简介：AbstractObjective:To evaluate the necessity and effectiveness of a preplanned technique for drilling during transcanal endoscopic ear surgery.Methods:Study design: Retrospective case series study from June 2011 to June 2015. Setting: Private tertiary care hospital. Patients: Eighty-five ears of 78 patients, age ranging from 9 to 57 years underwent transcanal endoscopic drilling for various types of pathology in their middle and external ear. Interventions: Application of a preplanned technique for transcanal drilling in endoscopic ear surgery that involved short timed drilling with use of intermittent irrigation and suction. Every events of the procedure were done one after another with the single hand of the surgeon. An attachment providing protecting sheath around rotating burr was used during each time of drilling. Main outcomes measure: Efficacy of such drilling technique in single handed endoscopic ear surgery. Presence of any postoperative thermal injury of facial nerve and any lacerated injury of skin of external ear.Results:This preplanned technique was found suitable for transcanal endoscopic drilling with the single hand of the surgeon. Postoperative facial nerve palsy or laceration of skin of external ear was not noted in any patient.Conclusion:After using the present technique, transcanal endoscopic drilling could be done easily and safely with single hand of the surgeon.

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简介：AbstractThe first practice of pre-implantation genetic testing (PGT) was reported more than 30 years ago. PGT, originally named preimplantation genetic screening (PGS) and pre-implantation genetic diagnosis (PGD), is now categorized as PGT for aneuploidies (PGT-A), PGT for monogenic/single-gene defects (PGT-M), and PGT for chromosomal structural rearrangements (PGT-SR). Patients with fertility issues caused by advanced maternal age, carrier status of chromosomal abnormalities, or harboring pathogenic variant(s) are recommended to undergo PGT to increase the possibility of successful live birth and avoid potentially affected newborns. High-throughput techniques, such as DNA microarrays and next-generation sequencing (NGS), have enabled comprehensive screening of all 24 chromosomes, instead of few loci at a time. Furthermore, as a comprehensive PGT, PGT-Plus was enabled by the rapid development of a genome-wide single-cell haplotyping technique to detect embryo aneuploidy, single-gene disorders, and chromosomal aberrations simultaneously using a single universal protocol. In addition, non-invasive approaches enable a more intact embryo during the biopsy procedure, which may avoid potential mosaicism issues at a certain scale by testing spent culture media (SCM). As a novel PGT application, PGT-P detects genome-wide variations in polygenic diseases, which account for a large proportion of premature human deaths and affect a markedly larger population than monogenic diseases, using polygenic risk score calculation to decrease the potential of affecting complex conditions. Owing to the emergence of new technologies recruited to PGTs, more couples with infertility issues have a promising chance of conceiving a healthy baby, ultimately facilitating the human species to live more prosper.

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简介：目的探讨乙型肝炎病毒pre—S1Ag、pre—S2Ag、HBV—DNA、HBV—M的相关性及其临床意义。方法HBV—DNA采用荧光定量PCR法；HBV—M及pre—S1Ag、pre—S2Ag采用ELISA法，检测96例HBV—DNA阳性感染者血清中pre-S1Ag、pre—S2Ag、HBV—M，同时以30例HBV—M全阴性的健康体检者血清作为对照，并对结果进行统计学分析。结果96例HBV—DNA阳性患者中HBsAg、HBeAg、HBcAb阳性检出率为64．6％；HBsAg、HBeAb、HBcAb阳性检出率为20．8％；HBsAg、HBcAb阳性栓出率为14．6％；pre—S1Ag在96例HBV—DNA阳性标本中检出率为70．8％；pre—S2Ag检出率为79．2％；均明显高于HBeAg的阳性率64．6％，30例对照中未检测出pre—S1Ag、pre—S2Ag及HBV—DNA。结论HBeAg、HBV—DNA、pre—S1Ag、pre—S2Ag之间具有一定的关联性。pre—S1Ag和pre—S2Ag均较HBeAg敏感。pre—S1Ag与pre—S2Ag的栓出率差异无显著性，ELISA检测HBV—M、pre—S2Ag及pre—S1Ag只是表型指标，只能提供HBV感染的间接证据。而HBV—DNA的检测是HBV感染与否的直接证据。HBV—M、pre—S1Ag、pre—S2Ag、HBV—DNA的检测各自有其独特的临床意义。应用pre—S1Ag、pre—S2Ag、HBV—DNA及HBV—M进行联合检测，对HBV感染的早期诊断，了解HBV复制、转归及监测疗效和预后有重要的意义。

