Objective To assess the values of TIMI myocardial perfusion grade (TMP), corrected TIMI frame count (CTFC), sum-ST-segment resolution (sumSTR), max-ST-segment deviation (maxSTE) in judging myocardial perfusion and to predict their clinical outcomes. Methods In 77 patients with AMI, methods of TMP, maxSTE, sumSTR, CTFC were used to judge myocardial perfusion grade respectively immediately after PCI. Sixty-five patients underwent 99m Tc-MIBI/ 18 FDG DISA SPECT within one months after PCI, in-hospital heart faiures and cardiac events in the 6 months were recorded. Results Compared with 99m Tc-MIBI/ 18 FDG DISA SPECT, sensitivity, specificity, accuracy of TMP, CTFC, maxSTE, sumSTR was calculated. Sensitivity, specificity, accuracy of maxSTE were 80%, 85.7%, 83.1% respectively; Those of TMP were 73.3%, 80%, 76.9%, respectively. But those of CTFC (40), CTFC (30), sumSTR (30%), sumSTR (50%) were lower. By multivariate analysis of TMP0/1, maxSTE was the independent risk factor for 6-month cardiac events. Conclusion TMP, maxSTE may better assess myocardial perfusion, and accurately predict the outcome in 6-months.

AIM: To investigate the effects of andrographolide on the invasion and apoptosis of ovarian cancer cell line SKOV-3, and to explore the possible mechanisms.METHODS: SKOV-3 cells were treated with different concentrations (0, 5, 10, 20 or 40 μmol/L) of andrographolide for different time (12, 24, 36 or 48 h), and then the cell viability was determined by CCK-8 assay.The cell invasion ability was analyzed by Transwell assay and cell apoptosis was detected by TUNEL staining.The protein levels of p-PI3K, p-Akt and p-mTOR were examined by Western blot.RESULTS: The results of CCK-8 assay revealed that andrographolide inhibited the growth of SKOV-3 cells in a dose-and time-dependent manner.Treatment with andrographolide at 20 μmol/L for 36 h significantly decreased the invasion ability of SKOV-3 cells, while increased cell apoptosis.In addition, the protein levels of p-PI3K, p-Akt and p-mTOR were reduced after andrographolide treatment.CONCLUSION: Andrographolide inhibits the growth and invasion of ovarian cancer SKOV-3 cells by suppression of PI3K/Akt/mTOR signaling pathway.

Objective To explore the diagnostic value of MRI in invasively pernicious placenta previa.Methods MRI and color doppler ultrasound were performed in 1 50 patients with pernicious placenta previa.According to the operation or pathology findings, the diagnostic value of placental invasion was compared among MRI,color doppler ultrasound and both of them.Analyzed and com-pared the MRI findings of 64 patients which were confirmed as invasive placenta including adherent placenta in 20 patients,implanted one in 38 and penetrated one in 6.Results Significant difference was not found among MRI,color doppler ultrasound and both in the diagnostic value of invasive placenta (P >0.05).There was a significant difference among adherent placenta,implanted one and pen-etrated one in the diagnostic value of MRI (P <0.05),and the highest and lowest values were penetrated placenta and adherent pla-centa respectively.Conclusion MRI is an important diagnostic method in invasively pernicious placenta previa,which was useful for its classification but with a limitation for the diagnosis of adherent placenta.

Objective To analyze the correlation between MRI features and pathological characterization of ovarian thecoma-fibro-ma.Methods MRI manifestations of 21 patients with ovarian thecoma-fibroma proved by pathological diagnosis were analyzed retro-spectively and compared with pathologic findings.Results The 21 cases involved 22 lesions (one patient had bilateral masses of the-cofibroma),including 13 fibrothecoma,4 thecofibroma and 5 fibroma.All lesions presented with well-defined margin,and cystic changes were found in 1 5 cases,7 lesions were solid masses ,1 9 lesions were round or oval masses ,2 lesions were lobulated mas-ses,and 1 lesion was irregular mass.The diameters of tumor ranged from 3.4 to 18.5 cm with mean diameter of 8.9 cm.On MR images,all lesions showed isointense or slight hypointense on T1 WI.On T2 WI,most tumors showed isointense or slight hypoin-tense,along with hyperintense cystic areas in 1 5 lesions,patchy slight hyperintense edema areas in 4 lesions,and homogeneous isointense or slight hypointense in 3 lesions.After contrast enhancement,all lesions demonstrated mild-to-moderate enhancement and delayed progressive enhancement slightly.13 cases associated with varied degrees of pelvic effusion,1 case with thickening of endometrium,and 1 case with endometrial carcinoma.Two patients had a higher level of CA125.Postoperative pathology demon-strated that all lesion were benign.Conclusion The MRI findings of the ovarian thecoma-fibroma are considerably characteristic and indirectly reflect pathology of tumor,thus beneficial to the correct diagnosis of tumor with relevant clinical information.

