Focal cortical dysplasia(FCD)is one of the most common etiologies leading to drug-resistant epilepsy(DRE),and its neuroimaging features are an important part of clinical evaluation.Only some types of FCD can show abnormalities on MRI,and there are still many difficulties in the diagnosis and treatment of MRI-negative FCD.Morphology-based image post-processing technology is developing rapidly,and various image post-processing tools to assist diagnosis and treatment,such as Matlab,3D slicer,SinoPlan,MRIcro,etc.,are increasingly favored by the majority of scholars in epilepsy surgery,which can not only strip and 3D reconstruct abnormal lesions shown by MRI,but also assist in the appearance of potential abnormal sites which are difficult to recognize with the naked eye.This has greatly improved the detection rate of FCD foci and further met the demand for accurate diagnosis and treatment of FCD,thereby creating new ideas and methods for the diagnosis and treatment of intractable epilepsy,and providing more references for more comprehensive and scientific clinical diagnosis and treatment.

The biological clock(also known as the circadian rhythm)is the fundamental reliance for all organisms on Earth to adapt and survive in the Earth's rotation environment.Circadian rhythm is the most basic regulatory mechanism of life activities,and plays a key role in maintaining normal physiological and biochemical homeostasis,disease occurrence and treatment.Recent studies have shown that the biologi-cal clock plays an important role in the development of oral tissues and in the occurrence and treatment of oral diseases.Since there is cur-rently no guiding literature on the research methods of biological clock in stomatology,researchers mainly conduct research based on pub-lished references,which has led to controversy about the research methods of biological clock in stomatology,and there are many confusions about how to rationally apply the research methods of circadia rhythms.In view of this,this expert consensus summarizes the characteristics of the biological clock and analyzes the shortcomings of the current biological clock research in stomatology,and organizes relevant experts to summarize and recommend 10 principles as a reference for the rational implementation of the biological clock in stomatology research.

Objective:To observe the neuroprotective effect of wind medicine (Puerariae Lobatue Radix and Acori Tatarinowii Rhizoma) in combination with Panax ginseng total saponin (PNS) on cerebral ischemia-reperfusion rats; To elucidate the mechanism of "wind medicine increasing effect".Methods:Totally 140 male SD rats were divided into sham-operation group, model group, PNS group, Puerariae Lobatue Radix group, Acori Tatarinowii Rhizoma group, Puerariae Lobatue Radix + PNS group, Acori Tatarinowii Rhizoma + PNS group according to the random number table method, with 20 rats in each group. Except for the sham-operation group, the cerebral ischemia/reperfusion rat model was established using the modified Longa line bolus method in the remaining groups. After 7 d of administration of the appropriate pharmacologic intervention in each group, neurological dysfunction was evaluated by Zea-longa score after final administration, cerebral infarct volume was determined by TTC staining; blood brain barrier (BBB) permeability of brain tissue on the ischemic side was detected by Evans blue content; BBB ultrastructure of each group of rats was observed by transmission electron microscopy; Claudin 5 protein expression level was detected by immunohistochemistry; Zonula occludens-1 (ZO-1), major facilitator supeffamily domain-containing protein 2a (Mfsd2a), Occludin, P-glycoprotein (P-gp), Monocarboxylate Transporters-1 (MCT1) and breast cancer resistance protein (BCRP) protein expression levels were detected by Western-blot.Results:Compared with the model group, the rat neurological function scores were reduced in each administration group ( P<0.05), infarct volume was reduced ( P<0.05), EB content of brain tissue decreased ( P<0.05), protein expressions of Claudin 5, ZO-1, Mfsd2a and Occludin in brain tissue were elevated ( P<0.05), the protein expressions of P-gp, BCRP and MCT1 were reduced ( P<0.05), and the protein expressions of Claudin 5, Mfsd2a, and Occludin was higher in the Puerariae Lobatue Radix + PNS group and Acori Tatarinowii Rhizoma + PNS group than that of each group of medication alone ( P<0.05), and the protein expression of MCT1 was lower than that of each group of medication alone ( P<0.05); the protein expression level of ZO-1 in the Puerariae Lobatue Radix + PNS group was higher than that of the group of medication alone ( P<0.05); P-gp protein expression was lower in Acori Tatarinowii Rhizoma + PNS group than in the PNS group and Acori Tatarinowii Rhizoma group ( P<0.05). Conclusion:Wind medicine (Puerariae Lobatue Radix and Acori Tatarinowii Rhizoma) may potentiate the neuroprotective effect of PNS on cerebral ischemia-reperfusion rats, and the mechanism may be related to the protection of BBB structural integrity and maintenance of central barrier properties, while regulating substance transport proteins and increasing the intracerebral content of the drug.

