Reversible cerebral vasoconstriction syndrome (RCVS) usually occurs during normal pregnancy or a few days after delivery. The gold standard of diagnosis is the reversibility of cerebral vascular constriction confirmed by digital subtraction angiography (DSA). In this article, we descried the clinical and imaging features of one RCVS case proved by repeating DSA, and discussed the probably pathophysiological mechanisms.

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Objective: To investigate the effects of simulated-thermobaric explosive gas on the respiration and nervous system in rats. Methods: 70 of SPF SD rats were randomly divided into four thermobaric explosive gas groups, two restoration observation groups and control group from April to August in 2018. The exposure time of in four thermobaric explosive gas groups were 3.75, 7.5, 15.0 and 30 min, respectively. The restoration observation groups were designed to observe for 30 and 120 min after exposure thermobaric explosive gas 30 min. The bloods were collected and analyzed at the end of exposure and recovery observation. The endogenous carbon monoxide (CO) , nitric oxide (NO) , glutamic acid (GLU) , acetylcholinesterase (AchE) and dopamine (DA) were detected in brain tissues, respectively. Results: The blood gas index (pH, PCO₂, PO₂, COHb, O₂Hb, MeHbt) and blood electrolytes (Na⁺, K⁺, Ca²⁺ and Cl^-) in exposure groups have significant differences with these in control (P<0.05) . The pH value decreased with the exposure time longer. However, it basically returned to normal level when terminating exposure for 120 min. The concentration of PCO₂, MeHb and CoHb increased first and then decreased with the exposure time extension. Conversely, The PO₂ and O₂Hb decreased first and then increased with the exposure time longer. The concentration of endogenous CO, GLU, and AchE decreased and NO increased in exposure group 4 and the restoration observation group 1 compared with those in control (P<0.01) . In addition, there were pathological changes in lung and brain tissue of exposure group, such as inflammatory cell infiltration and edema. Conclusion The blood gas index, electrolytes, neurotransmitter, histopathology of lung and brain were changed to various degrees by thermobaric bomb gas exposure. These findings would provide some beneficial support for evaluating the damage effect of thermobaric bomb gas on organisms.

Objective To investigate the characteristics of gray matter volume in Obsessive Compulsive Disorder (OCD) patients compared with healthy controls, and to explore the correlation between brain regions with altered gray matter volume and the patients'cognitive function and clinical symptoms. Method Thirty-six patients with first-episode OCD and 35 healthy controls who were matched by age, gender and education level were selected and examined by MATRICS Consensus Cognitive Battery (MCCB) and Yale-Brown Obsessive Compulsive Scale (Y-BOCS). The head MRI and the Voxel-based morphometry was used to test the volume of gray matter. The correlation analysis was conducted to analyze the correlation between brain areas with altered gray matter volume and patients'cognitive function and Y-BOCS results. Results Compared with the control group, the OCD group had increased gray matter volume in frontal parietal lobe (postcentral gyrus-L, precentral gyrus-L) (t=4.299, P<0.0005, voxels>100) and temporal-limbic system (fusiform gyrus-L, superior temporal gyrus-L, medial temporal lobe-L, parahippocampal gyrus-L) (t=4.841, P<0.0005, voxels> 100). Meanwhile, the volume of gray matter decreased in bilateral anterior cingulate gyrus (t=-4.181, P<0.0005, voxels>100). In the case group, there were a positive correlation between the volume of gray matter in the temporal lobo-limbic system and social cognition score (r=0.347,P=0.038) and a positive correlation between the volume of gray matter in the anterior cingulate gyrus and obsessions score (r=0.416,P=0.012). Conclusion Patients with OCD have abnormal gray matter volume in a wide range of brain regions, including the frontal parietal lobe, the temporal-limbic system, and bilateral anterior cingulate gyrus, among which the volume of gray matter in the temporal-limbic system is correlated with social cognition, and gray matter volume in the anterior cingulate gyrus is correlated with obsessions.

The effective implementation of curricular ideology should be vigorously promoted in the training process of postgraduate students in critical care medicine.The clinical practice of critical care medicine contains a large number of ideological elements.In the process of teaching,teachers need to explore the ideological and political elements closely related to critical care medicine,mainly including:correct value of life,self-supervision spirit,communication and collaboration ability,healer's benevolence,craftsmanship,honesty and integrity in medical practice,as well as the supremacy of the country and the people,and so on.In the process of implementing curriculum ideological and political teaching,teachers are required to continuously improve their professionalism and ethics,improve their teaching methods,and set a good example in their clinical work.In order to better implement the curriculum ideological and political education,it is necessary to establish a perfect teaching system and a unified curriculum ideological and political education material library.

