Volume 91  ·   Issue 37  ·  2011

Professor Qian Yijian, a famous expert in cardiovascular diseases and geriatrics in China, honorary president of Beijing Hospital, outstanding member of the Communist Party of China, and outstanding editor-in-chief of Chinese Medical Association magazines, died in Beijing on July 6, 2011 at the age of 86. In the early morning of July 12, representatives from all walks of life and editors of Chinese Medical Association magazines went to Beijing Hospital to bid farewell to Mr. Qian. On July 21, Beijing Hospital held a grand symposium in memory of Professor Qian Yijian. Nearly 100 people, including Vice Minister of Health Huang Jiefu, President of Beijing Hospital Lin Jiabin and the author, attended the symposium.

Hypertrophic scar is the result of excessive tissue repair after trauma. In the process of wound healing, the balance between collagen synthesis and degradation is maintained. Once this balance is destroyed, the synthesis of collagen obviously exceeds the degradation, resulting in a large number of irregular accumulation, forming hypertrophic scar (HS). HS not only seriously affects the appearance of patients, but also causes dysfunction due to joint contracture, and at the same time, it can cause unbearable itching and pain. Therefore, the prevention and treatment of HS has always been a hot topic for research and discussion [1]. Below, I will talk about my own views on the mechanism of scar occurrence, research model and the current situation of prevention and treatment.

Scar is the result of damaged tissue repair, and it is a common and frequently occurring disease in clinic. It is one of the important topics of medical research, and it has been paid much attention by plastic and cosmetic surgery. Although the mechanism of its occurrence and prevention and treatment measures have made some progress at present, in general, its pathogenesis is still unknown. Although there are many treatment methods, the curative effect is still not satisfactory, and it is still a basic problem that is increasingly prominent in clinic [1-2]. We believe that the relationship between scar and injury repair is "standard" and "root", and we advocate that the research of scar prevention and treatment should be closely combined with injury repair.

Objective To explore the efficacy of facial acne scars treatment with micro-plasma radio frequency.Methods A total of 24 patients with facial acne scars underwent micro-plasma treatment for 3 -5 times.And their efficacies were evaluated by the patient photographs before and 2 months after treatment.Results Facial acne scars were characterized by clouds of pitted scars with no specific shape.No difference appears in susceptibility between males and females.The overall improvement rate was 83.33％.The degree of improvement was as follows:significant 33.33％,moderate 25％,mild 25％ and poor 16.67％.Conclusion Micro-plasma technique is an effective therapy for acne scar.

Objective To explore the effects of PRX-2 gene transferred by lipofactamine on the human skin fibroblasts.Methods Normal human skin fibroblasts were cultured and PRX-2 gene was transferred by lipofactamine.The proliferation of fibroblasts was detected by MTT (3-(4,5-cimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide) and flow cytometry.Results The proliferation of PRX-2-transfected fibroblasts was stronger than that of normal counterparts.There were fewer cells during G0-G1 period and more cells during S and G2-M periods.The proliferative index increased.Conclusion The proliferation of fibroblasts may be modified by transfected PRX-2.Thus PRX-2 plays an important role during the healing of human skin wound.

A 74-year-old male developed cough and sputum without obvious trigger 10 months ago, mainly dry cough, with a little white mucous sputum. The cough was more frequent after waking up in the morning, and it was easy to develop after being multilingual. He had no fear of cold and fever, no night sweat and choking cough, no hissing voice, and coughed up bloody sputum for half a year, ranging from 1 to 3 times a day. There was no obvious abnormality in the chest radiograph of the local doctor. In the past 2 months, the patient's sputum with blood increased gradually, and occasionally bright red blood clots appeared. There was no dizziness, headache, palpitation and shortness of breath, no obvious change in weight, and no history of trauma or operation.

