Objective To investigate the effect of rosiglitazone on the expression of platelet CD40 ligand (CD40L) in insulin-resistant rats, and to further determine the relationship between CD40L and insulin resistance. Methods 60 healthy male SD rats [(200±20)g] were randomly divided into 4 groups: control group (C), high fat group (HF), low dose rosiglitazone group (LR) and high dose rosiglitazone group (HR). Rats in group C were fed normal chow diet, and the others were given high fat chow diet. After 12 weeks, high dose of rosiglitazone (10mg/kg) was given to rats in group HR and low dose of rosiglitazone (5 mg/kg) was given to rats in group LR for 4 weeks. Rats in group HF and group C were given 0.9% sodium chloride solution. The level of sCD40L was measured by ELISA and the expression of platelet membrane CD40L was detected by immunoprecipitation and Western blot. The insulin resistance (IR) index was calculated by homeostasis model assessment (HOMA). Results HOMA-IR, sCD40L level and platelet membrane CD40L expression were higer in group HF than in group C (9.8±3.2 vs. 5.9±1.7, 367.3 ±35.3 vs. 232.3±120.6, 2.1±0.4 vs. 1.4±0.2, respectively, all P<0.05). Compared with the group HF, HOMA-IR, sCD40L level and platelet membrane CD40L expression were obviously decreased in group HR(5.4±1.1, 276.9±54.0, 1.4±0.3, respectively, all P<0.05), and there were no significant differences in HOMA-IR, sCD40L level and platelet membrane CD40L expression between group HF and group LR (P>0.05). Conclusions In insulin-resistant rats, the level of sCD40L and the expression of platelet membrane CD40L were higher. After treatment with high dose of rosiglitazone, sCD40L level and platelet membrane CD40L expression were decreased with the improvement of insulin resistance.

Our aim was to assess the curative effect of endoscopic stenting in patients with pancreatic fistula. One patient suffered from pancreatic fistula was treated by pancreatic stenting drainage. The patient′s condition was significantly improved after endoscopic treatment, and no complications such as abdominal pain, bleeding, perforation, and elevation of serum amylase level were found. The fistula was cured in one week. Followed up for 5 months, no relapse of pancreatic fistula was found, and body weight of the patient increased 4kg. The results of B ultrasonography and abdominal X ray examination were also normal. So pancreatic stenting drainage is an effective and safe therapy for pancreatic fistula and should be the first choice.

Objective To investigate the relation between body mass index(BMI),skinfolds(SF)and relative weight(RW),arm girth(AG) and ag e of the children in order to look for the most suitable index used to diagnose children obesity in clinical work.Methods In 1496 healthy children (ranging from 1 to 13 years),their weight, height,AG, triceps skinfold(TSF), sub scapular skinfold(SSF) and abdominal skinfold(ASF) were measured and the relat ion of BMI,SF,RW,AG and age was analyzed.Results 1.Between BMI and the sum of three skinfolds(SF3) ,RW,AG,correlation coefficient was more t han 0.8(P＜0.001).2. With the increase of age, AG and ASF increase wh ile TSF and BMI decrease. 3.Skinfolds in girls of 3～6,12 years of age are thicker t han those in boys;BMI in boys of 8,9 years of age are higher than those in girls .Conc lusions 1.95 percentile of BMI and SF3 as index to diagnose children obes ity is better than single application of RW or one-site skinfold. 2. With the i ncrease of age, AG and abdominal fat increase, but triceps and total fat of body relatively decrease. 3. Fats in girls develop faster than in boys.

Objective To establish a neonatal transport network in order to improve the diagnosis and treatment levels of the basic medical unit and to decrease medical disputes and fatality rate of the new born Methods The first neonatal transport network in the Southwest of China, covering Chongqing and the adjacent areas, was established During the process of transport, warm keeping, unobstructed respiratory tracts, oxygen treatment, establishment of venous passage and placement of gastric canal were included Meanwhile, the vital signs, colors of the skin and mucosa and consciousness should be closely observed Corresponding measures could be taken at any time when needed Results Satisfactory results were achieved by means of the neonatal transport network Conclusion The neonatal transport network can play a very important role in strengthening the treatment of the newborn, decreasing the fatality rate and sequela and improving the diagnosis and treatment levels of the basic medical unit

Objective:To investigate the correlation between amide proton transfer-weighted (APTw) values and Ki-67 labeling index of cervical squamous cell carcinoma.Methods:From October 2017 to December 2018, 24 patients with cervical squamous cell carcinoma [International Federation of Gynecology and Obstetrics (FIGO) stage Ⅰ-Ⅲ] were prospectively enrolled in Peking Union Medical College Hospital and underwent pelvic morphological MRI on a 3.0 T MR scanner, including three-dimensional turbo-spin-echo APTw imaging and DWI. The maximum diameters of the lesions, APTw values and ADC values on the slice with the maximum diameter of the lesion were independently measured by two radiologists. The ICC was computed to evaluate the inter-observer consistency. Ki-67 immunohistochemical expression status was assessed by one pathologist. The Pearson correlation analysis was performed between the APTw values, maximum diameters, ADC values and Ki-67 labeling index.Results:The APTw values of cervical squamous cell carcinoma were (2.9±0.5)%. Inter-observer ICC was 0.972 (95%CI 0.937-0.988). The APTw values were positively moderately correlated with Ki-67 labeling index [(61.9±18.7)%, r=0.532, P=0.008]. The maximum diameters of the lesions were (28.7±10.6) mm. The mean ADC values were (0.998±0.217)×10 -3 mm 2/s. No correlations were found between maximum diameters, ADC values and Ki-67 labeling index ( r=0.038, P=0.859; r=0.238, P=0.263). Conclusion:APTw values can partially reveal the proliferation status of cervical squamous cell carcinoma.

