Diagnosis and treatment of the short-arm type posterior semicircular canal BPPV / Diagnóstico e tratamento da VPPB de braço curto do canal semicircular posterior

Abstract Introduction The Epley maneuver is useful for the otoconia to return from the long arm of the posterior semicircular canal into the utricle. To move otoconia out of the posterior semicircular canal short arm and into the utricle, we need different maneuvers. Objective To diagnose the short-arm type BPPV of the posterior semicircular canal and treat them with bow-and-yaw maneuver. Methods 171 cases were diagnosed as BPPV of the posterior semicircular canal based on a positive Dix-Hallpike maneuver. We first attempted to treat patients with the bow-and-yaw maneuver and then performed the Dix-Hallpike maneuver again. If the repeated Dix-Hallpike maneuver gave negative results, we diagnosed the patient with the short-arm type of BPPV of the posterior semicircular canal and considered the patient to have been cured by the bow-and-yaw maneuver; otherwise, probably the long-arm type BPPV of the posterior semicircular canal existed and we treated the patient with the Epley maneuver. Results Approximately 40% of the cases were cured by the bow-and-yaw maneuver, giving negative results on repeated Dix-Hallpike maneuvers, and were diagnosed with short-arm lithiasis. Conclusion The short-arm type posterior semicircular canal BPPV can be diagnosed and treated in a convenient and comfortable manner.

Resumo Introdução A manobra de Epley é útil para o retorno da otocônia do braço longo do canal semicircular posterior para o utrículo. Diferentes manobras são necessárias para mover a otocônia para fora do braço curto do canal semicircular posterior e para dentro do utrículo. Objetivo Diagnosticar a VPPB do tipo braço curto do canal semicircular posterior e tratá-la com a manobra de incline and balance. Método Foram diagnosticados 171 casos como VPPB de canal semicircular posterior com base na manobra de Dix-Hallpike positiva. Primeiro tentamos tratar os pacientes com a manobra de incline and balance e, em seguida, executamos a manobra de Dix-Hallpike novamente. Se a repetição da manobra de Dix-Hallpike desse resultados negativos, diagnosticávamos o paciente como VPPB do canal semicircular posterior do tipo braço curto e considerávamos que ele ou ela havia sido curado pela manobra de incline and balance; caso contrário, provavelmente o paciente apresentava VPPB do canal semicircular posterior do tipo braço longo e tratávamos o paciente com a manobra de Epley. Resultados Aproximadamente 40% dos casos foram curados pela manobra de incline and balance, com resultados negativos nas manobras de Dix-Hallpike repetidas, e foram diagnosticados com litíase de braço curto. Conclusão A VPPB de canal semicircular posterior do tipo braço curto pode ser diagnosticada e tratada de maneira conveniente e confortável.

Observational study of macular capillary perfusion with branch retinal vein occlusion by using DART-OCTA / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate the imaging characteristics of dense automatic real time B-scan optical coherence tomography angiography(DART-OCTA)in macular-involved branch retinal vein occlusion(BRVO)and the diagnostic value of capillary perfusion imaging in the macular area.METHODS: From June 2020 to December 2020, there were 51 cases of 51 eyes with BRVO diagnosed in Eye Hospital, Wenzhou Medical University. Imaging characteristics of the BRVO macular area were observed by fluorescein angiography(FA), optical coherence tomography angiography(OCTA)and DART-OCTA examination, respectively. According to the retinal capillary perfusion status, the included patients were divided into capillary and non-imaging groups, comparing the results of capillary perfusion imaging in the BRVO macular area among the three examination methods.Furthermore, quantitative analysis of capillary perfusion density in the lesion involved area and the lesion non-involved area was performed in DART-OCTA images. RESULTS: Patients with 51 eyes were included in this study, FA identified 10 eyes of capillary perfusion imaging, OCTA identified 14 eyes of capillary perfusion imaging, DART-OCTA identified 34 eyes of the capillary perfusion imaging.Comparison of the three test methods for capillary perfusion imaging findings in the BRVO macular area showed that DART-OCTA was more sensitive compared to FA and OCTA for capillary perfusion imaging in the ischemic area. In DART-OCTA examination, retinal capillary blood flow density was lower in the lesion-involved areas in both the capillary perfusion imaging group and the non-imaging groups(0.65±0.20/mm vs 1.16±0.31/mm,0.41±0.16/mm vs 1.06±0.38/mm, all P<0.0001).CONCLUSION: DART-OCTA can provide clearer tomographic imaging of retinal capillary perfusion. And the imaging with its observation of BRVO involving the macular area is least affected by macular hemorrhage and it is an important complementary method for BRVO patients with significant retinal hemorrhage.

