Efficacy and safety of noninvasive high-frequency oscillatory ventilation in the treatment of respiratory distress syndrome in premature infants : a Meta-analysis / 中国新生儿科杂志

Objective:To evaluate the efficacy and safety of noninvasive high-frequency oscillatory ventilation (nHFOV) as the initial ventilation mode for respiratory distress syndrome (RDS) in premature infants.Methods:From the establishment of the databases [(PubMed, Embase, Cochrane Library, CNKI, Wanfang database, CQVIP and CBM (SinoMed)] to March 1, 2022, literature on randomized controlled trials (RCTs) using nHFOV and nasal continuous positive airway pressure(NCPAP) as the initial ventilation modes for RDS in premature infants were searched. The qualities of the included literature were evaluated according to Cochrane Evaluation Manual. RevMan 5.4 software was used for Meta-analysis.Results:Seven RCTs involving 786 children were included for the final Meta-analysis, with 395 cases in the nHFOV group and 391 cases in the NCPAP group. The results showed that the nHFOV group had lower intubation rates than the NCPAP group ( OR=0.34, 95% CI 0.22~0.51, P<0.001). No significant differences existed in mortality rates and complication rates between the two groups ( P>0.05). Conclusions:nHFOV as the initial treatment for RDS in premature infants may reduce the incidence of early treatment failure without increasing complications.

The expression of miR-876-3p based on a rat model of bronchopulmonary dysplasia induced by hyperoxia / 中国小儿急救医学

Objective:To establish a neonatal rat bronchopulmonary dysplasia(BPD) model induced by hyperoxia, to detect the expression of miR-876-3p in the lung tissue, and to analyze the role of miR-876-3p in the occurrence and development of BPD, so as to provide a theoretical basis for the pathogenesis, prevention and treatment of BPD.Methods:Eighty newborn SD rats were randomly divided into hyperoxia group(FiO 2 60%) and air group(FiO 2 21%). Lung tissue samples were taken on the 1st, 7th, 14th and 21st day after birth, the pathological changes of lung tissue were observed.Quantitative real-time PCR technique was used to detect the expression level of miR-876-3p. Results:Within 21 days after birth, with the prolongation of hyperoxia exposure time, the general growth of rats in hyperoxia group were lower than those in air group[14 d: (35.46±1.62) g vs.(37.08±1.25) g; 21 d: (51.92±1.83) g vs.(58.87±2.43) g]( P<0.05). On the 14th and 21st day after birth, the radial alveolar counts in lung tissue of rats in hyperoxia group were significantly reduced compared with those in air group( P<0.05). On the 7th, 14th and 21st day after birth, the alveolar septal thickness of rats in air group were lower than those in hyperoxia group( P<0.05). The expression level of miR-876-3p in hyperoxia group decreased gradually and was significantly lower on the 7th, 14th and 21st day compared with air group at the same time points[7 d: (14.97±1.13) vs.(16.64±0.89); 14 d: (11.92±0.71) vs.(16.85±0.79); 21 d: (11.39±0.79) vs.(17.52±1.17)], and the differences were all statistically significant( P all<0.01). Conclusion:In this study, a new BPD model of neonatal rats can be induced by hyperoxia and the expression level of miR-876-3p in this model is decreased.The differential expression level of miR-876-3p may play a role in the occurrence and development of BPD.

Method establishment of components identification and content determination of index components in Gantaishu capsules / 中国药房

OBJECTIVE To establish methods to identify the chemical components of Gantaishu capsule， and determine the contents of 6 index components including glycyrrhizic acid. METHODS The chemical components of Gantaishu capsule were determined by HPLC-TOF/MS； the contents of 6 index components including glycyrrhizic acid were determined by UPLC-MS/MS. RESULTS A total of 41 chemical components were identified in Gantaishu capsules. The linear ranges of glycyrrhizic acid， mangiferin， luteolin， costunolide， oleanolic acid and berberine were 200-10 000 ng/mL（r were all greater than 0.999）. The limits of quantification were 200， 20， 10， 1， 10， 0.5 ng/mL， and the limits of detection were 100， 10， 5， 0.5， 5， 0.25 ng/mL， respectively； RSDs of precision， stability （24 h） and reproducibility tests were all less than 5.0% （n＝6 or n＝3）； the recoveries were 99.05%-101.08% （RSD were all less than 2.0%， n＝6）. The contents of them were 2.42-2.66， 0.85-1.16， 0.35-0.46， 6.18- 6.46， 0.99-1.29， 5.22-5.56 mg/g. CONCLUSIONS The established methods for identification and content determination are rapid and simple， and can be used for the identification of chemical components and the content determination of index components in Gantaishu capsule.

