Deep Learning-Based Facial and Skeletal Transformations for Surgical Planning.

The increasing application of virtual surgical planning (VSP) in orthognathic surgery implies a critical need for accurate prediction of facial and skeletal shapes. The craniofacial relationship in patients with dentofacial deformities is still not understood, and transformations between facial and skeletal shapes remain a challenging task due to intricate anatomical structures and nonlinear relationships between the facial soft tissue and bones. In this study, a novel bidirectional 3-dimensional (3D) deep learning framework, named P2P-ConvGC, was developed and validated based on a large-scale data set for accurate subject-specific transformations between facial and skeletal shapes. Specifically, the 2-stage point-sampling strategy was used to generate multiple nonoverlapping point subsets to represent high-resolution facial and skeletal shapes. Facial and skeletal point subsets were separately input into the prediction system to predict the corresponding skeletal and facial point subsets via the skeletal prediction subnetwork and facial prediction subnetwork. For quantitative evaluation, the accuracy was calculated with shape errors and landmark errors between the predicted skeleton or face with corresponding ground truths. The shape error was calculated by comparing the predicted point sets with the ground truths, with P2P-ConvGC outperforming existing state-of-the-art algorithms including P2P-Net, P2P-ASNL, and P2P-Conv. The total landmark errors (Euclidean distances of craniomaxillofacial landmarks) of P2P-ConvGC in the upper skull, mandible, and facial soft tissues were 1.964 ± 0.904 mm, 2.398 ± 1.174 mm, and 2.226 ± 0.774 mm, respectively. Furthermore, the clinical feasibility of the bidirectional model was validated using a clinical cohort. The result demonstrated its prediction ability with average surface deviation errors of 0.895 ± 0.175 mm for facial prediction and 0.906 ± 0.082 mm for skeletal prediction. To conclude, our proposed model achieved good performance on the subject-specific prediction of facial and skeletal shapes and showed clinical application potential in postoperative facial prediction and VSP for orthognathic surgery.

[Epidemiological investigation of iron deficiency among preschool children in 10 provinces, autonomous regions, or municipalities in China].

Objective: To understand the current status of anemia, iron deficiency, and iron-deficiency anemia among preschool children in China. Methods: A cross-sectional study was conducted with a multi-stage stratified sampling method to select 150 streets or townships from 10 Chinese provinces, autonomous regions, or municipalities (East: Jiangsu, Zhejiang, Shandong, and Hainan; Central: Henan; West: Chongqing, Shaanxi, Guizhou, and Xinjiang; Northeast: Liaoning). From May 2022 to April 2023, a total of 21 470 children, including community-based children aged 0.5 to<3.0 years receiving child health care and kindergarten-based children aged 3.0 to<7.0 years, were surveyed. They were divided into 3 age groups: infants (0.5 to<1.0 year), toddlers (1.0 to<3.0 years), and preschoolers (3.0 to<7.0 years). Basic information such as sex and date of birth of the children was collected, and peripheral blood samples were obtained for routine blood tests and serum ferritin measurement. The prevalence rates of anemia, iron deficiency, and iron-deficiency anemia were analyzed, and the prevalence rate differences were compared among different ages, sex, urban and rural areas, and regions using the chi-square test. Results: A total of 21 460 valid responses were collected, including 10 780 boys (50.2%). The number of infants, toddlers, and preschoolers were 2 645 (12.3%), 6 244 (29.1%), and 12 571 (58.6%), respectively. The hemoglobin level was (126.7±14.8) g/L, and the serum ferritin level was 32.3 (18.5, 50.1) µg/L. The overall rates of anemia, iron deficiency, and iron-deficiency anemia were 10.4% (2 230/21 460), 28.3% (6 070/21 460), and 3.9% (845/21 460), respectively. The prevalence rate of anemia was higher for boys than for girls (10.9% (1 173/10 780) vs. 9.9% (1 057/10 680), χ2=5.58, P=0.018), with statistically significant differences in the rates for infants, toddlers and preschoolers (18.0% (475/2 645), 10.6% (662/6 244), and 8.7% (1 093/12 571), respectively, χ2=201.81, P<0.01), and the rate was significantly higher for children in rural than that in urban area (11.8% (1 516/12 883) vs. 8.3% (714/8 577), χ2=65.54, P<0.01), with statistically significant differences in the rates by region (χ2=126.60, P<0.01), with the highest rate of 15.8% (343/2 173) for children in Central region, and the lowest rate of 5.3% (108/2 053) in Northeastern region. The prevalence rates of iron deficiency were 33.8% (895/2 645), 32.2% (2 011/6 244), and 25.2% (3 164/12 571) in infants, toddlers, and preschoolers, respectively, and 30.0% (3 229/10 780) in boys vs. 26.6% (2 841/10 680) in girls, 21.7% (1 913/8 821), 40.0% (870/2 173), 27.1% (2 283/8 413), 48.9% (1 004/2 053) in Eastern, Central, Western, and Northeastern regions, respectively, and each between-group showed a significant statistical difference (χ2=147.71, 29.73, 773.02, all P<0.01). The prevalence rate of iron-deficiency anemia showed a significant statistical difference between urban and rural areas, 2.9% (251/8 577) vs. 4.6% (594/12 883) (χ2=38.62, P<0.01), while the difference in iron deficiency prevalence was not significant (χ2=0.51, P=0.476). Conclusions: There has been a notable improvement in iron deficiency and iron-deficiency anemia among preschool children in China, but the situation remains concerning. Particular attention should be paid to the prevention and control of iron deficiency and iron-deficiency anemia, especially among infants and children in the Central, Western, and Northeastern regions of China.

