Objective:To explore effective schemes for improving cognitive function in patients with subjective cognitive decline (SCD) by EEG neurofeedback (NF) technique.Methods:Ten SCD patients recruited in Department of Neurology, Xuanwu Hospital, Capital Medical University from April 2019 to August 2019, were chosen in our study; all patients were subjected to neuro-regulation of mismatched negativity (MMN) for 5 times in 2 weeks by EEG NF technique. By using the midlines of frontal zone (Fz), central zone (Cz) and peak zone (Pz) as training electrodes, auditory tones (1000 Hz as standard stimulus, individual hearing discrimination threshold as deviation stimulus) were used to induce MMN characteristics of event-related potential (ERP) via Oddball paradigm. SCD patients received visual disc stimulation feedback with dynamic neural signal activity. ERP waveforms and standard MMN characteristics (amplitude and latency) before and after training were used to evaluate the changes in neural activity of these patients; nine N-Back working memory tasks (three types×three gradients) and hearing discrimination ability tests were used in these patients to evaluate the improvement of cognitive competence.Results:ERP analysis showed that the MMN waveforms in SCD patients after training were obviously different as compared with those before training; their standard stimulus and deviant stimulus in the point-by-point paired t-test analysis were significant different ( P<0.05). The MMN amplitudes at the Fz, Cz and Pz electrodes in these patients after training were significantly higher than those before training ( P<0.05). The accuracy of auditory tone 3-Back task in SCD patients was statistically significant before and after training ( P<0.05). Conclusion:NF based on MMN can significantly improve the MMN amplitude and accuracy of auditory working memory task in patients with SCD, which might provide a potentially effective cognitive intervention method for patients with early AD and the elderly with normal memory decline.

The 2013 National Practitioners Qualification Examination Work Conference proposed to reform the traditional one-stop test into two stage. In May 2017, Fujian University of Traditional Chinese Medicine participated in this empirical study as a pilot for the first time. This paper made a preliminary summary and analysis of the results of the phased examination. Because of the absence and deficiency of clinical skills of students in our school, we carried out a series of reform measures for clinical skill courses: enhancing teaching facilities, enriching teaching contents and methods, reforming assessment mode and strengthening the monitoring of the teaching quality of clinical skills. According to the students, reform measures are conducive to consolidating theoretical knowledge and improving clinical skills, laying a good foundation for successfully passing the national examination of medical practitioners and becoming a qualified medical talent.

Objective To analyze clinical significance of failure patterns and combined radiotherapy for advanced non-small cell lung cancer after EGFR-TKIs treatment.Methods A total of 111 patients who were treated with EGFR-TKIs for advanced non-small cell lung cancer (NSCLC) with EGFR exon mutation in Peking University Cancer Hospital from January 2009 to June 2013 were retrospectively analyzed.The impact of various failure patterns and combined radiotherapy on survial were analyzed with Kaplan-Meier method.Results Totally 111 patients were enrolled in the study.The median follow-up was 27.7 months (6.6-85.3 months).The median age,median PFS andmedian OS were 59 years (35-80 years old),10.3 months (6.2-30.5 months),and 29.8 months (7.1-90.7 months),respectively.The main failure mode was the progress of the original lesion (65 cases,58.6％) and the main failure site was the progress of intrathoracic lesions (57 cases,51.4％).The survival time of patients with oligoprogress (1-3 lesions during drug resistance) was significantly extended compared with the ones whose lesions were ≥ 4.The median OS were 32.5 months and 26.7 months,respectively (x2 =4.888,P＜0.05).For 43 patients with only intrathoracic progressed,there were 9 patients treated with radiotherapy and 34 patients treated without radiotherapy.The median PFS was 9.6 and 5.7 months,respectively.The median PFS of combined radiotherapy group was significantly prolonged (x2 =9.013,P＜0.05).And the median OS of retreatment after failure were 28.1 and 13.2 months,respectively,with no significant difference between two groups (P＞0.05).For 48 patients with oligo-progress,there were 12 patients treated with radiotherapy and 36 patients treated without radiotherapy.The median PFS were 9.6 and 4.2 months,respectively.The median PFS of the group treated with combined radiotherapy was significantly longer than that of the group without combined radiotherapy treatment (x2 =5.482,P＜0.05).And the median OS of retreatment after failure were 26.0 and 11.8 months,respectively.There was no significant difference between the two groups(P＞0.05).Conclusions Combined local radiotherapy can improve the PFS of patients who had only intrathoracic progress or oligo-progress after EGFR-TKIs treatment.Therefore,the patients whose T790 M mutation indicates negative or who are not in the position to perform coressoponding detection under the intrathoracic/oligo progress stage.The local intervention plays a very critical role for patients who have primary drug restisitance to GEN 1 EGFR-TKIs.

