Prevalence and influencing factors of reduced visual acuity among young children in Changning District， Shanghai / 上海预防医学

ObjectiveTo analyze the prevalence of reduced visual acuity of young children in Changning district of Shanghai and to explore the influencing factors， so as to provide a reference basis for formulating prevention and control measures for children’s reduced visual acuity. MethodsVisual acuity examination and questionnaire survey were conducted on 5 772 middle class children in kindergartens and first grade children in primary schools who participated in the refractive screening in Changning District in 2019. χ2 test and logistic regression analysis were used to explore the influencing factors of reduced visual acuity. ResultsThe overall prevalence of reduced visual acuity among lower-aged children was 10.4% （596/5 772）. The prevalence of reduced visual acuity in the first grade children was 10.1% （284/2 822）， and that in the middle class children of kindergarten was 10.8% （312/2 900）. The prevalence of reduced visual acuity was 10.2% （298/2 933） in boys and 10.7% （298/2 789） in girls. 98.1% of young children had one or more bad habits when using eyes. Multivariate logistic regression analysis showed that frequent excessive head lowering （OR=1.713） and sometimes too close to the screen （OR=1.294） were independent risk factors for reduced visual acuity in young children； After stratification by age， frequent excessive head lowering （OR=1.997） increased the risk of reduced visual acuity of children in the first grade of primary school. Premature birth （OR=1.841）， sometimes excessive head lowering （OR=1.363） and frequent excessive head lowering （OR=2.002） increased the risk of reduced visual acuity of children in the middle class of kindergarten. ConclusionFor young children， we should pay more attention to their daily eye use distance， correct their bad behaviors for using eyes such as excessively lowering their head when using eyes and too close to the video screen when using electronic products， so as to prevent and delay the occurrence and development of reduced visual acuity.

Clinical analysis of 31 cases of fetal umbilical artery thrombosis / 中华妇产科杂志

Objective: To analyze the ultrasonic manifestations, clinical features, high risk factors and key points of pregnancy management in prenatal diagnosis of umbilical artery thrombosis (UAT). Methods: The data of 31 pregnant women of UAT diagnosed by prenatal ultrasonography and confirmed after birth from July 2017 to July 2022 at the Women's Hospital, Zhejiang University School of Medicine were retrospectively analyzed, including the maternal characteristics, pregnancy outcomes and fetal complications. In addition, the baseline data and pregnancy outcomes were compared in 21 patients who continued pregnancy after diagnosis of UAT. Of the 21 UAT cases that continued pregnancy, 10 cases were treated with low molecular weight heparin (LMWH; LMWH treatment group), while the other 11 patients had expectant treatment(expectant treatment group). Results: The age of the 31 pregnant women was (30.2±4.7) years, of which 5 cases (16%,5/31) were advanced age pregnant women. The gestational age at diagnosis was (32.9±4.0) weeks, and the gestational age at termination of pregnancy was (35.6±2.9) weeks. In 31 fetuses with UAT, 15 cases (48%) had fetal distress, 11 cases (35%) had fetal growth restriction, and 3 cases (10%) had intrauterine stillbirth. There were 28 cases of live births, including 26 cases by cesarean section and 2 cases by vaginal delivery. There were also 3 stillbirths, all delivered vaginally. Four neonates had mild asphyxia and two newborns had severe asphyxia. Among the 31 cases, 10 cases were terminated immediately after diagnosis, the gestational age at diagnosis was (35.9±2.9) weeks. Another 21 pregnancies continued, and their gestational age at diagnosis was (31.4±3.7) weeks. The median prolonged gestational age in LMWH treatment group was 7.9 weeks (4.6-9.4 weeks), and all were live births. The median prolonged gestational age in the expectant treatment group was 0.6 weeks (0.0-1.0 weeks), and 2 cases were stillbirths. There was a statistically significant difference in prolonged gestational age (P=0.002). Conclusions: Ultrasound is the preferred method for prenatal detection of UAT. Clinicians need to be vigilant for UAT when a newly identified single umbilical artery is detected by ultrasound in the second or third trimesters. The decision to continue or terminate the pregnancy depends on the gestational age and the condition of fetus. Attention should be paid to fetal movements as the pregnancy continues. The treatment of LMWH as soon as possible after diagnosis of UAT may improve the pregnancy outcome.

