简介：AbstractBackground:The importance of identifying osteoporotic vertebral endplate or/and cortex fracture (ECF), which primarily includes endplate fracture (EPF) and vertebral anterior cortex buckling, has been recognized. However, some old traumatic ECFs with healing process in the elderly may be mistaken as osteoporotic. This study analyzes the radiological features of traumatic EPF.Methods:This was a retrospective analysis of 194 spine trauma patients with 263 vertebral fractures (mean age: 42.11 ± 9.82 years, 118 males and 76 females). All patients had traumatic EPF identified by X-ray/CT/MRI.Results:The involved vertebra was mostly L1 (29.7%), followed by T12 and L2. Except EPFs involved both superior and inferior endplates (12.6%), only 1.9% involved inferior endplate alone, with the majority involved superior endplate. If each endplate was divided into five segments of equal lengths (from anterior to posterior: a1, a2, m, p2, p1), the most depressed point of superior EPFs was mostly at segment-a2 (approximately 45%), followed by segment-a1 (approximately 20%) or segment-m (approximately 20%), and very rarely at segment-p1. The upper 1/3 of anterior vertebral wall was more likely to fracture, followed by middle 1/3 of anterior wall. For posterior vertebral wall fracture, 68.5% broke the bony wall surrounding the basivertebral vain. 58.6%, 30.0%, and 11.4% of vertebral fractures had <1/5, 1/5-1/3, and >1/3 vertebral body height loss. As the extent of vertebral height loss increased, the chance of having both superior and inferior EPFs also increased; however, the chance of having inferior EPF alone did not increase.Conclusion:Traumatic EPF features are characterized, which may help the differentiation of traumatic and osteoporotic EPFs.

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简介：Acupuncture,asacomplementarytherapy,hasbeenusedtomanagethecancerassociatedsymptomsofcancerpatients.Toidentifytheefficacyandsafetyofacupunctureinthemanagementofcancer,thisreviewcriticallyanalysestherelevantpublicationsincludingbothexperimentalandclinicalstudies.Themajorityofstudiessuggestthatacupunctureeffectivelyrelievessomecancerrelatedsymptomssuchascancerpain,andsomeadverseeffectscausedbythecancerconventionaltreatmentssuchasnausea,vomiting,neutropeniaandxerostomia.

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简介：ObjectivesToevaluatethesafetyandefficacyoftransradialcoronaryprocedures(TRCP).MethodsThedataof83caseswhoacceptedtransradialcoronaryangiography(CAG)andtransradialpercutaneouscoronaryintervention(PCI)inourdepartmentweresummarized.Thesuccessrates,proximalcoronarycomplications,peripheralvascularcomplications,severevagalreflex,meanoperationtime(MOT),meanrecumbenttime(MRT),meanhospital-stayingtime(MHT)wereanalyzed.Thedatawerecomparedwiththatof420casesoftransfemoralcoronaryprocedures(TFCP)inthesameperiod.ResultsSuccessratesandproximalcoronarycomplicationsweresimilarinbothgroups.SeverevagalreflexeswerelessinTRCPgroupthaninTFCPgroup.MOTwaslongerinTRCPgroup.MRTandMHTwereshorterinTRCPgroup.12(14.5%)radialarteryspasm,3(3.6%)radialarteryobstruction,1suddenrespiratoryarrestcausedbyjugularhematomawereobservedinTRCPgroup.ConclusionsTheefficacyandsafetyofTRCParedefinite.TRCPismoreeconomical.ForthepurposeofproperlyevaluatetheperipheralvascularcomplicationsofTRCP,itisnecessarytopayspecialattentiontoradialarteryocclusion,radialarterystenosis,andjugularhematoma.

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简介：Objective:Tointroducetheexperienceoftreatingfractureofbothtibiaandfibulawithmicro-invasivepercutaneousplateinternalfixationthroughfracturesiteapproach.Methods:Thedataof15patients(11malesand4females),including14adults(aged22-73years,mean=40years)and1child(aged10years),withfractureofbothtibiaandfibulawerestudiedretrospectivelyinthisstudy.Asmallincisionwasmadeatthefracturesiteoftibia.Thenrepositionwasmadeunderdirectvision,andinternalfixationwasemployedwithsteelplatesinsertingthroughthesmallincision.Results:Anatomicalreductionwasobtained.Nocomplicationwasfound.Unionoccurredontimein14patients.Onecasehealedafterasecondoperation.Conclusions:Micro-invasivepercutaneousplateinternalfixationisbeneficialtothehealingofboneandsofttissues.WithoutX-rayexamination,itisalsoeasytoreachanatomicalreductionandmaketibialinternalfixationwithbothplateswithmicro-invasivepercutaneousplateinternalfixation.

