Objective To investigate the changes of transcranial Doppler (TCD) patterns and parameters in various intracranial hypertension.Methods Sixty rabbits were randomized into 3 groups:control group,the group of mild-to-moderate intracranial hypertension,the group of serious intracranial hypertension.Acute intracranial hypertension was induced by inflating the balloon inserted into the epidural space.Blood flow velocity was measured with TCD and intracranial pressure (ICP) as well as cerebral perfusion pressure(CPP) was measured.Mannitol was injected to the animals of intracranial hypertension,blood flow velocity and ICP was measured.ResultsTwo characteristic flow patterns vere observed in the group of mild-to-moderate intracranial hypertension:high resistance pattern,systolic flow.At the last stage of extreme intracranial hypertension in the group of serious intracranial hypertension Doppler sonograms showed three characteristic flow patterns in the following sequence:retrograde diastolic flow,very small systolic flow and zero flow.Multiform retrograde diastolic flows were related to the phases of brain death.Very small systolic flow showed three shapes:systolic-spike,small systolic triangular and small double peak.AftermedicinaltreatmentICPdecreasedinthethegroupofmild-to-moderateintracranial hypertension,blood flow velocity also increased.After the same treatment IC,P and blood flow velocity did not change in the group of serious intracranial hypertension.ConclusionsAnalysing patterns and parameters of TCD may be helpful for evaluating ICP indirectly as well as clinical experience.

Objective To evaluate the expression of human kallikrein10 (KLK10) in different endometrioid tissues and analyse the relationship of KLK10 with ER and PR in endometrioid adenoearcinoma.Methods The expression of KLK10 protein in 12 normal endometria,19 endometrial hyperplasia and 34 endometrial carcinoma were detected by immunohistochemistry.The correlations of the expression of KLK10 protein,ER and PR were analyzed.Results The expression of KLK10 in stage Ⅰ,Ⅱ and Ⅲ were 64.3 ％(9/14),30.0 ％ (3/10),10.0 ％ (1/10),and the difference was statistically significant (P ＜ 0.05).The expression of KLK10 in endometrial carcinoma,normal endometria,endometrial hyperplasia were 66.7 ％ (8/12),33.3 ％(4/12),10.0 ％ (1/10),and the difference was statistically significant (P ＜ 0.05).The expression of KLK10 in G1,G2,G3 were 66.7 ％,33.3 ％,10.0 ％,and the difference was statistically significant (P ＜ 0.05).The positive rate of KLK10 expression was 38.2 ％ and the positive rates of ER and PR expression were 67.6 ％and 55.9 ％,respectively,in 34 endometrial carcinoma.The expression of KLK10 was positively correlated with ER and PR expression (x2 =0.448,P ＜ 0.01).Conclusion Absence or down-regulated expression of KLK10 may play an important role in the formation and development of endometrioid adenocarcinoma.The low expression of KLK10 is correlated with low expression of ER and PR in endometrioid adenocarcinoma.The positive expression of KLK00,ER and PR predicts a better prognosis.

Objective To establish the animal model of acute intracranial hypertension,investigate the changes of transeranial Doppler patterns in raised intraeranial pressure so that the necessary experimental evidence will be provided to clinical experience for monitoring intraeranial pressure (ICP) and cerebral perfusion pressure (CPP) using transeranial Doppler non-invasively. Methods Acute intraeranial hypertension was induced by inflating the balloon inserted into the epidural space. Blood flow velocity of basilar artery was measured with transcranial Doppler and intracranial pressure as well as cerebral perfusion pressure was measured. Results With progressive increase of intracranial pressure five characteristic flow patterns were observed, appearing in the following order: high resistance pattern, systolic flow, retrograde diastolic flow, very small systolic flow and zero flow. Conclusions Analysing patterns of TCD may be helpful for evaluating ICP and CPP qualitatively. The animal model is simple and strict so that it is worthy of being spreadcd.

