Acute basilar artery occlusion (ABAO) accounts for approximately 1% of all ischemic strokes, with high mortality and disability rates. Endovascular therapy is one of the effective treatment methods for ABAO, which can recanalize the occluded blood vessels, rescue ischemic penumbra, and improve the outcome of patients. This article reviews the current research status of endovascular treatment for patients with ABAO.

Patients with infections in the department of critical care medicine have complex sources and diverse sites of infection, which may be associated with multiple pathogenic bacteria and have a high rate of drug resistance, posing a significant challenge to clinical diagnosis and treatment. Infections in the department of critical care medicine can be divided into two types: hospital acquired infections and non-hospital acquired infections, with significant differences in clinical characteristics between the two. This article discusses the relevant concepts, risk factors, pathogenesis, and common characteristics of severe infections such as bloodstream infections, pulmonary infections, intra-abdominal infections, and intracranial infections, as well as diagnostic and treatment plans and prevention and control strategies from the perspectives of hospital acquired and non-hospital acquired infections, aiming to provide valuable guidance for the clinical management of critically ill patients.

Objective:To analyze the application value of non-invasive inflammation diagnosis model in the diagnosis of liver fibrosis in patients with non-alcoholic fatty liver disease (NAFLD) combined with hepatitis B virus (HBV) infection.Methods:A total of 98 patients with NAFLD complicated with HBV infection admitted to some coastal China Coast Guard Hospital of People′s Armed Police from June 2019 to October 2021 were selected. Their liver stiffness (LSM), aspartate aminotransferase to platelet ratio (APRI), γ-glutamyltranspeptidase to platelet ratio (GPR), and fibrosis index based on factor 4 (FIB-4) were measured, The receiver operating characteristic (ROC) curve was used to analyze its clinical diagnostic efficacy for liver fibrosis caused by NAFLD combined with HBV infection.Results:Among 98 patients, there were 7 cases in S0 stage, 47 cases in S1 stage, 21 cases in S2 stage, 14 cases in S3 stage, and 9 cases in S4 stage; Including 35 cases of obvious liver fibrosis and 9 cases of cirrhosis. There was no statistically significant difference in gender and body mass index (BMI) among patients in different stages (all P>0.05). Age: the S0 group

Objective To investigate the effect of intravenous ultrafine superparamagnetic iron oxide nanoparticles feraheme (generic name:ferumoxytol) on cerebral infarction volume and inflammatory response in mice with permanent middle cerebral artery occlusion.Methods Thirty C57BL/6J mice were divided into sham operation group,saline control group,and feraheme group by the random number table (n =10 in each group).A permanent right middle cerebral artery occlusion model was induced by the modified suture method in the saline control group and the feraheme group,and no suture was inserted into the mice of the sham operation group.The intervention was performed by tail vein injection at 24 h after modeling.The sham operation group and the feraheme group were injected with 18 mg/kg feraheme,and the saline control group was injected with the same volume of normal saline.The neurobehavioral scores were conducted at 24 h (before the feraheme or saline injection) and 48 h (before the MRI exam) after modeling.MRI scans were performed at 48 h after modeling,and the cerebral infarction volume was calculated according to T2-weighted imaging.After the end of the scan,orbital blood was collected for the detection of serum tumor necrosis factor (TNF)-α,interleukin (IL)-1 β,and IL-6 levels.Then,the mice were sacrificed and the brain tissue was taken for HE staining and Ibal immunohistochemical staining.Results There were no significant differences in the infarct volume and neurological function score between the saline control group and the feraheme group.The serum levels of TNF-α,IL-1β,and IL-6 in the saline control group and the feraheme group were significantly higher than those in the sham operation group (P ＜0.05),but there was no significant difference between the saline control group and the feraheme group.Conclusion Intravenous injection of 18 mg/kg feraheme at 24 h after cerebral ischemia did not affect the infarct volume and inflammatory response,suggesting that this dose of feraheme can be used for molecular imaging studies of inflammatory response after cerebral ischemia.

