简介：几份临床的报告证实那胃的萎缩是限于成年病人的一个病理不仅。在儿科，它最经常与Hpylori感染而是这联合被描述细菌不似乎是在孩子的这个肿瘤前状态的唯一的病因学的因素。因为他们系统地没在上面的胃肠的内视镜检查法期间被寻求，在孩子的胃的萎缩和肠的组织变形的频率是未知的。childrenosgastropathies的特定的组织学的分类的缺乏为病理学家使他们的诊断困难。迄今为止基于我们的知识，我们认为详细，描述是必要的这损害的自然功课在童年期间。靠近、延长的临床、内视镜的后续为有胃的萎缩的孩子是重要的。

简介：Objective:ToidentifytheeffectofdyslipidemiaonauditoryfunctiondetectedbyPureToneAudiometry.Tocheckifdyslipidemiaworsensthehearinglevelindiabetics.Design:Thiswasacomparativestudywhere120subjectsbetweentheagegroupof20and50yearsunderwentpuretoneaudiometry,lipidprofileandbloodsugars.Group1consistedof30subjectswithtype2diabetesanddyslipidemia;Group2had30subjectswithisolateddiabetes;Group3had30withisolateddyslipidemiaandGroup4included30normalsubjectsascontrol.Results:Significanthearinglosswasseenonlyinthegroupwithisolateddiabetes(63%).Themostcommontypeofhearinglosswashighfrequencysensorineuralhearingloss.Whencomparisonwasmadebetweenthecombinationsofdifferentlipidprofiles,noassociationwasfoundtothelevelofhearing.Conclusions:Diabeticsaremorepronetohighfrequencyhearingloss.Alteredlipidprofilehasnoroleincausinghearingloss.

简介：Takotsubosyndrome(TTS)isarecentlyidentifiedacuteheartsyndrome,characterizedbyregionalwallmotionabnormalitiesnotjustifiedbythepresenceofsignificantcoronaryarteryobstruction.Clinically,TTScloselyresemblesacutecoronarysyndromes(ACS)andthereforedifferentialdiagnosismaybeanimportantobstacleforitscorrectclinicalmanagement.TheprevalenceofTTSisestimatedtobearound2%ofacutemyocardialinfarctions,andthenumberofdiagnoseshasincreasedinrecentyears,possiblyreflectingourgrowingunderstandingofthiscondition.GiventhesimilaritiesbetweenTTSandACS,clinicalpresentationinthesepatientsisequivocal.However,numerouspeculiartraitshavebeenobserved,suchasthegreaterprevalenceinpostmenopausalwomenandthepresenceofstressfultriggers.ManypathogenetichypothesesforTTS,suchascatecholamineoverloadandmicrovasculardysfunction,havebeenproposed.Noneofthesehavebeencapableofindependentlyexplainingtheunderlyingmechanisms.ThediagnosticcriteriaproposedbytheHeartFailureAssociationoftheEuropeanSocietyofCardiologyrepresentanovelattempttointroducesemiquantitativeparameters,yetfurtherscientificvalidationisneeded.Contrarytopreviousopinions,TTSisnotalwaysbenign,consideringtherelativelyhighprevalenceofacutecomplications,anestimatedin-hospitalmortalitysimilartothatofacutemyocardialinfarction(1-8%),andasignificantrateofrecurrencesandpersistenceofsymptoms.ClinicalmanagementofTTShasbeenlargelybasedonempiricalexperiencerelatedtoACS,andthereforepharmacologicalstrategiesarepartiallyoverlapping.Anissueoftheutmostimportanceisthelackofrandomizedprospectivedatavalidatingdiagnosticcriteria,riskstratification,andspecifictherapeuticapproaches.

简介：AbstractMonochorionic dizygotic twin gestation is clinically very uncommon but poses significant antenatal and postnatal complications. Here we review the diagnosis, mechanism, perinatal management, and pregnant outcomes of monochroic dizygotic twin gestation.

简介：<正>DearSir,Oculartraumaisatopicofunresolvedcontroversiesandtherearecontinuouscontroversialanddebatablediagnosticandmanagementstrategiesforopen-globeinjuries[1].Amongstmanytypesofoculartrauma,theopenglobeinjuryisthemostseriousduetoitsverypoorvisualprognosisandyoungpopulationofpatientsaremostlyaffected[2].Thetreatmentoutcomemaybeimprovedbypromptdiagnosis,andimmediatesurgicalrepairperformedtohighstandard[3].Amongsttheotherclinicalsignstheintraocularpressure(IOP)isfoundtobeparticularlyreducedandconventionallythisisconsideredasaveryreliableindicatorofoccultglobe

简介：Cardiologistswhoseepatientsonageneralcardiologyservicearebeginningtoseeanincreasingnumberofpatientswhohavereceivedaprimarypreventionimplantablecardiacdefibrillator(ICD)buthaveneverhaditfire.ThereareadditionallyanumberofpatientswhohaveinappropriatefiringofICDs.Inappropriateshocksoccurinupto40%ofpatientswithanICD.Themaincauseissupraventriculartachyarrhythmia,includingsinustachycardia,atrialfibrillation,andotherrapidsupraventriculararrhythmias.

