Objective To investigate the diagnosis and the effect of microsurgery in patients with acute spontaneous spinal epidural hematoma (ASSEH). Method Five patients with ASSEH treated with microsurgery and confirmed pathologically were retrospectively analyzed. Results The main clinical presentations were root pain and palsy. The main manifestations of MRI were long-segment epidural lesion of high intensity in T1 and T2-weighted images without enhancement. With the microsurgery system, laminectomy via posterior approach and hematoma removal were successfully undergone with full recovery in all cases. Conclusions MRI assisted with the main clinical symptoms may aid preoperative diagnosis in symptomatic ASSEH. Microsurgery is an effective method for treating ASSEH. Postoperative (rather than preoperative) spinal DSA is advantageous for exclusion of spinal vascular malformation in treating ASSEH.

Objective To comprae the difference of Sex hormone,serum and follicular fluid anti Mullerian hormone (AMH) level tube,number of retrieved egg,the number of cleavage rate,fertilization oocytes,the number of available embryos and total embryo on in vitro fertilization and embryo transfer (IVF-ET) of different reaction groups,to explore the relationship between AMH and pregnancy outcome of IVF-EH.Methods Eighty-one cases of IVF-ET assisted pregnancy were divided into low ovarian response group,normal ovarian response group and high ovarian response group according to the response of the super ovulation.Serum sex hormone and AMH of all patients were detected on the third day of menstruation,on the day of HCG injection,oocyte pick-up (OPU) and embryo transfer (ET),AMH in FF were detected too.The difference of oocytes,cleavage rate,embryo quality and the indicators mentioned above among the three groups were compared.All of the above indicators were compared between pregnancy group and unpregnancy group.Results (1) The level of AMH on the third day of menstruation ((1.76 ± 0.47) μg/L,(3.45 ± 1.01) μg/L,(6.34 ± 1.29) μg/L,F =2.435,P＜0.001),HCG injection ((1.09±0.13)μg/L,(1.29±0.29)μg/L,(2.64±0.51)μg/L,F=1.542,P=0.001) and embryo planting((1.32±0.33) μg/L,(1.62±0.39) μg/L,(1o 91±0.41) μg/L,F =1.573,P ＜0.001) all were statistically significant in three groups.On day of OPU,the levels of serum AMH ((0.95±0.21)μg/L,(1.15±0.29) μg/L,(1.74±0.41) μg/L,F =12.573,P＜0.001) and AMH in FF((5.82±1.19) μg/L,(6.92±1.05) μg/L,(7.79±1.39) μg/L,F =9.83,P＜0.001) were statistically differences in the three groups.(2)The number of oocytes were positively correlated with AFC,based AMH,levels of E2,P and AMH on the day of HCG injection and OPU,E2 and AMH on the day of ET and AMH in FF(P＜0.05).(3)AMH in FF in pregnancy group was (6.22±0.82)μ g/L,significantly higher than those without pregnancy group ((5.31 ±0.71)μg/L,P =0.037).Conclusions Levels of AMH in serum and follicular fluid are good predictors of ovarian response in IVF-ET.The level of serum AMH can only predict ovarian response,but can not effectively predict pregnancy outcome.The level of AMH in FF is a good predictor of pregnancy outcome.

Objective To study the difference in post-resuscitation lung injury between cardiac arrest induced by anoxia and ventricular fibrillation in porcine model.Methods WuZhiShan inbred miniature pigs were randomly (random number) divided into the asphyxia (AS,n =24) and ventricular fibrillation group (VF,n =24).Cardiac arrest (CA) was induced by endotracheal tube clamping or programmed electric stimulation.Cardiopulmonary resuscitation (CPR) or defibrillation was performed for returning of spontaneous circulation (ROSC).Pulmonary perfusion/ventilation measured with isotope scanand positron emission tomography-computed tomography (PET-CT) scanning were done before and 4hrs after ROSC.The oxygenation index (OI),respiratory index (RI),oxygen delivery (DO2),blood lactic acid,and dynamic pulmonary compliance (Cdyn),airway resistance (Raw),extra-vascular lung water index (EVLWI),pulmonary vascular permeability index (PVPI),were measured before cardiac arrest,ROSC 0 h,ROSC15 min,ROSC 30 min,ROSC 1 h,ROSC 2 h,ROSC 4 h and ROSC 6 h.All pigs were sacrificed with euthanasia at ROSC 6 h and the lungs were dissected for observing histopathological changes.The level of Na +-K +-ATPase,Ca2+-ATPase,superoxide dismutase (SOD),Methane Dicarboxylic Aldehyde (MDA),Bcl-2,Bax,Caspase3 and apoptosis index (AI％) in lung were measured.Results The ROSC rate and ROSC 6hrs survival rate of in AS group was lower (P ＜0.01) than those of the VF group.The damages of lung in AS group were more severe than that in VF group by the results of enzymology and protein detection (Na +-K +-ATPase,Ca2 +-ATPase,SOD,MDA,Bax,Bcl-2 and Caspase3).AI％ was higher in AS group (P＜0.01).The deterioration of the indexes (OI,RI,DO2,Lac,Cdyn,Raw,EVLWI,PVPI) at all time points were more severe in AS group than those in VF group.Obvious filling-defect was found by the PET-CT scan of both groups,but not revealed by the isotope scan.Conclusions The lung injury after CA was closely related to the cause of CA rather than the external chest compression.Asphyxia induced more serious lung injury than ventricular fibrillation.

