P ¼ 0.043) at the tibia increased in eldecalcitol group, while these parameters decreased with alfacalcidol at the tibia (1.77 ± 1.72%, P ¼ 0.043 for cortical area; 1.40 ± 2.14%, P ¼ 0.042 for cortical thickness). Trabecular thickness at the radius (1.97 ± 1.93%, P ¼ 0.042) and number at the tibia (3.09 ± 3.04%, P ¼ 0.043) increased by eldecalcitol but did not increase by alfacalcidol. Trabecular separation decreased by eldecalcitol (2.22 ± 2.43%, P ¼ 0.043) but tended to increase by alfacalcidol at the tibia. Conclusions Eldecalcitol has the greater potential to improve cortical and trabecular microstructure at the peripheral bone than alfacalcidol which needs further more studies.

Objective:To investigate the effects of ulinastatin on liver function in patients with liver cancer after major hepatectomy.Methods:The clinical data of 232 patients with major liver resection due to liver cancer were retrospectively analyzed. According to whether ulinastatin was applied after operation, patients were divided into treatment group (105 cases) and control group (127 cases). The postoperative inflammatory factors, liver function, postoperative complications and hospital stay were compared.Results:The levels of CRP、IL-6 and TBIL、ALT、AST were significantly lower than the control group 3 days after surgery (CRP: t=4.520, P=0.000; IL-6: t=17.982, P=0.000; TBIL: t=9.843, P=0.000; ALT: t=11.913, P=0.000; AST: t=4.520, P=0.000). The incidence of massive ascites in the treatment group (χ 2=4.212, P=0.040) and the average postoperative hospital stay ( t=9.994, P=0.000) were significantly lower than that in the control group. Conclusion:Early application of ulinastatin effectively inhibits the inflammatory process, protects liver function, reduces the incidence of massive ascites, and shortens the postoperative hospital stay.

Objective To study the effect of the reinforcing and reducing method of acupuncture reported in first Chapter the Nine Needles and Twelve Yuan of the Miraculous Pivot on interstitial fluid pressure (IFP) in subcutaneous tissue of minipig, and to investigate its biomechanical mechanism of regulating the interstitial fluid. Methods Nine healthy minipigs were randomly selected for reinforcing method (pull or press) and reducing method (wave a big pinhole), and tested on soft skin tissues of the abdomen. The IFP in the normal state (NS), the low volume (LV) state (by extracting interstitial fluid) and the high volume (HV) state (by injecting saline solution) was measured before and after acupuncture. Results In the normal state, pulling and pressing the needle could obviously increase IFP, while reducing method could significantly decrease IFP, leading to a rapid decrease in 5 min after acupuncture. In the LV state, pulling and pressing the needle could increase IFP. However, in 10 min after acupuncture, the descend rates of IFP were relatively slower. In the HV state, the reducing method could significantly decrease IFP, and the changing trend in 5 min after acupuncture was different from that of the control group. Conclusions The reinforcing and reducing method of acupuncture could increase or decrease IFP, which proved that the acupuncture method could regulate IFP in the opposite direction. The research findings provide a new scientific basis for using reinforcing and reducing method of acupuncture in clinic.

Objective The echocardiography of patients with chronic Keshan disease (CKD) in the plateau and plain areas was compared,to analyze the specific manifestations of echocardiography in patients with high altitude CKD,to provide a reference for imaging diagnosis.Methods From October 2014 to December 2016,34 patients with CKD were selected in the Tibet Autonomous Region [18 males,16 females,aged (44.5 ± 5.6) years old] as plateau group;45 patients with CKD were selected in Shandong Province [21 males,24 females,age (47.3 ± 6.9) years old] as a plain group.Echocardiography was performed on the observed subjects,and cardiac morphology,hemodynamics and cardiac function were analyzed.Results The left atrial diameter (LAD),left ventricular end diastolic diameter (LVEDD),and left ventricular mass (LVM) of the plateau group were (39.2 ± 4.8),(56.5 ± 6.3) mm and (232.4 ± 40.2) g,respectively,which were lower than those of the plain group [(48.3 ± 5.7),(65.2 ± 7.8) mm,(283.7 ± 38.3) g,t =-7.52,-5.30,-5.74,P ＜ 0.01].The right atrial transverse diameter (RATD),right ventricular transverse diameter (RVTD) and right ventricular lateral wall thickness (RVWT) of the plateau group were (47.6 ± 8.5),(50.4 ± 7.3) and (4.8 ± 1.1) mm,respectively,which were higher than those of the plain group [(42.3 ± 7.2),(42.7 ± 6.8),(3.3 ± 0.7) mm,t =2.99,4.81,7.36,P ＜ 0.01].The early diastolic filling velocity (E),the early diastolic peak velocity of the mitral annular (Em) of the plateau group were lower than those of the plain group,E/Em of the plateau group was higher than that of the plain group (t =-2.64,-2.35,2.07,P ＜ 0.05).The fractional area change (FAC) of right ventricular,tricuspid annular plane systolic excursion (TAPSE) and tricuspid annular systolic velocity (S') of the plateau group [(24.9 ± 2.8)％,(13.2 ± 1.2) mm,(6.8 ± 1.0) cm/s] were lower than those of the plain group [(26.3 ± 3.2)％,(14.5 ± 1.3) rmm,(7.5 ± 1.2) cm/s,t =-2.02,-4.53,-2.74,P ＜ 0.05 or ＜ 0.01].The tricuspid annular diastolic velocity (e') of the plateau group was lower than that of the plain group,and tricuspid annular blood flow early diastolic filling velocity maximum (e)/e'was higher than that of the plain group (t =-2.07,2.09,P ＜ 0.05).The systolic pulmonary artery pressure (SPAP) of the plateau group [(48.5 ± 12.3) mmHg,1 mmHg =0.133 kPa] was higher than that of the plain group [(41.6 ± 13.3) mmHg,t =2.34,P ＜ 0.05].Conclusion Compared with CKD patients in plain area,CKD patients in plateau area have showed more obvious right heart enlargement and right ventricular failure,and combined with higher SPAP.

