Tongue acupuncture therapy is an external treatment method of "micro acupuncture system" based on the theory of Zang Fu meridians and holographic theory. It acts on the tongue and can be used for the treatment of swallowing disorder after stroke. It has the advantages of improving tongue and pharyngeal function, high safety, simplicity and quickness. It is often used in combination with rehabilitation training, Traditional Chinese Medicine therapy or other acupuncture methods in clinic, and has achieved good curative effects.

Objective:To validate the performance of cardiovascular risk prediction models based on the Sweden National Diabetes Register (NDR) and Diabetes Lifetime-perspective prediction (DIAL) model for assessing risks of 5-year and 10-year cardiovascular disease (CVD) among Chinese patients with type 2 diabetes.Methods:Based on the Chinese Electronic Health Records Research in Yinzhou study, 83 503 patients with type 2 diabetes aged 30-75 years without a history of CVD at baseline were included from January 1, 2010 to December 31, 2020. Recalibrated NDR model was used to estimate 5-year risk, while the recalibrated DIAL model was used to predict 5-year and 10-year risks. The competing events adjusted Kaplan-Meier analysis was used to obtain the observed cardiovascular events. Discrimination C statistics evaluated model accuracy, calibration χ2 value, and calibration plots. Results:Through a median follow-up of 7.0 years, 7 326 cardiovascular events, and 2 937 non-vascular deaths were identified among a total of 83 503 subjects. The recalibrated NDR model overestimated 5-year risk by 39.4% in men and 8.6% in women, whereas the overestimation for the recalibrated DIAL model was 14.6% in men and 50.1% in women. The DIAL model had a better discriminative ability ( C-statistic=0.681, 95% CI: 0.672-0.690) than NDR model ( C-statistic=0.667, 95% CI: 0.657-0.677) in 5-year risk prediction for men, and the models had a similar ability for women ( C-statistic=0.699, 95% CI: 0.690-0.708 for NDR and C-statistic=0.698, 95% CI: 0.689-0.706 for DIAL). The prediction accuracy of the DIAL model was improved in the 10-year risk, with the underestimation being 1.6% for men and the overestimation being 12.8% for women. Conclusions:Both recalibrated NDR and DIAL models overestimated 5-year cardiovascular risk in Chinese patients with type 2 diabetes, while the higher overestimation was shown using the DIAL model. However, the improvement was found in predicting 10-year CVD risk using the DIAL model, which suggested the value of lifetime risk prediction and indicated the need for research on the lifetime risk prediction model for cardiovascular risk assessment in Chinese patients with type 2 diabetes.

OBJECTIVE: The design and development of split memory alloy sternum bone plate are discussed, and the effect of split memory alloy sternum bone plate internal fixation in the treatment of sternal fractures are analysed. METHODS: The structure of the product is designed according to the anatomy and physiological characteristics of human bones, and the cross section shape of the product is designed according to the cross section shape of human bones. Internal fixation is effective in the treatment of sternal fracture. RESULTS: The split memory alloy sternal plate was successfully designed and developed, and all the patients with sternal fractures treated by internal fixation were clinically healed, the hospitalization and fracture healing time were significantly shortened, and no obvious complications occurred. CONCLUSIONS The application of split memory alloy sternal plate internal fixation in the treatment of sternal fracture has the advantages of small trauma, simple operation, safety, reliable fixation, good histocompatibility and less complications, and is conducive to promoting fracture healing and respiratory function improvement.
Alloys ; Bone Plates ; Fracture Fixation, Internal ; Fracture Healing ; Humans ; Sternum/surgery*

Objective:To evaluate the clinical value of suspensory incision and suture technique in endoscopic full-thickness resection (EFTR) for muscularis propria tumor of gastric fundus.Methods:A retrospective analysis was performed on the data of 20 patients with muscularis propria tumor in gastric fundus and undergoing EFTR in the First Medical Center of PLA General Hospital from June 2017 to June 2019. Patients were divided into the observation group (9 cases) treated with suspensory incision and suture technique in EFTR and the control group (11 cases) treated with traditional EFTR method. The baseline data and perioperative data of the two groups were analyzed.Results:EFTR was successfully performed on all 20 patients. The tumor size of the observation group and the control group was 10.0 (7.5, 21.0) mm and 14.0 (10.0, 20.0) mm, respectively. The resection time of the two groups was 26.4±6.3 min and 35.5±11.4 min, respectively. The postoperative hospital stay was 6.4±1.0 d and 7.7±1.5 d, respectively. No postoperative delayed bleeding, perforation, or other complications occurred in the two groups.Conclusion:Using suspensory incision and suture technique is safe and effective during EFTR for muscularis propria tumor in gastric fundus, and can reduce operation time. This technique is worth applying in clinic.