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简介：Thebraincontrolsvirtuallyallbodyfunctions,bothinternallyandininteractionwiththeexternalenvironment.Asthebasicbodyanatomyofallvertebrateshasabilateralsymmetry,structuresandfunctionsofvertebratebrainsarealsoorganizedaccordingtothisfundamentalanatomicalprincipletomeetallsensory,motor,andinternalrequirementsofbodycontrol.Consequently,particularpartsorfunctionsofthebodyarecontrolledbyparticularbrainstructures.Formammalswhosebrainsonlyhaveaverylimitedcapacityto

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简介：AbstractBackground:Hasner valve incision has been recently introduced as a new treatment for ophthalmic patients with epiphora symptoms. The aim of this study was to examine whether surgical outcomes of Hasner valve incision for inferior nasolacrimal duct obstruction were different between pediatric and adult patients.Methods:A total of 53 eyes of 52 patients who underwent Hasner valve incision in the Beijing Tongren Hospital from October 2016 to November 2019 were retrospectively observed. Patients were divided into two groups, including pediatric group (23 eyes of 22 patients, <18 years old) and adult group (30 eyes of 30 patients, ≥18 years old). Success rate of surgery was determined by both subjective measure (complete resolution of epiphora) and objective measure (lacrimal passage irrigation and tear meniscus height). Fisher exact test was conducted.Results:By conducting Fisher exact test and comparing complete resolution of epiphora (P = 0.627), lacrimal passage irrigation (P = 0.663), measurement of Tear Meniscus Height (P = 0.561), and appearance of complication (P = 0.339), there was no statistically significant difference of surgical outcomes between pediatric and adult patients (P > 0.05).Conclusion:Hasner valve incision was effective for both adult and children with inferior nasolacrimal duct obstruction, with no difference in surgical outcomes between the two groups.

简介：Theriskofbreastcancer(BC)overdiagnosisattributedtomammographyscreeningisanunresolvedissue,complicatedbyheterogeneityinthemethodologyofquantifyingitsmagnitude,andbothpoliticalandscientificelementssurroundinginterpretationoftheevidenceonthisphenomenon.EvidencefromrandomizedtrialsandalsofromobservationalstudiesshowsthatmammographyscreeningreducestheriskofBCdeath;similarly,thesestudiesprovidesufficientevidencethatoverdiagnosisrepresentsaseriousharmfrompopulationbreastscreening.Forboththeseoutcomesofscreening,BCmortalityreductionandoverdiagnosis,estimatesofmagnitudevarybetweenstudieshoweveroverdiagnosisestimatesareassociatedwithsubstantialuncertainty.Thetrade-offbetweenthebenefitandthecollectiveharmsofBCscreening,includingfalse-positivesandoverdiagnosis,ismorefinelybalancedthaninitiallyrecognized,howeverthesnapshotofevidencepresentedonoverdiagnosisdoesnotmeanthatbreastscreeningisworthless.Futureeffortsshouldbedirectedtowards(a)ensuringthatanychangesintheimplementationofBCscreeningoptimizethebalancebetweenbenefitandharms,includingassessinghowplannedoractualchangesmodifytheriskofoverdiagnosis;(b)informingwomenofalltheoutcomesthatmayaffectthemwhentheyparticipateinscreeningusingwell-craftedandbalancedinformation;and(c)investinginresearchthatwillhelpdefineandreducetheensuingovertreatmentofscreen-detectedBC.

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简介：AbstractAs the entire world is under the grip of the coronavirus disease 2019 (COVID-19), and as many are eagerly trying to explain the origins of the virus and cause of the pandemic, it is imperative to place more attention on related potential biosafety risks. Biology and biotechnology have changed dramatically during the last ten years or so. Their reliance on digitization, automation, and their cyber-overlaps have created new vulnerabilities for unintended consequences and potentials for intended exploitation that are mostly under-appreciated. This study summarizes and elaborates on these new cyberbiosecurity challenges, (1) in terms of comprehending the evolving threat landscape and determining new risk potentials, (2) in developing adequate safeguarding measures, their validation and implementation, and (3) specific critical risks and consequences, many of them unique to the life-sciences. Drawing other's expertise and my previous work, this article reviews and critically interprets our current bio-economy situation. The goal is not to attribute causative aspects of past biosafety or biosecurity events, but to highlight the fact that the bioeconomy harbors unique features that have to be more critically assessed for their potential to unintentionally cause harm to human health or environment, or to be re-tasked with an intention to cause harm. It is concluded with recommendations that will need to be considered to help ensure converging and emerging biorisk challenges, in order to minimize vulnerabilities to the life-science enterprise, public health, and national security.