Current Status and Research Trends of Panax Between 1900-2019: A Bibliometric Analysis / 中国结合医学杂志

OBJECTIVE@#To investigate the current status and further development of Panax genus and 6 important individual species including P. notoginseng, P. quinquefolium, P. vietnamensis, P. japonicus, P. stipuleanatus and P. zingiberensis.@*METHODS@#The bibliometric analysis was based on the Web of Science core database platform from Thomson Reuters. Totally, 7,574 records of scientific research of Panax species published from 1900-2019 were analyzed. The statistical and visualization analysis was performed by CiteSpace and HistCite software.@*RESULTS@#The academic research of Panax species increase promptly. Plant science is the main research field while research and experimental medicine and agricultural engineering will be the further development tendency. Particularly, the discrimination research of P. notoginseng will be the research tendency among Panax species, especially diversity research. In addition, P. vietnamensis deserves more attention in the genus Panax.@*CONCLUSION@#This research provides a reference for further research of the genus and individual species.

Gallic Acid: A Potential Anti-Cancer Agent / 中国结合医学杂志

Cancer is one of the most devastating diseases worldwide and definitive therapeutics for treating cancer are not yet available despite extensive research efforts. The key challenges include limiting factors connected with traditional chemotherapeutics, primarily drug resistance, low response rates, and adverse side-effects. Therefore, there is a high demand for novel anti-cancer drugs that are both potent and safe for cancer prevention and treatment. Gallic acid (GA), a natural botanic phenolic compound, can mediate various therapeutic properties that are involved in anti-inflammation, anti-obesity, and anti-cancer activities. More recently, GA has been shown to exert anti-cancer activities via several biological pathways that include migration, metastasis, apoptosis, cell cycle arrest, angiogenesis, and oncogene expression. This review discusses two aspects, one is the anti-cancer potential of GA against different types of cancer and the underlying molecular mechanisms, the other is the bibliometric analysis of GA in cancer and tumor research. The results indicated that lung cancer, prostate cancer, stomach cancer, and colon adenocarcinoma may become a hot topic in further research. Overall, this review provides evidence that GA represents a promising novel, potent, and safe anti-cancer drug candidate for treating cancer.

Evaluation of the effect of comprehensive prevention and management of diabetes mellitus of two cross-sectional surveys based on community population / 中华预防医学杂志

To investigate the prevalence of diabetes mellitus (DM) among residents in Chongchuan district, Nantong city in 2012 and 2018, and evaluate the effectiveness of community comprehensive management of DM. Based on the data of 17 780 and 13 382 residents in the cross-sectional surveys of the " National Demonstration Area for Comprehensive Prevention and Control of Chronic Diseases " project in Chongchuan District of Nantong City, Jiangsu Province in 2012 and 2018, 4 583 and 3 996 DM-related information were obtained. The population of Jiangsu Province in 2012 and 2018 was used as the reference for standardization. The rates of prevalence and management (including awareness, treatment, treatment of patients who knew their diabetic situation, control and control of patients under treatment) of DM in the two surveys were compared using chi-square test. The results showed that in 2012 and 2018, the prevalence rates of DM were 12.0% and 15.7% (χ²=24.25, P<0.05), and the standardized rates were 10.1% and 10.8% (χ²=1.05, P=0.306). The incidence rates were 5.7% and 2.3%, respectively (χ²=55.60, P<0.05). The standardized prevalence rates in the two surveys were 9.7% and 11.6% for males (χ²=3.66, P=0.056) and 10.5% and 9.9% for females (χ²=0.50, P=0.481), 7.2% and 6.5% (χ²=0.85, P=0.357) for people aged 18-59 years old and 20.6% and 21.9% (χ²=0.91, P=0.339) for people aged 60 years and over, respectively. The standardized rates of awareness, treatment, treatment of patients who knew their diabetic situation, control, and control of patients under treatment in 2018 were 84.4%, 80.3%, 95.2%, 58.4%, and 70.2%, respectively, higher than 47.2%, 23.4%, 44.8%, 30.4% and 59.4% in 2012 (χ²=183.33, χ²=380.65, χ²=282.99, χ²=93.24, χ²=6.22, all P<0.05). Among men, the standardized rates of awareness, treatment, treatment of patients who knew their diabetic situation, and control in 2018 were 85.8%, 78.8%, 91.8% and 62.7%, higher than 50.5%, 37.5%, 72.3% and 32.6% in 2012 (χ²=78.40, χ²=96.17, χ²=27.55, χ²=48.96, all P<0.05). Similarly, the standardized management rates in 2018 were 83.0%, 81.7%, 98.5%, 54.1% and 65.1%, higher than 44.0%, 10.0%, 18.3%, 28.2% and 48.8% in 2012 among women (χ²=105.52, χ²=326.36, χ²=317.22, χ²=43.34, χ²=3.87, all P<0.05). The standardized rates of awareness, treatment, treatment of patients who knew their diabetic situation, and control of people aged 18-59 and 60 years and over were 82.9%, 79.7%, 96.1%, 55.0% and 88.0%, 81.8%, 93.0% and 67.2%, higher than 42.6%, 19.8%, 42.2%, 27.5% and 63.9%, 36.8%, 53.9%, 40.8% in 2012 (χ²=44.51, χ²=102.17, χ²=57.78, χ²=21.65, all P<0.05; χ²=71.18, χ²=181.55, χ²=146.26, χ²=59.23, all P<0.05). The comprehensive prevention and control system of chronic diseases, which comprehensively covered the life of community residents, had good management effect on DM, and effectively promoted health education and health promotion.

