Objective To evaluate the role and effect of intraoperative microvascular Doppler ultrasonography(IMD)in the in-tracranial aneurysm clipping operation.Methods The blood flow velocities of aneurysmal sac,adjacent vessels and parental arteries were determined by IMD before and after clipping in 79 cases of intracranial aneurysm clippings;the influence of IMD on the effect of craniotomy for intracranial aneurysm clipping was comparatively analyzed.Results IMD demonstrated that the clip adj ustment was more likely to happen in the patients with anterior intracranial artery(ACA),anterior communication artery(ACoA)and middle intracranial artery(MCA)aneurysms,and the patients with complex,giant aneurysm due to the change of blood flow velocity in ad-jacent vessels and parental arteries caused by inadvertent occlusion or incomplete closure.In addition,the higher the preoperative Hunt-Hess classification,the easier the inadvertent occlusion or incomplete closur;the patients with conventional use of intraopera-tive IMD were significantly superior to those without intraoperative IMD in the aspects of the postoperative hospital stay,reopera-tion rate,postoperative GOS and complication occurence rate.Conclusion The routing use of IMD in the intracranial aneurysm clip-ping operation conduces to find the inadvertent occlusion or incomplete closure and the timely adj ust the aneurysm clip position;the IMD can assist operation can significantly improve the postoperative GOS score,short the hospital stay and reduce the reoperation rate and the probability of complication occurrence.

Using immunocytochemical method and image analysis computer system, quantitative analysis of substance P (SP) containing nerve fibers and neurons in the nucleus of dorsolateral funiculus (NDLF) was studied in the rat spinal cord. Under light microscope, in the white substance of the whole length of the spinal cord, a concentrated triangular or cuneiform area of SP-immunoreactive positive fibers and cells could be observed in the NDLF region. Using the image anlysis computer system (IBAS 2000) the outline of the whole SP stained area in the NDLF was drawn with a light point of the Mouse and this whole area was measured and named as the reference area (REFAREA). We selected the optimal gray level of the image in NDLF region by the Interactive Segment as the threshold. The sum of the SP labelled areas was called the field area (FAREA). The ratio of the FAREA to REFAREA (AREA%) represented the percentage of density to area of the SP labelled substance in NDLF. The mean value of REFAREA, FAREA, and AREA% are: 47931.38?m~2, 21995.25?m~2, and 45.89% in the cervical segments; 31575.15 ?m~2, 7646.85?m~2, and 24.22% in the thoracic region; 26889.89?m~2, 8470.66?m~2, and 31.50% in the lumbar and sacral segments, respectively. In short, according to the density of SP positive fibers and neurons in NDLF and the size of their distributive area, the sequence of density and size from highest to lowest is: cervical, lumbar, sacral and thoracic segments, with the lowest one at thoracic 8-10 segments.

The purpose of this research work is to find out the longitudinal distribution of the preganglionic neurons which project to the superior cervical sympathetic ganglion (SCSG). Experiments were performed on 12 adult rabbits and a monkey. Under sodium pentobarbital anesthesia, 20 microliters of 10% HRP were injected slowly into the rabbit's SCSG. In the monkey, 20 microliters of 15% HRP was injected.After a postoperative survival time of 3～6 days, the animals were perfused through,the ascending aorta with a cold fixative mixture composed of 2% paraformaldehyde and 1.25% glutaraldyhyde in 0.1mol phosphatebuffer at pH 7.4. The spinal cord segments C_1～L_3 were cut serially in transverse plane on a cryostat at 48 micra.The HRP reaction product was demonstrated according to Mesulam's (1976) benzidine blue reaction method, and counterstained with neutral red.HRP labeled neurons in the spinal cord were located exclusively on the side ipsilateral to the injected SCSG. The total number of labeled cells were 7908 in 12 rabbits, but the number of labeled cells varied from animal to animal. The highest amount was 1690 (423~#) and the lowest amount was 71 (425~#). The longitudinal distribution of the labeled cells in 12 rabbits was 12 segaments of the spinal cord (C_6～T_9), but the largest proportion (86.18%) of them was concentrated from T_1 to T_4, especially at the level of T_2 and T_3 (56.22%), and with a peak at T_2 (29.10%).In cross section of the spinal cord. HRP-labeled cells were concentrated in four cell groups, they are: nucleus intermediolateralis pars principalis (ILp), nucleus intermediolateralis pars funicularis (ILf), nucleus intercalatus (IC) and nucleus intercalatus pars paraependymalis (ICpe). The latter is subdivided into dorsal portion and ventral portion. HRP positive cells were mainly located in the ILp, In 12 rabbits about 92.99% cells were located in it. A small portion of labeled cells(6.25%) were seen in the ILf. A few labeled neurons could be detected within,the IC (0.68%) and ICpe (0.08%). Furthermore, occasionally, very few labeled cells were found at the dorsol portion of the anterior horn.In the monkey, generally speaking, the pattern of the distribution of labeled cells was the same as the rabbit.