Study on the Quality Control Standard of Lvxintong Rugao / 药学实践杂志

Objective To establish a quality control method for Lvxintong Rugao. Methods Ketoconazole, Halcinonide and Neomycin sulfate were identified by TLC. The content of Ketoconazole and Halcinonide were determined by HPLC. The chromatographic column of Agilent ZORBAX SB-C18 (4.6 mm×150 mm, 5 μm) column was used. Methanol-phosphate buffer (pH=7.40, 75:25) was applied as the mobile phase. The detection wavelength was 235 nm. The flow rate was 1.0 ml/min and the column temperature was set at room temperature. Neomycin Sulfate was determined by polarimetric analysis. Results The identification and determination methods showed good specificity. Ketoconazole and Halcinonide displayed good linearity within the range of 1.999~39.98 μg (r=0.999 9) and 0.400 8~8.016 μg (r=0.999 9), respectively. The average recoveries were 97.75% (RSD 0.77%) and 97.57% (RSD 0.84%), respectively. For the determination of Neomycin Sulfate, r=0.999 6 (n=6) in the range of 130.4~2 608 U/ml (n=6). The precision and repeatability of RSD were 1.1% and 1.6%, respectively. The solutions were stable in 6 h and the average recovery was 98.8% (RSD 2.6%). Conclusion The method could be used as the quality control method for Lvxintong Rugao.

Sustained release of alginate hydrogel containing antimicrobial peptide Chol-37(F34-R) in vitro and its effect on wound healing in murine model of Pseudomonas aeruginosa infection

Background@#Antibiotic resistance is a significant public health concern around the globe.Antimicrobial peptides exhibit broad-spectrum and efficient antibacterial activity with an added advantage of low drug resistance. The higher water content and 3D network structure of the hydrogels are beneficial for maintaining antimicrobial peptide activity and help to prevent degradation. The antimicrobial peptide released from hydrogels also hasten the local wound healing by promoting epithelial tissue regeneration and granulation tissue formation. @*Objective@#This study aimed at developing sodium alginate based hydrogel loaded with a novel antimicrobial peptide Chol-37(F34-R) and to investigate the characteristics in vitro and in vivo as an alternative antibacterial wound dressing to treat infectious wounds. @*Methods@#Hydrogels were developed and optimized by varying the concentrations of crosslinkers and subjected to various characterization tests like cross-sectional morphology, swelling index, percent water contents, water retention ratio, drug release and antibacterial activity in vitro, and Pseudomonas aeruginosa infected wound mice model in vivo. @*Results@#The results indicated that the hydrogel C proved superior in terms of cross-sectional morphology having uniformly sized interconnected pores, a good swelling index, with the capacity to retain a higher quantity of water. Furthermore, the optimized hydrogel has been found to exert a significant antimicrobial activity against bacteria and was also found to prevent bacterial infiltration into the wound site due to forming an impermeable barrier between the wound bed and external environment. The optimized hydrogel was found to significantly hasten skin regeneration in animal models when compared to other treatments in addition to strong inhibitory effect on the release of pro-inflammatory cytokines (interleukin-1β and tumor necrosis factor-α). @*Conclusions@#Our results suggest that sodium alginate -based hydrogels loaded with Chol-37(F34-R) hold the potential to be used as an alternative to conventional antibiotics in treating infectious skin wounds.

