Objective To explore the clinical efficacy of high-frequency electric snare device under elec-tronic laryngoscope in the treatment of epiglottic cyst.Methods A total of 100 patients with definitely diag-nosed epiglottic cyst receiving outpatient operation treatment in the First Affiliated Hospital of Gannan Medi-cal University from April 2021 to March 2023 were selected as the research subjects and included into the ob-servation group and control group according to the visiting order,50 cases in each group.The observation group was treated with high-frequency electric snare for epiglottic cyst resection under electronic laryngo-scope,and the control group was treated with laryngeal tissue forceps under electronic laryngoscope for uncov-ering operation of epiglottic cyst.The operation time,intraoperative blood loss volume,pain degree within postoperative 24 h,pain duration,complete resection rate and recurrence rate in postoperative 3 months were compared between the two operation methods.Results The operation time,intraoperative blood loss volume,VAS score within postoperative 24 h and pain duration in the observation group were significantly less than those in the control group,the complete resection rate was significantly higher than that in the control group,and the differences were statistically significant (P<0.05).The two groups were followed up for 3 months. Only 2 cases in the control group relapsed,which were epiglottic multiple cyst,and the recurrence rate had no statistical difference between the two groups (P>0.05).No dyspnea,massive bleeding and epiglottic adhesion appeared.Conclusion The high-frequency electric snare device under electronic laryngoscope for treating epi-glottic cyst has the advantages of short operation time,less blood loss,postoperative light pain and high com-plete resection rate.

Objective To explore the key of post-processing techniques for continuous and symmetrical display of cervical verte-bral bony structures using curve planar reformation(CPR).Methods Data from 150 patients who underwent cervical spine CT scans were collected and divided into three groups based on cervical curvature:normal,straightened,and kyphotic.A multi-slice CPR post-processing method was designed,using the display rate of structures such as C2/C3 to C6/C7 intervertebral foramina,uncovertebral joints,facet joints,and pedicles of vertebral arch as the measurement index to find the optimal site and angle for CPR baseline selection.Additionally,the consistency of the intervertebral foramen diameter and area measurements on both sides of the CPR baseline level,as well as the normal appearance of the cervical vertebral bony structures during baseline translation were observed.Results The optimal site for the CPR baseline was C4/C5 with a best angle of 100° for normal or straightened cervical curvature,and C5/C6 with a best angle of 100° for kyphotic curvature.At these baseline levels,the measurements of the longitudinal and transverse diameters,as well as the area,of the intervertebral foramina on both sides were similar,providing a valuable comparison.When translating the baseline forwards and backwards,CPR could continuously and symmetrically display the cervical vertebral bony structures clearly.Conclusion Performing multi-slice CPR image post-processing based on the aforementioned baseline sites and angles aids in the comparison of the left and right sides,facili-tating the convenient and intuitive detection of subtle abnormalities in cervical vertebral bony structures.

Anti-seizure medications (ASMs) are the main therapy for epilepsy.There are many kinds of ASMs with complex mechanism of action, so it is difficult for pharmacists to examine prescriptions.This paper put forward some suggestions on the indications, dosage forms/routes of administration, appropriateness of usage and dosage, combined medication and drug interaction, long-term prescription review, individual differences in pathophysiology of children, and drug selection when complicated with common epilepsy, for the reference of doctors and pharmacists.