Background Congenital aniridia is a rare bilateral hereditary ophthalmopathy which impact panocular.Researches showed that congenital aniridia can be caused by different mutation locus of PAX6 genes,and the mutations are multifarious.Objective This study was to detect and anaiyze the mutations of a Chinese family with congenital aniridia by using targeted sequence capture sequencing and direct Sanger sequencing.Methods This study was approved by Ethic Committee of the First Affiliated Hospital of Zhengzhou University and followed Declaration of Helsinki.Written informed consent was obtained from subjects or their custodians before any related medical examination.A cross-sectional study was performed.A Chinese congenital aniridia family was included at the First Affiliated Hospital of Zhengzhou University in March,2016.All the family members received systemic medical examinations including nervous system and oral glucose tolerance test and then the ocular examinations were carried out.The periphery blood of 10 ml was collected from the members for genomic DNA extraction.Targeted sequence capture sequencing was performed on the DNA of proband to screen out the suspicious mutant locus.The mutation was verified by comparing the Sanger direct sequencing results from all family members.Results A total of 3 generations of 9 members were included in this congenital aniridia pedigree,and the Ⅰ 1 was dead without eye abnormality.Three patients (Ⅱ2 and her children Ⅲ1,Ⅲ2) and 5 normal family members were determined,showing an autosomal dominant inheritance pattern.No abnormal signs were found in nervous system and oral glucose tolerance test in the families.The reduce of visual acuity,ocular hypertension (21 mmHg),absence of biocular iris,opacification of corneal stroma,horizontal nystagmus,hapoplasia of fovea were found in all the sufferers.In addition,the ptosis of the left eye,congenital cataract of the right eye in Ⅱ 2 patient as well as biocular cataract and subluxation of lenses also were exhibited.The c.183C＞A mutation of the PAX6 gene was screened out to be a possible pathogenic mutation.The result of Sanger direct sequencing in the families verified a co-segregation of this mutation with mutant phenotypes.Conclusions PAX6 gene c.183C ＞A,a rare mutation in Chinese population,is a virulence mutation site in this aniridia family.

20?10~9/L. This regimen was given for one course for induction, and was followed by conventional chemotherapy as maintenance or consolidation when complete remission(CR) achieved, or succeeding with other treatment when no response could be observed. Results Six patients achieved CR (54.5%) and one achieved partial remission (PR)(9.1%) with one course of treatment. Among 6 of 11 patients with CR, 5 relapsed at 2,3,6,8 and 16 months respectively. Three relapsed patients were retreated with the same protocol but achieved only one partial responses. Nine of the 11 patients had been died and their mean survival (since induction chemotherapy) was 9.2 months. Infectious complications during cytopenia were less serious than conventional chemotherapy withno treatment-related.Conclusion This moderate intensity protocol with G-CSF priming is effective and safe but remissions are of short duration.