简介：Background:ConcernshavebeenexpressedaboutpotentialtoxicityofthesmokeproducedbytheburningofmoxaintraditionalChinesemedicine.Withtheadventofstrictanti-smokinglegislationintheUK,itwasdecidedtotestthevolatilesproducedbymoxibustionandcomparethemwithcurrentagreedsafeexposurelevels.

简介：Objective:InfraredTympanicThermometer(ITT)isoneofthemostusefulinstrumentsforaccuratelymeasuringtemperature.TheeffectsofearpathologiesonITTmeasurementremainunclear.Thepurposeofthisstudyistodetermineiftympanicmembraneperforation(TMP)affectsITTmeasurementsinadultpatients.Materialandmethods:Atotalof90adultpatientswithmonauralcentralTMPwereenrolledinthisstudy.Patientswerecategorizedintothreesubgroupsaccordingtoperforationsize(1-3mm,4-7mm,and8-10mm).Thetympanictemperaturesoftheaffectedandunaffectedsites,andsubgroupswerecomparedwitheachother.Results:Thisstudycontained54(60%)malesand36(40%)femalesrangingfrom20to58yearsofage(meanage:30.74±9.61years).ThemeantympanictemperatureofthesideaffectedwithTMPwas36.34oC±0.61oC.Themeantympanictemperatureoftheunaffectedsidewithhealthyandintacttympanicmembranewas36.33oC±0.6oC.ThePearsoncorrelationscoreforthetympanictemperaturesandthesizeofTMPwas0.22whichwasnotsignificant(r=-0.12).Conclusion:TMPandperforationsizedonotaffectITTmeasurementsinadultpatients.

简介：AbstractBackground:Preterm premature rupture of membranes (PPROM) is associated with high neonatal morbidity and mortality. However, the influences of cesarean section (CS) on neonatal outcomes in preterm pregnancies complicated with PPROM are not well elucidated. The aim of this study was to investigate the influence of delivery modes on neonatal outcomes among pregnant women with PPROM.Methods:A retrospective cross-sectional study was conducted in 39 public hospitals in 14 cities in the mainland of China from January 1st, 2011 to December 31st, 2011. A total of 2756 singleton pregnancies complicated with PPROM were included. Adverse neonatal outcomes including early neonatal death, birth asphyxia, respiratory distress syndrome (RDS), pneumonia, infection, birth trauma, and 5-min/10-min Apgar scores were obtained from the hospital records. Binary variables and ordinal variables were respectively calculated by binary logistic regressions and ordinal regression. Numerical variables were compared by multiple linear regressions.Results:In total, 2756 newborns were involved in the analysis. Among them, 1166 newborns (42.31%) were delivered by CS and 1590 newborns belonged to vaginal delivery (VD) group. The CS proportion of PPROM obviously increased with the increase of gestational age (χ2 = 5.014, P = 0.025). Compared with CS group, VD was associated with a higher risk of total newborns mortality(odds ratio [OR], 2.38; 95% confidence interval [CI], 1.102–5.118; P = 0.027), and a lower level of pneumonia (OR, 0.32; 95% CI, 0.126–0.811; P = 0.016). However, after multivariable adjustment and stratification for gestational age, only pneumonia was significantly related with CS in 28 to 34 weeks group (OR, 0.34; 95% CI, 0.120–0.940; P = 0.038). There were no differences regarding to other adverse outcomes in the two groups, including neonatal mortality, birth asphyxia, Apgar scores, RDS, pneumonia, and sepsis.Conclusions:The proportion of CS of pregnant women with PPROM was very high in China. The mode of delivery does not affect neonatal outcomes of pregnancies complicated with PPROM.

简介：Nervefibersareattractedbysuturelessend-to-sidenervecoaptationintotherecipientnerve.Openingawindowintheepineuriumenhancesaxonattractionandmyelination.Theauthorsanalyzethefeaturesofnerverepairbyend-to-sidecoaptation.Theyhighlighttheknownmechanismsofaxonsproutinganddifferenthypothesesofstartupsignals(presenceorabsenceofanepineurialwindow,roleofSchwanncells,signalingfromthedistaltrunk).Theclinicalliteratureisalsopresentedanddifferencesbetweenexperimentalandclinicalapplicationsarepointedout.Theauthorsproposetheirpointofviewandperspectivesderivingfromrecentexperimentalandclinicalexperiences.