简介：Pre-mRNAsplicingisafundamentalprocessrequiredfortheexpressionofmostmetazoangenes.Itiscarriedoutbythespliceosomethatcatalyzestheremovalofnon-codingintronsequencestoligateexonsintomaturemRNApriortotransportandtranslation.Thepurposeofourstudyistoexplorewhethertheinvitrounlabeledpre-mRNAsplicingassaycouldbeperformedasanalternativemethodofsplicingreactionotherthantheradiolabeledone.Twodifferentsplicingmethodsinvitro,Plabeledandunlabeledpre-mRNAasthesubstratesinthereaction,wereinvestigated.TheradiolabeledproductswerevisualizedbyautoradiographywhiletheunlabeledproductswereobservedbyEthidiumBromide(EB)staining.Asaresult,althoughtherearemoreunspecificbandsintheEBstainingassaythan32Plabeledone,theRNAproductsofinvitrosplicingcouldbeobservedclearly.Thissuggeststhattheunlabeledpre-mRNAsplicingassaycanbeanoptionalsubstitutionfortheisotope-labeledassay.

简介：Gapinducedpie-pulseinhibition(Gap-PPI)ofacousticstartlereflexhasbeenusedasameasurementoftinnitusinanimalmodels.However,whetherthistestissensitivetodetecttinnitusinhumansisstillunclear.Basedonthetestingprocedureusedinanimalstudies,ahumansubjecttestingmethodwasformulatedandconductedtoinvestigateifasimilarresultcouldbefoundintinnituspatients.Audiologicandtinnitusassessmentsandacousticstartlereflexmeasurementswereperformedonseventinnitussubjectsandnineagematchedsubjectswithouttinnitus.TherewasnosignificantdifferencefoundbetweenthecontrolandtinnitusgroupontheGap-PPlacrossthefrequenciesevaluated.Theamplitudeofthestartleresponseinthetinnitusgroupwithnormalhearingthresholdswassignificantlyhigherthanthecontrolgroupandthosewithtinnitusandhearingloss.Thispreliminaryresultsuggeststhathyperexcitabilityinthecentralauditorysystemmaybeinvolvedintinnitus.Therewasnocorrelationbetweenhearingthresholdsandtheincreasedamplitudeofstartleresponse.

简介：Objective:Toreportasurgicalmethodforthetreatmentofpre-auricularfistulatolowerpost-operativerecurrencerate.Methods:Clinicaldataof187patientswithpre-auricularfistulawhounderwentenblocresectionattheAffiliatedHospitalofLuzhouMedicalCollegefromAugust2006toNovember2012wereretrospectivelyreviewed.FactorsthatmightaffecttheprognosisfollowingEnblocfistularesectionborderedbythesuperficialtemporalisfascia,helixperichondriumandauriculocephalicsulcuswereinvestigated.Results:Ofthe187patients,181achievedprimaryhealingand6endedupwithdelayedhealing.Duringthefollow-upperiod(onetosevenyears),therewere4casesofrecurrence(2.1%).Conclusions:Cleardemarcationofsurgicalresectioncanfacilitateeasyandthoroughresectionofpreauricularfistulaandleadtolowrecurrencerate.Propertimingandcarefulsearchforpotentialfistulabranchesarethetwocrucialfactorsaffectingprognosis.

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简介：AbstractBackground:We aimed to describe and analyze the pre-hospital emergency medical service (EMS) in Beijing and provide information for the government and medical institutions to optimize EMS.Methods:We collected all pre-hospital emergency data in Beijing from 2008 to 2017. The chief complaint in each case was classified according to the Medical Priority Dispatch System (MPDS). The sites’ administrative districts were determined through geo-encoding of addresses and then classified into four functional regions. We analyzed the demand for EMS, emergency response times (ERT), and disease spectrum for Beijing as a whole, and for each functional region.Results:A total of 4,192,870 pre-hospital EMS cases met the inclusion criteria, with a significant increase (P < 0.001) of 51.60% from 2008 to 2017. EMS demand was positively associated with population (r= 0.946, P < 0.001). The pre-hospital EMS demand rate was 1907.05 in 2008 and 2172.23 in 2017 per 100,000, with no significant change (P = 0.57). ERT increased significantly (P = 0.001), from 19.18 min in 2008 to 24.51 min in 2016. According to MPDS classifications, the demand for pre-hospital care increased for 14 diseases, remained stable for 19, and decreased for only 1 disease. Cases of injury-related disease increased significantly from approximately 90,000 in 2017, accounting for 20% of all pre-hospital EMS cases, and the demand rate decreased in the core region but increased in the sub-urban regions. Cases of heart problems and stroke/transient ischemic attack also increased significantly in the four functional regions, with the highest demand rate in the Core Functional Region.Conclusions:More resources and effort should be devoted to pre-hospital EMS according to the increased pre-hospital EMS demand and prolonged ERT in Beijing over our 10-year study period. Changes in disease spectrum and differences between functional regions should also be considered.