Distinct forebrain regions define a dichotomous astrocytic profile in multiple system atrophy.

The growing recognition of a dichotomous role of astrocytes in neurodegenerative processes has heightened the need for unraveling distinct astrocytic subtypes in neurological disorders. In multiple system atrophy (MSA), a rare, rapidly progressing atypical Parkinsonian disease characterized by increased astrocyte reactivity. However the specific contribution of astrocyte subtypes to neuropathology remains elusive. Hence, we first set out to profile glial fibrillary acidic protein levels in astrocytes across the human post mortem motor cortex, putamen, and substantia nigra of MSA patients and observed an overall profound astrocytic response. Matching the post mortem human findings, a similar astrocytic phenotype was present in a transgenic MSA mouse model. Notably, MSA mice exhibited a decreased expression of the glutamate transporter 1 and glutamate aspartate transporter in the basal ganglia, but not the motor cortex. We developed an optimized astrocyte isolation protocol based on magnetic-activated cell sorting via ATPase Na+/K+ transporting subunit beta 2 and profiled the transcriptomic landscape of striatal and cortical astrocytes in transgenic MSA mice. The gene expression profile of astrocytes in the motor cortex displayed an anti-inflammatory signature with increased oligodendroglial and pro-myelinogenic expression pattern. In contrast, striatal astrocytes were defined by elevated pro-inflammatory transcripts accompanied by dysregulated genes involved in homeostatic functions for lipid and calcium metabolism. These findings provide new insights into a region-dependent, dichotomous astrocytic response-potentially beneficial in the cortex and harmful in the striatum-in MSA suggesting a differential role of astrocytes in MSA-related neurodegenerative processes.

TSUnet-CC: Temporal Spectrogram Unet embedding Cross Channel-wise attention mechanism for MDD identification.

Automatic detection of major depressive disorder (MDD) with multiple-channel electroencephalography (EEG) signals is of great significance for treatment of the mental diseases. In a U-net network, clear EEG signals are fed to obtain temporal feature tensor through encoder and decoder networks with several convolution operations. Moreover, the clear EEG signals can be converted into multi-scale spectrogram to obtain the rich saliency information and then the spectrogram feature tensor can be extracted by another symmetrical U-net. The temporal and spectrogram feature tensors can provide more comprehensive information, but may also contain redundant information, which may affect the detection of MDD. To deal with such issue, this paper proposed a novel Temporal Spectrogram Unet (TSUnet-CC), which embeds the cross channel-wise attention mechanism for multiple-channel EEGbased MDD identification. We make three novel contributions: 1) multi-scale saliency-encoded spectrogram using Fourierbased approach to capture rich saliency information under different scales, 2) TSUnet network using a symmetrical twostream U-net architecture that learns multiple temporal and spectrogram feature tensors in time and frequency domains, and 3) cross channel-wise block enabling the larger weights of key feature channels that contain MDD information. The leaveone-subject-out experiments show that our proposed TSUnetCC gains high performance with a classification accuracy up to 98.55% and 99.22% in eyes closed and eyes open datasets, which outperformed some state-of-the-art methods and revealed its clinical potential.

