Objective To evaluate MR Dual echo imaging in the differential diagnosing liver lesions.Methods:MR Dual echo features in 80 patients with different liver lesions,including 40 cases of benign lesions and 40 cases of malignant lesions,were analyzed,and comparison with MR Dual echo imaging was made.Results MR Dual echo sensitivity and specificity were 85% and 95% in the benign lesions,80% and 94% in the malignant lesions respectively.Conclusion MR Dualecho imaging is a useful MR technique,which is helpful in differentiating benign from malignant lesions.

Six compounds were isolated from the dried leaves and tender branches of Rabdosia ma-crocalyx (Dunn ) Hara. Their structures were identified as excisanin A, excisanin B, rabdol-oxin B, ursolic acid, ?-sitosterol and palmitic acid.

Objective? To compare the reliability and validity of Intensive Care Delirium Screening Checklist (ICDSC) and Neelon and Champagne Confusion Scale (NEECHAM) when evaluating non-mechanical ventilation patients in Neurosurgery Department. Methods? A total of 100 non-mechanical ventilation patients in the Neurosurgery Department of a ClassⅢ Grade A hospital in Shanxi Province from August to December 2018 were selected. The non-operative patients were assessed on the third day after admission, and the operative patients were assessed on the third day after operation. Qualified nurses assessed the patients at 00:00—1:00, 8:00—9:00 and 16:00—17:00 with ICDSC and NEECHAM. Psychiatrists assess the patients at 16:30—17:30 on the same day by Richmond Agitation and Sedation Scale (RASS) and Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV). Using the results of DSM-IV as the gold standard, the curve of ROC was drawn, and the sensitivity and specificity of the two scales were compared. Results? Area under ROC Curve (ROCAUC) of ICDSC was 0.891 (95%CI: 0.826-0.956,P＜0.01). The ROCAUC of NEECHAM was 0.987 (95% CI: 0.970-0.999, P＜ 0.01). When the optimal threshold of ICDSC was 4.25, the sensitivity and specificity were 87.8% and 76.2% respectively. When the optimal threshold of NEECHAM was 23.5, the sensitivity and specificity were 98.0% and 92.9% respectively. Conclusions? The misdiagnosis rate of NEECHAM is lower than ICDSC, and the diagnostic efficacy, authenticity, reliability and diagnostic value of NEECHAM are higher than ICDSC. NEECHAM is more suitable for nurses to evaluate delirium in neurosurgery patients without mechanical ventilation.

Objective:To analyze the changes of preterm birth rate and proportion of multipara in 10 years, and to explore the possibility of multipara as a risk factor for preterm birth.Methods:This study was a cohort study. The general clinical data and pregnancy outcomes of 53 979 parturients delivered in Peking University First Hospital from January 2013 to December 2022 were collected, and the changes of preterm birth rate and proportion of multipara in the past 10 years were analyzed retrospectively. Single factor and multivariate logistic regression analysis were used to explore the risk factors of spontaneous preterm birth and the influence of multipara on pregnancy outcome.Results:(1) The total preterm birth rate of 53 979 parturients was 8.3%(4 478/53 979), and the overall preterm birth rate showed an upward trend in the past 10 years, among which the preterm birth rate was higher in 2017 and 2018, which were 8.9% and 9.2% respectively. The proportion of multipara was 24.9% (13 440/53 979), which showed a trend of rising first, then declining and then stabilizing. In 2017 and 2018, the proportion of multipara was the highest, accounting for 35.0%. (2) Multivariate logistic regression analysis showed that multipara was a risk factor for spontaneous preterm birth before 37 weeks of pregnancy ( OR=1.678, 95% CI: 1.523-1.850; P<0.001), which was also a risk factor for spontaneous preterm birth before 34 weeks of pregnancy ( OR=1.937, 95% CI: 1.632-2.301; P<0.001). The high risk factors of spontaneous preterm birth also include multiple pregnancies, hyperglycemia during pregnancy, abnormal amniotic fluid volume, premature rupture of membranes, intrauterine infection, cervical incompetence, history of cervical surgery and abnormal uterine development. (3) Compared with primiparas, multiparas was older, had earlier delivery weeks, higher premature delivery rate, higher birth weight and fewer multiple pregnancies. Among pregnancy complications, the incidence of gestational diabetes mellitus, placenta previa, placenta implantation, urgent delivery and macrosomia was higher, while the incidence of pregnancy-induced hypertension, pre-eclampsia, intrahepatic cholestasis of pregnancy, oligohydramnios, fetal growth restriction, premature rupture of membranes, intrauterine infection and postpartum hemorrhage was lower, and the differences were statistically significant ( P<0.05). Conclusions:In recent 10 years, the overall rate of preterm birth is on the rise, and the risk factors of preterm birth are basically similar to those in previous studies. Multipara is a high-risk group of spontaneous preterm birth, and the risk of various pregnancy complications increases, which should be paid attention to in pregnancy care.

