Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

Objective: The status of masked obesity in female college students and the related factors were investigated to provide a theoretical reference for instructing the physical health education of female college students and improving their physical exercises. Methods: Body composition tests were performed on 2 975 female college students, selected from 3 colleges in North China by using cluster sampling method during October to December in 2018, and their basic information and lifestyle were investigated using questionnaires. Results: The incidence of masked obesity among female college students was 33.18%, of which 2.53% came from low-weight people. The difference in the incidence of masked obesity among female college students with different take-out frequencies was statistically significant (χ2=21.98, P<0.01). Compared with those who never take takeaway, people who take takeaway every day have an increased risk of masked obesity (OR=1.49, 95%CI=0.76-2.91). The difference in the incidence of masked obesity with the frequency of eating midnight snack was statistically significant (χ2=20.80, P<0.05). The difference in the incidence of masked obesity among female college students with different exercise time was statistically significant (χ2=18.49, P<0.01). Compared with exercise time above 60 min/d, female college students who are not exercising have an increased risk of masked obesity (OR=3.20, 95%CI=1.63-6.30). The difference in the incidence of masked obesity among female college students with different weight satisfaction was statistically significant (χ2=217.54, P<0.01). Compared with female college students who were satisfied with weight, female college students who were not satisfied with weight had an increased risk of masked obesity (OR=3.47, 95%CI=1.91-6.31). The difference in the incidence of masked obesity in different weightdown plans is statistically significant (χ2=186.40, P<0.01). Those who want to lose weight have a higher risk of developing masked obesity than those who want to gain weight (OR=18.11, 95%CI=5.54-50.13). Conclusion Female college students who drink a small amount of water, eat takeaways often, eat midnight snacks, do not exercise, and are not satisfied with their weight are more likely to develop masked obesity.

Objective To investigate the clinical pathologic features of a distinct variant of focal cortical dysplasia (FCD) characterized by neuronal loss of layer four.Methods Between 2005 and 2017,approximately 3 000 surgeries were performed for the treatment of intractable epilepsy at Xuanwu Hospital,Capital Medical University and Yuquan Hospital,Tsinghua University.Retrospective analysis of clinic-pathological data of patients with epilepsy surgery was made and histological manifestations of neuronal loss of cortical layer four were included in this study.Results In this cohort,25 patients (22 males and three females) were identified with early onset pharmaco-resistant epilepsy and regionally circumscribed neuronal loss of cortical layer four in surgical specimens from the occipital lobe.Histologically,except for neuronal loss in cortical layer four in all cases,glial scar lesions were found in some patients.Thus the histology of those cases can be subdivided into two groups:group A (13 cases):neuronal loss of cortical layer four without glial scar lesions;and group B (12 cases):neuronal loss of cortical layer four with glial scar lesions.Due to the prominent horizontal disorganization of cortical layering and lack of any other microscopically visible principle lesion,group A should be classified hitherto as FCD International League Against Epilepsy (ILAE) type Ⅰ b,however,group B with scar lesions and cortical dysplasia around the main leision,should be classified as FCD ILAE type Ⅲd.This retrospective analysis of clinical histories revealed a perinatal distress in 20 patients (80％),suggesting an acquired pathomechanism.Magnetic resonance imaging revealed abnormal signals in the occipital lobe in all patients,and signal changes suggestive of encephalomalacia were found in 18 patients.Surgical treatment achieved favorable seizure control (Engel class Ⅰ and Ⅱ) in 18 patients (75％ among 24 available follow up).Comparion of the two groups with age at epilepsy onset (group A:5.00±2.76,group B:5.01±3.78),the proportion of perinatal distress (group A:11/13,group B:9/12) and the follow-up results (favorable seizure control of the two groups was 9/13,9/11 respectively) showed that there was no statistically significant difference between the two groups.Conculsion Neuronal loss of cortical layer four in the occipital lobe should be classified as a distinct variant of FCD ILAE type Ⅲd.