Objective To evaluate the effects of assisted reproduction technology ( ART) on gestational weight gain ( GWG) and glucose metabolism .Methods The study was performed in ART women with single-ton and full-term delivery .Age-and pre-pregnancy body mass index matched healthy women with spontaneous pregnancy, singleton, and full-term delivery were recruited as controls .Maternal characteristics (height, age, education level , pre-pregnancy body mass , pre-delivery body mass , medical history , history of abortion , fasting plasma glucose , triglyceride , total cholesterol , and glucose tolerance ) and fetal data ( delivery mode , gender , birth body mass , birth body length ) were collected by a trained nutritionist .Results A total of 200 women were recruited into this study (53 ART women and 147 controls).There was no significant difference in number of previous abortion ( the ratio between the women who had ≥3 abortions to those who had <3 abortions was 6∶47 in the ART group , and 10∶137 in the control group , χ2 =1.080 , P=0.299 ) .Compared with the control group, the ART group had higher education level (33 in the ART and 85 in the control group with un-dergraduate or higher education , 20 in the ART group and 62 in the control group with a college degree or lower education ,χ2 =6.303 , P=0.012 ) .There were no statistically significantly differences between the ART and the control groups in pre-pregnancy body mass index [ (22.00 ±3.05 ) kg/m2 vs.(21.81 ±2.62 ) kg/m2 , P=0.661] and average GWG [ (13.89 ±5.33) kg vs.(14.78 ±4.60) kg, P=0.247].GWG was appro-priate in 22 ART women, excess in 18, and inadequate in 13;in the control group, GWG was appropriate in 66 women, excess in 54, and inadequate in 27.The distribution of GWG showed no significant difference be-tween the two groups (χ2 =1.162 , P=0.247 ) .Oral glucose tolerance test in 24-28 gestational weeks showed no significant difference in fasting blood glucose between the ART and the control groups [ (4.66 ±0.39) mmol/L vs.(4.66 ±0.52) mmol/L, P=0.996], but 1-hour and 2-hour blood glucose levels were significantly in-creased in the ART women [ ( 7.87 ±1.83 ) mmol/L vs.( 7.31 ±1.51 ) mmol/L, P=0.034; ( 7.49 ± 1.29) mmol/L vs.(6.69 ±1.30) mmol/L, P=0.029].The overall prevalence of gestational diabetes melli-tus was 13.5%(27/200), with no significant difference between the ART and the control groups (18.9%vs. 11.6%, P=0.182 ) .Conclusion ART may not affect GWG , but it may cause changes of glucose metabo-lism during pregnancy .