Objective To explore the clinical efficacy of transrectal lapse valve repair in the treatment of patients with middle and low rectovaginal fistula.Methods Totally 24 patients with middle and low rectovaginal fistula were divided into transanal group (n =15) and transvaginal group (n =9).The transanal group was treated by rectal lapse valve repair,and the transvaginal group was treated with the transvaginal repair.The indexes of oxidative stress such as serum IL-6,ROS,CRP were compared between the two groups,and the success,recurrence and satisfaction rate were compared as well.Results After treatment,the levels of IL-6,ROS and CRP in both groups were significantly higher than those before treatment,but there were no significant differences in the stress response indexes between the two groups (P ＞ 0.05).The success rate and satisfaction rate in the transanal group were significantly higher than those in the transvaginal group (P ＜ 0.05),and the recurrence rate was significantly lower than the transvaginal group (P ＜ 0.05).Conclusion Transrectal lapse valve repair has higher success rate and low recurrence rate in the treatment of patients with middle and low rectovaginal fistula.

Purpose/Significance To explore the important factors affecting the connotation quality of inpatient medical records,and to provide model prediction and improve the connotation quality of inpatient medical records.Method/Process A total of 590 inpatient medical records monitored by quality control in Shanghai First People's Hospital from June to November 2022 are collected.The influen-cing factors are initially screened by single factor analysis,and a multi-layer perceptron neural network prediction model for the connota-tion quality of inpatient medical records is constructed.Result/Conclusion The area under the curve(AUC)of the prediction model is 0.940,95％CI is 0.928～0.951,the sensitivity is 93.73％,and the specificity is 78.22％.The top three independent factors affecting the rating of a case as grade A are concentrated in the surgical safety checklist,the analysis of the first director's ward round,and the surgical nursing record.The multi-layer perceptron neural network connotation quality prediction model has good prediction efficiency,which provides theoretical references for the connotation quality management of inpatient medical records.

Objective To explore the clinical efficacy of transrectal lapse valve repair in the treatment of patients with middle and low rectovaginal fistula.Methods Totally 24 patients with middle and low rectovaginal fistula were divided into transanal group (n =15) and transvaginal group (n =9).The transanal group was treated by rectal lapse valve repair,and the transvaginal group was treated with the transvaginal repair.The indexes of oxidative stress such as serum IL-6,ROS,CRP were compared between the two groups,and the success,recurrence and satisfaction rate were compared as well.Results After treatment,the levels of IL-6,ROS and CRP in both groups were significantly higher than those before treatment,but there were no significant differences in the stress response indexes between the two groups (P ＞ 0.05).The success rate and satisfaction rate in the transanal group were significantly higher than those in the transvaginal group (P ＜ 0.05),and the recurrence rate was significantly lower than the transvaginal group (P ＜ 0.05).Conclusion Transrectal lapse valve repair has higher success rate and low recurrence rate in the treatment of patients with middle and low rectovaginal fistula.

Objective To explore the application value of MR diffusion weighted imaging(DWI)and T2*mapping of parotid gland function in patients with head and neck tumors at different radiotherapy periods.Methods A total of 82 patients with head and neck tumors treated were selected.The data of parotid gland volume,salivary volume and parotid gland function were collected.MR DWI and T2*mapping were used to measure the apparent diffusion coefficient(ADC)value and T2*value of parotid gland tissue,and the correlation between parotid gland function and imaging values were analyzed.Results There were all significant differences in parotid gland volume,salivary volume and secretion index among different radiotherapy periods,and parotid gland volume,salivary volume and secretion index during and after radiotherapy were significantly lower than those before radiotherapy.There were signifi-cant differences in T2*values among different radiotherapy periods,and T2*value during and after radiotherapy was significantly lower than that before radiotherapy.There were significant differences in ADC values among different radiotherapy periods,and the ADC value during and after radiotherapy was significantly higher than that before radiotherapy.ADC value was negatively correlated with parotid gland volume,salivary volume and secretion index(r=-0.436,-0.730,-0.718,respectively,P＜0.001),while the T2*value was positively correlated with parotid gland volume,salivary volume and secretion index(r=0.430,0.720,0.707,respec-tively,P＜0.001).Conclusion Parotid gland volume,secretion index and salivary volume show abnormal levels at different radio-therapy periods.MR DWI is negatively correlated with parotid gland function,while T2*mapping is positively correlated with parotid gland function.

Objective To understand the current situation and relevant factors on sexual violence in 18-34 year-olds men in Chengdu,in order to provide data for setting up prevention and reduction programs on sexual violence and other related problems.Methods By multi-stage random sampling,young men who were 18-34 years old in Chengdu were interviewed and screened.Questionnaire and multivariate logistic regression models were used to assess risk factors on sexual violence.Results The overall prevalence of sexual violence was 17.8％,with factors as child exposure to parent violence/family conflict (P＜0.01),child physical abuse (P＜0.01),alcohol abuse (P＜0.01),anxiety (P＜0.01),disharmony marriage (divorce/ widowed/separation) (P＜0.01),marriage status (P＜0.05),depression (P＜0.05) as risk factors of sexual violence.Conclusion The status on sexual violence among young men in Chengdu should not be overlooked and interventions for high-risk populations should be taken urqently.