Objective:To observe any effect of combining low-frequency transcranial magnetic stimulation (rTMS) with interactive virtual scenario training on the recovery of upper limb motor function after a stroke.Methods:Ninety stroke survivors were randomly divided into a pseudo-rTMS group, an rTMS group and a combination group, each of 30. In addition to basic medication, conventional rehabilitation and nursing care, the pseudo-rTMS, rTMS and combination groups received either sham rTMS treatment, 1Hz rTMS or virtual situational interaction along with 1Hz rTMS 5 days a week for 4 weeks. Before and after the 4 weeks their motor evoked potentials, cortical latency and central motor conduction time were measured, and surface electromyography was applied to the affected biceps brachii and triceps brachii. Meanwhile, the National Institutes of Health Stroke Scale, the Fugl-Meyer upper extremity assessment and the modified Barthel index were employed to assess the degree of neurological deficit, upper extremity motor function and ability in the activities of daily living (ADL).Results:After the 4-week intervention, a significant improvement was observed in all of the outcome measurements with all three groups. At that time the average scores of the rTMS group were significantly better than the pseudo-rTMS group′s averages but the average scores of the combination group were significantly better than those of either of the other two groups.Conclusion:Repeated application of low-frequency transcranial magnetic stimulation combined with virtual scenario interactive training can effectively improve the upper limb motor function and ADL performance of stroke survivors, and relieve the symptoms of neurological deficit. The combined therapy is worthy of application in clinical practice.

Tumor-associated macrophages(TAMs), abundantly infiltrated in the tumor microenvironment, have a significant influence on tumor metastasis, angiogenesis and immune escape. Therefore, TAMs-targeted immunotherapy has become a hot point in the field of cancer treatment. However, most of the conventional TAMs-targeted agents may cause serious adverse effects, such as short retention time, poor drug enrichment and drug-resistance. In order to overcome these shortcomings, nanobiotechnology has attracted considerable attention. More recently, a series of important progress for nanomedicine has been achieved in the area of drug delivery and diagnostic imaging, because of their special physical and chemical properties. Hence, the TAMs-targeted nanomedicine delivery system provides new ideas for tumor immunotherapy. This paper reviews the role of TAMs in tumor microenvironment, the tumor-promoting mechanism, and introduces the research progress of nanomedicine in TAMs polarization, nanodrug delivery, TAMs-targeted imaging and preventing the TAMs recruitment, so as to provide reference for the application of nanotechnology in tumor immunotherapy.

Objective:To investigate the impact of China's Mental Health Law on the work of psychological counseling in colleges and universities, and to explore ways to improve the law. Methods: Totally 12 heads of college and university counseling centers in Beijing were conducted with semi-structured interviews. The average age of the interviewees was (40 ±7) years old, with master or doctor degrees in psychology or related disciplines. The method of content analysis was used to analyze the interviewees' understanding of the " Mental Health Law". Results: All of the 12 interviewees had gained some understanding of the "Mental Health Law", and accordingly amended the regulation of their counseling centers. Also, interviewees suggested the positive and negative impacts brought by the law, such as enhancing practitioners' legislative sense, clarifying their responsibilities and boundaries as college and university counseling, as well as difficulties to distinguish psychotherapy and psychological counseling, ambiguity in the legality of working with students who were diagnosed with mental disorders. Moreover, interviewees threw out suggestions on improving the law from the aspect of industry standard, supervision department and vocational qualification. Conclusion: The execution of "Mental Health Law" improves practitioners' legislative sense, clarifies their responsibility. Nevertheless, it does not clearly distinguish psychotherapy from psychological counseling, and be lack of regulation on the psychological counseling industry.

