Objective To evaluate the value and limitation of CTA, MRI and DSA in the diagnosis of the cerebral venous malformation. Methods CT angiography in 8 cases and MRI in 10 cases were performed among 12 cases of cerebral venous malformation confirmed by carotid angiography . Results All cases had typical DSA appearance and it could be seen both the number and the direction of the guide vein. The typical “Medusa-head” sign could be seen on MRI and could be more obvious after contrast enhancement.The other complications might be seen on the postcontrast. On CTA,both the lesion itself and the “caput medusae”sign could be displayed.Conclusion In diagnosis of cerebral venous malformation,DSA is the gold standard,CTA is the significant method in diagnosing and following up,while MRI is the most useful method.

Objective To analyze the CT and MRI features of giant cell tumors of the skull. Methods 8 cases of giant cell tumors of the skull proven surgically and pathologically were analyzed retrospectively. CT and MRI(6 cases with post contrast CT and 5 cases with post contrast MRI scans)were performed in all cases. All tumors were excised surgically. Two weeks later,all patients undertook postoperative radiotherapy with the dosage of 4 500-6 000 cGy for five to six weeks. Results CT scan showed bone destruction and calcification. Most of the tumours were well defined with low signal intensities on T1 WI images, T2 WI images showed ununiformity signal. The low signal on T1 WI was still low signal intensity on T2 WI which suggested calcification. All patients had no distinctive change within the follow up period. Conclusion CT is able to clearly show bone destruction and calcification. MRI is superior to CT in demonstrating the outlines of the tumours. CT and MRI are effective methods in the diagnosis of the giant cell tumors. Surgery and postoperative radiotherapy are effective methods in the treatment of the giant cell tumors.

BACKGROUND: Key point for subculture of human embryonic stem cells (hESCs) is to inhibit spontaneous differentiation and make sure totipotency of cells. Although mouse embryonic fibroblasts (MEF) or human foreskin fibroblasts (HFF) used as the feeder layer can maintain undifferentiated state of embryonic stem cells, cell clone is still imperfect and parallel arranged. OBJECTIVE: To establish mixed feeder layer of mouse embryonic fibroblasts plus human foreskin fibroblasts and to observe the hESCs growth.DESIGN: Multi-sample observation and comparison.SETTING: Medical Center of Reproduction, the Affiliated Hospital of Hainan Medical College. MATERIALS: This study was performed at the Medical Center of Reproduction, the Affiliated Hospital of Hainan Medical College from April 2006 to July 2007. Foreskin was derived from the children who underwent circumcision and came from Urinary Surgery, the Affiliated Hospital of Haihan Medical College. The children's family members provided the informed consent, and the experiment received confirmed consent from the local ethic committee. hESCs line HN-1 was separated from human blastula. Eleven 12.5-14.5-day-old fetal mice of clean grade were selected in this study. The experimental animals were disposed according to ethical criteria. METHODS: Heads, four extremities, and viscera were removed from fetal mice under anesthesia. Subsequently, cell suspension was prepared using routine trypsinase digestion and inoculated. When cells were cultured in confluent monolayer, some primary cells were frozen, processed with mitocin-C for 2.0-3.0 hours, and inoculated based on the density of 1×108 L-1 in gelatin-coated dish, I.e., MEF feeder layer. The HFF separation and culture and the preparation of HFF feeder layer were the same as above-mentioned processing. In addition, the two fibroblasts were respectively counted and mixed together according to the ratios of 1∶0, 3∶1, 1∶1, 1∶3, and 0:1. And then, the mixture was inoculated based on the density of 1×108 L-1 in gelatin-coated dish, I.e., mixed feeder layer. The growth of subcultured hESCs in vitro was observed in three different feeder layers, and hESCs in the mixed feeder layer underwent alkaline phosphatase test, OCT-4 expression immunohistochemical measurement, and OCT-4 and telomerase mRNA expression RT-PCR detection. Finally, differentiation in vitro of hESCs was observed after removing the feeder layer.MAIN OUTCOME MEASURES: ① Growth of hESCs in the three different feeder layers; ② Growth of hESCs in the mixed feeder layer based on different mixed ratios; ③ undifferentiated state of hESCs in the mixed feeder layer; ④ differentiation in vitro.RESULTS: ① hESCs clone in the MEF and HFF feeder layers was thin and flat and imperfect, but hESCs clone in the mixed feeder layer was perfect and thick and solid. Apparently, the clone form in the mixed feeder layer was superior to MEF and HFF feeder layers. ② When MEF and HFF was mixed together according to the ratio of 1∶1, hESCs grew in apparent accumulation; clone border was clear; eminentia was apparent and perfect. However, there were no changes according to the ratio of 1∶3. The ratio of 1∶1 was superior to the ratios of 1∶0, 3∶1, and 0∶1. ③ Alkaline phosphatase staining and OCT-4 antigen expression were strongly positive. Specific straps of OCT-4 and telomerase mRNA expression were observed at 200-300 bp and 300-400 bp, respectively. ④ Embryoid bodies were formed. hESCs could differentiate into multi-morphological cells after attachment.CONCLUSION: ① The mixed feeder layer may well support in vitro subculture of hESCs to acquire excellent clone form compared to MEF or HFF feeder layer. ② The mixture of MEF and HFF has excellent effect according to the ratio of 1∶1.

