Objective The purpose of this study was to investigate the clinical features and the magnetic resonance imaging of brain of children with Japanese encephalitis (JE) and whether this relationship can be used in early diagnosis.MethodsMRI was performed in 145 children with JE.T1-weighted,T2-weighted and FLAIR of brain were obtained in 98 patients with 0.35 T MRI system and conventional MRI and DWI were performed in 47 patients with 1.5 T MRI system.The position,range and MRI features were analyzed.ResultsMR imaging studies of 106 patients showed hyperintensity in the thalamic with 87 patients involved the caudex cerebri,as seen on T2-weighted images.The lesions were also seen in basal ganglia (32 cases),cerebral cortex (43 cases),cerebellum (2 cases),and white matter (15 cases).Lesions showed high intensity signal on T2WI and T2-FLAIR,and iso- or low intensity on T1WI.The number of the lesions in FLAIR were more than T2WI.The positive rate on 1.5 T MRI (87.2%) was higher than that on 0.35 T MRI(66.3%,χ2＝7.06,P＜0.01).ConclusionsMultiple brain tissues can be involved and the thalamic and the caudex cerebri involvement are the conspicuous characteristics in children with JE.T2-FLAIR and DWI are helpful in the early diagnosis of JE.

Objective To investigate the clinical characteristics,diagnosis and therapeutic principle of thyroid microcarcinoma(TMC).Metllotis Clinical data of 29 TMC cases from January 1997 to December 2006 were retrospectively analyzed.Results 27 cases were performed B-ultrasonography and minimal lesion of thyroid Was detected in all patients,5 cases were diagnosed as TMC suspiciously,of whom 1 case was found to have lymph node swell in cervical part and was diagnosed as metastasis thyroid cancer by lymph node biopsy.All cases took operation and experienced intra operative frozen section and paraffin section evaluation,indicating that 23 cases were confirmed by intra operative frozen section and 6 cases were confirmed by paraffin section.All cases were followed up after operation,of whom 2 patients undergoing homo-lateral near total thyroidectomy experienced recurrent after 2 years and 3 years operation respectively,and one patient died from cerebral hemorrhage.Conclusion Though it is difficult to confirm the diagnosis of TMC before operation,B-uhrasonography before operation combined with frozen section intra operation is the effective diagnostic method,and homolateral lobe and isthmus total thyroidectomy is the fundamental operation management.

BACKGROUND:Which an ideal method to treat type Rockwood Ⅲ acromioclavicular joint dislocation is,traditional or surgical therapy,is still controversial.OBJECTIVE:To investigate the clinical effect of clavicular hook plate implantation on type Rockwood Ⅲ acromioclayicular joint dislocation.METHODS:A total of 56 patients with type Rockwood Ⅲ acromioclavicular joint dislocation were selected from Department of Orthopaedics of Yiling Hospital between December 2005 and June 2008.There were 42 males and 14 females,aged 16-65 years and mean age of 32 years.All patients were treated with clavicular hook plate implantation.Indicators including visual analogue scale (VAS),the United States shoulder and elbow surgeon score (ASES),and Constant and Murley scoring system were tested pre-operatively,one year postoperatively,before internal fixation,and 3 months after internal fixation;additionally,functional changes of the shoulder joint and complications were analyzed before and after clavicular hook plate implantation.RESULTS AND CONCLUSION:The surgery and following-up were successfully achieved in 56 cases.The following-up lasted for 15-30 months,with the mean time of 20 months.The internal fixation was taken out at about 1 year after implantation.Coracoclavicular ligament was repaired in 32 cases but not in the 24 cases.Two patients with acromioclavicular joint dislocation recurrence were excluded,and coracoclavicular ligament therapy was not performed.Shoulder pain,foreign body sensation,and internal fixation failure occurred in two cases.One year after operation,VAS was decreased compared with that before operation,but ASES and Constant and Murley score were significantly increased (P＜0.01).At three months after internal fixation,VAS was decreased compared with that at 1 year after operation,but ASES and Constant and Murley score were increased (P＜0.05).The results demonstrated that clavicular hook plate implantation for treating type Rockwood Ⅲ acromioclavicular joint dislocation is simple and less invasive,thus it is an ideal internal fixation.

