Objective:To discuss the autoimmune response on the mechanism and clinical significance of nerve root injury induced by the non-compressive nucleus pulposus protrusion.Methods:Forty-eight female SD rats were randomly divided.Twenty-four female SD rats were recruited as model group,and the others as control.After ten days,twenty days and forty days,the pain threshold of left hind leg and the levels of TNF-α, CD4+, CD8+T cells were measured, the nerve root changes in morphology were observed by HE.Results:Compared with the control group,model group in ten days,twenty days,which left hind leg pain threshold,the proportion of CD4,CD8+T cell and the expression of TNF-αare significantly different.After forty days,these two groups have no statistical differ-ence.After ten days,lumbar nerve root cross-sectional myelin of model group was partial disintegrated.The worst damage happened in twenty days,and almost recovered to normal in forty days.Conclusion:T cell-mediated autoimmunity and TNF-αplay an important role to the nerve root injury in the early time of the non-compressive nucleus pulposus protrusion.

Objective To analyze the working stress related factors of nurses in intensive care unit (ICU), and put forward the corresponding counter measures.Methods During January to March 2016, a questionnaire survey was conducted with a commonly used nurses working pressure source scale on 110 ICU nurses in three People's Liberation Army (PLA) 3A grade hospitals in Beijing. The questionnaire survey involved 35 items within 5 main categories, including nursing professional issues, nursing workload and time allocation, working environment and resources, special care for critical patients and inter-personnel relationships between the head of nurses and other nurses. The correlations between the ICU nursing working stress and alternative factors were analyzed.Results Ninety-six nurses said the job was stressful, and 88.5% of them expressed that the degree of pressure was more than medium. The correlation analysis showed that ICU nurse working stress was correlated with 29 items in the survey scale (allP < 0.05), of which the top 6 items the mostly closely related were the frequent working shift (r = 0.58,P = 0.000), low nursing social status (r = 0.54,P = 0.000), less promotion opportunities (r = 0.54,P = 0.000), less opportunities to pursue further study (r = 0.53, P = 0.000), nurse low salary (r = 0.52,P = 0.000) and excessive workload (r= 0.50,P = 0.000).Conclusions ICU nurses face a lot of pressure in their work, the management departments should pay more attention to them, and actively energetically improve the nurse system construction, raise ICU nurses' pride, enhance the quality of nurse care and promote the healthy development of nursing profession.

Objective:To explore the application effect of magnetic resonance imaging (MRI) sequence experiment based on virtual simulation software in undergraduate teaching of medical imaging technology.Methods:Fifty-six undergraduate students from the Batch 2015 and Batch 2016 medical imaging technology of West China Clinical Medical College of Sichuan University were recruited in this study. They were divided into 2 groups: experimental group (Batch 2016) and control group (Batch 2015). The experimental group adopted the teaching method based on virtual simulation experiment, and the control group used the teaching method based on traditional small-sized magnetic resonance. The after-class test scores and final exam scores of the two groups of students were compared, and the questionnaire survey on teaching effectiveness was conducted for students in the experimental group SPSS 21.0 was used for ttest and Mann-Whitney Utest. Results:The scores of theoretical knowledge and the final grades in the experimental group were significantly higher than those of the control group [(84.55 ± 6.57) points vs. (79.37 ± 6.13) points; (90.03 ± 4.72) points vs. (80.06 ± 7.29) points, all P< 0.05). The effective recovery rate of the questionnaires was 100%, and the questionnaire survey showed that the experimental group was significantly superior to the control group in such four aspects as increasing subject interest, expanding relevant knowledge, solving clinical work, and promoting teamwork ( P< 0.05). Conclusion:In MRI sequence teaching, the teaching method based on virtual simulation software can increase the students' interests in learning, strengthen their understanding of MRI principles, then effectively improve the teaching effect of medical imaging undergraduate education.