Differences between trapeziometacarpal arthrodesis and trapeziectomy with ligament reconstruction for the treatment of trapeziometacarpal osteoarthritis: a systematic review and meta-analysis.

The optimal management of trapeziometacarpal (TMC) osteoarthritis remains controversial. This meta-analysis assessed the subjective and objective outcomes of trapeziometacarpal arthrodesis (TMA) versus trapeziec-tomy with ligament reconstruction (LRTI). The PubMed, Cochrane Library, Embase, Web of science data-bases were searched from inception to June 30, 2022. Keywords included "trapeziometacarpal osteoarthrosis", "trapeziometacarpal arthrodesis" and "trapeziectomy with ligament reconstruction". Randomized controlled trials (RCTs) and controlled clinical trials (CCTs) including patients treated for TMC osteoarthritis were included. The subjective outcomes visual analogue scale (VAS) , Patient-Rated Wrist and Hand Evaluation (PRWHE), Disabilities of arm, shoulder and hand (DASH) scores, Kapanji scores, objective outcomes total interphalangeal (IP) and metacarpophalangeal (MCP) joint motion, palmar abduction, grip strength, tip, key pinch strength and complications were extracted. The methodological quality of each was assessed in- dependently. Meta-analysis was performed for comparative trials. From the 5 included studies (2 RCTs, 3 CCTs), 208 cases were divided into TMA group (n = 107) and LRTI group (n =101) groups. Compared with the TMA group, PRWHE, tip pinch strength and palmar abduction was better in the LRTI group. There was no statistical difference in DASH score, VAS, kapandji score, grip strength, key pinch strength, total IP joint motion, total MCP joint motion and complications. The LRTI group had more obvious advantages in term of PRWHE, tip pinch strength and palmar abduction. Moreover, there was no statistical difference in DASH score, VAS, kapandji score, grip strength, key pinch strength, total IP joint and total MCP joint motion and complications. Therefore, we concluded LRTI was more recommendable for more management of TMC osteoarthritis. Certainly, high-quality studies are required in long-term follow-up.

[Clinicopathological analysis of primary gastric (gastrointestinal)-type mucoglandular lesion of endometrium].

Objective: To investigate the clinical and pathological features of primary gastric (gastrointestinal)-type mucoglandular lesions of the endometrium. Methods: Eight cases of primary gastric (gastrointestinal)-type mucoglandular lesions of endometrium diagnosed between 2014 to 2022 were retrieved from pathology archives of the Obstetrics and Gynecology Hospital Affiliated to Fudan University, Shanghai, China. The clinical history, pathological sections and follow-ups were analyzed. Results: The eight patients ranged in age from 35 to 67 years, with an average age of 55.5 years. Seven patients were examined for high-risk human papillary virus (HPV) before operation. Only one of them was positive for high-risk HPV52. No cervical mucinous lesions were found in any of the patients. Two cases were invasive gastric (gastrointestinal)-type adenocarcinoma, 2 cases were benign gastric (gastrointestinal)-type mucinous metaplasia, and the other 4 cases were atypical gastric (gastrointestinal)-type mucinous gland hyperplasia. Microscopically, tumor cells showed mucous epithelium with gastrointestinal differentiation. Immunophenotyping showed that MUC6 was diffusely or focally positive in 5 cases, CK20 and CDX2 were positive in 3 cases. And p16 was negative or focally positive in 5 cases and strongly positive in 1 case. ER was expressed in both benign and atypical lesions, and weakly positive or negative in the invasive adenocarcinoma. p53 showed mutant expression in one case and wild-type expression in the rest. HPV in situ hybridization was negative. Conclusions: Primary gastric (gastrointestinal)-type mucoglandular lesions of the endometrium show various forms of gastrointestinal differentiation, which are high-risk HPV independent. Morphology combined with immunohistochemistry is helpful for the diagnosis, which can only be made on exclusion of cervical gastrointestinal glandular lesion, gastrointestinal metastatic carcinoma and the mucinous subtype of endometrioid carcinoma.

Deacetylation of FOXO4 by Sirt1 stabilizes chondrocyte extracellular matrix upon activating SOX9.