Objective:To explore the clinicaleffect of radial arterial puncture cannulationunder ultrasonic guidance in patients with critical diseases.Methods:From December 2016 to May 2017,120 patients under critical conditions in Department of Intensive Care Unit,Xiangya Hospital,Central South University,who received arterial cannulation,were randomly divided into 2 groups:a control group (traditional blind puncture method) and an observation group (ultrasound-guided radial arterial cannulation) (60 cases in each group).The success ratio of radial arterial puncture cannulation by one time,total success ratio of radial arterial puncture cannulation,numbers of puncture,the rate of complications and the time of consumption were compared between the 2 groups.Results:There was no statistically significant difference in the total success ratio of radial arterial puncture cannulationin the 2 groups (P＞0.05).The success ratio radial arterial puncture cannulation by one time was significantly greater in the observation group than that in the control group (P＜0.05);the numbers of puncture,the rate of complications and the time of consumption in the observation group were lower than those in the control group,with statistically significant (all P＜0.05).Conclusion:The application of ultrasound-guided radial arterial puncturecannulation can improve the success ratio of radial arterial puncturecannulation by one time,decrease the numbers of puncture,reduce the incidence of complications and save operation time.

Objective: To investigate the prevalence of breast and gynecological diseases in female workers in the administrative office and workshop of an automobile part factory, and to provide a basis for promoting the health of female workers. Methods: In March 2015, color ultrasound examination of the breast, uterus, and bilateral adnexa was performed for all female workers, and routine gynecological examination, routine leucorrhea examination, and thinprep liquid-based cytology test were performed for married female workers. The detection rates of breast and gynecological diseases in female workers in the administrative office and workshop were analyzed. Results: In the 314 female workers, the overall detection rate of breast and gynecological diseases was 86.31%; the detection rate of abnormal breast ultrasound results was 72.93%, mainly breast hyperplasia; the detection rate of abnormal gynecological ultrasound results was 12.14%, mainly hysteromyoma, pelvic effusion, and uterus-rectum fossa effusion. The overall detection rate of cervicitis or vaginitis in married female workers was 66.86%. The univariate analysis showed that compared with those in the administrative office, the female workers in the workshop had significantly higher detection rates of breast hyperplasia and grade 2 breast lesions on the Breast Imaging-Reporting and Data System (BI-RADS) and significantly lower detection rates of hysteromyoma and grade 3 breast lesions on the BI-RADS (all P <0.05) . The multivariate analysis showed that age was a risk factor for hysteromyoma (OR=1.261) , age and working in the workshop were risk factors for breast hyperplasia (OR=1.065 and 1.834) , married status was a protective factor against breast hyperplasia and grade 2 breast lesions on the BI-RADS (OR=0.334 and 0.450) , and working in workshop was a risk factor for grade 2 breast lesions on the BI-RADS (OR=1.890) and a protective factor against grade 3 breast lesions on the BI-RADS (OR=0.355) . Conclusion Female workers in an automobile part factory have high prevalence rates of breast and gynecological diseases. Night shifts for female workers in the workshop should be reduced as much as possible, and female workers, especially those in the administrative office, should be guided to release pressure and take a balanced diet.

Objective:To explore the effect of nursing intervention based on the integration theory of health behavior change in pelvic floor muscle exercise of patients with pelvic floor dysfunction (PFD) after early cervical cancer surgery.Methods:A total of 134 patients with pelvic floor dysfunction after early cervical cancer surgery were selected and divided into test group ( n=67) and control group ( n=67) by random digits table method. The test group received three months of pelvic floor muscle exercise based on the theory of healthy behavior change. The control group received conventional pelvic floor rehabilitation care. The Pelvic Floor Distress Inventory-Short Form 20(PFDI-20), Pelvic Floor Impact Questionnaire-7(PFIQ-7), General Self-Efficacy Scale (GSES) and Social Support Rating Scale (SSRS) were evaluated before the intervention (T0), After one month of intervention (T1) and at the end of the intervention (T2). Results:The results of repeated measurement analysis of variance showed significant group/time interaction between PFDI-20 and PFIQ-7 scores ( Finteraction=29.196,13.213, both P<0.05); significant group/time interaction between GSES and SSRS scores ( Finteraction value was 25.664,70.240, both P<0.05). At the end of the intervention, the scores of PFDI-20 and PFIQ-7 in the test group were 66.54±14.04 and 73.20±7.41, which were lower than 77.47±15.91 and 78.39±8.51 in the control group over the same period. The difference was statistically significant ( t value was -4.216, -3.765, both P<0.01); the GSES and SSRS scores of the test group were 2.86±0.30 and 50.37±2.45, which were higher than the control group (2.51±0.34 and 46.42±2.82), the differences between the groups were statistically significant ( t value was 6.447, 8.662, both P<0.01). Conclusion:The nursing intervention plan based on the integration theory of health behavior change can significantly improve the self-efficacy, social support level and quality of life of patients with PFD after early cervical cancer surgery, and enhance the short-term and long-term pelvic floor rehabilitation effect of patients.