Objective To explore the effect of posterior debridement, grafting and internal fixation for treatment of non-specific lumbar intervertebral infection. Methods Clinical data of 20 patients with non-specific lumbar intervertebral infection treated in General Hospital of Ningxia Medical University from October 2013 to June 2013 were retrospectively analyzed. There were 15 males and 5 females with an average age of 41 years (range, 36-51 years). All patients suffered from single lumbar inter-vertebral infection, including 3 cases at L2/3,4 at L3/4,10 at L4/5 and 3 at L5/S1. All 20 cases underwent one-stage posterior debride-ment, autogenous bone grafting and internal fixation, tissue samples in focus were collected for bacterial culture and pathological examination. The disease controlling statues were evaluated based on laboratory results of ESR and CRP. Imaging examinations were taken to evaluate the fusion of vertebral body. Clinical effects were evaluated using the visual analog scale (VAS) and the Jap-anese Orthopaedic Association scores (JOA) score of lumbar fumction. Results All patients underwent the surgery successfully. The surgery duration time was 90-160 min, average 125 min, and the blood loss was 200-700 ml, average 360 ml. Cerebrospinal fluid leakage occurred in one case. Postoperatively, all patients experienced significant reliefof back pain, improving in the func-tion of movement, and no fever. The lower back VAS score: average (5.35 ± 1.15) points before operation , average (2.76 ± 0.34) points one week after operation, and an average score of (0.85±0.65) points by the last follow-up time. JOA lumbar function score:all patients were effective after operation, the improvement rate was excellent in 65%(13cases), good in 25%(5 cases), and pass-able in 10%(2cases). Comparing with preoperation, the excellent and good rate was 90%. All patients ESR and CRP returned to normal levels at the last follow-up. Ordinary bacterial culture was positive in 8 cases and negative in 12 cases. The pathogens iden-tified were staphylococcus aureus (6 cases), Escherichia coli (2 cases) and staphylococcus epidermidis (2cases). All incisions achieved primary healing. All patients were followed up from 6-18 months (average,12 months), and the symptom of pain relieved significantly. No recurrent infection had happened. A solid bony fusion was found in all patients at 6-14 months (average, 8.5 months) after the surgery. Conclusion Posterior debridement, grafting and internal fixation are effective treatments for non-spe-cific lumbar intervertebral infection, can reduce the time of staying in hospital, this operation is safe and reliable.

BACKGROUND:Positioning of the distal locking screws of a tibial intramedulary nail is often chalenging and time consuming. The traditional free-hand technique under fluoroscopic control involves considerable radiation exposure.OBJECTIVE: To evaluate the results of a new electromagnetic navigation system (TRIGEN-SURESHOT navigation system) for distal locking of tibial intramedullary nail in tibial diaphyseal fracture and to compare the effects with the free-hand method.METHODS: Forty-five cases of tibial diaphyseal fracture in the Second Hospital of Anhui Medical University from May 2014 to August 2015 were analyzed retrospectively, and were divided into two groups. Patients in navigation group (n=23) were treated with intramedullary nail using the TRIGEN-SURESHOT navigation system for distal locking, and the remainings in free-hand group (n=22) were given the free-hand method.RESULTS AND CONCLUSION: All cases were followed up for 17-32 months. The one-time success rate of distal locking nail operation was 100％ in the navigation group, which was significantly higher than that in the free-hand group (P < 0.05). The locking nail time in the navigation group was significantly less than that in the free-hand group (P < 0.05).No significant differences were found in the incidence of adverse events and fracture healing time between two groups (P > 0.05). To conclude, the effect of the TRIGEN-SURESHOT navigation system for distal locking of tibial intramedullary nail is satisfactory, exhibiting the advantages of short operation time, high success rate, and no radiation.

Objective To develop an ultra?high performance liquid chromatography mass spectrometer method for the rapid determination of 8?hydroxy?2'?deoxyguanosine (8?OHdG) in human urines. Methods 8?OHdG standard solution with the concentration from 0.01 to 0.1μg/ml was formulated. The solution was implanted into ion source with a rate of 7μl/min, the mass?to?charge ratio of parent ion and product ions, and ion mass to charge ratio was identified. The mass spectrum parameters of each Ion pairs, such as DP, EP and EXP, were gradually optimized. The urine sample with a concentration of 10.0μg/L was detected, and the pH of the sample was adjusted using 1 mol/L ammonium formate and formic acid solution with a volume ratio of 5∶1, 4∶1, 3∶1, 2∶1, and 1∶1. It was tested using three different polarity of SPE, i.e.:HLB, MCX, and MAX. The elution effect of methanol and water mixture with the proportion of 90∶10, 80∶20, 50:50, 20:80, and 10:90 were tested, and then acetonitrile and water mixture with the proportion of 90∶10, 80∶20, 50∶50, 20∶80, 10∶90 were also tested. The standard curve was constructed using the ratio of a standard series application fluid concentration to corresponding compounds quantitative ion liquid concentration of the peak area. The detection limit was determined as 3 times of the signal to noise ratio corresponding to the concentration of 8?OHdG, and the quantitative lower limit was determined as 10 times of the signal to noise ratio corresponding to the concentration of 8?OHdG. The blank urine spiked recovery method was used to evaluate the precision and recovery rate. Results The mass to charge ratio of parent ion was 284.1 and the product ions was 168.1, 140.1, 123.0, and 112.0, respectively. The collision voltage of quantitative ion?pair 284.1/168.1 was 18 V, the 284.1/140.1 collision voltage was 42 V, the 284.1/123.0 collision voltage was 48 V, and the 284.1/112.0 collision voltage was 53 V. The recovery rate was the highest (87.9%-104.3%) when the pH of urine was adjusted by a 10 ml 1 mol/L ammonium formate solution, 2 ml of formic acid, 88 ml of water are mixed with the sample solution volume ratio of 1∶5, and then purified with 3 ml of methanol and 3 ml water activated HLB extraction column. Within 1.0-100.0 μg/L concentration range, 8?OHdG standard application solution test results showed a good linear relationship. The regression equation was y=1.25x+0.74, and the correlation coefficient was r=0.999 5. The detection limit was 0.2μg/L, and the limit of quantification was 0.7μg/L. The method of recovery rate was in the range of 87.9%to 104.3%, the precision was in the range from 1.5% to 3.7% and inter?assay precision was in the range from 1.6% to 5.4%. Conclusion The method developed in this study had high sensitivity, good precision and accuracy, and a wide range of testing concentrations.