Objective:To explore the pathogenic variants of a family with syndromic deafness by high-throughput sequencing.Methods:The family was from Puyang City, Henan Province, and had four members, including two with syndromic deafness. The proband and his sister had congenital deafness, and their parents had normal phenotypes. The clinical phenotype of the family was characterized using clinical examinations and pedigree analysis. The clinical examinations included imaging examination, audiometry (pure tone audiometry, acoustic immittance, brainstem auditory evoked potential, and otoacoustic emission), vestibular function test, and ophthalmic examination (visual acuity test, visual field test, fundus examination, visual evoked potential, and electroretinogram). Target exome sequencing of 129 known deafness genes and bioinformatics analysis were used to screen suspected pathogenic variants. Sanger sequencing and minigene assay were used to verify and functionally investigate the mutation detected, respectively. According to the standards and guidelines for interpreting genetic variants proposed by the American College of Medical Genetics and Genomics, the variants c.6049G>A and c.8699A>G were classified as pathogenic/likely pathogenic, and the variant c.9856C>G was classified as variants of uncertain significance.Results:The probands and his sister had severe sensorineural hearing loss with decreased binocular vision, night blindness, decreased peripheral visual field sensitivity and partial visual field defect, and normal vestibular function. Both of them had three CDH23 mutations, including CDH23 (NM_022124.5) c.6049G>A (p.Gly2017Ser),c.9856C>G (p.His3286Asp), and c.8699A>G (p. Asp2900Gly), The first two were inherited from the father, and the last one was from the mother. The missense variants c.9856C>G and c.8699A>G were not included in the gnomad database. The missense mutation c.6049G>A was located in the last position of exon 46 and was predicted to affect splicing by bioinformatics software. The minigene experiment showed that the mutation cause exon skipping of exon 46, resulting in an abnormal protein. Conclusions:Compound heterozygous variations of the CDH23 are the leading cause of USH1D in the family. This study confirms that the compound heterozygosity of splicing and missense variants of the CDH23 gene could lead to USH1D.

Objective To assess the efficacy and safety of autologous skin-grafting surgery ( ASGS) in the prevention of esophageal stenosis after complete circular endoscopic submucosal tunnel dissection ( ESTD) for early esophageal cancer. Methods Between January 2018 and March 2018, five patients with early esophageal cancer underwent complete circular ESTD and ASGS in Chinese PLA General Hospital. The skin-graft survival situation, and occurrence of esophageal stenosis and complications were observed by endoscopy follow-up. Results Complete circular ESTD and ASGS were successfully performed in all 5 patients, and no complications including perforation, bleeding, wound infection or stent migration occurred. The mean skin-graft survival rate was 86. 0％. Four patients did not experience esophageal stenosis over the mean follow-up of 9. 5 months. One patient experienced esophageal stenosis after operation, and underwent endoscopic balloon dilatation. No stenosis occurred in 8 months of follow-up. Conclusion ASGS is a safe and effective method to prevent esophageal stenosis after complete circular ESTD.

Objective: To evaluate optical coherence tomography(OCT)for predicting invasion depth of early esophageal cancer(EEC) and to compare OCT and magnifying endoscopy-narrow band imaging (ME-NBI)in clinical performance. Methods: Twenty-eight patients who were diagnosed with EEC and accepted OCT and ME-NBI before endoscopic submucosal dissection(ESD)were enrolled in this prospective study. On the basis of OCT and ME-NBI images, real-time prediction of EEC invasion depth was conducted. Postoperative pathological results were taken as golden standard to compare the accuracy of OCT and ME-NBI in evaluation of EEC invasion depth. The procedure time and incidence of complications during evaluation process were also analyzed. Results: The overall accuracy of OCT and ME-NBI in predicting invasion depth of 28 EEC patients were 67.9% (19/28) and 75.0% (21/28) respectively, with no significant difference(P>0.05). The accuracy of OCT and ME-NBI in distinguishing lesions located in epithelium/lamina propria mucosa (EP/LPM) lesions were 78.9%(15/19) and 68.4% (13/19), with no significant difference(P>0.05). The procedure time of OCT was significantly shorter than that of ME-NBI (6.0±2.9 min VS 16.3±5.4 min, P<0.001). Conclusion The ability of OCT to predict invasion depth of EEC and distinguish lesions located in the EP/LPM is comparable with that of ME-NBI. Besides, OCT requires shorter procedure time for evaluation.

