Objective To explore the cause and the interventional treatment of restenosis after percutaneous transhepatic biliary stent.Methods 20 patients with biliary restenosis after percutaneous transhepatic biliary stent placement were collected.According to drainage volume from biliary tract and degree of amelioration of jaundice,post-operation hepatic function,blood,urine and stool routines,ultrasound,CT scan and cholangiography were performed to determine the nature and location of biliary restenosis,and then all cases underwent recanalization with intervention method by the exteriorized drainage tube approach.The China-made nickel-titanium alloy stents with diameter of 10 mm and length ranged from 40 mm to 80 mm were used.Results The biliary restenosis occurred in mid-inferior segment of common bile duct in 9 patients, common hepatic duct in 7 patients and hepatic porta in 4 patients. As regarding the causes of restenosis included tumor compression in 9 cases, angulation in upper segment of stent in 3 cases, obstruction in stent by bile, food or clot in 4 cases, cholangitic stenosis in 2 cases and granulation proliferation in 2 cases.The obstruction in all cases was relived by extraction through drainage tube, drug irrigation,dredging by wire, balloon dialtion or stent replacement, so that the total survival rate was beyond 6 months.Conclusion After percutaneous transhepatic biliary stent placement in treating the malignant biliary obstruction,the rate of biliary restenosis is still high,which should be attached importance to.

Objective:To investigate the clinical value of modified acute aortic dissection risk score in the early diagnosis of acute aortic dissection (AAD).Methods:The general, clinical, and imaging data of 162 patients who complained of chest and back pain who received treatment between January 2019 and January 2021 in the Department of Emergency, The Second Hospital of Jiaxing, China were collected for this study. The included patients were divided into control (non-AAD, n = 120) and observation (AAD, n = 42) groups according to whether they were diagnosed with AAD. The indexes with statistical significance between the two groups were analyzed using multivariate logistic regression analysis. A score table was established according to the size of OR value. The modified AAD risk score was predicted using the receiver operating curve. Results:Multivariate logistic regression analysis showed that male sex, family history, sudden severe chest and back pain, bilateral blood pressure asymmetry, hypertension, abnormal ultrasound, and D-dimer level were independent risk factors for the diagnosis of AAD (statistical values = 7.84, 6.96, 7.04, 11.38, 7.12, 8.15, 15.07, 9.11, all P < 0.05). Taking the total score of 5 as the prediction standard, the specificity and sensitivity in the prediction of the occurrence of AAD were 84.94% and 95.43%, respectively. The area under the receiver operating curve regarding the modified AAD risk score was 0.909. Conclusion:The modified AAD risk score can be used to conveniently and quickly predict the occurrence of AAD and has a high predictive value. This study is highly innovative and scientific.

Objective This study aims to discuss the research hotspot and development trend in the field of polycystic ovary syndrome(PCOS)through bibliometric statistics and visual analysis of long noncoding RNA(lncRNA)related studies.Methods Utilizing the Web of Science core database as the literature data source,we searched for PCOS lncRNA-related literature from 2015 to 2023.CiteSpace software was used to conduct a visual analysis,including the annual distribution,citation trends,countries,institutions,funding sources and key words,as well as co-occurrence and cluster analysis of key words.Results The visual analysis of 108 PCOS lncRNA literature revealed that China was the country with the highest number of publications.The first contributing institution was the Shandong University.The national natural science fund of China gave the biggest funding.The keyword cluster analysis suggested that PCOS lncRNA signal pathway regulation,related receptor activators,and the expression of regulatory factors were the research hotspots in ovary syndrome lncRNA research.Conclusion LncRNA related regulatory factors,bioinformatics analysis,and gene transcription in PCOS are new targetsfor PCOS treatment,providing valuable insights for clinical therapy and new strategies for the development of PCOS-related pharmaceuticals.

