50 cases of the brancnes and anastomoses of the cavernous segment of theinternal corotid artery were dissected on 3 adult and 22 infant cadavers under aspectacle type magnifying glass and a binocular dissection microscope.The principalresults are summarized as follows:1.From the proximal to the distal portion of the cavernous segment of theinternal carotid artery there were two curves,the first one curves forward and thesecond curve curves upward.Both curves divided the cavernous segment into threeportions,i.e.the posterior ascending,horizontal and anterior ascending portions.2.Normally within the cavernous segment of the internal carotid artery therewere two major branches which were the meningo-hypophyseal trunk and the arteryof the inferior cavernous sinus.In some cases there was also a capsular arterypresent.The meningo-hypophyseal trunk usually gave rise to three branches,viz,the tentorial artery,the dorsal meningeal artery and the inferior hypophyseal artery.According to the number of the primary branches within the cavernous segment ofthe internal carotid artery,we classify four types of ramification namely:of onebranch,of two branches,of three branches and of four branches.3.With regard to various branches,their origins,average external diameters,proper names,courses and distributions were presented in detail.4.The anastomoses of the cavernous segment of the internal carotid arterywithin various branches were described.The clinical significance of what has beenmentioned above was discussed.5.Parkinson's cavernous triangle,which is of practical significance to themicrosurgical operation,has been likewise measured.

Objective To investigate the training demaneds of nursing administrators in Dongguan district. Method A self-designed questionnaire was used to investigaste 744 nursing supervisors from 68 hospitals in Dongguan. Results Among them, master,bachelor and primary professional title account for 1.35%,60.35%and 30.25%respectively, Risk and crisis manngement and quality control are the main training demands.The influencing factors are as follows,funds,time and supports from leaders or/and by on-the-spot visits.Conclusion The training for the nursing administrators should be need-oriented in different forms.

Objective To study the anatomic data of the first metatarsal dorsal artery and to provide anatomical basis for clinical tissue transplantation based on the first metatarsal dorsal artery.Methods The 16 adult cadaver specimens with 32 feet were dissected and meas-ured by vernier caliper.Then the anatomic data of the first metatarsal dorsal artery were analyzed.Results Through the examinations of 32 feet sample,the first metatarsal dorsal artery were classified into 5 types.Type Ⅰ:the first metatarsal dorsal artery runs at the surface of the first dorsal interosseous muscle (13 sides,40.6%).Type Ⅱ:the first metatarsal dorsal artery runs in the interior of the first dorsal interosse-ous muscle (11sides,34.4%).Type Ⅲ:the first metatarsal dorsal artery runs underneath the first dorsal interosseous muscle (6 sides, 18.8%).Type Ⅳ:the first metatarsal dorsal artery is slender (1 side,3.1%).TypeⅤ:the first metatarsal dorsal artery is absent (1 side, 3.1%).Distance relationship was measured between the first metatarsal bone and the first metatarsal dorsal artery:the vertical distance be-tween the origin of the posterior branch of the first metatarsal dorsal artery and base of the first metatarsal bone was (2.4 ±0.3)mm,the ver-tical distance between the origin of the posterior branch of the first metatarsal dorsal artery and head of the first metatarsal bone was (10.1 ±1.0)mm;the vertical distance between the origin of the anterior branch of the first metatarsal dorsal artery and the first metatarso-phalangeal joint was (7.6 ±2.7)mm.Conclusion The first metatarsal dorsal artery has clinical reference significance for the hands and feet’s trauma and skin flap transplantation such as thumb reconstruction.

In recent years,unexpected outbreaks of infectious diseases caused by emerging and re-emerging viruses have become more frequent,which is possibly due to environmental changes.These outbreaks result in the loss of life and economic hardship.Vaccines and therapeutics should be developed for the prevention and treatment of infectious diseases.In this review,we summarize and discuss the latest progress in the development of small-molecule viral inhibitors against highly pathogenic coronaviruses,including severe acute respiratory syndrome coronavirus and Middle East respiratory syndrome coronavirus,Ebola virus,and Zika virus.These viruses can interfere with the specific steps of viral life cycle by blocking the binding between virus and host cells,disrupting viral endocytosis,disturbing membrane fusion,and interrupting viral RNA replication and translation,thereby demonstrating potent therapeutic effect against various emerging and re-emerging viruses.We also discuss some general strategies for developing small-molecule viral inhibitors.