Polysaccharides exhibit multiple pharmacological activities which are closely related to their structural features.Therefore,quantitatively quality control of polysaccharides based on their chemical charac-teristics is important for their application in biomedical and functional food sciences.However,poly-saccharides are mixed macromolecular compounds that are difficult to isolate and lack standards,making them challenging to quantify directly.In this study,we proposed an improved saccharide mapping method based on the release of specific oligosaccharides for the assessment of Hericium eri-naceus polysaccharides from laboratory cultured and different regions of China.Briefly,a polysaccharide from H.erinaceus was digested by β-(1-3)-glucanase,and the released specific oligosaccharides were labeled with 8-aminopyrene-1,3,6-trisulfonic-acid(APTS)and separated by using micellar electrokinetic chromatography(MEKC)coupled with laser induced fluorescence(LIF),and quantitatively estimated.MEKC presented higher resolution compared to polysaccharide analysis using carbohydrate gel elec-trophoresis(PACE),and provided great peak capacity between oligosaccharides with polymerization degree of 2(DP2)and polymerization degree of 6(DP6)in a dextran ladder separation.The results of high performance size exclusion chromatography coupled with multi-angle laser light scattering and refractive index detector(HPSEC-MALLS-RI)showed that 12 h was sufficient for complete digestion of polysaccharides from H.erinaceus.Laminaritriose(DP3)was used as an internal standard for quantifi-cation of all the oligosaccharides.The calibration curve for DP3 showed a good linear regression(R2＞0.9988).The limit of detection(LOD)and limit of quantification(LOQ)values were 0.05 μg/mL and 0.2 μg/mL,respectively.The recovery for DP3 was 87.32(±0.03)％in the three independent injections.To sum up,this proposed method is helpful for improving the quality control of polysaccharides from H.erinaceus as well as other materials.

The number of investigator initiated research (IIR) is increasing. But the recognition and management of IIR in China is still in its infancy, and there is a lack of specific and operable guidance for the implementation process. Based on our practical experiences, previous literature reports, and current policy regulations, the authors took prospective IIR as an example to summarize the implementation process of IIR into 14 steps, which are as the following: study initiation, ethical review, study registration, study filing, case report form design, database establishment, standard operating procedure making, investigator training, informed consent, data collection, data entry, data verification, data locking and data archiving.

Objective:To observe any effect of combining extracorporeal shock wave stimulation with proprioceptive neuromuscular facilitation (PNF) on the lower limb motor function of stroke survivors with foot drop.Methods:Thirty-six stroke survivors with foot drop were randomly divided into an extracorporeal shock wave group, a PNF group and a combination group, each of 12. The extracorporeal shock wave group and PNF group were given those therapies alone, while the combination group was provided with both. The extracorporeal shock wave therapy protocol was 2000 times on each muscle at an intensity of 2.5 bar and a frequency of 10Hz, twice a week for 4 weeks, while the PNF was provided at least 3 times per week for 4 weeks. Before and after the intervention, all of the participants were evaluated using the modified Ashworth scale (MAS), the 10-metre walk test (10 MWT) and the Fugl-Meyer lower limb motor function scale (FMA). Active range of the ankle joint and toe out angle were also observed.Results:After the intervention the lower limb muscle tone had decreased significantly in 8 of the PNF group members and in 9 of those in the extracorporeal shock wave group, but it has decreased significantly in all 12 members of the combination group. And the average magnitude of the improvement was also significantly greater in the combination group than in the other two groups. Moreover, significant differences were observed in the active range of the ankle joint after the treatment in the combination group, but not in the other two groups. After the intervention the average 10 MWT times and FMA scores of the PNF and combination groups had improved significantly, but not those of the extracorporeal shock wave group, but significant improvement in toe out angles was observed in all three groups, though the average improvement in the combination group was significantly greater than in the other 2 groups.Conclusion:Combining extracorporeal shock waves with PNF can effectively improve the lower limb motor function of stroke survivors with foot drop.