OBJECTIVE: FOXO4 has essential roles in cellular metabolism and prevents cartilage degeneration in osteoarthritis (OA). Here we aim to provide evidence that deacetylated-FOXO4 stabilizes chondrocyte (CH) extracellular matrix (ECM) related to SOX9 activation. PATIENTS AND METHODS: We used Chromatin immunoprecipitation (ChIP) and Dual-Luciferase reporter assay to verify that the FOXO4 protein activates SOX9 by binding to its promoter. We cultured human CHs with IL-1ß to cause degeneration and supplied Sirt1 protein to deacetylate FOXO4. To confirm the function of FOXO4 and SOX9 during CHs degeneration, we also used the FOXO4 and SOX9 silenced CHs by siRNA transfection as a comparison. Western blot assay was used to analyze the protein level of Sirt1, SOX9, and the acetylated condition of FOXO4. Besides, RT-PCR was used to measure the mRNA level of collagen I/II/X, aggrecan, MMP-13, and ADAMTS-5 for determining the ECM states. RESULTS: FOXO4 protein transcriptionally activates SOX9 expression by binding to its promoter. Under the IL-1ß stimulation, FOXO4 acetyl-lysine rate increased, and the SOX9 protein expression decreased, which was alleviated after the supplement of exogenic Sirt1 protein. Meanwhile, Sirt1 overexpression increased the collagen II and aggrecan and reduced the collagen I, collagen X, MMP-13, and ADAMTS-5 mRNA expression. However, the silencing of FOXO4 abolished the Sirt1 induced SOX9 expression and weakened the ECM production stability. Additionally, SOX9 silencing also alleviated the effect of the Sirt1 supplement on the degenerated CHs, though the FOXO4 was highly deacetylated. CONCLUSIONS: FOXO4 acetylation aggravates during the degeneration of CHs, and the deacetylation of FOXO4 by Sirt1 could activate the SOX9 expression and result in maintaining the ECM stability of cartilage.

[Risk factors of postoperative pulmonary infection of gastric cancer and perioperative intervention measures].

Gastric cancer is a common digestive system malignancy. Surgical operation is the main treatment of radical treatment for gastric cancer. Pulmonary infection is a common postoperative complication of gastric cancer. Because there is no clear and unified definition of pulmonary complications, the current researches show that the incidence of postoperative pulmonary infection of gastric cancer is about 1.8%-18.1%. The incidence of postoperative pulmonary infection will prolong the hospital stay, increase the cost of hospitalization, and even develop into respiratory failure leading to early postoperative death. There are many factors affecting postoperative pulmonary infection of gastric cancer, including age, smoking history, pulmonary function, pulmonary disease history, operation method, operation time, intraoperative bleeding volume, gastric tube retention time, postoperative lying time and so on. There are also many perioperative interventions. This article reviews the risk factors and perioperative interventions of postoperative pulmonary infection of gastric cancer.

[Application of ultrasound in the diagnosis and preoperative evaluation of cystic hepatic echinococcosis].

Objective: To investigate the value of ultrasound in the diagnosis and preoperative evaluation of cystic hepatic echinococcosis. Methods: The data of 59 patients (102 lesions) with cystic hepatic echinococcosis confirmed by surgical pathology and serological examination in the Fifth Medical Center of PLA General Hospital from January 2018 to December 2019 were retrospectively analyzed, including 23 males and 36 females; age13 to 64 (42±6) years. The ultrasonographic manifestations were classified, and the involvement of the lesions in the blood vessels and bile ducts was determined. The coincidence rate between ultrasound diagnosis of hepatic echinococcosis and surgical pathology was compared, and the accuracy, sensitivity and specificity of ultrasounic diagnosis of hepatic echinococcosis were analyzed. Results: Ultrasound showed 12 CE1 type lesions, 24 CE2 type lesions, 16 CE3a type lesions, 6 CE3b type lesions, 34 CE4 type lesions, and 10 CE5 type lesions. The coincidence rates of hydatid ultrasound and surgical pathological classification were 91.66% (11/12), 95.80% (23/24), 93.75% (15/16), 83.33% (5/6), 91.17% (31/34) and 100.00% (10/10), respectively. Ultrasound diagnostic efficiency analysis: the accuracy of classification was 94.12%, the sensitivity was 96.94%, and the specificity was 25%. Among the characteristic ultrasound manifestations, the gyrus sign and the polycystic sign were the most frequent, followed by homogeneous thickening of the cyst wall, double wall, separation of the inner cyst wall, and thick wall calcification. There were significant differences between ultrasound in the determination of lesions involving blood vessels and bile ducts and intraoperative findings (all P<0.05). Conclusion: Ultrasound could clearly diagnose cystic hepatic echinococcosis, could better display the imaging characteristics of the disease, and had important clinical significances in indicating the evolution of the disease and determining the involvement of the lesions in the blood vessels and bile ducts.