Objective:To evaluate the short-term efficacy and the improvement of quality of life of enzyme replacement therapy (ERT) with Imiglucerase on children with Gaucher disease(GD) through the same time monitoring.Methods:Six children diagnosed as GD who were treated by ERT with Imiglucerase in the Department of Hematology of the Children′s Hospital of Shanxi Province from May 2019 to May 2020 were recruited.Every 3 months, the sizes of the liver and spleen was palpated, the change of bone pain was recorded, and the haematological index was examed.The volumes of the liver and spleen at 1-year treatment were measured by CT.Bone involvement was examined by magnetic resonance imaging (MRI). In addition, the body weight, height, and the 36-Item Short Form Survey (SF-36) were measured and compared with pre-treatment levels.These data were analyzed statistically by SPSS 25.0 and the difference between pretherapy and post-treatment was compared by paired t test. Results:Six children diagnosed as GD received ERT with Imiglucerase.No adverse events were reported.Decreased volumes of the liver and spleen, and increased hemoglobin level and platelet count were detected after 3-6 months of ERT.After 1 year of ERT, hemoglobin level significantly increased compared with pre-treatment level ( t=4.200, P=0.008). Although the platelet count increased at 1-year ERT, it was comparable with pre-treatment level ( t=2.260, P=0.073). The volumes of liver and spleen decreased by (22.10±15.28)% ( t=2.725, P=0.042) and (47.10±18.42)% ( t=3.162, P=0.034) after 1 year of ERT, respectively.During the first year of ERT, the height and weight increased (6.17±2.86) cm ( t=5.286, P=0.003) and (4.08±2.01) kg ( t=4.975, P=0.004), respectively.SF-36 score increased significantly from (489.35±103.99) points to (632.75±73.34) points ( t=5.740, P=0.002). After 1 year of ERT, 1 patient still had bone pain, and 2 cases were worse in bone MRI, which may be attributed to the short period of follow-up and insufficient dose, and another 3 had no change in bone MRI. Conclusions:ERT ameliorates GD-associated anemia, organomegaly and growth retardation, and improves the growth rate of body mass and height and the quality of life in the short period.However, short-term ERT does not improve the bone disease.

Objective:To explore the clinical characteristics and prognostic factors of children with relapsed acute lymphoblastic leukemia (ALL).Methods:The clinical data of 52 children with relapsed ALL in Children's Hospital of Shanxi Province from January 2010 to April 2019 were retrospectively analyzed. The clinical characteristics of the children were summarized and the prognostic factors after recurrence were analyzed.Results:Till May 1, 2019, 5 out of 52 children gave up treatment after diagnosis and were lost to follow-up. For the remaining 47 children with successful follow-up, the median age at initial diagnosis was 60 months (11-168 months), the median time from initial diagnosis to relapse was 21 months (2-112 months), the median follow-up time was 5.5 months (1.0-69.0 months), and the 2-year overall survival (OS) rate after relapse was 31%. Nine patients accepted allogeneic hematopoietic stem cell transplantation after the second time complete remission, the median time from diagnosis to transplantation was 4.5 months (3.0-7.0 months), and the median follow-up time was 22 months (4-69 months). The 2-year OS rates in relapsed children with white blood cell count < 50×10 9/L and ≥ 50×10 9/L at initial diagnosis were 39% and 13%, respectively (χ 2=5.623, P=0.018). The 2-year OS rate after relapse in standard-risk, intermediate-risk and high-risk groups were 72%, 31% and 8%, respectively (χ 2=10.068, P=0.007). The 2-year OS rate after relapse in very early relapse, early relapse and late relapse groups were 0, 33% and 79%, respectively (χ 2=30.066, P < 0.01). The 2-year OS rate after relapse in chemotherapy with or without radiotherapy group, transplantation group and irregular treatment group were 57%, 89% and 0, respectively (χ 2=26.885, P < 0.01). Cox multivariate analysis showed that relapse time was the independent risk factor affecting the prognosis of children with relapsed ALL ( HR=0.340, 95% CI 0.146-0.789, P=0.012). Compared with the transplantation group, the risk of death in the chemotherapy with or without radiotherapy group and the irregular treatment group was significantly higher ( HR=12.313, 95% CI 1.266-119.758, P=0.031; HR=20.699, 95% CI 2.230-192.129, P=0.008), suggesting that hematopoietic stem cell transplantation is a protective factor for the prognosis of children with relapsed ALL. Conclusions:The relapse of ALL in children mainly happens in very early and early time. The main part of relapse is bone marrow, and there are many high-risk patients at initial diagnosis. The risk group at initial diagnosis, white blood cell count at initial diagnosis, relapse time, and treatment after relapse are the risk factors affecting the prognosis, and the relapse time and hematopoietic stem cell transplantation are the independent prognostic factors.

Objective To explore the nursing methods for the treatment of lung cancer by thoracoscopy.Methods A total of 120 patients with lung cancer in our hospital were divided into control group and study group by random numbers table method,with 60 cases in each group.The control group took routine perioperative nursing intervention,while the control group implemented comprehensive nursing intervention.The operation time,length of hospital stay and postoperative complications of the two groups were observed and compared.Results The hospitalization time of the study group was lower than that of the control group (P ＜ 0.05).There was no significant difference in operation time between the two groups (P ＞ 0.05).The incidence of postoperative complications was 1.67％ in the study group,which was lower than 13.33％ in the control group (P ＜0.05).Conclusion Comprehensive nursing can reduce the incidence of postoperative complications,shorten the length of hospital stay,so it is suitable for clinical application.