Cardiovascular diseases, including heart failure, coronary artery disease, atherosclerosis, aneurysm, thrombosis, and hypertension, are a great economic burden and threat to human health and are the major cause of death worldwide. Recently, researchers have begun to appreciate the role of microbial ecosystems within the human body in contributing to metabolic and cardiovascular disorders. Accumulating evidence has demonstrated that the gut microbiota is closely associated with the occurrence and development of cardiovascular diseases. The gut microbiota functions as an endocrine organ that secretes bioactive metabolites that participate in the maintenance of cardiovascular homeostasis, and their dysfunction can directly influence the progression of cardiovascular disease. This review summarizes the current literature demonstrating the role of the gut microbiota in the development of cardiovascular diseases. We also highlight the mechanism by which well-documented gut microbiota-derived metabolites, especially trimethylamine N-oxide, short-chain fatty acids, and phenylacetylglutamine, promote or inhibit the pathogenesis of cardiovascular diseases. We also discuss the therapeutic potential of altering the gut microbiota and microbiota-derived metabolites to improve or prevent cardiovascular diseases.

In-patient service is a crucial link in the whole medical chain,how to construct an economical and efficient inpatient service model,so as to let patients spend the least amount of money,get the best quality medical service,and effectively improve their sense of well-being and sense of acquisition is a social problem that needs to be solved urgently.From the perspective of economics and combined with practical experience,a new inpatient service model(pre-hospitalization and pre-discharge model)is constructed,which is an upgrading and transformation of the original model on the basis of the existing business system,simplifies the existing service process of hospitalization and discharge,effectively reduces the average hospitalization day and the subperiod average hospitalization cost,and significantly improves the evaluation indexes of inpatient service compared with the traditional inpatient service model.

Atherosclerosis (AS) is a chronic and progressive arterial disease. It is an important cause of the occurrence and development of cardiovascular and cerebrovascular diseases. With the development of Traditional Chinese Medicine (TCM), TCM has many advantages in the therapy of AS, with less adverse reactions. Studies have shown that TCM can resist AS, and the mechanism mainly belongs to regulating lipid metabolism, anti-lipid peroxidation, anti-inflammation, anticoagulation, and protecting the structure and function of vascular endothelial cells. The mechanism of TCM for AS is warranted to be studied systematically, and the chemical components need to be further clarified.