简介：PURPOSE:Weinvestigatethepatternsoffailureinthetreatmentofglioblastoma(GBM)basedonclinicaltargetvolume(CTV)marginsize,dosedeliveredtothesiteofinitialfailure,andtheuseoftemozolomideandintensity-modulatedradiotherapy(IMRT).METHODS:BetweenAugust2000andMay2010,161patientswithGBMweretreatedwithradiotherapywithorwithoutconcurrenttemozolomide.PatientsweretreatedwithCTVexpansionsthatrangedfrom5to20mmusingashrinkingfieldtechnique.PatternsoffailureandtimetoprogressionandoverallsurvivalwerecomparedbasedonCTVmargin,useoftemozolomide,anduseofIMRT.KaplanMeieranalysiswasusedtoestimatesurvivaltimes,andχtestwasusedforcomparisonofcohorts.RESULTS:Forpatientstreatedwith5-,10-,and15-to20-mmCTV,79%,77%,and86%experiencedfailuresinthe60Gyvolume,respectively.Forty-eightpercent,55%,and66%ofpatientswith5-,10-,and15-to20-mmCTVexperiencedfailuresinthe46Gyvolume,respectively.Therewasnostatisticaldifferencebetweenpatientstreatedwith5-,10-,15-to20-mmmarginswithregardto60Gyfailure(P=0.76),46Gyfailure(P=0.51),ormarginalfailure(P=0.73).Eightypercentofpatientsreceivingtemozolomideexperiencedfailuresinthe60Gyvolume.TherewasnoincreasedlikelihoodofmarginalfailuresinpatientsreceivingIMRT(P=0.97).CONCLUSIONS:Moderntreatmenttechniquesincludinguseofconcurrenttemozolmide,limitedCTVmarginsize,andIMRThavenotgreatlychangedthepatternsoffailureofGBM.

简介：Objective:TheobjectiveofthisstudywastoexaminetheeffectofhypothyroidismonhearingfunctioninpatientssurgicallytreatedfordifferentiatedthyroidcancerandsubsequentlyexperiencedhypothyroidismduringpreparationforfollowupI-131scintigraphyscanbyeitherrecombinanthumanthyroidstimulatinghormone(rhTSH)treatmentorthyroidhormonewithdrawal(THW).Methods:Atotalof55patientsundergoingI-131scintigraphyscanfollowingsurgeriesfordifferentiatedthyroidcancerwereincludedinthestudy,including25patientspreparedbyadministrationofrecombinantTSH(rhTSHGroup)and30patientsbythyroidhormonewithdrawal(THWGroup).Results:Airconductionthresholdsat1,2and4kHzforbothearswerehigherduringhypothyroidperiodthanduringeuthyroidperiodforpatientsintheTHWgroup(p<0.05)butnotforpatientsintherhTSHgroup.Conclusion:Sensorineuralhearinglosswasdetected,especiallyatlowfrequencies,inpatientswithDTCaftersurgicaltreatmentwhosehormonereplacementtherapywaswithdrawnbutnotinthosereceivingrhTSH.ItisthereforepreferredtouserhTSHwhenpreparingforI-131scintigraphyscaninpatientsatriskforhearingloss.

简介：Therearecurrentlynofederallyapprovedneuroprotectiveagentstotreattraumaticbraininjury.Progesterone,ahydrophobicsteroidhormone,hasbeenshowninrecentstudiestoexhibitneuroprotectiveeffectsincontrolledcorticalimpactratmodels.Aktisaproteinkinaseknowntoplayaroleincellsignalingpathwaysthatreduceedema,inflammation,apoptosis,andpromotecellgrowthinthebrain.ThisstudyaimstodetermineifprogesteronemodulatesthephosphorylationofAktviaitsthreonine308phosphorylationsite.Phosphorylationatthethreonine308siteisoneofseveralsitesresponsibleforactivatingAktandenablingtheproteinkinasetocarryoutitsneuroprotectiveeffects.ToassesstheeffectsofprogesteroneonAktphosphorylation,C57BL/6miceweretreatedwithprogesterone(8mg/kg)at1(intraperitonally),6,24,and48hours(subcutaneously)postclosed-skulltraumaticbraininjury.Thehippocampuswasharvestedat72hourspostinjuryandpreparedforwesternblotanalysis.TraumaticbraininjurycausedasignificantdecreaseinAktphosphorylationcomparedtoshamoperation.However,micetreatedwithprogesteronefollowingtraumaticbraininjuryhadanincreaseinphosphorylationofAktcomparedtotraumaticbraininjuryvehicle.Ourfindingssuggestthatprogesteroneisaviabletreatmentoptionforactivatingneuroprotectivepathwaysaftertraumaticbraininjury.