Interpretation of the complete scientific connotation of functional foods accurately prior to approval and registration based on animal tests and small sample size human food tests is challenging. Further technical evaluation after market introduction should be carried out on safety, health function and other aspects of those widely used commercial scale production products. According to the analysis report on the consumption situation of post-marketing population submitted when applying for product registration extension since the implementation of the functional food registration and filing management measures more than 3 years ago, the post-marketing evaluation report of functional food still lacks systematic and perfect evidence support. Based on the successful experience of evidence-based medicine and post-marketing evaluation evidence, this paper analyzes the post-marketing evaluation content, evidence source construction, evidence classification and classification of functional food, and puts forward the preliminary idea of constructing post-marketing evaluation evidence body of functional food safety and health function technology from multiple view points, so as to provide insights into evidence system research in this field in the future.
Objective To evaluate the clinical appliance and significance of the technique of anorectal manometry. Methdos Different ways of anorectal manometry, domain of its appliance and its clinical appliance was summarized and reviewed. Results The technique of anorectal manometry not only has important value on the study of analrectal pathology and physiology, but also can be associated with other examinations to manage biofeedback therapy, diagnose all kinds of anorectal diseases and evaluate anorectal function. Conclusion Anorectal manometry is a safe, simple, harmless and impersonal examination technique. It is necessary in the examination of analrectal function, in the diagnosis and treatment of anolrectal diseases.
Objective To estimate the clinical curative effect of replacement of inverttype artificial total scapula and shoulder joint prosthesis and reserving arm with rehabilitation of function in the treatment of malignant tumor in shoulder. Methods From February 2001 and November 2004, five youth patients with primary malignant shoulder tumors were treated operatively by resection of neoplasmsthoroughly, replacement of inverttype artificial total shoulder blade and joint prosthesis, the functional reconstruction. Of them, there were 4 males and 1 female, aging from 19 to 26 years with an average of 23.6 years. Two cases were diagnosed as having osteosarcoma, one as having chondrosarcoma, and 2 as having Ewing sarcoma. After operation, the upper limbs was immobilized for 3 weeks. The rehabilitation training including passive exercise and initiative exercise. Results The average operative time was 425 min (380 to 530 min), and the blood loss ranged from 1 250 ml to1 900 ml(1 540 ml on average). The follow-up ranged from 7 to52 onths,with an average of 24.6 months. Postoperative complication included 1 case of pneumothorax, one case of shoulder incision skin part necrosis and 1 case of clavicle stump raising and pierce skin with shallow infection. No complication of postoperative incision deeply infection, nerve damage and prosthesis exposure or dislocation occurred. According to the scoring system of JOA(Japan orthopaedics association), the average score was 65 (60 to 72). The flexion and extension function of elbow joint recovered to normal. Conclusion The replacement of inverttype artificial total scapula and shoulder joint prosthesis is an efficacious method for the treatment of malignant tumor in shoulder. There are advantages of numerous adaption, wide range of motion and goodstability. It can not only reserve arm but also rehabilitate function.
ObjectiveTo investigate the establishment of a risk nomogram model for predicting vagus excitatory response in patients with functional epilepsy after radiofrequency thermocoagulation.MethodsA total of 106 patients with epilepsy admitted to the neurosurgery department of our hospital from January 2016 to June 2020 were selected and divided into the Vagus excitatory response (VER) group and the non-VER group according to their occurrence or absence. Logistic regression analysis was used to screen out the risk factors of VER during SEEG-guided Percutaneous radiofrequency thermocoagulation (PRFT) in patients with functional epilepsy, and R software was used to establish a histogram model affecting VER in SEEG-guided PRFT. Bootstrap method was used for internal verification. C-index, correction curve and ROC curve were used to evaluate the prediction ability of the model.ResultsLogistic regression analysis showed that age [OR=0.235, 95%CI (0.564, 3.076)], preoperative fugl-meyer score [OR=4.356, 95%CI (1.537, 6.621)], depression [OR=0.995, 95%CI (1.068, 7.404)], and lesion range [OR=1.512, 95%CI (0.073, 3.453)] were independent risk factors for the occurrence of VER in PRFT under the guidance of SEEG (P<0.05), and were highly correlated with the occurrence of VER in PRFT. Based on the above six indicators, a SEEG-guided colograph model of VER risk in PRFT was established, and the model was validated internally. The results showed that the C-index of the modeling set and validation set were 0.779 [95%CI (0.689, 0.869)] and 0.782 [95%CI (0.692, 0.872)], respectively. The calibration curves of the two groups fit well with the standard curves. The areas under the ROC curve (AUC) of the two groups were 0.779 and 0.782 respectively, which proved that the model had good prediction accuracy.ConclusionFor patients with functional epilepsy requiring seeg-guided PRFT therapy, age, preoperative Fugl-meyer score, depression and lesion range should be taken into full consideration to comprehensively assess the incidence of VER, and early intervention measures should be taken to reduce and reduce the incidence, which has good clinical application value.