Objective To identify the risk factors of major bleeding in patients undergoing off-pump coronary artery by-pass grafting( OPCAB) .Methods Data on coronary artery disease patients who underwent off-pump CABG between December 2009 and December 2014 were reviewed.Baseline characteristics were compared between patients with clopidogrel discontinua-tion ≥5 days and <5 days.Univariate and multivariate logistic regression analyses were performed to investigate the risk fac-tors of perioperative major bleeding.Major bleeding was defined as the Universal Definition of Perioperative Bleeding(UDPB) class 3 -4.Results A total of 3988 patients who underwent OPCAB were included in this study.Major bleeding rate was 9.23%(n=368).Multivariable regression analysis showed that female sex(OR=1.99, 95%CI:1.57-2.52), age(OR=1. 02, 95%CI:1.00-1.03), lower BMI(BMI≤25 kg/m2)(OR=1.40,95%CI:1.12-1.75), decreased GRF(GFR<60 ml/min)(OR=1.43,95%CI:1.01-2.02), decreased preoperative Hct(Hct <0.40)(OR =1.57, 95%CI: 1.23-1.99) and clopidogrel discontinuation <5 days(OR=1.97, 95%CI:1.58-2.44) conferred a higher risk of perioperative major bleeding during OPCABG.Conclusion Female, advanced age, lower BMI, decreased GRF, decreased preoperative Hct and clopi-dogrel discontinuation<5 days are independent risk factors of perioperatice major bleeding in patients undergoing OPCAB .Pre-dicting risk of major bleeding can help sugeons to optimize perioperative management .

Rosuvastatin(RVS)is an excellent drug with anti-inflammatory and lipid-lowering properties in the aca-demic and medical fields.However,this drug faces a series of challenges when used to treat atherosclerosis caused by hyperhomocysteinemia(HHcy),including high oral dosage,poor targeting,and long-term toxic side effects.In this study,we applied nanotechnology to construct a biomimetic nano-delivery system,macrophage membrane(M?m)-coated RVS-loaded Prussian blue(PB)nanoparticles(MPR NPs),for improving the bioavailability and targeting capacity of RVS,specifically to the plaque lesions associated with HHcy-induced atherosclerosis.In vitro assays demonstrated that MPR NPs effectively inhibited the Toll-like receptor 4(TLR4)/hypoxia-inducible factor-1α(HIF-1α)/nucleotide-binding and oligomerization domain(NOD)-like receptor thermal protein domain associated protein 3(NLRP3)signaling pathways,reducing pyroptosis and inflammatory response in macrophages.Additionally,MPR NPs reversed the abnormal distribution of adenosine triphosphate(ATP)-binding cassette transporter A1(ABCA1)/ATP binding cassette transporter G1(ABCA1)/ATP binding cassette transporter G1(ABCG1)caused by HIF-1α,promoting cholesterol efflux and reducing lipid deposition.In vivo studies using apolipoprotein E knockout(ApoE-/-)mice confirmed the strong efficacy of MPR NPs in treating atherosclerosis with favorable bio-security,and the mechanism behind this efficacy is believed to involve the regulation of serum metabolism and the remodeling of gut microbes.These findings suggest that the synthesis of MPR NPs provides a promising nanosystem for the targeted therapy of HHcy-induced atherosclerosis.

Objective: To investigate the effect of tripartite motif containing 59(TRIM59) on the biological function of human colorectal cancer HCT116 cells and its possible mechanism. Methods: The recombinant TRIM59 interference plasmid(si-TRIM59) was constructed and transfected into colorectal cancer cell line HCT116 by liposome transfection. The transfection efficiency was verified by RT-qPCR and Western blot. The effects of TRIM59 gene silencing on the proliferation, colony-formation ability and cell cycle of colorectal cancer cells were detected by CCK-8 method, colony formation assays and flow cytometry respectively. Western blot was used to detect the expression level of CDK4 and cyclinD1. Results: The expression levels ofTRIM59mRNA and protein in colorectal cancer cells were significantly higher than those in normal colorectal mucosa cells(P<0. 05). After knockdown of TRIM59expression, the proliferation activity and colony forming ability of HCT116 cells were significantly inhibited(P<0. 05), and the cell cycle was arrested in G0/G1 phase. At the same time, the expression levels of CDK4and CyclinD1 significantly decreased(P<0. 05). Conclusion TRIM59was highly expressed in colorectal cancer cells. Down regulation ofTRIM59expression can inhibit the proliferation and clone formation of colorectal cancer cells, suggesting thatTRIM59may become a new target for gene therapy of colorectal cancer.