The clinical and neuroelectrophysiological characteristics of patients with sudden unexpected death in epilepsy / 中华神经科杂志

Objective:To investigate the clinical and electrophysiological characteristics of patients with sudden unexpected death of epilepsy (SUDEP).Methods:Using "epilepsy" as the keyword, the relevant cases entered from October 2011 to March 2012 were searched in the database of the Electroencephalogram (EEG) Monitoring Center, Xijing Hospital, the Air Force Military Medical University. Telephone follow-up was conducted for all confirmed epilepsy patients, and for the death cases confirmed by telephone follow-up, the patients identified as consistent with SUDEP diagnosis were included in this study based on their past medical history, clinical data, death details, etc, and their clinical and neuroelectrophysiological characteristics were summarized and analyzed.Results:Among the 1 232 patients who underwent 24-hour video-EEG monitoring during the study period, 354 patients were successfully followed up by telephone interview, of whom 17 patients were died (4.8%), 12 individuals met the diagnosis of SUDEP (7 men, 5 women). The duration of the disease in 9 patients exceeded 10 years. Eight cases presented with focal-bilateral tonic clonic seizures. Nine patients were treated with anti-seizure drug monotherapy. All the 24-hour video EEG of 12 patients were abnormal. There were 8 occasions when the EEG occipital α background rhythm slowed down compared with the standard frequency of peers or was dominated by slow waves. Interictal epileptic discharge (IED) located in temporal lobe were found in 12 EEG records, of which 9 EEG records were found with frontal IED. One of the 12 cases received 24-hour video EEG twice within 6 years, and his EEG background rhythm was significantly slower and the IED region was expanded compared with the first EEG record. At the third year after reexamination of EEG, SUDEP developed in this patient.Conclusions:SUDEP patients have a long course of disease and bilateral tonic-clonic seizure. The interictal EEG shows occipital slow α activity and temporofrontal epileptiform discharges, which may increase the risk of SUDEP.

Opinions on the nomenclature of familial cortical myoclonic tremor with epilepsy / 中华神经科杂志

Familial cortical myoclonic tremor with epilepsy (FCMTE) is a rare neurological disorder. There were more than 10 different terms of disease name in domestic and international published articles by searching FCMTE from PubMed and Wanfang database (from 1990 to 2022), which indicated the different understanding of the disease. It is necessary to discuss the correct and consentaneous name of the disease to facilitate the professional investigation in the future. The name evolution of FCMTE and the author′s views are described in this article.

Adult Léri-Weill dyschondrosteosis coexists with endocrinal metabolic disorders: a report of two cases / 中华内分泌代谢杂志

Léri-Weill dyschondrosteosis (LWD) has typical triad: short middle limbs, short stature, Madelung deformity of wrist, and increased body mass index. Short stature and high body mass index are risk factors for metabolic syndrome, type 2 diabetes, cardiovascular diseases, and autoimmune thyroid diseases. However, metabolic disorders and thyroid diseases in adult LWD patients have not been elucidated. This paper reports two adult patients with LWD presented to the Department of Endocrinology and metabolism. By introducing clinical characteristics, genetic variations, and diagnostic methods, physicians can deepen their understanding of LWD, improve diagnosis, and be aware of the comorbid metabolic diseases and thyroid disorders with a view of early prevention and treatment.

Relationship between miR-27a and SIRT1 during myocardial ischemia-reperfusion in rats / 中华麻醉学杂志