Objective To evaluate the color Doppler ultrasonography and contrast enhanced ultrasound (CEUS) findings of congenital intrahepatic portosystemic venous shunts (IPSVS).Methods Nineteen patients of congenital IPSVS were examined with color Doppler ultrasonography and CEUS.All patients were confirmed by CT angiography.The hepatic artery arrival time (HAAT),portal vein arrival time (PVAT),and hepatic vein arrival time (HVAT) on CEUS were recorded.The interval time between hepatic artery arrival time and hepatic vein arrival time (HA-HVTT) and the interval time between portal vein arrival time and hepatic vein arrival time (PV-HVTT) were calculated.Results The types of IPSVS between portal and systemic veins were based on Park's classification.Color Doppler ultrasonography showed abnormal communication between the portal vein branch and the hepatic veins,duplex Doppler ultrasonography showed abnormal spectral pattern from the portal vein such as undulating,triphasic waveform mimicked that of the hepatic vein.CEUS demonstrated abnormal communication between portal vein branch and hepatic vein.HVAT,HA-HVTT,and PV-HVTT were shorter statistically in congenital IPSVS group than those in cirrhosis and normal groups.Conclusions Congenital IPSVS is a rare vascular abnormality that is usually asymptomatic.Color Doppler ultrasonography is a useful tool for diagnosis of congenital IPSVS.CEUS provides helpful data for the diagnosis and differential diagnosis of congenital IPSVS.

Objective To explore the symptoms of anxiety,family structure,and the distribution features of family about in-patients.And to find out the influence of the family structure on in-patients' symptoms of anxiety.The results would provide evidentiary support and suggestions for in-patients to improve quality of life and for prevention and intervention of anxiety.Methods Family table was used to register the family structure which was classified as the nuclear family,stem/expended family and other classification.The anxiety of in-patients was measured by self-rating anxiety scale.Results A total of 512 cases of in-patients completed the survey,there were 483 valid questionnaires.The rate of effective questionnaire was 94.34％.In family structure of in-patients,core family accounted for 48.65％,stem/expended family was 36.85％.The sex of family structure showed significant difference,the female proportion of the nuclear family was significantly higher than male.Among all in-patients,78.05％ did not have anxiety,low-level,medium-level,and severe anxiety showed no significant differences.The effects of anxiety on family structure had significant differences.The anxiety level of stem family was relatively higher.Conclusions Economic development and the population flow due to industrialization and globalization changed family structure of our country,especially in coastal de-velopment cities with fast economic development,fast-paced and stressful work,and it may affect the influ-ence of Chinese traditional family structure on anxiety of the in-patients.

Objective To explore the clinical manifestations,imaging findings,pathological classification and treatment of congenital cystic adenomatoid malformation (CCAM)of the lung.Methods The clinical features,imaging findings,pathology information,diagnosis,treatment method and its prognosis of children with CCAMconfirmed by ope-ration and pathology were retrospectively analyzed in Yuying Children′s Hospital Affiliated to Wenzhou Medical Univer-sity from August 2006 to August 201 4.Results Eleven patients were boys and 4 patients were girls.One case had a-symptomatic clinical features,1 2 cases had pulmonary infection,1 case had recurrent chest pain,and 1 case had de-pressed deformity in sternum inferior segment.Chest CT scanning indicated that 9 cases had multiple gas cysts at unila-teral side of lung,among which 1 case was of funnel chest and pulmonary sequestration,1 case of huge cyst containing air and fluid at inferior lobe of left lung,and 4 cases of high density lung shadow;CT examination indicated that 1 case had recurrent chest pain and eventration of diaphragm of the right side combined with pulmonary sequestration.All ca-ses were treated by surgical resection,of whom 1 case was given cystectomy and sequestrectomy,diaphragmatic plication respectively,1 case complicated with funnel chest disease underwent lesion pulmonary lobectomy,sequestrectomy and minimally invasive corrective surgery in pectus excavatum (Nuss surgery),and the remaining 1 2 cases received lesion pulmonary lobectomy.All of 1 5 cases recovered well without complications.Pathological classification type of CCAMin-cluded 1 1 cases of type Ⅰ,3 cases of type Ⅱ and 1 case of type Ⅲ,among which 2 cases had pulmonary sequestration. Conclusions CCAMis a rare disease which can be discovered along with pulmonary infection.Multiple gas cysts are the most common imaging findings and the preoperative diagnosis of CCAM is mostly based on chest CT examination. Type Ⅰ and type Ⅱ are the most common pathological classification.The surgical resection should be given early surgi-cal resection and the prognosis is usually good.