Objective To analyze the spatial and temporal clustering characteristics of typhoid and paratyphoid fever and its change pattern in Yunnan, Guizhou and Guangxi provinces in southwestern China in recent years. Methods The incidence data of typhoid and paratyphoid fever cases at county level in 3 provinces during 2001-2012 were collected from China Information System for Diseases Control and Prevention and analyzed by the methods of descriptive epidemiology and geographic informatics. And the map showing the spatial and temporal clustering characters of typhoid and paratyphoid fever cases in three provinces was drawn. SaTScan statistics was used to identify the typhoid and paratyphoid fever clustering areas of three provinces in each year from 2001 to 2012. Results During the study period, the reported cases of typhoid and paratyphoid fever declined with year. The reported incidence decreased from 30.15 per 100000 in 2001 to 10.83 per 100000 in 2006 (annual incidence 21.12 per 100000);while during 2007-2012, the incidence became stable, ranging from 4.75 per 100000 to 6.83 per 100000 (annual incidence 5.73 per 100000). The seasonal variation of the incidence was consistent in three provinces, with majority of cases occurred in summer and autumn. The spatial and temporal clustering of typhoid and paratyphoid fever was demonstrated by the incidence map. Most high-incidence counties were located in a zonal area extending from Yuxi ofYunnan to Guiyang of Guizhou, but were concentrated in Guilin in Guangxi. Temporal and spatial scan statistics identified the positional shifting of class Ⅰ clustering area from Guizhou to Yunnan. Class Ⅰ clustering area was located around the central and western areas (Zunyi and Anshun) of Guizhou during 2001-2003, and moved to the central area of Yunnan during 2004-2012. Conclusion Spatial and temporal clustering of typhoid and paratyphoid fever existed in the endemic areas of southwestern China, and the clustering area covered a zone connecting the central areas of Guizhou and Yunnan. From 2004 to 2012, the most important clustering area shifted from Guizhou to Yunnan. Findings from this study provided evidence for the identifying key areas for typhoid and paratyphoid fever control and prevention and allocate health resources.

Objective:To analyze the causes of out-of-hospital cardiac arrest (OHCA) and the differences in outcomes of pre-hospital first-aid measures and cardiopulmonary resuscitation for different etiologies, improved the success rate of rescue.Methods:A retrospective study was conducted on OHCA patients admitted to Beijing Emergency Medical Centre from January to December 2021. The pre-hospital emergency medical records and rescue results within medical institutions were collected. Compared the basic situation between patients with cardiogenic and non-cardiogenic cardiac arrest, the differences of rescue measures and CPR outcomes between the groups were compared by non-parametric test and χ 2 test. Results:A total of 7 517 patients were included in this study. Cardiogenic arrest patients were older, more underlying diseases (84.2%), and cardiac arrest mainly occurred at home. The cause of non-cardiogenic arrest included disease (85.1%), trauma (2.9%), suicide (5.0%), traffic accidents (1.7%), poisoning (1.1%), and so on. In terms of first-aid measures, after the emergency doctor arrived at the scene, the proportion of first-aid measures used for cardiogenic patients was high (22.3%), and the first aid measures include cardiopulmonary resuscitation, tracheal intubation, defibrillation, oxygen inhalation, injection of adrenaline and use of other drugs. All the proportions of first-aid measures for cardiogenic patients were significantly higher than non-cardiogenic patients (all P<0.001). In terms of clinical outcomes, there were no statistical differences in return of spontaneous circulation ( P=0.072) and 24-hour survival ( P=0.093) between cardiogenic and non-cardiogenic patients. Conclusions:Cardiogenic cardiac arrest was the main cause of OHCA. Cardiogenic arrest patients were more underlying diseases, and older in age, the main clinical feature was onset at home. The comprehensive treatment measures for pre-hospital first-aid cardiac arrest should continue to be strengthened to improve the success rate of rescue for OHCA.