Objective:To investigate the CT image characteristics of anterior ethmoidal artery（AEA） through CT scan and its significance in nasal endoscopic surgery. Methods:A retrospective study of 82 patients（164 sides） with chronic sinusitis was conducted. All patients underwent CT scan and the images were reconstructed. The AEA classification was used and calculate the rate of AEA suspension. The AEA was classified, and the suspension rate of the AEA was calculated. The height of the lateral lamella of the cribriform plate （LLCP） was measured, and Keros classification was performed. The relationship between Keros classification and AEA suspension was analyzed. The supraorbital ethmoidal cell （SOEC） was identified, and its relationship with AEA suspension was analyzed. Results:Type Ⅰ AEA accounted for 42.07%（69/164）. Type Ⅱ AEA accounted for 22.56%（37/164）. Type Ⅲ AEA accounted for 35.37%（58/164）. The suspension rate was 35.37%. The average height of the LLCP was （3.7±1.8） mm. In the Keros classification, type Ⅰaccounted for 53.05%（87/164）, Type Ⅱaccounted for 37.80%（62/164）. Type Ⅲ accounted for 9.15%（15/164）. The results of the Spearman analysis showed that there was a moderate positive correlation between the Keros classification and the suspension of the AEA（r=0.526, P<0.01）. Among 164 sides, SOEC was present in 15 sides. The suspension rate of AEA in the group with SOEC was significantly higher than that in the group without SOEC（P<0.01）. Conclusion:Sinus CT and multiplanar reconstruction can clarify the image characteristics of AEA and its relationship with surrounding structures. When the level of Keros classification is higher or SOEC is present, the suspension rate of AEA increases significantly. It is of great significance to clarify the characteristics of AEA before surgery in order to avoid injury during surgery.
Humans ; Retrospective Studies ; Endoscopy ; Ethmoid Sinus/diagnostic imaging* ; Tomography, X-Ray Computed ; Arteries/diagnostic imaging* ; Sinusitis/diagnostic imaging* ; Male ; Female ; Middle Aged ; Adult ; Aged

Patients undergoing bariatric surgery are often accompanied by moderate to severe post-operative pain,and the application of high-dose opioids after surgery is more likely to cause adverse reac-tions such as respiratory depression,nausea and vomiting.Multimodal analgesia strategy based on ultrasound-guided regional nerve block has gradually shown outstanding advantages in the pain management of bariatric surgery,which can effectively reduce the dosage of opioids,reduce the incidence of postoperative complications,and improve the quality of postoperative recovery.In recent years,the applica-tion of different regional nerve block methods in bariatric surgery has been reported.This article reviews the characteristics of pain after laparoscopic bariatric surgery,the application,effects and limitations of different nerve block techniques,so as to provide reference for clinical application.

Objective To compare the size discrepancy between ultrasonic and pathological measurement of solitary cN0M0 papillary thyroid microcarcinoma(PTMC),and to explore their correlation with lymph node metastasis.Methods From April 2021 to January 2022,234 patients with solitary cN0M0 PTMC who received thyroid lobectomy or total thyroidectomy in the Department of Thyroid and Breast Surgery of Nanjing University of Chinese Medicine,Affiliated Hospital of Integrated Traditional Chinese and Western Medicine were analyzed retrospectively.The size discrepancy between ultrasonic and pathological measurement were compared,and the risk factors of central lymph node metastasis were analyzed.Results The mean of maximum diameter of PTMC measured by ultrasound was 6.8(range 5.6 to 8.4)mm,which was significantly bigger than that measured by pathology 5.0(range 4.0 to 7.0)mm(P=0.000).Of them,37.2%of the tumor size measured by ultrasound is consistent with pathology,61.1%of the tumor size measured by ultrasound is bigger than that measured by pathology,and only 1.7%of the tumor size measured by ultrasound is smaller than that measured by pathology.There was a linear correlation between the diameter measured by ultrasound and pathology.And the regression equation can be expressed as:pathological diameter=0.799×ultrasonic diameter-0.221.In addition,28.6%patients had central lymph node metastasis.Multivariate Logistic regression analysis showed that the diameter measured by pathology is a risk factor for central lymph node metastasis in patients(OR=17.845,95%CI:2.507-127.025,P=0.004),and the cutoff value is 5.5 mm which corresponded to the diameter measured by ultrasound as 7.2 mm.Conclusions The sizes of solitary cN0M0 PTMC measured by ultrasound and pathology are different but also correlated.PMTC with pathological diameter>5.5 mm with its corresponding ultrasonic diameter as 7.2 mm indicated an increased risk of central lymph node metastasis.

