Objective To summarize the preliminary experience of coils, Onyx and covered stents for the treatment of carotid-cavernous sinus fistula (CCF). Methods Of the 25patients with CCF, 22 were traumatic CCF, and 3 were spontaneous CCF; the fistula orifices of 14 patients were located in the cavernous segment of right internal carotid artery (ICA), and 11were located in the cavernous segment of left ICA. According to the Barrow classification,Types A, C, and D were 22,2, and 1, respectively. Eighteen patients were treated with Guglielmi detachable coils alone, 1 was treated with Guglielmi detachable coils and Onyx, 2 were treated with Onyx alone, and 4 were treated with covered stents. Results Intracranial bruit disappeared immediately in all patients after the procedures. Postoperative angiography showed complete occlusion of the fistula orifices, the symptoms disappeared after 1 to 20 days, and there were no death and procedure-related complications. The recanalized ICAs were patent in patients (12/18) treated with coils, and the ICAs were patent in 4 patients treated with the covered stents.The ICAs were patent in 2 patients treated with Onyx, the ICA was patent in 1 patent treated with detachable coils and Onyx. One patient with traumatic CCF treated with coils had clinical recurrence, and was cured after re-embolization with coils. The remaining patients were followed-up for 6 to 24 months, and no recurrence of clinical symptoms was found. The followup cerebral angiography of 6 patients was obtained, and no CCF recurrence was observed.Conclusion Endovascular treatment with Guglielmi detachable coils, Onyx, and covered stents is a safe and useful method for closing CCFs.

Objective To explore the feasibility and safey of superselective intra-arterial contact thrombolysis and balloon mechanical expanding in treatment of patients with acute infarction.Methods Five acute infarction patients were treated by superselective intra-artedal contact thrombolysis and balloon mechanical expanding within 9 hours after the first attack,including 2 cases of middle cerebral artery occlusion,1 case of anterior eerebral artery occlusion and 2 cases of internal carotid artery occlusion.Results The main occlusive arteries ineiting ischemic clinical symptom were all recanalized,and all patients had gotten better outeome.Conclusion Superselective intra-arterial contact thrombolysis and balloon mechanical expanding in acute infarction treatment is safe and efficient,and the ratio of recanalization was greatly improved.

Objective To value the capability of MRI in assessing invasiveness of intraductal papillary neoplasms of the bile duct(IPNB). Methods Thirty-nine patients with pathologically confirmed IPNB, who had upper abdominal MR examination within 6 weeks before complete resection of the tumor, were included in the retrospective study. Patients were divided into noninvasive and invasive groups pathologically. Eighteen cases were noninvasive and 21 were invasive. All had undergone MRI plain scans, MR cholangiopancreatography as well as contrast enhanced scans including arterial, portal and delayed phases. Tumor size, location, biliary dilation, thread signs, lesion morphology, lobe atrophy, cholelithiasis, biliary hemorrhage, vascular invasion and intraperitoneal lymphadenopathy were observed on MRI. ADC values and enhancement level of lesions were also measured. Between invasive and noninvasive groups, laboratory results, enhancement levels and ADC values were compared by t test or Mann-Whitney U test, and categorical variables like location and lesion morphology were compared by χ2 test. The diagnostic accuracy was calculated using receiver operating characteristic(ROC)curve analysis. Results No difference was found between invasive and noninvasive groups on gender, age, lesion morphology, bile duct diameter, location, existence of thread signs or cholelithiasis(P>0.05). While the differences on serum CA19-9 level, lesion size, ADC value, and lymph nodes/vascular invasion between groups reached statistical significance (P<0.05). Other than on plain scan(P>0.05), CNR and enhancement levels were also statistically different on arterial, portal and delayed phases between both groups(P<0.05). CA199, enhancement level and CNR of portal phase, as well as ADC value exhibited areas under the ROC curve(AUC)of 0.790, 0.891, 0.817 and 0.882 respectively in invasiveness judgment. Conclusion MR demonstrated relatively high value in assessing invasiveness of IPNB.