Objective:To investigate the characteristics, process, and prognosis of esophageal stricture after circumferential endoscopic submucosal dissection (ESD), and to preliminarily analyze the prevention and treatment effects of simple dilation, stent placement, mucosal transplantation, and glucocorticoid (hereinafter referred to as hormone) application in esophageal stricture.Methods:From August 2017 to March 2022, at the First Affiliated Hospital of Zhengzhou University, the clinical and follow-up data of 55 patients who underwent circumferential ESD for early esophageal cancer and precancerous lesions were retrospectively analyzed. According to the prevention and treatment methods for esophageal stricture, the patients were divided into two groups: simple dilation group (23 cases) and combined dilation group (32 cases). The combined dilation group was divided into mucosal transplantation subgroup (9 cases), stent placement subgroup (14 cases), hormone application subgroup (7 cases), and bleomycin subgroup (2 cases, excluded from comparative analysis due to limited cases). Overall prognosis of patients was observed. Treatment efficacy, prognosis, and adverse events were compared among the simple dilation group, mucosal transplantation subgroup, stent placement subgroup, and hormone application subgroup. Independent samples t-test, chi-square test, and Fisher′s exact test were used for statistical analysis. Results:Among the 55 patients, the follow-up time was (894.1±417.7) days. Refractory esophageal stricture (total dilation times ≥ 5) occurred in 33 patients (60.0%). Fifty-two patients (94.5%) achieved clinical remission of the stricture. The total number of dilations was 5.8±4.0, and the average dysphagia-free period was (52.3±37.1) days. The dysphagia-free period of mucosal transplantation subgroup was longer than that of the simple dilation group, stent placement subgroup, and hormone application subgroup ((114.5±50.0) days vs. (40.9±20.0), (39.7±10.0), and (40.9±25.5) days, respectively), and the differences were statistically significant ( t=4.82, 3.77 and 3.14, P<0.001, =0.011, =0.009). There were no statistically significant differences between the simple dilation group and the mucosal transplantation subgroup, stent placement subgroup, and hormone application subgroup in the total number of dilations (6.8±4.8 vs. 3.0±2.5, 5.8±2.2, and 5.7±5.0), stricture remission rate (95.7%, 22/23 vs. 8/9, 13/14, and 7/7), and incidence of adverse events (17.4%, 4/23 vs. 5/9, 5/14, and 2/7; all P>0.05). Conclusions:Esophageal stricture formed after circumferential ESD shows the characteristics of recurrence and intractability. The over all number of dilations is high, and the average dysphagia-free period is short. Most patients can achieve clinical remission of the stricture after multiple times of endoscopic dilation treatment. However mucosal transplantation, stent placement, and hormone application cannot well intervene the natural process of esophageal stricture.

Objective To analyze the constituent of the 32 kD protein band and its expression in schizophrenia se?rum. Methods Sixty schizophrenia patients and 58 health controls were recruited. The serum samples were collected and precipitated with 7%PEG. The sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) was used to ob?tain the abnormal 32 kD proteins band in patients. This protein band was cut and then analyzed using mass spectrometric technique. Results The 32 kD protein band was present in 38 schizophrenia patients but not in control and positive rate was 63.33%. The mass spectrometric analysis showed that 32 kD protein band contained 14 proteins ranging from 30 kD to 35 kD, including 6 high-frequency proteins (cDNA coded protein 1 and 2, Apolin protein A-1, Isoform 2 of ficolin-2, Complement factor H and clusterin) and 8 low-frequency proteins (IgG H chain, zinc-alphg-2-glycoprotein, fermitin,family apolin protein L-1, isoform 10 of collectin-1, purine nucleoside, anne xin and cDNA coded protein 3). Three cD?NA coded unknown proteins were highly similar to complement C4-B, β2-glycoprotein and erythrocyte band 7 integral membrane protein. Conclusion There is a unknown specific 32 kD protein that is consisted mainly of fourteen proteins in serum of schizophrenia.

Objective:To explore the clinical characteristics and medical nutritional therapy of 6 patients with late-onset ornithine transcarbamylase (OTC) deficiency.Methods:The clinical features, biochemical data, gene variations and treatment outcomes of 6 children with late-onset OTC deficiency admitted to the Department of Clinical Nutrition, Children′s Hospital of Nanjing Medical University from January 2020 to April 2022 were retrospectively analyzed.The 6 patients were all intervened by a long-term medical nutrition management.Results:Liver dysfunction and hyperammonemia (172.1-348.0 μmol/L) were found in all the 6 children with late-onset OTC deficiency.Serum citrulline decreased in 3 patients (3.95-5.43 μmol/L). Three patients showed increased urine orotic acid (123.48-342.60 mmol/mol Cr). Urine uracil increased in 4 patients (106.77-1 207.26 mmol/mol Cr). Variations of the OTC gene [c.364G>C p. (E122Q), c.1028C>G p. (T343R), c.664-2(IVS6)A>C, c.635G>T p. (G212V), c.929_c.931delAAG p. (E310del), c.829C>T p. (R277W)] were identified in all patients.The 6 children were all managed by individualized medical nutrition program and followed up for a long time.During the follow-up period, 3 cases developed hypoproteinemia, acute metabolic crisis and growth retardation, 3 cases had normal growth and laboratory indicators, and 1 case received liver transplantation after 3 months of nutritional management. Conclusions:The clinical manifestations of OTC deficiency are non-specific.Blood amino acids, urine organic acids and genetic tests are important for the diagnosis.Long-term regular medical nutrition management is helpful to improve the prognosis and quality of life of children.