Objective:To evaluate the relationship between microRNA-27a (miR-27a) and silent information regulator 1 (SIRT1) during myocardial ischemia-reperfusion (I/R) in rats.Methods:Fifty clean-grade healthy male Sprague-Dawley rats, aged 2-3 months, weighing 220-280 g, were divided into 5 groups ( n=10 each) by the random number table method: sham operation group (Sham group), myocardial I/R group (I/R group), AAV9-miR-27a overexpression + myocardial I/R group (AAV+ I/R group), miR-27a antagomir + myocardial I/R group (AG+ I/R group) and AAV9-miR-27a negative control+ myocardial I/R group (NC+ I/R group). The myocardial I/R injury model was prepared by ligating the anterior descending branch of the left coronary artery for 30 min followed by 120 min reperfusion. At day 14 before ischemia, AAV9-miRNA-27a adeno-associated virus 2×10 11 v. g was injected via the tail vein in AAV+ I/R group, and AAV9-miR-27a NC 2×10 11 v. g was injected via the tail vein in NC+ I/R group. miR-27a antagomir 10 mg/kg was injected via the tail vein once a day at 3 days before ischemia in AG+ I/R group. At the end of 120 min of reperfusion, serum cardiac troponin T(cTnT), creatine kinase isoenzymes (CK-MB) and lactic dehydrogenase (LDH) concentrations and contents of glutathione (GSH), superoxide dismutase (SOD) and malondialdehyde (MDA) in myocardial tissues were determined by enzyme-linked immunosorbent assay, the percentage of myocardial infarct volume by TTC staining, the expression of miR-27a in myocardial tissues by quantitative real-time polymerase chain reaction, and the expression of SIRT1 in myocardial tissues by Western blot. Results:Compared with Sham group, the percentage of myocardial infarct volume and serum concentrations of cTnT, CK-MB and LDH were significantly increased, the contents of GSH and SOD in myocardial tissues were decreased, MDA contents were increased, miR-27a expression was up-regulated, and SIRT1 expression was down-regulated in I/R group ( P<0.05). Compared with I/R group, the percentage of myocardial infarct volume and serum concentrations of cTnT, CK-MB and LDH were significantly increased, the contents of GSH and SOD in myocardial tissues were decreased, MDA contents were increased, miR-27a expression was up-regulated, and SIRT1 expression was down-regulated in AAV+ I/R, and the percentage of myocardial infarct volume and serum concentrations of cTnT, CK-MB and LDH were significantly decreased, the contents of GSH and SOD in myocardial tissues were increased, MDA contents were decreased, miR-27a expression was down-regulated, and SIRT1 expression was up-regulated in AG+ I/R group ( P<0.05), and no significant change was found in the parameters mentioned above in NC+ I/R group ( P>0.05). Compared with AAV+ I/R group, the percentage of myocardial infarct volume and serum concentrations of cTnT, CK-MB and LDH were significantly decreased, the contents of GSH and SOD in myocardial tissues were increased, MDA contents were decreased, miR-27a expression was down-regulated, and SIRT1 expression was up-regulated in AG+ I/R group ( P<0.05). Conclusions:miR-27a is involved in the pathophysiological mechanism underlying myocardial I/R injury probably through inhibition of SIRT1 expression in rats.

An exploration of registered dietitian accreditation system development in China.

The registered dietitian system started late in China, and since 2014 a working committee of registered dietitians has been formed by the Chinese Nutrition Society to establish a national accreditation system in accordance with the international standard academic and internship requirements. The data from the certification examinations and registrations were collected and analyzed. 8,328 registered dietitians were included in the study, with 5,673 registered dietitians (RD) and 2,655 registered dietetic technicians (DTR). Among them, 45.27% of RDs have master degree or above, and 66.44% of DTRs have bachelor or above. 53.25% RDs work in medical institutions, 14.77% in colleges and universities, and 14.56% in enterprises; 48.21% DTRs work in the medical institutions, 30.28% in enterprises, and 7.34% in the community. Although six years of work has initially established a foundation of standardized registered dietitian accreditation system, the problems of limited resources for academic education and the lack of legislative protection for the profession remain prominent.

Analysis of the registered dietitian competence assessment examination during 2017-2021 in China / 中华临床营养杂志

Objective:To analyze the competence assessment examinations of registered dietitians in China during 2017-2021 to inform the training of dietetic professionals.Methods:A systematic review was conducted about the composition and changing trends of examination participants during 2017-2021. Participants were divided into subgroups based on gender, age, education, professional background and affiliations and the qualification rate was compared across different subgroups.Results:The number of examination participants showed an increasing trend overall, with the majority being females and aged 26-35 years. The ratio of participants with bachelor's: master's: doctor's degree was about 15: 9: 1. The proportion of participants majoring in nutrition science decreased from 32.1% to 20.3%, while that of participants majoring in other medical and food sciences increased. Among participants from healthcare institutions, a decreasing proportion of participants were with a major in nutrition science, while this proportion among participants from companies were stable at 38.8% to 50.2%. The average qualification rate was 35.7%, showing no significant differences among different gender and age groups. But the qualification rate varied significantly across subgroups with different education level, professional background, and affiliations ( P < 0.05). Subgroups with more advanced degrees showed higher qualification rate and the best rate was observed in the subgroups with professional background in nutrition science and from nutrition-related institutions. Conclusion:The training of dietetic professionals in China should be improved, lifelong learning should be promoted in nutrition practitioners, and the sustainable development of dietitians should be impelled.