Clinical efficacy of OPT intense pulsed light combined parameters in treatment of lip hairiness / 中华医学美学美容杂志

Objective:To carry out the clinical observation and research of OPT intense pulsed light combined parameters in the treatment of lip hairiness.Methods:A total of 94 female patients with lip hairiness who were treated with OPT intense pulsed light depilation were collected, of which 22 were treated with single parameter and 72 were treated with combined parameters, both once a month for 7 months. The treatment effects of the two groups were compared. From October 2013 to October 2019, the patients were collected from the Department of Medical Cosmetology, the Quzhou Affiliated Hospital of Wenzhou Medical University.Results:With the increase of treatment times, the curative effect of patients gradually appeared, and the χ 2 value was 10.87 in the single parameter group and 105.25 in the combined parameter group. The difference was statistically significant ( P<0.05). There was no statistical significance in the single parameter array between the two comparisons of different treatment times; there was statistical significance in the combined parameter group. The χ 2 value of treatment (1 vs. 3) times was 26.05, (1 vs. 7) times was 73.3, (3 vs. 7) times was 23.82 ( P<0.017). There was significant difference in the constituent ratio and total effective rate between the two groups after 3 and 7 times of treatment. The total effective rate of 3 times of treatment was 36.36% in single parameter group and 70.83% in combined parameter group; The total effective rate of 7 times of treatment was 59.09% in the single parameter group and 81.94% in the combined parameter group ( P<0.05). Conclusions:Combined parameters OPT intense pulsed light therapy has better effect on lip hairiness than single parameter, and the treatment is safe and has good clinical application value.

Analysis of efficacy of different treatment modalities and prognostic factors in patients with locally advanced Masaoka-Koga stage Ⅲ thymoma / 中华放射肿瘤学杂志

Objective:To analyze the clinical efficacy of different treatment modalities and prognostic factors of patients with Masaoka-Koga stage Ⅲ thymoma.Methods:Clinical data of patients diagnosed with Masaoka-Koga stage Ⅲ thymoma admitted to Affiliated Cancer Hospital of Zhengzhou University from January 2000 to December 2018 were analyzed retrospectively. A total of 133 patients had complete treatment and follow-up data. Kaplan-Meier method was used to calculate the cumulative survival rate, log-rank method was used to compare the survival between two groups, and Cox regression model was used for multivariate analysis.Results:The median follow-up time was 50 months (3-221 months). The median overall survival (OS) was 51 (3-221) months, and the median disease-free survival (DFS) was 45 (2-221) months. The survival rate in the radical surgery group was better than that in the palliative surgery group. The 5- and 10-year OS rates in radical surgery group were 88.2% and 74.4% respectively, while in palliative surgery group were 51.8% and 32.4% respectively ( P<0.001). The 5- and 10-year DFS rates in radical surgery group were 72.2% and 45.5%, respectively, while in palliative surgery group were 32.3% and 16.1% respectively ( P=0.001). The OS in the surgery combined with radiotherapy group was better than that in the surgery alone group. The 5- and 10-year OS rates in the radical surgery group were 82.8% and 64.2% respectively, while in the palliative surgery group were 55.8% and 50.2% ( P=0.033). There was no significant difference in DFS between two groups ( P=0.176). Multivariate analysis showed that age < 50 years old ( HR=0.264, P=0.001), radical resection ( HR=0.134, P<0.001), surgery combined with radiotherapy ( HR=2.778, P=0.009) were independently associated with better OS. Age < 50 years old ( HR=0.550, P=0.046), radical resection ( HR=0.555, P=0.042), and invasion of single organ ( HR=0.111, P=0.003) were independently associated with better DFS. Conclusions:OS and DFS in patients undergoing radical surgery are significantly better than those in their counterparts treated with palliative surgery, which is the most important factor affecting prognosis. Surgery combined with radiotherapy yields better OS. It is necessary to design a rigorous and reasonable multicenter prospective study to evaluate the efficacy of various treatment modalities and prognostic factors.