Objective:To investigate functional outcomes and condition-specific quality-of-life (CSQoL) after intersphincteric resection (ISR) in patients with low rectal cancer using traditional and exploratory questionnaires.Methods:A prospective observational study was conducted in the Characteristic Medical Center of the People′s Liberation Army Rocket Force. Patients with low rectal cancer who underwent ISR with ileostomy reversal from May 2020 to April 2023 were enrolled. An electronic self-assessment survey was sent to enrolled patients at 3 to 6, 12, and 24 to 36 months after reversal, and differences in functional and CSQoL results between the 3 groups were analyzed with generalized estimation equations. Functional outcomes were determined by the Wexner incontinence score (WIS) and the low anterior resection syndrome (LARS) score. In line with the five frequency responses ranging from never (score 0) to always (score 4) defined by the WIS, an exploratory survey was used to measure the severity of 16 LARS-specific variables confirmed by the latest international Delphi consensus. Furthermore, CSQoL was evaluated using the fecal incontinence quality-of-life scale (FIQL) and the visual analog scale (VAS).Results:A total of 90 patients were enrolled in the study. There were 64 males and 26 females, aged (58.6±10.4) years (range: 28 to 79 years). The median distance from the distal tumor margin to the anal verge( M(IQR)) was 3.0 (1.5) cm (range: 1.0 to 5.0 cm). There were 55 patients who completed the questionnaires at 3 to 6 months, 59 patients at 12 months, and 40 patients at 24 to 36 months of follow-up, respectively. The summary score of FIQL and VAS improved significantly after reversal (2.33±0.69 vs. 2.40±0.66 vs. 2.79±0.76, χ2=11.703, P=0.003; 5.31±1.65 vs. 5.61±1.90 vs. 6.58±1.92, χ2=12.781, P=0.002), but the differences in the WIS and LARS score did not reach statistical significance (both P>0.05). The survey responses for the LARS-specific variables indicated that “emptying difficulties” and “dissatisfaction with the bowels” were the most frequent symptom and consequence after ISR, respectively. The exploratory severity score for LARS improved significantly among the 3 time periods(34 (14) vs. 31 (13) vs. 23 (17), χ2=13.952, P=0.001). Furthermore, the FIQL summary score was strongly correlated with the LARS severity score ( r s=-0.72, P<0.01). Conclusions:Although a high prevalence of LARS may persist for years, patients reported an improvement in CSQoL and functional outcomes after ISR. The highest priorities recommended by the international consensus might provide better assessments the severity of LARS.

Objective:To identify the strengths and weaknesses of hospital development through the application of individual scientific research performance assessment, thereby providing a basis for the formulation of science and technology policies.Methods:We established a research performance assessment system and conducted research performance assessments across the hospital for three consecutive years. The assessment results were analyzed in-depth, utilizing the Kruskal-Wallis test to determine if there were differences in the overall level of assessment scores between years and series; the Mann-Whitney test to analyze differences between the promoted and non-promoted groups; the χ2 test to analyze whether age, degree, gender, and maternity situations affected assessment grades. Results:From 2020 to 2022, the individual scientific research performance assessment scores showed an overall upward trend, with the average per capita assessment score increasing significantly from 35.26 points in 2020 to 74.04 points in 2022. There were statistical differences in the assessment scores of different professional titles, indicating that the senior professionals > the associate senior professionals > the intermediates. There was no significant difference between the promoted and non-promoted groups. Additionally, age, degree, gender, and maternity factors affected assessment grades.Conclusions:It has been preliminarily established that the assessment of individual scientific research performance can effectively steer the scientific innovation activities of researchers, and play a positive role in enhancing the overall scientific research strength. The findings from the data analysis indicate that the hospital is expected to continuously enhance its scientific research performance by focusing on newly recruited doctoral personnel, establishing a system of support and guidance, and providing preferential support to female researchers. The assessment results serve as a " benchmark" for management departments and provide data-driven insights for the development of science and technology policies.

