Objective To explore ideal treatment strategy for hemangioma and vascular malformations.Methods The clinical data of 863 cases of hemangioma and vascular malformation were analyzed retrospectively.There were 414 male and 449 female patients,The ages ranged from 2 weeks to 55 years.Among these cases,742 were hemangioma while 121 were vascular malformation.The different treatment methods were selected based on the type,location,and extent of the lesion and the patient′s individnal situation.Seven hundred and forty-six patients underwent surgical treatment,89 patients underwent operation combined with sclerotherapy,and 28 patients received embolization of feeding arteries with or without operation.Results Early postoperative results showed that 772 cases(89.46%) were cured,78 cases(9.04%) markedly improved and 13 cases(1.5%) improved.A total of 620 cases were followed up for 0.5-3.0y,of which,556 cases(89.68%) were cured,51 cases(8.23%) markedly improvod,and 13 cases(2.09%) had improved.Conclusions Operation is ideal strategy for the limited disease focus,while non-surgical treatment is necessary for patients with extensive and deep lesions or who are not fit for surgical treatment.Combining surgical treatment and non-surgical treatment can achieve better therapeutic efficiency.

Objective To observe the effect of elevated local sheer stress of abdominal aota on its caliber and wall expression of MMP-9,and analyse the action of high shear stress on arterial remodling.Methods Forty-eight SD rats were randomly divided into 4 experiment and 4 comparison groups.An infra-renal aortocaval fistula was constructed by needle puncture using a 0.4mm needle in the experiment groups.The aorta proximal to the fistula was harvested after 1 d,7 d,14 d and 28 d respectively,while sham operation was done in the comparison groups.The diameter and wall thickness of the aorta were measured after fistula was made and before harvest.The level of change of MMP-9 was observed by immunohistochemistry.Results The diameter of aorta proxinal to the fistula was enlarged in the 1d group(P

Objective To investigate the influence of sevoflurane and total intravenous anesthesia with propofol on hepatic and renal function in elder patients under gastrectomy .Methods 55 patients between the ages of 60-75 ,ASA physical status class Ⅰor Ⅱ ,scheduled for an elective gastrectomy were randomly divided into two groups .Anesthesia was maintained with sevoflurane 1% -1 .2% and remifentanil (0 .1-0 .2)μg · kg -1 · min-1 in the group S and propofol (1 -2)mg · kg -1 · h-1 and remifentanil (0 .1-0 .2)μg · kg -1 · min-1 in the group T .The hepatic and renal function ,aspartate aminotransferase (AST ) ,alanine amin-otransferase(ALT),bloodureanitrogen(BUN)andcreatinineweretestedatpreoperation(baseline),postoperative1dayand3 days .Results AST was increased at postoperative 1 day and 3 day ,compared with that of the preoperation in the group S and group T .Serum BUN at 3 day and creatinine at 1 day and 3 day were significantly higher from the preoperative values in group S (P<0 .05) ,but the values were within its normal limit .ALT was not changed after anesthesia in the both groups .And Serum BUN and creatinine were not changed after anesthesia in the T groups (P>0 .05) .There were no significant difference in the AST ,ALT , BUN and creatinine between the groups(P>0 .05) .Conclusion The changes of hepatic and renal effect after inhalation anesthesia with sevoflurane and remifentanil and TIVA with propofol and remifentanil for gastrectomy are clinically insignficant ,and there is no difference between the two methods .

Objective To evaluate the diagnostic value of DCE-MRI and breast MR reporting and data system(BI-RADS-MR)in differentiation of breast lesions. Methods Seventy-five patients with 75 pathological-confirmed breast lesions underwent DCE-MRI before treatment and DCE-MRI quantitative analysis. Two senior doc-tors assessed the imaging features blindly by BI-RADS-MR. The pathology results were set as a gold standard. The receiver operating characteristic curve(ROC)interpretation of two physician′s curve analysis was used to evaluate the sensitivity,specificity of BI-RADS classification. Results According to the BI-RADS MR score,38 breast cancer patients were rated as 1 case in grade Ⅰ,0 case in grade Ⅱ,4 cases in gradeⅢ,13 cases in gradeⅣ,20 cases in grade V;37 breast benign tumors were rated as 17 cases in grade Ⅰ,5 cases in grade Ⅱ,12 cases in gradeⅢ,3 cases in gradeⅣandⅤ0 cases. The statistical difference of Tpeak,S max,K1 between benign and malig-nant breast tumors were significant(P<0.05). On ROC,the area under the curve was 0.940,95%confidence in-terval was from 0.887 to 0.994. The sensitivity of BI-RADS in the diagnosis of breast cancer was 94.59%and speci-ficity was 92.11%. Conclusion DCE-MRI combined with BI-RADS-MR classification in diagnosis of benign and malignant breast tumors has an important value and can improve diagnosis and differential diagnosis level.

