Objective By using ultrasonography to calculate the ratio of optic nerve sheath diameter(ONSD)at 3 mm behind eyeball to the eyeball transverse diameter(ETD),based on which to evaluate the effect of dexmedetomidine on intracranial pressure(ICP)in patients with intracranial aneurysm after receiving interventional embolization under general anesthesia.Methods A total of 40 patients with intracranial aneurysm,who were scheduled to receive interventional embolization under general anesthesia at the Affiliated Lihuili Hospital of Ningbo University of China from May 2023 to November 2023,were selected for this study.By using random number table method,the patients were divided into control group(group C)and dexmedetomidine group(group D)with 20 patients in each group.Standardized anesthesia strategy was adopted in both groups.For patients of group D,a loading dose of dexmedetomidine was pumped at a velocity of 1 μg/(kg·h)for 10 min before the surgery,the pumping was continued at 0.5 μg/(kg·h)velocity during the operation,and the pumping stopped half an hour before the end of the operation.For patients of group C,the same anesthesia strategy was used,while no any special treatment was given.At the different time points,including before awakening(T0),immediately after extubation(T1),and 5 min(T2),10 min(T3),15 min(T4)after extubation,ONSD at 3 mm behind eyeball and ETD were measured by transorbital ultrasonography,and ONSD/ETD ratio was calculated to evaluate ICP.The mean arterial pressure(MAP),heart rate(HR),blood oxygen saturation(SPO2),severity of cough,and extubation time were recorded at the time to remove the catheter.Results Compared with the data obtained at T0,the ONSD/ETD ratios obtained at T1 and T2 were increased in both groups(P＜0.05),while the ONSD/ETD ratios obtained at other time points were not significantly different from the ONSD/ETD ratio obtained at T0(P＞0.05).Compared with Group C,in Group D the ONSD/ETD ratios obtained at T1 and T2 were smaller,the differences were statistically significant(P＜0.05).The incidence of moderate to severe cough in Group D was lower than that in Group C(P＜0.05).Compared with Group C,in Group D the HR and MAP determined at the time of removing catheter were lower(P＜0.05).The extubation time in Group D was longer than that in group C,the difference was statistically significant(P＜0.05).Conclusion ONSD/ETD ratio calculated by ultrasono-graphy can objectively reflect the changes of ICP during the extubation period.Dexmedetomidine can reduce the elevation degree of ICP through effectively inhibiting cough reflex and circulatory fluctuation during tracheal extubation.However,dexmedetomidine may increase the incidence of adverse events such as bradycardia,delayed extubation,etc.

Objective:To summarize the clinical features of primary segmental volvulus (PSV) in neonates.Methods:A retrospective analysis was conducted on the clinical data of neonates with PSV who were admitted to the Department of Neonatal Surgery, Children's Hospital Affiliated to Capital Institute of Pediatrics from May 2014 to May 2023. The clinical manifestations, auxiliary examinations, treatment and prognosis of the neonates were summarized, and descriptive statistical analysis was performed on the collected data.Results:A total of 10 neonates with PSV were included, with a mean gestational age of (34.1±3.0) weeks and birth weight of (2 291±646) g. Eight cases had an onset age of 3 d or less, and 2 cases had an onset age of more than 3 d. Abdominal distension was observed as the main manifestation in all cases, while bilious vomiting occurred in seven cases and hematochezia in five cases. Imaging examinations mainly revealed low intestinal obstruction without specific manifestations. Laboratory tests showed metabolic acidosis and varing degrees of anaemia. Nine cases underwent diagnostic abdominal puncture, of which five had bloody ascites, two had clear ascites, one had bloody mixed with fecal-like ascites, and one had chylous ascites. All the cases underwent emergency exploratory laparotomy and segmental small bowel resections with either primary intestinal anastomosis or enterostomy. All cases were successfully cured and had been followed up to the age of 4 months to 9 years with good growth and development as normal children of the same age.Conclusions:Neonatal PSV is an independent abdominal emergency characterized by non-specific clinical manifestations and difficult preoperative diagnosis, but the overall prognosis is favorable after active surgical treatment.

