Objective To explore the value of spiral CT in venous phase in measuring the diameter of bilateral transverse sinus.Methods The CT vascular imaging findings of 200 cases at torcular herophili area in our hospital were analyzed retrospectively.The resource images, volume rendering (VR) and maximum intensity projection (MIP) were performed to observe the presentation of vascular anatomy in the torcular herophili area, and to determine the dominant transverse sinus and types of torcular herophili (typeⅠ-Ⅵ).The diameters of bilateral transverse sinus were measured by original CT images.Two groups were categorized according to the genders, and four ones (20-30 years, 30-40 years, 40-50 years and 50-60 years) according to the age.Results Between different genders, there was significant difference in right transverse diameter (P<0.05), and there was no significant difference in left transverse diameter (P>0.05).There was no significant difference among four age groups in bilateral transverse diameter (P>0.05).Conclusion Spiral CT is helpful for the evaluation of the diameter of bilateral transverse sinus.These findings can provide anatomical basis for clinical disease with significant implication.

To determine the bufalin concentration in rats' plasma by establishing a high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) method, and to evaluate and compare the pharmacokinetic characteristics of bufalin-loaded bovine serum albumin nanoparticles (bufalin-BSA-NP) and bufalin.

Objective To investigate the clinical applications of 64-MSCTA for the follow-up of endovascular stent-graft exclusion (EVE). Methods Between Oct 2006 and Feb 2008, forty-four 64-MSCTA examinations were performed in 30 patients with aortic dissection (AD) and 5 patients with abdominal aortic aneurysm (AAA) who underwent EVE. Imaging reconstruction including MPR, MIP and VR were finished on workstation. The outcomes and complications after EVE of aortic dissection and aortic aneurysm were evaluated. Results (1) Of 30 patients with aortic dissection, large thrombosis in false lumen was observed in 28 cases and small thrombosis in 2 cases. The cavity of aortic aneurysm outside the stent was thrombosed completely in 5 patients with AAA. (2) Thrombosis in the innominate artery on follow-up CTA after EVE was found in 1 AD patient with the innominate artery involved, Thrombosis in the superior mesenteric artery was observed on 15 days follow-up CTA but thrombolysis on 3 months after EVE in 1 case, lntimal tear in right common iliac artery was found in 1 case. Of 5 patients with AAA, occlusion of right inner iliac artery was observed in 1 case, and instent thrombosis in distal right common iliac artery was found in 1 case. (3) Endoleak was found in 14 patients with AD, including 8 with type Ⅰ and 6 with type Ⅲ endoleaks, one type Ⅲ endoleak was disappeared on follow-up CTA after 3 months. Conclusions 64-MSCTA with fast, non-invasive and effective merits, combining multiple reconstructive methods, has become one of preferred imaging methods in post-operative evaluation of EVE.

Neuronal intranuclear inclusion disease (NIID) is a slowly progressive neurodegenerative disease characterized by eosinophilic hyaline intranuclear inclusions in the central and peripheral nervous system, and also in the visceral organs. Although in recent years skin biopsy is useful for the antemortem diagnosis of this disease, it is often misdiagnosed due to its highly variable clinical manifestations. A case of NIID is reported here. The patient had a long course of disease, mainly presenting as dysfunction of autonomic nervous system. No significant cognitive impairment was found. Thus, a new idea is provided for the diagnosis of this disease.

Objective To investigate the inhibitory effect of a new antihypertensive drug on carotid artery intimal hyperplasia in balloon-injured rats and its possible mechanism.Methods A total of 48 SD rats were randomly divided as follows:sham operation group,model group,low-dose Azilsartan medoxomil group and high-dose Azilsartan medoxomil group(n =12).The rats in sham operateion group and model group were treated by by gavage with 3ml normal saline every day,and rats in low-dose Azilsartan medoxomil group and high-dose Azilsartan medoxomil group were treated by by gavage at adose of 2mg/kg and 4mg/kg Azilsartan medoxomil(3ml) every day.14 and 28 days after operation,we can observe the morphological changes of the injured arteries by HE staining and measure intimal area (IA),medial area(MA),the intimal/medial area ratio (IA/MA).The expression of PCNA,TLR4,NF-κB p65 in each group were detected by immunohistochemistry and the plasma level of TNF-α,IL-6 were detected by enzyme-linked immunosorbent assay (ELISA).Results Compared with the model group,the intimal area and the intimal / medial area ratio were significantly reduced in the low-dose group and hige-dose group (P ＜ 0.05).The expression of PCNA,TLR4 and NF-κB p65 in carotid artery were significantly lower (P ＜ 0.05).The plasma level of TNF-α、IL-6 were significantly lower (P ＜ 0.05).Compared with the sham operation group,the intimal area and the intimal/medial area ratio were significantly increased in the operation group (P ＜ 0.05) and the expression of PCNA,TLR4 and NF-κB p65 in carotid artery were significantly increased (P ＜0.05).The plasma level of TNF-α、IL-6 were significantly increased (P ＜ 0.05).Conclusion Azilsartan medoxomil can alleviate the incidence of vascular restenosis.The mechanism of action possibly was related to reducing the expression of inflammatory factors such as TNF-α,IL-6 by TLR4/NF-κB pathway and inhibiting the carotid artery intimal hyperplasia.