Objective:To conduct a statistical analysis on the condition of patients with pneumoconiosis complicated with chronic pulmonary heart disease based on the Tei index, and to establish a relevant prediction model.Methods:In March 2022, a retrospective analysis of 226 patients diagnosed with pneumoconiosis in the Department of Occupational Disease of Yantai Yantaishan Hospital from January 2016 to January 2022 was conducted. The patients with pneumoconiosis complicated by pulmonary heart disease were included in the pulmonary heart disease group and others were included in the non-pulmonary heart disease group. logistic regression analysis was used to screen out the relevant factors and establish a risk prediction model. Hosmer-Lemeshow test was applied to determine the goodness of fit of the model, and the receiver operating characteristic (ROC) area under the curve (AUC) was used to evaluate the predictive effect of the model.Results:Among the 226 patients with pneumoconiosis, 58 patients had chronic pulmonary heart disease, accounting for 25.7% of the surveyed population. The logistic analysis showed that the course of disease, pneumoconiosis stage and Tei index were influencing factors of pneumoconiosis complicated with pulmonary heart disease ( P<0.05). A risk prediction model for pneumoconiosis patients complicated with pulmonary heart disease was developed: Z=6.253 X1+1.265 X2+1.423 X3+9.264, in which X1 was the stage of pneumoconiosis, X2 was the course of disease, and X3 was the Tei index. Hosmer-Lemeshow test was used to evaluate the goodness of fit of the risk prediction model for pneumoconiosis patients complicated with pulmonary heart disease, the results indicated that the prediction model was in good agreement with the actual situation (χ 2=11.59, P=0.254). The diagnostic ability of the model was evaluated by the ROC curve, and the results showed that its AUC was 0.897, the sensitivity was 0.947, and the specificity was 0.784. Conclusion:The course of disease, pneumoconiosis stage and Tei index are the influencing factors of pneumoconiosis complicated with pulmonary heart disease. The model constructed based on these factors has a good prediction effect, which can provide a basis for the early detection and intervention of pneumoconiosis complicated with pulmonary heart disease.

Objective:To conduct a statistical analysis on the condition of patients with pneumoconiosis complicated with chronic pulmonary heart disease based on the Tei index, and to establish a relevant prediction model.Methods:In March 2022, a retrospective analysis of 226 patients diagnosed with pneumoconiosis in the Department of Occupational Disease of Yantai Yantaishan Hospital from January 2016 to January 2022 was conducted. The patients with pneumoconiosis complicated by pulmonary heart disease were included in the pulmonary heart disease group and others were included in the non-pulmonary heart disease group. logistic regression analysis was used to screen out the relevant factors and establish a risk prediction model. Hosmer-Lemeshow test was applied to determine the goodness of fit of the model, and the receiver operating characteristic (ROC) area under the curve (AUC) was used to evaluate the predictive effect of the model.Results:Among the 226 patients with pneumoconiosis, 58 patients had chronic pulmonary heart disease, accounting for 25.7% of the surveyed population. The logistic analysis showed that the course of disease, pneumoconiosis stage and Tei index were influencing factors of pneumoconiosis complicated with pulmonary heart disease ( P<0.05). A risk prediction model for pneumoconiosis patients complicated with pulmonary heart disease was developed: Z=6.253 X1+1.265 X2+1.423 X3+9.264, in which X1 was the stage of pneumoconiosis, X2 was the course of disease, and X3 was the Tei index. Hosmer-Lemeshow test was used to evaluate the goodness of fit of the risk prediction model for pneumoconiosis patients complicated with pulmonary heart disease, the results indicated that the prediction model was in good agreement with the actual situation (χ 2=11.59, P=0.254). The diagnostic ability of the model was evaluated by the ROC curve, and the results showed that its AUC was 0.897, the sensitivity was 0.947, and the specificity was 0.784. Conclusion:The course of disease, pneumoconiosis stage and Tei index are the influencing factors of pneumoconiosis complicated with pulmonary heart disease. The model constructed based on these factors has a good prediction effect, which can provide a basis for the early detection and intervention of pneumoconiosis complicated with pulmonary heart disease.