A clinical analysis of bronchiectasis in 78 children / 中国小儿急救医学

Objective:To analyze the clinical features of bronchiectasis, in order to improve the diagnosis, treatment, and prognosis.Methods:The clinical data of 78 children with bronchiectasis at Qingdao Women and Children′s Hospital of Qingdao University from January 2010 to January 2020 were analyzed, including age, regional distribution, etiology, clinical manifestations, lung function characteristics, results of lung high-resolution CT, results of fiberbronchoscopy examination, treatment, and prognosis.Results:Among 78 children with bronchiectasis, there were 35 males(44.9%)and 43 females(55.1%), with a median age of 8.7(6.1, 9.0)years.There were 51 children in rural areas(65.4%)and 27 children in urban areas(34.6%). The incidence of children in rural areas was higher than that in urban areas.The top three causes of bronchiectasis were 40 (51.3%)cases after infection, nine cases(11.5%)of primary immunodeficiency and seven cases(9.0%)of inhalation.The main clinical manifestations were wet cough, expectoration, wheezing and repeated respiratory infection.High-resolution CT of the lungs showed 36(46.2%)cases with diffuse bronchiectasis and 37 (47.4%) cases with localized bronchiectasis.Forty-nine(62.8%) cases had abnormal pulmonary ventilation function.Sixty-one(78.2%)cases were treated with fiberoptic bronchoscopy, of which 49(80.3%)cases had "fishbone" changes.After anti-infection, fiberbronchoscopy examination, expectorant and physical therapy, 67 cases were discharged and followed up for more than one year.Among them, 55 cases had symptoms improved, 12 patients had recurrent respiratory tract infection, and three patients died.Conclusion:The clinical manifestations of bronchiectasis in children have no obvious specificity.Early diagnosis, identification of the cause and comprehensive management are critical to prognosis of bronchiectasis.

Expression of miR-155 and IFN-γ in lung injury model of neonatal rats with acute respiratory distress syndrome / 国际儿科学杂志

Objective:To study the expression of micro RNA-155(miR-155) and IFN-γ in lung tissue in a neonatal rat model of acute respiratory distress syndrome(ARDS)lung injury by intraperitoneal injection of lipopolysaccharide(LPS).Methods:Eighty neonatal SD rats on the 7th day after birth were assigned to the experimental group(LPS group)and control group(isotonic NaCl group), with 40 rats in each group.LPS solution(4 mg/kg)was injected into the abdominal cavity of neonatal SD rats in the experimental group to establish an animal model of neonatal acute respiratory distress syndrome(NARDS). The control group was established by isotonic NaCl solution(4 ml/kg)in the same way.The lung tissue samples were taken at 3 h, 6 h, 12 h and 24 h after drug administration to observe the surface changes.Then the lung sections were stained with HE to observe the pathological changes and score the lung tissue injury.Finally, the expression levels of miR-155 and IFN-γ in the lung tissue were tested by RT-PCR and ELISA techniques, respectively.Results:(1)At the beginning of the experiment, the neonatal rats in the experimental group gradually showed the clinical manifestations of ARDS, and the macroscopic observation, pathological changes and lung tissue injury scores of the lung tissues suggested the appearance of NARDS lung injury, indicating that the model was successful.(2)The expression levels of miR-155(1.33±0.12 vs 0.95±0.02、1.77±0.17 vs 0.96±0.01、2.18±0.09 vs 0.96±0.02 and 2.43±0.06 vs 0.96±0.02)and IFN-γ(370.79±13.89 vs 273.03±11.44、424.24±10.11vs270.70±13.05、466.63±6.57 vs 268.11±7.88 and 519.13±7.09 vs 272.97±12.54)ng/L in the lung tissue of rats between the experimental group and the control group were significantly different( P<0.01), and the difference was statistically significant among the groups in the experimental group( F values were 165.983 and 408.574, P<0.01). The expression levels of miR-155 and IFN-γ in the lung tissue of the experimental group increased gradually over time and showed an increasing trend. Conclusion:After the successful establishment of NARDS animal model, the expression levels of miR-155 and IFN-γ in the lung tissue of NARDS rats have significantly increased and showed a sequential pattern.MiR-155 is expected to become an early biomarker for the diagnosis of NARDS.