Clinical analysis of 80 death cases with coronavirus disease 2019 / 中华传染病杂志

Objective:To analyze the clinical characteristics and causes of death of 80 dead cases with confirmed coronavirus disease 2019 (COVID-19).Methods:The clinical data of 80 dead patients with COVID-19 who were admitted to Renmin Hospital of Wuhan University from January 11 to February 11, 2020 were retrospectively analyzed.The laboratory examination indexes (including white blood cells, lymphocytes, procalcitonin (PCT), lactic acid, D-dimmer, fibrinogen degradation products, N-terminal pro-brain natriuretic peptide (N-proBNP), ultra sensitive-troponin I, lactate dehydrogenase (LDH) and CD4 + T lymphocyte) of the patients at the time of admission were compared with the indexes at the last time before death. Statistical analysis was conducted by using paired t test or Wilcoxon′s signed rank test. Results:The median age was 72 years old of the 80 patients, and 78.75%(63/80) of them were older than 60 years. Thirty-six cases (45.00%) were severe and 44(55.00%) were critical at admission. Fifty-eight cases (72.50%) had underlying diseases. The common underlying diseases were hypertension, diabetes mellitus, coronary atherosclerotic heart disease, and chronic obstructive pulmonary disease. Comparing the patients′ first laboratory tests at admission with those before death, white blood cells increased (8.01(4.86, 12.29)×10 9/L vs 12.55(8.25, 17.66)×10 9/L), lymphocytes decreased (0.70(0.46, 0.88)×10 9/L vs 0.54(0.39, 0.75)×10 9/L), PCT increased (0.20(0.11, 0.74) μg/L vs 1.00(0.20, 1.99) μg/L), lactic acid increased (2.10(1.40, 3.10) mmol/L vs 3.10(2.60, 4.10) mmol/L), D-dimmer increased (4.33(0.97, 18.98) mg/L vs 15.29(5.17, 53.44) mg/L), fibrinogen degradation products increased (15.90(3.58, 76.60) mg/L vs 63.14(21.23, 110.67) mg/L), N-proBNP increased (1 078.00(347.35, 2 996.50) ng/L vs 3 439.50(1 576.00, 9 281.50) ng/L), ultra-sensitive troponin I increased (0.08(0.03, 0.17) μg/L vs 0.33(0.14, 2.47) μg/L), LDH increased (397.00(327.00, 523.50) U/L vs 624.00(481.00, 854.00) U/L) and CD4 + T lymphocyte decreased (137.00(104.00, 168.00)/μL vs 97.00(67.00, 128.00)/μL). The differences between the two groups were all statistically significant ( W=238.00, 1 053.50, 150.00, 152.00, 192.00, 190.00, 108.00, 57.00, 53.00 and 40.00, respectively, all P<0.05). All patients received antiviral and respiratory-support therapy and the main cause of death was respiratory failure caused by intractable hypoxemia and multiple organ failure. Among them, seven cases died in one day hospitalization, and 66 cases died in seven days hospitalization. Conclusions:Elderly patients with a variety of chronic underlying diseases have poor prognosis. It′s essential to pay more attention and deal with the above clinical characteristics at an early stage to improve the outcome of the COVID-19 patients.

Regional leptomeningeal collateral score on CT angiography predicts the outcome after endovascular therapy in patients with late window anterior circulation stroke / 国际脑血管病杂志