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简介：Trafficruleisakeyfactoraffectingtrafficflowandsafety.Wedevelopourmodels,includingthecellularautomatatrafficflowmodelaswellasthelinearregressionone,aimingatcalculatingtrafficflowandevaluatingsafetyconditionswithvariedtrafficrules.Then,wethoroughlyinvestigatefourtypesofpathsinafreeway,namelytwostraightlanes,threestraightlanes,ramps,androundaboutsascasestudiesanddiscussthedifferenttrafficrulesascomparison.Theresultsdemonstratethat“Keep-Right-Except-To-Pass”ruleisnotaseffectiveasthefreeruleinpromotingtrafficflow;however,thisruleensuressafetyfordriversbetterthanthefreerule.Additionally,anewtrafficrule,whichsetsdifferentpostedspeedlimitsforadjacentlanes,isproposedtopromotebettertrafficflowwithsafetyrequirementssatisfied.Furthermore,weapplyeffectiverulesandalternatives,leftdrivingnormsaswellasintelligentsystemasextensionandobtainbetterresults.Finally,model’ssensitivityanalysisregardingtoprobabilityofdeceleratingandpostedspeedlimitsprovesthestabilityofourresults.

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简介：From1990to2000,weusedHanssonpin,AOhollow-pullingscrew,andbendablescrewtotreat150casesoffreshfemoralneckfractureandtheresultwasanalysedtocomparetheefficacyofthethreemethodsofinternalfixation.

简介：AbstractBackground:Conventional treatment has limited efficacy in relapsed/refractory B-cell lymphoma. Since chimeric antigen receptor T-cell (CAR-T) technology has shown high safety and results in high remission rates, we investigated its efficacy and safety in B-cell lymphoma treatment and analyzed potential affecting factors to provide evidence for therapeutic strategies and applications.Methods:We searched databases including PubMed, Embase, and Cochrane up to July 2019. Meta-analysis 1 was conducted to study the efficacy of CAR-T cell for treating B-cell lymphoma, measuring the response rate and complete remission rate as outcomes. Sub-group analysis was performed for age, pathological type, target antigen, co-stimulatory molecule, and conditioning chemotherapy. Meta-analysis 2 was undertaken on the safety of the treatment with the incidence rate of toxicity (cytokine-releasing syndrome [CRS], neurotoxicity) as an outcome.Results:Seventeen studies were included in the systematic review and meta-analysis. It was found that CAR-T cells had good therapeutic effects in the following cases: B-cell lymphoma (patients ≥65 years old); diffuse large B-cell lymphoma pathological type; patients with treatment target antigen other than CD19; patients treated with co-stimulatory molecules other than CD28, including 4-1BB+CD28 or 4-1BB; and patients treated with cyclophosphamide/fludarabine pre-treatment protocol conditioning chemotherapy. Although the CRS and neurotoxicity incidences were high, most were reversible with minimal risk of death.Conclusion:CAR-T cell treatment is safe for clinical application; however, toxicity effects should be monitored.

简介：道德认知不能仅停留于知识层面。它最终应该内化为学生的一种品质,升华为学生的一种精神,而传统的教学方法使学生获得的道德认识却难以实现这一升华。因此,我们在思想道德教育中必须融入现代教育理念,让学生从自身实际出发,以兴趣为先导,以内需为动力,以实践为载体,积极倡导自主学习、合作学习与探究学习。使学生的主体性得到充分的发挥,让学生在主动思考、写作探索、亲身经历中自主地去发掘,自主地去构建科学的道德认知,为自身思想道德素质的全面提高创设扎实的基础。

简介：AbstractBackgrounds:GALLIUM is a global phase III study that demonstrated significant improvements in progression-free survival (PFS) for obinutuzumab plus chemotherapy (G-chemo) vs. rituximab plus chemotherapy (R-chemo) in previously untreated patients with follicular lymphoma (FL). This study aimed to report the results of a subgroup of patients in China.Methods:Patients were randomized to G-chemo or R-chemo. Responders received maintenance therapy for 2 years or until disease progression. The primary endpoint was investigator (INV)-assessed PFS. Secondary endpoints included the overall response rate (ORR) and complete response rate (CRR) at the end of induction chemotherapy, overall survival (OS), and safety.Results:Overall, 58 patients with FL were randomized to the G-chemo (n = 25) and R-chemo arms (n = 33). The INV-assessed PFS rate at 3 years was 81.8% in the G-chemo arm, vs. 70.2% in the R-chemo arm (hazard ratio 0.35; 95% confidence interval: 0.09-1.34; P = 0.1120). The INV-assessed CRRs (without positron emission tomography [PET]) in these arms were 24.0% and 21.2%, respectively, whereas the ORRs were 80.0% and 90.9%, respectively. INV-assessed CRR-PET was 52.6% in the G-chemo, vs. 60.9% in the R-chemo. Median OS was not reached in either arm. Grade 3 to 5 adverse events were more frequent in the R-chemo arm (97.0% vs. 88.0%).Conclusions:The results of this subgroup analysis were consistent with those of the global population, and they suggest that G-chemo has a positive benefit-risk profile in patients from China with FL.Trial registration:ClinicalTrials.gov, No. NCT01332968.