Objective: To investigate the situation of social sports activities and the relationship with depression among junior middle school students, to provide evidence for depression intervention. Methods: A total of 3 623 students from eight middle schools in Chengdu were recruited and surveyed by self-made questionnaire during Sept. to Dec. 2019 Z test, Chi-Square test and Logistic regression analysis were applied to explore influence factors. Results: The prevalence of depression symptoms was 45.60%. 57.34% of the students liked social sports activities, 65.87% of them participated in social sports activities during the past week, 42.25% took less than 30 minutes on exercise while 22.24% took over 45 minutes. Among the students, 20.16% of them had no special feeling after social sports activities, while 31.88% felt sweat. Uni-variate analysis indicated that compared with boys, girls participated more frequently and got stronger feeling than boys (χ2/Z=6.28，-2.67，P<0.05). Regression results indicated that for boys, high grade,low education degree of mother, low household socioeconomic status, not the only-child ,exercise alone would significantly increase the risk of depression, while liking social sports activities was protective factor (OR=1.26，1.91，1.52，2.56，1.58，1.71，0.77，P<0.05). For girls, high grade,low education degree of father, without one-child would significantly increase the risk of depression, while like social sports activities was protective factor(OR=1.29，1.74，1.37，1.47，0.66，P<0.05). Conclusion Social sports activities could reduce depression symptoms, which can be considered as first choice as after-class activity among junior middle school students.

Objective: To investigate the clinical features and pulmonary function of preterm infant-bronchopulmonary dysplasia-wheezing syndrome(PBPDWS). Methods: Twenty-five cases of children with PBPDWS who were hospitalized at Anhui Provincial Hospital Affiliated to Anhui Medical University were collected, and 24 cases of non-bronchopulmonary dysplasia (BPD) preterm infants and 26 cases of term infants with the same symptoms of wheezing were selected as the control group.A retrospective analysis was performed among 3 groups of children.The perinatal conditions, the days of wheezing within 1 year after birth, the number of lower respiratory tract infection, the days of hospitalization, and 1 year after the birth of the pulmonary function result of these children were compared; due to recurrent respiratory symptoms, pulmonary CT was performed on children with BPD when they were 6 to 12 months after birth, their pulmonary CT of these children were analyzed, and the pulmonary CT was compared at birth. Results: There were significant differences in body height and weight between the 3 groups (P<0.05), among which PBPDWS group was the lowest, and the term infants group was the highest [(70.40±3.48) cm, (74.50±1.87) cm, (77.92±3.01) cm, P=0.000; (7.97±1.04) kg, (9.51±1.15) kg, (10.38±1.47) kg, P=0.000]. There was significant difference in the number of wheezing (F=71.389, P<0.05), among which the PBPDWS group was the highest and the term infants group was the lowest [(7.4±1.8) times, (4.2±1.2) times, (3.4±0.6) times]; during the first year of life, PBPDWS group had 18 cases of respiratory tract infection, 9 cases in non-BPD preterm infants group, 3 cases in term infants group, the difference among the 3 groups was statistically significant(χ²=19.505, P<0.05); 16 cases in PBPDWS group were hospitalized within 1 year after birth, 7 cases in non-BPD preterm infants group, 2 cases in term infants group, the difference among the 3 groups was statistically significant(χ²=18.460, P<0.05). There were significant differences in the indexes of pulmonary function[ time to peak tidal expiratory flow as a proportion of expiratory time(tPF%tE) and volume to peak expiratory flow as a proportion of exhaled volume(VPF%VE)] among the 3 groups(all P<0.05), among which PBPDWS group was the lowest and the term group was the highest [(15.69±4.29)%, (20.63±1.90)%, (25.95±3.79)%; (19.13±3.16)%, (21.51±2.17)%, (28.02±4.84)%]; the main manifestations of lung CT in PBPDWS group at 6 to 12 mouths, included 9 cases had limited emphysema(36%), 20 cases with fiber strips, grid shadow and triangular subpleural opacities(80%), 6 cases had bronchiectasis(24%), the same child with non-single lesion, often 2 to 3 lesions coexist. Conclusion PBPDWS children have high prevalence rate of respiratory diseases, growth retardation, pulmonary function has a certain obstruction, pulmonary CT has a specific imaging characteristics.