Through comparative study on Naotaifang containing serum and plasma proteomics (peptide), this article revealed differential proteins (peptides) in the Naotaifang. The characteristics of differential proteins were identified with mass spectrometry. It provides scientific evidences for the pharmacodynamic material basis and Chinese herbal medicine plasma pharmacological method development in the exploration of Naotaifang. A total of 20 healthy adult SD rats were randomly divided into the control group, Naotaifang treatment group according to their weights. Ten rats in each group. Intragastric administration of medication was given for seven consecutive days. Before surgery, rats were fed with water but without food. One hour after the last drug administration, 10% chloral hydrate was injected for intraperitoneal anesthesia. Blood was taken through the common carotid artery. Serum and plasma samples were made after blood was taken from each rat. Serum and plasma samples of five rats were randomly selected from each group. And the two-dimensional electrophoresis (2-DE) technique was used in the comparative study of serum pro-teomics (peptide). The 300 DPI scanning and PDQuest 7.3.0 were used in the analysis. The ESI-MS/MS was used to identify important differences in proteins and screen characteristic serum and plasma protein. The results showed that 20 differential proteins of 5 plasma samples were identified. There were 15 types of proteins expressing up-regulation and 5 types expressing down-regulation. Comparative analysis on the 2-DE gel pictures of Naotaifang containing serum, 19 differential proteins of 5 plasma samples were identified, among which 15 types of proteins express up-regulation and 4 down-regulation. Comparative analysis on the 2-DE gel pictures of Naotaifang containing serum and Naotaifang containing plasma showed that 24 differential proteins of 5 plasma samples were identified, among which 9 types of proteins express up-regulation and 15 down-regulation. The highly expressed proteins were selected to MALDI-TOF-MS between Naotaifang containing serum and Naotaifang containing plasma. There were six successful-ly identified proteins, which were inter-alpha trypsin inhibitor, heavy chain 3, group-specific component, comple-ment factor B, Receptor Complexed with A Heterodimeric Fc, isoform CRA-d, Transferrin. It was concluded that protein with obvious changes in the Naotaifang containing serum and plasma may be related with fibrinolysis and an-ticoagulant. These proteins are involved in angiogenesis, inflammation and other pathological regulations of physiolog-ical processes. They are of great significance in the study of effective target and its signal transduction pathway of Naotaifang.

Aim To confirm the inhibitory effect of chronic intermittent hypobaric hypoxia ( CIHH) on my-ocardial apoptosis induced by metabolism syndrome ( MS) , and to investigate its mechanism. Methods A rat model of MS induced by fructose was used. The blood pressure and the plasma content of glucose, tri-glyceride, cholesterol, and insulin after 12 h fasting were detected. HE stain were used to detect the cardi-ac structure. The TUNEL staining and activity of caspase-3 were used to detect the apoptosis of myocar-dium. The protein expression of Bcl-2 and Bax was detected by Western blot . Results Compared with the control rats, the blood pressure and the plasma content of glucose, triglyceride, cholesterol, and insu-lin were all increased in rats with MS. In rats with MS, the impairment of cardiac structure and the increase of apoptosis were also observed. The protein expression of Bcl-2 was significantly down-regulated, and that of Bax was significantly up-regulated in MS rats. The ratio of Bcl-2/Bax was also significantly decreased. Interest-ingly, CIHH could ameliorate all of the above issues. There was no significant difference between control group and CIHH group. Conclusion CIHH may im-prove the increased apoptosis in rats with MS via inhib-iting the mitochondrial pathway of apoptosis. This stud-y might provide new targets for therapy and the preven-tion of MS patients.