Clinical study of Zhongfeng Xingnao liquid as adjuvant treatment for acute ischemic stroke / 国际中医中药杂志

Objective:To evaluate the efficacy of Zhongfeng Xingnao liquid combined with conventional treatment for acute ischemic stroke (AIS).Methods:A total of 92 patients with AIS in our hospital from May 2020 to March 2021 who met the inclusion criteria were selected and divided into 2 groups according to the end number of the medical records, with 46 cases in each group. Both groups were given conventional western medicine therapy, and the control group added intravenous drip of edaravone injection, and the study group added Zhongfeng Xingnao liquid on the basis of the control group. Both groups were treated continuously for 2 weeks. Before and after treatment, the National Institutes of Health Stroke Scale (NIHSS) and the modified Rankin Scale (mRS) were used to evaluate the degree of neurological deficit and prognosis. The whole blood high-shear viscosity, hematocrit, whole blood low-shear viscosity, fibrinogen were detected by automatic blood rheometer, and the levels of high-sensitivity C-reactive protein (hs-CRP), IL-6 and endothelin-1 (ET-1) were detected by ELISA. Adverse events were recorded, and clinical effect rate was evaluated.Results:After treatment, the mRS score (2.06±0.18 vs. 2.73±0.23, t=15.56) and NIHSS score (5.25±2.36 vs. 10.61±2.48, t=14.58) of the study group were significantly lower than those in the control group ( P<0.01). The total clinical effective rate was 89.1% (41/46) in the study group and 69.6% (32/46) in the control group, with a statistically significant difference between the two groups ( χ2=5.37, P=0.020). After treatment, the serum levels of hs-CRP [(9.04±1.98)mg/L vs. (14.36±2.09)mg/L, t=12.57], IL-6 [(23.14±1.46)ng/L vs. (39.37±2.51)ng/L, t=12.39] and ET-1[(67.18±13.22)ng/L vs. (98.14±22.29)ng/L, t=19.37] in the study group were significantly lower than those in the control group ( P<0.01). The whole blood high shear viscosity [(7.53± 1.37)mPa·s vs. (9.24±1.42)mPa·s, t=5.89], hematocrit [(0.27±0.06)% vs. (0.39±0.08)%, t=8.14], whole blood low shear viscosity [(5.92±1.09)mPa·s vs. (8.35±1.24)mPa·s, t=9.98] and fibrinogen [(1.63±0.42) g/L vs. (2.47±0.58) g/L, t=7.96] were significantly lower than those in the control group ( P<0.01). During the treatment period, the incidence of adverse events was 8.70% (4/46) in the control group and 15.22% (7/46) in the study group, and there was no significant difference between the two groups ( χ2=0.93, P=0.335). After treatment, the good outcome rate was 73.9% (34/46) in the control group and 93.5% (43/46) in the study group, with a statistically significant difference between the two groups ( χ2=6.45, P=0.011). Conclusion:The Zhongfeng Xingnao liquid combined with edaravone injection can reduce the level of inflammatory cytokines in patients with AIS, improve hemorheological indicators, and play a role in brain protection.

Application of three-dimensional shear wave elastography in the differential diagnosis of benign and malignant breast masses / 中华超声影像学杂志

Objective:To evaluate the application value of three-dimensional shear wave elastography(3D-SWE) with quantitative parameters and qualitative analysis of stiff rim sign in differentiating benign and malignant breast masses.Methods:One hundred and seventeen female patients (121 breast masses) admitted to the First Affiliated Hospital of Soochow University from January 2020 to February 2021 were examined by conventional ultrasound, two-dimensional shear wave elastography (2D-SWE) and 3D-SWE. Surgical or puncture pathology were used as the gold standard, the ROC curves of 2D-SWE and 3D-SWE were drawn to obtain the optimal qualitative and quantitative indicators. Afterwards, BI-RADS category was adjusted according to the optimal indicators, which could be used to evaluate the diagnostic value in differentiating benign and malignant breast masses.Results:The area under ROC curve (AUC) of BI-RADS category was 0.846, the sensitivity and specificity were 89.6% and 79.6%, respectively. The AUC value of mass-to-fat elasticity ratio(Eratio) of coronal plane was 0.869, which was the highest among all quantitative parameters and was significantly higher than that of 2D-SWE ( P<0.05). In addition, the AUC value of stiff rim sign of coronal plane was significantly higher than those of 2D-SWE, sagittal plane and transverse plane (All P<0.05). The AUC of combination of stiff rim sign of coronal plane and conventional US was 0.901, which was significantly higher than that using conventional ultrasound alone( P<0.05). Conclusions:Compared with 2D-SWE, Eratio and stiff rim sign of coronal plane of 3D-SWE yield better diagnostic efficiency.Adjusting stiff rim sign coronal plane to BI-RADS category can effectively improve the diagnostic efficiency.

