Objective:To investigate the clinical features of patients with epilepsy in Neurosurgery Outpatient and influencing factors for their seizure control.Methods:Six hundred and seventy-three epilepsy patients admitted to Neurosurgery Outpatient of 6 hospitals including Fifth Affiliated Hospital of Zhengzhou University from September 2017 to December 2022 were chosen. Clinical data (including general demographic data, education level, onset age, onset cycle and duration, course of onset, family annual income and seizure control) were collected using a questionnaire prepared by He'nan Epilepsy Systematic Diagnosis and Treatment Center to summarize the clinical features. Univariate and multivariate Logistic regressions were used to analyze the influencing factors for their seizure control.Results:(1) In these 673 epilepsy patients, 50 (7.4%), 78 (11.6%), 192 (28.5%), 100 (14.9%), 68 (10.1%), 72 (10.7%) and 113 (16.8%), respectively, were <1 year old (infant stage), 1-2 years old (children stage), 3-5 years old (preschool stage), 6-16 years old (juvenile stage), 17-39 years old (young stage), 40-64 years old (middle-aged stage) and ≥65 years old (elderly stage). In the past medical treatment history, 23.0% (155/673) patients did not receive intervention, 72.4% (487/673) received medication, and 4.6% (31/673) received surgical treatment; 55.9% (376/673) had good seizure control and 44.1% (297/673) had poor seizure control. (2) Secondary education ( OR=2.199, 95% CI: 1.037-15.221, P=0.033), primary education or below ( OR=3.544, 95% CI: 2.101-21.343, P=0.012), daily seizures ( OR=4.788, 95% CI: 1.369-33.103, P=0.011), each seizure lasted ≥3 min ( OR=4.179, 95% CI: 3.338-18.550, P=0.003), course of disease≥3 years ( OR=0.199, 95% CI: 0.077-0.602, P=0.001), course of disease for 1-3 years ( OR=0.379, 95% CI: 0.108-0.882, P=0.031), and currently taken antiepileptic drugs for 3 or more ( OR=6.237, 95% CI: 2.195-17.837, P=0.001) were independent risk factors for poor seizure control in epilepsy patients. Conclusion:In Neurosurgery Outpatient, children with diseases before childhood enjoy the largest proportion; drug therapy remains the main treatment; low education level, short seizure cycle, long duration of attack, long course of disease, and multiple drugs used in these patients imply poor anti-epileptic effecacy.

In view of the shortage of research on the seismic performance of medical imaging equipment, this paper investigates and summarizes the seismic regulatory requirements and seismic tests of medical imaging equipment, and focuses on the parameter selection, detection steps, result evaluation and detection equipment requirements of seismic detection of medical imaging equipment. The seismic test data of medical imaging equipment with various installation modes are analyzed, and the seismic performance of medical imaging equipment is analyzed and summarized.
Diagnostic Imaging

Objective:To analyze the cognition and willingness of family physicians on contracted service, and to explore the implementation obstacles and feasible strategies of implementing contracted service of family physicians from the perspective of suppliers.Methods:From July to October 2020, 850 family physicians in community health service centers or township health centers in three cities of Shandong Province were investigated by questionnaire survey and key person interview. Descriptive analysis and binary logistic regression model were used to analyze the willingness of family physicians to provide contracted service. Through questionnaire survey and key person interview, the implementation obstacles and service optimization strategies of family physicians were discussed.Results:791 valid questionnaires were obtained, of which 688(87.0%) approved the implementation of family physician contract service, and 679(85.8%) expressed willingness to provide family physician contract service. Marital status, recognition of service policy, satisfaction of service operation effect, optimistic degree of service development prospect and residents′ first choice of illness were the factors influencing family physician′s service willingness.Conclusions:We should effectively improve the family doctor′s service intention and promote the efficient and orderly implementation of family doctor′s contract service policy through enriching policy supporting measures, innovating the application of " Internet plus" , increasing personnel training, optimizing performance appraisal work and creating favorable public opinion environment.