Objective:According to the characteristics and common problems of hematology analysis in cancer patients, an autoverification scheme for cancer patients was formed, and the effectiveness and efficiency of the autoverification scheme were verified.Methods:The hematology review of international consensus and ourselves were respectively combined with Chinese multicenter autoverification rules to form two autoverification schemes. 10 063 blood samples (460 cases reviewed by microscope) were selected as the establishment group. Retrospective judgment was made in the instrument middleware, and various indexes such as autoverification pass rate and missed detection rate of different schemes were compared. By analyzing the data of missed cases one by one, the autoverification rules are adjusted according to the characteristics of diagnosis and treatment of cancer patients. By analyzing the platelet count variation range within 7 days in 19 300 cases, the Delta rules of platelet count were established. The platelet count Delta rules and the adjusted autoverification rules were combined to form the autoverification rules of our hospital and then combined with our hematology review rules to form the autoverification scheme of our hospital. The establishment group and verification group (10 876 cases, including 1 740 cases of microscopic examination) of the autoverification schemes were judged. The recognition function of Ethylenediaminetetraacetic acid-dependent pseudo thrombocytopenia (EDTA-PTCP) and PLT Delta check were programmed in the laboratory information system (LIS), and other rule judgment functions are performed in middleware. After four months of clinical trial application of 61 602 specimens, the effectiveness of our autoverification scheme was comprehensively evaluated.Results:The autoverification pass rates of international hematology review rules, our review rules, and Chinese multicenter autoverification rules are 46.36%, 52.26%, and the missed detection rates are 2.02%, 1.06%, respectively. The autoverification pass rates of our hospital autoverification scheme in the establishment group and the verification group are 51.19% and 52.78%, the missed detection rates are 0% and 0.03%, and the true positive rate are 100% and 99.95%, respectively. 56.06% of cases were passed automatically during the clinical trial application, and there were no missing cases, the true positive rate is 100%. The performance of our autoverification scheme is superior to the current autoverification schemes combined with mainstream hematology review rules and autoverification rules. The median time of TAT by autoverification was shortened by 15 minutes, and the 90th percentile time was shortened by 58 minutes, which was significantly lower than that of the same period last year. The marker function of "EDTA-PTCP" identified 31 special patients and 68 samples had been analyzed in total. After correction, the median increase of PLT was 76.5×10 9/L ( Z=-7.17, P<0.001). Conclusions:This study has established an autoverification scheme that combined by rules of hematology review and autoverification rules. It is suitable for cancer patients with high pass rate and very low rate of missed detection. This autoverification scheme can ensure the accuracy of the hematology analysis of cancer patients in our hospital and improve work efficiency.

Objective:To investigate the status of work performance among rural doctors in Shanxi province and the factors related to their performance.Methods:From July to September 2019, 528 rural doctors in Shanxi province were selected by multi-stage stratified cluster sampling for the survey. Their job competency, job performance, psychological capital and burnout were evaluated. The structural equation model was used to construct the job performance analysis based on post competency.Results:The total score of post competency of rural doctors in Shanxi province was (188.6±20.3), and the total score of job performance was (71.3±11.5), both of which were in the middle level. The structural equation model was well fitted [goodness-of-fit index (GFI)=0.958, normal fix index (NFI)=0.920, adjusted goodness-of-fit index (AGFI)=0.910, root mean square error of approximation (RMSEA)=0.076]. Post competency, psychological capital and job burnout had direct effects on job performance ( P<0.05), with influence coefficients of 0.64, 0.35 and -0.25, respectively. Job competency indirectly affected job performance through psychological capital and job burnout ( P<0.05). Conclusion:The study suggest that higher post competency would facilitate to improve the work performance of rural doctors.

Objective: To evaluate the medical services of tertiary hospitals in Shanxi province from the perspective of patients and provide references for improving the quality of medical services. Methods: From April to December 2018, 1 358 patients at 8 tertiary hospitals in Shanxi province were selected for the survey of medical service quality evaluation scale based on patient experience, while the status quo of patient experience in tertiary hospitals in Shanxi province was evaluated, and the multivariate mixed linear model was constructed based on the three-level model of hospital-department-patient to analyze the relevant factors of patient experience. If the quantitative data conform to the normal distribution, it was expressed as ±s. Otherwise, it was expressed as M(QR). Results: The patient experience score was 626±126, which was in the middle level. Whether the hospital was directly affiliated to the teaching hospital, and patient factors(marriage, occupation, education, medical insurance, number of hospital stays, etc.)were the main factors that affect the patient experience score(P<0.05). Conclusions Through the investigation, the influence characteristics of patients′ medical experience were discussed to improve the medical service and the overall service level.

Previous studies have shown that postoperative cognitive dysfunction (POCD) is related to multiple factors including age, postoperative trauma, inflammation, postoperative pain, and anesthesia, among which postoperative pain is thought to play an important role in the development of POCD. This review summarizes the recent findings in the study of the role of postoperative pain in the pathogenesis of POCD in light of nerve injuries, neural remodeling and stress, and the progress in the prevention and treatment of POCD in elderly patients. It is of vital important to assess the postoperative pain and formulate adequate analgesic regimens for effective prevention and management of POCD to protect the brain functions of elderly patients.
Aged ; Cognitive Dysfunction ; etiology ; Humans ; Inflammation ; Pain, Postoperative ; complications ; therapy ; Postoperative Complications