Analysis of result of gene screening of neonatal deafness in Huizhou and surrounding urban areas / 中华医学遗传学杂志

OBJECTIVE@#To detect common pathogenic variants associated with congenital deafness among neonates from Huizhou and surrounding areas and discuss its implications.@*METHODS@#Thirteen hot-spot mutations in four most common pathogenic genes were screened among 20 934 neonates from March 2017 to December 2019.@*RESULTS@#In total 760 neonates were found to carry common pathogenic variants (3.63%). Sixty two neonates have carried homozygous/compound heterozygous variants or homoplasmy/heteroplasmy mutations of mtDNA (0.29%). Further analysis of five abnormal cases revealed that 3 of them have carried compound heterozygous mutations of GJB2 gene, and 2 were due to compound heterozygous variants of the CDH23 gene.@*CONCLUSION@#Genetic testing has a great clinical significance for the prevention and reduction of congenital hearing loss, but the scope needs to be updated and redefined by removing mutation sites with a very low rate, adding new significant sites, and improvement of the technical strategies.

Analysis of the soil microbial community of Cistanche deserticola and Cynomorium songaricum in the saline-alkali soil of Ebinur Lake / 药学学报

To explore the characteristics of soil microbial communities of Cistanche deserticola and Cynomorium songaricum, two typical parasitic medicinal plants that live in an extreme saline alkali environment, 16S PCR was used to sequence the soil microbial communities of C. deserticola and C. songaricum in Ebinur Lake, Xinjiang. Redundancy analysis and correlation analysis were carried out based on the abundance of core microbiome and ecoclimatic factors. The results show that the diversity of the soil microbial community of C. deserticola was significantly higher than that of C. songaricum. The core microbial groups of C. deserticola and C. songaricum were Marinomona, Halomonadaceae, Rhizobiales, Halomonas, and Acidimicrobiales. Six specific biomarkers were identified as Micrococcacea, Echinicola, Glutamicibacter, Galbibacter, Pseudoalteromonas, and Marinobacterium_ rhizophilum. The results of redundancy analysis and correlation analysis show that the average temperature in the driest season and the average temperature in the coldest season, and the clay content and soil texture classification were the main ecological factors affecting the composition of these soil microbial communities. This study provides a theoretical basis for finding molecular markers of C. deserticola and C. songaricum and promoting the quality of C. deserticola and C. songaricum.

Progress of Aflibercept of clinical application for neovascular age-related macular degeneration / 国际眼科杂志(Guoji Yanke Zazhi)

@#Aflibercept is a recombinant human fusion protein that acts as a soluble decoy receptor for vascular endothelial growth factor(VEGF)family members. VEGF-A, VEGF-B and placental growth factor(PLGF)were included in VEGF family that could inhibit downstream signalling mediated by these ligands. Aflibercept binds to all isoforms of VEGF-A with high affinity, and presented a markedly higher affinity compared with ranibizumab or bevacizumab. Intravitreal injection aflibercept has been approved for the treatment of patients with age-related macular degeneration(ARMD). Numerous studies showed it could improve best corrected visual acuity(BCVA), reduce macular edema and with fewer complications that has been another choice for ARMD patients. However, studies of participation time with large sample are lacking, and relevant studies are limited in China. Contribution in clinical efficacy, advancement in selection and use of medicines, safety and limitations with aflibercept will be here summarized.

Development and preliminary application of the measurement scale for medical students' professionalism cognition / 中华医学教育探索杂志

Objective:To explore the present situation of medical students' professionalism cognition and provide reference for medical personnel training and medical education.Methods:A cross-sectional survey was conducted on medical students among 2 affiliated hospitals of a medical university in H province by cluster sampling. Exploratory factor analysis and reliability and validity test were carried out and a descriptive analysis of the present situation of professionalism was conducted by SPSS 20.0. Amos21.0 software was used for a confirmatory factor analysis on the samples.Results:The measurement scale had good reliability and validity, and the Cronbach alpha coefficient of the scale was 0.901. The average professionalism score of the medical students was about 80 points. The score of "physical and mental status and self-development ability" was the highest (83.65 points), and the lowest score was "academic ability" (72.21 points). There was a little difference in the professionalism cognition between the two hospitals, with significant differences between the dimension "respect and care" and "responsibility".Conclusion:This study has initially formed a medical professionalism measurement scale with good reliability and validity. The professionalism of medical students in the 2 affiliated hospitals of a medical school in Province H is in good condition as a whole. In the future, medical education should pay more attention to the combination of basic professional knowledge and clinical practice of medical students, and change the training model of medical students in order to improve the academic ability of medical students and medical students' overall cognition of professionalism.