简介：Manypatientswithsensorineuralhearinglosshaveaprecipitoushigh-frequencylosswithrelativelygoodthresholdsinthelowfrequencies.Thispresentpaperbrieflyintroducesandcomparesthebasicprinciplesoffourtypesoffrequencyloweringalgorithmswithemphasisonnonlinearfrequencycompression(NLFC).AreviewoftheeffectsoftheNLFCalgorithmonspeechandmusicperceptionandsoundqualityappraisalisthenprovided.Forvowelperception,itseemsthatthebenefitsprovidedbyNLFCarelimited,whichareprobablyrelatedtotheparametersettingsofthecompression.Forconsonantperception,severalstudieshaveshownthatNLFCprovidesimprovedperceptionofhighfrequencyconsonantssuchas/s/and/z/.However,afewotherstudieshavedemonstratednegativeresultsinconsonantperception.Intermsofsentencerecognition,persistentuseofNLFCmightprovideimprovedperformance.Comparedtotheconventionalprocessing,NLFCdoesnotalterthespeechsoundqualityappraisalandmusicperceptionaslongasthecompressionsettingisnottooaggressive.Inthesubsequentsection,therelevantfactorswithregardtoNLFCsettings,time-courseofacclimatization,listenercharacteristics,andperceptualtasksarediscussed.AlthoughtheliteratureshowsmixedresultsontheperceptualefficacyofNLFC,thistechniqueimprovedcertainaspectsofspeechunderstandingincertainhearing-impairedlisteners.LittleresearchisavailableonspeechperceptionoutcomesinlanguagesotherthanEnglish.MoreclinicaldataareneededtoverifytheperceptualefficacyofNLFCinpatientswithprecipitoushigh-frequencyhearingloss.Suchknowledgewillhelpguideclinicalrehabilitationofthosepatients.

简介：AbstractImportance:Octreotide is an off-label medicine for congenital hyperinsulinism (CHI), but is currently widely used for treatment of patients with CHI. Thus far, variable efficacy and adverse effects have been reported for octreotide.Objective:The present study evaluated the efficacy and safety of a subcutaneous octreotide injection for treatment of diazoxide-unresponsive CHI in China.Methods:This study was a retrospective review of children with diazoxide-unresponsive CHI who were treated with a subcutaneous octreotide injection. The efficacy and side effects of the treatment were assessed.Results:Twenty-five Chinese children (15 boys) were involved in the study. Their median age at diagnosis was 8 weeks (range, 1-24 weeks) and median age at the final follow-up was 1.8 years (range, 0.3-3.3 years). Octreotide therapy effectively increased blood glucose levels in all patients. The intravenous glucose infusion rate was reduced in all patients. Twenty-one patients gradually discontinued the intravenous glucose infusion while receiving octreotide combined with frequent carbohydrate/glucose-rich feeding. Among patients with a monoallelic ATP-sensitive potassium (KATP) channel mutation, 50.0% showed gradual remission during follow up, indicating that the octreotide treatment may be a feasible alternative to surgery, especially for patients with monoallelic KATP-channel mutations. Transient elevation of liver enzymes occurred in 20.0% of patients, while asymptomatic gallbladder pathology occurred in one patient. The growth rates of these patients were normal (height standard deviation score was 0.3 ± 1.5 at the final follow-up).Interpretation:Octreotide was a well-tolerated, effective therapy for most children with diazoxide-unresponsive CHI.

简介：AIM:Toestablishtheefficacyandsafetyofbimatoprost0.03%monotherapyinglaucomaandocularhypertension(OHT)patientswithinadequateintraocularpressure(IOP)oncurrenttherapy.METHODS:Pre-andpost-switchIOPswereanalyzedfor59consecutivepatientswhowereswitchedfromcurrenttherapytobimatoprostmonotherapybetween2011-2015.Demographicinformation,diagnosis,andanyadverseeventswererecorded.ChangeinIOPpost-preswitchwasanalyzedusinga2-sidedStudent'spairedt-testatthe5%significancelevel.RESULTS:TherewasastatisticallysignificantmeanreductioninIOPatthefirstfollowupvisit,whichwasmaintainedatsubsequentfollowupvisitsforpatientsregardlessofdiagnosis,orpre-switchtreatment(P<0.001).SubgroupanalysisalsodemonstratedastatisticallysignificantmeanreductioninIOPwhenlookingatOHTpatientsonly,aswellaspatientswithanydiagnosisswitchedfromlatanoprostmonotherapytobimatoprostmonotherapy(P<0.001).CONCLUSION:Thisisthelargestindependentdatasetwhichsupportsswitchingglaucomapatientswithpoorresponsetocurrenttreatmentontobimatoprostmonotherapybeforeconsideringotheradjuvantmedicalormoreinvasivetherapy.