Objective To develop an ultra?high performance liquid chromatography mass spectrometer method for the rapid determination of 8?hydroxy?2'?deoxyguanosine (8?OHdG) in human urines. Methods 8?OHdG standard solution with the concentration from 0.01 to 0.1μg/ml was formulated. The solution was implanted into ion source with a rate of 7μl/min, the mass?to?charge ratio of parent ion and product ions, and ion mass to charge ratio was identified. The mass spectrum parameters of each Ion pairs, such as DP, EP and EXP, were gradually optimized. The urine sample with a concentration of 10.0μg/L was detected, and the pH of the sample was adjusted using 1 mol/L ammonium formate and formic acid solution with a volume ratio of 5∶1, 4∶1, 3∶1, 2∶1, and 1∶1. It was tested using three different polarity of SPE, i.e.:HLB, MCX, and MAX. The elution effect of methanol and water mixture with the proportion of 90∶10, 80∶20, 50:50, 20:80, and 10:90 were tested, and then acetonitrile and water mixture with the proportion of 90∶10, 80∶20, 50∶50, 20∶80, 10∶90 were also tested. The standard curve was constructed using the ratio of a standard series application fluid concentration to corresponding compounds quantitative ion liquid concentration of the peak area. The detection limit was determined as 3 times of the signal to noise ratio corresponding to the concentration of 8?OHdG, and the quantitative lower limit was determined as 10 times of the signal to noise ratio corresponding to the concentration of 8?OHdG. The blank urine spiked recovery method was used to evaluate the precision and recovery rate. Results The mass to charge ratio of parent ion was 284.1 and the product ions was 168.1, 140.1, 123.0, and 112.0, respectively. The collision voltage of quantitative ion?pair 284.1/168.1 was 18 V, the 284.1/140.1 collision voltage was 42 V, the 284.1/123.0 collision voltage was 48 V, and the 284.1/112.0 collision voltage was 53 V. The recovery rate was the highest (87.9%-104.3%) when the pH of urine was adjusted by a 10 ml 1 mol/L ammonium formate solution, 2 ml of formic acid, 88 ml of water are mixed with the sample solution volume ratio of 1∶5, and then purified with 3 ml of methanol and 3 ml water activated HLB extraction column. Within 1.0-100.0 μg/L concentration range, 8?OHdG standard application solution test results showed a good linear relationship. The regression equation was y=1.25x+0.74, and the correlation coefficient was r=0.999 5. The detection limit was 0.2μg/L, and the limit of quantification was 0.7μg/L. The method of recovery rate was in the range of 87.9%to 104.3%, the precision was in the range from 1.5% to 3.7% and inter?assay precision was in the range from 1.6% to 5.4%. Conclusion The method developed in this study had high sensitivity, good precision and accuracy, and a wide range of testing concentrations.

Objective To observe CT features of ovarian thecofibroma and the clinical significance.Methods CT manifestations, clinical data and pathological diagnosis of 12 cases of ovarian thecofibroma proved by pathology were retrospectively analysed.Results The CT manifestation of ovarian thecofibroma was typical,which was showed as following:on one side of the attachment area tumor,single,ovoid or class circular shape,most boundary clear,equal or slightly low density solid masses,internal or boundary ar-ea accompanied by a small amount low density area,mild delay enhancement in solid ingredients or no obvious enhancement.Conclu-sion CT examination is important for qualitative diagnosis of ovarian thecofibroma and finding complications.