[Application of electrical impedance tomography in pulmonary rehabilitation].

Pulmonary rehabilitation is a comprehensive and individualized intervention for patients suffering from respiratory dysfunction due to various diseases. This approach has been highly valued and implemented by clinical medical professionals. However, the lack of equipment and real-time monitoring of ventilatory lung function during pulmonary rehabilitation treatment is a challenge. In addition, there is a need for improved methods that can directly guide physiotherapists to provide precise treatment. Electrical impedance tomography (EIT) is a novel medical imaging technology that allows real-time monitoring of lung ventilation status. It is currently being translated from basic research into clinical applications and is widely used in respiratory disease, particularly in critical care respiratory management. However, there is a lack of reports on pulmonary rehabilitation guidance and outcome evaluation. This article aimed to provide a comprehensive review of this field, with the aim of generating more ideas for clinical research and further improving individualized treatment in the field of pulmonary rehabilitation.

[Expression and clinical significance of plasma methylated SEPT 9 gene in patients with primary liver cancer].

Objective: To investigate the expression and clinical significance of plasma methylated SEPT9 (mSEPT9) gene in patients with primary liver cancer. Methods: 393 cases who visited our hospital from May 2016 to October 2018 were selected. Among them, 75 cases were in the primary liver cancer (PLC) group, 50 cases were in the liver cirrhosis (LC) group, and 268 cases were in the healthy control group (HC). The three groups' positive rates of mSEPT9 expression in the peripheral plasma were detected by the polymerase chain reaction (PCR) fluorescent probe method. The correlational clinical features of liver cancer were analyzed. At the same time, the electrochemiluminescence detection method was used to compare the AFP positive rate. Statistical analysis was conducted using chi-square tests or continuity-corrected chi-square tests. Results: 367 cases actually had valid samples. There were 64, 42, and 64 cases in the liver cancer group, cirrhosis group, and healthy control group, respectively. Among them, 34 cases of liver cancer were verified from pathological tissues. The positive rate of plasma mSEPT9 was significantly higher in the liver cancer group than that in the liver cirrhosis and healthy control groups [76.6% (49/64), 35.7% (15/42), and 3.8% (10/261), respectively], and the differences were statistically significant (χ (2) = 176.017, P < 0.001). The sensitivity of plasma mSEPT9 detection (76.6%) was significantly better in liver cancer (76.6%) than that of AFP patients (54.7%), and the difference was statistically significant (χ (2) = 6.788, P < 0.01). Compared with the single detection, the sensitivity and specificity of plasma mSEPT9 combined with AFP were significantly improved (89.7% vs. 96.3%, respectively). Patients with liver cancer aged≥50 years, with clinical stage II or above, and those with pathological signs of moderate to low differentiation had higher levels of plasma mSEPT9 positive expression, and the differences were statistically significant (χ (2) = 6.41, 9.279, 6.332, P < 0.05). During the follow-up period, the survival time of liver cancer patients with positive plasma mSEPT9 expression was significantly shorter than that of those with negative expression (310 ± 26 days vs. 487 ± 59 days, respectively), with statistically significant differences (Log Rank P = 0.039). Conclusion: In China, the positive rate of plasma mSEPT9 detection in liver cancer patients is higher than that of AFP in relation to age, clinical stage, and degree of tissue differentiation; additionally, it has certain survival predictive values. As a result, detecting this gene has important clinical significance and potential clinical application value in the non-invasive diagnosis and prognosis assessment of patients with primary liver cancer.

[Advances in the classification and treatment of isolated superior mesenteric artery dissection].

Isolated superior mesenteric artery dissection (ISMAD) has attracted more and more clinicians' attention in recent years. Patients onset of ISMAD often present with abdominal pain. The misdiagnosis or miss diagnosis is common because of the non-specific symptoms and signs, which even can endanger lives in serious cases. Imaging classification is of great significance for diagnosis and treatment of ISMAD. The Sakamoto classification and the Yun classification are two classical classified methods. However, with the further study of ISMAD, various new classifications emerge. Conservative treatment was once considered as the preferred. As the rapid development of endovascular therapy and the great progress of new devices, stenting therapy can significantly improve symptoms and achieve satisfactory long-term effects, and be even expected to become the preferred method for clinical therapy of ISMAD. However, the long-term effects of endovascular therapy still need a large number of follow-up data, and complications after stent implantation can't be ignored.