Objective:To investigate the predictive value of regional leptomeningeal collateral (rLMC) score on CT angiography (CTA) for the outcome after endovascular therapy in patients with late window anterior circulation stroke.Methods:Patients with acute anterior circulation large vessel occlusive stroke received endovascular treatment 6 to 24 h after onset in the Department of Neurology, the First Affiliated Hospital of Soochow University from January 2018 to July 2021 were enrolled retrospectively. At 3 months after onset, the outcome was evaluated according to the modified Rankin Scale. A score of ≤ 2 was defined as good outcome, and a score of >2 was defined as poor outcome. The clinical data, non-enhanced CT and CTA parameters of the patients were collected. Multivariate logistic analysis was used to determine the independent influencing factors of poor outcomes after endovascular treatment. Results:A total of 74 patients with acute anterior circulation large vessel occlusive stroke treated with endovascular treatment in the late window were enrolled. Their age was 64.41±12.98 years, 43 were males (58.1%). The baseline National Institutes of Health Stroke Scale (NIHSS) score was 13.18±5.22, and the median time from onset to puncture was 527.5 min. Fifty-three patients (71.6%) chose direct thrombectomy and 21 (28.4%) chose intravenous thrombolysis and bridging thrombectomy. Thirty-six patients (48.6%) had a good outcome and 38 (51.4%) had a poor outcome, including 4 (5.4%) died. Univariate analysis showed that there were significant differences in age, atrial fibrillation, fasting blood glucose, NIHSS score, Alberta Stroke Program Early CT Score (ASPECTS), rLMC score and clot burden score between the good outcome group and the poor outcome group (all P<0.05). Multivariate logistic regression analysis showed that higher ASPECTS (odds ratio 0.352, 95% confidence interval 0.157-0.791; P=0.012) and rLMC score (odds ratio 0.550, 95% confidence interval 0.329-0.919; P=0.022) were the independent predictors of good outcomes after endovascular therapy. Conclusion:ASPECTS and rLMC scores were the independent predictors of clinical outcomes after endovascular therapy in patients with late window anterior circulation large vessel occlusive stroke. It had certain guiding value for the decision-making of endovascular treatment in such patients.

Effect of exogenous miR206 on the development of denervated muscular atrophy by inhibiting the expression of myostatin of rats / 中华显微外科杂志

Objective:To investigate the effects and mechanism of miR206 in rat model of denervated muscular atrophy.Methods:From September, 2020 to December, 2020, a total of 40 rats were selected for this study. Denervated muscular atrophy model was established on 16 SPF Sprague-Dawley rats, by removing 1 cm in length of sciatic nerve. The rats were classified into 4 groups according to the sampling time: 0 d, 3 d, 7 d and 14 d(4 rats per group). The other 24 rats were also established into denervated skeletal muscle atrophy models and assigned into 3 groups: denervation add miR206 group, denervation add NC transfection reagent group, and sham-operated group( n=8 in each group). After sampling, the area of cross section of the gastrocnemius muscle and gastrocnemius muscle mass were measured to evaluate muscle atrophy. The mRNA and protein expression of myostatin were determined by real-time PCR and Western blot. Combining with luciferase report to explore the underlying mechanism of miR206, the t-test and oneway ANOVA were used for data analysis used in this study. In one-way ANOVA analysis, if the difference between groups was statistically significant, Bonferroni method would be used for further comparing of all pairs. P<0.05 was considered statistically significant. Results:After excision of a part of sciatic nerve of rat models, gastrocnemius muscle mass of denervation plus miR206 group, denervation plus NC transfection reagent group and sham-operated group were: (0.63±0.04), (0.51±0.02) and (1.05±0.02), respectively. The cross section areas of gastrocnemius muscle in each groups were: (761.30±21.79) μm 2, (640.30±30.31) μm 2 and (1066.00±51.65) μm 2, respectively( P<0.05). Myostatin mRNA expression showed lower in miR206 group than in NC group tested by Western blot, which were(0.57±0.04) in miR206 and (0.81±0.04) in NC group tested by qPCR( P<0.05). The protein expression measured by Western blot test revealed same expression pattern as mRNA expression pattern. The different of relative expression between miR206 group and NC group( P<0.05). Finally, in the mmu-miR206 co-transfected with the MSTN 3'UTR-luciferase sensor group, the relative luciferase activity was measured at 0.26±0.07 and it was significant lower than any other groups( P<0.05). Conclusion:The miR206 can counteract denervated skeletomuscular atrophy through down regulating the myostatin expression. Myostatin is a new discovered target gene of miR206.

Comparison of Sonazoid contrast-enhanced ultrasound and contrast-enhanced MRI in the diagnosis of focal liver lesions / 中华超声影像学杂志