Objective To study explore the roles of spinal cord conduction velocity (SCCV) test in the diagnosis of spinal lesions in patients with subacute combined degeneration (SCD) of spinal cord and examine the values of SCCV in the localization of spinal lesions.Methods A total of 22 SCD patients recruited from 2005 to 2010 at our hospital underwent the SCCV test,the somatosensory evoked potential (SEP) test and MRI in spinal cord respectively.The results of SCCV were compared with those of SEP and MRI.Results There were 16 males and 6 females with an average age of (56 ± 13) years old (range:28-84).All SCD patients underwent the examinations of SCCV and spinal MRI.And 18 patients received the test of SEP.The abnormalities of SCCV test were 81.8％ (18/22) and those of MRI and SEP 13.6％(3/22)and 72.2％ (13/15)respectively.The results of SCCV and spinal MRI were both abnormal in 3 patients.Nineteen patients had normal MRI while 18 had abnormal SCCV results.Conclusion The early electrophysiological abnormalities in spinal cord of SCD patients may be detected objectively by SCCV.They appear earlier than those of pathological and imaging findings.The abnormal rates of SCCV are much higher than those of spinal MRI.The SCCV test can also help to localize the lesions in spinal cord of SCD patients.It may provide an objective diagnostic basis for the lesions of spinal cord of SCD patients at an early stage.

Objective To observe the efficacy and safety of fascia illiaca compartment block (FICB) with 0.2％ ropivacaine in the early analgesia of children with development dislocation of the hip (DDH) undergoing Salter arthroplasty.Methods Approved by the hospital ethics committee,a total of 64 DDH children were divided randomly into 2 groups:group F ( FICB with ropivacaine 0.2％,1 ml/kg,max.30 ml) and group C (FICB with 0.9％ normal saline 1 m[/kg,max.30 ml).The intra-operative doses of fentanyl,PACU (post-anesthesia care unit),CRIES pain score at 1,4 and 24 h postoperatively,patient satisfaction score and side effects were recorded.Results The intra-operative doses of fentanyl and PACU were lower.Pain scores at 1,4 and 24 h postoperatively were lower.And the patient satisfaction score was significantly higher in the FICB group.Conclusion The administration of ropivacaine (0.2％ ) for FICB in the early analgesia of DDH children has the advantages of safety,precision,long-lasting and convenience.

Objective To evaluate the safety and efficacy of enteral nutritional suspension (TPF-FOS) JEVITY in acute stroke patients.Methods A multicenter,prospective,post-marketing observational study was conducted.A total of 103 acute stroke patients with dysphagia received a 10-day regimen of enteral nutritional suspension (TPF-FOS) JEVITY via nasal gastric tube feeding.The parameters of serum prealbumin,serum albumin and percentage of abnormal blood glucose were evaluated and compared.The incidence of adverse events was recorded.The data were analyzed by paired t-test.Results At the end of the study in comparison with the baselines,the serum prealbumin increased significantly (213 mg/L ±56 mg/L vs 219 mg/L + 66 mg/L) and serum albumin decreased markedly (38 g/L + 5 g/L vs 36 g/L ±5 g/L) but stayed stable during tube feeding.No significant changes were found in percentage of abnormal blood glucose (40.78％ vs 38.76％ ),body mass index (23.1 kg/m2 ± 3.0 kg/m2 vs 22.8 kg/m2 ±2.9 kg/m2 ) and C-reactive protein ( 13 mg vs 14 mg).Only 18 adverse events were related with the study product.And most of them were gastrointestinal reactions.Conclusion Enteral nutritional suspension (TPF-FOS) JEVITY may increase the level of serum prealbumin in acute stroke patients and improve the patient nutritional status.With a low incidence of adverse events,it is a preferred option for enteral nutrition formulas in stroke.

Objective To evaluate the preoperative effects of acute hypervolemic hemodilution (AHH) on intracranial pressure,cerebral oxygen supply-demand balance and cardiovascular functions of neurosurgical patients.Methods Approved by hospital ethics committee,a total of 80 ASA grade Ⅰ/Ⅱ patients at our hospital during 2009,of either gender aged 18-60 yrs,undergoing elective craniotomy were recruited.The subjects were randomly divided equally into 2 groups:group H (hemodilution) and group C (control) (n ＝ 40 each).After induction,6％ hydroxyethyi starch solution was infused at the rate of 24 ml · kg-1 · h-1in group H,while patients in group C received compound electrolyte solution at the rate of 6 ml · kg-1 · h-1.Central venous pressure (CVP),cardiac output index (CI),stroke volume variation (SVV) and cerebral spinal fluid pressure (CSFP) were recorded at the following time points:TBase (before induction),T0 ( after induction and hemodynamic stabilization),T30 ( after infusion for 30 min) and T60 ( after infusion for 60 min).Blood samples from radial artery and jugular bulb were collected and calculated for systemic vascular resistance index (SVRI) and cerebral oxygen uptake rate (CERO2 ).The dosing frequency of vasoactive drugs was also recorded.Results CI in group H was significantly higher than that in group C (P ＜ 0.01 ).No significant difference was found in both SjvO2 and CERO2 between groups and among different points of time (P＞0.05).At the end of AHH,CVP and CSFP were (12 +2.2) mm Hg and (20.0 ±2.1 ) mm Hg respectively.They were significantly higher than that in group C (P ＜ 0.01 ).Conclusion Preoperative AHH in craniotomy will increase Ci and maintain the balance of cerebral oxygen supply.But its clinical application is limited in the patient with high intracranial pressure due to the simultaneous increases in CVP and CSFP.