Objective To observe the effect of sitagliptin on carotid intima-media thickness (c-IMT) and serum hs-CRP and IL-6 levels in the patients with newly diagnosed type 2 diabetes mellitus. Methods 65 patients with newly diagnosed type 2 diabetes mellitus who were admitted to the outpatient clinic and were hospitalized in our hospital were selected. They were randomly divided into sitagliptin phosphate tablet group (experimental group) with 35 cases and metformin hydrochloride tablet group (control group) with 30 cases. All patients were given health education about diabetes, diet guidance and exercise. All patients were given drawing of venous blood at a fasting condition ≥10 h before treatment and 6 months after treatment to determine the following indicators: FPG, 2 hPG, hs-CRP, IL-6, TC, TG, HDL-c, LDL-c, HbA1 c, hs-CRP, IL-6, etc, and c-IMT was determined. Results There was no statistically significant difference in blood glucose, blood lipids, inflammation index and c-IMT between the two groups before treatment (P>0.05); after treatment, FPG, 2 hPG and HbA1 c were significantly lower than those before treatment in both groups, and the difference was statistically significant (P<0.01). There were statistically significant differences in FPG and HbA1 c between the two groups (P<0.01). There was no statistically significant difference in 2-hour postprandial blood glucose between groups (P>0.05). The c-IMT, hs-CRP and IL-6 levels in the experimental group after treatment were significantly lower than those before treatment, and the differences were statistically significant (P<0.05). There was no significant change in c-IMT in control group after treatment (P>0.05). hs-CRP and IL-6 had a decreasing trend compared with those before treatment, and the difference was not statistically significant (P>0.05). There were statistically significant differences in c-IMT, hs-CRP and IL-6 between the two groups after treatment (P<0.05). Spearman linear correlation analysis: c-IMT was positively correlated with hs-CRP levels and IL-6 (r=0.6585, P=0.000; r=0.571, P=0.000). There was no significant correlation between fasting blood glucose and glycosylated hemoglobin (P>0.05). Conclusion The DPP-4 inhibitor of sitagliptin has a clear hypoglycemic effect and can reduce c-IMT, hs-CRP and IL-6. The anti-inflammatory effects besides hypoglycemic effect may be involved in the reduction of atherosclerosis in the patients with diabetes mellitus.

Objective To evaluate the distribution of Pneumoconiosis and provide scientific basis for preventing the occur-rence of Pneumoconiosis and improving the life quality of patients for the workers in coal mine of Songzao.Methods Retrospective epidemiological research and chi-square test were used for all collected Pneumoconiosis cases in Songzao coal mine of Chongqing from 2010 to 2012.Results From 2010 to 2012,the incidence was significantly different(χ2 =25.048,P <0.05),and the prevalence was significantly different(χ2 = 11.223,P <0.05).Besides,the mean duration of dust exposure was(20.50± 5.45)years.Mean-while,the difference of proportion between stageⅠand stageⅡ、stage Ⅲ show statistical significance(χ2 =9.162,P <0.05).What′s more,the rate of complicated pulmonary tuberculosis with pneumoconiosis was 2.94%.From 1979 to 2012,the difference in propor-tion of different stage′s fatality was significantly different(χ2 = 174.101,P <0.05).Conclusion Nearly three years,although the incidence and prevalence were all decreasing,but the situation was not optimistic.Pneumoconiosis are mainly in stageⅠ,and the le-thality of Ⅲ period is far stronger than the other two.Prevention of complication should be paid high attention.

Objective To assess the application of Chinese children's intelligence equation (CCIE) and Bayley Scales of infant and toddler development-Ⅲ (BSID-Ⅲ) in screening of postoperative cognitive dysfunction (POCD) in children after general anesthesia.Methods The study group (Group A),including 50 ASA-Ⅰ participants of 1-3 years old who would undergo hernia repair laparoscopic surgery,was assessed on one day (1 d) before and three days (3d) after the surgery respectively by both of CCIE and BSID-Ⅲ according to their ages of month.The control group (Group C),including 50 healthy participants with the matched age,was assessed in the same period by the same method.Both of Group A and C were assessed by the Z score method to diagnose POCD and both scales were used to analyze the results of POCD screening and their agreement.Results (1) Compared with preoperative 1 d,the CCIE score of Group A on 3d after surgery was relatively decreased (21.22±4.96 vs 18.65±4.74,P＜0.05) and the POCD rate was 12.0％.While in Group C,the CCIE score and the POCD rate had no statistical significance (20.83±4.97 vs 21.22±5.21,P＞0.05).(2) Compared with preoperative 1d,the scores of cognition,language,motion,social-emotion and adaptive behaviors in BSID-Ⅲ of Group A decreased (100.00±4.58 vs 96.44± 4.20,103.22±4.99 vs 96.24± 5.75,102.06±4.01 vs 95.28±4.27,101.22±7.38 vs 91.06±7.10,98.52±9.11 vs 90.5±8.47,P＜0.05) and the POCD incidence was 20.0％.While in group C,the BSID-Ⅲ score and the POCD rate had no statistical significance (104.61±5.48 vs 103.79±5.38,107.68±5.60 vs 107.11 ±6.05,108.29±5.91 vs 108.29±4.21,101.11±7.61 vs 101.86±6.99,99.00±7.99 vs 100.82±7.36,P＞0.05).(3)Reasonable agreement of the CCIE and BSID-Ⅲ was observed (Kappa value was 0.70;P＜ 0.05).Conclusion There is considerable agreement between BSID-Ⅲ and CCIE.While BSID-Ⅲ is relatively more sensitive to the POCD and more efficient in the diagnosis of POCD than the CCIE.Thus,BSID-Ⅲ is more likely to provide better evaluation of the postoperative cognitive functions of children within 1-3 years old and should be recommended to the health professionals in China.