[Research Progress on the Effect of Synthetic Cathinones on Animal Behavior].

ABSTRACT: Synthetic cathinones are a class of new psychoactive substances with a structure similar to amphetamine drugs, which can produce excitatory effects similar to drugs such as amphetamine and cocaine after being taken. In recent years, the abuse of synthetic cathinones worldwide has become increasingly serious, posing a serious threat to social security and public health. This article focuses on several common synthetic cathinones, collects their research results in animal autonomous activity experiments and drug dependence model experiments and summarizes their relevant experimental conclusions in animal body temperature regulation, learning and memory, and anxiety, in order to provide data reference and method guidance for the domestic development of related drug research.

[The prevention and management of approach-specific complications of abdominal aortic balloon occlusion in pelvic and sacral surgery].

Objective: To investigate the causes,prevention and treatment of femoral artery puncture related complications caused by the application of resuscitative endovascular balloon occlusion of the aorta (REBOA) in the resection of pelvic and sacral tumors. Methods: Clinical data of 23 patients with femoral artery puncture related complications who received REBOA in the resection of pelvic and sacral tumors from August 2010 to August 2018 at the Musculoskeletal Tumor Center,Peking University People's Hospital were retrospectively analyzed.There were 8 males and 15 females,with the an age of (37.0±16.2) years (range:15 to 65 years).Arterial access via the Seldinger technique for REBOA was obtained in the right common femoral artery of 18 cases,and in the left of 6 cases.An arterial sheath with a diameter of 11 to 12 F(1 F≈0.33 mm) was used for the patient.The occurrence and treatment of postoperative complications were analyzed. Results: Acute femoral arterial thrombosis occurred in 18 patients,which was managed by open repair 48 hours postoperatively.Among the 349 patients admitted before 2015 who received hemostasis by compression after femoral artery sheath removal,12 patients (3.4%) developed acute femoral artery thrombosis.While the 476 patients admitted after 2015 who used a vascular stapler to close the femoral artery wound,6 patients (1.3%) developed acute femoral artery thrombosis.One case of retroperitoneal hematoma and 1 case of femoral pseudoaneurysm were found and surgically fixed.Postoperative follow-up was (40±18) months (range:13 to 108 months).Three cases with chronic lower extremity ischemia were confirmed by Doppler ultrasonography during 1 to 5 years follow-up.Two of them had minimal symptoms and denied further treatment,while the other one received femoral-femoral artery bypass surgery to restore distal flow for pain and numbness relief. Conclusions: Acute femoral arterial thrombosis was the most common femoral artery puncture.Technique refinement of REBOA,the use of percutaneous suture device and close follow-up can reduce the approach-specific complications,and help to detect and treat the complications timely,which may popularize the clinical application of REBOA.

[Technology specification of bedside hypertonic saline-contrast electrical impedance tomography of lung perfusion and clinical application].

Bedside hypertonic saline-contrast electrical impedance tomography (EIT) method for lung perfusion evaluation has several advantages of bedside, simple, noninvasive and radiation-free. For a long time, EIT perfusion image of hypertonic saline was mostly limited to animal experiments, and related clinical research is in the ascendant. This technical specification for clinical application is reached based on our previous researches, review of literatures in this field. The purpose of this technical specification is to facilitate the unified and standardized use of hypertonic saline-contrast EIT technology for regional lung perfusion, to evaluate the safety and quality control of the technology, and to unify the results.

[Understanding of the lower mediastinal lymph node dissection in the adenocarcinoma of the esophagogastric junction through abdomino-transhiatal approach].

In recent years, the incidence of adenocarcinoma of esophagogastric junction (AEG) keeps increasing. Siewert type II and type III AEG invades at 2-4 cm in the lower esophagus, and it has a higher rate of lower mediastinal lymph node metastasis. Lower mediastinal lymph node clearing through the abdomino-transhiatal (TH) approach is preferred, which can be accomplished by entering the lower mediastinum through the hiatus and mobilize the esophagus upward and the surrounding lymph and connective tissue for approximately 6.5 cm. Using the infracardiac bursa (IBC) as an anatomical landmark improves the safety and operability of the thorough dissection of the lower mediastinum. Total resection of the mesenterium at the esophagogastric junction can entirely dissect the lower mediastinal lymph nodes, which conforms to the safety principles in oncology.