Objective:To explore the current status of medical preventive integration at primary medical institutions, analyze the problems of medical prevention integration, and put forward optimization suggestions.Methods:From June to July 2020, 169 primary medical institutions in a city were selected as the survey objects to conduct a questionnaire survey on the basic information of institutions and the evaluation indicators of medical preventive integration. The evaluation index system of medical preventive integration was divided into a factual survey and a sensory survey. In addition, 32 relevant personnel were interviewed on the current situation of medical preventive integration at primary medical institutions. The reliability and validity of the data were tested and analyzed, while descriptive analysis and classification extraction analysis were carried out.Results:The reliability and validity analysis proved the data reliability. The factual survey extracted three common factors, namely organization management, performance appraisal distribution and information management. The sensory survey extracted two common factors, namely working mode and personnel training. In terms of organization, management and working methods, the degree of medical preventive integration was low. Among them, 53.8% of the institutions had formulated the medical preventive integration norms, and only 41.4% of them had shared residents′ health information in time.Conclusions:The degree of medical preventive integration of primary medical institutions in the city still need to be improved. In the future, we should strengthen the top-level design, establish the norms and cooperation mechanism of medical preventive integration, improve the awareness of medical preventive integration of medical personnel, improve the information level, and to build a new service model integrating disease prevention, medical treatment and health management.

Objective: To evaluate the efficacy and safety of ombitasvir/paritaprevir/ritonavir (OBV/PTV/r) 25/150/100 mg once daily and dasabuvir (DSV) 250 mg twice daily combined with ribavirin in adult patients of Mainland China with chronic HCV genotype 1b infection and compensated cirrhosis. Methods: An open-label, multicenter, phase 3 clinical trial study was conducted in mainland China, Taiwan, and South Korea. Adult patients with compensated cirrhosis (Metavir score =F4) who were newly diagnosed and treated for hepatitis C virus genotype 1b infection with ombitasvir/paritaprevir/ritonavir and dasabuvir combined with ribavirin for 12 weeks were included. Assessed SVR rate of patients obtained at 12 and 24 weeks after drug withdrawal. Efficacy and safety were evaluated in patients who received at least one time study drugs. Results: A total of 63 patients from mainland China were enrolled, 62 of whom (98.4%) had a baseline Child-Pugh score of 5 points. The overall rate of SVR12 and SVR24 in patients was 100% (95% CI: 94.3% to 100.0%). Most of the adverse events that occurred were mild. The incidence of common (≥10%) adverse events and laboratory abnormalities included elevated total bilirubin (36.5%), weakness (19.0%), elevated unconjugated bilirubin (19.0%) and conjugated bilirubin (17.5%), and anemia (14.3%). Three cases (4.8%) of patients experienced Grade ≥ 3 adverse events that were considered by the investigators to be unrelated to the study drug. None patients had adverse events leading to premature drug withdrawal. Conclusion Mainland Chinese patients with chronic HCV genotype 1b infection and compensated cirrhosis who were treated with OBV/PTV/r plus DSV combined with RBV for 12 weeks achieved 100 % SVR at 12 and 24 weeks after drug withdrawal. Tolerability and safety were good, and majority of adverse events were mild.

Objective To investigate the clinical effect of proximal femoral nail anti-rotation (PFNA) on femoral intertrochanteric fracture in the elderly.Methods Eighty-seven elderly patients from June 2007 to March 2012,who had femoral intertrochanter fracture and received treatment of PFNA,were enrolled in this study.Patients were comprised by forty seven people with stable fracture and forty people with unstable fracture.Results They were all followed up from 4.5months to 14 months,with the average time of 7.2 months.No death were found in hospital.The operation time was 25 min in average.During operation,losing blood was 80 ml.Ambulation time was 5.5 d,and the fracture healing time was 22 weeks in average.However,there were significant differences in intraoperative resetpostoperative position of the blade between the stable and unstable fracture patients (P＜0.01).Conclusions PFNA is one of the effective methods in the treatment of intertrochanter fracture,and it has shorter operation time,less losing blood,earlier ambulation,and hardly has complications.