Application value of CT examination of lymph node short diameter in evaluating left recurrent laryngeal nerve lymph node metastasis in thoracic esophageal squamous cell carcinoma / 中华消化外科杂志

Objective:To investigate the application value of computed tomography (CT) examination of lymph node short diameter in evaluating left recurrent laryngeal nerve lymph node metastasis in thoracic esophageal squamous cell carcinoma.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 628 patients with thoracic esophageal squamous cell carcinoma who were admitted to 2 medical centers (236 cases in the Sun Yat-sen University Cancer Center and 392 cases in the Affiliated Cancer Hospital of Zhengzhou University) from October 2009 to December 2016 were collected. There were 462 males and 166 females, aged from 38 to 85 years, with a median age of 62 years. Observation indicators: (1) operation status, dissection and metastasis of left recurrent laryngeal nerve lymph node; (2) efficacy of CT examination of the left recurrent laryngeal nerve lymph node short diameter in evaluating postoperative lymph node metastasis; (3) determination of the optimal cut-off value; (4) examination results using different diagnostic criteria. Measurement data with skewed distribution were represented as M (range). Count data were described as absolute numbers or percentages. The area under curve (AUC) of receiver operating characteristic curve (ROC) was used to estimate the efficiency of detection methods. The maximum value of Youden index corresponded to the optimal cut-off point. Results:(1) Operation status, dissection and metastasis of left recurrent laryngeal nerve lymph node: among the 628 patients, there were 572 cases undergoing two-field lymph node dissection while 56 cases undergoing three-field lymph node dissection, there were 408 cases undergoing minimally invasive surgery while 220 cases undergoing open surgery. Sixty of 628 patients had left recurrent laryngeal nerve lymph node metastasis. A total of 1 666 left recurrent laryngeal nerve lymph nodes were dissected from the 628 patients, among which 75 were metastatic lymph nodes, with a metastasis rate of 4.502%(75/1 666). (2) Efficacy of CT examination of the left recurrent laryngeal nerve lymph node short diameter in evaluating postoperative lymph node metastasis: the AUC of CT examination of the left recurrent laryngeal nerve lymph node short diameter in predicting postoperative lymph node metastasis was 0.854 (95% confidence interval as 0.792 to 0.916, P<0.05). (3) Determination of the optimal cut-off value: the Youden indices were 0.556, 0.384, 0.258, 0.063 and 0.003 respectively when using 5 mm, 6 mm, 7 mm, 8 mm, 9 mm or 10 mm as the optimal cut-off value for CT examination of the left recurrent laryngeal nerve lymph node short diameter. The short diameter as 5 mm was the optimal cut-off value for CT examination of the left recurrent laryngeal nerve lymph node short diameter. (4) Examination results using different diagnostic criteria: the sensitivity, specificity, accuracy, positive predictive value, negative predictive value, cases being missed diagnosis were respectively 66.3%, 92.3%, 89.5%, 46.3%, 96.0%, 20 and 5.0%, 99.8%, 90.7%, 75.0%, 90.9%, 57 when using short diameter ≥5 mm or ≥10 mm in CT examination of the left recurrent laryngeal nerve lymph node as the diagnostic criteria for left recurrent laryngeal nerve lymph node metastasis of thoracic esophageal squamous cell carcinoma. Conclusions:CT examination of lymph node short diameter can be used to evaluate left recurrent laryngeal nerve lymph node metastasis in thoracic esophageal squamous cell carcinoma. The sensitivity, specificity and accuracy is preferable when using short diameter ≥5 mm in CT examina-tion of the left recurrent laryngeal nerve lymph node as the diagnostic criteria for left recurrent laryngeal nerve lymph node metastasis of thoracic esophageal squamous cell carcinoma.