China's experience in COVID-19 prevention and control among children in its different regions.

OBJECTIVE: To summarize the experience of three Chinese cities (Wuhan, Shanghai and Haikou) and provide a reference for global efforts to combat COVID-19 spread among children. MATERIALS AND METHODS: Through collecting the measures and outcomes of preventing and controlling COVID-19 in China's three hospitals, we compared the effect of different strategies. RESULTS: From January to March 2020, the number of suspected and confirmed COVID-19 cases in Wuhan increased exponentially, and Wuhan Children's Hospital as a whole was transformed into a designated quarantine and treatment facility, which is the "Wuhan Model". Shanghai has more children's hospitals with better capabilities to tackle public health emergency. Besides, it is far away from Wuhan and had a small caseload. Children's Hospital of Fudan University, a facility in Shanghai to treat pediatric infectious diseases, is famous for its well-equipped building for infectious disease treatment and professional medical team, and therefore no major transformation was required. That is the "Shanghai Model". Haikou is located on an island. Amid the outbreak, large numbers of tourists and travelers from Hubei had already arrived in Haikou. Hainan Women and Children's Medical Center, as the only pediatric care hospital in Hainan Province, did not have a separate building for infectious disease treatment. After a citywide survey of the medical resources and facilities available, a temporarily idle hospital 3 kilometers away from Hainan Women and Children's Medical Center was requisitioned as the quarantine and treatment facility for pediatric cases. That is the "Hainan Model". The three models enabled the treatment of all suspected and confirmed cases and no fatality was reported. CONCLUSIONS: The COVID-19 coping strategies for children should be designed according to the existing conditions of the local children's hospitals and the risk levels of the epidemic.

Nanofibrillar networks enable universal assembly of superstructured particle constructs.

Superstructured colloidal materials exploit the synergies between components to develop new or enhanced functions. Cohesion is a primary requirement for scaling up these assemblies into bulk materials, and it has only been fulfilled in case-specific bases. Here, we demonstrate that the topology of nanonetworks formed from cellulose nanofibrils (CNFs) enables robust superstructuring with virtually any particle. An intermixed network of fibrils with particles increases the toughness of the assemblies by up to three orders of magnitude compared, for instance, to sintering. Supramolecular cohesion is transferred from the fibrils to the constructs following a power law, with a constant decay factor for particle sizes from 230 nm to 40 µm. Our findings are applicable to other nanofiber dimensions via a rationalization of the morphological aspects of both particles and nanofibers. CNF-based cohesion will move developments of functional colloids from laboratory-scale toward their implementation in large-scale nanomanufacturing of bulk materials.

Potential effects of IL-17A rs2275913 and IL-17F rs763780 polymorphisms on susceptibility to gastric cancer in Chinese population: a meta-analysis.

OBJECTIVE: This meta-analysis aims to clarify the effect of IL-17 polymorphisms on the susceptibility to GCa in the Chinese population. MATERIALS AND METHODS: Relevant pieces of literature were searched in PubMed, Web of School, VIP, and CNKI using the key words as "IL-17, gastric/stomach cancer" or "IL-17 polymorphisms, gastric/stomach cancer susceptibility". The odds ratio (OR) and 95% confidence interval (CI) in the selected studies were calculated using RevMan5.3 and STATA12.0. RESULTS: A total of 12 investigations reporting mutations in IL-17A rs2275913 and IL-17F rs763780 were enrolled. There were 11 studies reporting rs2275913 G>A, involving 3299 cases of GCa patients and 3339 cases of healthy controls. The random-effects model was performed since the heterogeneity test results of the recessive genetic model (GG&GA vs. AA) and the allelic model (G vs. A) of IL-17A rs2275913 G>A were I2>66%/p=0.001. Meanwhile, the dominant genetic model (GG vs. GA&AA) and the super-dominant genetic model (GA vs. GG&AA) of IL-17A rs2275913 G>A were I2< 50%/p>0.05, and the fixed-effects model was used. The meta-analysis showed that IL-17A rs2275913 G>A was positively correlated with GCa susceptibility under four genetic models (p<0.05). Five studies reporting IL-17F rs763780 T>C were enrolled, including 2535 cases of GCa patients and 2402 cases of healthy controls. The heterogeneity test showed that, except for the super-dominant genetic model, the p-value was <0.00001 in the dominant, recessive, and allelic models, and their I2 values were 87%, 88%, and 93%, respectively. Hence, a random-effects model was selected. IL-17F rs763780 T>C was positively correlated with GCa susceptibility under the super-dominant genetic model (p=0.003), rather than the other three models (p>0.05). CONCLUSIONS: IL-17A rs2275913 G>A polymorphism contributes to susceptibility to GCa in the dominant, recessive, allelic, and super-dominant models. Meanwhile, IL-17F rs763780 T>C polymorphism is positively correlated with GCa susceptibility in the super-dominant model.