[Study on treatment of chronic tinnitus by tetanus stimulation and evaluation methods of tinnitus].

Objective:The purpose of this study was to explore the efficacy of tetanus stimulation in tinnitus treatment and the correlation between the mainstream questionnaires of tinnitus and tinnitus-matching in order to find a more convenient and accurate method for tinnitus evaluation. Method:Ten patients with chronic tinnitus and normal or mild hearing impairment were enrolled in this study, totaling 13 ears. Their age ranged from 23 to 53 years old. The stimulus sound（white noise, frequency modulation 14.1 Hz, repetitive amplitude modulation, duty cycle 0.5） was selected and the sound intensity was 50 dB SL. Experimental procedure: （4 minutes sound stimulation+4 minutes rest） ×4 times, totaling 32 minutes. The patients were treated three times a week for 5 weeks. The loudness of tinnitus was matched before and after each treatment, and tinnitus handicap inventory（THI）, tinnitus handicap questionnaire（THQ） and visual analog scales（VAS） were also used for assessment before the first treatment each week. The loudness matching and the above scales were performed once more at follow-up for one week after end-of-treatment. Result:①Single treatment: the matched loudness value decreased by 1.000（0.000, 3.000） dB（Z=7.553, P<0.01） after each single treatment. ②After five weeks' treatment: the matched loudness value decreased（9.692±8.038） dB（t=4.348, P<0.01）; VAS value decreased by 2.000（1.000, 3.000）（Z=2.890, P<0.01）; total score of THQ decreased（7.389%±8.847%）（t=2.641, P<0.05）. ③Correlation analysis: there was positive correlation between total scores of THI and THQ（r=0.747, P<0.01）; the matched loudness values have positive correlation with VAS value（r=0.593, P<0.01）, THI-F（r=0.346, P<0.01） and THQ-factor 3 score（r=0.294, P<0.05）; there was positive correlation between the VAS value and THI-F（r=0.326, P<0.05）, the total score of THI（r=0.466, P<0.01）, THQ-factor 3 score（r=0.291, P<0.05）, the total score of THQ（r=0.497, P<0.01）. Conclusion:The loudness of tinnitus declined with significant fluctuation during tetanus sound therapy. THQ scale is recommended as a sensitive indicator for evaluating the efficacy of tinnitus treatment; VAS is recommended for rapid assessment of tinnitus. Tetanus stimulation is expected to become an important direction in tinnitus sound therapy.

Surgical treatment of primary malignant tumours of the distal tibia: clinical outcome and reconstructive strategies.

AIMS: We retrospectively report our experience of managing 30 patients with a primary malignant tumour of the distal tibia; 25 were treated by limb salvage surgery and five by amputation. We compared the clinical outcomes of following the use of different methods of reconstruction. PATIENTS AND METHODS: There were 19 male and 11 female patients. The mean age of the patients was 19 years (6 to 59) and the mean follow-up was 5.1 years (1.25 to 12.58). Massive allograft was used in 11 patients, and autograft was used in 14 patients. The time to union, the survival time of the reconstruction, complication rate, and functional outcomes following the different surgical techniques were compared. The overall patient survival was also recorded. RESULTS: Out of 14 patients treated with an autograft, 12 (86%) achieved union at both the proximal and distal junctions. The time to union at both junctions of the autograft was significantly shorter than in those treated with an allograft (11.1 vs 17.2 months, p = 0.02; 9.5 vs 16.2 months, p = 0.04). The complication rate of allograft reconstruction was 55%. The five patients treated with an amputation did not have a complication. Out of the 25 patients who were treated with limb salvage, three (12%) developed local recurrence and underwent amputation. The mean functional Musculoskeletal Tumor Society (MSTS) score after autograft reconstruction was higher than after allograft reconstruction (81% vs 67%; p = 0.06), and similar to that after amputation (81% vs 82%; p = 0.82). The two- and five-year overall rates of survival were 83% and 70%, respectively. CONCLUSIONS: This consecutive case series supports the safety of limb salvage and the effectiveness of biological reconstruction after the resection of a primary tumour of the distal tibia. Autograft might be a preferable option. In some circumstances, below-knee amputation remains a valid option.