Objective To investigate the nutritional risk of hospitalized infants with severe pneumonia and its relationship with clinical outcome. Methods Totally 113 infants with severe pneumonia admitted to pediatric intensive care unit (PICU)were enrolled in the study. Nutritional risks were screened by STRONGkids, and the nutritional were assessment with WHO Anthro. Clinical outcomes were recorded and analyzed, including mechanical ventilation, length of PICU stay, total hospital expenses, prognosis, and biochemical test index. Results A total of 44 infants (38.9％) had high nutritional risk, 49 (43.4％) had medium nutritional risk, 20 (17.7％) had low nutritional risk when they admitted to PICU. A total of 59 (52.2％) infants were malnourished when they admitted to PICU. There was a significant correlation between the degree of malnutrition and nutritional risk (r =0.574, P<0.01).The incidence of high nutritional risk was significantly higher in 28d～1year-old group than in 1～3 year-old group (χ2=20.46, P<0.01). Nearly 42.5％(48/113) of the children had congenital disease and had higher incidence of high nutritional risk (χ2=11.375, P=0.003) and higher incidence of malnutrition (χ2=10.083, P=0.001) than those without congenital disease. The rate of mechanical ventilation (P=0.028), the duration of mechanical ventilation (P<0.01), total hospital expenses (P=0.002) and the incidence of poor prognosis(P=0.014) were significantly higher in high nutritional risk group than the low nutritional risk group. The retinol binding protein in the high nutrition risk group was significantly lower than the low nutrition risk group (χ2=6.333, P=0.021). Conclusions High nutritional risk and malnutrition are common in infants with severe pneumonia. Malnutrition and nutritional risk are increased in patients less than 1 year old or suffering from congenital disease. Patients with high nutritional risk are more likely to have worse clinical outcomes. STRONGkids is a valid tool for nutritional risk screening in hospitalized children, and early nutrition support is recommended.