Objective TodeterminethevalueofT1WIsignalratioofbilateralglobuspallidustoputamenindiagnosisofhighbilirubin relatedencephalopathyoftermneonates.Methods ThecranialMRIsignalcharacteristicsandclinicaldataof105newbornswereanalyzed retrospectively.Accordingtothetotalserumbilirubin (TSB)andclinicalsymptoms,86caseswithoutriskfactorsofterm neonates weredividedinto4groups(Ⅰ~Ⅳand3groups(A~C).TheT1WIsignalintensityofbilateralglobuspallidusandputamenwere m easured and the ratio of G/P w as calculated.T he data of each group w ere co m pared and analyzed by t test and ANOVA.R O C curve ofG/Pratiowasperformedtopredicttheprogressofdisease.Results TherewasstatisticallysignificantdifferencebetweengroupⅠandgroupⅡ,groupⅠandgroupⅢ,groupⅠandgroupⅣ,groupⅡandgroupⅢ,groupⅡandgroupⅣ(P＜0.05),whereasno differencewasfoundbetweengroupⅢandgroupⅣ (P＞0.05).Comparingthethreegroupsdividedbyclinicalsymptoms,statistically significantdifferenceswereobserved(P＜0.05).TheROCcurverevealedthatforserum TSB,thepredictiveriskofhyperbilirubinemia with1.51and1.62,thepredictiveperformanceforhighbilirubinrelatedencephalopathywith1.70and1.69.Conclusion TheT1WI signalintensityratioofG/Ppotentiallyassistsinthediagnosisofhighbilirubinrelatedencephalopathy.Combinedwithclinicalmanifestations, itcanbecomprehensivelyanalyzeddialectically,therebyincreasingtheobjectiveaccuracyofdiagnosis.

Tumor-associated macrophage (TAM) plays a key role in tumor progression and metastasis, and their properties are highly dependent on signaling stimuli in the tumor microenvironment (TME). Moreover, TAM, as a major player in tumor-related inflammation, is associated with the prognosis of multiple solid tumors. Immune checkpoint inhibitor (ICI) was found to significantly improve the survival prognosis of patients with microsatellite instability/mismatched repair deficient colorectal cancer. However, the efficacy of ICI as monotherapy is limited in the vast majority of CRC patients. Although the exact functions of TAM have not been fully elucidated, targeting TAM as a therapeutic strategy significantly enhances the efficacy of ICI in CRC, and TAM also demonstrates important value as predictive biomarkers for CRC prognosis.

Objective To explore the correlation between hyponatremia at admission and all-cause mortality within one year after discharge in elderly patients with intestinal obstruction.Methods The 331 cases of elderly patients with intestinal obstruction(aged ≥ 60 years)who visited the General Surgery Department of Nanjing Meishan Hospital from January 2017 to December 2020 were selected as the research objects for retrospective cohort study analysis.According to the patient's blood sodium level at admission,they are divided into two groups:the hyponatremia group(Na＜135 mmol/L)and the non hyponatremia group(Na≥135 mmol/L).Divided into death group and survival group based on whether death occurred within one year after discharge.SPSS 25.0 software was used for statistical analysis.Independent sample t test,x2 test,Kaplan Meier method,and multivariate Cox regression analysis were used to observe the correlation between admission hyponatremia and all-cause mortality within one year after discharge in elderly patients with intestinal obstruction.Results A total of 331 patients were enrolled.The incidence of hyponatremia was 32.3％,and 56 deaths occurred within one year,accounting for 16.92％.The one-year mortality rate in the hyponatremia group was 23.4％(25/107),which was higher than 13.8％(31/224)in the non hyponatremia group.The difference was statistically significant(P＜0.05).The survival analysis(Kaplan Meier)results showed that the survival rate of the hyponatremia group was lower than that of the non hyponatremia group(Log Rank P＜0.05).After adjusting for other confounding factors in multivariate Cox regression analysis,hyponatremia(HR=1.88,95％CI:1.07-3.29)was an independent risk factor for one-year all-cause mortality in elderly patients with intestinal obstruction(P＜0.05).Conclusion Hyponatremia at admission is an independent risk factor for all cause mortality in elderly patients with intestinal obstruction within one year after discharge.