Towards high-energy, high-resolution computed tomography via a laser driven micro-spot gamma-ray source.

Computed Tomography (CT) is a powerful method for non-destructive testing (NDT) and metrology awakes with expanding application fields. To improve the spatial resolution of high energy CT, a micro-spot gamma-ray source based on bremsstrahlung from a laser wakefield accelerator was developed. A high energy CT using the source was performed, which shows that the resolution of reconstruction can reach 100 µm at 10% contrast. Our proof-of-principle demonstration indicates that laser driven micro-spot gamma-ray sources provide a prospective way to increase the spatial resolution and toward to high energy micro CT. Due to the advantage in spatial resolution, laser based high energy CT represents a large potential for many NDT applications.

[A meta-analysis of prognosis after bipolar umbilical cord coagulation or radiofrequency ablation to reduce complicated monochorionic multiple pregnancies].

Objective: To evaluate the prognosis and complications after reduction of monochorionic multifetal pregnancies using bipolar umbilical cord coagulation (BCC) or radiofrequency ablation (RFA). Methods: A literature search were performed by using online databases including PubMed, Embase, and COCHRANE.The publications that described prognosis and complications after selective reduction of monochorionic twin pregnancies using either BCC or RFA for studies with clear outcome data were identified. Results: We identified five retrospective cohort studies for the meta-analysis and 231 cases of BCC and 174 cases of RFA.There was no statistical difference in overall survival after reduction between BCC group (79.2%) and RFA groups (76.4%) (RR=0.96; 95%CI: 0.86~1.08; P=0.48). Neonatal mortality was similar in both groups (8.2% vs 11.1%, respectively; RR=1.34; 95%CI: 0.60~2.99; P=0.48). However, intrauterine fetal death (IUFD) in the RFA group was 13.6%, and it significantly higher than that in the BCC group 7.7% (RR=2.15; 95%CI: 1.10~4.21; P=0.03). In contrast, after reduction, those in the RFA group had less preterm premature rupture of membranes (PPROM) compared with the BCC group (17.1% vs 27.5%, RR=0.58; 95%CI: 0.39~0.86; P=0.007). Conclusions: RFA and BCC groups have similar overall survival for complicated monochromic multiple pregnancies, but RFA was more prone to IUFD, and BCC tended to have more PPROM.Thus, procedures should be chosen according to specific clinical situations and pregnancy conditions.

Influence of ethanol on the metabolism of alprazolam.

BACKGROUND: Alprazolam is a commonly used benzodiazepine in clinical practice, and when coingested with ethanol, alprazolam can increase behavioral irritability and aggression. However, the mechanism of its interaction with ethanol remains unknown. RESEARCH DESIGN AND METHODS: The pharmacokinetics of alprazolam was studied in vivo in rat experiments involving the simultaneous administration of alprazolam and ethanol, and the interactions between ethanol and alprazolam were investigated in vitro in human liver microsomes. In silico molecular docking was applied to analyze the change in the CYP3A4-alprazolam-binding conformation when ethanol was coadministered with alprazolam. RESULTS: Compared with alprazolam administered alone (2 mg/kg), the Cmax of alprazolam increased when ethanol was simultaneously administered at 3 g/kg. The concentrations of alprazolam significantly increased by 39%, 17%, 105%, and 642% at 5, 10, 30, and 120 min intervals in the brain when coadministered with ethanol, respectively. Molecular docking results suggested that the conformation of CYP3A4 with alprazolam changed when ethanol was bound to the SER119 residue, which seems critical in the process of CYP3A4-alprazolam binding. CONCLUSIONS: Ethanol might increase the toxicity of alprazolam by inhibiting the activity of CYP3A4, although other pharmacokinetic processes may be affected. Ethanol could change the conformation of CYP3A4 and affect alprazolam binding.