Prevalence and influencing factors of mental health problems among hypertensive patients in Ya'an city five years after Lushan earthquake / 四川精神卫生

ObjectiveTo analyze the prevalence and influencing factors of mental health problems among hypertensive patients in Ya'an city five years after the Lushan earthquake， so as to provide references for promoting the mental health of hypertensive patients in earthquake-stricken areas. MethodsStratified random cluster sampling method was adopted to select 800 hypertensive patients in Ya'an city in December 2018. The general information of patients were collected via a self-designed questionnaire， and their mental health problems were assessed via the 12-item General Health Questionnaire （GHQ-12）.Then Logistic regression analysis was applied to explore the influencing factors. ResultA total of 744 valid questionnaires （93.00%） were obtained， and mental health problems were detected in 79 cases （10.62%）. Univariate analysis denoted that the detection rate of mental health problems yielded statistical difference among patients of different marital status （P<0.01）， family per capita monthly income （P=0.012） and social assistance recipients （χ2=25.194， P<0.01）. Logistic regression analysis indicated that the unmarried/separated/divorced/widowed status （OR=3.879， P=0.015） and social assistance recipients （OR=4.705， P<0.01） were risk factors for mental health problems among hypertensive patients. ConclusionThe detection rate of mental health problems is low among hypertensive patients in Ya'an city， while the unmarried/separated/divorced/widowed and social assistance recipients may suffer more serious mental health problems.

Interpretation of diagnostic criteria related to epilepsy and migraine / 中华神经科杂志

The concepts and diagnostic criteria such as "migralepsy" and "ictal epileptic headache" have been proposed by International Headache Society in succession, and have been widely used in clinical practice. However, the authors believe that these diagnostic criteria are worth discussing. Headache can be a symptom of epileptic seizures, or be a state after seizures. Migraine and epilepsy can be comorbid, while migralepsy may be a form of focal epilepsy essentially from the professional perspectives of epilepsy. All medical points of views and thoughts need to be focused, so the sub-professional groups of epilepsy and headache should strengthen the dialogue and consultation, in order to formulate the diagnostic criteria of epilepsy and migraine scientifically.

Digenic inheritance of PROKR2 and WDR11 mutations in Kallmann syndrome—A case report and literature review / 中华内分泌代谢杂志

Kallmann syndrome(KS) is a subtype of idiopathic hypogonadotropic hypogonadism(IHH), characterized by delayed puberty, undeveloped secondary sexual characters, accompanied by anosmia, or hyposmia. At present, more than 40 genes are related to the pathogenesis of IHH, and new gene loci have been found continuously. At the same time, digenic gene mutation or oligogenic mutation is considered to be an important pathogenic mechanism of IHH. The clinical phenotype of KS/IHH caused by different gene mutations is complex and diverse, and the response to treatment is also variable. This paper presents the clinical data and treatment of a case of KS caused by a compound double heterozygous mutation of WDR11 and PROKR2 genes. PROKR2 gene is a classic KS pathogenic gene, while the WDR11 gene is a relatively new type of KS pathogenic gene. Included with this case report is a literature review of characteristics of cases with WDR11 gene mutation.

Comparison of efficacy of three suture methods in pterygium conjunctival transplantation / 中华实验眼科杂志