Objective To investigate the nutritional status and the clinical outcome of the critically ill chil-dren,and to provide scientific evidence for further clinical nutrition management. Methods Nutritional risk screening was performed on 1183 critically ill children hospitalized at the Intensive Care Unit (ICU),Children′s Hospital of Nanjing Medical University from October 2016 to October 2017 by using the Screening Tool for Risk on Nutritional Sta-tus and Growth (STRONGkids),the ICU including of Pediatric Intensive Care Unit (PICU),Surgical Intensive Care Unit (SICU)and Coronary Care Unit (CCU). Median age of the children was (2. 6 ± 2. 4)years (29 d - 12. 9 years). Nutritional status was estimated,and scores of anthropometric parameters such as weight - for - age Z - score (WAZ)(< 5 years)or body mass index - for - age Z - score (BAZ)(≥5 years)were calculated. The data on inci-dence of infectious complications,duration of ICU stay and mechanical ventilation,the total hospital expenses and in -hospital mortality were recorded. Results Of the 1183 cases,134 children(11. 3％)had low nutritional risk,746 children(63. 1％)had moderate nutritional risk and 303 children(25. 6％)high nutritional risk. The prevalence of se-vere malnutrition,moderate malnutrition and mild malnutrition was 8. 1％ (96 / 1183 cases),8. 2％ (97 / 1183 ca-ses),and 12. 8％ (151 / 1183 cases)respectively. The severe malnutrition group had a higher incidence of high nutri-tional risk than other groups [74. 0％(71 / 96 cases)vs. 67. 0％(65 / 97 cases),40. 4％(61/ 151 cases),12. 6％(106/839 cases)],and the differe-nce was statistically significant (P < 0. 001). The incidence of high nutritional risk in the CCU was higher than that than that in the PICU and SICU,and the difference was statistically significant [36. 5％(96 /263 cases),23. 8％(125 / 524 cases)and 20. 7％(82 / 396 cases)respectively,P < 0. 01]. And the incidence of high nutritional risk was higher in infants[37. 6％(198 / 527 cases)]than those in the other age groups[18. 4％(52 / 282 cases),12. 0％(21 / 175 cases),16. 0％(32 / 199 cases)],and the difference was statistically significant (χ2 = 68. 90, P < 0. 0001). Children with a high nutritional risk had increased incidence of infectious complications [8. 6％(26 / 303 cases)vs. 4. 7％ (35 / 746 cases),3. 7％ (5 / 134 cases)],incidence of mechanical ventilation [66. 0％ (200 / 303 cases)vs. 41. 4％(309 / 746 cases),38. 8％(52 / 134 cases)]and total hospital expenses (￥ 52500 vs. ￥ 39700 and￥ 48700 RMB)compared with those with the moderate or the low nutritional risk,and the differences were statistically significant(all P < 0. 05). There were 16 deaths and 8 deaths (2. 7％)in the high nutrition risk group,which was sig-nificantly higher than those in the moderate nutrition risk group [8 cases (1. 1％)]and the low nutrition risk group [0 case(0)](χ2 = 7. 60,P = 0. 02). Conclusions Moderate or high nutritional risk is seen in the critically ill chil-dren,especially in infants and the children with congenital heart disease. Nutritional risk score is correlated with clinical outcomes. Nutritional risk screening and standard nutritional support are recommended so as to improve clinical treat-ment outcomes.

Objective To explore the CT and MRI imaging and clinicopathological features of extranodal NK/T cell lymphoma (NK/TCL). Methods Sixty-six patients with NK/TCL diagnosed from 2002 June to 2016 April in Beijing Tongren Hospital with intact CT and/or MRI imaging results were enrolled in this study. All the patients had tailed clinical information and follow-up. The imaging and clinicopathological features were analyzed retrospectively and their prognostic value on overall survival was analyzed. Results There were 49 males and 17 females with median age of 42 years. The median follow-up time was 18 months. The cases showed surrounding invasions including 10 cases (15.2 %) in soft palate, 5 cases (7.6 %) in hard palate, 2 cases(3.0 %) in tonsil, 8 cases(12.1 %) in upper lip, 13 cases(19.7 %) in maxillofacial soft tissue, 9 cases (13.6 %) in eyelid, 10 cases (15.2 %) in orbital, 3 cases (4.5 %) in maxilla, 6 cases (9.1 %) in pterygopalatine fossa,6 cases(9.1 %)in infratemporal fossa,3 cases(4.5 %)in skull base, 3 cases(4.5 %) in eyeball and 2 cases (3.0 %) in brain tissue. Kaplan-Meier survival analysis found that the 2-year overall survival rates of the patients with the involvement of hard palate, upper lip, maxillofacial soft tissue, eyelid, orbital, maxillary, eyeball and brain organizer were lower than those of the patients without the involvement of these sites(χ2values were 4.470,4.041,4.456,13.933,8.986,4.000,44.121,6.527,16.822,respectively, all P< 0.05). Further multivariate Cox regression analysis showed that maxilla and brain involvement were independent adverse factors (RR=34.717, 95 % CI 3.404-354.035, P=0.003; RR=37.545, 95 % CI 3.188-442.187, P= 0.004). Conclusions MRI and CT examinations are of great value in diagnosis and prognostic assessment of NK/TCL. Clinicians can make correct and timely diagnosis by comprehensive clinical, radiological and pathological features and can make a detailed clinical assessment to give patients appropriate treatment,thus improving the outcome of the NK/TCL patients.