Objective To study the bio-safety of a multifunctional dressing based on isobutyl-chitosan,a derivative of chitosan.Methods To investigate the local irritation of the multifunctional dressing by skin,subcutaneous and eye application,determine its sensitization by patch test and observe its systemic acute toxicity by abdominal injection.Results The isobutyl-chitosan multifunctional dressing had no irritation,sensitization and systemic acute toxicity.Conclusion The isobutyl-chitosan multifunctional dressing has a good bio-safety as a wound dressing.

Objective:To develop a grading prediction model of traumatic hemorrhage volume based on deep learning and assist in predicting traumatic hemorrhage volume.Methods:A retrospective observational study was conducted based on the experimental data of pig gunshot wounds in the time-effect assessment database for experiments on war-traumatized animals constructed by the General Hospital of the Chinese People's Liberation Army. The hemorrhage volume data of the study population were extracted, and the animals were divided into 0-300 mL, 301-600 mL, and > 600 mL groups according to the hemorrhage volume. Using vital signs indexes as the predictive variables and hemorrhage volume grading as the outcome variable, trauma hemorrhage volume grading prediction models were developed based on four traditional machine learning and ten deep learning methods. Using laboratory test indexes as predictive variables and hemorrhage volume grading as outcome variables, trauma hemorrhage volume grading prediction models were developed based on the above fourteen methods. The effect of the two groups of models was evaluated by accuracy and area under the receiver operator characteristic curve (AUC), and the optimal models in the two groups were mixed to obtain hybrid model 1. Feature selection was conducted according to the genetic algorithm, and hybrid model 2 was constructed according to the best feature combination. Finally, hybrid model 2 was deployed in the animal experiment database system.Results:Ninety-six traumatic animals in the database were enrolled, including 27 pigs in the 0-300 mL group, 40 in the 301-600 mL group, and 29 in the > 600 mL group. Among the fourteen models based on vital signs indexes, fully convolutional network (FCN) model was the best [accuracy: 60.0%, AUC and 95% confidence interval (95% CI) was 0.699 (0.671-0.727)]. Among the fourteen models based on laboratory test indexes, recurrent neural network (RNN) model was the best [accuracy: 68.9%, AUC (95% CI) was 0.845 (0.829-0.860)]. After mixing the FCN and RNN models, the hybrid model 1, namely RNN-FCN model was obtained, and the performance of the model was improved [accuracy: 74.2%, AUC (95% CI) was 0.847 (0.833-0.862)]. Feature selection was carried out by genetic algorithm, and the hybrid model 2, namely RNN-FCN* model, was constructed according to the selected feature combination, which further improved the model performance [accuracy: 80.5%, AUC (95% CI) was 0.880 (0.868-0.893)]. The hybrid model 2 contained ten indexes, including mean arterial pressure (MAP), hematocrit (HCT), platelet count (PLT), lactic acid, arterial partial pressure of carbon dioxide (PaCO 2), Total CO 2, blood sodium, anion gap (AG), fibrinogen (FIB), international normalized ratio (INR). Finally, the RNN-FCN* model was deployed in the database system, which realized automatic, continuous, efficient, intelligent, and grading prediction of hemorrhage volume in traumatic animals. Conclusion:Based on deep learning, a grading prediction model of traumatic hemorrhage volume was developed and deployed in the information system to realize the intelligent grading prediction of traumatic animal hemorrhage volume.

Objective:To analyze the influencing factors and improvement paths of the cultivation of full-time doctoral scientific and technological innovation ability in large public hospitals, and propose countermeasures and suggestions.Methods:This studyed conducted a survey and analysis of 122 doctors from Linyi People′s Hospital in Shandong Province, and completed a current situation study based on the analysis results.Results:There was no significant difference between the two groups in gender, age, degree type, professional category, discipline level, Graduate School type, job type and other indicators. There were significant differences between the two groups in scientific research topic selection ability score, project design ability score, data analysis ability score, data interpretation ability score, project approval in recent 5 years, project level, number of SCI journal papers published in recent 5 years, cumulative impact factors of SCI journal papers, and annual number of academic activities ( P<0.05). Conclusions:The hospital can improve the scientific and technological innovation ability of full-time doctors by setting up a special cultivation plan, establishing an interdisciplinary team, optimizing scientific research management services, improving the evaluation and assessment system, and improving welfare protection.