Objective To evaluate the health status ,dyspnea and exercise endurance in the patients with chronic obstructive pul-monary disease(COPD) by the CAT scale ,modified medical research council(mMRC) dyspnea scale and 6-min walk test(6MWT) and to analyze the correlation between their evaluation results with the percentage (FEV1% pred) of the forced expiratory volume at 1 second(FEV1) in the predict value and whether complicating pulmonary hypertension (PH) .Methods 70 patients with COPD were performed the examinations of the lung function ,CAT scale ,mMRC score and 6MWT .The correlation among the various e-valuation systems and between each evaluation system with the severity of the pulmonary function airway limitation were compre -hensively evaluated .The CAT scores ,mMRC scores and 6 min walking distance(6MWD) were compared between the COPD com-plicating PH group and the simple COPD group .Results The CAT scale was negatively correlated with 6MWD(r= -0 .623 ,P<0 .01) and had no correlation with FEV1% pred(P=0 .159) .The CAT scale was positively correlated with mMRC (r=0 .492 ,P=0 .000) .mMRC was negatively correlated with 6MWD(r= -0 .514 ,P= 0 .000) and had no correlation with FEV1% pred(P>0 .05) .The CAT scores had statistical difference between the COPD complicating PH group and the simple COPD group (P<0 .01) .6MWD had the highest accuracy for screening COPD whether complicating PH ,followed by CAT .The diagnostic cut-off point by adopting CAT for judging the risk of COPD complicating PH was 21 .Conclusion The CAT scale has good correlation with 6MWD and no correlation with FEV1% pred .The CAT scale is more suitable for the overall assessment of the total severity of COPD .Patients with the high CAT scores have higher risk of suffering from PH .

Objective: To investigate the mediating effect of parent-child conflict on paternal phubbing and externalizing behavior problems in children, so as to provide insights into the prevention and interventions of childhood externalizing behavior problems. Methods: The fathers of children at ages of 3 to 6 years were sampled from seven kindergartens in Liaoning Province and one kindergartens in Sichuan Province using a convenience sampling method in June 2021. The Generic Scale of Phubbing, the Parent-child Relationship Scale, and the Strengths and Difficulties Questionnaire in Children were employed. The mediating effect of parent-child conflict on paternal phubbing and externalizing behavior problems in children was examined using a structural-equation model and Bootstrap method. Results: A total of 583 questionnaires were allocated, and 531 valid questionnaires were recovered, with an effective recovery rate of 91.08%. The fathers had a mean age of (34.86±8.39) years, and 172 fathers had an educational level of bachelor degree and above (32.39%) and 285 had a single child (53.67%). Among paternal phubbing questions, the mean scores of nomophobia, interpersonal conflict, self-isolation and problem acknowledgement dimensions were (3.71±1.53), (2.02±1.18), (2.26±1.29) and (3.07±1.38), respectively, and the mean score of parent-child conflict was (2.25±0.82). Among all childhood externalizing behavior questions, the mean scores of conduct and attention deficits/hyperactivity dimensions were (0.31±0.26) and (0.82±0.46), respectively. Paternal phubbing posed an direct positive effect on childhood externalizing behavior problems (β=0.165, P=0.005), and indirectly affected childhood externalizing behavior problems (β=0.449, P<0.001) via parent-child conflict (β=0.358, P<0.001). The mediating effect of father-child conflict was 0.161 (95%CI: 0.104-0.221), and was contributed 49.39% to the total effect. Conclusions Parent-child conflict plays a partial mediating role in the association between paternal phubbing and childhood externalizing behavior problems. Paternal phubbing may directly affect childhood externalizing behavior problems, and may indirectly affect childhood externalizing behavior problems through the positive effect on parent-child conflict.

Objective To evaluation the efficacy of ketamine on the expression of adhension molecular CR3and intracellular cAMP, cGMP in neutrephils in patients associated with cardiopulmonary bypass (CPB), as well as the cardiovascular function of the CPB patients. Method Sixty patients operated on with prosthetic valve replace-rnent under CPB were randomly divided into 4 groups: placebo, ketamine 0.1 mg/kg ( ketamine Ⅰ) ,ketamine 0.5 mg/kg ( ketamine Ⅱ) ,ketamine 1 mg/kg( ketamine Ⅲ). Each group included 15 eases. Venous blood sam-pies were obtained during anesthesia induction (T1), 10 min before CPB (T2), end of CPB (T3) and 24 hoursafter operation (T4). The expression of CR3 was measured by Flow cytometry and the concentration of cAMP/cGMP by HPLC. Results Ketamine with various dosages decreased the expression of CR3 at the T3 and T4 inpatients of ketamine groups compared with patients of placebo group (P<0.05). The dosages of ketamine Ⅱgroup and ketamine Ⅲ group had more significant effect than that of ketamine Ⅰ group. The dosages of ketamineⅡ and ketamine Ⅲ group increased the intracellular cAMP at the T3 and T4 compared with ketamine Ⅰ groupand placebo (p<0.05), respectively. However,cGMP was lower in ketamine Ⅱ and ketamine Ⅲ group thanthat in ketamine Ⅰ group and placebo (P<0.05) at the T3.Morever,the mean arterial blood pressure was higherin ketamine Ⅱ and ketamine Ⅲ group at T4. Only the patients of ketamine Ⅲ group required less inotropic drugsafter operation. Conclusions Ketamine can reduce the expression of adhhension molecular CB3 and intracellularcAMP, cGMP in neutrophils from patients associated with CPB.