Objective To explore the nursing methods for the treatment of lung cancer by thoracoscopy.Methods A total of 120 patients with lung cancer in our hospital were divided into control group and study group by random numbers table method,with 60 cases in each group.The control group took routine perioperative nursing intervention,while the control group implemented comprehensive nursing intervention.The operation time,length of hospital stay and postoperative complications of the two groups were observed and compared.Results The hospitalization time of the study group was lower than that of the control group (P ＜ 0.05).There was no significant difference in operation time between the two groups (P ＞ 0.05).The incidence of postoperative complications was 1.67％ in the study group,which was lower than 13.33％ in the control group (P ＜0.05).Conclusion Comprehensive nursing can reduce the incidence of postoperative complications,shorten the length of hospital stay,so it is suitable for clinical application.

Objective:To construct a risk nomogram early prediction model for myasthenia gravis (MG) after thymoma resection and to verify the predictive performance of the model.Methods:Using the convenient sampling method, a total of 477 patients undergoing thymoma resection who were admitted to Department of Thoracic Surgery in Beijing Tongren Hospital Affiliated to Capital Medical University from March 2018 to February 2021 were selected as the training set. A total of 62 patients who underwent thymoma resection from March 2017 to February 2018 were set as the validation set for retrospective analysis. The clinical data of the included patients were analyzed. Logistic regression analysis was used to explore the independent risk factors of MG after thymoma resection and a risk nomogram prediction model was constructed.Results:The incidence of postoperative MG in 477 patients who underwent thymoma resection was confirmed by chest X-ray, CT and related tests, which was 14.05% (67/477) . There were statistical differences between the two groups of patients with MG and those without MG in terms of combination of immune diseases, preoperative course of disease, surgical route, complete tumor resection, WHO pathological classification, postoperative pulmonary infection, postoperative radiotherapy and chemotherapy and other data ( P<0.05) . Logistic regression analysis showed that combined immune disease, thoracotomy, incomplete tumor resection, WHO pathological classification of A+AB, postoperative pulmonary infection and no postoperative chemoradiotherapy were independent risk factors for MG after thymoma resection ( P<0.05) . Based on 6 independent risk factors, a risk nomogram prediction model of MG after thymoma resection was established. The results showed that the C- index of the training set and the validation set were 0.837 (95% CI: 0.807-0.867) and 0.817 (95% CI: 0.807-0.867) , respectively. The calibration curves for both sets showed good fit to the ideal curve, with areas under the receiver operating characteristic curves of 0.834 (95% CI: 0.794-0.874) and 0.825 (95% CI: 0.789-0.861) , respectively. Conclusions:Combination of immune diseases, surgical approach of thoracotomy, incomplete tumor resection, WHO pathological classification of A+AB, postoperative pulmonary infection and no postoperative radiotherapy and chemotherapy are independent risk factors for MG after thymoma resection. The risk nomogram prediction model established based on the above risk factors can accurately assess and quantify the risk of MG after thymoma resection, which has good predictive ability.

Objective:To investigate the relationship between NUDT15 gene polymorphism and tolerance to treatment with 6-mercaptopurine (6-MP) in children with acute lymphoblastic leukemia (ALL).Methods:Fifty-eight children diagnosed with ALL in Shanxi Children's Hospital from January 2019 to December 2020 were recruited. All of them were treated with CCLG-ALL2018 chemotherapy regimen and the bone marrow showed complete remission. They received 6-MP oral treatment during maintenance treatment. Single nucleotide polymorphism of NUDT15 gene was detected by real-time fluorescence quantitative polymerase chain reaction. The bone marrow suppression after 6-MP treatment and 6-MP tolerance dose in patients with different NUDT15 genotypes were analyzed.Results:Among 58 patients, 3 patients had NUDT15 TT genotype, 46 patients had CC genotype and 9 patients had TC genotype. During maintenance treatment with 6-MP, the differences in leukocyte count, hemoglobin and platelet count among the three groups of patients with different NUDT15 genotypes were statistically significant (all P < 0.05). Among 58 patients, 23 (39.66%) patients had varying degrees of neutropenia after medication, including 16 cases of NUDT15 CC genotype, 5 cases of TC genotype and 2 cases of TT genotype. There was a statistically significant difference in bone marrow suppression among the three groups ( H = 29.10, P < 0.05). The dosages of 6-MP used in patients with TT, CC and TC genotypes were (10.4±8.8) mg·m -2·d -1, (41.5±1.3) mg·m -2·d -1 and (36.7±2.4) mg·m -2·d -1, respectively, and the difference was statistically significant ( F = 16.95, P < 0.05). Conclusions:Children with different NUDT15 genotypes have different tolerance to 6-MP, and NUDT15 gene polymorphism is associated with 6-MP intolerance during maintenance treatment in children with ALL, which may affect the treatment of the disease.