Objective To evaluate the CT manifestations of intrathoracic metastasis in nasopharyngeal carcinoma and its rule.Methods CT manifestations of intrathoracic metastasis of nasopharyngeal carcinoma in 35 cases confirmed by pathology were analysed.Results The CT findings were:nodular type(27/35),pulmonary hilar type(5/35),peripheral massive type(3/35).Of them,60% patients had metastasis of mediastinum.Conclusion CT is a very useful method in diagnosis of intrathoracic metastasis of nasopharygeal carcinoma.

Among the different x-ray features of breast carcinoma, mass and calcification are the most significant reference parameters in the screening and diagnosis of early carcinoma. Mammographic follow-up after conservation therapy is the other important value of mammography for breast carcinoma. Calcification is the most important sign to show residue or recurrence of conservation therapy.

Objective To investigate the relationship between CT characteristics and histological differentiation of soft tissue sar-comas.Methods Forty-two cases with pathologically proved soft tissue sarcomas were collected.The tumor size,morphology,den-sity and relationship of the tumor to the adjacent structures on CT were analyzed retrospectively.The value of the CT signs in evalu-ating the histological differentiation of the tumor was explored.Results The maximal diameter of the tumor was over 5 cm in 36 ca-ses.Oval shape was seen in 29 cases and irregular shape was seen in 13 cases.Heterogeneous density was seen in 32 cases including intratumoral calcification in 3 cases and intratumoral necrosis in 22 cases.Adjacent structures were infiltrated in 25 cases.Compared to the pathological results,intratumoral necrosis and invasion of adjacent structures were related to the degree of histological differ-entiation (P <0.05),and the relation coefficients were 0.64 and 0.57,respectively (P <0.01).Conclusion Intratumoral necrosis and invasion of adjacent structures are correlated with the histological differentiation of the soft tissue sarcomas.They may reflect the biological behavior of low-differentiated or undifferentiated soft tissue sarcomas to some extent.

Objective To explore the implementation methods and effects of precise quality control model mediated by nursing quality indexes in quality management.Methods Fifty-seven care units with complete quality control data were collected. From January to December 2015, the 57 using the traditional quality control mode were selected as control group, whilst from January to December 201657 units were chosen for the intervention group using precision quality control mode, that was, to select the number of indicators and target values, screening quality control points, unified the acquisition path of indicators, lock the key departments and monitoring points affecting the quality to carry out quality management performance. We observed the changes of the two groups of quality indicators.Results The nine process quality indicators including wards 6S management, first aid techniques, health education, primary care, first class and critical care nursing, safe treatment, operating nursing documents,drug and sterile product quality and pass rate of identity verification were significant difference between the two groups(P<0.05). The five outcome quality indicators including hospitalized patients fall, dosing defects, hospital pressure sores, burns and urinary uncontrolled extubation rates were significant difference between the two groups(P<0.05) as well.Conclusions The quality control model, which is mediated by the nursing quality index, is helpful to improve the nursing quality. It is an effective quality control mode to achieve continuous improvement of nursing quality.

Objective To retrieve,analyse and integrate the best evidences in perioperative fluid management for elderly patients with hip fracture,therefore to provide references for patient care.Methods Following the 6S evidence model,databases and websites were searched to collect the evidences on perioperative fluid management of elderly patients with hip fracture.The searched databases including BMJ Best Practice,UpToDate,AAOS Clinical Practice Guidelines,ASBMR,ANZHFR,ESTES,NICE,SIGN,JBI,Cochrane Library,CINAHL,Embase,PubMed,Web of Science,CNKI,Wanfang Data,VIP database,CEBM Database,Medive,China Science and Technology Journal Database,SinoMed,and other websites about orthopaedics.The searched literatures included guidelines,clinical decision-making,best practices,expert consensus and systematic reviews.The time span for the published literatures was from the inception of the databases and websites to August 2022.Two researchers independently completed quality evaluations of the retrieved literatures,as well as extraction,assessment and integration of the abstracted evidences.Results A total of 15 articles were included,they were 2 guidelines,3 clinical decision-makings,1 best practice,7 expert consensus,and 2 systematic reviews.Thirty pieces of evidence were summarised from 7 aspects,covering multidisciplinary team collaboration,dynamic assessment and monitoring of fluid status,fluid resuscitation,fluid management before and after the surgery and health education.Conclusions This study summarised the best evidences in perioperative fluid management for elderly patients with hip fracture.The evidences provide an evidence-based solution which will enable the healthcare workers to fully combine the clinical scenarios,evaluate changes in fluid volume status dynamically,develope personalised fluid management strategies and improve patient outcomes.

The objective was to investigate the effect of kinsenoside (Kin) treatments on macrophage polarity and evaluate the resulting protection of chondrocytes to attenuate osteoarthritis (OA) progression. RAW264.7 macrophages were polarized to M1/M2 subtypes then administered with different concentrations of Kin. The polarization transitions were evaluated with quantitative real-time polymerase chain reaction (qRT-PCR), confocal observation and flow cytometry analysis. The mechanism of Kin repolarizing M1 macrophages was evaluated by Western blot. Further, macrophage conditioned medium (CM) and IL-1 were administered to chondrocytes. Micro-CT scanning and histological observations were conducted on anterior cruciate ligament transection (ACLT) mice with or without Kin treatment. We found that Kin repolarized M1 macrophages to the M2 phenotype. Mechanistically, Kin inhibited the phosphorylation of IB, which further reduced the downstream phosphorylation of P65 in nuclear factor-B (NF-B) signaling. Moreover, Kin inhibited mitogen-activated protein kinases (MAPK) signaling molecules p-JNK, p-ERK and p-P38. Additionally, Kin attenuated macrophage CM and IL-1-induced chondrocyte damage. , Kin reduced the infiltration of M1 macrophages, promoted M2 macrophages in the synovium, inhibited subchondral bone destruction and reduced articular cartilage damage induced by ACLT. All the results indicated that Kin is an effective therapeutic candidate for OA treatment.