Objective To analyze the degeneration parameters of the multifidus muscle at the disjunc-tion in patients with isthmus spondylolisthesis and its correlation with the degree of spondylolisthesis.Meth-ods A retrospective analysis was conducted on the medical records and MRI imaging data of 59 patients with isthmus spondylolisthesis who visited this hospital from January 2022 to July 2024.The degeneration parame-ters of multifidus muscle were selected and assessed as cross-sectional area(CSA)and percentage of fat infil-tration area(FIA%).CSA and FIA%of the multifidus muscle at the disjunction and the previous non-sliding disconnection segment were measured and compared using Image J software.The degree of spondylolisthesis was evaluated referring to the Meyerding standard,and the correlation was analyzed between CSA,FIA%of the multifidus muscle at the disjunction and the degree of spondylolisthesis.Results Among the 59 patients,there were 2 cases of L3 spondylolisthesis,27 cases of L4 spondylolisthesis and 30 cases of L5 spondylolisthe-sis.CSA of the multifidus muscle at the disjunction and the previous non-sliding disconnection segment were(882.22±236.01)mm2 and(845.59±263.37)mm2 respectively,the difference was not statistically significant(t=0.796,P=0.428).FIA%were 37.16%(25.56%,50.78%)and 33.26%(18.65%,43.04%)respective-ly,the difference was statistically significant(Z=-2.008,P=0.045).Among the 59 patients,50 cases(84.75%)had grade Ⅰ spondylolisthesis,9 cases(15.25%)had grade Ⅱ spondylolisthesis,there were no pa-tients with grade Ⅲ or Ⅳ spondylolisthesis.The degree of spondylolisthesis was correlated with FIA%(r=0.443,P<0.001),but not correlated with CSA(r=-0.188,P=0.153).Conclusion In patients with isth-mus spondylolisthesis,FIA%of the multifidus muscle at the disjunction is significantly higher than that in the previous non-sliding disconnection segment,and it is related to the degree of spondylolisthesis.However,CSA of the multifidus muscle at the disjunction showed no significant difference from that in the previous non-slid-ing disconnection segment and was not correlated with the degree of spondylolisthesis.FIA%is more accurate in assessing the severity of multifidus muscle degeneration than CSA.

Objective:To analysis the prevalence and characteristics of comorbid insomnia and sleep disordered breathing (SDB) in community population.Methods:This is a cross-sectional study. Cluster sampling was applied. Community residents in Shantou and Meizhou were investigated during April to May, 2021. Essential information collection, sleep related health investigation, and sleep study were conducted. Insomnia was defined as the insomnia severity index (ISI)≥8. A type Ⅳ wearable intelligent sleep monitor was applied for sleep study. Comorbid insomnia and SDB was defined as both diagnosis of insomnia and SDB. Statistical analysis was conducted by SPSS 25. Prevalence and characteristics of insomnia only, SDB only and comorbid insomnia and SDB were analyzed. Logistic regression was conducted to analyze the relationship between sleep disorders and unrestored sleep, abnormal glucose metabolism, hyperlipidemia, and cardiovascular disease.Results:There were 3 730 residents completed the investigation. The median age was 55.0 (46.0, 63.0) years. The prevalence of insomnia only, SDB only, and comorbid insomnia and SDB were 26.0%, 20.2%, and 10.4% respectively. The incidence of unrestored sleep in insomnia only and comorbid insomnia and SDB were 2.900 times and 3.777 times of that in no insomnia or SDB (both P<0.001); the risk of hyperlipidemia was elevated in insomnia only, SDB only and comorbid insomnia and SDB ( OR=1.553, 1.415, and 1.868; all P<0.05); the risk of cardiovascular disease increased 40.8% in SDB only ( P=0.001), and 42.1% in comorbid insomnia and SDB ( P=0.007), after adjusted by age, sex, body mass index (BMI), smoking, drinking, abnormal glucose metabolism, and hyperlipidemia. Stratified analysis revealed that young female (age<60 years) with normal BMI (<25 kg/m 2) and comorbid insomnia and SDB were associated with higher risk of cardiovascular disease. Female with normal body weight and insomnia only or comorbid insomnia and SDB were associated with higher risk of hyperlipidemia. Conclusions:The prevalence of comorbid insomnia and SDB is high in community population. Patients with comorbid insomnia and SDB present with more significant unrestored sleep, and are correlated with higher risk of hyperlipidemia and cardiovascular diseases.