Objective To study the clinical effects of extensively hydrolyzed protein formula (eHPF) and standard preterm infant formula (SPF) in very/extremely low weight (V/ELBW) infants.To provide a theoretical basis for the early feeding of V/ELBW infants.Method From August 2015 to August 2016, V/ELBW infants (gestational age <32 w and birth weight <1500 g) hospitalized in our neonatal ward were randomly assigned into eHPF group and SPF group .The eHPF group received eHPF feeding from birth to corrected gestational age of 32 weeks, and then fed with SPF;the SPF group was fed with SPF after birth.The clinical data of the two groups were compared including the time needed to regain birth weight , the time needed to achieve total enteral nutrition , the duration of nasogastric tube usage , the complications and blood biochemical indexes .Result A total of 85 cases were included in the eHPF group , and 91 cases in the SPF group.The hospitalization duration , weight increase rate , nasogastric tube duration , the time needed to regain birth weight , the time needed to achieve total enteral nutrition of eHPF group were better than SPF group [ ( 38.4 ±7.8 ) d vs.( 42.1 ±11.0 ) d, ( 25.5 ±10.1 ) g/d vs.( 21.8 ±7.8 ) g/d, (12.1 ±4.0) d vs.(16.0 ±3.8) d, (11.6 ±3.9) d vs.(13.0 ±3.8) d, (9.3 ±2.2) d vs.(14.3 ±1.8) d], and the differences were statistically significant (P<0.05).No statistically differences existed on discharge weight between the two groups ( P>0.05 ) .Compared with the SPF group , the incidences of cholestasis, NEC and feeding intolerance were lower in the eHPF group (22.7% vs.24.3%, 6.8% vs. 7.2%, 15.9%vs.17.1%) , and the differences were statistically significant ( P<0.05 ) .No significant differences existed on the incidence of extrauterine growth retardation between the two groups (P>0.05). No significant differences existed on serum total bilirubin level at 7 d after birth between the two groups ( P>0.05).Compared with the SPF group , the serum total bilirubin at 14 d was lower in the eHPF group [(40.3 ±23.0)μmol/L vs.(53.6 ±26.5) μmol/L], the serum total protein [(50.5 ±3.7) g/L vs. (46.7 ±5.3) g/L] and albumin[(31.3 ±4.1) g/L vs.(29.4 ±5.2) g/L] at 21 d were higher, the differences were statistically significant ( P<0.05 ) .Conclusion eHPF can shorten the time needed to achieve total enteral nutrition and regain birth weight , accelerate the regression of hyperbilirubinemia , reduce the incidences of feeding intolerance and NEC , and it is a safe and effective choice for enteral nutrition in V/ELBW infants.

Background:Gross target volume of primary tumor (GTV?P) is very important for the prognosis prediction of patients with nasopharyngeal carcinoma (NPC), but it is unknown whether the same is true for locally advanced NPC patients treated with intensity?modulated radiotherapy (IMRT). This study aimed to clarify the prognostic value of tumor volume for patient with locally advanced NPC receiving IMRT and to ifnd a suitable cut?off value of GTV?P for prognosis prediction. Methods:Clinical data of 358 patients with locally advanced NPC who received IMRT were reviewed. Receiver oper?ating characteristic (ROC) curves were used to identify the cut?off values of GTV?P for the prediction of different end?points [overall survival (OS), local relapse?free survival (LRFS), distant metastasis?free survival (DMFS), and disease?free survival (DFS)] and to test the prognostic value of GTV?P when compared with that of the American Joint Committee on Cancer T staging system. Results:The 358 patients with locally advanced NPC were divided into two groups by the cut?off value of GTV?P as determined using ROC curves: 219 (61.2%) patients with GTV?P≤46.4mL and 139 (38.8%) with GTV?P>46.4mL. The 3?year OS, LRFS, DMFS, and DFS rates were all higher in patients with GTV?P≤46.4mL than in those with GTV?P>46.4mL (allP<0.05). Multivariate analysis indicated that GTV?P>46.4mL was an independent unfavorable prognostic factor for patient survival. The ROC curve veriifed that the predictive ability of GTV?P was superior to that of T category (P<0.001). The cut?off values of GTV?P for the prediction of OS, LRFS, DMFS, and DFS were 46.4, 57.9, 75.4 and 46.4mL, respectively. Conclusion:In patients with locally advanced NPC, GTV?P>46.4mL is an independent unfavorable prognostic indi?cator for survival after IMRT, with a prognostic value superior to that of T category.