Objective·To investigate the intervention effect of oral motor training combined with pediatric tui-na on feeding intolerance in preterm infants to provide new treatment options and improve the quality of care.Methods·By using a non-simultaneous controlled clinical trial method,75 eligible preterm infants from the neonatal unit of a tertiary care hospital in Jinan were selected as the experimental group to implement oral training combined with pediatric massage therapy.Another 60 preterm infants admitted in 2020 were selected as the control group,who had already received oral motor training but had not received pediatric massage.The experimental group was treated for 7 d and the efficacy of the two groups was compared.Comparisons between the two groups included signs of feeding intolerance such as vomiting,gastric remnants and other outcome indicators such as first oral feeding time,gastric tube retention time,increased milk volume at day 3 and increased milk volume at day 7,feeding initiation time,increased weight at day 3 and increased weight at day 7,recovery time of birth weight,and days of hospitalization in both groups.Results·The differences in gender,age,birth weight,and Apgar score between the two groups before treatment were not statistically significant(P>0.05)indicating comparability.After treatment,preterm infants in the experimental group showed significant improvement in feeding performance,first oral feeding time,gastric tube retention time,increased milk volume at day 3 and increased milk volume at day 7,increased weight at day 3 and increased weight at day 7,hospitalization days and other observed indexes compared with the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the feeding initiation time and recovery time of birth weight between the two groups(P>0.05).Conclusion·The combined application of oral motor training and pediatric tui-na is significantly more effective than single oral motor training in the short-term treatment of feeding intolerance in preterm infants.This combination therapy helps preterm infants to increase milk intake and accelerate weight gain,helps the children to recover intestinal function,establishes early nutritional support,promotes growth and development,and reduces the risk of long-term complications.This treatment is simple,safe and efficient,and has the value of popularization.

Objective:To explore the clinical phenotypes, pregnancy outcomes, and follow-up of fetuses with 1q21.1 distal microdeletion/microduplication, and to provide a basis for prenatal and genetic counseling.Methods:This was a retrospective study involving 14 singleton fetuses with 1q21.1 distal microdeletion/microduplication that were prenatally diagnosed by karyotype analysis and chromosomal microarray analysis (CMA) at Wuxi Maternity and Child Health Care Hospital from January 2017 to June 2022. The results of ultrasound and genetic analysis, pregnancy outcome after genetic counseling, and postnatal follow-up were summarized using descriptive statistical methods.Results:All 14 fetuses had normal karyotypes. Out of the 14 cases, CMA indicated 1q21.1 distal microdeletion in eight cases and 1q21.1 distal microduplication in six cases. The fragments ranged from 813 kb to 4.48 Mb, all of which contained the key region of 1q21.1 microdeletion/microduplication syndrome and were pathogenic copy number variations (CNV). Among eight fetuses with distal 1q21.1 microdeletion, four cases had abnormal prenatal ultrasound findings, including one case with overlapping fingers of left hand and polyhydramnios, two were small for gestational age, and one with small head circumference. Among the six cases who underwent parental origin detection, the microdeletions were de novo in four fetuses and two fetuses were inherited from the parent with normal phenotype. As for six fetuses with distal 1q21.1 microduplication, nasal bone absence or hypoplasia was shown by ultrasound in four cases and no obvious abnormality was found in the other two cases. Parental origin detection was performed in four cases, which found that one case was de novo and the other three cases were inherited from their phenotypically normal parents. After genetic counseling, five families chose to terminate the pregnancies and the remaining nine cases continued the pregnancies to delivery. The last follow-up showed that all of the nine live births grew well, whose ages ranged from seven months to half past five years old. Conclusions:CMA is of great value in prenatal diagnosis of 1q21.1 distal microdeletion/ microduplication. Ones carrying pathogenic CNV may not develop the disease. Combined with ultrasound findings and parental genetic tracing results, individualized genetic counseling and long-term follow-up are of great importance for reasonable guidance in pregnancy outcome and reproduction.

Humans ; HIV-1 ; Leukocytes, Mononuclear ; Lymphoma, Non-Hodgkin ; DNA ; HIV Infections

"Flipped Classroom" is a new kind of "student-centered" teaching model, which can give full play to the advantages of both sides of teaching and learning. According to this teaching model, we redesigned the teaching process, in which the students studied by themselves and built their own knowledge system. Moreover, each of them took part in three stages of experimental design including digital signal collection, analysis and processing in groups. Results have shown that this model can fully stimulate students' learning interest, not only helps students to deepen understanding of digital signal processing theory knowledge, but also strengthen the ability of autonomous learning and team collaboration. The teaching model maybe have certain reference function in comprehensive experiment teaching of Digital Signal Processing course for biomedical engineering specialty.