Objective:To compare the diagnostic efficacies of Sonazoid contrast-enhanced ultrasound (CEUS) and contrast-enhanced magnetic resonance imaging (CE-MRI) in the diagnosis of focal liver lesions (FLLs), and to evaluate the clinical value of Sonazoid.Methods:A total of 58 FLLs in 50 patients who underwent Sonazoid-CEUS and CE-MRI examinations from July 2019 to January 2021 in the First Affiliated Hospital of Zhejiang University School of Medicine were enrolled in this study according to the inclusion criteria. The final diagnostic reference standard was decided by surgical pathology or ultrasound-guided biopsy pathology. Sonazoid-CEUS and CE-MRI features of benign and malignant FLLs were analyzed, and the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic coincidence rate of the two tests were calculated respectively.Results:There was a statistically significant difference between benign and malignant FLLs in the imaging pattern of homogeneous or heterogeneous intratumoral enhancement in the artery-dominant phase and washout images in the late phase( P<0.001).9.8%(4/41) of the malignant lesions did not decrease until the late phase but decreased in the post-vascular phase. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic coincidence rate of the two tests were 97.6%, 52.9%, 83.3%, 90.0%, 84.5%(Sonazoid-CEUS) and 85.4%, 64.7%, 85.4%, 64.7%, 79.3%(CE-MRI), the differences of sensitivity and specificity were not statistically significant ( P=0.125, P=0.687). Conclusions:The vascular phase in Sonazoid-CEUS is still an important diagnostic sign of FLLs, and the unique Kupffer phase can provide additional information for the diagnosis. Sonazoid-CEUS has the same important value as CE-MRI in the diagnosis of FLLs.

Blended Teaching Practice of Molecular Biology Driven by Discipline Frontiers / 中国生物化学与分子生物学报

Molecular Biology is the core course of biology major, whose fundamentals are classical and which develops rapidly as well. The introduction of the discipline frontiers is an ideal way to enhance the vitality of the classroom. Based on MOOC resources, the course group combined online independent study and offline face to face class to implement blended learning. Driven by the discipline frontiers, diversified teaching methods were introduced and classroom ecology was reconstructed. Multiple teaching sessions, including students’ independent study, questioning and presentation, class leading role of the teachers, questions and answers and knowledge expansion have been rolled out and unified so as to cultivate the science and humanity spirit of the students and enhance the vitality of the classroom. This blended teaching model effectively exercises students’ innovative thinking, improves students’ participation, and plays a positive role in enriching learning experience, stimulating professional dream and promoting students’ enlightenment.

Risk factors for fatal outcome in patients with severe COVID-19: an analysis of 107 cases in Wuhan / 中华临床感染病杂志

Objective:To analyze the risk factors of fatal outcome in patients with severe COVID-19.Methods:The clinical characteristics of 107 patients with severe COVID-19 admitted in Renmin Hospital of Wuhan University from February 12 to March 12, 2020 were retrospectively analyzed. During the hospitalization 49 patients died (fatal group) and 58 patients survived (survival group). The clinical characteristics, baseline laboratory findings were analyzed using R and Python statistical software. The risk factors of fatal outcome in patients with severe COVID-19 were analyzed with multivariate logistic regression.Results:Univariate analysis showed that the two groups had statistically significant differences in age, clinical classification, dry cough, dyspnea and laboratory test indicators ( P<0.05 or <0.01). The random forest model was used to rank the significance of the statistically significant variables in the univariate analysis, and the selected variables were included in the binary logistic regression model. After stepwise regression analysis, the patient’s clinical type, age, neutrophil count, and the proportion of CD3 cells are independent risk factors for death in severe COVID-19 patients. Dry cough is an independent protective factor for the death of severe COVID-19 patients. Conclusion:COVID-19 patients with fatal outcome are more likely to have suppressed immune function, secondary infection and inflammatory factor storm. These factors may work together in severe patients, leading to intractable hypoxemia and multiple organ dysfunction and resulting in fatal outcome of patients. The study indicates that timely intervention and treatment measures against above factors may be effective to save the lives of patients with severe COVID-19.

Epidemiology and endoscopic treatment of portal hypertension associated with ectopic varices / 中国内镜杂志

Portal hypertension (PH) was defined as an increase in portal pressure caused by various etiologies. The formation of portosystemic collateral circulation was a compensatory form of PH. Gastrointestinal varices were one of the clinical manifestations of PH, and which clould be broadly divided into esophageal varices (EV), gastric varices (GV) and ectopic varices (EcV). At present, it is found that EcV has difficulty in diagnosis, large amount of bleeding, difficulty in hemostasis and poor prognosis. So far, the study of EcV is very limited. There was no guideline and expert consensus on EcV treatment. This review will focus on the epidemiological features of EcV and the research status of endoscopic treatment.

