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简介：AbstractPreeclampsia (PE) is one of the leading causes of maternal and perinatal morbidity and mortality worldwide. This disorder has profound short-term and long-term impacts on both the affected woman’s and her child’s health. Early-onset PE requiring preterm delivery (preterm PE) is of particular importance because it is associated with a higher risk of adverse pregnancy outcomes than term PE. First trimester screening model developed by the Fetal Medicine Foundation (FMF), which uses Bayes-theorem to combine maternal characteristics and medical history together with measurements of mean arterial pressure, uterine artery pulsatility index, and serum placental growth factor, has been proven to be effective and have superior screening performance to that of traditional risk factor-based approach for the prediction of PE. Identification of high risk pregnant women for preterm PE and giving aspirin prophylaxis before 16th week of gestation would reduce the incidence of preterm PE. In Asia, although the prevalence of PE is slightly lower than the global estimation, early screening and prevention of this life-threatening condition is still crucial. The FMF Bayestheorem based screening method has been validated in a large-scale prospective Asia-wide study and revealed that the first trimester triple test achieves the highest detection rate, compared with the traditional risk factor-based approaches, and that the screening performance is comparable to the published data from the FMF in East Asian women. However, in order to achieve optimal screening performance, the key is to establish standardized methods for biomarker measurements and regular biomarker quality assessment, as each biomarker is susceptible to inaccurate measurement, thus affecting performance of screening. Furthermore, it is of great importance to emphasize that the optimal preventive effect of aspirin on preterm PE is clearly associated with good compliance to treatment. In conclusion, global implementation of an effective first trimester "screen and prevent" program for preterm PE would provide the opportunity to reduce the risk of both short-term maternal and perinatal morbidity and mortality, with the possibility of intergenerational prevention of future chronic diseases for both the mother and her offspring.

简介：Objective:Tostudytheemergencymanagementprinciplesofseveretraumainhospital(injuryseverityscore≥16).Methods:Weused'ATPprinciple'tomanageseveretraumaticpatients.TheATPprincipleiscomposedof:1)attendingsurgeonsofferinginitialmanagement(A);2)teamworkcommencementimmediatelyafterpatientsadmittedtohospital(T);3)parallelprinciple,ie,emergencyresuscitation,evaluationandlaboratorytestperformedsimultaneously(P).ClinicaleffectsbeforeandafterapplyingATPprinciplewereretrospectivelyanalyzedandcompared.Results:DuringJanuary1,2002toDecember31,2003,338patientsweretreatedwithoutapplyingATPprinciple,inwhichISSwas25.9±6.4,152casesdiedwiththemortalitybeing39.2%,andthetimestayedinemergencydepartmentandthetimetooperationroomafteradmissionwere(102.8±16.7)min,(140.3±20.6)min,respectively.DuringJanuary1,2004toDecember31,2005,438patientsweretreatedbasedonATPprinciple,inwhichISSwas28.6±7.8,87casesdiedwiththemortalitybeing19.9%,andthetimeinemergencydepartmentandthetimetooperationroomafteradmissionwere(69.5±11.5)min,(89.6±9.3)min,respectively.ISSshowednosignificantdifferencebetweenthetwogroups(P>0.05),butthemortality,thetimestayedinemergencydepartmentandthetimetooperationroomafteradmissionweregreatlyreducedandshowedsignificantdifferencebetweenthetwogroups(P<0.05).Conclusions:ApplyingATPprincipletotreatseveretraumaticpatientscanshortenemergencytreatmenttimeinhospitalanddecreasemortality.

简介：Braintumorsincidenceinpediatricagehasbeenestimatedbetween1.3to5%witharelativeincidenceof1.4to11%duringthefirstyearoflife;theimprovementininstrumentaldeviceshasleadtoarelativeincreaseinprecociousdiag-nosis.Thechoicetostudybraintumorsofthefirstyearoflifeasaseparatetopicfrompediatricageonesdependsontheobservationthatthesele-sionshavepeculiarclinical,topographicandtis-sularcharacteristics.Thesurvivalrateofthesepatientsisverypoorifcomparedwiththatfound

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简介：ObjectivesToreportauthors'experiencesinthediagnosisandtreatmentsofcongenitalfirstbranchialfistula(congenitalauriculocervicalfistula).MaterialsandMethodsTwelvecasesofcongenitalfirstbranchialfistulawerereviewed.Ofthese,8underwentfistulectomywithfacialnervedissectionandpartialparotidectomyand4underwentsimplefistulectomy.ResultsTheinneropenings(upperopening)offistulaelayinthefollowingsites:inferioposteriorwallatthejunctionofcartilaginousandbonysegmentsoftheauricularcanalandinferiorwallofcartilaginousauricularcanal.Theouteropenings(loweropening)layalongtheanteriorborderofuppersternocleidomastoidmuscle,atthemastoidtipandposteriortothemandibularangle.Completefistulaeresectionwasachievedinallbutonecase.Elevencaseswerefollowedfor5yearwithnorecurrence.Recurrenceoccurredin1case6monthsaftertheprimarysurgeryandrevisionsurgerywasperformed.ConclusionsPre-operativeradiographyforthelocationandcourseofthefistulaiscrucialforsuccessfulfistularesection,especiallyincaseswithpastinfections.Facialnervedissectionshouldbedoneroutinelyfordeeplylocatedfistulae.

