Objective To investigate the changes in the phosphorylation of N-methyl-D-aspartate (NMDA) receptors in spinal dorsal horns in a rat model of neuropathic pain induced by chronic compression of dorsal root ganglion (CCD).Methods Ninety-six male Sprague-Dawley rats,weighing 200-250 g,were randomly divided into 3 groups (n =32 each) using a random number table:control group (group C),sham operation group (group S) and group CCD.In CCD group,a small stainless steel needle (4 mm in length and 0.8 mm in diameter) was inserted into the L4,5 intervertebral foramen in pentobarbital sodium-anesthetized rats,developing intervertebral foramen stenosis and hence producing a chronic steady compression of the dorsal root ganglion.In group S,the intervertebral foramen was only exposed without inserting the needle.The paw withdrawal latency (PWL) was measured at 1 day before operation and 1,2 and 4 weeks after operation.The rats were then sacrificed after measurement of PWL and the lumbar enlargement segments of the spinal cord were removed for determination of the expression of interleukin-1β (IL-1β) and phosphorylation of NMDA receptor NR1 subunits at serine 896 (pNR1S896) on the injured side by immunohistochemistry and Western blot.Results Compared with group C,the PWL was significantly shortened at each time point after operation,and the expression of IL-1β and pNR1S896 was up-regulated in group CCD,and the PWL was shortened at 1 week after operation,the expression of IL-1β and pNR1S896 was up-regulated,and no significant change was found in PWL and expression of IL-1β and pNR1S896 at the other time points in group S.Compared with group S,the PWL was significantly shortened at each time point after operation,and the expression of IL-1β and pNR1S896 was up-regulated in group CCD,Compared with the baseline value at 1 day before operation,the PWL was slowly shortened starting from 1 week after operation,and decreased to the lowest level at 2 weeks after operation and maintained at this level for 2 weeks,the expression of IL-1β and pNR1S896 was slowly up-regulated starting from 1 week after operation,and increased to the highest level at 2 weeks after operation and maintained at this level for 2 weeks in group CCD,and the PWL was shortened at 1 week after operation,and the expression of IL-1β and pNR1 S896 was up-regulated in group S.Conclusion The development and maintenance of neuropathic pain induced by CCD are related to phosphorylation of NMDA receptors in spinal dorsal horns of rats.

Objective:To explore the predictive value of the recurrence risk estimator at 90-days(RRE-90) score combined with lipoprotein-associated phospholipase A2 (Lp-PLA2) and high sensitivity C-reactive protein(hs-CRP) in the recurrence risk of acute atherosclerotic cerebral infarction.Methods:Totally 400 patients with acute atherosclerotic cerebral infarction who were hospitalized for the first time in neurology department were followed up for 90 days.However, 8 cases were lost and 392 cases were included finally.According to recurrence or not, 64 cases were divided into recurrence group and 328 cases into non-recurrence group.The RRE-90 score was applied to all the participants and the levels of Lp-PLA2 was detected by enzyme-linked immunosorbent assay, the levels of hs-CRP was detected by immunoturbidimetry.The ROC curve was used to analyze the predictive value of RRE-90 score combined with Lp-PLA2 and hs-CRP for the recurrence risk of acute cerebral infarction.Results:Compared with the non-recurrence group(RRE-90: (3.07±1.01)score, Lp-PLA2: (103.53±8.11)μg/L, hs-CRP: (4.07±1.48)mg/L), the levels of (RRE-90 score: (4.11±0.78)score, Lp-PLA2: (121.52±13.95)μg/L, hs-CRP: (12.40±2.46) mg/L)in the recurrence group of cerebral infarction were significantly higher ( P<0.05, P<0.01). Compared with RRE-90 score (0.705), Lp-PLA2 (0.697), hs-CRP (0.622), RRE-90 score combined with Lp-PLA2 (0.752), RRE-90 score combined with hs-CRP (0.746), RRE-90 score combined with Lp-PLA2 and hs-CRP (0.782) had the largest area under the curve for predicting recurrence of cerebral infarction within 90 days, with statistical significance( P<0.05), sensitivity was 87.8%, specificity was 89.6%. Conclusion:RRE-90 score combined with Lp-PLA2 and hs-CRP detection can further improve the accuracy of predicting recurrence within 90 days in patients with cerebral atherosclerotic infarction, and the predictive value is high.