Tea consumption and risk of fractures: an updated meta-analysis.

This meta-analysis included 16 studies, involving seven cohort studies and nine case-control studies, and the results indicated that tea consumption may be associated with a reduced the risk of fractures. INTRODUCTION: Regarding relationship of tea consumption with the risk of fractures remains controversial. We performed a meta-analysis to elucidate the association between tea consumption and the risk of fractures. METHODS: Relevant articles were identified up to March 2019 by searching PubMed, Web of Science, and Embase databases. The pooled relative risks (RRs) with 95% confidence intervals (CIs) were computed utilizing fixed or random effects model based on heterogeneity. RESULTS: Altogether 16 studies (seven cohort and nine case-control studies) were included in this meta-analysis, involving 772,707 participants with 37,166 fracture cases. The RRs (95% CIs) of fracture for the highest versus lowest category of tea consumption were 0.86 (0.78-0.94). Subgroup analysis indicated significant associations in cohort studies (0.90 (0.86-0.94)) and case-control studies (0.77 (0.69-0.85)). CONCLUSIONS: The current meta-analysis indicates that tea consumption may be associated with a reduced the risk of fractures.

[Curative effects of Ningmitai capsules on the residual fragments and postoperative complications following lithotripsy treatment of upper urinary calculi].

Objective: To observe the clinical efficacy of Ningmitai capsules, a traditional Chinese medicine using for clearing heat and dampness, in the treatment of residual fragments and postoperative complications following lithotripsy for upper urinary stones. Methods: During October 2016 and March 2018, patients from Wuhan 1st Hospital, Wuhan 2nd Hospital, Wuhan 3rd Hospital, and Wuhan Puai Hospital having upper urinary residual fragments following minimally-invasive stone treatment were randomly assigned to control group and Ningmitai group with a proportion of 1∶3. The patients in control group were treated with antibiotics or sodium diclofenac suppository on demand, while patients in Ningmitai group took additional Ningmitai capsule orally (4 capsules per time, 3 times per day). The observation was started when a patient was enrolled in this study and continued for a maximum of 12 weeks or until stone-free status. During the observation, the stone expulsion time, stone-free time, stone-free rate were observed, and the difference in curative effect between the two groups on postoperative complications such as pain and infection were compared. Statistical analysis was done using t-test or χ2 test by GraphPad Prism 5 software. Results: Totally 269 cases enrolled in this study. Eighty-six patients were from Wuhan 1st Hospital, 69 patients from Wuhan 2nd Hospital, 58 patients from Wuhan 3rd Hospital, 56 patients from Wuhan Puai Hospital, respectively. There were 66 cases in control group and 203 cases in Ningmitai group. The residual fragments expulsion time in Ningmitai group was significantly earlier than that in control group ((4.5±0.4) days vs. (7.5±1.3) days, t=2.877, P=0.004), the residual fragments clearance time in Ningmitai group was significantly shorter than that in control group ((13.6±1.0) days vs.(25.6±3.8) days, t=4.252, P=0.000), and the stone-free rate within 4 weeks post operation in Ningmitai group was significantly higher than control group (91.6% vs. 68.2%, χ2=22.57, P=0.000). After 12 weeks of treatment, the total effective rate of control group was 89.4%, and the total effective rate of Ningmitai group was 99.5%, with statistically significant difference (χ2=17.65, P=0.000). The proportion of caregivers that offered analgesia in Ningmitai group was significantly lower than that in control group (16.3% vs. 30.3%, χ2=6.212, P=0.013), the recovery rate of routine urinalysis following 4 weeks' treatment was significantly higher in Ningmitai group than that in control group (88.2% vs.71.2%, χ2=10.67, P=0.001). No obvious adverse effects were observed in both groups. Conclusions: Ningmitai capsule can facilitate the stone passage and increase the stone-free rate in the treatment of residual fragments and postoperative complications of upper urinary stones. It is also helpful for the prevention and treatment of postoperative pain, infection and other complications.

