Objective:To evaluate the value of 18F-FDG PET/CT for preoperative localization of epileptogenic foci in refractory epilepsy patients with negative MRI. Methods:Clinical data (550 lobes) of 55 epilepsy patients (38 males, 17 females, age (20.0±8.1) years) with negative MRI who underwent preoperative 18F-FDG PET/CT-MRI between January 2014 and June 2020 at the First Affiliated Hospital of Jinan University were retrospectively analyzed. The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of 18F-FDG PET/CT, video electroencephalogram (VEEG), PET/CT+ VEEG and PET/CT-VEEG for localizing epileptogenic foci were calculated using stereoelectroencephalography (SEEG) and the outcomes of at least 1 year of postoperative follow-up as reference standards. χ2 test was used to compare the efficiencies of different examination modalities for unilobar, multilobar and all patients. Results:The correct lateralization rate of epileptogenic foci was 92.6%(25/27) using PET/CT. The sensitivity, specificity, accuracy, PPV and NPV of PET/CT for localization of epileptogenic foci were 65.1%(54/83), 77.9%(364/467), 76.0%(418/550), 34.4%(54/157) and 92.6%(364/393), respectively. The sensitivities of PET/CT-VEEG for localization of epileptogenic foci in all patients and patients with multilobar epilepsy were higher than those of VEEG alone (75.9%(63/83) vs 45.8%(38/83), 68.6%(35/51) vs 31.4%(16/51); χ2 values: 15.80, 14.16, both P<0.001). The specificities of PET/CT+ VEEG for localization of epileptogenic foci in all patients and patients with unilobar epilepsy were higher than those of VEEG alone (97.6%(456/467) vs 94.6%(442/467), 97.9%(282/288) vs 94.1%(271/288); χ2 values: 5.66, 5.48; P values: 0.017, 0.019). The sensitivity of PET/CT-VEEG (PET/CT and VEEG concordance) for localization of epileptogenic foci was higher than that of PET/CT+ VEEG (PET/CT and VEEG discordance) (8/9 vs 28.4%(21/74); χ2=10.40, P=0.001), and its specificity and accuracy were higher than those of PET/CT-VEEG (PET/CT and VEEG discordance) (93.4%(57/61) vs 71.7%(291/406), 92.9%(65/70) vs 72.1%(346/480); χ2 values: 13.23, 13.96; both P<0.001). Conclusions:18F-FDG PET/CT can localize and lateralize epileptogenic foci in patients with negative MRI. The combination of 18F-FDG PET/CT and VEEG improves the sensitivity, specificity, and accuracy for epileptogenic foci detection. 18F-FDG PET/CT is more accurate in detecting epileptogenic foci when it is concordant with VEEG.

Objective To explore the clinical effect of two different connecting tubes in hemodialysis combined with hemoperfusion. Methods A total of 25 patients were selected and divided into observation group and control group by self- control method. In the observation group, the hemodialysis combined with hemoperfusion was used 8 times, and the control group was treated with hemodialysis combined with hemoperfusion 8 times using conventional connecting tube. The time of the unloading of the perfusate and the amount of physiological saline required were compared between the two groups. There was no blood spillover during the unloading of the perfusate, the number of cases of allergic reaction during the treatment, and the coagulation of the dialyzer and the pipeline after the treatment. Results There was no allergic reaction in both groups. There was no significant difference between the two groups in the amount of saline needed to return blood (t=46.412, P=0.307). In the control group, there was 15 cases of blood spillover, while the observation group did not show blood spillover. There was significant difference between the two groups in unloading perfusion time(4.43±0.14)min vs. (3.02±0.11) min (t=10.784, P=0.003). The level Ⅰ and Ⅱ blood coagulation of dialyzer and pipeline was 12, 2 cases in the control group after the treatment and 5, 0 case in the observation group, no level Ⅲ blood coagulation cases, and there was a significant difference between the two groups (χ2=10.667, P<0.01). Conclusion In the hemodialysis combined with hemoperfusion therapy, multi-function group of the application effect is superior to conventional piping, is worthy of clinical application.

Objective To explore how to reduce and quickly deal with all kinds of alarm in the dialysis process, to ensure the safety of dialysis, improve the coping ability of nurses, improve the quality of nursing and the satisfaction of patients. Methods Various kinds of alarm and nurse processing time in hemopurification center of our hospital from 2013 to 2014 were recorded and analyzed, the emergency treatment measures were found out, the coping methods were developed, the coping process were improved, and the training of nurses was strengthened. The various parameters were rerecorded and compared after training (2015 to 2016). Results The most common alarm in dialysis process was venous pressure alarm, accounting for 16.45%(15925/96831) of the total alarm, the lowest limit was 10.34%(10020/96831), and the highest limit was 6.11%(5905/96831). The total conductivity alarm was 10.33%(9969/968310), the nurse' s alarm processing time of the lowest limit was (53.11 ± 12.84) s, the highest limit was (136.77 ± 42.88 ) s, the conductivity alarm was (54.17 ± 33.55) s. After the training of nurses, the alarm frequency was reduced (χ2=3.164, P<0.05), the venous pressure alarm accounts for 14.69% (15415/104913) of the total alarm , the lowest limit was 9.52% (9985/104913),and the highest limit was 5.18%(5430/104913), the total conductivity alarm was 7.54%(7913/104913). The alarm processing time was shortened:the lowest limit was (40.94 ± 10.38) s, the highest limit was (119.15 ± 38.79) s (t=3.944, 3.304, P<0.05). The work efficiency and patient satisfaction degree were improved. Conclusions Through the summary and training of all kinds of alarm in the dialysis process, it can effectively reduce the alarm frequency of the dialysis process, improve the work efficiency of nurses, and improve the satisfaction degree of patients.