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简介：CHINABROKETHEsilencethisNovember,hostingtheFirstChinaAIDS/STDConferencefromNovember13-16inBeijing.Theeventdrewalmost2000attendeesfromeveryprovinceinChinaandseveralinternationallyrenownedscientists,physicians,andpublichealthpractitionersfromtheinternationalAIDScommunity.

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简介：AbstractPurpose:Blunt thoracic injuries are common among elderly patients and may be a common cause of morbidity and death from blunt trauma injuries. We aimed to examine the impact of chest CT on the diagnosis and change of management plan in elderly patients with stable blunt chest trauma. We hypothesized that chest CT may play an important role in providing optimal management to this subgroup of trauma patients.Methods:A retrospective analysis was performed on all the admitted adult blunt trauma patients between January 2014 and December 2018. Stable blunt chest trauma patients with abbreviated injury severity (AIS) < 3 for extra-thoracic injuries confirmed with chest X-ray (CXR) and chest CT on admission or during hospitalization were included in the study. The AIS is an international scale for grading the severity of anatomic injury following blunt trauma. Primary outcome variables were occult injuries, change in management, need for surgical procedures, missed injuries, readmission rate, intensive care unit (ICU) and length of hospital stay.Results:There are 473 patients with blunt chest trauma included in the study. The study patients were divided into two groups according to the age range: group 1: 289 patients were included and aged 18-64 years; group 2: 184 patients were included and aged 65-99 years . Elderly patients in group 2 more often required ICU admission (11.4% vs. 5.2%), had a longer length of ICU stay (days) (median 11 vs. 6, p = 0.01), and the length of hospital stay (days) (median 14 vs. 6, p = 0.04). Injuries identified on chest CT has led to a change of management in 4.4% of young patients in group 1 and in 10.9% of elderly patients in group 2 with initially normal CXR. Chest CT resulted in a change of management in 12.8% of young patients in group 1 and in 25.7% of elderly patients in group 2 with initially abnormal CXR.Conclusion:Chest CT led to a change of management in a substantial proportion of elderly patients. Therefore, we recommend chest CT as a first-line imaging modality in patients aged over 65 years with isolated blunt chest trauma.

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简介：AbstractBackground:Schizophrenia (SCZ) is a complex psychiatric disorder associated with widespread alterations in the subcortical brain structure. Hemispheric asymmetries are a fundamental organizational principle of the human brain and relate to human psychological and behavioral characteristics. We aimed to explore the state of thalamic lateralization of SCZ.Methods:We used voxel-based morphometry (VBM) analysis, whole-brain analysis of low-frequency fluctuations (ALFF), fractional amplitude of low-frequency fluctuations (fALFF), and resting-state seed-based functional connectivity (FC) analysis to investigate brain structural and functional deficits in SCZ. Also, we applied Pearson's correlation analysis to validate the correlation between Positive and Negative Symptom Scale (PANSS) scores and them.Results:Compared with healthy controls, SCZ showed increased gray matter volume (GMV) of the left thalamus (t = 2.214, p = 0.029), which positively correlated with general psychosis (r = 0.423, p = 0.010). SCZ also showed increased ALFF in the putamen, the caudate nucleus, the thalamus, fALFF in the nucleus accumbens (NAc), and the caudate nucleus, and decreased fALFF in the precuneus. The left thalamus showed significantly weaker resting-state FC with the amygdala and insula in SCZ. PANSS negative symptom scores were negatively correlated with the resting-state FC between the thalamus and the insula (r = -0.414, p = 0.025).Conclusions:Collectively, these results suggest the possibility of aberrant laterality in the left thalamus and its FC with other related brain regions involved in the limbic system.

简介：Reasonabledenturedesignwillaffectthehealthoforalsupportingtissueandrelatetothesuccessandfailureofprosthodontic.Inordertoinvestigatethestressdistributeoforalsupportingtissueswiththreevariousdesignsunderconditionsofverticalloading,wemeasuredthemodelofthelossoflowerfirstmolarwith3-Dco-ordinatemeasuringapparatus,anddidanaloguedenturedesignwithauto-CADsoft-waresystemincomputer.AllmodelswereanalyzedwithSuper-SAPfiniteelementprogram.Ineachcase,150Nverticalloadingwasappliedonthesecondpremolar,

简介：摘要Corona virus disease 2019 (COVID-19) is a new disease characterized by lung damage and involvement in multiple tissues and organs in the whole body. Some of the patients may have long-term impairment and dysfunctions, including pulmonary fibrosis, heart, liver, kidney, nerve and immune system. Rehabilitation has certain beneficial effect in the acute stage, and especially in the recovery stage, including improving respiratory function, exercise endurance, self-care in daily living activities, as well as psychological support, etc. Rehabilitation is not offside or absent. A reasonable rehabilitation program needs scientific research to avoid arbitrary conclusions.

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