[Etiological analysis on patients with vertigo or dizziness].

Objective: To explore the spectrum of causes for patients with vertigo or dizziness in the Department of Neurology, and provide a reference for diagnosis and treatment of patients with vertigo or dizziness. Methods: Clinical data of patients in the Department of Neurology, Baotou Central Hospital between January 2016 and September 2017 was retrospectively analyzed. The target group under study was diagnosed based on the uniform diagnostic criteria. Results: A total of 9 200 patients with a chief complaint of vertigo or dizziness were included. The ratio of male to female was 1∶1.8, with an age range of 19 to 85 years. The different etiology was as follows: benign paroxysmal positional vertigo (BPPV) (3 148 cases, 34.22%), persistent postural-perceptual dizziness (PPPD) (2 006 cases, 21.80%), vertigo caused by cerebrovascular diseases (1 463 cases, 15.90%), vestibular neuritis (741 cases, 8.05%), vestibular migraine (536 cases, 5.83%), vestibular paroxysmia (336 cases, 3.65%), Ménière disease (187 cases, 2.03%), drug-induced vertigo (96 cases, 1.04%), neurological degenerative diseases (74 cases, 0.80%), sudden sensorineural hearing loss (51 cases, 0.55%), multiple sclerosis and neuromyelitis optica (21 cases, 0.23%), other reasons (22 cases, 0.24%), unknown reasons (519 cases, 5.64%). Conclusions: Dizziness is resulted from various causes, and BPPV is the most common reason. Vertigo caused by cerebrovascular diseases appears to gradually increase along with age. PPPD is very common in clinical practice, so clinicians needs to be highly aware of BPPV and PPPD. Although those dizziness diseases have a low incidence, they should not be ignored. There are still certain proportion of vertigo patients whose diagnosis are undetermined.

Serum uric acid level and left ventricular hypertrophy in elderly male patients with nonvalvular atrial fibrillation.

BACKGROUND AND AIMS: Recent studies have suggested that serum uric acid (SUA) induces oxidative stress and inflammation, which are involved in the mechanism of cardiac hypertrophy. In patients with atrial fibrillation (AF), comorbidity of left ventricular hypertrophy (LVH) exacerbates cardiac function. In this study, we investigated the association between SUA and cardiac hypertrophy in AF patients. METHODS AND RESULTS: Initially, 1296 consecutive elderly patients (age >60) with nonvalvular AF were retrospectively selected from the inpatient clinic between January 2012 and April 2015. Demographic, clinical, and echocardiographic characteristics were carefully recorded. The final study population was 577 patients. The mean SUA level was significantly higher in patients with LVH than those without LVH. Compared with the non-LVH group, the LVH group was older, had a higher percentage of female patients, and had lower hemoglobin levels and estimated glomerular filtration rates. Patients in the LVH group also had a higher rate of coronary heart disease and fewer had history of radiofrequency ablation compared with the non-LVH group. In the hyperuricemia group, B-type natriuretic peptide levels, left atrial diameter, left ventricular mass index, and percentage of NYHA (New York Heart Association) class III/IV were significantly higher than the SUA normal group. Multivariate logistic regression analysis indicated the independent risk factors for LVH in elderly AF patients included SUA, age, male sex, the presence of coronary heart disease, and diuretic therapy. Subgroup analysis identified SUA as a significant risk factor associated with LVH in men. CONCLUSIONS: SUA was independently associated with LVH in elderly male patients with nonvalvular AF.

Quantifying connectivity in a physiology based model using adaptive dynamic causal modelling.

This paper proposes an Adaptive Dynamic Causal Modelling based approach to detect and quantify effective connectivity in human brain structures injured by epileptic activities. The identification of the parameters in the physiology based model subtended the Electroencephalographic observations is performed by improving the optimization step in the Expectation Maximization algorithm. Considering unidirectional flow propagation, we show the efficiency of our proposed approach compared to the conventional technique.