Objective To characterize myocardial metabolism using positron emission tomography (PET) in porcine models of ventricular fibrillation cardiac arrest (VFCA) and asphyxiation cardiac arrest (ACA) after resuscitation.Methods Thirty-two healthy miniature pigs were randomized into two groups.The pigs of VFCA group (n =16) were subject to programmed electric stimulation to create a ventricular fibrillation cardiac arrest,and the pigs of ACA group (n =16) were subjected to endotracheal tube clamping to establish a cardiac arrest (CA).Once modeling was established,pigs with CA were left untreated for a period of 8 min.Two minutes following initiation of cardiopulmonary resuscitation (CPR),defibrillation was attempted until the restoration of spontaneous circulation (ROSC) was achieved or animals died.To assess myocardial metabolism,PET was performed before modeling,4 hrs and 24hrs after ROSC.To analyze 18F-FDG myocardial uptake in PET,the maximum standardized uptake value (SUVmax)) was measured.Results ROSC was obtained in 100％ of pigs in VFCA group and only 50％ in ACA group.The average survival time in VFCA pigs was significantly longer than that in ACA pigs (22.63 ± 0.95) hvs.(8.75 ± 2.54) h,P ＜0.01.VFCA pigs had better mean arterial pressure and cardiac output after ROSC than ACA pigs.Myocardial metabolism imaging using PET demonstrated that myocardial metabolism injuries after ACA were more severe and widespread than those after VFCA at 4 hrs and 24hrs after ROSC and SUVmax) was much higher in VFCA group than that in ACA group [4 h after ROSC:(1.9 ± 0.3) vs.(1.0 ± 0.4),P ＜ 0.01;24 hafterROSC:(2.4±0.6) vs.(1.2±0.5),P＜0.01].Conclusions Compared with VFCA,ACA causes more severe cardiac metabolism dysfunction associated with less successful resuscitation and shorter survival time;therefore they should be treated as different pathological entities.

Purpose/Significance To study and develop an intervention plan for the utilization barriers of health information services for empty nest elderly,in order to provide a basis for improving their knowledge,attitude,and action abilities in health information serv-ices.Method/Process Selecting residents of Yan'an community in Bengbu as research subjects,who are randomly divided into a control group and an intervention group.The intervention group use a pre-constructed intervention plan.After the intervention study,the con-trol group is provided with the same health education content as the intervention group.Result/Conclusion The intervention programs can improve the knowledge level and behavioral ability of empty nest elderly in utilizing information services.

Purpose/Significance To understand the influencing factors of health information literacy of elderly discharged patients receiving continuous nursing services,and to provide theoretical basis for related health education and health promotion.Method/Process The selective quota sampling method is used to conduct a questionnaire survey on elderly discharged patients aged 60 and above receiving continuous nursing services in Bengbu city,and a structural equation model is constructed to analyze the effect pathway of influencing fac-tors.Result/Conclusion The level of health information literacy of the discharged elderly patients receiving continuous nursing services is average.Healthy lifestyle has direct influence on health information literacy of them,and social support and psychological status have in-direct influence on them through self-efficacy and healthy lifestyle.It is suggested that family members and medical staffs should pay positive attention to patients,help patients maintain a good psychological state,promote the recovery of diseases,and improve the level of health information literacy.

Objective:To explore the effect of remote blood glucose management led by specialist nurses on blood glucose, self-management ability and quality of life of type 2 diabetic patients during home rehabilitation.Methods:From January to December 2019, convenience sampling was used to select 218 patients with type 2 diabetes in the First Affiliated Hospital of Xinjiang Medical University. According to the random number table method, the patients were divided into the observation group and the control group, each with 109 cases. The control group conducted conventional blood glucose management, and the observation group implemented remote blood glucose management led by specialist nurses for a total of three months of observation. Both were observed for 3 months. The self-management behavior and quality of life of the two groups of patients before and after the intervention were evaluated with the Diabetes Self-Management Behavior Scale (SDSCA) and the Diabetes Quality of Life Specific Scale (DSQL), and the blood glucose indicators of the two groups before and after the intervention were compared.Results:All 218 cases cooperated to complete all the research contents, and there was no dropout case. After the intervention, the fasting blood glucose, two hours postprandial blood glucose, glycosylated hemoglobin and DSQL score of the observation group were lower than those of the control group, and the SDSCA score was higher than that of the control group. The differences were all statistically significant ( P<0.05) . Conclusions:Compared with conventional blood glucose management, the remote blood glucose management led by specialist nurses can more effectively control the blood glucose of patients with type 2 diabetes, improve the patients' self-management ability and quality of life, and overall increase the management efficiency of patients during home rehabilitation.