Neurofeedback may improve cognitive function and behaviour by regulating the cerebral neural activities. Neurofeedback works as a kind of therapy for patients with Parkinson's disease, primarily based on electroencephalogram signals and hemodynamic signals. It regulates abnormal neuronal rhythm oscillations in the cortical-spinal system by electroencephalogram neurofeedback and sensory motor rhythm as the main adjustment frequency band, and modulates activation in the cortical-basal ganglia-thalamic-cortical network of brain with the supplementary motor area as the target area via functional magnetic resonance imaging neurofeedback. Neurofeedback effectively improves the motor symptoms of Parkinson's patients, both dynamic and static. However, the number of samples is limited in these researches, and the assessments before and after neurofeedback training are not yet comprehensive. Neurofeedback technology might be a potential effective rehabilitation for patients with Parkinson's disease.

Objective To explore the appropriate frequency of ventilator tube replacement by researching the influence of different ventilator circuit change frequency on ventilator-associated pneumonia (VAP).Methods A prospective randomized sampling study was conducted.The patients undergoing invasive mechanical ventilation over or equal to 3 days admitted to emergency intensive care unit (EICU) of the First Affiliated Hospital of Kunming Medical University from December 2012 to December 2015 were enrolled.The patients were divided into 3,7 and 10 days group according to the frequency of ventilator tube replacement.Bacteriology of ventilator tube and the incidence of VAP were compared among the groups.Results Ninety-eight patients were enrolled,mainly with the artificial airway of endotracheal intubation or tracheotomy,with 56 male and 42 female,aging 8 to 86 years with mean of (51.97 ± 17.56) years.There were no statistical differences in gender,age,Glasgow coma scale (GCS) score,cough function and application of glucocorticoid,enteral nutrition,atomization and sedative therapy among three groups,indicating that the risk factors among three groups were consistent.The bacteria detection rates of extension tube,breathe out tube,breathe in tube,and hydrops collection cup were 36.7％,36.7％,33.3％,and 33.3％ respectively in 3 days group,and they were 73.0％,67.6％,62.2％,and 62.2％ in 7 days group respectively,and were all 90.3％ in 10 days group.It was showed that the bacteria detection rate in different pipe parts was almost the same with the same change frequency,and the rate was higher with the longer usage of ventilator tube (x2 values were 20.599,19.879,21.975,21.975,all P =0.000).The longer of the tube used time,the higher incidence of VAP.The incidence of VAP in 3,7,10 days groups were 26.7％,59.5％ and 77.4％,respectively,but there was statistically significant difference among all groups (x2 =30.486,P ＜ 0.001).Based on the value of 3 days group,the incidence of VAP in the 7 days group was 15.950 folds of 3 days group,and the incidence of VAP in the 10 days group was 18.333 folds of the 3 days group (both P ＜ 0.001).Conclusion This study suggests that the longer of pipeline using time,the more serious degree of bacterial contamination of pipeline,the higher incidence of VAP.

No abstract available.
Base Sequence ; Cell Cycle Proteins/*genetics ; Chromosomes, Human, Pair 11 ; Chromosomes, Human, Pair 22 ; Female ; Gene Rearrangement ; Histone-Lysine N-Methyltransferase/*genetics ; Humans ; Immunophenotyping ; In Situ Hybridization, Fluorescence ; Karyotype ; Leukemia, Myeloid, Acute/*diagnosis/metabolism ; Male ; Myeloid-Lymphoid Leukemia Protein/*genetics ; Oncogene Proteins, Fusion/genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Septins/*genetics ; Sequence Analysis, DNA ; Translocation, Genetic ; Young Adult