Objective To explore the effects of splenic flexure and sigmoid colon variation on anastomosis after left colectomy.Methods The clinical data of 76 descending colon patients were collected retrospectively from March 2004 to April 2011 at our hospital.Statistical analysis was performed for the types of splenic flexure and sigmoid colon with regards to the choice of anastomosis.Results There were mesenteric type (n ＝55),mobile type (n ＝7) and adhesive type (n ＝ 14) for splenic flexure.And among 61 regular types,15 were of variable type for sigmoid colon variation.There was significant difference of anastomosis between the types of sigmoid colon variation [43(78.2％ ) vs 5(71.4％ ) vs 9(64.3％ ),P＞0.05] while no significant difference existed between the types of splenic flexure [ Ⅰ type 56(91.8％ ) vs Ⅱ type 1 ( 14.3％ ),Ⅲ or V type 0,P ＜ 0.05 ].Conclusion A clinician should pay more attention to the types of sigmoid colon variation.And it helps to select the right approach of anastomosis after left colectomy.

Objective To evaluate the values of serum level of B type natriuretic peptide level (BNP) in the prediction of fluid overloading after major abdominal operations.Methods The levels of BNP were dynamically monitored in 105 patients during peri-operative period from February 2009 to November 2010.Then comparisons were made with age and the volume of positive fluid balance.Results A post-operative elevation of BNP was observed in all cases.Among them,the peak level of BNP exceeded 100 ng/L in 32 patients while a normal peak level of BNP was found in 73 patients.Congestive heart failure (CHF) was diagnosed in 5 patients.At every single time point,the volume of positive fluid balance showed no significant difference among the peak level of BNP ＜ 100 ng/L,≥ 100 ng/L and CHF patients ( all P ＞0.05).In the group of peak level of BNP ≥100 ng/L,the patients received post-operative diuretic and the urine volume increased significantly [ ( 280 + 55 ) ml/h vs ( 82 + 22 ) ml/h,P ＜ 0.05 ].However,in the group of the peak level of BNP ＜ 100 ng/L,the urine volume showed no difference after dosing of diuretic [ (95 ± 18)ml/h vs (89 ±24) ml/h,P ＞0.05].Single variance analysis showed that the elevated level of BNP was associated with age and concurrent cardiopulmonary diseases(R ＝0.87,P ＝0.006) but not with the volume of positive fluid balance ( R ＝ 0.43,P ＝ 0.080).And multiple variance analysis showed the similar results (R＝0.59,P ＝0.020,R＝0.38,P＝0.120).In all cases,the levels of BNP peaked at 12 hours post-operation.However,body weight and the volume of positive fluid balance peaked at 18 - 24 hours post-operation.Conclusion The post-operative level of BNP is associated with age.And a highly elevated level of BNP may predict the occurrence of fluid overloading.An early peak of BNP value may be used as a cut-off point of positive and negative fluid balances.

Objective To explore the hospital expenses and hospital stay of surgical management for endometriosis and adenomyosis.Methods The average hospital expenses and average hospital stay were compared for a total of 12003 patients of endometriosis and adenomyosis confirmed operatively at our hospital from January 1994 to December 2008.And the relevant factors consisted of surgical phases,pathological types,surgical approaches,surgical routes,definite procedures and age groups.Results The average hospital expenses were significantly higher than average gynecologic surgical expenses( RMB 7073 vs RMB 6847,P ＜0.01 )while and the average hospital stays significantly shorter than the latter(6.8 vs 8.6 days,P ＜ 0.01 ).The periods of 2006 -2008 and 1994 - 1996 had significantly different average hospital expenses ( RMB 7853 vs RMB 3382,P ＜0.01 )and average hospital stay(6.4 vs 9.5 days,P ＜0.01 ).Multivariate analysis showed age was the most important correlated factor for the hospital expenses of endometriosis and adenomyosis surgeries( all P ＜ 0.01 ).And surgical approach was one of the most important factors for hospital stay(all P ＜ 0.01 ).Conclusion Adenomyosis has the highest cost and younger endometriosis patients carry the lowest economic burden.Laparoscopy and conservative surgery may reduce the economic burden of endometriosis and adenomyosis operations.

