Malignant mesenchymoma is composed by two or more unrelated mesenchymal elements ,it is rare in clinic.Both domestic and abroad have few case reports ,it tends to occur in older people and the incidence of mesenchymoma is higher in males than in females .The malignant tumor in young female genital is more rare . Malignant mesenchymoma often appears in limbs ,it is difficult to be diagnosed before surgical operation .It is con-firmed by pathological examination .The degree of this malignant is higher and the recurrence rate is high .There is no specificity in clinic .The imaging characteristics are so less that it can not be taken seriously .We report a case of malignant mesenchymoma in vulva which is confirmed by pathology .

The primary transitional cell carcinoma in nasal cavity is clinically manifested by progessively increasing nasal decongestion,bloody and purulent secretion intermittent appear ,headaches,hearing loss.The macroscopic character showed that a medium gray red ground tissue .The tumor cells were arranged in nested ,pa-pillary by microscopy,the nucleus was round or oval shape ,the tumor cells was infiltrating growth,basophilia or bright.Immunhistochenmical showed that P63,CK5/6,CK18,UroplakinIII,CerbB -2,CEA were positive,Ki67 positive index was about S -100,Cga,Syn,Calponinare all tested negative .Nasal primary transitional cell carcino-ma is uncommon clinically ,and it is easy to misdiagnosed .Its diagnosis and differential diagnosis mainly depends on pathological histoloy and immunohistochenmical examination .

Aim To explore the effect and mechanism of resveratrol (Res) on proliferation and differentiation of murine 3T3-L1 preadipocytes.Methods 3T3-L1 preadipocytes were cultured and treated with resveratrol in different dosages.Cell proliferation was analyzed by WST-1 method. Oil red O staining method and spectrophotography were applied to analyze the degree of differentiation. Real-time PCR was applied to detect the mRNA expression of adiponectin and leptin. Western blot was applied to detect the expression of silent information regulator 1 (Sirt1),peroxisome proliferator activated receptor γ (PPARγ) and CCTTA enhancer binding proteinα (C/EBPα).Results Res inhibited proliferation of murine 3T3-L1 preadipocytes in a time-dose dependent manner.The expression levels of adiponectin and leptin mRNA were decreased, and Res also inhibited 3T3-L1 preadipocytes to differentiate into mature adipocytes. Res increased the expression levels of Sirt1 and decreased the expression levels of PPARγ and C/EBPα.Conclusions Resveratrol can inhibit the proliferation and differentiation of 3T3-L1 preadipocytes.The underlying mechanisms may include enhancing expression of Sirt1 and inhibiting expression of PPARγ,C/EBPα which are related to cell differentiation.

Objective To investigate the effect of predeposit autotransfusion in operation of the patients with lumbar disc protrusion.Methods Fifty patients of transfusion with lumbar disc protrusion were assigned into two groups by stratified sampling randomly,30 patients whose blood were predeposited before operation in experimental group,and the other 20 patients whose blood were not predeposited before operation in control group.The blood loss,the blood requirements during operations,the hemotological routine indexes and the complications related to blood transfusion were compared respectively.Results The blood loss of experimental group [ (720 ± 665 ) ml ] perioperative period was lower than that of control group [ ( 1060 ± 558 ) ml ],but there was no significant difference between two groups (P ＞ 0.05 ).All the patients in experimental group went through perioperative period safely without allogenic blood transfusion.Hemoglobin,red blood cell and white blood cell were not significantly different between two groups before and after operation for 3,7 days (P＞ 0.05 ),the platelet count after operation for 7 days was significantly different between two groups (P ＜ 0.05).No complication was observed in experimental group but 1 case with complication was observed in control group.Conclusions Predeposit autotransfusion is an effective to avoid homologous blood transfusion and its complications for the patients with lumbar disc protrusion.Furthermore,the clinical effect is not significantly different between the predeposit autotransfusion patients and the allogenic blood transfusion patients.

This article described the background,concept,characteristic and objective of the research-based nursing,systematically introducing the main measures including management mechanism, nursing service,nursing staff training,and nursing scientific development.Other areas covered include innovation management mechanism,updating service philosophy,improving nursing staff training,and constructing scientific research platform.