Objective: To explore the relationship between Adverse childhood experiences(ACEs) and depression in early adolescence, and to provide scientific basis for effectively coping with the impact of ACEs on adolescents’ mental health. Methods: Stratified cluster sampling method was used to select adolescents in grade 6-8 in three middle schools of Shanghai during November and December of 2017. Adolescents were investigated anonymously using computer assisted self-interview approach via the tablets. Information including demographic characteristics, ACEs, and depression was collected. The chi-square test and multivariate logistic regression were used to explore the relationship between ACEs and depression, after controlling potential confounders. Results: Totally 1 629 eligible records were obtained. 65.25% of the respondents had experienced of neglect, followed by those abused(61.26%), and the incidence of family dysfunction was relatively low(20.81%). About 79.01% of the respondents had experienced at least one ACE, and more than half(61.45%) of the respondents had experienced at least two ACEs, and 10.01% of the respondents had experienced five or more ACEs. Multivariate logistic regression analysis showed that abuse and neglect experienced by male and female adolescents was associated with depression severity, with the OR values ranging from 2.62 to 3.60. Family dysfunction was found to be associated with depression only in male adolescents, with the OR of 1.91. The cumulative effect of ACE score on depression was observed. Conclusion Different types of ACEs in early adolescents are associated with depression, and ACEs have cumulative effects on depression severity.

Objective:To explore the application effect of case-based learning combined with problem-based learning teaching model in refresher training of medical imaging technologists.Methods:The study recruited 46 imaging technologists trained in radiology department in the Batch 2017 and Batch 2018 of West China Hospital of Sichuan University. They were divided into 2 groups: experimental group (23 persons) and control group (23 persons). Case-based learning combined with problem-based learning teaching method was used in the experimental group, and traditional lecture-based learning method was used in the control group. 2 test was used for sex distribution comparisons between the two groups, and independent t test was conducted to compare the differences in age, working years, entrance examination results, attitude rating scores, stage examination scores, completion examination scores, and operational examination scores between the two groups. Mann-Whitney U test was used for comparisons of non-parametric variables between the two groups, such as qualifications, occupation title, and questionnaire results.Results:Theoretical examination results at the second stage, the third stage, completion and operational examination results in the experimental group were higher than those in the control group [(91.17±2.59) vs. (85.26±3.03), (92.00±1.86) vs. (87.43±3.23), (92.39±2.08) vs. (87.04±2.93), (85.70±5.48) vs. (80.87±5.57), P<0.05]. The questionnaire survey showed that the stimulation of subject interest, the cultivation of exploration spirit, the exercise of self-learning ability, the establishment of clinical ideas, the analysis of difficult problems, the mastering of practical operations, and the affirmation of self-worth in the experimental group were better than those in the control group, with significant difference [4(3, 4) scores vs. 3(2, 3) scores, 4(3, 4) scores vs. 2(2, 3) scores, 3(3, 4) scores vs. 2(2, 3) scores, 3(3, 4) scores vs. 3(2, 3) scores, 3(3, 4) scores vs. 2(2, 3) scores, 4(3, 4) scores vs. 3(2, 3) scores, 4(3, 4) scores vs. 3(2, 3) scores, P<0.05], while the consolidation of theoretical knowledge of the experimental group was not different from the control group [3(2, 3) scores vs. 3(2, 3) scores, P>0.05]. Conclusions:The reasonable application of case-based learning combined with problem-based learning teaching model in refresher training of medical imaging technologists is helpful to improve their learning enthusiasm, self-learning ability, clinical analysis ability, practical operation ability, and long-term consolidation of theoretical knowledge, and it also can contribute to affirmation of self-worth.