Objective To evaluate the value of dynamic susceptibility contrast-enhanced MR imaging (DSC)in evaluation of brain tumor after operation.Methods 41 cases with brain tumors verified histologically,including 8 cases of high-grade gliomas,16 of low-grade gliomas,7 of metastases and 10 of meningiomas underwent DSC examination.All the cases at 3.0T MR unit.All primitive data were sent to ADW4.3 workstation for post-processing.The mean maximal rCBV and rCBF ratios of tumors,1 cm and 2 cm regions of peri-tumor were obtained respectively.The relativity of MR perfusion parameters(rCBV and rCBF)between diferent tumors were statistically evaluated by using Pearson correlative analysis.Results In the　solid region of tumors,rCBV and rCBF were statistically significant differences (P<0.05)between low-grade gliomas and the other three groups of tumors; in 1 cm region of peri-tumor between high-grade gliomas and the other three groups,and between low-grade gliomas and metastases,between the solid region and both regions of 1 cm and 2 cm peri-tumors at the same tumor were all of statistically significant differences(P<0.05),between 1 cm and 2 cm region of peri-tumors at high-grade gliomas and metastases,the rCBV and rCBF were also of statistically significant differences.Pearson correlative analysis showed that there were significant positive correlations between the mean maximal rCBV and rCBF　ratios at the same region in the same tumor's group.Conclusion DSC is very valuable in evaluation of the histopathological grade and the differentiation of brain tumor.

ObjectiveTo investigate the MRI features of placenta accreta.MethodsFrom Apr 2009 to Jun 2011,15 patients with placenta accrete received MRI examination.In them,placenta accrcta was diagnosed based on clinical manifestations or postoperative histopathologv.The MR features of placenta accreta in thcm( study group) were retrospectively analyzed and compared with those in 15 pregnant women without placenta accreta (control group)with Fisher exact test.ResultsIn the 15 patients with placenta accreta,uterine bulging and(or) a focal outward contour bulge was detected in 14 patients; heterogeneous signal intensity in the placenta was detected in 15 patients; dark intraplacental bands on T2-weighted images was detected in 15 patients; and increased subplacental vascularity was detected in 11 patients on T1- weighted images.In the study group,14 patients showed at least three of the above four features,and in all of them uterine bulging and(or) a focal outward contour bulge,heterogeneous signal intensity in the placenta and dark intraplacental bands on T2-weighted images were detected; one patient showed heterogeneous signal intensity in the placenta,dark intraplacental bands on T2-weighted images and increased subplacental vascularity.In the control group,none patient had three of the above features.Uterine bulging and(or) a focal outward contour bulge,heterogeneous signal intensity in the placenta,dark intraplacental bands on T2-weighted images and increased subplacental vascularity were detected in 3,6,3 and 4 patients (P=0.000,0.001,0.000 and 0.027 ),respectively.ConclusionsThe main MRI features of placenta accreta are uterine bulging and(or) a focal outward contour bulge,heterogeneous signal intensity in the placenta and dark intraplacental bands on T2-weighted images Besides,increased subplacental vascularity also could provide useful information for the diagnosis of placenta accreta.