Objective:To evaluate the value of blood urea nitrogen (BUN)/creatinine (Cr) ratio for guiding the access route of double balloon enteroscopy (DBE) for small intestinal bleeding.Methods:The clinical information was collected from 105 patients who underwent DBE for suspected small intestinal bleeding at Air Force Medical Center from January 2015 to October 2019. Patients were divided into the elevated BUN/Cr group ( n=52) and the normal BUN/Cr group ( n=53), with a cut-off value of 81. Comparison was made for the detection rate of lesions between the oral route and anal route separately in the two groups using Chi-square test. Results:Among the 105 patients with suspected small intestinal bleeding, definite causes of bleeding were identified in 79 patients by DBE, and the overall lesion detection rate was 75.24% (79/105). In the elevated BUN/Cr group, the overall lesion detection rate was 76.92% (40/52), among which 79.49% (31/39) was through oral and 47.37% (9/19) through anal enteroscopy. In the normal BUN/Cr group, the overall lesion detection rate was 73.58% (39/53), and 63.64% (21/33) was transoral and 51.43% (18/35) transanal. The lesion detection rate of transoral enteroscopy in the elevated group was significantly higher than that in the normal group ( χ2=6.576, P=0.010). There was no significant difference in the lesion detection rate of transanal enteroscopy between the two groups ( χ2=2.230, P=0.135). Conclusion:For patients with active small intestinal bleeding (active bleeding within 48 hours), the BUN/Cr ratio higher than 81 may indicate that DBE should be performed firstly via oral route.

Objective:To investigate the efficacy of double balloon enteroscopy (DBE) in the treatment of bleeding from small intestinal vascular lesion and risk factors of bleeding recurrence .Methods:From April 2013 to May 2020, at Air Force Medical Center, the clinical data of 65 patients with confirmed or suspected bleeding from small intestinal vascular lesion were retrospectively analyzed. The patients were divided into DBE treatment group (patients of Yano classification 1a and 1b received argon plasma coagulation, and patients of Yano classification 2 and 3 accepted combination of titanium clip and submucosal injection of lauromacrogol sclerosing agent) and non-DBE treatment group (traditional treatments such as stopping anticoagulant or antiplatelet drugs, blood transfusion, and iron supplementation). The bleeding recurrence of patients with single small intestinal vascular lesion between DBE treatment group and non-DBE treatment group, and patients with single or mulitiple vascular lesion of DBE treatment group were compared. Univariate analysis was used to analyze the clinical data of patients with or without recurrent bleeding. Multivariate logistic regression model was used to analyze the independent risk factors and protective factors of recurrent bleeding in small intestinal vascular lesion. Independent sample t test, chi-square test and Fisher exact probability method were used for statistical analysis. Results:Forty-four (25 of single vascular lesion and 19 of multiple vascular lesion) patients were diagnosed with small intestinal vascular lesions and received DBE treatment (DBE treatment group). Twenty-one patients with single vascular lesion accepted traditional treatment (non-DBE treatment group). The recurrent rate of bleeding in patients with single vascular lesion of DBE treatment group was lower than that in patients with single vascular lesion of non-DBE treatment group and patients with multiple vascular lesion of DBE treatment group (24.0%, 6/25 vs. 71.4%, 15/21 and 12/19), and the differences were statistically significant ( χ2=10.348 and 6.848, P=0.001 and 0.009). The results of univariate analysis showed that the proportion of blood transfusion, hypertension, complicated with valvular heart disease and DBE treatment in patients with rebleeding or not rebleeding from small intestinal vascular lesion was different with statistically significant (69.7%(23/33) vs. 37.5%(12/32), 51.5%(17/33) vs. 18.8%(6/32), 42.4%(14/33) vs. 12.5%(4/32) and 54.5%(18/33) vs. 81.2%(26/32), χ2=6.777, 7.628, 7.265, and 5.298, all P<0.05). The results of multivariate logistic regression analysis indicated that blood transfusion during the course of disease (odds ratien ( OR)=3.736, 95% confidence interval ( CI) 1.082 to 12.898, P=0.037) and complication with valvular heart disease ( OR=4.916, 95% CI 1.107 to 21.829, P=0.036) were independent risk factors of bleeding recurrence in patients with small intestinal vascular lesions. DBE treatment was the protective factor of bleeding recurrence in patients with small intestinal vascular lesion ( OR=0.214, 95% CI 0.057 to 0.808, P=0.023). Conclusions:DBE is effective in the treatment of small intestinal vascular lesion bleeding, especially for single vascular lesion. Blood transfusion during disease course and complication with valvular heart disease are independent risk factors for bleeding recurrence in patients with small intestinal vascular lesion.