Effects of ursolic acid on activation of NOX2/ROS/NLRP3 inflammasome in liver fibrosis rats / 基础医学与临床

Objective To investigate the effect of ursolic acid(UA) on NOX2/ROS/NLRP3 inflammasome activation in carbon tetrachloride(CCl4)-induced liver fibrosis SD rat,and to observe the improvement of collagen deposition in liver tissues. Methods All rats were randomly divided into 3 group:control group,CCl4model group,UA treatment group. Liver fibrosis model SD rats was established by the CCl4-induced method and half of them was used as UA treatment group. Serum ALT was detected by ALT detection kit.The liver pathology and collagen deposition were ob-served by HE and Sirius-red staining. The mRNA expression of Nox2,Nlrp3,Caspase1,IL-1β in liver tissues was detected by RT-qPCR. The protein expression of NOX2,NLRP3,caspase-1 and IL-1β in liver tissues was detected by Western blot and immunohistochemistry and the ROS generation in liver tissues was detected by DCFH-DA fluores-cence probe. Results Compared with control group,in the CCl4model group,the serum ALT was much higher (P<0.05);the Ishak's fibrosis score and collagen deposition was significantly increased(P<0.05) and mRNA of Nox2, Nlrp3,Caspase1,IL-1β was increased.In addition,both the NOX2,NLRP3,caspase-1 p10 and IL-1β protein expres-sion and ROS level (P<0.05) of CCl4model group were significant increased.Compared with CCl4model group,in the UA treatment group Ishak's fibrosis score,collagen deposition and ALT decreased.Both mRNA expression of the Nox2, Nlrp3,Caspase1,IL-1β and protein expression of NOX2,NLRP3,caspase-1 p10 and IL-1β as well as ROS were signif-icant decreased,but the caspase-1 p45 protein level has no difference among all these groups (P>0.05). Conclusions Ursolic acid attenuates the liver injury and reduces the collagen deposition,which may relate to its inhibitory effects on NOX2/ROS/NLRP3 inflammasome activation to reduce IL-1β releasing.

Clinical application of contrast-enhanced ultrasonography in central lung cancer with obstructive atelectasis / 中华医学超声杂志（电子版）

Objective To evaluate the clinical value of contrast-enhanced ultrasonography (CEUS) in the diagnosis of central lung cancer with obstructive atelectasis. Methods During the period from July 2015 to October 2017, 36 central lung cancer patients with atelectasis were admitted to the First People's Hospital of Hangzhou. All the patients were diagnosed by clinical pathology, and the lesions can be demonstrated by ultrasound. CEUS was performed on all the patients. After the examination, the time from which central lung cancer began to increase, the time at which the lungs began to inflate, and the peak and disappearance time of both were analyzed, and the enhancement pattern of the lesions were observed. Results CEUS clearly distinguished central lung cancer and atelectasis in all the 36 (100%) patients. CEUS showed central lung cancer as ″slow-in and fast-out″ mode in 32 of 36 patients, and as ″fast-out and fast-in″mode in the remaining four cases. Among all patients, 18 had uniform low enhancement, 12 had non-uniform low enhancement, 4 had uniform high enhancement, and 2 had non-uniform high enhancement. The onset enhancement time was 4-10 seconds in 32 patients, and 10-18 seconds in 4 cases. The onset enhancement time of the tumor tissue was 10-15 seconds. Conclusion CEUS can distinguish tumor tissue from atelectasis and is helpful in discovering tumor tissue hidden in atelectasis.

The value of virtual touch tissue imaging quantification and real-time elastography techniques in the differentiation of Thyroid Imaging Reporting and Data System 4 nodules of thyroid / 中华医学超声杂志（电子版）

Objective To study the value of virtual touch tissue imaging quantification (VTIQ) and real-time elastography technology in the differential diagnosis of benign and malignant Thyroid Imaging Reporting and Data System (TI-RADS) 4 thyroid nodules. Methods The real-time elastography imaging and touch tissue imaging quantitative (VTIQ) image features of 110 patients (117 nodules) with TI-RADS 4 thyroid nodules were retrospectively analyzed. The real-time elastic technology was used to measure strain ratio (SR) of nodules. VTIQ technique was used to measure the shear wave velocity (SWV) of nodules. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of the two methods alone and in combination were calculated using postoperative pathology as the gold standard. Then, the ROC curve was drawn, and the area under the curve (AUC) and the optimal cut-off value were obtained. Results There were 43 benign nodules and 74 malignant nodules in 117 thyroid nodules. The specificity, accuracy, positive predictive value, negative predictive value, the area under the ROC curve of the two technologies alone and in combination were 80.3% vs 86.7% vs 83.7%,72.5% vs 82.3% vs 84.2%,76.1% vs 84.6% vs 87.5%,73.3% vs 83.4% vs 84.5%,79.7% vs 85.5% vs 88.7%,0.786 vs 0.869 vs 0.881.According to the ROC curve, the optimal cut-off value of SR was 3.3 and the optimal cut-off value of VTIQ was 3.03 m/s. The Z values and P values of the two methods alone and in combination were (Z=1.95, 1.83, 1.03, all P>0.05), respectively. There was no difference statistically among the three methods. Conclusion The two techniques alone or in combination are valuable in the differential diagnosis of TI-RADS 4 thyroid nodules with similar diagnostic value in the three methods.