Objective:To explore the application effect of case-based learning (CBL) combined with problem-based learning (PBL) teaching model in refresher training of medical imaging technologists.Methods:The study recruited 46 imaging technologists trained in radiology department in the Batch 2017 and Batch 2018 of West China Hospital of Sichuan University. They were divided into 2 groups: experimental group (23 persons) and control group (23 persons). CBL combined with PBL teaching method was used in the experimental group, and traditional lecture-based learning (LBL) method was used in the control group. The results of attitude evaluation, staged exminations, graduation assessment and operational skill tests were compared between the two groups, and the questionnaire survey was performed to test the affirmation of self-worth of the two groups of interns. SPSS 17.0 was used for chi-square test, independent t test, and Mann-Whitney U test. Results:Theoretical examination results at the second stage, the third stage, completion and operational examination results in the experimental group were significantly higher than those in the control group [(91.17±2.59) vs. (85.26±3.03), (92.00±1.86) vs. (87.43±3.23), (92.39±2.08) vs. (87.04±2.93), (85.70±5.48) vs. (80.87±5.57), P<0.05]. The questionnaire survey showed that such 7 aspects as the stimulation of subject interest, the cultivation of exploration spirit, the exercise of self-learning ability, the establishment of clinical ideas, the analysis of difficult problems, the mastering of practical operations, and the affirmation of self-worth in the experimental group were better than those in the control group, with significant difference ( P<0.05), while the consolidation of theoretical knowledge of the experimental group was not statistically different from the control group ( P>0.05). Conclusion:The reasonable application of CBL combined with PBL teaching model in refresher training of medical imaging technologists is helpful to improve their learning enthusiasm, self-learning ability, clinical analysis ability, practical operation ability, and long-term consolidation of theoretical knowledge.

Objective:To further understand the etiological distribution of fever of unknown origin (FUO) in patients underwent 18F-fluorodeoxyglucose (FDG) PET/CT imaging, and to explore the significance of 18F-FDG PET/CT in the diagnosis of different types of diseases in FUO patients. Methods:From January 2013 to August 2019, the clinical and PET/CT image data of 466 FUO patients (194 males, 272 females, age: 3-91(52.7±20.9) years) in Peking University People′s Hospital were retrospectively analyzed. The etiological distribution of FUO patients was analyzed according to the final clinical diagnosis. PET/CT imaging manifestations were analyzed for different types of diseases in FUO patients. The role of 18F-FDG PET/CT in differential diagnosis for FUO was evaluated through clinical questionnaire. Data were analyzed by using χ2 test. Results:The common disease types in FUO patients were rheumatic and immune disease (48.7%, 227/466), infection (28.5%, 133/466) and malignant tumor (11.2%, 52/466). For PET/CT imaging, 95.5% (445/466) of the patients were positive, of which 313 (70.3%, 313/445) were found to have focal lesions, and the other 132 (29.7%, 132/445) showed only nonspecific abnormal uptake. Lesions in different types of diseases were varied in the location, morphological changes as well as FDG uptake. The results of the questionnaire showed that PET/CT imaging could benefit 95.9% (447/466) of the patients in the FUO diagnosis and treatment. PET/CT reached direct etiological diagnosis of malignant tumors more frequently than other types of diseases ( χ2 values: 14.408-25.466, all P<0.001). PET/CT helped or directly reached the etiological diagnosis of rheumatologic diseases more frequently than infection and unknown cause group( χ2 values: 7.922, 9.647, both P<0.05). Conclusion:18F-FDG PET/CT imaging has high clinical value in the diagnosis of FUO etiology and can provide multilevel diagnostic information.

OBJECTIVE: To analyze the clinical phenotype and pathogenic variant in a child diagnosed with mental retardation and microcephaly with pontine and cerebellar hypoplasia (MICPCH). METHODS: Clinical phenotype of the child was reviewed. Whole exome sequencing was carried out for the child. Candidate variant was verified by Sanger sequencing of the family member. RESULTS: The proband manifested dyskinesia, development delay, cerebellar hypoplasia and bilateral hearing impairment. WES results revealed that the proband has carried a pathogenic c.1641_1644delACAA (p.Thr548Trpfs*69) variant of the CASK gene, which was verified by Sanger sequencing to be a de novo variant. CONCLUSION The c.1641_1644delACAA (p.Thr548Trpfs*69) variant of the CASK gene probably underlay the MICPCH in the proband. Above finding has provided a basis for genetic counseling. WES should be considered for the diagnosis of neurological dysplasia.
Cerebellum/abnormalities* ; Child ; Developmental Disabilities ; Family ; Humans ; Mental Retardation, X-Linked ; Microcephaly/genetics* ; Nervous System Malformations