Objective:To evaluate the efficacy and safety of nimotuzumab combined with definitive radiotherapy in the treatment of inoperable locally advanced oral and maxillofacial squamous cell carcinoma.Methods:A total of 33 patients with inoperable locally advanced oral and maxillofacial squamous cell carcinoma admitted to the Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from March 2015 to December 2019 were retrospectively selected as the research objects. The treatment regimen was all targeted therapy (nimotuzumab) combined with definitive radiotherapy, with or without chemotherapy, and the efficacy and safety of the treatment were analyzed. The primary endpoints were optimal response and overall survival (OS) , and the secondary endpoints were optimal duration of response (DOR) and progression-free survival (PFS) . The survival curve was drawn using the Kaplan-Meier method, the survival rate of the patients was analyzed, and the related adverse reactions were counted.Results:Of the 33 patients, there were 20 cases of complete remission (CR) , 5 cases of partial remission (PR) , 5 cases of stable disease (SD) , 2 cases of progressive disease (PD) , and 1 case could not be evaluated. The objective response rate was 75.8% (25/33) , and the disease control rate was 90.9% (30/33) . The mean OS of all cases was 54.5 months, and the 5-year OS rate was 57.0%. The mean DOR of the overall cases was 57.2 months, and the 5-year DOR rate was 64.4%. The mean PFS of the overall cases was 54.4 months, and the 5-year PFS rate was 59.8%. The 5-year OS rates of CR, PR and SD patients were 83.6%, 20.0% and 0 ( χ2=20.07, P<0.001) , the 5-year DOR rates were 85.0%, 20.0% and 0 ( χ2=16.89, P<0.001) , and the 5-year PFS rates were 84.0%, 20.0% and 0 ( χ2=15.91, P<0.001) . The OS, DOR and PFS of patients with CR were significantly better than those of patients with PR and SD (all P<0.05) . The 5-year OS rates of patients with oropharyngeal cancer and oral cancer were 62.5% and 40.6% ( χ2=1.67, P=0.197) , the 5-year DOR rates were 73.3% and 44.0% ( χ2=1.34, P=0.247) , and the 5-year PFS rates were 68.8% and 40.9% ( χ2=1.13, P=0.289) , with no statistically significant differences, but oropharyngeal cancer patients still showed a certain advantage. Common adverse reactions included oral mucositis and hematological toxicity, most of which were grade 1-2. Two (6.1%) patients had rash, and two (6.1%) patients had nausea and vomiting, which were considered to be related to nimotuzumab. All adverse reactions were relieved after symptomatic treatments. Conclusion:For patients with locally advanced oral and maxillofacial squamous cell carcinoma who are not suitable for surgery, the choice of nimotuzumab combined with definitive radiotherapy has a relatively satisfactory efficacy and survival rate, with good safety and high clinical value.

Model informed precision dosing for warfarin is to provide individualized dosing by integrating information related to patient characteristics, disease status and pharmacokinetics /pharmacodynamics of warfarin, through mathematical modeling and simulation techniques based on the quantitative pharmacology. Compared with empirical dosing, it can improve the safety, effectiveness, economy, and adherence of pharmacotherapy of warfarin. This consensus report describes the commonly used modeling and simulation techniques for warfarin, their application in developing and adjusting dosing regimens, medication adherence and economy. Moreover, this consensus also elaborates the detailed procedures for the implementation in the warfarin pharmacy service pathway to facilitate the development and application of model informed precision dosing for warfarin.