Morbidity and Mortality of Nosocomial Infection after Cardiovascular Surgery: A Report of 1606 Cases / 华中科技大学学报（医学）（英德文版）

Nosocomial infection (NI) is one of the most significant complications arising after open heart surgery,and leads to increased mortality,hospitalization time and health resource allocation.This study investigated the morbidity,mortality,and independent risk factors associated with NI following open heart surgery.We retrospectively surveyed the records of 1606 consecutive cardiovascular surgical patients to identify those that developed NI.The NI selection criteria were based on the Centers for Disease Control and Prevention (CDC) guidelines.The term NI encompasses surgical site infection (SSI),central venous catheter-related infection (CVCRI),urinary tract infection (UTI),respiratory tract infection and pneumonia (RTIP),as well as other types of infections.Of 1606 cardiovascular surgery patients,125 developed NI (7.8％,125/1606).The rates of NI following surgery for congenital malformation,valve replacement,and coronary artery bypass graft were 2.6％ (15/587),5.5％ (26/473) and 13.6％ (32/236),respectively.The NI rate following surgical repair of aortic aneurysm or dissection was 16.8％ (52/310).Increased risk of NI was detected for patients with a prior preoperative stay ≥3 days (OR=2.11,95％ CI=1.39-3.20),diabetes (OR=2.00,95％=CI 1.26-3.20),length of surgery ≥6 h (OR=2.26,95％ CI=1.47-3.47),or postoperative cerebrovascular accident (OR=4.08,95％ CI=1.79-9.29).Greater attention should be paid toward compliance with ventilator and catheter regulations in order to decrease NI morbidity and mortality following cardiovascular procedures.

Morbidity and Mortality of Nosocomial Infection after Cardiovascular Surgery: A Report of 1606 Cases / 华中科技大学学报（医学）（英德文版）

Nosocomial infection (NI) is one of the most significant complications arising after open heart surgery,and leads to increased mortality,hospitalization time and health resource allocation.This study investigated the morbidity,mortality,and independent risk factors associated with NI following open heart surgery.We retrospectively surveyed the records of 1606 consecutive cardiovascular surgical patients to identify those that developed NI.The NI selection criteria were based on the Centers for Disease Control and Prevention (CDC) guidelines.The term NI encompasses surgical site infection (SSI),central venous catheter-related infection (CVCRI),urinary tract infection (UTI),respiratory tract infection and pneumonia (RTIP),as well as other types of infections.Of 1606 cardiovascular surgery patients,125 developed NI (7.8％,125/1606).The rates of NI following surgery for congenital malformation,valve replacement,and coronary artery bypass graft were 2.6％ (15/587),5.5％ (26/473) and 13.6％ (32/236),respectively.The NI rate following surgical repair of aortic aneurysm or dissection was 16.8％ (52/310).Increased risk of NI was detected for patients with a prior preoperative stay ≥3 days (OR=2.11,95％ CI=1.39-3.20),diabetes (OR=2.00,95％=CI 1.26-3.20),length of surgery ≥6 h (OR=2.26,95％ CI=1.47-3.47),or postoperative cerebrovascular accident (OR=4.08,95％ CI=1.79-9.29).Greater attention should be paid toward compliance with ventilator and catheter regulations in order to decrease NI morbidity and mortality following cardiovascular procedures.