Objective〓〖WTBZ〗To assess treating results of functional reconstruction of irrecoverable partial injury of brachial plexus and to improve the function ofinjured upper extremity. Methods Seventiy-nine cases with irrecoverable partial injury of brachial plexus were treated in transfer of muscle (tendon) or by fuctional anthrodesis (fixation of tendon) from January 1984 to June 2003. According to the evaluation criterion by American Shoulder and Elbow, Hand Association,all patients were followed up in motion of reconstructive joint and daily activities after operation for 1 year to 19 years. The effect of the operation was comprehensively scored and evaluated. Results Final results in 54 caseswere as follows: 30 patients with good results, 19 patients with fair results, and 5 with poor results. The results demonstrated some points as follow: ①if the shoulder was instable, athroedesis of shoulder would be a better choice;②the flexion of the elbow joint should be only reconstructed with the dynamic reconstructive methods. The reconstruction of flexion of elbow by transfer of pectoral major muscle was more effective than that by transfer of flexor carpi ulnaris muscle; ③the dynamic reconstruction of extension of digital and carpi was better than that of flexion of digital and opposition function of the thumb; ④the supination of the forearm was effectively reconstructed by transfer of flexorcarpi ulnaris muscle. Pronation teres muscle should be studied more in reconstruction of supination function of the forearm.
ObjectiveTo explore the feasibility to protect great auricular nerve during surgery for first branchial cleft anomaly in children.MethodsThe data of 17 cases of first branchial cleft cyst, sinus or fistula admitted to West China Hospital of Sichuan University from September 2005 to May 2015 were reviewed. The extent of lesion was demonstrated by enhanced CT before operation. Later surgery further proved that the middle ear and mastoid process was not involved in any of the cases. During surgery, some branches of great auricular nerve were dissected and spared. The cyst, sinus or fistula was obliterated completely while the whole or part of the parotid gland was preserved. The patients were followed-up from half a year to three years with mean time of 2 years and 1 month.ResultsNo recurrence or facial paralysis were found in all patients after surgery. Twelve patients had no paresthesia in the area innervated by great auricular nerve, five patients experienced numbness of ear lobe or inferior 1/3 of the auricle.ConclusionIt is feasible to protect some branches of great auricular nerve during the operation for first branchial cleft anomaly, which does not hinder the thoroughness of the resection for the lesion, and helps to improve the children’s quality of life.
OBJECTIVE: To study the reconstructional method and effect of shoulder joint function in the older obstetrical palsy with medial rotation contracture deformity. METHODS: From April 1996 to July 1999, 7 patients of older obstetrical palsy were adopted in this study. Among them, there were 5 males and 2 females, aged from 13 to 21 years old. No previous operation history and the main deformity was medial rotation contracture of shoulder. During operation, these patients were treated with "Z"-shape elongation of the tendon of subscapular muscle, transfer of the tendons of latissimus dorsi and teres major muscle to the tendons of supraspinous and infraspinous muscles. RESULTS: Followed up for 6 to 44 months(averaged 19 months), the Gilbert grading and Mallet scoring were 1.57, 7.57 preoperatively versus 3.45, 10.86 postoperatively, the abduction and external rotation of the shoulder joints recovered obviously. CONCLUSION: It is an effective operation for the older obstetrical palsy with medial rotation contracture of shoulder.
Temporal lobe epilepsy is the most common type of epilepsy in clinic. In recent years, many studies have found that patients with temporal lobe epilepsy have different degrees of influence in executive function related fields. This influence may not only exist in a certain field of executive function, but may be affected in several fields, and may be related to the origin site of seizures. However, up to now, there is no unified standard for the composition of executive function, and it is widely accepted that the three core components of executive function are working memory, inhibitory control and cognitive flexibility/switching. In addition, the International League Against Epilepsy proposed a new definition in 2010, and epilepsy is a brain network disease. There is a close relationship between brain neural network and cognitive impairment. According to the cognitive field, the brain neural network can be divided into six types: default mode network, salience network, executive control network, dorsal attention network, somatic motor network and visual network. In recent years, there has been increasing evidence that four related internal brain networks are series in a range of cognitive processes. The executive dysfunction of temporal lobe epilepsy may be related to the changes of functional connectivity of neural network, and may be related to the left uncinate fasciculus. This article reviews the research progress related to executive function in temporal lobe epilepsy from working memory, inhibitory control and cognitive flexibility, and discusses the correlation between the changes of temporal lobe epilepsy neural network and executive function research.