Objective:To investigate the application value of contrast-enhanced ultrasound (CEUS) before and after microwave ablation of thyroid nodules.Methods:Fifty-six patients (79 thyroid nodules) who received microwave ablation of thyroid nodules in Huaian Medical District, General Hospital of Eastern Theater Command from March 2016 to October 2019 were included in this study. CEUS was performed before microwave ablation to accurately assess the size, number and blood supply of thyroid nodules as well as the position of the feeding vessels. CEUS was performed immediately after microwave ablation to determine whether the lesion area was thoroughly ablated and to measure the volume of thyroid nodules. At 1, 3, 6 and 12 months after surgery, the level of thyroid hormone was measured and the absorption of thyroid nodules was evaluated.Results:Preoperative CEUS showed that among the 79 thyroid nodules, 42 were solid nodules that had different degrees of enhancement, including 33 annular homogeneously highly enhanced nodules and 9 heterogeneously highly enhanced nodules; 24 were cystic mixed solid nodules that had solid components, including 16 homogeneously highly enhanced nodules and 8 nodules with only local high enhancement in the solid component; 13 were cystic nodules, including 9 nodules with septa and 3 nodules with contrast medium on the diaphragm. Contrast medium was still visible around three nodules immediately after microwave ablation. Ablation continued in three nodules until there was no contrast medium. The incidence of complications during and after treatment was 0%. The average volume of the thyroid nodules before treatment was (7.52 ± 6.74) cm3. At 1, 3, 6 and 12 months after surgery, the average volume of the thyroid nodules was (6.06 ± 5.19) cm3, (3.06 ± 2.85) cm3, (1.32 ± 1.23) cm3 and (0.59 ± 0.52) cm 3, respectively. There was significant difference in volume of thyroid nodules between before and after microwave ablation ( F = 96.32, P < 0.001). Conclusion:Preoperative CEUS can determine the distribution of the blood supply of thyroid nodules and the course of the feeding vessels, identify the needle-entering position for microwave ablation and the primary ablation area, improve the accuracy of treatment, and reduce the occurrence of complications such as bleeding. Postoperative CEUS can determine whether lesion area is thoroughly ablated, reduce residual lesions and excessive ablation.

Objective:To understand the epidemic characteristics of malaria in Nanchang, and provide a basis for timely adjustment of prevention and control strategies and measures after elimination of malaria in Nanchang.Methods:By retrospective analysis, the malaria case information and epidemiological case questionnaire reported in Nanchang from 2016 to 2020 were collected from the "China Disease Control and Prevention Information System Infectious Disease Report Information Management System" and "Parasitic DiseasePrevention and Control Information Special Report System". General situation of the cases, three distributions (time, region and population distributions) and the source of infection were described and statistically analyzed.Results:A total of 69 malaria cases were reported in Nanchang from 2016 to 2020, including 39 cases of falciparum malaria, 19 cases of vivax malaria, 9 cases of ovale malaria, 1 case of quartan malaria and 1 case of mixed infection. The onset time of 69 malaria cases was not seasonal, and cases were reported every month; they were distributed in 8 districts (counties) of Nanchang, with Jinxian County was most, accounting for 36.2% (25/69); the sex ratio of men and women was 22 ∶ 1 (66 ∶ 3), and the age of the cases was mainly 20 - < 60 years old, accounting for 97.1% (67 cases); the occupation distribution was dominated by workers, accounting for 26.1% (18/69). The 69 malaria cases were all imported cases from abroad, of which 67 cases were imported from Africa, accounting for 97.1%.Conclusions:There is no report of local malaria case in Nanchang from 2016 to 2020, all cases are imported from abroad. In the future, the control and prevention of imported personnel from abroad should be strengthened.

Objective:To study the surveillance results of soil-transmitted nematode (STN) disease at the national surveillance site in Nanchang City, so as to scientifically formulate prevention and control strategies for parasitic diseases in Nanchang City.Methods:From 2016 to 2020, in Nanchang County, the national surveillance site of STN disease in Nanchang City, no less than 1 000 fecal samples and 25 soil samples of permanent residents over 3 years of age were investigated annually. The improved Kato-Katz thick smear method was used to detect the eggs of STN in the population, species identification of hookworm was carried out by test-tube filter paper incubation, the Enterobius vermicularis eggs of 3 - 9 years old children were detected by cellophane anal swab method, and the soil samples were used to identify hookworm larvae and of Ascaris lumbricoides eggs. Results:The total infection rate of STN was 0.93% (47/5 054) from 2016 to 2020 in the national surveillance site of Nanchang City. The annual infection rates were 0.10% (1/1 000), 2.94% (30/1 021), 0.79% (8/1 008), 0.50% (5/1 002) and 0.29% (3/1 023), respectively; the infection rates of hookworm, Ascaris lumbricoides and Trichuris trichiura were 0.42% (21/5 054), 0.02% (1/5 054) and 0.49% (25/5 054), respectively. Totally 97.87% (46/47) of the infected persons were mild infection. The population distribution characteristics showed that there was significant difference in STN infection rate among different education levels (χ 2 = 18.06, P = 0.001), but there was no significant difference in infection rate among different sex, age and occupation (χ 2 = 0.92, 2.01, 13.60, P > 0.05). Among them, the infection rate of junior high school cultural was the highest (1.84%, 24/1 301). The culture of hookworm larvae showed that 90.48% (19/21) were Necator americanus; the infection rate of Enterobius vermicularis in 3 - 9 years old children, the contamination rate of soil hookworm larvae and Ascaris lumbricoides eggs, were all 0. Conclusion:STN disease shows a low prevalence trend at the national monitoring site in Nanchang City, Trichuris trichiura and hookworm are the key insect species for STN disease control in Nanchang City in the future.