Iodine 131 joint radio frequency ablation treatment for child with hyperthyroidism goiter: one case report / 浙江大学学报·医学版

A 12-year-old girl presented with a history of cervical mass, and one week of throat discomfort and dyspnea. Five years ago, the patient was diagnosed as Hashimoto's thyroiditis and hyperthyroidism; she received antithyroid drug treatment, but the result was not satisfactory. B-ultrasonic showed that the size of thyroid gland was 8.1 cm×3.2 cm in the left and 8.2 cm×4.8 cm in the right. After iodine 131 combined with radiofrequency ablation (RFA) treatment, throat discomfort and recumbent breathing difficulties disappeared, and B-ultrasonic showed that the size of thyroid reduced to 2.3 cm×1.7 cm (left) and 2.8 cm×2.0 cm (right). No recurrence was observed during the two and a half years of follow-up.

Experience of professor LI Zhidao in the treatment of mental disorders by "regulating the heart and smoothing the liver" / 中国针灸

The experience of Professor LI Zhidao is introduced in the treatment of mental disorders by "regulating the heart and smoothing the liver". In his experience, the basic prescription includes: penetrating needling technique from Neiguan (PC 6) to Jianshi (PC 5), Ximen (PC 4), penetrating needling technique from Qiuxu (GB 40) to Zhaohai (KI 6) and penetrating needling technique at four groups of acupoints on the gallbladder meridian [Hanyan (GB 4) to Xuanlu (GB 5) and Xuanli (GB 6), Qubin (GB 7) to Shuaigu (GB 8), Shuaigu (GB 8) to Tianchong (GB 9), Tianchong (GB 9) to Fubai (GB 10) and Touqiaoyin (GB 11)]. The manipulation with respiration involved is combined with interactive needling technique so that the patients can feel the weak needling sensation at the local acupoint regions during the treatment. In the paper, the concrete clinical cases are introduced to explain this application and the satisfactory efficacy achieved. The therapeutic method provides a new approach to the clinical treatment of mental disorders.

Value of real-time virtual navigation system combined with contrast-enhanced ultrasonography for hepatocellular carcinoma undetectable by conventional ultrasonography and contrast-enhanced ultrasonography / 中华超声影像学杂志

Objective To evaluate the feasibility and therapeutic efficacy of real-time virtual navigation system (RVS) combined with contrast-enhanced ultrasonography (CEUS) for hepatocellular carcinoma undetectable by conventional ultrasound and CEUS.Methods A total of 213 patients with 265 lesions (undetectable on conventional ultrasound but detectable by other imaging examinations) were enrolled in this study.CEUS was performed,and lesions which were detected with CEUS were given CEUS guided radio-frequency ablation (RFA) (CEUS group).RVS combined with CEUS was performed to locate the rest lesions and guide RFA (RVS + CEUS group).Diagnostic value and therapeutic efficacy of RVS + CEUS were assessed.Results In 256 lesions,174 (65.7％) could be detected with CEUS,and among the rest 91 lesions,82 (90.1％) lesions could be detected by RVS combined with CEUS.The technique effectiveness rate of RVS + CEUS was significantly higher than that of CEUS (x2 =18.85,P ＜0.0001).Complete ablation rate after one month in RVS+ CEUS group was 9t.5％ (75/82),which was significantly higher than that in CEUS group [86.2％ (150/174),P ＜0.05].Local progression in one year in CEUS group and RVS + CEUS group were 13.4％ and 10.9％,respectively.Conclusions RVS combined with CEUS is feasible for hepatocellular carcinoma undetectable by conventional ultrasonography and CEUS,and the therapeutic efficacy of RVS + CEUS guided RFA is satisfactory.

Clinical analysis of nasal endoscope antrostomy treatment of maxillary sinus cyst through two approaches / 中国医师进修杂志

Objective To explore the clinical effect of nasal endoscope antrostomy treatment of maxillary sinus cyst through two approaches. Methods Eighty patients with maxillary sinus cyst were selected. The patients were divided into experiment group and control group according to the treatment method. Experiment group (40 cases) was treated through windowing middle meatus maxillary sinus associated with antrostomy of inferior nasal meatus approach. Control group (40 cases) was treated through antrostomy of inferior nasal meatus approach. On the basis of the review, the local state of the nasal endoscope and the CT examination of the sinus and the nasal sinuses, the patients were evaluated comprehensively. Results The recovery rate in experiment group was significantly higher than that in control group:97.5%(39/40) vs. 77.5% (31/40), and the complication rate in experiment group was significantly lower than that in control group:10.0%(4/40) vs. 35.0%(14/40). And there were statistical differences ( P<0.01). Conclusions The approach of windowing middle meatus maxillary sinus associated with antrostomy of inferior nasal meatus in the treatment of maxillary sinus cyst in nasal endoscope has wide field and no dead ends. Moreover, the lesions can be cleared completely. The procedure can reduce the recurrence. The complication rate is lower than the antrostomy of inferior nasal meatus approach.