Objective: To determine the prevalence and determinants of folic acid (FA) supplementation in Chinese couples planning for pregnancy and in women during early pregnancy. Methods: This was a cross-sectional study based on the Shanghai PreConception Cohort (SPCC) study. Data on FA supplementation and socio-demographic features were collected using questionnaires. Couples visiting clinics for pre-pregnancy examination and pregnant women at < 14 gestational weeks were recruited in Shanghai, China, between March 2016 and September 2018. Results: Among the pregnancy planners, 42.4% (4,710/11,099) women and 17.1% (1,377/8,045) men used FA supplements, while 93.4% (14,585/15,615) of the pregnant women used FA supplements. FA supplement use was higher in female pregnancy planners who were older ( : 1.13, 95% : 1.08-1.18), had higher education ( : 1.71, 95% : 1.53-1.92), and were residing in urban districts ( : 1.06, 95% : 1.01-1.11) of FA supplementation; female pregnancy planners with alcohol consumption ( : 0.95, 95% : 0.90-0.99) had lower odds of FA supplementation. In early pregnancy, women with higher educational level ( : 1.04, 95% : 1.03-1.06), who underwent pre-pregnancy examination ( : 1.02, 95% : 1.01-1.03) had higher odds of using an FA supplement; older aged ( : 0.99, 95% : 0.98-0.99), and multigravida ( : 0.97, 95% : 0.96-0.98) had lower odds of FA supplementation. Conclusion Although the majority of pregnant women took FA supplements, more than half of the women planning for pregnancy did not. Urgent strategies are needed to improve pre-conception FA supplementation.
Adult ; China ; Cohort Studies ; Cross-Sectional Studies ; Diet ; Dietary Supplements ; analysis ; Female ; Folic Acid ; administration & dosage ; Humans ; Male ; Pregnancy ; Surveys and Questionnaires ; Vitamin B Complex ; administration & dosage ; Young Adult

In this paper, the micro-video teaching mode was explored in the course construction of . The micro-video teaching contents include the academic thought, experience in diagnosis and treatment, characteristic technology and clinical manipulation of famous acupuncture experts in the Henan University of CM. Each micro-video film is designed within 15-18 min, including three sections of knowledge, i.e. basic theory, technological application and clinical manipulation. Each section is designed within 5-6 min. The construction of the teaching course of is the innovation of practice mode of TCM and the new approach to the inheritance of the experience of experts. The construction of micro-video teaching course propels the reform of teaching mode, improves the learning initiative of students and clinical manipulative ability so as to improve the teaching effect and quality.
Acupuncture Therapy ; Humans ; Learning ; Moxibustion ; Students ; Teaching

Objective:To observe the clinical efficacy of half-dose photodynamic therapy (PDT) in the treatment of acute central serous chorioretinopathy (CSC) by enhanced deep imaging-OCT (EDI-OCT).Methods:A retrospective case study. From September 2015 to November 2018, 100 patients with acute CSC who received half-dose PDT in Hangzhou Branch of the Eye Optometry Hospital of Wenzhou Medical University were included in the study. Among 100 patients, 69 patients were males and 31 patients were females; the average age was 49.63±7.97 years; the average duration of disease was 2.19±0.71 months. All patients underwent BCVA, EDI-OCT, FFA, ICGA and other examinations. BCVA was used on the international standard visual acuity chart and converted to logMAR visual acuity records. Before treatment, the average logMAR BCVA was 0.29±0.19, the average macular foveal retinal thickness (CMT) was 370.59±134.98 μm, and the average macular subfoveal choroidal thickness (SFCT) was 366.93±86.95 μm. All patients were treated with half-dose PDT. We compared the changes of BCVA, CMT, SFCT, and subretinal fluid (SRF) of the eye before treatment and 2 weeks after treatment and 1, 3, and 6 months. Pearson correlation analysis method was used to analyze the correlation between BCVA and baseline BCVA, CMT, SFCT after 6 months of treatment.Results:Six months after treatment, SRF was completely absorbed in 98 eyes, with an effective rate of 98.0%. Compared with before treatment, 2 weeks and 1, 3, and 6 months after treatment, the BCVA of the eye significantly increased ( F=66.493, P<0.001), and CMT and SFCT significantly decreased ( F=134.625, 30.394; P<0.001,<0.001). The results of Pearson correlation analysis showed that BCVA was positively correlated with baseline BCVA 6 months after treatment ( r=0.529, P<0.001), and there was no significant correlation with CMT and SFCT. There were no serious complications related to treatment during the follow-up period. Conclusions:Half-dose PDT can effectively increase BCVA in a short period of time for acute CSC. EDI-OCT can observe that CMT, SFCT and SRF absorption are significantly reduced after treatment.

