Objective:To investigate the value of radiomics based on three-dimensional high resolution MR vessel wall imaging (3D HRMR-VWI) for identifying culprit plaques in symptomatic patients with middle cerebral atherosclerosis.Methods:The clinical and imaging features of 117 patients (139 middle cerebral artery plaques) with cerebrovascular diseases in Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from October 2018 to October 2020 were respectively reviewed. Stratified random sampling was used to divide 139 plaques into training set (97 plaques) and validation set (42 plaque) at the ratio of 7∶3. The plaques were divided into 69 culprit plaques and 70 non-culprit plaques based on plaque MR features and clinical symptoms. The clinical and imaging characteristics of culprit plaques and non-culprit plaques were compared by independent sample t-test, Mann-Whitney U test and χ 2 test, and factors with significant difference between two groups in univariate analysis were further analyzed by multivariate logistic regression to find out the independent predictors of culprit plaques. Radiomics features were extracted, screened and radiomics model was constructed using pre-and post-contrast 3D HRMR-VWI based on the training set. The combined model was constructed by combining the independent predictors and radiomics model. Receiver operating characteristic curve and area under curve (AUC) were used to evaluate the efficacy of each model, and DeLong test was used to compare the efficacy of different models. Results:Significant difference was found in intraplaque hemorrhage, lumen area of stenosis, stenosis diameter, stenosis rate, plaque burden and enhancement rate between culprit and non-culprit plaques (all P<0.05). Multivariate logistic regression analysis confirmed that only intraplaque hemorrhage was the independent predictor for culprit plaques (OR=7.045,95%CI 1.402-35.397, P=0.018). In the validation set, the AUC of the pre-contrast 3D HRMR-VWI model was lower than that of the post-contrast 3D HRMR-VWI model ( Z=-2.01, P=0.044). The AUC of pre+post-contrast 3D HRMR-VWI model was not significantly different from that of post-contrast 3D HRMR-VWI model ( Z=0.79, P=0.427). The AUC showed no significant difference between combined model and pre+post-contrast 3D HRMR-VWI model ( Z=-0.59, P>0.05). The combined model showed the best performance in predicting culprit plaques of middle cerebral artery (AUC=0.939), with the sensitivity, specificity and accuracy of 95.24%, 76.19% and 85.71%. Conclusion:Radiomics based on 3D HRMR-VWI has potential values in identifying culprit plaques in symptomatic patients with middle cerebral atherosclerosis.

Objective: To develop a model incorporating radiomic features and clinical factors to accurately predict acute ischemic stroke (AIS) outcomes. Materials and Methods: Data from 522 AIS patients (382 male [73.2%]; mean age ± standard deviation, 58.9 ± 11.5 years) were randomly divided into the training (n = 311) and validation cohorts (n = 211). According to the modified Rankin Scale (mRS) at 6 months after hospital discharge, prognosis was dichotomized into good (mRS ≤ 2) and poor (mRS > 2); 1310 radiomics features were extracted from diffusion-weighted imaging and apparent diffusion coefficient maps. The minimum redundancy maximum relevance algorithm and the least absolute shrinkage and selection operator logistic regression method were implemented to select the features and establish a radiomics model. Univariable and multivariable logistic regression analyses were performed to identify the clinical factors and construct a clinical model. Ultimately, a multivariable logistic regression analysis incorporating independent clinical factors and radiomics score was implemented to establish the final combined prediction model using a backward step-down selection procedure, and a clinical-radiomics nomogram was developed. The models were evaluated using calibration, receiver operating characteristic (ROC), and decision curve analyses. Results: Age, sex, stroke history, diabetes, baseline mRS, baseline National Institutes of Health Stroke Scale score, and radiomics score were independent predictors of AIS outcomes. The area under the ROC curve of the clinical-radiomics model was 0.868 (95% confidence interval, 0.825–0.910) in the training cohort and 0.890 (0.844–0.936) in the validation cohort, which was significantly larger than that of the clinical or radiomics models. The clinical radiomics nomogram was well calibrated (p > 0.05). The decision curve analysis indicated its clinical usefulness. Conclusion The clinical-radiomics model outperformed individual clinical or radiomics models and achieved satisfactory performance in predicting AIS outcomes.