Objective:To explore the effect of nursing management model based on the man, machine, material, method, measurement and environment (5M1E) analysis on nosocomial infection of multidrug-resistant organism (MDRO) in Intensive Care Unit (ICU) .Methods:From January 2019 to December 2020, convenience sampling was used to select ICU patients in the Second Hospital of Shanxi Medical University as the research objects. Patients admitted to the hospital from January to December 2019 were taken as the control group ( n=1 224) to implement routine nursing management. Patients admitted to the hospital from January to December 2020 were taken as the observation group ( n=1 134) , and the nursing management model based on 5M1E analysis was implemented. The differences in the use rate of antibacterial drugs, the intensity of antibacterial drug use, the separation amount of newly MDRO per thousand hospitalization days, the length of ICU stay, the total length of stay, and the cost of treatment were compared between the two groups. Results:The use rate of antibacterial drugs, the intensity of antibacterial drug use, and the separation amount of newly MDRO per thousand hospitalization days in the observation group were lower than those in the control group, and the differences were statistically significant ( P<0.01) . The length of ICU stay, total length of stay, and treatment costs of the observation group were less than those of the control group, and the differences were statistically significant ( P<0.01) . Conclusions:The nursing management model based on the 5M1E analysis can reduce the use rate of antibacterial drugs in ICU patients, the intensity of antibacterial drug use, the separation amount of newly MDRO per thousand hospitalization days, shorten the length of ICU stay, total length of stay, and reduce treatment costs, which is worthy of clinical promotion.

Objective To investigate the feasibility and effectiveness of focused ultrasound on the acne of rabbit ear.Methods Eighteen male rabbits were randomly divided into blank control group,model control group and ultrasound irradiation group.Acne rabbit ear model was established by Kligman's method in model control group and ultrasound irradiation group.Then,continuous ultrasonic irradiation was given in ultrasound irradiation group.Pathological changes were observed at the time of before and after ultrasound irradiation and 14 days after ultrasound irradiation.Results After modeling,hair follicle expansion,hyperkeratosis,acupoint hypertrophy were observed in blank control group.Compared with blank control group,the thickness of horn layer,the sebaceous gland diameter and other index in model controlgroup were statistically significant (P＜0.01);After irradiation,there were hyperemia and edema in epidermis,angiotelectasis and inflammatory infiltrating,but coagulative necrosis in slice was not observed,14 days later,hair follicle mild expansion,mild keratosis,spiny thinning were observed in ultrasound irradiation group,when compared with model control group,the thickness of horn layer,sebaceous gland diameter and other index were decreased in ultrasound irradiation group,and the differences were statistically significant(P＜0.01).Conclusion The ultrasonic focusing treatment on rabbit ear acne is feasible and effective.

With the recent ongoing autumn/winter 2022 COVID-19 wave and the adjustment of public health control measures, there have been widespread SARS-CoV-2 infections in Chinese mainland. Here we have analyzed 369 viral genomes from recently diagnosed COVID-19 patients in Shanghai, identifying a large number of sublineages of the SARS-CoV-2 Omicron family. Phylogenetic analysis, coupled with contact history tracing, revealed simultaneous community transmission of two Omicron sublineages dominating the infections in some areas of China (BA.5.2 mainly in Guangzhou and Shanghai, and BF.7 mainly in Beijing) and two highly infectious sublineages recently imported from abroad (XBB and BQ.1). Publicly available data from August 31 to November 29, 2022 indicated an overall severe/critical case rate of 0.035% nationwide, while analysis of 5706 symptomatic patients treated at the Shanghai Public Health Center between September 1 and December 26, 2022 showed that 20 cases (0.35%) without comorbidities progressed into severe/critical conditions and 153 cases (2.68%) with COVID-19-exacerbated comorbidities progressed into severe/critical conditions. These observations shall alert healthcare providers to place more resources for the treatment of severe/critical cases. Furthermore, mathematical modeling predicts this autumn/winter wave might pass through major cities in China by the end of the year, whereas some middle and western provinces and rural areas would be hit by the upcoming infection wave in mid-to-late January 2023, and the duration and magnitude of upcoming outbreak could be dramatically enhanced by the extensive travels during the Spring Festival (January 21, 2023). Altogether, these preliminary data highlight the needs to allocate resources to early diagnosis and effective treatment of severe cases and the protection of vulnerable population, especially in the rural areas, to ensure the country's smooth exit from the ongoing pandemic and accelerate socio-economic recovery.