Objective To investigate the effects of individual and collective health education on hemodialysis patients with hyperkalemia. Methods Thirty hyperkalemia patients treated with maintenance hemodialysis from Mar. 2013 to Mar. 2014 were set as the control group, in which the patients were given pre-established individual health education by the hemodialysis nurse weekly. Another 30 patients of the same sort, as the experiment group, were treated with individual health education combined with collective health education weekly from Apr. 2014 to Apr. 2015. The two groups were compared in term of serum potassium before and after intervention. Result Serum potassium of the experiment group after the intervention were significantly lower than the control group and the experiment group after the intervention (P<0.001). Conclusion Individual health education combined with collective health education can change traditional indoctrination one-way communication to the two-way communication conversion , make the patients consciously change their incorrect dietary behaviors, and reduce the serum potassium levels in the hemodialysis patients with hyperkalemia.

Objective To evaluate the efficacy and toxicity of induction chemotherapy with nedaplatin and docetaxel plus concurrent intensity?modulated radiotherapy ( IMRT) with nedaplatin or cisplatin in the treatment of locally advanced nasopharyngeal carcinoma (NPC). Methods A total of 223 patients with pathologically diagnosed locally advanced NPC in five treatment centers from 2011 to 2012 were randomly divided into two groups. In the test group, one hundred and thirteen patients received two cycles of induction chemotherapy with docetaxel (65 mg/ m2 on day 1) and nedaplatin (80 mg/ m2 on day 1) plus concurrent IMRT with nedaplatin (40 mg/ m2 on day 1). In the control group, 110 patients received two cycles of induction chemotherapy with the same regimens plus concurrent IMRT with cisplatin (40 mg/ m2 on day 1). The survival rates were calculated with the Kaplan?Meier method and the differences in the survival rates between the two groups were analyzed using the log?rank test. Comparison of the incidence rates of adverse reactions between the two groups was made by the chi?square test. Results The follow?up rate was 99?? 1%.The response rates at 3 months after treatment in the two groups were both 100%. The 2?year local recurrence?free, regional recurrence?free, distant metastasis?free, and overall survival rates were 94?? 0%, 94?? 2%, 88?? 2%, and 90?? 3%, respectively, in the test group, versus 93?? 4%, 94?? 1%, 86?? 7%, and 87?? 3% in the control group ( P= 0?? 757、 0?? 478、 0?? 509、 0?? 413). The incidence rates and severity of leucopenia, neutropenia, and thrombocytopenia were significantly higher in the test group than in the control group ( P= 0?? 027 , 0?? 028 , 0?? 035 ) . The incidence rates and severity of hemoglobin reduction and nausea /vomiting were significantly lower in the test group than in the control group (P= 0?? 000,0?? 023). There were no significant differences in the incidence rates of mucositis and xerostomia between the two groups ( P=0?? 483,0?? 781). Conclusions The short?term efficacy of induction chemotherapy with nedaplatin and docetaxel plus concurrent IMRT with nedaplatin is similar to that with cisplatin in the treatment of locally advanced NPC. The mild gastrointestinal reactions can be tolerated by patients. However, the severe myelosuppression should be closely monitored during the treatment.

Objective To investigate the distribution and antibiotic resistance characteristics of pathogen in mastitis patients and to provide important foundation for clinical rational antibiotic use .Methods The bacterial isolates from 114 mastitis specimens were collected .Identification and antimicrobial susceptibility testing were carried out .Results A total of 67 strains were isolated from clinical specimen ,in which Staphylococcus aureus[50 .7% (34/67)] and Staphylococcus epidermidis[44 .8% (30/67)] were themostcommonisolate,also Escherichiacoli[1.49% (1/67)],Klebsiellapneumoniae[1.49% (1/67)]andAcinetobactercalcoace-ticus[1 .49% (1/67)] were isolated .The rates of methicillin-resistant Staphylococcus aureus(MRSA) and methicillin-resistance to coagulase-negative Staphylococci(MRCNS) were 8 .8% and 46 .7% ,respectively .The sensitive rates of minocycline ,vancomycin , teicoplanin ,furadantin to MRSA strains were 100 .0% .The sensitive rates of vancomycin ,teicoplanin ,levofloxacin ,furadantin and oxacillin to methicillin-sensitive Staphylococcus aureus(MSSA) were 100 .0% .The sensitive rates of minocycline ,rifampin ,furadan-tin ,vancomycin ,teicoplanin and oxacillin to methicillin-sensitive to coagulase-negative Staphylococci(MSCNS) were 100 .0% .The sensitive rates of vancomycin ,teicoplanin ,minocycline and furadantin to MRCNS were 100 .0% .The resistance rates of penicillin to MRSA ,MSSA ,MSCNS ,MRCNS were 100 .0% .Conclusion Staphylococcus is the main pathogen of mastitis patients .Penicillin is not a first selective drug for acute mastitis .