Objective:To evaluate the efficacy of embedding suture in pterygium excision combined with autologous conjunctival transplantation, and to compare the differences between embedding suture, continuous suture and intermittent suture.Methods:A randomized controlled study was conducted.One hundred and twenty patients (120 eyes) with primary pterygium, who underwent pterygium excision combined with autologous conjunctival transplantation in Shanghai Aier Eye Hospital from May to July 2020, were enrolled.The patients were randomly divided into the embedding suture group, continuous suture group and interrupted suture group, with 40 eyes in each group.The operation duration was recorded and the patients received follow-up visit at 0.5, 1, 3, 7, 10, 14 days and 1, 3 and 6 months after the operation.The five-point method was used to record the postoperative pain score.The corneal epithelial healing was evaluated by sodium fluorescein staining.The complications such as graft detachment, graft displacement or pterygium recurrence were observed with a slit lamp microscope.This study adhered to the Declaration of Helsinki.The study protocol was approved by an Ethics Committee of Shanghai Aier Eye Hospital (No.SHAIER2020RB03). Written informed consent was obtained from each subject before any medical examination.Results:The operation time of continuous suture, interrupted suture and embedding suture was (14.45±2.78), (16.28±2.24) and (16.58±2.22) minutes, respectively, and the overall difference was statistically significant ( F=8.98, P<0.05). The operation time of continuous suture was significantly shorter than that of interrupted suture and embedding suture (both at P<0.017), and there was no significant difference between embedding suture and interrupted suture ( P>0.017). There was a statistically significant overall difference in pain scores among the three groups at various time points after the operation ( P<0.05). At 0.5, 1, 3, 7 and 10 days after the operation, the pain scores of embedding suture were lower than those of continuous suture and interrupted suture (all at P<0.05). On the 7th day after the operation, there was no significant difference in the unhealed rate of corneal epithelium among the three groups ( P=1.000). On the 10th day after the operation, the corneal epithelia of the three groups were all healed.During the six months after the operation, no complications such as displacement, detachment, necrosis, infection of graft and eye movement disorder occurred in the three groups.There was no significant difference in the recurrence rate of pterygium ( P=1.000). Conclusions:Embedding suture method can effectively reduce the irritation symptoms after pterygium conjunctival transplantation, and has stable fixation of implants.Compared with the traditional interrupted suture, it does not increase the recurrence rate, incidence of adverse reactions, operation time and economic burden of patients.

The influence of the superior mesenteric artery blood flow on umbilical cord milking of premature infants assessed by Doppler ultrasound / 中华实用儿科临床杂志

Objective:To investigate the correlation between the dynamic changes of the superior mesenteric artery (SMA) blood flow after umbilical cord milking (UCM)detected and feeding tolerance in premature infants.Methods:This was a prospective study a total of 88 premature infants delivered in Shanghai Jiading Maternal and Child Health Care Hospital from June 2018 to February 2020 were randomly divided into UCM group(45 cases) and early cord clamping group (ECC group, 43 cases). SMA blood flow indexes 15 min before the first feeding (prefeed) and 60 min after the first feeding (post-feed) were detected using the GE Voluson 730 Ultrasound Machine, including the peak systolic velocity (PSV), time-averaged mean velocity (TAMV), pulsatility index (PI) and resistance index (RI). The gestational age, birth weight, the weight at discharge, SMA blood flow indexes, time to achieve enteral nutrition, length of stay and incidence of complications between the two groups were analyzed using t test, Chi- square test or Fisher′ s exact test. Results:(1)There were no significant differences in the gestational age, birth weight, the mother′s hemoglobin before deliver, and the incidence of complications between UCM group and ECC group (all P>0.05). (2) Except for RI, all SMA blood flow indexes were higher in UCM group than those of ECC group.However, only prefeed TAMV[(24.74±11.47) cm/s vs.(20.24±7.71) cm/s], post-feed TAMV[(42.11±15.74 )cm/s vs.(28.31±9.99) cm/s] and TAMV change before and after feeding [(13.89-20.86) cm/s vs.(5.31-10.82) cm/s]were detected to be significantly higher in UCM group than those of ECC group (all P<0.05). (3) Multivariable linear regression analysis showed that the gestational age, birth weight, PSV elevation and PI reduction were negatively correlated with the length of adequate feeding (all P<0.05). (4) The time to achieve enteral nutrition[(11.75±7.36) d vs.(13.38±8.12) d] and the incidence of feeding intolerance [13.3% (6/45 cases) vs.20.9%(9/43 cases)] were lower in UCM group than those of ECC group, although no significant differences were detected (all P>0.05). Conclusions:UCM increases the hemoglobin level in premature infants, which is beneficial to feeding tolerance of premature infants by improving SMA blood flow.