Abstract School based lifestyle interventions have many advantages, which can effectively reduce the prevalence of overweight and obesity, improve children and their families knowledge of overweight and obesity, and enhance their cognition of behaviors related to energy balance. Moreover, it can improve the level of cardiometabolic risk (CMR). By searching PubMed, CNKI and Wanfang databases, the article review the effects of school based physical activity and dietary interventions on children s blood pressure, blood lipids, blood glucose, and other CMR indicators, and analyze the differences among different groups of people, such as gender, age, and race, in order to provide the evidence for future school based intervention studies on overweight and obesity in children.

Objective ToinvestigatethevalueofpreoperativeMRIforplacentapreviainpredictionofmassivepostpartumhemorrhage. Methods AretrospectiveanalysisoftheclinicalhistoryandprenatalMRIfeaturesof362patientswithplacentapreviawereperformed. Ofthese,54casesexperiencedseverepostpartum hemorrhage.Results Univariateanalysisshowedthattheageofpregnantwomen (χ2＝3.951,P＝0.047),gestationalage(χ2＝6.257,P＝0.012),numberofcesareansections(χ2＝36.372,P＝0.001)andgemellary pregnancy(χ2＝7.933,P＝0.005)wereassociated with massivepostpartum hemorrhage.Amongthe MRIsigns,Uterinebulging (OR,46.712;95%CI,13.067－166.987),placentalprotrusionsign (OR,22.787;95% CI,4.595－113),andintroplacentalT2dark band(OR,14.757;95%CI,7.149－30.461)indicatedhighriskwithmassivepostpartumhemorrhage.Myometrialthinningorlocalized interruption,unevenplacentalsignal,abnormalbloodvesselsbelowtheplacenta,abundantbloodvesselsinloweruterusandcervix, cervicalshorteningandothersignsfortheevaluationofseverepostpartumhemorrhagewerealsostatisticallysignificant.Conclusion MRIcanpredictmostoftheseverepostpartumhemorrhagebeforesurgeryandisveryhelpfultoimprovethepatientprognosis.

The outbreak of COVID-19 has spread quickly across 114 countries/territories/areas in six continents worldwide and has been announced as a pandemic by WHO. This study analyzed global COVID-19 epidemiological trends, examined impact of the pandemic on global health security, diplomacy, and social environment in China, and provided short- and long-term strategic policy recommendations for China’s subsequent preparedness and responses.

Objective     To investigate the influence of prior percutaneous coronary intervention (PCI) on the outcome of coronary artery bypass grafting (CABG). Methods     Clinical data of 5 216 patients from Jiangsu Province CABG registry who underwent primary isolated CABG from 2016 to 2019 were retrospectively analyzed. Patients were divided into a PCI group (n=673) and a non-PCI group (n=4 543) according to whether they had received PCI treatment. The PCI group included 491 males and 182 females, aged 62.6±8.2 years, and the non-PCI group included 3 335 males and 1 208 females, aged 63.7±8.7 years. Multivariable logistic regression and propensity score matching (PSM) were used to compare 30-day mortality, incidence of major complications and 1-year follow-up outcomes between the two groups. Results     Both in original cohort and matched cohort, there was no statistical difference in the 30-day mortality [14 (2.1%) vs. 77 (1.7%), P=0.579; 14 (2.1%) vs. 11 (1.6%), P=0.686], or the incidence of major complications (myocardial infarction, stroke, mechanical ventilation≥24 h, dialysis for new-onset renal failure, deep sternal wound infection and atrial fibrillation) (all P>0.05). The rate of reoperation for bleeding in the PCI group was higher than that in the non-PCI group [19 (2.8%) vs. 67 (1.5%), P=0.016; 19 (2.8%) vs. 7 (1.0%), P=0.029]. Both in original cohort and matched cohort, there was no statistical difference in 1-year survival rate between the two groups [613 (93.1%) vs. 4 225 (94.6%), P=0.119; 613 (93.1%) vs. 630 (95.2%), P=0.124], while the re-admission rate in the PCI group was significantly higher than that in the non-PCI group [32 (4.9%) vs. 113 (2.5%), P=0.001; 32 (4.9%) vs. 17 (2.6%), P=0.040]. Conclusion     This study shows that a history of PCI treatment does not significantly increase the perioperative mortality and major complications of CABG, but increases the rate of cardiogenic re-admission 1 year postoperatively.