Objective To observe the effects of chemotherapy on nutritional status and quality of life in elderly patients aged 60 years and over with stage Ⅲ or Ⅳ non-small-cell lung cancer,who were unable to undergo molecular-targeted drug therapy according to genetic testing.Methods A total of 100 elderly patients with stage Ⅲ or Ⅳ non-small cell lung cancer were randomized into an observation group(n=50)and a control group(n=50).Patients in the observation group were treated with GP regimen(gemcitabine+ cisplatin),while patients in the control group were treated with TP regimen(paclitaxel+cisplatin).The scores of nutritionally relevant indicators and quality of life were compared between the two groups.Results After chemotherapy,the body weight,body mass index,plasma total protein,plasma albumin,and triglyceride concentrations were significantly lower in the GP regimen group than in the TP regimen group(P＜0.0001,P =0.0027,P =0.0305,P＜0.0001,P＜ 0.0001,respectively).The overall health status score,physical function,role function,and emotional function scores were higher in the GP group than in the TP group(P =0.0017,0.0044,0.0064,0.006,respectively) after chemotherapy.The scores of shortness of breath,insomnia,loss of appetite,constipation,and diarrhea were significantly lower in the GP group than in the TP group(P =0.0067,P ＜0.0001,P =0.0026,P =0.0066,P =0.0023).The clinical effective rate was significantly higher in GP regimen than in TP regimen(56.0％ vs 30.0％,x2 =6.90,P=0.009).The incidence of grade Ⅰ adverse reactions was higher in the observation group (54.0％,27/50 cases),and the incidences of grade Ⅱ,Ⅲ and Ⅳ adverse reactions were higher in the control group(36.0％,18/50 cases;24.0％,12/50 cases;and 24.0％,12/50 cases,respectively) (x2 =16.40,P =0.001).Conclusions The TP chemotherapy is more beneficial to patients' nutrition,while the GP chemotherapy can achieve both higher clinical efficacy and better quality of life.

Xeroderma pigmentosum (XP) is a group of genetic disorders caused by mutations of XP-associated genes, resulting in impairment of DNA repair. XP patients frequently exhibit neurological degeneration, but the underlying mechanism is unknown, in part due to lack of proper disease models. Here, we generated patient-specific induced pluripotent stem cells (iPSCs) harboring mutations in five different XP genes including XPA, XPB, XPC, XPG, and XPV. These iPSCs were further differentiated to neural cells, and their susceptibility to DNA damage stress was investigated. Mutation of XPA in either neural stem cells (NSCs) or neurons resulted in severe DNA damage repair defects, and these neural cells with mutant XPA were hyper-sensitive to DNA damage-induced apoptosis. Thus, XP-mutant neural cells represent valuable tools to clarify the molecular mechanisms of neurological abnormalities in the XP patients.
DNA Damage ; DNA Repair ; DNA-Binding Proteins ; genetics ; metabolism ; Female ; Humans ; Induced Pluripotent Stem Cells ; metabolism ; pathology ; Male ; Models, Biological ; Mutation ; Neural Stem Cells ; metabolism ; pathology ; Xeroderma Pigmentosum ; genetics ; metabolism ; pathology

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cell Culture Techniques ; methods ; Child ; Female ; Humans ; Induced Pluripotent Stem Cells ; cytology ; metabolism ; Male ; Middle Aged

Analogy is to construct the theory of traditional Chinese medicine in clinical thinking method,which the proper use of this thinking is helpful to improve the clinical thinking of Chinese medicine,contributes to the development of disease differentiation and treatment ideas.This article tried to analyze the diagnosis and treatment of kidney diseases with Professor Zhu Zongyuan on the process,to explore the analogy on disease differentiation treatment guide.

"Absorbing image "is an important method in establishing fundamental theoretical system of TCM.The term and concept of "nomenclature according to manifestations" is the starting point of theoretical thoughts and the results of scientific studies."Testing viscera via the state of internal organs" is a method of "understanding the interior from the exterior",which makes TCM surpass productivity level and practical tools of that time,finally aquire knowledge.The huge theoretical system of TCM is constructed on the basis of "classification according to manifestation",discovering unknown fields according to infinite knowledge.

Views of "Integrated whole of heaven,earth and man","Derive the theory of the human body from natural environment" and "Xing-ming Ying-yin" combined with medical practice were origins of traditional Chinese medicine theory.On the premise of ensuring internal coordination of the whole theory in accordance with the logic of proposition,physicians kept on enriching connotation,validating hypothesis and using the theories in practice,made traditional Chinese medicine theory has scientific conformation of medical model of "environment-body and spirit",logic system of "dialectical-analogize" and subject character of "manifestation-state ".