Objective To explore the risk factors associated with twin pregnancy in double embryo transfer.Methods A retrospective analysis was performed for 2970 double embryo transfer cycles,including 1984 cycles of fresh embryo transfer and 986 cycles of frozen-thawed embryo transfer (FET).Multiple factor Logistic regression was used.The twin pregnancy rate was studied in group of age ＜ 35 or age ≥ 35 years old,in group of zero,single or double high-quality embryos transferred and group of fresh embryo transfer or FET cycles.Results (1) There was a significantly negative correlation between women's age and twin pregnancy according to the analysis of multiple factor Logistic regression ( P ＜ 0.01 ).And a significantly positive correlation existed between the number of high-quality embryos transferred,FET and twin pregnancy (P ＜0.0l ) ; (2)the twin pregnancy rate of both fresh embryo transfer and FET cycles was higher in group of age ＜35 years than that in group of age ≥35 years ( 16.0％ vs 8.0％,P ＜0.01 ; 26.9％ vs 14.2％,P ＜0.01 ) ; (3) the twin pregnancy rate of fresh embryo transfer cycles with double high-quality embryos transferred was higher than that with zero or single high-quality embryos transferred ( 19.1％ vs 5.4％ ;19.1％ vs 11.0％,P ＜ 0.01 ); the twin pregnancy rate of FET cycles with double high-quality embryos transferred was also higher than that with zero or single high-quality embryos transferred (32.7％ vs 10.8％ ; 32.7％ vs 20.7％,P ＜0.01 ) ; (4)the twin pregnancy rate of FET cycles was significantly higher than that of fresh embryo transfer cycles (24.7％ vs 14.9％,P ＜0.01 ).Conclusion Women's age,the number of high quality embryos transferred and FET are risk factors associated with twin pregnancy.At reproductive centers with a mature technique of FET,we recommend performing single high-quality embryo transfer in FET cycles to reduce the occurrence of twin pregnancy.

Objective To investigate the clinical feature of cryptosporidium infection in HIV/AIDS patients with chronic diarrhea.Methods 253 Stool samples were collected from HIV/AIDS patients with chronic diarrhea during Nov.2009 to Dec.2010.The samples were concentrated by Formalin-Ethyl Acetate Sedimentation technique and stained by Modified acid-fast stain (AFS) for the identification of oocysts by microscopy.Derided the cases into three groups according to their CD4 cell counts ( ＜ 200,≥ 200 and ＜500,≥ 500/μl) ; meanwhile the cases were devided into three groups by their age ( 20 - 35,36 - 55,56 -69).Analyzed the groups by comparison.Results The total infection rate of Cryptosporidium in AIDS patients was 12.6％ in 253 cases.CD4+ T-lymphocyte counts was related to the infection rates of cryptosporidium,the difference was statistically significant ( x2 ＝ 10.33,P ＜ 0.01 ):the infection rate were 20.4％ (20/98),9.23％ (12/130),0(0/25) separately.In the 32 Cryptosporidium positive cases,22 (68.8％ )cases stood with diarrhea above 5 times per day,the three kind of CD4 counts level were separately 15( 15/20),7(7/12),0.The difference was no statistically significant ( P ＞0.05).HIV/AIDS patients with chronic diarrhea who progressed during asymptomatic period,pre-AIDS period,AIDS period,had the infection rate of 0 (0/7),21.3％ ( 19/89 ),8.3％ ( 13/157 ) respectively,the difference was statistically significant ( x2 ＝9.822,P ＜0.01 ) ; 22 out of 32 Cryptosporidium positive cases in HIV patients were diagnosed with enteritis,the infection rate in urban area and rural area was 6.5％ (7/104) and 16.8％ ( 25/149 ) separately,the difference was statistically significant ( x2 ＝ 5.596,P ＜ 0.05 ).Comparing different age groups,Cryptosporidium infection status were separately 7.3％ (4/55),13.4％ (22/164),17.6％ (6/34).Each group's comparative difference was no statistically significant (x2 ＝2.29,P ＞ 0.05).Conclusion The infection rate of cryptosporidium and clinical severity of cryptospofidium infection are statistically correlated with CD4 + T-lymphocyte counts,with AIDS stage,with HIV associated proctitis.