[Neurofeedback therapy in the treatment of tinnitus].

Neurofeedback therapy is a fast-growing field of tinnitus treatment, which is a new type of biofeedback therapy. In the past, the "muscle tone" and "blood flow" were used as feedback signals in biofeedback therapy to treat tinnitus, however there was no long-term follow-up report. Instead, neurofeedback therapy utilizes EEG (electroencephalogram) as the feedback signal, which is also called EEG biofeedback therapy. At present, most treatments of tinnitus only record subjective measures of patients as evaluation indicators, whereas neurofeedback therapy is more convincing for using comprehensive evaluation including changes of brain wave as objective indicators and subjective measures of patients. A significant number of tinnitus patients have varying degree of hearing loss. As neurofeedback therapy takes advantage of EEG as feedback signal that is delivered to the patients through visual information, it has unique advantages of being not affected by the degree of hearing loss compared to the sound masking or other sound treatment. Long-term follow-up results showed that the efficacy of neurofeedback therapy was stable after half a year of short-term treatment. This paper summarizes the progress of the various types of biofeedback therapy in the treatment of tinnitus, and focuses on the neurofeedback therapy for the mechanism, indication, process, efficacy evaluation, defect and prospect of neurofeedback therapy in tinnitus treatment in order to help promote the development of domestic clinical neurofeedback therapy in tinnitus.

[The establishment of the immortalized mouse brain microvascular pericytes model and its preliminary application in screening of cerebrovascular toxicants].

Objective: To establish the immortalized mouse brain microvascular pericytes model and to apply to the cerebrovascular toxicants screening study. Methods: Brain pericytes were isolated from 3 weeks of mice by tissue digestion. Immortalized pericyte cell line was constructed by infecting with LT retrovirus. Monoclone was selected to purify the immortalized pericyte cell line. The pericyte characteristics and purity were explored by immunocytochemistry. Cell proliferation was measured by using the Pomega MTS cell Proliferation Colorimetric Assay Kit. Pericytes were treated with 0, 160, 320, 640, 1 280, 2 560 µmol/L lead acetate, 0, 5, 10, 20, 40, 80 µmol/L cadmium chloride and 0, 5, 10, 20, 40, 80 µmol/L sodium arsenite in 24 hours. Cell toxicity of each group was determined by MTS assay, median lethal dose (LD(50)) was calculated in linear regression. Results: Mouse brain pericytes were successfully isolated by tissue separation and enzyme digestion method. After immortalized by LT retroviruses, monoclone was selected and expanded to establish pericyte cell line. The brain pericytes exhibited typical long spindle morphology and positive staining for α-SMA and Vimentin. The proliferation of brain pericytes cell lines was very slowly, and the doubling time was about 48 hours. The proliferation of immortalized brain pericytes cell lines was very quickly, and the doubling time was about 24 hours. After lead acetate, cadmium chloride and sodium arsenite treatment for 24 hours respectively, gradual declines in cell viability were observed. The LD(50) of lead acetate was 2 025.0 µmol/L, the LD(50) of cadmium chloride was 36.6 µmol/L, and the LD(50) of sodium arsenite was 33.2 µmol/L. Conclusion: The immortalized mouse brain microvascular pericyte model is established successfully by infecting with LT retrovirus, and can be applied to screen cerebrovascular toxicants. The toxicity of these toxicants to immortalized mouse brain microvascular pericyte is in sequence: sodium arsenite,cadmium chloride, lead acetate.

[Cerebral cavernous malformation 3 gene deficiency promotes early changes in Alzheimer disease-like lesions induced by low lead exposure].