Objective To study the treatment method and effect of abduction and lateral rotation l imitation of the shoulder in obstetric brachial plexus palsy (OBPP). Methods From February 2005 to August 2008, 11 patients with abduction and lateral rotation l imitation of the shoulder in OBPP were treated with dissection of the origin of subscapular muscle,transfer of the tendons of latissimus dorsi and teres major muscle to the tendons of supraspinous and infraspinous muscles. Among them, there were 6 males and 5 females with a mean age of 6 years (1-15 years). The main cl inical manifestations showed adduction, internal rotation contracture deformity of shoulder, l imited active and passive external rotation and severely restricted active abduction of shoulder. The passive abduction was more than 90°. According to Gilbert grading, there were 7 cases of grade 1 and 4 cases of grade 2. Based on Mallet score systems, the scores were 5 points in 3 cases, 6 points in 3 cases, and 7 points in 5 cases. The muscle strength of deltoid, supraspinatus, infraspinatus, teres major muscle and latissimus dorsi all reached 3-4 grades. Results One patient developed postoperative hematoma, wound healed after symptomatic management. Other patients achieved incision heal ing by first intention. All patients were followed up for 12 to 37 months (17 months on average). The active abduction and external rotation of the shoulder joints recovered obviously. The Gilbert grading were grade 2 in 1 case, grade 3 in 1 case, and grade 4 in 9 cases; the Mallet scores were 10 points in 1 case, 11 points in 2 cases, 12 points in 4 cases, 13 points in 3 cases, and 14 points in 1 case; showing significant differences when compared with those before operation(P lt; 0.01). The muscle strength of deltoid, supraspinatus, infraspinatus, teres major muscle and latissimus dorsi increased to 4-5 grades. Conclusion The dissection of the origin of subscapular muscle, transfer of the tendons of latissimus dorsi and teres major muscle to the tendons of supraspinous and infraspinous muscles can resolve shoulder adduction, internal rotation contracture, and can enhance abduction, external rotation strength. It is an effective operation for abduction and lateral rotation l imitation of the shoulder in OBPP.
Objective To investigate the value and significance of the changes of plasma level of brain natriuretic peptide（BNP） in evaluating ventricle performance of functional single ventricle after total cavopulmonary connection （TCPC）. Methods We studied 11 patients with functional single ventricle undergone TCPC procedure after 2.1 years, who were followed-up at our ward between April 2004 and November 2004, 7 of them were males and 4 of them were females （TCPC group）. The clinical heart function of patients was scored according to the modified scoring system described by Ross. We obtained 3ml blood samples from the extremital vein of all subjects. Blood was collected into chilled tubes containing EDTA and aprotinin （4.5mg and 1 500u/ml blood, respectively）. The blood samples were promptly centrifuged （-4℃, 3 000r/min for 10 min） and the plasma was separated. BNP concentration was determined using immunoradiometric assay kits. Magnetic resonance imaging （MRI） examination was undertaken in 6 patients of TCPC group to analyse the relative factors with the change of BNP. Control group included 9 healthy children. Results （1） Median plasma BNP level for TCPC group and control group was 400pg/ ml （IQR200-690） and 110 pg/ml （IQR90-190）, respectively. There was a significant difference in plasma BNP between them （P=0. 003）. （2） The results of the index of heart function of TCPC group determined by MRI were 65. 76±8. 65 ml/m2 in end-diastolic volume index, 31. 90±6. 36ml/m2 in end-systolic volume index, 39.09±11.76ml/m2 in stroke volume index, 0. 52± 0. 06 in ejection fraction（EF）, 2.38±0.58L/min·m2 in cardiac index （CI）, 103.49±21.57g/m2 in mass index and 1.57±0.24 in mass/EDV. （3） The plasma BNP level for TCPC group was significant correlation with operation ages（r=0.632, P=0.041 ）. There was no correlation between plasma BNP level with EF, CI, score of Ross, gender, ages, percutaneous oxygen saturation（SpO2） and the type of dominant ventricle, respectively. Conclusions Raised concentration of plasma BNP in patients 2 years after undertaken TCPC procedure indicates that nervous-endosecretory system is still under stress condition. This pattern suggests that neurohormonal activation is primarily related to the altered postoperative physiology. the significance of BNP in patients of functional single ventricle after undertaken TCPC is different from tat in biventricular physiology patiens. The plasma BNP level could not be correctly evaluated the cardiac function after TCPC operation.