Objective To explore the prevalence,clinical and prognostic significance of anticardiolipin (aCL) IgG/M/A antibodies and anti-β2-glycoprotein Ⅰ (2-GPI) IgG/M/A antibodies in patients with lymphoma.Methods ACL IgG/M/A antibodies and anti-β2-GPl IgG/M/A antibodies were determined by enzyme-linked immunosorbent assay (ELISA) in 129 lymphoma patients,46 SIE patients,38 rheumatoid arthritis (RA) patients,24 primary Sj(o)gren's syndrome (pSS) patients and 58 healthy controls.Laboratory and clinical features (thrombosis,event-free-survival time,etc.) were analyzed retrospectively from the clinical database.Results ( 1 ) Elevated APL level was found in 52/129 lymphoma patients (40.3％):aCL IgG/M/A antibodies in 11.6％ (15/129) and anti-β2-GPl IgG/M/A antibodies in 32.6％ (42/129) of lymphoma patients.There were significant differences between the prevalence and level of APL in lymphoma patients and healthy controls.But no difference was found between the lymphoma patients and SLE,RA or pSS patients.(2) APL was correlated with lymphoma dervied from T or NK/T cells ( P ＜ 0.05 ).( 3 ) No difference was found between the incidence of thrombosis in lymphoma patients with or without APL.(4) A strong negative correlation was found between the elevated APL and the eventfree survival.Conclusion APL is elevated in 40.3％ of lymphoma patients.And it is significantly higher than that in healthy controls and similar with that in SLE,RA or pSS patients.APL is correlated with lymphoma cell origin and shortened event-free survival.

Objective To explore the methylation status of T-cadherin promoter region in human esophageal carcinoma cell lines EC1 and EC109 and elucidate the effects of 5-azacytidine-2′-deoxycytidines (5-Aza-CdR) on their abilities of proliferation and invasion,the methylation status and the expression of T-cadherin.Methods The expression level of T-cadherin was measured by Western blot.And the methylation status of T-cadherin promoter region was analyzed by methylation-specific PCR (polymerase chian reaction),separately before and after a treatment of demethylating agent 5-Aza-CdR.Results The T-cadherin gene was hypermethylated in EC109 cells but semi-methylated in EC1 cells.After a treatment of 5-Aza-CdR,T-cadherin gene methylation was reversed.And the gene expression was strongly up-regulated in both cells.5-Aza-CdR could decrease the proliferation and effectively inhibit the ability of cell invasion ( P ＜ 0.01 ).Conclusion The aberrant methylation in promoter region is an important mechanism of T-cadherin gene inactivation in human esophageal carcinoma cells.5-Aza-CdR can increase the expression of T-cadherin by a reversal of hypermethylation and effectively inhibit the proliferation and invasion of tumor cells.

Objective To explore the effects of receptor interacting protein (RIP) 140 gene overexpression upon the in vitro proliferation,apoptosis,invasion and migration of microglioma cells.Methods The BV-2 RIP140 overexpression model (BV-2-1)was constructed by Lipofection and G418 selection,then validated by real-time PCR and Western blotting.The proliferation,apotosis,invasion and migration potencies were compared between BV-2-1 and its parents by 3- (4,5-cimethylthiazol-2-yl)-2,5-diphenyl tetraxzolium (MTT) assay,flow cytometry and Transwell chamber.Results The BV-2-1 model was successfully constructed.Compared to those of the BV-2 group,the RIP140 mRNA and protein expression levels of BV-2-1 were markedly higher than those of the BV-2 group(t ＝ 49.794,P ＜ 0.01 ).MTT assay showed that the absorbance values in the BV-2 group were 1.157 ±0.013,1.679 ±0.005 and 2.609 ± 0.008 at 24,48,and 72 hours respectively.And those were 0.929 ± 0.013,1.188 ± 0.008 and 1.528 ±0.012 in the BV-2-1 group respectively.The proliferation at the time points of 48 and 72 hours of the BV-2-1 group were significantly lower than that of the BV-2 group ( t ＝ 6.058 and 9.245,both P ＜0.01 ).Annexin-V staining showed that there were significant differences in the apoptosis rates between the BV-2 and BV-2-1 cells [ (5.35 ± 0.23 ) ％ vs ( 3.46 ± 0.45 ) ％,t ＝ 6.619,P ＝ 0.003 ) ].Transwell assay showed that the invaded cell number of the BV-2-1 group was 166 +43.And it was obviously higher than that of the BV-2 group (93 ± 32,t ＝ 3.403,P ＝ 0.007 ).Transwell assay also showed that the migrated cell number of BV-2 cells was 101 ± 25.And the migration potency of the BV-2-1 group (202 ± 50) was significantly stronger than that of the BV-2 group (t ＝4.104,P ＝0.002).Conclusion RIP140 effectively inhibits the proliferation and facilitates the apotosis of microglioma cells.And it may effectively facilitate the in vitro invasion and migration of microglioma cells.

