Clinicians need to focus on various points in the diagnosis and treatment of insomnia.This article prescribed the treatment protocol based on the unique features,such as insomnia in the elderly,women experiencing specific physiologi-cal periods,children insomnia,insomnia in sleep-breathing disorder patients,insomnia in patients with chronic liver and kidney dysfunction.It pro-vides some reference for clinicians while they make decision on diagnosis,differentiation and treat-ment methods.

Objective:To investigate the feasibility of magnetic anchor technique for endoscopic submucosal dissection (ESD) in the treatment of early esophageal cancer.Methods:A self-designed magnetic anchoring device (including an anchor magnet and a target magnet) was used to perform ESD on the hypothesized esophageal lesion mucosa of six isolated esophagus of Beagle dogs. The feasibility and convenience of the operation was evaluated.Results:ESD of 6 isolated esophagus of dogs was successfully completed. Through adjusting the position of anchor magnet, the pulling direction and force of the target magnet on the mucosa could be flexibly controlled, the mucosal peeling surface was fully exposed, and tissue tension was provided to ensure the smooth removal of the diseased mucosa. The entire operation was smooth, and the target magnet was conveniently retained. No target magnet slippage or mucosal laceration occurred during the operation.Conclusion:The magnetic anchor technique is safe and feasible for the ESD, effectively pulling the diseased mucosa in treatment of early esophageal cancer, which can greatly improve the endoscopic operation experience.

Objective:To analyze some problems identified in the transformation of scientific and technological achievements in hospitals and put forward corresponding strategies in order to provide reference for other hospitals.Methods:This paper analyzes some problems identified in the transformation of scientific and technological achievements in hospitals.Results:The common problems identified in the research include: too many steps in the transformation of scientific and technological achievements, market information is asymmetry, there is also risks of leakage and infringement, lack of professional institutions and specialized talents. Several strategies to solve these problems were proposed.Conclusions:The management department needs to create a good external environment to adapt to the transformation of achievements. That is to integrate the intellectual property layout and the transformation of achievements; optimize the transformation model; implement the whole process of security supervision to protect the confidentiality; improve the construction of transformation platform; strengthen the construction of professional talent team. This can promote the "bench-to-bed" transition of medical scientific research, as well as assure the long-term development of scientific and technological innovation.

OBJECTIVE: To assess the value of BACs-on-Beads (BoBs) technique for the detection of chromosomal abnormalities in abortus tissues from recurrent pregnancy loss. METHODS: A total of 109 abortus samples were collected and analyzed with the BoBs technique. The incidence and types of chromosomal abnormalities for different age groups and gestational weeks were compared. RESULTS: The BoBs assay has succeeded in all cases, with an incidence for chromosomal abnormalities reaching 62.39% (68/109). The major findings included trisomy 16 (12/68), trisomy 22 (9/68), trisomy 13 (9/68) and trisomy 21 (8/68). The abnormal rate was significantly higher in those above 35-year-old compared with that of the <35-year-old group (P<0.05). More aberrations were found among abortus tissues derived from 42-70 days of pregnancy albeit with no statistical significance (P>0.05). The aberration rates were similar for samples derived from second, third and fourth time abortions (P>0.05). CONCLUSION BoBs technique can detect chromosomal aberrations in miscarriages and may be routinely used for the analysis of early spontaneous abortions.
Abortion, Habitual ; Abortion, Spontaneous ; Adult ; Chromosome Disorders ; Down Syndrome ; Female ; Humans ; Karyotyping ; Pregnancy ; Prenatal Diagnosis

Objective? To explore the current perceived vulnerability and parenting stress (PS) in mothers of children with congenital heart disease (CHD) and to analyze the correlation between the two. Methods? The mothers of 176 children with congenital heart disease admitted in the 2nd Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University from September 2017 to September 2018 were selected using convenient sampling and investigated with the General Information Questionnaire, Child Vulnerability Scale (CVS) and Parenting Stress Index-Short Form (PSI-SF). Results? Totally 176 questionnaires were distributed and collected, including 168 valid questionnaires, accounting for a recovery rate of 95.45%. The CVS score of the mothers of CHD children averaged (8.77±3.59); their PSI-SF scores saveraged (100.74±10.55); there was statistically significant difference in PSI-SF scores between mothers with different educational background and single child or not (P＜0.05); the total CVS score was positively correlated with the total PSI-SF score and the scores of its various dimensions (r=0.262-0.569); multivariate stepwise regression analysis showed that mothers with different educational background, single child,and the total score of CVS were factors of parenting stress, except the effect of general information, the total score of CVS can explain 17% of the total variation. Conclusions? The perceived vulnerability and PS of the mothers of CHD children stand at high levels. Their perceived vulnerability is positively correlated with their PS. Medical and nursing workers may improve their PS by reducing their perceived vulnerability, thus providing better family care for CHD children.

OBJECTIVETo explore the effect of donations after cardiac death (DCD) kidney transplant performed in northwest China and the measures for management of delayed graft function (DGF).

METHODSIn the period of 2011-2013, a total of 51 families of DCD donor gave their consent to organ donation by signing the informed consent with the help by a Red Cross Organization (ROC) coordinator, and 102 kidneys were retrieved by organ procurement organization (OPO) teams. Ninety-four operations of renal transplantation were carried out in our hospital. All the patients were followed-up and based on the occurrence of DGF after transplantation, they were divided into DGF group and non-DGF group for comparative studies.

RESULTSThe success rate of donation after cardiac death was 29.3%, and the incidence of post-transplantation DGF was 27.7%. The 1-year human/kidney survival rate was 98.9%/95.7%. Within six months after the transplant, the values of eGFR in DGF group were significantly lower and serum creatinine significantly higher than those in non-DGF group (P<0.05), but no significant differences were found between the two groups thereafter (P>0.05). The occurrence of DGF in LifePort mechanical perfusion cohorts was significantly lower than that in the simple cold preservation group (21.5% vs. 41.4%, P<0.05).

