Objective To investigate the relationships between the plasma fibrinogen level before treatment and prognosis and tumor metastasis in patients with nasopharyngeal carcinoma.Methods The clinical data of 817 patients with non-distant metastasis nasopharyngeal carcinoma from January 2005 to October 2014 in our hospital were collected.All the patients were followed up,and the median follow-up time was 37.6 months.The critical value of plasma fibrinogen before treatment was determined by receiver operating characteristic (ROC) curve.The overall survival (OS) and distant metastasis free survival (DMFS) and their relevant factors were analyzed by Kaplan-Meier and Cox regression model.Results The critical value of plasma fibrinogen before treatment was 3.314 g/L determined by ROC curve analysis.The plasma fibrinogen level before treatment was related to the TNM stage (x2 =6.048,P =0.014),T stage (x2 =13.764,P ＜0.001) and distant metastasis after treatment (x2 =14.637,P ＜0.001).Survival analysis showed that the 3-year OS rate and 3-year DMFS rate in patients with plasma fibrinogen level ≥3.314 g/L before treatment were significantly lower than those in patients with plasma fibrinogen level ＜ 3.314 g/L,with significant differences (87.2％ vs.95.6％,x2 =4.562,P＜0.001;71.1％ vs.82.2％,x2 =5.153,P ＜0.001).Cox multivariate analysis showed that high level of plasma fibrinogen before treatment (HR =1.961,95％ CI:1.332-2.917,P =0.001),EB virus DNA (HR =1.929,95％ CI:1.275-2.849,P =0.001) and pretreatment stage (HR =1.653,95％ CI:1.013-2.709,P =0.045) were the independent influencing factors of OS.The high level of plasma fibrinogen before treatment (HR =1.519,95％ CI:1.142-1.964,P =0.002) and EB virus DNA (HR =1.950,95％ CI:1.483-2.555,P ＜ 0.001) were the independent influencing factors of DMFS.Of the 817 patients,179 patients (21.91％) had metastasis during the follow-up period,and 159 patients (88.83％) had metastasis within 3 years after treatment.The plasma fibrinogen level before treatment in 638 patients with-out metastasis (3.197 ± 1.009) was significantly lower than that in 179 patients with metastasis (3.351 ± 1.042;t =5.089,P =0.024),and was significantly lower than that in 87 patients with bone metastasis (3.430 ± 1.004;t =6.752,P =0.009),68 patients with pulmonary metastasis (3.301 ± 1.018;t =4.281,P=0.039) and71 patients with liver metastasis (3.413±1.107;t=6.398,P=0.011).Conclusion The plasma fibrinogen level before treatment can be used as an independent index to predict the prognosis of patients with nasopharyngeal carcinoma,which is related to tumor metastasis.

Clinically,tandem carotid artery stenosis(TCAS)is a relatively rare atherosclerotic disease,and with the development of interventional techniques,its treatment has become more and more minimally invasive,and the technical feasibility of hybrid surgery(HS)has been already confirmed for long time.In recent years,with the increasing of the number of patients and the deepening of research both at home and abroad,it has been found that the safety and effectiveness of HS for TCAS are still questionable,and it is particularly important to choose the appropriate treatment for such patients.This article aims to make a comprehensive review about the HS for TCAS,focusing on its surgical process,comparison of its surgical methods,and the current controversies over the treatment of TCAS,with the hope that clinicians can get a more comprehensive understanding about this surgical method.(J Intervent Radiol,2024,32:95-99)

Objective To investigate the characteristics of sleep structures in patients with multiple dreams through the retrospective analysis of polysomnography in patients with multiple dreams,and to provide a theoretical basis for the treatment of multiple dreams.Methods Twenty-two cases with multiple dreams in Department of Neurology,the People's Hospital of Zhengzhou University from July 2015 to Ferbuary 2018 were included in multi-dream group and 12 healthy people in control group.The sleep parameters related to polysomnography during the visit were collected and recorded,and the differences between the two groups were compared.Resluts There was no statistically significant difference in apneahypopnea index,sleep latency,rapid eye movement (REM) sleep latency,slow-wave sleep ratio,and REM-arousal index between the two groups.Compared with the control group,sleep efficiency (73.46％ ± 12.41％ vs 90.43％ ± 4.42％,t=-4.555,P=0.000),REM period ratio (16.28％ ± 5.59％ vs 21.59％ ± 2.70％,t =-3.727,P =0.001) decreased in the multi-dream group;whereas ratio of light sleep (66.49％ ±9.97％ vs 59.85％ ±3.01％,t =2.966,P =0.006),awakening numbers (13.4 ±6.98 vs 6.08 ± 3.34,t =3.411,P =0.002),arousal index (20.11 ± 10.69 vs 11.82 ± 8.09,t =2.338,P =0.026),non-REM arousal index (20.22 ± 10.53 vs 12.08 ± 8.69,t =2.283,P =0.029) increased.Conclusion The sleep efficiency of patients with multiple dreams is reduced,and their perceived dreams may originate from light sleep periods.

Objective To study the effects of atherosclerotic high-fat diet on body weight, blood glucose, blood lipid levels and atherosclerotic plaque formation in mice, and to determine the effect of fasting time on the results of blood lipid testing. Methods 10-week-old male ApoE knockout (ApoE^-/-) mice were given high-fat diet and normal diet. The atherosclerotic plaques were observed four months later. 10 week old C57BL/6J male mice were given regular diet for 4 weeks, regular diet for 2 weeks + high-fat diet for two or four weeks. Body weight、liver、glucose, and the serum lipid levels were examined. The influence of fasting for 12 h, 6 h or no fasting on blood lipid detection results before sacrificing were studied. Results The atherosclerotic plaque area of ApoE^-/- mice given high-fat diet increased significantly (P<0.01). C57BL/6J mice given high-fat diet gained weight (P<0.01). The glucose, TC, LDL-c and HDL-c were also increased in C57BL/6J mice with liver fat accumulation while the level of TG was significantly decreased(P<0.01). Compared with the fasting 12 h group, serum triglyceride (TG) was significantly increased (P<0.01）in fasting 6 h and no fasting groups. Conclusion The atherosclerotic high-fat diet can accelerate the formation of atherosclerotic plaques in ApoE^-/- mice, significantly increase blood sugar, TC and LDL-c levels, but significantly reduce TG values.. The fasting time can affect serum triglyceride (TG) level.