Objective To label murine bone marrow derived endothelial progenitor cells (EPCs) with nanometer magnetic probe (Resovist) and perform magnetic resonance (MR) imaging on these labeled cells.Methods Murine bone marrow derived mononuclear cells (MNCs) were isolated.And EPCs were selected by adherence method,expanded and incubated with Resovist.Cell surface markers were detected with immunofluorescence.Endocytosis of DiI-AcLDL (dil-labeled acetylated low density lipoprotein) and in vitro binding of FITC-UEA-1 (fluoresceinisothiocynate-vicia ervilia lectin-1 ) were also detected.Intracellular iron was detected by Prussian blue dye.Different quantities of labeled cells were visualized by 7.0T MR.Results The cultured cells expressed the endothelial cell markers of CD31 and KDR with immunofluorescence.The cells could bind UEA and endocytosize LDL.Iron particles could be observed in cells with Prussian blue dying and the ratio of label was approximately 100 percent.The Resovist labeled cells showed a lower signal than the non-labeled counterparts on T2* WI ( weighted imaging),especially the 1 x 106 labeled cells showed the lowest signal.Conclusions Murine bone marrow derived MNCs can be induced into EPCs and Resovist can label them effectively.The labeled cells can be visualized in vitro by 7.0T MR for cellular therapy and real time in vivo monitor.

The prevalence of epilepsy is 7‰, of which 1/5 is refractory epilepsy [1]. The pathogenesis of epilepsy is many, including a series of genetic and acquired causes. Even in well-controlled epilepsy patients, the current treatment only treats symptoms, but does not improve the brain abnormalities that cause epilepsy. Standard drugs for epilepsy, such as phenytoin and sodium valproate, can only reduce the number of short-term seizures of traumatic epilepsy, but cannot prevent the development of chronic epilepsy [2].

keloid (keloid) is a common and multiple pathological scar in clinic. The pathogenesis is unknown until now, and there is a lack of radical treatment in clinic [1]. At present, the comprehensive treatment based on surgery is the generally accepted and recognized first-line treatment scheme. In recent years, with the deepening of molecular level research in the pathogenesis of keloid, cytokine and gene therapy have brought new hope for the cure of keloid.

Acquired respiratory tract infections in intensive care unit (ICU) lead to high mortality rate, especially when some highly drug-resistant bacteria cause acquired respiratory tract infections, which lead to the increase of mortality rate of patients and increase the burden of social medical care. A multicenter study by de Smet et al. at Utrecht University Medical Center in the Netherlands found that SOD and SDD could reduce the production of drug-resistant bacteria and the incidence of acquired infection in ICU patients. The results of the study were published in Lancet Infect Dis, 2011, 11: 372-380.

A 35-year-old female had intermittent blurred vision with confusion in her right eye for more than 10 days, and her vision and consciousness returned to normal after about 40 minutes each time. At the age of 17, she had a history of fever, cough, sputum, hemoptysis, etc., and her symptoms were relieved after anti-tuberculosis treatment. Neurological specialist examination showed clear speech, normal time and space orientation, basically normal memory and cognitive function (generalization, calculation, judgment and thinking), no change in personality, no neck rigidity, negative Kernig sign and Lasegne sign; The visual acuity, visual field and fundus examination of both eyes showed no abnormalities.

In the review work, the author found that the quality of some clinical research papers is inconsistent with the academic status and ability of the authors and responsible authors (or corresponding authors), and the responsible authors fail to fulfill their due responsibilities is an important reason. The responsible authors are the core of clinical research, and the responsible authors participate in or undertake the whole process and key work of research, such as topic selection, fund application, scheme design, organization and implementation, analysis and summary, submission and publication.