CONCLUSIONThe overall effect of DCD kidney transplant is good despite a high incidence of early DGF, and we recommend the use of low-temperature mechanical perfusion for storage and transportation of DCD donor kidney.

Adult ; China ; Death ; Delayed Graft Function ; etiology ; Female ; Humans ; Kidney Transplantation ; Male ; Tissue and Organ Procurement ; statistics & numerical data ; Young Adult

Objective To explore the effect of donations after cardiac death (DCD) kidney transplant performed in northwest China and the measures for management of delayed graft function (DGF). Methods In the period of 2011-2013, a total of 51 families of DCD donor gave their consent to organ donation by signing the informed consent with the help by a Red Cross Organization (ROC) coordinater, and 102 kidneys were retrieved by organ procurement organization (OPO) teams. Ninety-four operations of renal transplantation were carried out in our hospital. All the patients were followed-up and based on the occurrence of DGF after transplantation, they were divided into DGF group and non-DGF group for comparative studies. Results The success rate of donation after cardiac death was 29.3%, and the incidence of post-transplantation DGF was 27.7%. The 1-year human/kidney survival rate was 98.9%/95.7%. Within six months after the transplant, the values of eGFR in DGF group were significantly lower and serum creatinine significantly higher than those in non-DGF group (P<0.05), but no significant differences were found between the two groups thereafter (P>0.05). The occurrence of DGF in LifePort mechanical perfusion cohorts was significantly lower than that in the simple cold preservation group (21.5% vs. 41.4%, P<0.05). Conclusion The overall effect of DCD kidney transplant is good despite a high incidence of early DGF, and we recommend the use of low-temperature mechanical perfusion for storage and transportation of DCD donor kidney.

Objective To explore the effect of donations after cardiac death (DCD) kidney transplant performed in northwest China and the measures for management of delayed graft function (DGF). Methods In the period of 2011-2013, a total of 51 families of DCD donor gave their consent to organ donation by signing the informed consent with the help by a Red Cross Organization (ROC) coordinater, and 102 kidneys were retrieved by organ procurement organization (OPO) teams. Ninety-four operations of renal transplantation were carried out in our hospital. All the patients were followed-up and based on the occurrence of DGF after transplantation, they were divided into DGF group and non-DGF group for comparative studies. Results The success rate of donation after cardiac death was 29.3%, and the incidence of post-transplantation DGF was 27.7%. The 1-year human/kidney survival rate was 98.9%/95.7%. Within six months after the transplant, the values of eGFR in DGF group were significantly lower and serum creatinine significantly higher than those in non-DGF group (P<0.05), but no significant differences were found between the two groups thereafter (P>0.05). The occurrence of DGF in LifePort mechanical perfusion cohorts was significantly lower than that in the simple cold preservation group (21.5% vs. 41.4%, P<0.05). Conclusion The overall effect of DCD kidney transplant is good despite a high incidence of early DGF, and we recommend the use of low-temperature mechanical perfusion for storage and transportation of DCD donor kidney.

Objective To evaluate the effects of micro-screw on the intrusion of lower incisors and the leveling of curve of Spee in the process of orthotherapy.Methods Fifteen patients (5 males,10 females) with deep-bite were selected,aged from 11.3 to 28.8 years,with average of 17.2 years.All of them were Angle Class Ⅱ Classification 1 malocclusion and had a curve of Spee larger than 3 mm.Orthotherapy of extraction was adopted for the first premolars of two upper mandible and second premolars of two lower mandible.All these patients had micro-screws implanted at root apex area between lower lateral incisor and canine bilaterally,and when the 0.457 mm× 0.635 mm (0.018 in ×0.025 in) Ni-Tisquare wire was internalized,the strength of intrusion from micro-screws was used.Lateral cephalometric radiographs were taken before loading the micro-screw and immediately when the curve of Spee was leveled.Two linear and two angular measurements were selected for cephalometric analysis.Results The following results were noted: the lower incisors were significantly intruded for a mean of (4.10±0.98) mm; the mandibular molars were not significantly extruded for a mean of (0.91±0.69) mm; some lower incisors proclined and some lower incisors retroclined for a mean of (-0.09±4.12)°.After bite opening,the mandibular plane angle was minimally altered for a mean of (0.25±0.70)°; the ratio of lower incisor intrusioin to lower molar extrusion was 4.5: 1.0.Conclusions The combined use of micro screw with Ni-Ti wire is capable of enhancing the intrusion of lower incisors and leveling the curve of Spee,and it has minimal side effects on the posterior teeth.

Objective To establish the differential templates of juvenile and children in Shandong with normal occlusion, according to the group of skeletal age. Methods 212 juvenile and children at the age of 8-16 years (107 males and 105 females) with normal occlusion in Shandong natives were took cephalomatric radiographs, and divided into different groups by cervical vertebrae skeletal age. Then these cephalomatric radiographs were scanned on the computer and 14 skeletal landmarks were vectorizated. An analytical method of Ricketts and McNamara with WinCept 7.0 was used to make statistics and variance analysis among gender and every group of cervical vertebrae skeletal age,and then established the templates. Results The juvenile and children in Shandong natives with normal occlusion had different templates. Conclusion By overlapping the same skeletal age of templates by SN plane, we can see that male face outline is greater than female and male mandibular plane angle is smaller than female. By overlapping the same gender of templates, there is a developmental trend of mandibular bone to be forward and downward, and to revolve anticlockwise with age.