Objective:To investigate whether the risk of intravesical recurrence increases in patients with upper urinary tract urothelial carcinoma (UUT-UC) and diabetes mellitus (DM) after radical nephroureterectomy (RNU) with bladder cuff excision. Methods:We ret-rospectively analyzed the clinicopathological data of 282 UUT-UC patients with no history of bladder neoplasm and who underwent RNU with bladder cuff excision in the Second Hospital of Tianjin Medical University from January 2005 to December 2013. The recurrence-free survival (RFS) and cancer-specific survival (CSS) were compared between the non-diabetic (233 patients) and diabetic (49 patients) patients. The factors influencing intravesical recurrence in patients with UUT-UC after RNU were analyzed. These factors included age, DM, pathologic grade, and stage. Results:Among the 282 patients included in the study, 80 (28.4%) patients developed intravesical recurrence during the median fol ow up of 41 months, and the median time to recurrence was 11 months. Non-diabetic patients had a significantly longer duration of bladder neoplasm RFS than diabetic patients (P=0.013). Multivariate analysis using Cox's regression model indicated that DM (P=0.014), renal pelvis and ureter tumor (P=0.001), and postoperative chemotherapy (P=0.024) were independent influential factors for intravesical recurrence in patients with UUT-UC after RNU with bladder cuff excision. Conclusion:DM posed an increased risk for intravesical recurrence after RNU with bladder cuff excision in patients with UUT-UC. Therefore, these patients need to be closely monitored, and their blood glucose must be controlled.

Objective To study on the factors of countercurrent occured in hysterosalpingography to improve the understanding of countercurrent.Methods 180 patients who underwent hysterosalpingography due to infertility were recruited,and 63 of them who were involved in countercurrent in the process of hysterosalpingography were analyzed statistically.Results The single factor analy-sis demonstrated that such four factors of primary/secondary infertility,menstrual clean days,tubal obstruction or not,and depth of cannula were associated with countercurrent,while Logistic regression analysis indicated that the factors of menstrual clean days, tubal obstruction or not,and depth of cannula during the hysterosalpingography operation were closely related.Conclusion Counter-current are caused by the comprehensive impact of several comprehensive factors like menstrual clean day,tubal obstruction or not, and cannula operation.Therefore adequate preparation should be made before and during the operation,to reduce the occurrences of countercurrent.

Objective To assess and compare the overall diagnostic value of positron emission tomography(PET)-CT and DWI in lymph node staging in patients with prostate cancer by using Meta-analysis.Methods Relevant English articles published on PubMed,EMBASE,Cochrane Library and SCI database were searched.Subsequently,the characteristics of the included articles were appraised and extracted.Statistical analysis was performed employing Meta Disc version 1.4.Heterogeneity of the included articles was tested,which was used to select proper effect model to calculate the pooled sensitivity and specificity and the corresponding 95％ CI,summary receiver operating characteristics(SROC) curve was performed and the area under the curve was calculated.The diagnostic performanceincluding the sensitivity,specificity,and the area under the curve was compared between the two groups via x2 test and Z test respectively.Results Eleven of 182 retrieved articles were included,in which 3 articles used two methods of imaging examination at the same time.In PET-CT group,there were eight articles using 11C-Choline as imaging agents,three with 18F-Fluorocholine.The pooled sensitivity and specificity and area under SROC curve for PET-CT were 0.64 (0.574.71),0.93 (0.90-0.96),and 0.8795 respectively.They were 0.59 (0.47-0.70),0.82 (0.70-0.91),and 0.7707 for DWI group.The specificity of PET-CT was significantly higher than that of DWI (x2=5.531,P＜0.05).No significant differences were found in the sensitivity and AUC between the two groups (x2=0.528,Z=1.699,P＞0.05).Conclusion For lymph node staging in patients with prostate cancer,PET-CT has an equal sensitivity and a higher specificity,a better diagnostic performance compared with DWI.