Objective:To analyze the risk factors of bronchopulmonary dysplasia(BPD)in very preterm infants(VPI), and to provide scientific basis for the prevention and treatment of BPD in VPI.Methods:A prospective multicenter study was designed to collect the clinical data of VPI in department of neonatology of 28 hospitals in 7 regions from September 2019 to December 2020.According to the continuous oxygen dependence at 28 days after birth, VPI were divided into non BPD group and BPD group, and the risk factors of BPD in VPI were analyzed.Results:A total of 2 514 cases of VPI including 1 364 cases without BPD and 1 150 cases with BPD were enrolled.The incidence of BPD was 45.7%.The smaller the gestational age and weight, the higher the incidence of BPD( P<0.001). Compared with non BPD group, the average birth age, weight and cesarean section rate in BPD group were lower, and the incidence of male infants, small for gestational age and 5-minute apgar score≤7 were higher( P<0.01). In BPD group, the incidences of neonatal respiratory distress syndrome(NRDS), hemodynamically significant patent ductus arteriosus, retinopathy of prematurity, feeding intolerance, extrauterine growth restriction, grade Ⅲ~Ⅳ intracranial hemorrhage, anemia, early-onset and late-onset sepsis, nosocomial infection, parenteral nutrition-associated cholestasis were higher( P<0.05), the use of pulmonary surfactant(PS), postnatal hormone exposure, anemia and blood transfusion were also higher, and the time of invasive and non-invasive mechanical ventilation, oxygen use and total hospital stay were longer( P<0.001). The time of starting enteral nutrition, cumulative fasting days, days of reaching total enteral nutrition, days of continuous parenteral nutrition, days of reaching 110 kcal/(kg·d) total calorie, days of reaching 110 kcal/(kg·d) oral calorie were longer and the breastfeeding rate was lower in BPD group than those in non BPD group( P<0.001). The cumulative doses of amino acid and fat emulsion during the first week of hospitalization were higher in BPD group( P<0.001). Multivariate Logistic regression analysis showed that NRDS, invasive mechanical ventilation, age of reaching total enteral nutrition, anemia and blood transfusion were the independent risk factors for BPD in VPI, and older gestational age was the protective factor for BPD. Conclusion:Strengthening perinatal management, avoiding premature delivery and severe NRDS, shortening the time of invasive mechanical ventilation, paying attention to enteral nutrition management, reaching whole intestinal feeding as soon as possible, and strictly mastering the indications of blood transfusion are very important to reduce the incidence of BPD in VPI.

Objective:To analyze the clinical characteristics of late-onset epileptic spasm (LOS), thus providing basis for its early identification and treatment.Methods:Clinical data[electroencephalogram(EEG), imaging, treatment and prognosis]of LOS patient hospitalized in the Department of Pediatrics, the Second Affiliated Hospital of Xi′an Jiaotong University from January 2017 to June 2019 were retrospectively analyzed.Results:The age of onset of spasm in 35 children with LOS ranged from 18 months to 11 years old, with a median of 42 months.There were 21 cases of symptomatic LOS (60.0%) and 14 cases of cryptogenic LOS (40.0%). Epileptic spastic seizures, generalized seizures, partial seizures and myoclonic seizures as the first onset were reported in 13 cases (37.1%), 11 cases (31.4%), 10 cases (28.6%), and 1 case (2.9%), respectively.There were 15 cases (43.9%) of flexion type, 11 cases (30.4%) of extension type and 9 cases (25.7%) of mixed type.Spastic seizures can be presented as genera-lized or focal seizures.Among the 35 cases of LOS, 12 cases (34.3%) had normal EEG background, 18 cases (51.4%) had slow EEG background, and 5 cases (14.3%) had high EEG irregularity.Three cases were in accor-dance with Lennox-Gastaut syndrome and the other 32 cases were not in accordance with the defined epileptic syndrome.Eighteen cases were treated with antiepileptic drugs, and sodium channel blockers were added in 9 cases; 17 cases were treated with glucocorticoid.Eight cases did not have seizures at the last follow-up.There were 17 children with seizure reduction ≥ 50%, 3 cases with seizure reduction < 50%, and 7 cases with no reduction of seizure.Conclusions:LOS is mostly symptomatic and often associated with other types of seizures.Most of cases do not have high irregularity in the EEG, and the focal discharges are mainly in the temporal region or frontotemporal region, with refractory epilepsy mainly.The onset age, etiology and EEG characteristics of LOS differ from those of West syndrome, which should be detected and treated as soon as possible to improve the prognosis in pediatric patients.