Objective:To analyze the characteristics of HIV-1 molecular network in men who have sex with men (MSM) from 2016 to 2018 in Kunming, Yunnan province, explore the risk factors associated with HIV-1 transmission network and provide evidence for the effective implementation of intervention.Methods:A total of 540 samples of newly reported HIV-1 positive MSM were consecutively collected in Kunming from 2016 to 2018, the pol gene fragments were amplified by nested polymerase chain reaction (PCR). HIV-1 molecular networks were constructed according to the bootstrap value of the maximum likelihood evolutionary tree over 95% and the genetic distance less than 3%. The factors associated with the subjects entering network and network growth were further analyzed. Results:Among 459 successfully sequenced samples, seven genotypes were found, in which CRF07_BC (49.2%, 226/459) and CRF01_AE (40.3%, 185/459 ) were predominant. Other genotypes included URFs (4.8%, 22/459), CRF08_BC (3.1%, 14/459), CRF55_01B (1.7%, 8/459), B (0.7%, 3/459) and CRF68_01B (0.2%, 1/459). A total of 163 sequences entered the network, with an entry rate of 35.5%(163/459), forming 56 clusters with the number of individuals in the cluster was between 2 and 13. The analysis of the factors associated with entering network showed that the MSM who married and had multiple homosexual partners were more likely to be found in HIV-1 molecular networks. Multivariate logistic regression analysis showed that the number of sexual partners was the factor for the growth of HIV-1 molecular network. According to the criteria for the emergence of three or more newly reported cases in every year, six transmission clusters were judged as active transmission clusters, in which MSM who were not Kunming natives, had sexually transmitted diseases (STD), were divorced and students were the key targets of intervention.Conclusions:HIV-1 genotypes in MSM in Kunming were becoming complex, the risk factors associated with transmission networks in MSM in Kunming included being married and having multiple partners, the intervention targets in active transmission clusters included MSM who were not Kunming natives, had STD, were divorced and students. This study provided the basis for applying HIV-1 molecular networks to real-time intervention in this population.

Objective To describe the repetitive nerve stimulation ( RNS) in anti-muscle specific tyrosine kinase (anti-MuSK) receptor antibody positive myasthenia gravis (MG), and compare with anti-acetylcholine receptor ( AChR ) positive myasthenia gravis , to figure out characteristics of anti-MuSK receptor MG.Methods We analyzed clinical and RNS data of nine anti-MuSK receptor MG and 19 age-and sex-matched anti-AChR MG.RNS was performed to the abductor digiti minimi , orbicularis oculi or musculus frontalis and trapezius .Results In anti-MuSK receptor MG , abnormal RNS in facial nerve was seen in 6/9 and in trapezius was 5/9, in limbs was 0.In anti-AChR MG, abnormal RNS in facial nerve was seen in 13/19, in trapezius was 18/19 and in limbs was 7/19.Abnormal in any of three parts was 8/9 and 19/19 in anti-MuSK receptor MG and anti-AChR MG, respectively.The RNS decrementing was more obvious in facial nerve in anti-Musk receptor MG than in anti-AChR MG.Negative prostigmin test was independently associated with anti-MuSK receptor MG (OR=4.25,95% CI 2.19 -15.25, P=0.015). Conclusions Abnormal RNS in any of three parts is more pronounced in anti-AChR MG compared with anti-MuSK receptor MG.RNS decrementing in facial nerve is more obvious in anti-AChR MG.Negative prostigmin test can aid in early suspicion in anti-MuSK receptor MG.