Relationship between programmed cell death and myocardial ischemia-reperfusion injury and new perspectives of traditional Chinese medicine intervention / 中国中药杂志

Myocardial ischemia-reperfusion injury(MIRI) is an urgent problem in clinical treatment. As cardiomyocytes are terminal cells, MIRI-induced cardiomyocyte death will irreversibly damage the structure and function of the heart. In previous studies, apoptosis was considered to be the only way to regulate cell death, while necrosis could not be regulated. However, current studies have shown that cell necrosis could also be regulated, which was collectively called programmed cell death(PCD). Regulated cell death is actively mediated through molecular pathways, so there is the possibility of inhibiting this signaling to reduce MIRI. At present, PCD mainly includes apoptosis, autophagy, necrosis, pyroptosis and ferroptosis. As a unique treature in China, traditional Chinese medicine has the advantages of multiple pathways, multiple targets, low toxicity, less side effects and low economic costs. With the in-depth study of the efficacy of traditional Chinese medicine against MIRI, it has been confirmed that traditional Chinese medicine could regulate PCD to reduce MIRI. Therefore, this paper focuses on the relationship between PCD and MIRI, and new studies on intervention with relevant traditional Chinese medicine, with the aim to provide new MIRI prevention and treatment methods from the perspective of "intervention of PCD".

The diagnostic value of dual-layer detector spectral CT calcium suppression technique in acute and chronic thoracolumbar compression fractures / 中华放射学杂志

Objective:To evaluate the diagnostic value of spectral CT calcium suppression (CaSupp) technique in acute and chronic thoracolumbar compression fractures.Methods:A total of 31 patients with thoracolumbar compression fractures were given spectral CT and MR scans from March to October 2020 in the Second Hospital of Shanxi Medical University. Acute and chronic vertebral fractures were diagnosed by doctor A and B based on CaSupp diagram, and the consistency between the two doctors was evaluated by Kappa test. CT values of fractured vertebra and adjacent normal vertebra were measured on conventional CT and CaSupp graphs respectively, and the CT value difference between fractured vertebra and adjacent vertebra was calculated. Independent sample t-test was used to compare the conventional CT value and CT value difference, CaSupp CT value and CT value difference between acute and chronic fractured vertebra. Using MRI as the gold standard, the ROC curves were drawn to evaluate the subjective diagnostic efficacy of physicians and the diagnostic efficacy of each quantitative parameter. DeLong test was used to compare the area under the curve (AUC) of each quantitative parameter in pairs. Results:The number of vertebral bodies in acute and chronic compression fractures diagnosed by MRI was 48 and 11 respectively. The Kappa value of subjective diagnosis of acute and chronic vertebral fractures by doctors A and B was 0.782, and the AUC, sensitivity, specificity were 0.882 and 0.857, 85.4% and 89.6%, 90.9% and 81.8%, respectively. The differences of conventional CT value, CaSupp CT value and CaSupp CT value difference between acute and chronic compression fractures were statistically significant (all P<0.05), and the AUC values of conventional CT value, CaSupp CT value, conventional CT value difference and CaSupp CT value difference were 0.824, 0.930, 0.706 and 0.934, respectively. Pair comparison showed that the AUC of the CaSupp CT value and CaSupp CT value difference was greater than that of conventional CT value difference, with statistically significant differences ( Z=2.014, P=0.044, Z=2.028, P=0.043), while there were no statistically significant differences between other AUC values (all P>0.05). Conclusion:The dual-layer detector spectral CT CaSupp technique has high value in differentiating acute and chronic thoracolumbar compression fractures, and the CaSupp CT value and CaSupp CT value difference are recommended for diagnosis.

Effect evaluation on training mode based on core competence of nurses in clinical practice of nursing / 中华医学教育探索杂志

Objective:To explore the influence of training mode based on core competence of nurses on comprehensive performance, critical thinking ability and clinical communication ability of nursing students.Methods:A total of 102 Batch 2015 nursing students from the four-year program of Hubei University of Medicine who were interned in a "three A" general hospital in Shiyan City from May 2018 to January 2019 were selected as subjects, and were randomized into the control group ( n=51) and the intervention group ( n=51). The control group received traditional training mode and the intervention group adopted the training mode based on core competence of nurses. The two groups of nursing students were graded on the critical thinking scale and clinical communication ability scale before practice and at 2 months, 4 months, 8 months after intervention respectively. The comprehensive performance of two groups was assessed before and after 8 months of intervention. All data were analyzed by SPSS 19.0. Results:Comparison of effect, interaction effect, time effect of critical thinking scale and clinical communication ability scale between the two groups showed significant differences ( P<0.05). The comprehensive performance differences between the two groups were statistically significant after the intervention ( P<0.05). Conclusion:The practice training mode based on core competence of nurses can effectively improve the comprehensive performance, critical thinking ability and clinical communication ability of nursing students.