Objective:To establish a real-time fluorescent quantitative TaqMan reverse transcription polymerase chain reaction (Real-time RT-PCR) detection method for Wuxiang virus (WUXV).Methods:All gene sequences of WUXV were downloaded from GenBank, and multi-sequence alignment analysis was performed using Mega-X. Primers and probes designed for the highly conservative region of S-segment genes were selected to evaluate the specificity, sensitivity and stability of detection reactions.Results:The established method can specifically detect WUXV and does not cross-react with various arboviruses. The lowest detection limit was 1 pfu/ml. The inter-batch variation coefficients of repeated detection cycle threshold ( Ct) of the same sample were all less than 1.00%. TaqMan RT-PCR was used to detect 30 batches of sandflies nucleic acid samples, and 7 of them showed positive amplification curve of WUXV. Conclusions:TaqMan RT-PCR with high sensitivity, specificity and repeatability has been successfully established, which can be used to screen large quantities of samples of WUXV.

Objective:To explore the effects of scenario simulation teaching of junior nurses in a burns department on the fluid resuscitation care of massive burn patients during shock stage.Methods:From March 2018 to July 2019, 25 junior nurses fixed in the Department of Burn of Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine met the inclusion criteria and were recruited in this prospective before-after self-control study, including 21 females and 4 males, aged 23 to 26 years. They had a work experience of 1.0 (1.0, 2.0) years in the Department of Burn. Three teaching scenarios were made according to the three major problems in the fluid resuscitation nursing of extensive burn patients during shock stage. The teaching plans were written based on the theoretical framework of Jeffrie's nursing simulation teaching. The high feasibility and practicability of the teaching plans was verified through expert consultation and evaluation by junior nurses. According to the three scenarios in the teaching plan, the junior nurses were performed with scenario simulation teaching, with 2 hours for each scenario, 6 hours in total. In one month before and after the teaching (hereinafter referred to as before and after teaching), the comprehensive ability of junior nurses was evaluated by the teachers using the self-designed junior nurse comprehensive ability evaluation scale, and their behaviors were evaluated by themselves with Performance Self-rating Scale for Nursing Students on High Simulation Training. Data were statistically analyzed with paired sample t test. Results:After teaching, the scores on communication skills, patient admissions, condition assessments, fluid resuscitation, emergency treatment, drug management, nursing skills, instrument use, teamwork, and humanitarian care and total score in the comprehensive ability evaluation of junior nurses as evaluated by teachers were significantly higher than those before teaching ( t=-8.060, -11.421, -17.232, -24.800, -4.670, -11.916, -12.131, -11.606, -14.632, -13.325, -25.068, P<0.01), with 4 items including fluid resuscitation, condition assessment, nursing skills, and equipment operation having higher scores. After teaching, the nurses' self-rating scores on communication, division of labor and cooperation, clinical decision-making, professional knowledge and skills, and professional development and critical thinking and total score were (4.6±0.4), (4.8±0.3), (4.6±0.3), (4.6±0.4), (4.6±0.4), and (23.2±1.5) points respectively, which were significantly higher than the corresponding scores of (4.1±0.7), (4.2±0.7), (3.9±0.5), (3.7±0.6), (3.9±0.5), and (18.8±2.6) points before teaching ( t=-3.361, -5.721, -6.987, -7.923, -7.922, -7.367, P<0.01). Conclusions:With solving the practical problems in nursing works of fluid resuscitation care of massive burn patients during shock stage as entry point, scenario simulation teaching aims to train the clinical practice ability and adaptability of junior nurses, thereby improving junior nurses' comprehensive ability of clinical practice in the fluid resuscitation care of massive burn patients during shock stage, enhancing their self-confidence and critical thinking ability.