Objective:To describe the family resilience experience of colorectal cancer patients′ spouses in the process of care, and to provide reference for making effective clinical nursing interventions.Methods:Objective sampling method was used to select the spouses of colorectal cancer patients who were hospitalized in Shanghai East Hospital from March to April 2023. A phenomenological research was used. Semi-structured, in-depth interviews were conducted with 10 spouses of colorectal cancer patients undergoing colostomy. Data was transcribed and analyzed using Colaizzi′s method.Results:Three themes were extracted: family crisis and coping pressure including increased burden of care, accompanying emotional internal friction, heavy economic pressure; internal adjustment and adaptation within the family including positive family beliefs, timely adjustment of family roles, clear and effective communication and interaction; integration and utilization of external resources including active access to information, medical professional support, social external support.Conclusions:With the help of the perspective of family advantage, medical staff should pay attention to the evaluation of care needs and family resilience of colorectal cancer patients′ spouses, to fully mobilize advantage resources and give effective intervention measures to improve the family and social adaptation level of patients and their spouses.

Objective:To compare the tolerance to indwelling urethral catheterization in surgical patients who received the pro‐cedure before general anesthesia with that after general anesthesia ,and to find out the best timing for indwelling urethral cathe‐terization .Methods:Totally 300 cases undergoing laparoscopic gallbladder operation with general anesthesia were randomly di‐vided into group A and group B ,with 150 cases in each group .In group A ,Indwelling urethral catheterization was done 10 min before general anesthesia ,while in group B it was done after tracheal intubation of general anesthesia .And the procedures in two groups were conducted with No .16 disposable urethral catheterization bag and complied with the standard criteria of cathe‐terization .Heart rate and mean arterial pressure before anesthesia and that in 5 min after tracheal extubation ,were recorded respectively ,and were evaluated in accordance with the degree of agitation scale .Results:Occurrence rate of moderate and severe agitation in group A was less than that in group B .Heart rate before general anesthesia was higher in group A than that in group B ,while mean arterial pressure and heart rate 5 min after tracheal extubation was lower in group A than that in group B .And the differences were statistically significant(P<0 .05) .Conclusions:To indwell urethral catheters before the general anesthesia could significantly improve the tolerance to urethral catheterization in surgical patients more comfortable .

Objective To develop the duration knowledge requirement questionnaire of myocardial infarction patients, in order to provide tools for understanding duration knowledge requirement of myocardial infarction patients. Methods By literature review and semi-structure interview as the main sources of questionnaire dimensions and items, the primary questionnaire had been formed by experts conference method, but the formal questionnaire was established after the confirmation and perfection by pre-survey and recognition interview. Results The duration knowledge requirement questionnaire of myocardial infarction patients included 5 dimensions 37 items. The Cronbach′s α coefficient of questionnaire reliability was 0. 839, each dimensions′ Cronbach′s αcoefficient was 0. 704-0. 825. The content of validity was 0. 86. Conclusions This questionnaire has favorable validity and reliability, which is suitable for the survey of duration knowledge requirement in myocardial infarction patients.

Objective:To construct the "Internet + Nursing Service" quality evaluation index based on the three-dimensional quality structure model, so as to provide an objective basis for the standardized and effective development of the "Internet + Nursing Service" quality evaluation.Methods:From January to October 2020, with the three-dimensional quality structure model as the framework, the "Internet + Nursing Service" quality evaluation index item pool and the initial questionnaire were preliminarily constructed by combining with literature retrieval, semi-structured interviews and group discussions. Purpose sampling was used to select 31 clinical nursing, nursing management, human resources, public health management and information technology experts who were engaged in "Internet + Nursing Service" or home care. The Delphi method was used to revise the first draft of the plan to construct the "Internet + Nursing Service" quality evaluation index, and to determine the weight of the index system combined with the analytic hierarchy process.Results:In the two rounds of expert consultation, the authority coefficients were 0.792 and 0.828 respectively, and the Kendall coordination coefficients were 0.076 and 0.075 for the second-level indicators, and 0.138 and 0.150 for the third-level indicators, and the difference was statistically significant ( P<0.05) . Finally, the construction of "Internet + Nursing Service" quality evaluation indicators includes 3 first-level indicators, 13 second-level indicators, and 42 third-level indicators. Conclusions:The "Internet + Nursing Service" quality evaluation index constructed based on the three-dimensional quality structure model is scientific and reliable, and can provide a basis for scientific and effective evaluation of the "Internet + Nursing Service" quality and sustainable improvement.