简介：Atotalof30studentsscoringbetween12and20ontheTestAnxietyScalewhohadbeenexhibitingananxiousstate>24hours,and30normalcontrolstudentswererecruited.IndicesofheartratevariabilitywererecordedusinganActiheartelectrocardiogramrecorderat10minutesbeforeauricularpressing,inthefirsthalfofstimulationandinthesecondhalfofstimulation.Theresultsrevealedthatthestandarddeviationofallnormaltonormalintervalsandtherootmeansquareofstandarddeviationofnormaltonormalintervalsweresignificantlyincreasedafterstimulation.Theheartratevariabilitytriangularindex,very-low-frequencypower,low-frequencypower,andtheratiooflow-frequencytohigh-frequencypowerwereincreasedtodifferentdegreesafterstimulation.Comparedwithnormalcontrols,therootmeansquareofstandarddeviationofnormaltonormalintervalswassignificantlyincreasedinanxiousstudentsfollowingauricularpressing.Theseresultsindicatedthatauricularpressingcanelevateheartratevariability,especiallytherootmeansquareofstandarddeviationofnormaltonormalintervalsinstudentswithpre-examanxiety.

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简介：目的探讨构建携带人pre—mir181a基因的重组腺病毒载体，为基因治疗研究提供一种新的方法，并观察其在神经胶质瘤细胞U251细胞中的表达。方法以从Genesil公司购买的含有mir181a的质粒为模板扩增pre—mir181a基因，将回收的PCR产物片段克隆入pGenesil载体，获得重组质粒pGenesil—pre—mir181a。从pGenesil—pre—mir181a上通过LR体外同源重组将mir181amicroRNA表达框转移至pGSadeno腺病毒表达载体上。在体外用不同感染复数（M·O·I）值rAd5-mir181ab分别转染神经胶质瘤细胞U251细胞。采用流式细胞仪、RT—PCR方法检测目的基因的转染效率和表达。结果PCR、酶切鉴定以及序列测定与比对分析表明，重组腺病毒rAd5-mir181a构建正确。神经胶质瘤细胞U251细胞转染rAd5-mir181a的最高效率可达99％，转染后的神经胶质瘤细胞U251细胞表达相应的mir181a。结论本实验成功构建了含mir181a基因的重组腺病毒rAd5-mir181a载体，在体外能高效转染神经胶质瘤细胞U251细胞。

简介：摘要目的探讨乙肝病毒前S1抗原（Pre-S1Ag）与HBV血清标志物（HBVM）同步检测的临床价值。方法对确诊的380例乙肝病例空腹抽血，采用ELISA法及HAMILTN全自动酶联免疫分析仪同步检测Pre-S1Ag与HBVM（HBsAg、抗-HBs、HBeAg、抗-HBe、抗-HBc），并对结果进行比较分析。统计学处理采用χ2检验。结果统计显示PreS1Ag的检出率HBsAg、HBeAg、HBcAb阳性组（78.8%）明显高于HBsAg、HBeAb、HBcAb阳性组（41.6%），差异有显著性（χ2=21.04，P＜0.01）；HBsAg、HBeAg阳性组PreS1Ag阳性率（79.3%）明显高于HBsAg、HBcAb阳性组（25.3%），提示HBeAg阳性组中PreS1Ag阳性率明显高于HBeAg阴组，差异有显著性(χ2=21.49，P＜0.01)；提示PreS1Ag是一个与HBeAg同时存在的较好指标。结论前S1抗原与病毒复制有关，与HBeAg具有一致性；与HBVM同步检测，可减少和避免HBeAg系统发生变异所致的假阴性对临床的误导。

简介：AbstractTotal pancreatectomy with islet autotransplantation (TPIAT) is an effective treatment option for non-diabetic patients with intractable chronic pancreatitis. The outcome and potential benefits for pre-diabetic and diabetic patients are less well established. Thirty-four patients underwent TPIAT were retrospectively divided into 3 groups according to pre-operative glycemic control: diabetes mellitus (DM) (n=5, 15%), pre-DM (n=11, 32%) and non-DM (n=18, 54%). Pre-operative fasting c-peptide was detectable and similar in all 3 groups. Islet yield in the DM group was comparable to pre-DM and non-DM groups (median islet equivalents [IEQ] was 191,800, 111,800, and 232,000 IEQ, respectively). Patients received islet mass of over the target level of 2000 IEQ/kg in pre-DM and DM at lower but clinically meaningful rates compared to the non-DM group: 45% (5/11) and 60% (3/5) for a combined 50% (8/16) rate, respectively, compared to 83% (15/18) for the non-DM group. At 1 year, fasting c-peptide and HbA1c did not differ between DM and pre-DM groups but c-peptide was significantly higher in non-DM. Islet transplantation failed (negative c-peptide) only in 1 patient. Preoperatively, all patients experienced pancreatic pain with daily opioid dependence in 60% to 70%. Pancreatic-type pain gradually subsided completely in all groups with no differences in other painful somatic symptoms. Diabetic patients with measurable pre-operative c-peptide can achieve similar benefit from TPIAT, with comparable outcomes to pre-diabetic and non-diabetic patients including pain relief and the metabolic benefit of transplanted islets. Not surprisingly, endocrine outcomes for diabetic and prediabetics patients are substantially worse than in those with normal pre-operative glucose control.