OBJECTIVE: To explore the application effect of clinical nursing pathway( CNP) in nursing care on patients with occupational noise-induced deafness( ONID) under medical observation.METHODS: The patients with ONID under medical observation in hospital were randomly selected and divided into CNP group( 50 cases) and control group( 50 cases) by random number table method.The control group was given routine nursing care,and the CNP group was given CNP care according to the nursing path table.Self-Rating Anxiety Scale,Self-rating Depression Scale and SF-36 Scale were used to observe the anxiety, depression and quality of life of these two groups.The time and expenses of hospitalization,and degree of nursing satisfaction were also observed.RESULTS: Before nursing care implementation,the scores of anxiety,depression and 8 dimension of quality of life did not show statistical significance between these two groups( P > 0.05).After nursing care implementation,the improvement of anxiety,depression and quality of life in the CNP group were significantly better than that of the control group( P < 0.01).The patients in the CNP group had shorter duration of hospitalization( P < 0.01),decreased hospitalization expenses( P < 0.05),and increased nursing satisfaction( P < 0.01) compared with the control group.CONCLUSION: CNP implementation can effectively reduce the anxiety and depression symptoms of patient with ONID under medical observation during the diagnostic process of occupational diseases.It can reduce the time and costs of hospitalization,improve their quality of life and satisfaction of nursing care.CNP can be widely used in clinical practice.

OBJECTIVE: To investigate the effect of health education in the treatment of pneumoconiosis patients with bronchoalveoar lavage( BAL) during perioperative period. METHODS: Ninety-six pneumoconiosis patients treated with BAL in hospital were divided into observation group and control group( 48 cases in each group). The patients in the control group were given routine perioperative health education, and the patients in the observation group implemented perioperative health education in accordance with the health education pathway. Adverse reactions in hospital were collected,and the awareness of perioperative health knowledge of BAL was surveyed. RESULTS: Before implement of the health education pathway,there was no difference( P > 0. 05) in the health knowledge between the 2 groups. After implementation of the health education pathway,the awareness of health knowledge of observation group and control group were higher than that of the same group before implementation of the health education pathway( P < 0. 01). The awareness of 15 items of health knowledge was higher( P < 0. 05) and the incidences of intraoperative cough and postoperative low fever were lower in the observation group than in the control group( 4. 2% vs 25. 0%,2. 1% vs 16. 7%,P < 0. 05).CONCLUSION: Executing effective healthy education pathway in perioperative BAL is helpful to improve the knowledge of disease prevention and control in pneumoconiosis patients,and reduce the occurrence of adverse reactions during BAL.

The system of first contact in community health institutions, as the core element of hierarchical di-agnosis and treatment system, is of great importance for reforming successfully China’ health service system. The sys-tem of first contact in community health institutions implemented among labor workers in Shenzhen City plays an im-portant role in patients ’ distribution and the interested parties can accept this mandatory system. Campared with Shenzhen City, the level of services is enough to meet patients’ primary health demands in some cities which the com-munity health service develops well, and it should be thought highly of the mandatory in the process of policy imple-mentation in order to ensure the implementation effect.

OBJECTIVETo examine the spatiotemporal profiles and localization of CysLT1R, CysLT2R and GPR17 in mice with 1-methyl-4-phenyl-1, 2, 3, 6-tetrahydropyridine (MPTP)-induced Parkinson disease (PD).

METHODSPD model was induced by subcutaneous injection of MPTP (25 mg/kg) for 5 d in adult male C57BL/6 mice. At d10 after MPTP injection, the expression and cellular localization of CysLT1R, CysLT2R and GPR17 in the substantia nigra were detected by immunohistochemistry and immunofluorescence.

RESULTSCysLT1R, CysLT22 and GPR17 were normally localized in TH-positive dopaminergic neurons and microglia, while CysLT2R was also expressed in astrocytes. In dopaminergic neurons, approximately 91% co-expressed GPR17, 77% co-expressed CysLT1R and 52% co-expressed CysLT2R. Compared with the control group, TH-positive cells in the substantia nigra were significantly reduced in PD mice. CysLT1R, CysLT2R and GPR17-positive cells were significantly reduced; and CysLT1R, CysLT2R, GPR17-positive dopaminergic neurons were also significantly reduced in the PD group. In the striatum, both CysLT1R and GPR17 were normally expressed in neurons; whereas CysLT2R was expressed in astrocytes. In PD striatum, CysLT1R and GPR17-positive cells were decreased, but CysLT2R expression was significantly increased which mainly expressed in the proliferating astrocytes.

CONCLUSIONCysLT1R, CysLT2R and GPR17 may be involved in the MPTP-induced PD damage in mice.