Objective:To investigate functional outcomes and condition-specific quality-of-life (CSQoL) after intersphincteric resection (ISR) in patients with low rectal cancer using traditional and exploratory questionnaires.Methods:A prospective observational study was conducted in the Characteristic Medical Center of the People′s Liberation Army Rocket Force. Patients with low rectal cancer who underwent ISR with ileostomy reversal from May 2020 to April 2023 were enrolled. An electronic self-assessment survey was sent to enrolled patients at 3 to 6, 12, and 24 to 36 months after reversal, and differences in functional and CSQoL results between the 3 groups were analyzed with generalized estimation equations. Functional outcomes were determined by the Wexner incontinence score (WIS) and the low anterior resection syndrome (LARS) score. In line with the five frequency responses ranging from never (score 0) to always (score 4) defined by the WIS, an exploratory survey was used to measure the severity of 16 LARS-specific variables confirmed by the latest international Delphi consensus. Furthermore, CSQoL was evaluated using the fecal incontinence quality-of-life scale (FIQL) and the visual analog scale (VAS).Results:A total of 90 patients were enrolled in the study. There were 64 males and 26 females, aged (58.6±10.4) years (range: 28 to 79 years). The median distance from the distal tumor margin to the anal verge( M(IQR)) was 3.0 (1.5) cm (range: 1.0 to 5.0 cm). There were 55 patients who completed the questionnaires at 3 to 6 months, 59 patients at 12 months, and 40 patients at 24 to 36 months of follow-up, respectively. The summary score of FIQL and VAS improved significantly after reversal (2.33±0.69 vs. 2.40±0.66 vs. 2.79±0.76, χ2=11.703, P=0.003; 5.31±1.65 vs. 5.61±1.90 vs. 6.58±1.92, χ2=12.781, P=0.002), but the differences in the WIS and LARS score did not reach statistical significance (both P>0.05). The survey responses for the LARS-specific variables indicated that “emptying difficulties” and “dissatisfaction with the bowels” were the most frequent symptom and consequence after ISR, respectively. The exploratory severity score for LARS improved significantly among the 3 time periods(34 (14) vs. 31 (13) vs. 23 (17), χ2=13.952, P=0.001). Furthermore, the FIQL summary score was strongly correlated with the LARS severity score ( r s=-0.72, P<0.01). Conclusions:Although a high prevalence of LARS may persist for years, patients reported an improvement in CSQoL and functional outcomes after ISR. The highest priorities recommended by the international consensus might provide better assessments the severity of LARS.

Objective:To explore the clinical efficacy of a wearable robot for improving the balance and walking function of stroke survivors.Methods:Eighty stroke survivors were randomly divided into an observation group and a control group, each of 40. Both groups were given routine rehabilitation, but the observation group additionally received 20 minutes of training assisted by a wearable robot six days a week for 4 weeks. Before and after the experiment, both groups were evaluated using the Berg Balance Scale (BBS) and functional ambulation categories (FACs). Their movement distance and ellipse area were measured using a Prokin balance instrument, and their step length and pace on the affected side were recorded.Results:Significant improvement in the average BBS and FAC scores, exercise length, ellipse area, and step length and speed on the affected side was observed in both groups. On average, the experimental group′s results were significantly better than those of the control group.Conclusion:Supplementing conventional rehabilitation with wearable robot assistance can significantly improve the balance and walking function of stroke survivors.