Objective To compared the macular blood flow parameters among myopic choroidal neovascularization (mCNV), high myopia (HM) and normal subjects.Methods Retrospective study. Forty patients (40 eyes) diagnosed as mCNV (mCNV group) in the Eye Hospital of Wenzhou Medical University at Hangzhou from June 2016 to November 2018, age-matched, sex-matched and diopter-matched 40 HM patients (40 eyes, HM group), age-matched and sex-matched 40 healthy persons (40 eyes, normal group) were enrolled in this study. Retina superficial and deep vessel density, the area of foveal avascular zone (FAZ), a-circularity index (AI) and vessel density around the 300 μm width of the FAZ region (FD) on macular 3 mm×3 mm scan on OCTA of 3 groups were compared.Results There were significant differences in the average retina superficial, deep vessel density, the area of FAZ, AI and FD among 3 groups (F=24.82, 9.18, 3.58, 7.68, 14.15;P<0.05). The average retina superficial and deep vessel density and FD in mCNV group were lower than those in HM group (P<0.05). The average retina superficial and deep vessel density and FD in HM group were lower than those in control group (P<0.05). The average area of FAZ in mCNV group was smaller than that in control group (P<0.05). The average AI in mCNV group was less than that in the other 2 groups (P<0.05). Conclusions The retina superficial, deep vessel density and FD decreased, the area and the form of FAZ remained unchanged in HM subjects comparing with normal subjects. While retina superficial, deep vessel density and FD decreased more, the area of FAZ reduced, the form of FAZ tend to be irregular in mCNV.

Chylothorax is a rare cause of pleural effusion in children, and it is usually difficult to identify the location of chyle leakage due to the small size of the thoracic duct in children. Herein we report an infant case with chylothorax whose leakage of the thoracic duct was successfully located by magnetic resonance lymphangiography (MRL) using pre-contrast MR cholangiopancreatography (MRCP) and gadodiamide-enhanced spectral presaturation inversion recovery (SPIR) T-weighted imaging, which demonstrate the imaging method is easy and effective for detecting the focal disruption of the thoracic duct in children with chylothorax and younger than 8 months old.

AIM: To investigate the incidence of trachoma in children aged 1 to 9y in Hainan Province and determine high-risk trachoma endemic and non-endemic areas in Hainan, and thus provide evidence for developing trachoma control and prevention therapy.METHODS:The areas of investigation were chosen on the basis of past literatures, expert interviews and survey on the spot.In 2013, Hainan Provincial Office of Blindness Prevention carried out the survey in 7 counties including Dongfang City, Wuzhishan City, Ledong County, Baisha County, Baoting County, Lingao County and Changjiang County.In these districts, 356 pupils including 192 boys and 164 girls were examined, their age ranging from 1 to 9 and their average age being 7 years old.The targeted students received the trachoma rapid assessment by the adoption of simplified trachoma classification system which was recommended by the World Health Organization.RESULTS: No case of active trachoma was found among the 356 students.CONCLUSION:The prevalence rate of trachoma in children under 9 years is less than 5% in Hainan Province.Active trachoma is not a public health issue in Hainan Province.