AIM: To investigate the effect of atorvastatin ( AT) on the release of endothelial microparticles (EMP) and myocardial apoptosis in the rats with myocardial infarction .METHODS: SD male rats (n=24) were ran-domly divided into 3 groups:sham operation ( sham) group , myocardial infarction ( MI) group and MI+AT group.The rat model of acute myocardial infarction was prepared by coronary artery ligation .At 2 h and 24 h after modeling , the pe-ripheral blood was collected to detect creatine kinase-MB (CK-MB) and cardiac troponin T (cTnT).The circulating levels of EMP were measured by flow cytometry .The myocardial apoptosis was detected by terminal deoxynucleotidyl transferase -mediated dUTP nick end labeling (TUNEL) assay.RESULTS: At 2 h after modeling, the level of CK-MB was signifi-cantly increased in MI group compared with sham group , and the level of EMP and the myocardial apoptotic rate were sig-nificantly increased in MI group and MI +AT group compared with sham group .At 24 h after modeling , the level of EMP was significantly increased in MI group compared with sham group .The levels of CK-MB, cTnT, EMP and the myocardial apoptotic rate were significantly decreased in MI +AT group compared with MI group .Moreover , the level of CK-MB in MI group was significantly increased at 24 h compared with that at 2 h after modeling .The levels of CK-MB, cTnT and EMP were significantly decreased in MI +AT group at 24 h compared with those at 2 h after modeling .CONCLUSION: Ator-vastatin may reduce the level of EMP and the myocardial apoptotic rate in the rats with acute myocardial infarction , indica-ting that atorvastatin plays a role in protecting endothelium .

Background and objective With the rapid development of technology, stereotactic radiotherapy has been widely used. In a cohort of medically operable non-small cell lung cancer patients receiving stereotactic body radiation therapy (SBRT) survival rates“potentially equivalent to those of surgery”have been reported. Removing the ifeld lfattening iflter, Clinac is capable of delivering dose rates much higher than conventional linac as well as reducing the treatment time. hTe goals of this work were to report safety and effcacy of SBRT treatment using a lfattening iflter-free model for non-small cell lung cancer (NSCLC) with small lesions. Methods From December 2011 to December 2013, 31 NSCLC patients who were T1-2N0M0, solitary pulmonary recurrence atfer surgery, and stage IV with oligo metastasis were enrolled, receiving SBRT treatment (60 Gy/8 f or 48 Gy/4 f ) applying a lfattening iflter-free model. Results Compared with conventional technique, lfat-tening iflter-free model shortened the treating time with equivalent target dose and normal tissue dose. hTe median follow-up time is 19.4 mo. hTe 1-yr local control, regional control, distant control, progression free survival and overall survival rates were 96.8%, 96.8%, 83.9%, 77.4%and 96.8%. hTe most common side effects were radiation pneumonitis (29%grade 1, 3.2%grade 2) and chest pain (12.9%grade 1, 6.5%grade 2). Conclusion hTe use of lfattening iflter-free model in SBRT for small lesions of NSCLC patients is safe and effective. Long time follow-up and additional studies are still needed to validate our conclusions.

Objective To evaluate application value of choledochoscope and nasal bile duct drainage in the treatment of complicated liver echinococcosis combined biliary fistula.Methods The anthors retrospectively summarized and analyzed the clinical data of 144 patients with complicated liver echinococcosis combined biliary fistula.Treatment group (n 68) underwent liver hydatid internal capsule remove + intraoperative choledochoscopy and nose biliary drainage,control group (n-76) underwent the traditional internal capsule remove.The average length of hospital stay,residual cavity drainage catheter time,residual cavity bile leakage and residual cavity infection index of two groups were measured.Results The rate of T tube utilization,residual cavity infection,the incidence of biliary fistula in treatment group were significantly lower than the control group (P＜0.05).The length of hospital stay,the rate of discharge with drainage tube and the average length with tube were significantly less than control group (P＜0.05).Conclusion Intraoperative choledochoscopy and nasal bile duct drainage treatment of complicated liver hydatid,can reduce liver hydatid content residual and biliary fistula,reliable to deal with biliary fistula,part of a primary suture common bile duct,biliary fistula and residual cavity infection rate is low,patients recover quickly,shorter time of hospital stays,is worth popularizing.

Objective To compare the dosimetric difference between RapidArc and fixed gantry angle dynamic IMRT (dIMRT) for central-type lung cancer radiotherapy. Methods Therapy for 10 patients previously treated with dIMRT was replanned with RapidArc. Dose prescription was 66 Gy/33 fraction. Comparative endpoints were planning target volume (PTV) dose, doses to surrounding structures,number of monitor units, and treatment delivery time. Results There was no significant dosimetric difference between RapidArc and dIMRT. Compared with dIMRT, RapidArc slightly elevated target volume dose, lung V5, V10. The average values of lung V20, V30 and heart V30 were larger in dIMRT than those in RapidArc. The number of monitor units was reduced by 32% and the treatment time by 66% in RapidArc.Conclusions Both RapidArc and dIMRT plans could meet the clinical therapy needs. RapidArc could achieve similar target coverage and sparing of organs at risk, with fewer monitor units and shorter delivery time than dIMRT.