Objective To clarify the effect of iodine intake on serum thyroglobulin (Tg). Methods A 5-year prospective study was conducted in the 3 different iodine intake areas in China [Panshan (miht deficiency) ,Zhangwu (more than adequate) and Huanghua (excess)]. A total of 3 099 people with normal serum levels of Tg in 1999 were followed and 2 448 of these participants were feasible to be observed in 2004 and included in the present study. The serum levels of Tg, thyraglobulin antibody(TgAb), thyroid peroxidase antibody(TPOAb) and TSH, thyroid volume, family and personal histories of thyroid diseases were measured and inquried. The general linear model (GLM) was used to explore the determinants of Tg. Results Among the study population at baseline, serum Tg were significantly different in three areas [7.5 (4.4-13. 1) μg/L at Panshan, 6.8 (3.6-11.2)μg/L at Huanghua, 5.9 (3.2-10.7) μg/L at Zhangwu, P<0.01]. They were associated with age, sex and the rate of positive TgAb, abnormal thyroid volume, abnormal TSH and positive personal history of thyroid diseases, in order to control the effects of confounding factors, the data from 1856 subjects with thyroid-related indexes all in normal range and without personal history of thyroid diseases were analyzed to clarify the effect of iodine intake on Tg. The serum Tg among three areas were significantly different in both 1999 and 2004, they were all increased in 5 years with significant augment (△ Tg) among the three areas[3.1 (-0.2-8.0) μg/L at Panshan, 3.5 (0.5-9.0)μg/L at Huanghua vs 2. 5(0.3-6.1) μg/L at Zhangwu,P<0.01]. The GLM analysis revealed that age, Tg and TSH levels at baseline were the determinants of △Tg in addition to iodine intake. Conclusion Iodine intake is a dominant determinant of serum Tg. Age and TSH should also be considered while indicating iodine intake by serum Tg.

Objective:To investigate the prognostic value of molecular subtypes in patients with resected invasive breast cancer.Methods:Between 2015 and 2018 7 869 patients with invasive breast cancer after undergoing surgery were included in this analysis. Breast cancer was classified into four subtypes according to the status of hormone receptor (HR) and HER2: HR+/HER2-, HR+/HER2+, HR-/HER2+, and HR-/HER2-. Kaplan-Meier curves and COX regression were used to compare disease-free survival (DFS) and overall survival (OS) among different subtypes.Results:The 5-year DFS and OS were 86.30% and 94.29%, respectively. Proportions of HR+/HER2-、HR+/HER2+、HR-/HER2+ and HR-/HER2- were 52.9%、17.5%、14.1%和15.5%, respectively. The 5-year DFS of HR+/HER2- subtype (88.12%) was higher than HR+/HER2+ (84.67%, P=0.026), HR-/HER2+ (84.19%, P<0.001) and HR-/HER2- (83.70%, P<0.001). The 5-year OS of HR+/HER2- (95.38%) was not different from HR+/HER2+ (95.17%, P=0.187), while it was higher than that of HR-/HER2+ (92.26%, P<0.001) and HR-/HER2- (91.69%, P<0.001). Subtype was still a significant factor regarding DFS and OS in multivariable analyses adjusting for age, sex, stage, Ki67, types and time of surgery. The DFS ( P=0.257) and OS ( P=0.511) was not different between HR-/HER2+与HR+/HER2- subtypes, while HR-/HER2+ and HR-/HER2- patients had worse DFS ( P<0.05) and OS ( P<0.05) than that with HR+/HER2-. Conclusions:Molecular subtype is a significant independent prognostic factor for DFS and OS in operable invasive breast cancer. HR+ subtypes have better prognosis compared with HR- subtypes. The DFS and OS were not different between HR+/HER2- and HR+/HER2+, or between HR-/HER2+ and HR-/HER2-.

Monitoring neuronal activity in vivo is critical to understanding the physiological or pathological functions of the brain. Two-photon Ca imaging in vivo using a cranial window and specific neuronal labeling enables real-time, in situ, and long-term imaging of the living brain. Here, we constructed a recombinant rabies virus containing the Ca indicator GCaMP6s along with the fluorescent protein DsRed2 as a baseline reference to ensure GCaMP6s signal reliability. This functional tracer was applied to retrogradely label specific V1-thalamus circuits and detect spontaneous Ca activity in the dendrites of V1 corticothalamic neurons by in vivo two-photon Ca imaging. Notably, we were able to record single-spine spontaneous Ca activity in specific circuits. Distinct spontaneous Ca dynamics in dendrites of V1 corticothalamic neurons were found for different V1-thalamus circuits. Our method can be applied to monitor Ca dynamics in specific input circuits in vivo, and contribute to functional studies of defined neural circuits and the dissection of functional circuit connections.