Based on the summary and reflection of the existing course construction content, this paper redesigns the course teaching to Brain Functional Imaging and forms a new curriculum construction scheme, including improving the professional teachers' ability of the teaching team by means of "internal training" + "external introduction", building an online and offline integrated teaching mode by combining online teaching resources such as course website with offline teaching (such as literature guidance, classroom discussion, comprehensive experimental design, etc.), and designing comprehensive experiments related to Electroencephalography (EEG) and functional near-infrared spectroscopy (fNIRS), which is driven by scientific research projects, based on the scientific research experimental platform of the teaching and research department. This construction scheme is of great significance for improving the teaching quality of the course, stimulating the learning interest of graduate students, and cultivating the comprehensive application and practical innovation ability of graduate students' brain imaging technology. And it also provides the reference for the further construction of the course and teaching reform in the future.

Objective:To systematically evaluate the real experience and needs of caregivers of children with type 1 diabetes mellitus.Methods:Qualitative researches on the real experience and needs of caregivers of children with type 1 diabetes mellitus were searched through Wanfang Databese, China National Knowledge Infrastructure, VIP, CBM, PubMed, Cochrane Library, Web of Science and Embase. The retrieval time limit was from the establishment of database to March 6, 2022. Literature screening and data extraction were conducted independently by 2 researchers. The quality of the literatures was evaluated using the Australian Joanna Briggs Institute (JBI) evidence-based health care center qualitative research quality evaluation standard (2016). The results were synthesized by the integrating method.Results:A total of 15 literatures were included, 62 research results were extracted, 8 categories were classified, and 3 integrated results were synthesized: the caregivers of children with type 1 diabetes mellitus suffer from multiple pressure and burden at the early stage of diagnosis; caregivers during the home care period are eager to obtain various support due to lack of knowledge, experience and support; caregivers gradually adapt to the role change brought by the disease, actively respond and regain confidence.Conclusions:Families, medical institutions and society should pay attention to the psychological emotion of caregivers of children with type 1 diabetes mellitus, and provide information, psychological, economic and social support, help them better perform their role as caregivers, so as to improve the quality of life of children and caregivers.

Hypertensive disorder of pregnancy (HDP) involves two major public health issues: mother-infant safety and prevention and controlling major chronic disease. HDP poses a serious threat to maternal and neonatal safety, and it is one of the leading causes of maternal and perinatal morbidity and mortality worldwide, as well as an important risk factor for long-term cardiovascular disease (CVD). In order to explore effective strategies to prevent and control the source of CVD and reduce its risk, we have established a cohort of HDPs in Shenzhen for the primordial prevention of CVD. The construction of the HDP cohort has already achieved preliminary progress till now. A total of 2 239 HDP women have been recruited in the HDP cohort. We have established a cohort data management platform and Biobank. The follow-up and assessment of postpartum cardiovascular metabolic risk in this cohort has also been launched. Our efforts will help explore the pathophysiological mechanism of HDP, especially the pathogenesis and precision phenotyping, prediction, and prevention of pre-eclampsia, which, therefore, may reduce the risk of adverse pregnancy outcomes, and provide a bridge to linking HDP and maternal-neonatal cardiovascular, metabolic risk to promote the cardiovascular health of mothers and their infants.

To investigate the relationship between thrombospondin 1 （TSP1） and angiogenesis factors in acute cerebral infarction. Methods 107 cases of acute cerebral infarction in the Department of Neurology，the Second Affiliated Hospital of Zhengzhou University were selected as the case group，and 90 healthy people admitted to hospital for physical examination were selected as the control group. Enzyme-linked immunosorbent assay （ELISA） was used to detect TSP1，transforming growth factor （TGFα） and fibroblast growth factor 2（FGF2），and the expressions of the three were compared between the case group and the control group，as well as under different NIHSS scores；Spearman method was used to analyze the correlation between TSP1 and TGFα，FGF2；multivariate regression method was used to analyze the occurrence of cerebral infarction The risk factors of cerebral infarction；ROC curve analysis of TSP1，TGFα and FGF2 on the prognosis of cerebral infarction. Results TSP1，TGFα，FGF2 in the case group were higher than those in the control group，and the difference was statistically significant （P< 0.05）. NIHSS score grouping only had significant difference in TSP1 （P< 0.05），and mild group