Objective: To explore the treatment technique, occurrence and development patterns of such radiation injuries as in a major radiological accident in which a victim suffered mild bone marrow radiation sickness combined grade degree Ⅲ acute radiation induced skin injury, based on his dose estimation, clinical manifestations and disease treatments. Methods: History inquiry in detail, earlier physical dose estimation and biological dose estimation were conducted in conjunction with analyzing the chromosome aberration of peripheral blood lymphocytes. The physical dose was estimated by Monte Carlo method.The systematic laboratory and imaging examination was performed to evaluate the condition. The comprehensive analysis was conducted to determine the diagnosis and treatment plan. Results: At 3d after the exposure, "Ren" felt mild pain and discomfortable on the skin of the right index finger. The body of the right hand index finger was covered with blister at 21 d after exposure.The estimation of biological dose was 0.43 Gy (95%CI: 0.31-0.58 Gy), and the physical dose was estimated to be 36-164 Gy for each part of the right hand finger. The hematopoietic system, immune system and endocrine system were normal. The liver function index value was transiently increased. The liver damage resulted from the use of antibiotic-induced combined with the patient′s past medical history and admission examination result, and the relevant antibiotics were discontinued. The liver function returned to normal after liver protection treatment. At 22 d after irradiation, a right finger incision and decompression surgery were performed. The stem cells were extracted and implanted into the right index finger. After 59 days of hospitalization, there was no obvious discomfort in the body, and the right index finger recovered well, as well as the pain significantly relieved, and the knuckle activity was basically normal. Conclusions The patient with excessive radiation and grade Ⅲ acute radiation skin injury was successfully treated, and local application of autologous adipose-derived stem cell transplantation achieved good result .

Objective To analyze the difference of echocardiography in patients with chronic Keshan disease (CKD) at different altitudes areas,explore the effects of altitude on the structure and functional of right heart in CKD patients,and provide a reference for imaging diagnosis of CKD.Methods According to the three step distribution of the terrain in China,30 cases of CKD patients in the first step (altitude ＞ 4 000 m) of Tibet autonomous region were randomly selected as the Tibetan plateau group.In the second step (altitude:1 000-2 000 m),31 cases were randomly selected in Gansu Province as the Loess plateau group.In the third step (altitude ＜ 500 m),42 cases were randomly selected in Shandong Province as the plain group.Echocardiography was used to analyze the morphology,hemodynamics and function of right heart.Results Right atrial transverse diameter (RATD),right ventricular transverse diameter (RVTD),right ventricular lateral wall thickness (RVWT) and main pulmonary artery diameter (MPAD) of the Tibetan plateau group,the Loess plateau group and the plain group (mm:49.75 ± 8.40,45.64 ± 7.63,43.56 ± 7.34;50.89 ± 7.13,46.56 ± 5.62,43.27 ± 6.01;4.75 ± 1.02,3.53 ± 0.61,3.37 ± 0.51;32.87 ± 3.62,28.93 ± 2.12,28.44 ± 2.71) were significant differences among the three groups (F =5.36,12.91,37.08,23.33,P ＜ 0.01).The above indexes of the Tibetan plateau group were higher than those of the Loess plateau group and the plain group (P ＜ 0.05).RVTD of Loess plateau group was higher than that of plain group (P ＜ 0.05).The fractional area change [FAC,(24.85 ± 2.75)％,(26.26 ± 3.42)％,(26.73 ± 3.14)％],tricuspid annular plane systolic excursion [TAPSE,(12.87 ± 1.12),(14.59 ± 1.63),(14.13 ± 1.31) mm] of the Tibetan plateau group,the Loess plateau group and the plain group were significant differences among the three groups (F =3.36,13.47,P ＜ 0.05 or ＜ 0.01);the above indexes of the Tibetan plateau group were lower than those of the Loess plateau group and the plain group (P ＜ 0.05).Tei index (0.87 ± 0.18,0.78 ± 0.16,0.71 ± 0.14),tricuspid flap diastolic maximum filling speed/tricuspid annulus early diastolic peak velocity (E/E',9.48 ± 1.22,8.64 ± 0.91,8.12 ± 1.13),systolic pulmonary artery pressure [SPAP,(49.58 ± 11.76),(44.35 ± 11.41),(42.67 ± 12.13) mmHg,1 mmHg =0.133 kPa] of the Tibetan plateau group,the Loess plateau group and the plain group were significant differences among the three groups (F =12.89,13.99,3.12,P ＜ 0.01 or ＜ 0.05);the Tei index and E/E'of the Tibetan plateau group were higher than those of the Loess plateau group and the plain group (P ＜ 0.05).Tei index,E/E'of the Loess plateau group were higher than those of the plain group (P ＜ 0.05).Conclusions The right heart structure and function of CKD patients are affected by the altitude of their residence.With the increase of altitude,the right heart is enlarged,the right ventricular systolic and diastolic functions are decreased,and SPAP is increased in CKD patients.