Objective To explore the effect of teach-back on the health education of osteoporosis knowledge in diabetic patients. Methods A total of 152 cases of diabetic patients hospitalized in endocrinology department, the Second Affiliated Hospital of Xi′an Jiaotong University were recruited. The study subjects were divided into control group and experimental group according to the admission date, 76 cases in each group respectively. Intervention was conducted using a unified set of publicity materials and slides of osteoporosis knowledge. The routine health education was applied in the control group, and the experimental group was carried out the teach-back health education. The effect of health education was evaluated by the Osteoporosis Knowledge Test (OKT) before intervention, 1 day after intervention, and 3 months after intervention. Results Before intervention, the OKT score of two groups were not statistically different (t=0.071, P=0.943). The OKT score of the control group was (19.21±3.91) points for 1 day after intervention and (16.95 ± 4.14) points for 3 months after intervention. The OKT score of the experimental group was (21.61 ± 2.59) points for 1 day after intervention and (20.54 ± 3.09) points for 3 months after intervention. After intervention, the OKT score of the experimental group was higher than that of the control group, and the results were statistically different (t=4.455, 6.057,P<0.01). Repeated measures analysis of variance revealed that there were significant differences in OKT score between the two groups (P<0.01). Conclusion Teach-back health education is more beneficial for diabetic patients to understand and remember the knowledge of osteoporosis and is worth further research and application.

Background A large amount of iron deposition in the brain can cause neuronal damage by inducing oxidative stress, neuroinflammation, and abnormal mitochondrial function. In addition, iron deposition is also reported to be closely related to the pathogenesis of Alzheimer's disease (AD). The neurofibrillary tangles aggregated by tau hyperphosphorylation are one of the important pathological features of AD. Objective To investigate potential effect of exogenous trivalent iron ions on neuronal activity in human neuroblastoma (SH-SY5Y) cells and tau hyperphosphorylation and aggregation. Methods SH-SY5Y cells were treated with ferric chloride (FeCl₃) at four concentrations (10, 100, 200, and 400 mg·L⁻¹). Cell survival rate was then detected by CCK8 assay. Intracellular iron content was determined prussian blue (Perl's) by iron staining after 24 h exposure to FeCl₃ at 10 or 200 mg·L⁻¹. Transfection of tau-P301L plasmid was conducted to construct an AD-like cell model for tau overexpression. The differences in the expression of the phosphorylated tau (p-tau) protein in SH-SY5Y cells and SH-SY5Y cells with tau overexpression were detected by Western blotting after 24 h exposure to FeCl₃ at 10 and 200 mg·L⁻¹. After dilution with phosphate buffered saline (PBS), FeCl₃, human tauR3, and FeCl₃ + tauR3 were incubated at 37℃, and the fluorescence intensity reflecting tau aggregation level was measured by thioflavin T(ThT) method at 12, 24, 36, 48, 60, 72, 84, and 96 h, respectively. Meanwhile, after 96 h coincubation of FeCl₃ and tauR3, the fibers formed by tau aggregation were observed under a transmission electron microscope (TEM). Results After 24 h of FeCl₃ exposure, the cell survival rate of SH-SY5Y cells among all groups was statistically different (F=8.63, P<0.01). The cell survival rates in the 200 and 400 mg·L⁻¹ groups were 80.1% and 68.7% of the control group, respectively (P<0.05). Compared with the control group, the nuclei of the 200 mg·L⁻¹ FeCl₃ group were mainly yellowish-brown after iron staining and the positive cell rate was up-regulated by 12.9% (P<0.01). After 24 h of FeCl₃ exposure , the p-tau (Ser396) protein expression was statistically different among all groups (F=11.6, P<0.01). Compared with the control group, the p-tau protein expression level of SH-SY5Y cells in the 200 mg·L⁻¹ group was up-regulated by 72.7% (P<0.01). After FeCl₃-treated SH-SY5Y cells with tau overexpression for 24 h, the p-tau (Ser396) protein expression was statistically different among all groups (F=27.8, P<0.01). Compared with the tau group, the p-tau (Ser396) protein expression level of SH-SY5Y cells in the tau + 200 mg·L⁻¹ group was up-regulated by 44.6% (P<0.05). Compared with the tauR3 group, the fluorescence intensities in the 84 and 96 h tauR3 + FeCl₃ groups were up-regulated by 49.9% and 53.7% (P<0.01) respectively. After 96 h of coincubation, compared with the tauR3 group, FeCl₃ + tauR3 aggravated tau aggregation and formed fiber deposition under TEM. Conclusion Exogenous trivalent iron ions may inhibit SH-SY5Y cell viability, promote the phosphorylation of tau in SH-SY5Y cells transfected with tau-P301L plasmid, and aggravate tauR3 aggregation and fiber production.