Objective To investigate the sleep quality of maintenance hemodialysis (MHD) patients and analyze its associated factors. Methods The convenience sample method was used to choose 424 MHD patients from 7 hospitals.A set of questionnaires were used in this investigation,including demographic data form,Pittsburgh sleep quality index (PSQI),restless legs syndrome (RLS),social support rate scale (SSRS),subjective global assessment (SGA),family APGAR index (APGAR) and family burden scale of disease (FBS). Results PSQI score of 395 MHD patients (93.2％) was ≥5.APGAR and social support total points were negatively correlated with sleep quality (r=-0.133,P=0.006; r=-0.105,P=0.031).Family burden total point was positively correlated with sleep quality (r=0.215,P=0.000).Nutrition (F=46.123,P=0.000),restless legs syndrome (F=9.392,P=0.000) and sleep apnea syndrome (F=5.645,P=0.001) were closely associated with sleep index scores. Conclusions Incidence of poor sleep quality in MHD patients of our study is quite high.Sleep quality of MHD patients is correlated with lots of factors,such as family concern,social support.

ObjectiveTo study the anatomic characteristic of the attachment of medial patellofemoral ligament and its function in patellar stability. MethodsThirty adult cadaver knees were used for anatomic study, and the attachments of medial patellofemoral ligament were observed and measured. Results The femoral attachment of medial patellofemoral ligament was anchored to the bone between the medial femoral epicondyle and the adductor tubercle. The fibers here were thin and narrow, and became thick and wide to the anterior. The patellar attachment was in the superior two-thirds of the medial margin of the patella. The fiber here were the thickest and the widest. Conclusion The anatomic characteristic of the attachment of medial patellofemoral ligament was revealed, providing anatomical bases for surgery.

Objective: To investigate the relationship between type 2 diabetes mellitus (T2DM) and the pathogenesis and metastasis of colorectal cancer. Methods: A case-control study was performed to compare 852 colorectal cancer patients with 940 controls (patients without cancer) recruited from 2001 to 2006, with respect to their sex, cancer subsite, the course of T2DM, hepatic metastasis, smoking and drinking. Correlated risk factors were analyzed. Results: The risk of colorectal cancer was increased in patients with T2DM and the relative risk (OR) was 2.466. The OR of male patients was higher than that of female patients, but with no significant difference (2.775 vs 2.070, P=0.394). The incidence of T2DM in patients with left hemicolon cancer was higher than that in those with right hemicolon cancer and rectal cancer, but with no significant difference between them. The colorectal cancer risk in T2DM patients with a DM course of 10 ～ 20 years was the highest, and the OR was 4.696. The rate of hepatic metastasis was higher in T2DM patients with colorectal cancer than that in celorectal cancer patients without T2DM and the OR was 2.888. Conclusion: T2DM may be one of the important pathogenic risk factors for colorectal cancer. The OR is increased with the extension of DM course within 20 years. Colorectal cancer patients with T2DM may be more prone to hepatic metastasis.

Objective To provide an anatomic evidence for the double-bundle posterior cruciate ligament (PCL) reconstruction, the sizes and locations of the attachments of the PCL to the tibia and the femur were measured. Methods We studied 30 cadaveric knees. PCLs were divided into anterolateral and posteromedial bundles to the insertion footprint, and those locations were measured and described. Results The distances from the center of the femoral insertions of the anterolateral and posteromedial bundles to the anterior margin of the medial femoral condyle were (8.52±1.81)mm and (11.63±1.81)mm. The vertical distances from the center of the femoral insertions of the double-bundle to the intercondylar roof were (4.67±0.55)mm and (10.32±1.23) mm. The vertical distances from the tibial insertion of the center of the double-bundle to the plane of the tibial articular surface were (8.43±1.21)mm and (14.52±2.31)mm. The distances from the medial margin of the articular cartilage of the tibial plateau to the center of the tibial insertions of double-bundle were (47.44±6.23)mm and (45.95±6.32)mm. The areas of the insertions of the anterolateral and posteromedial bundles on the femur were (107.12±15.25)mm~2 and (65.35±10.27)mm~2. The areas of the insertions of the double-bundle on the tibia were (50.07±11.33)mm~2and (51.08±10.22)mm~2. Conclusion The anatomic characteristic of the attachment of the anterolateral and posteromedial bundles was revealed, providing anatomical bases for surgery.