Objective: To investigate the effects of cerebral cavernous malformation 3 (CCM3) gene knockout on the lead exposure-induced blood-brain barrier malfunction in mice brain, and the relationship between CCM3 knockout and the Alzheimer's disease (AD). Methods: Wide type (WT) mice and CCM3(+)/- mice were divided into 4 groups, control group and lead exposed group in WT as well as CCM3(+/-) mice. Lead exposed groups were treated with 0.05% lead acetate in drinking water for 12 weeks, while control group drink deionized water freely. Blood lead and brain lead levels in each group were detected by graphite furnace atomic absorption spectrometry. The brain tissue of each group was made into paraffin sections, whose morphology were observed by HE staining. The expression of Aß(1-42) in brain tissue was detected by immunohistochemistry and the brain capillaries were labeled by VRGFR2. The protein expression of Claudin-5, ZO-1, and p-Tau was detected by Western blot. The brain tissue RNA was extracted and the relative expression of LRP-1 mRNA was detected by qRT-PCR. Results: The levels of blood lead WT (216.07±84.16) and CCM3(+/-) (189.64±101.86) µg/L in lead exposed group were higher than those in control group WT (19.52±11.46) and CCM3(+/-) (11.79±8.20) µg/L, the difference was statistically significant (t=4.18, P=0.006; t=3.79, P=0.016). The levels of brain lead WT (1.78±0.69) and CCM3(+/-) (1.74±0.66) µg/L were higher than those in control group WT (1.06±0.87) and CCM3(+/-) (0.97±0.64) µg/L, the difference was statistically significant (t=3.67, P=0.018; t=3.88, P=0.015). The HE staining showed no obvious lesions in the brain of each group of mice. The results of immunohistochemistry showed that there was no Aß(1)-42 deposition in the brain of mice in each group. The numbers of microvessels in the brain of CCM3(+/-) mice in the lead exposed group were decreased. Compared with the relative expression levels of Claudin-5 (WT: 1.30±0.03, CCM3(+/-): 1.07±0.08) in control group mice brain, the relative expression of Claudin-5 (WT: 0.96±0.04, CCM3(+/-): 0.59±0.01) was decreased with statistical significance (F=199.27, P<0.001). The relative expression level of LRP-1 gene mRNA in brain of lead exposed group (WT: 0.32±0.10, CCM3(+/-): 0.06±0.01) was higher than that of unexposed group (WT:1.00±0.06, CCM3(+/-):2.12±0.18), the difference was statistically significant (F=288.29, P<0.001). The relative expression level of LRP-1 gene mRNA in brain of CCM3(+)/- mice exposed to lead was lower than that of WT mice ((0.06±0.01)vs(0.32±0.10), t=26.90, P<0.001). Conclusion: The mice did not show significant AD-like lesions under low-does lead exposure, but resulted in early damage of brain blood-brain barrier and early changes of AD-like lesions in mice, with CCM3(+/-) mice being sensitive to lead exposure stronger than that of WT mice, suggesting that deletion of CCM3 gene may be one of the potential risk factors for accelerating the development of AD in mice exposed to lead.

CD14 gene polymorphisms associated with increased risk of bovine tuberculosis in Chinese Holstein cows.

Cluster differentiation antigen 14 (CD14) is an important pattern recognition receptor protein in innate immunity. The aim of this study was to identify and assess the association of single-nucleotide polymorphisms (SNPs) in the CD14 gene with susceptibility to bovine tuberculosis (BTB) in Chinese Holstein cows. DNA samples from 517 Chinese Holstein cows (257 tuberculosis positive cases and 259 healthy controls) were collected from dairy farms in China. SNPs in the entire CD14 gene, including exonic regions, intronic regions and close to the 5'- and 3'-terminal untranslated regions, were detected by PCR, followed by direct sequencing. Five SNPs (-5C/T, 613G/A, 1023G/A, 1306G/A and 1326G/T) were found in the CD14 gene region. Significantly increased BTB susceptibility was evident in T allele carriers of -5C/T (P<0.001; odds ratio, OR 2.02; 95% confidence interval, CI 1.57-2.77), G allele carriers of 613G/A (P<0.001; OR 2.17, 95% CI 1.50-3.08) and TG haplotype carriers of both SNPs (P<0.001; OR 3.14, 95% CI 1.24-4.50). These results suggest that -5C/T and 613G/A are risk factors for BTB in Chinese Holstein cattle and might be used as candidate genetic markers in breeding cows with natural resistance to BTB.

Forensic Analysis of 24 Cases of Long-term Antipsychotics Use-Induced Sudden Unexpected Deaths.