The comparative study of calcium-dependent and calcium-independent of dephosphorylation of myosin light chain and its effect on pulmonary artery pressure and right ventricular remodeling in rats / 中华实用儿科临床杂志

Objective To investigate the effects of calcium - dependent and calcium - independent in myosin light chain(MLC)dephosphorylation on pulmonary hemodynamics and right ventricular remodeling,and to observe whether there is a superimposition effect while intervention is conducted in two ways at the same time. Methods Ac-cording to random number table,50 rats were divided into 5 groups:sham operation group,model group,3 mg/(kg·d) ML - 7[MLC kinase(MLCK)inhibitor]treating group(M group),20 mg/(kg·d)Fasudil(Rho kinase inhibitor) treating group(F group)and 3 mg/(kg·d)ML - 7 plus 20 mg/(kg·d)Fasudil treating group(M + F group). The shunt between the abdominal aorta and inferior vena cava was used to establish rat models of pulmonary hypertension in-duced by high pulmonary flow in group of C and the experimental groups. The sham operation group was given a sham operation. MLCK and Rho kinase inhibitor were administrated intraperitoneally to rats with the shunt. After 8 weeks of shunting,mean right ventricular pressure(MRVP),mean pulmonary arterial pressure(MPAP),right ventricular hyper-trophy index(RVHI)and width of inferior venacava were evaluated by the right cardiac catheterization procedure. Results Compared with the sham operation group,MRVP,MPAP,and RVHI were obviously elevated in the model group [(2. 65 ±0. 57)kPa vs(4. 19 ±0. 67)kPa;(2. 42 ± 0. 48)kPa vs(4. 04 ± 0. 61)kPa,F = 295. 368,263. 912,all P ﹤0. 01;(0. 21 ±0. 01)g/ g vs(0. 41 ±0. 03)g/ g,F =247. 024,P ﹤0. 01]. Compared with model group,the MRVP,MPAP and RVHI in M group and F group were decreased significantly[(3. 51 ± 0. 47)kPa vs(4. 19 ± 0. 67)kPa;(3. 68 ± 0. 55)kPa vs(4. 19 ±0. 67)kPa,all P ﹤0. 01;M group:(0. 29 ±0. 02)g/ g,model group:(0. 41 ± 0. 03)g/ g,F group (0. 30 ±0. 03)g/ g,F =247. 024,P ﹤0. 05]. But the MRVP,MPAP and RVHI in M group and F group were higher than those of rats in the sham operation group. The MRVP,MPAP and RVHI of M + F group were elevated much obviously compared with those of the M or F group(P ﹤0. 05). Conclusions The calcium - dependent and calcium - independent in MLC dephosphorylation can respectively restrain the development of pulmonary hypertension and right ventricular re-modeling,and the obvious additive effect can be observed when the 2 drugs are used jointly.

Effect analysis of hiatus sinus maxillaris treatment with different methods during nasal endoscope paranasal sinuses operation / 中国医师进修杂志

Objective To explore the relationship between different treatment methods of hiatus sinus maxillaris during nasal endoscope paranasal sinuses operation and prognosis.Methods Eighty patients with chronic rhinosinusitis and rhinopolyp were divided into observation group and control group byrandom digits table method with 40 cases each.Expanding hiatus sinus maxillaris were given according to the modality of hiatus sinus maxillaris and lesion of maxillaris sinus in observation group.The patients in control group were given expanding hiatus sinus maxillaris.The opening rate of hiatus sinus maxillaris and postoperative complication were observed.Results All the patients were followed up ≥ 1 year.The opening rate of hiatus sinus maxillaris in observation group (97.5％,39/40) was significantly higher than that in control group (77.5％,31/40),the rate of postoperative complication in observation group (5.0％,2/40) was significantly lower than that in control group (27.5％,11/40),and there were statistical differences (P ＜ 0.01).Conclusion Whether or not to enlarge hiatus sinus maxillaris during nasal endoscope paranasal sinuses operation should base on intraoperative specific situation,and it can reduce intraoperative injury,prevent the shutting of sinus and postoperative complication.