Objective:To understand the willingness of pre-exposure prophylaxis (PrEP) use to prevent HIV infection and related factors in men who have sex with men (MSM) in Yunnan Province.Methods:Cross-sectional study method and snowball sampling method was used to carry out the survey in 14 cities (autonomous prefectures) in Yunnan from April to June 2021. According to national sentinel surveillance program, the sample size was 400 at national sentinel sites and 100 at provincial sentinel sites. The related factors of PrEP use willingness were analyzed by multiple logistic regressions with software SPSS 22.0.Results:A total of 2 450 questionnaires were completed, the rate of having heard of PrEP was 68.5% (1 677/2 449), the willingness rate of PrEP use was 56.7% (1 343/2 368), the willing rate of PrEP use at their own expense was 30.6% (724/2 368), and the willingness rate of free PrEP use was 56.2% (1 330/2 367). The of multivariate logistic analysis results showed that related factors of low willingness to use PrEP included aged 40-49 years and 50 years or above (a OR=2.49 and a OR=4.48), Han ethnic group (a OR=1.47), residence in other provinces (a OR=1.64), education level of senior high school (a OR=1.96) and college or above (a OR=3.49), sample source of bath house (a OR=3.53), online recruiting (a OR=2.53) and voluntary counseling and testing (a OR=1.42), local living time for 3-6 months and 7-12 months (a OR=0.18 and a OR=0.25) ,class 2 and 3 of survey areas (a OR=3.63 and a OR=1.71), having no anal sex with men in the past week (a OR=2.60), having no commercial homosexual behavior in the past six months (a OR=13.32) and self-perceived higer risk for HIV infection (a OR=0.50). Conclusions:There was more than half of MSM with willingness to use PrEP. The health education to promote PrEP use should be strengthen in MSM who had low willingness to use PrEP from underdeveloped areas, in Han ethnic group, with older age, from other provinces, with shorter local living time and self-perceived low risk for HIV infection.

Objective: To explore the protective effects of folic acid on retinas and its anti-oxidative stress mechanism in diabetic mice. Methods: Thirty-two 16-week-old SPF degree male db/db mice were randomized into model group and folic acid group, and 16 matched C57BL/KsJ mice were used as controls.Folic acid was used to the mice by oral gavage once per day with the dose of 71 μg/kg (2 ml) for 60 days in the folic acid group, and the same volume of normal saline solution was used in the model group and control group in the same way.The activities, mental state, body weight, and fasting plasma glucose (FPG) of the mice were recorded during experiment.At the end of the intervention, the mice were sacrificed and the retinas and blood sample were obtained.The histopathology of the retinas was examined with hematoxylin- eosin staining; serum homocysteine (Hcy) was detected by ELISA assay; the relative expressions of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) mRNA were detected in the retinas by real-time fluorescence quantitative PCR; the relative expressions of B lymphoma 2 protein (bcl-2), bcl-2 related X protein (bax), 3-nitrotyrosine (3-NT) and 4-Hydroxynonine (4-HNE) proteins were assayed by Western blot assay; superoxide dismutase (SOD), 8-hydroxydeoxyguanosine (8-OHdG) and malondialdehyde (MDA) levels in the retinas were detected by biochemical kits, and immunofluorescence assay was used to detect the expression of NADPH oxidation 4 (NOX4) in the retinas.The use and care of the experimental animals adhered to the ARVO Statement by the American Association for Vision and Ophthalmology Research and this study protocol was approved by Ethic Committee of Qinghai University (QHDX 2018-35). Results: Over the experimental period, The FPG was normal and body weight was gradually increased in the mice of control group.The FPG>16.7 mmol/L and the mice appeared obese.In the folic acid group, both body mass and FPG of the mice were gradually reduced.At the end of drug administration, serum Hcy concentration of the mice was (27.18±3.18)μmol/L in the model group, which was significantly higher than (8.28±2.18)μmol/L in the control group and (13.73±2.54)μmol/L in the folic acid group (all at P<0.05). The retinal structure was intact in the control group, and the retinas were thinning with more capillaries and inflammatory cells in the model group, the thickness of the retinas was increased and the capillaries and inflammatory cells were decreased in the folic acid group.The relative expressions of TNF-α and IL-6 mRNA in the retinas were significantly higher in the model group than those in the control group, and those in the folic acid group were reduced in comparison with the model group (all at P<0.05). The relative expression of bcl-2 protein in the retinas of folic acid group was lower than that in the control group and higher than that in the model group, and the relative expressions of bax, 3-NT and 4-HNE proteins in the retinas of the folic acid group were significantly higher than those in the control group and lower than those in the model group (all at P<0.05 ). The T-SOD activity in the folic acid group was significantly stronger than that in the control group and weaker than that in the model group, and the concentrations of 8-OHdG and MDA in the retinas of the folic acid group were significantly reduced in comparison with those of the control group and elevated in comparison with those of the model group (all at P<0.05). The expressing intensity of NOX4 protein in the retinas of the folic acid group was significantly weaker than that of the model group. Conclusions Folic acid appears aprotective effect on retinal tissue in diabetic mice by reducing serum Hcy, inhibiting oxidative stress and cell apoptosis.