Objective To analyze the imaging features of pulmonary artery sarcoma(PAS)on CT and MRI.Methods The clini-cal features,CT and MRI findings of 21 patients with pathologically confirmed PAS were analyzed retrospectively.Results All PAS lesions involved the central pulmonary artery,of which 15 cases involved the main pulmonary artery and bilateral pulmonary artery trunks,4 cases involved the main pulmonary artery and right pulmonary artery trunk,1 case involved the main pulmonary artery and left pulmonary artery trunk,and 1 case involved the right pulmonary artery trunk.Five cases involved the pulmonary artery valve and right ventricular outflow tract as well.Nineteen cases of PAS showed complete filling defects in the central pulmonary artery,and the other 2 cases presented with nodular or lobulated filling defects attached to the pulmonary artery wall.The proximal margin of 19 PAS lesions was bulging or lobulated,and the distal pulmonary artery of 9 PAS lesions showed aneurysm-like dilatation.On MRI,all 13 cases of PAS were hyperintense on fat-suppressed T2WI,of which 11 cases were hyperintense on diffusion weighted imaging(DWI),and all lesions demonstrated significantly heterogeneous enhancement or delayed enhancement.Conclusion On computed tomography pul-monary angiography(CTPA),filling defects which grow expansively in the central pulmonary artery,and which have proximal bul-ging shape or distal aneurysm-like dilatation are highly suggestive of PAS.On contrast-enhanced MRI,the significantly heterogene-ous enhancement mass in the central pulmonary artery should be highly suspected of PAS.

Objective? To explore the effect of staged continuous nursing mode on self-care ability of arteriovenous fistula among hemodialysis patients. Methods? A total of 120 patients with arteriovenous fistula in Blood Purification Center at the First Affiliated Hospital of Zhengzhou University were enrolled in the study by convenience sampling methods from January to December in 2017. Patients were divided into control group and observation group by random numeral table method. The control group received routine nursing and health education. On the basis of these, the observation group was given a phased continuous nursing intervention. The intervention was divided into 3 stages. The Exercise of Self-care Agency Scale (ESCA) was used to evaluate patients before and after the intervention. Complications of arteriovenous fistula were observed and compared in two groups. Results? There was no significant difference in self-concept, knowledge and information seeking, passiveness, motivation, and self-care scores between two groups before intervention. After intervention, the observation group patients' self-concept, knowledge and information seeking, passiveness, motivation, and self-care scores were higher than the control group, and the differences were statistically significant (P＜ 0.05). After intervention, the result of comparing the occurrence of obstruction of internal fistula, thrombosis, infection, and hemorrhage/hematoma in two groups showed that those in control group was higher than observation group with statistical differences (P＜ 0.05). Conclusions? The staged continuous care model improves the self-care ability of arteriovenous fistula among hemodialysis patients, and reduces the occurrence of related complications.

Objective To explore the diagnostic value of MRI in adnexal torsion.Methods A retrospective study was conducted on 32 patients with adnexal torsion confirmed by surgery and pathology.The MRI features were analyzed in combination with clinical data.Results Among the 32 cases of adnexal torsion,there were 12 cases of ovarian cyst,5 cases of cystic ovarian teratoma,4 cases of theca cell tumor,6 cases of ovarian cystadenoma,1 case of high-grade serous carcinoma,1 case of corpus luteum hematoma,1 case of simple ovarian torsion,1 case of ovarian goiter,1 case of fibrotheca cell tumor with serous cystadenoma;There were 13 cases on the left side and 19 cases on the right side;The torsion angle of adnexal was about 90 °-1 440 °.MRI showed that 13 of 32 patients were cystic masses and 19 were cystic solid masses;torsion pedicle can be seen near the mass,of which 13 cases showed"whirlpool sign",27 cases showed"T2WI dot low signal sign",10 cases showed"nodule sign",5 cases showed"triangle sign",and 9 cases had structural disorder around the mass.Enhancement showed no obvious enhancement in 12 cases,and mild enhancement in 20 cases.Thirty cases complicated with pelvic effusion;The uterus moved to the affected side in 9 cases,to the healthy side in 20 cases,and no obvious deviation in 3 cases.Conclusion The MRI imaging features of adnexal torsion are characteristic,which are cystic or cystic solid lesions.The torsion pedicle is characterized by"whirlpool sign"and"T2WI dot low signal sign",etc.The enhancement is mild or no enhancement.Combined with the clinical history,it is of great value for the preoperative diagnosis and treatment of adnexal torsion.