Therapeutic Observation of Shipiyin Combined with Diosmin in Treatment of Lymphedema with Spleen Yang Deficiency Syndrome After Modified Radical Mastectomy / 中国实验方剂学杂志

ObjectiveTo investigate the clinical effect of Shipiyin combined with diosmin in the treatment of lymphedema with spleen Yang deficiency syndrome（SYDS）after modified radical mastectomy and the specific effect on the function of the affected limb. MethodEighty-two patients with lymphedema with SYDS after modified radical mastectomy from outpatient and inpatient department of breast department and oncology department of the First Affiliated Hospital of Hunan University of Chinese Medicine were randomly divided into an observation group（41 cases） and a control group（41 cases）. The control group was given diosmin tablets（0.9 g per time， two times per day）on the basis of conventional treatment，and the observation group was given Shipiyin（one dose per day）on the basis of the control group. The course of treatment was 14 days. The clinical symptoms were observed and the limb circumference，traditional Chinese medicine（TCM） syndrome score，functional assessment of cancer therapy-breast cancer（FACT-B） score，disability of arm， shoulder and hand questionnaire（DASH） score，and joint range of motion were measured to analyze the TCM syndrome therapeutic effect and clinical efficacy. ResultAfter 14 days of treatment， the total effective rate of the observation group was 85.37% （35/41） and that of the control group was 63.41% （26/41） in the TCM symptoms， showing a statistically significant difference （Z=-2.212， P<0.05）. In terms of the clinical efficacy， the total effective rate in the observation group was 82.93% （34/41） and that in the control group was 75.61% （31/41）， indicating a statistically significant difference （Z=-2.061， P<0.05）. Compared with the situations before treatment， the scores of clinical symptoms such as the swelling of the upper limb， pain， sense of heaviness， stuffiness， fatigue， fullness， tightness， and skin keratosis and pruritus in the two groups were significantly lowered （P<0.01） after treatment. Compared with the control group， the observation group could better improve the swelling and fullness（P<0.01），as well as the feeling of pain，heaviness，stuffiness，fatigue，tightness，skin keratosis and pruritus （P<0.05）of the upper limbs of patients. The affected limb circumference， TCM syndrome score， and DASH score decreased significantly， while the FACT-B score and upper limb joint range of motion increased significantly in the two groups after treatment （P<0.01）. Compared with the control group， the observation group showed significantly reduced limb circumference at 10 cm proximal to the elbow striae， lowered TCM syndrome score， elevated FACT-B score（P<0.05）， decreased DASH score and improved range of motion of the upper limb joint （P<0.01） after treatment. ConclusionShipiyin combined with diosmin has better clinical efficacy in the treatment of lymphedema with SYDS after modified radical mastectomy than diosmin alone，which can better improve the clinical symptoms，signs，quality of life and limb functional activity of patients. This provides a new clinical program for the treatment of lymphedema after breast cancer surgery with integrated Chinese and western medicine.

Clinical and electrophysiological study of sleep-related hypermotor epilepsy during rapid eye movement sleep / 中华神经科杂志

Objective:To explore the electro-clinical characteristics of sleep-related hypermotor epilepsy (SHE) in rapid eye movement (REM) stage.Methods:Five patients of SHE in REM stage were studied and followed up in the Electroencephalogram Monitoring Center, Department of Neurology, Xijing Hospital, the Air Force Military Medical University, from January 2016 to August 2021.Results:Among the 5 patients, there are 3 male patients, aged 21 to 46 years. A total of 23 seizures were monitored in 5 patients, of which 22 occurred in REM sleep and 1 occurred in non-REM Ⅲ sleep. Each attack lasted from 30 seconds to 1 minute, and was manifested as "hyperkinetic attack" during sleep, with or without disturbance of consciousness. There were no obvious abnormalities in electroencephalography during 13 attacks, with the focal sharp slow waves or slow waves during 9 attacks, and the focal slow waves occurrence at the end of the 10 attacks.Conclusion:Most of the hypermotor epileptic seizures in REM stage started from awakening reaction, and the interictal discharges occured in waking and non-REM sleep stage, which is necessary to distinguish from the REM sleep behavior disorder.