Alanine-serine-cysteine transporter 2 (ASCT2) is reported to participate in the progression of tumors and metabolic diseases. It is also considered to play a crucial role in the glutamate-glutamine shuttle of neuroglial network. However, it remains unclear the involvement of ASCT2 in neurological diseases such as Parkinson's disease (PD). In this study, we demonstrated that high expression of ASCT2 in the plasma samples of PD patients and the midbrain of MPTP mouse models is positively correlated with dyskinesia. We further illustrated that ASCT2 expressed in astrocytes rather than neurons significantly upregulated in response to either MPP⁺ or LPS/ATP challenge. Genetic ablation of astrocytic ASCT2 alleviated the neuroinflammation and rescued dopaminergic (DA) neuron damage in PD models in vitro and in vivo. Notably, the binding of ASCT2 to NLRP3 aggravates astrocytic inflammasome-triggered neuroinflammation. Then a panel of 2513 FDA-approved drugs were performed via virtual molecular screening based on the target ASCT2 and we succeed in getting the drug talniflumate. It is validated talniflumate impedes astrocytic inflammation and prevents degeneration of DA neurons in PD models. Collectively, these findings reveal the role of astrocytic ASCT2 in the pathogenesis of PD, broaden the therapeutic strategy and provide a promising candidate drug for PD treatment.

Objective:To observe the effects of ultrasound intermediate frequency acupoint targeted drug guiding technology on the recovery of gastrointestinal function and serum gastrin levels in elderly patients after lumbar spine surgery under general anesthesia.Methods:This study used prospective research methods.A total of 90 elderly patients undergoing lumbar spine surgery after general anesthesia in the orthopaedic ward of Beijing Geriatrics Hospital from June 2019 to June 2021 were randomly divided into blank control group, drug control group, and drug-guided treatment group, with 30 cases each group. After the operation, no intervention was given to the blank control group, the drug control group received oral mosapride citrate tablets, the drug-guided treatment group used the D patch to guide the medicine at the two acupoints of Zusanli and Zhongwan with ultrasound medium frequency guided medicine instrument for 1 week each. The serum gastrin levels of the patients in each group were detected 1 d before operation, 3 d after operation, and 1 week after operation, and the time of first exhaust and first defecation after operation were recorded.Results:The results showed that the level of serum gastrin preoperativein the three groups was not significantly different ( P>0.05). On the third day after operation, the levelof serum gastrin in the drug guide treatment group, drug control group and blank control group were lower than those at 1 d before operation: (66.51 ± 5.34) ng/L vs. (69.36 ± 6.50) ng/L, (58.34 ± 5.71) ng/L vs. (68.75 ± 5.13) ng/L, (55.76 ± 6.23) ng/L vs. (70.20 ± 6.71) ng/L, the differences were statistically significant ( P<0.05), and showed a decreasing trend in turn. Among them, the level of serum gastrin in the drug guide treatment group was higher than that in the drug control group and blank control group, the difference was statistically significant ( P<0.05). One week after operation, the level of serum gastrin in the three groups increased compared with the third day after operation ( P<0.05), and the drug guiding treatment group was higher than the drug control group and the blank control group: (72.38 ± 6.78) ng/L vs. (67.15 ± 6.27) ng/L, (63.52 ± 5.38) ng/L, the differences were statistically significant ( P<0.05). The time of first exhaust and defecation after the operation of the three groups of patients, the drug-guided treatment group was significantly shorter than the drug control group and the blank control group: (15.25 ± 3.10) h vs. (20.38 ± 4.21) h and (28.52 ± 3.69) h, (24.14 ± 3.53) h vs. (36.15 ± 3.54) h and (49.51 ± 4.37) h, the differences were statistically significant ( P<0.05). Conclusions:Ultrasound intermediate frequency acupoint drug guiding technology can increase the patient′s serum gastrin level and promote the recovery of gastrointestinal function in elderly patients with lumbar spine surgery after general anesthesia.

Objective:To formulate the Nursing standards of clinical practice of critical care ultrasonography (referred to as the Standards), so as to provide recommendations for the application of ultrasound in intensive care nursing practice. Methods:Based on the experience of intensive care ultrasound nursing practice and literature research, combined with the consensus recommendations of intensive care ultrasound, the critical care ultrasound study group formed the first draft of the Standards. After expert interview, consensus discussion, two rounds of Delphi expert letter consultation and other methods, the content of the Standards was revised and improved, and the final draft of the Standards was formed. Results:The Standards included four parts, such as basic application of intensive care ultrasound, nursing evaluation standard of intensive care ultrasound guidance, nursing operation process guided by ultrasound and intensive care ultrasound training. Conclusions:The establishment of Standards is scientific and practical, which can provide guidance for nursing practice of clinical operation technology of critical care ultrasonography.