Animals ; Brain ; metabolism ; Disease Models, Animal ; Male ; Mice ; Mice, Inbred C57BL ; Nerve Tissue Proteins ; metabolism ; Parkinson Disease ; metabolism ; Receptors, G-Protein-Coupled ; metabolism ; Receptors, Leukotriene ; metabolism

Objective To explore the correlation between the carotid atherosclerosis unstable plaque lipoprotein(a) [ Lp(a)]levels with acute cerebral infarction patients.Methods 120 patients with acute cerebral infarction were selected as the research group,and at the same period,120 health cases were selected as the control group.The level of Lp(a) of the two groups was tested,and neck vascular color dopplar ultrasound examination was conducted.Results The incidence of atherosclerotic plaque in carotid artery and unstable plaques was 70.8％,51.7％,respectively,and significantly higher than that of the control group(25.8％,6- 7％ ) ( x2 =5.12,6.43,all P ＜0.05 ).The Lp(a) level of the research group[ (273.6 ± 221.7 )ag/L] was significantly higher than that of the control group[ ( 81.6 ± 64.9) mg/L ] ( t =6.53,P ＜ 0.05 ).Conclusion High level of LP(a) is the independent risk factor of cerebral infarction.The instability of carotid atherosclerotic plaques is the important cause of cerebral infarction.

Objective:To summarize our clinical experience of robot-assisted laparoscopic partial nephrectomy (RALPN), and to discuss its efficacy and safety. Methods:Between December 2007 and October 2008, 6 patients with small exophytie renal masses underwent intraperitoneal robotic partial nephrectomy utilizing the Da Vinci sur-gical system. The perioperative data were collected, and were compared with those performed the same operation in abroad and those performed laparoseopic partial nephrectomy(LPN) with the same team in internal. Results: All the operations were accomplished successfully except the one which required conversion to open nephron-sparing surgery (NSS) due to bleeding occured after the renal artery had been clamped. The mean lesion diameter was 3.2 (2.2-3.6)cm; the mean operative time (not including preoperative set-up time of the Da Vinci surgical system) was 130 (110-160) minutes; the mean warm ischemia time were 40(33-50)minutes; the mean estimated blood loss was 188 (100-380) ml. The patients were ambulant in the 7th postoperative days, and tubes were removaled in 3 days, and mean hospital stay was 9 (8-12)days. Renal function of all patients was in the normal range. Pathology revealed renal cell carcinoma in five, papillary renal cell carcinoma in one. All resection margins were negative. Follow-up ranged from 4 to t5 months, no local residual lesions, local recurrence, incision implantation and dis-tant metastasis were found in all patients. Conclusions.. Robot-assisted laparoscopic partial nephrectomy can be safe-ly performed in selected patients, and it is a feasible approach and a minimally invasive operation for small renal tumors.

Objective To establish a mouse model for scleroderma.Methods Forteen BALB C and 14 C3H female mice were averagely divided into model 1 and controls.Daily 0 1 ml BLM at a concentration of 200 ?g/ml was injected intracutaneusly into the backs of model 1 mice for 3 weeks,and 0 1 ml solution of PBS were injected intracutaneusly into the backs of control mice for 3 weeks.Observing the histological change of skin and lungs was made and measuring the thickness of dermis was performed with a medical analysis system of the color picture,determined the collagenic quantity was done with photoelectric colorimetry,and calculating the immunohistochemical index of collagen type Ⅰ and Ⅲ and transforming growth factor ? 1 (TGF ? 1) in the skin lesions from the mouse model and control was done.SPSS was used to finish the statistical analysis of the detective value from model 1 and controls.Results In the skin of model mice,the thickness of dermis markedly thickened ( P

Objective To investigate the role of immune response induced by different T-helper 1 and T-helper 2 (Th1 and Th2) ratio in peripheral blood and decidua from patients with hypertensive disorder complicating pregnancy in the pathogenesis of the disease. Methods Peripheral blood and decidua from 12 non-pregnant women (no deciduas)(normal women group), 12 healthy pregnant women(healthy pregnant women group), 10 patients with gestational hypertension(gestational hypertension group), 25 patients with pre-eclampsia (PE)(including 10 patients with mild pre-eclampsia and 15 patients with severe pre-eclampsia)(pre-eclampsia group). Th1/Th2 ratio in peripheral blood and decidua was determined by flow-cytometrically. Results The ratio of Th1/Th2 in peripheral blood with normal women group is 10.5?1.5, the ratios of Th1/Th2 in peripheral blood and deciduas with healthy pregnant women group are 9.5 ?2.9 and 7.6?4.6 respectively, those with gestational hypertension group are 12.1?3.4 and 13.1?5.6 respectively, those with pre-eclampsia group are 16.8?3.8 and 26.7 ?9.4 respectively. The ratios of Th1/Th2 in peripheral blood and deciduas with pre-eclampsia group are much higher than those with other groups!, when they are compared with each other, there are statistical difference(P