Identification of factors affecting Oncomelania hupensis density in Eastern Dongting Lake regions / 中国血吸虫病防治杂志

Objective To evaluate the impact of water pollutants, water levels and meteorological factors on the Oncomelania hupensis density in Eastern Dongting Lake regions, so as to provide insights into schistosomiasis control. Methods O. hupensis snails were surveyed using a systematic sampling method in snail-infested marshlands in Eastern Dongting Lake regions from 2007 to 2014, and data pertaining to water pollutants, water levels and meteorological factors were collected. The duration of submergence and the date of the start of submergence were calculated. The snail density and its influencing factors were descriptively analyzed, and a linear mixed model was generated to examine the impacts of variables on the snail density. In addition, smooth curves were fitted to investigate the relationship between snail density and variables. Results The snail density appeared a fluctuation in Eastern Dongting Lake regions during the period from 2007 to 2014, with the highest density on October, 2010 (52.79 snails/0.1 m2) and the lowest density on January 2009 (2.15 snails/0.1 m2). Linear mixed-model analysis showed that permanganate index, total phosphorus and the date of the start of submergence affected the snail density (t = 6.386, −2.920 and −3.892, all P values < 0.01). Smooth curve analysis revealed that the associations of the snail density with the permanganate index and total phosphorus appeared an approximately quadratic curve. After the end of April, the earlier date of the start of submergence resulted in a higher snail density. Conclusion Permenganate index, total phosphorus and the date of the start of submergence affect the O. hupensis snail density in Eastern Dongting Lake regions.

Study on neurogenic bladder-induced renal fibrosis based on AngⅡ/TGF-β1/Smads signaling pathway / 中华肾脏病杂志

Objective:To establish a rat model of neurogenic bladder and analyze the changes in kidney morphology and function and the expression of proteins in AngiotensinⅡ(AngⅡ)/transforming growth factor β1 (TGF-β1)/Smads pathway.Methods:Sprague-Dawley rats were randomly divided into experimental group (spinal nerve amputation, n=36) and control group (sham operation, n=12). At 6, 12, and 24 weeks, the bladder compliance was measured by cystometry, the kidney morphology was detected by B-ultrasound, blood urea nitrogen (BUN) and serum creatinine (Scr) in blood samples were examined, the kidney pathological changes were detected by Masson and HE staining, the distribution of AngⅡ/TGF-β1/Smads pathway proteins was analyzed by immunohistochemisty, and the protein expressions in kidney were detected by Western blotting. Results:Urodynamics showed that the basic bladder pressure in experimental group was higher than that in control group. B-ultrasound showed that compared with the control group, the diameter of the renal pelvis of the rats with nerve dissection gradually increased ( P<0.05), and the hydronephrosis was gradually obvious. Compared with the control group, the BUN and Scr in experimental group gradually increased (both P<0.01). Masson and HE staining showed that compared with the control group, the collagen expression and renal tubulointerstitial scores in experimental group were gradually increased (both P<0.01). Immunohistochemisty showed that compared with the control group, in experimental group the expression of angiotensinⅡ receptor type 1 (AT1), TGF-β receptor 1(TGF-βR1), phosphorylated Smad2 gradually increased (all P<0.01), the pathway inhibitor Smad6 gradually decreased ( P<0.01), and the distribution of each protein in kidney was consistent. Western blotting showed a corresponding expression trend with immunohistochemisty. Conclusions:In neurogenic bladder caused by bilateral spinal nerve amputation, due to bladder dysfunction, increased bladder pressure induces hydronephrosis, destruction of the nephron structure, activation of AngⅡ/TGF-β1/Smads pathway, and renal fibrosis. This method is effective and has clinical similarities, laying a foundation for exploring neurogenic bladder treatment.

Cerebral infarction complicated with multiple arterial thrombosis caused by cystathionine beta-synthase gene mutation in youth: a case report / 中华神经科杂志

Hyperhomocysteinemia (HHcy) is one of the independent risk factors for youth cerebral infarction. Gene mutation of key enzymes in homocysteine metabolism is the main cause of HHcy. Few cases of cystathionine beta-synthase (CBS) compound heterozygous mutation complicated with pulmonary embolism and lower extremity artery embolism have been reported. This article reported a young cerebral infarction patient complicated with pulmonary embolism and lower extremity artery embolism, who was subsequently detected with significantly elevated blood Hcy, and finally etiologically diagnosed with CBS 833 T>C/1082C>T compound heterozygous mutation. With the treatment of folic acid, methyl cobalt amine, vitamin B 6 and anticoagulant, the blood Hcy has been gradually declined, and no new thrombotic events occurred during the follow-up period of a year.