10.3969/j.issn.2095-4344.2013.23.011

Objective To investigate the clinical and radiographic outcome of traumatic pubic symphyseal diastases fixed with the locked plate. Methods From December 2007 to December 2009,17 patients(11 males,6 females,at mean age of 45.3 years)with pubic symphysis diastasis of unstable pelvic ring injuries were treated with open reduction and fixation with the locked plate.According to Tile classification system,five patients were with type B1 fractures,one with type B2,one with type B3,six with type C1,three with type C2 and one with type C3.All operations were performed under general anesthesia.Pubic symphyseal diastasis was treated by open reduction and fixation with the locked plate.There were 13 patients with associated posterior pelvic disruption,of which seven patients were treated by open reduction via anterior approach and fixed wich the reconstruction plates,three by close reduction and fixed with percutaneoua sacroiliac cannulated screws and three by posterior approach and fixed with M type plates. Results Of all the patients,16 patients were followed up for a mean time of 16 months(6-30months),which showed mean blood loss of 200 ml(50-600 ml)and mean hospital stay of 21 days (14-62 days).The clinical outcome was measured according to Majeed scores system,which showed excellent results in seven patients,good in seven and fair in two. Conclusions The locked plate fixation takes advantages of sailsfactory clinical outcomes with less operative trauma and a lower implant failure and wound infection rate in treatment of traumatic pubis symphysis diastasis.Locked plate fixation of symphysis call be performed alone when the posterior pelvic ring is only partially disrupted (Tile B).Posterior fixation construction should be used if the pelvic ring is under complete instability(Tile C).

BACKGROUND:Muscle transposition is a conventional method to treat muscle tissue defects,but it results in damage to another piece of muscle.For this reason,we designed this study to search for a method to in situ repair muscle tissue defects.OBJECTIVE:To investigate the conditions for in vitro induced differentiation of rat bone marrow mesenchymal stem calls(BMSCs)into skeletal muscle cells.METHODS:Following isolation and culture,passage 3 BMSCs were induced to differentiate in vitro by a combination of5-azacytidine,myogenic differentiation factor,transforming growth factor β1,and insulin like growth factor.At 9 days after induction,cells were harvested and identified by immunohistochemistry.RESULTS AND CONCLUSION:Primary cultured BMSCs exhibited an adherent,colony-like growth.After 5-7 days,multi-synaptic calls,thin and fiat polygonal cells,polygonal cells,and triangle-shaped cells were observed.After 12 days,calls confluenced and covered the whole bottom of culture flask,with slightly altered morphology of BMSCs.After 5-azacytidine induction,some calls died and grew slowly.After 7 days,cells markedly grew and soma was gradually enlarged,presenting with an oval,spindle-shaped,or irregular appearance.After 14 days,spindle-shaped calls become more.After 18-22 days,myotubes were increased in number and enlarged in volume,and myotube nucleuses were also increased.The newly formed myotubes and spindle-shaped fibroblasts were distributed in parallel interval.The immunohistochemistry of BMSCs revealed that cells were positive for CD44,with dark brown granules in the cytoplasm,especially around the nucleus,but they were negative for CD34.The immunohistochemistry of induced BMSCs demonstrated that calls were positive for desmin and skeletal muscle myosins.These findings indicate that myogenic differentiation factors and 5-azacytidine could induce the oriented differentiation of BMSCs into skeletal cells,with the presence of positive expression of desmin and skeletal muscle myosins.

Objective To evaluate the result of percutaneous internal fixation in treatment of uncomminuted ankle fractures (inner malleolus,extemal malleolus and ventral condyle). Methods A total of 26 patients with uncomminuted ankle fractures at age range of 20-55 years(mean 35.2 years)were treated with closed reduction and percutaneous internal fixation by screws,eannulated screws or Kirschuer pins under C-arm X-ray scan.All patients were followed up for 12-24 months(mean 14 months).Results All fractures were healed successfully.with healing time of 8-24 weeks(mean 10.3 weeks).According to Bourne Standard,excellent ankle function results were reposed in 15 patients,good in 9 and fair in 2,with excellence rate of 92%.There was no implant failure,postoperative infection or dehiscence. Conclusions With advantage of early rehabilitation and minor incision of the affected ankles,closed reduction and percutaneous internal fixation can be selected for transverse or oblique uncomminuted ankle fractures,especially for those patients with severe swelling or skin injury.