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简介：Objective:Totestforpre-attentiveauditorydiscriminationskillsinIndianclassicalvocalmusiciansandnon-musicians.Design:Mismatchnegativity(MMN)wasrecordedtotestforpre-attentiveauditorydiscriminationskillswithapairofstimuliof/1000Hz/and/1100Hz/,with/1000Hz/asthefrequentstimulusand/1100Hz/astheinfrequentstimulus.Onset,offsetandpeaklatenciesweretheconsideredlatencyparameters,whereaspeakamplitudeandareaunderthecurvewereconsideredforamplitudeanalysis.Studysample:Exactly50participants,outofwhichtheexperimentalgrouphad25adultIndianclassicalvocalmusiciansand25age-matchednon-musiciansservedasthecontrolgroup,wereincludedinthestudy.ExperimentalgroupparticipantshadaminimumprofessionalmusicexperienceinIndianclassicvocalmusicof10years.However,controlgroupparticipantsdidnothaveanyformaltraininginmusic.Results:Descriptivestatisticsshowedbetterwaveformmorphologyintheexperimentalgroupascomparedtothecontrol.MANOVAshowedsignificantlybetteronsetlatency,peakamplitudeandareaunderthecurveintheexperimentalgroupbutnosignificantdifferenceintheoffsetandpeaklatenciesbetweenthetwogroups.Conclusion:Thepresentstudyprobablypointstowardstheenhancementofpre-attentiveauditorydiscriminationskillsinIndianclassicalvocalmusicianscomparedtonon-musicians.ItindicatesthatIndianclassicalmusicaltrainingenhancespre-attentiveauditorydiscriminationskillsinmusicians,leadingtohigherpeakamplitudeandagreaterareaunderthecurvecomparedtonon-musicians.

简介：MidwivesintheWellingtonregionhavenotedthatwomenreceivingprebirthacupunctureconsistentlyexperiencemoreefficientlabours.Midwivesreportthatthelengthoflabourisreduced,particularlyinprimigravidwomen,withareductioninmedicalinterventionrequired.Thispaperwillevaluateanauditof15midwiveswhohavecompletedaspecializedtrainingprogrammeinacupunctureandcurrentlyofferprebirthacupunctureasanadjuncttotheirmidwiferypractice.

简介：AbstractBackground:Patients’ recovery after surgery is the major concern for all perioperative clinicians. This study aims to minimize the side effects of peri-operative surgical stress and accelerate patients’ recovery of gastrointestinal (GI) function and quality of life after colorectal surgeries, an enhanced recovery protocol based on pre-operative rehabilitation was implemented and its effect was explored.Methods:A prospective randomized controlled clinical trial was conducted, patients were recruited from January 2018 to September 2019 in this study. Patients scheduled for elective colorectal surgeries were randomly allocated to receive either standardized enhanced recovery after surgery (S-ERAS) group or enhanced recovery after surgery based on pre-operative rehabilitation (group PR-ERAS). In the group PR-ERAS, on top of recommended peri-operative strategies for enhanced recovery, formatted rehabilitation exercises pre-operatively were carried out. The primary outcome was the quality of GI recovery measured with I-FEED scoring. Secondary outcomes were quality of life scores and strength of handgrip; the incidence of adverse events till 30 days post-operatively was also analyzed.Results:A total of 240 patients were scrutinized and 213 eligible patients were enrolled, who were randomly allocated to the group S-ERAS (n = 104) and group PR-ERAS (n = 109). The percentage of normal recovery graded by I-FEED scoring was higher in group PR-ERAS (79.0% vs. 64.3%, P < 0.050). The subscores of life ability and physical well-being at post-operative 72 h were significantly improved in the group PR-ERAS using quality of recovery score (QOR-40) questionnaire (P < 0.050). The strength of hand grip post-operatively was also improved in the group PR-ERAS (P < 0.050). The incidence of bowel-related and other adverse events was similar in both groups till 30 days post-operatively (P > 0.050).Conclusions:Peri-operative rehabilitation exercise might be another benevolent factor for early recovery of GI function and life of quality after colorectal surgery. Newer, more surgery-specific rehabilitation recovery protocol merits further exploration for these patients.Trial Registration:ChiCTR.org.cn, ChiCTR-ONRC-14005096