OBJECTIVES: To analyze the forensic characteristics of 24 psychiatric patients who died of long-term use of psychotropic drugs. METHODS: Cases of sudden death of psychiatric patients from 2011 to 2016 were collected. The forensic characteristics of these sudden deaths were retrospectively analyzed by systematic investigation plus results of autopsy and toxics （drugs）. RESULTS: Among the 24 psychiatric patients who died of long-term use of psychotropic substances, the ratio of male to female was 1.7∶1, and the average age was （59.0±8.8） years. Fifteen patients had clear disease durations （14.4±8.2） years, and other the nine were known to have disease durations of over 3 years. The death time of 62.5% of patients was the daytime in working days, and 91.7% of the patients died at home. Most patients complained different degrees of physical discomfort before death. Patients with schizophrenia （20 cases） were the most common, followed by depression （4 cases）. All patients had the history of taking psychotropic drugs, with clozapine and chlorpromazine being the mostly detected ones. The causes of death were mainly circulatory diseases （15 cases）, with the most common being myocarditis （11 cases） followed by pneumonia （4 cases）. CONCLUSIONS: Critical attention should be paid to the risk of antipsychotics-induced sudden unexpected deaths for psychiatric patients, particularly for those with schizophrenia.

[Study on the three-dimensional mapping to reduce the X-ray exposure dose of interventional doctors in radiofrequency catheter ablation of atrioventricular nodal reentry tachycardia].

Objective: To explore the advantage of radiofrequency catheter ablation under the three-dimensional mapping in the treatment of atrioventricular nodal reentrant tachycardia (AVNRT) in reducing the X-ray exposure dose of interventional doctors. Methods: 79 patients with AVNRT, in the first hospital of Shanxi Medical University from January 2015 to June 2016, performed to do radiofrequency catheter ablation treatment were selected, and according to the random number method were divided into two-dimensional mapping group and three-dimensional mapping group. The two-dimensional mapping group was mapped the ablation target at the X-ray, while the ablation target was mapped by CARTO 3 system in the three-dimensional mapping group. Compare the X-ray fluoroscopy time, success rate, complications rate and doctor's X-ray exposure dose between the two groups. Results: Compared with the two-dimensional mapping group, acute success rate and complication rate of the three dimensional mapping group were not statistically significant (P>0.05) , while the X-ray fluoroscopy time and the X-ray dose of the three-dimensional mapping group decreased significantly, the difference was statistically significant (P<0.05) . Conclusion: Three-dimensional mapping can significantly reduce the X-ray irradiation time and interventional doctor's X-ray exposure dose in radiofrequency catheter ablation of AVNRT patients and the potential hazards of ionizing radiation on the human body.

Mitigating ammonia emission from agriculture reduces PM2.5 pollution in the Hai River Basin in China.

The Hai River Basin (HRB), one of the most populated areas in China, is experiencing high NH3 emissions, mostly from agricultural sources, and suffering from strongly enhanced PM2.5 concentrations in all urban areas. Further population growth and urbanization projected until 2030 may exacerbate this situation. Here, the NUFER (NUtrient flows in Food chains, Environment and Resources use) and GAINS (Greenhouse gas - Air pollution Interactions and Synergies) models have been coupled for the first time to understand possible changes of agricultural NH3 emission between 2012 and 2030 and their impacts on ambient PM2.5 concentrations, and to explore options to improve this situation. Results show that agricultural ammonia emissions in the HRB were 1179kt NH3 in 2012, 45% of which was from the hotspots at or near conurbation areas, including Beijing-Tianjin, Tangshan-Qinhuangdao, Shijiazhuang-Baoding, Dezhou, Handan-Liaocheng, and Xinxiang. Without intervention, agricultural ammonia emissions will further increase by 33% by 2030. The impacts of several scenarios were tested with respect to air pollution. Compared to the business-as-usual scenario, a scenario of improved technology and management combined with human diet optimization could greatly reduce emission (by 60%), and lead to 22-43% and 9-24% decrease of the secondary inorganic aerosols and PM2.5 concentrations, respectively, in the hotspots of NH3 emissions. Our results further confirmed that ammonia control is needed for air pollution abatement strategies (SO2, NOx and primary PM reduction) to be effective in terms of PM2.5.