Objective To explore the application value of triggered angiography non-contrast enhanced (TRANCE) technology in diagnosing lower limb arterial occlusive disease.Methods Totally 22 lower limb arterial occlusive disease patients were randomly selected,and then underwent TRANCE and DSA examinations.The arteries from the abdomen to the lower limb were divided into abdominal aorta,common iliac artery,external iliac artery,internal iliac artery,superficial femoral artery,deep femoral artery,popliteal artery,anterior tibial artery,posterior tibial artery and peroneal artery.Totally 337 sections displayed clearly were chosen to go through examinations by TRANCE and DSA.Results Of the 337 sections there were 312 ones with the same stenoses found by TRANCE and DSA,TRANCE found 16 sections with worse stenoses and 9 milder ones than by DSA.There were 153 sections with the same moderate stenoses (≥50％) displayed by TRANCE and DSA;Of the 153 sections,there were 15 ones with worse stenoses and 6 ones with milder stenoses found by TRANCE than by DSA.Kappa value of the two methods was 0.905.Conclusion TRANCE technology is a non-invasive,safe and nonradiative diagnosing method for the lower limb arterial occlusive disease.

Epilepsy occurs as a result of episodic abnormal synchronous discharges in cerebral neuronal networks.It is characterized by an imbalance between excitatory and inhibitory neurotransmission.Although various non-conventional mechanisms are implicated in epileptic synchronization, glutamate excitatory neurons play an essential role.AMPA receptors mediate fast synaptic excitation within and between brain regions relevant to epilepsy, and play a role in epileptogenesis and in seizure-induced brain damage.However, direct modulation of AMPA receptors may have undesirable consequences, given its wide expression within the central nervous system and critical roles on brain circuitry development.Hippocampal CA1 region, as the main site of epilepsy, selectively regulates the high expression of AMPA receptor GluA2 subunit and transmembrane AMPA receptor regulatory protein family(TARPs)γ-8 subtype and its complex GluA2/TARPγ-8, whether it can produce anti-epileptic and avoid adverse reactions.

Objective : To study the epidemiological characteristics of coronavirus disease 2019 （COVID-19） in Zhoushan, so as to provide reference for improving the prevention and control capability of COVID-19. Methods : All the confirmed cases of COVID-19 in Zhoushan, diagnosed according to China’s “COVID-19 diagnosis and treatment plan （fifth version） ” and reported from January 19 to February 17, 2020, were extracted from the infectious disease surveillance system. Data of general information, clinical characteristics, laboratory Results, transmission and detection routes were collected and analyzed. Results : By February 17, Ten confirmed cases of COVID-19 in Zhoushan had been reported, including 7 males and 3 females. They were all adults, with an average age of （50.90±15.00） years. Five cases were discharged. The incubation period ranged from 2 to 12 days, with a median of 5 days. The first symptoms were fever （8 cases）, cough （7 cases） and muscle pain （2 cases）. Chest computed tomographic （CT） scans showed ground glass opacities in the lungs of all the cases. Six cases had Wuhan related exposure. SARS-CoV-2 was tested positive in the sputum specimens or throat swabs of all the cases and the faeces of 4 cases. The last suspicious exposure of 5 cases occurred before, and that of another 5 cases occurred after the onset of clinical symptoms in the confirmed maternal cases. Three cases were found in active consultation after clinical symptoms, and another 7 cases were found in the monitoring of close contacts. Conclusions The 10 confirmed cases of COVID-19 reported in Zhoushan are all adults, and most have Wuhan related exposure. SARS-CoV-2 can be detected in the fecal samples, but the existence of fecal-oral transmission needs more research. SARS-CoV-2 has strong infectivity, and may also have infectivity before the onset of symptoms （at the end of incubation period）. Isolation and early detection of close contacts are conducive for early case-finding.

Objective? To investigate the readability evaluation of the printed health education materials by working nurses, to understand the perception of readability of health education materials and to lay the basis for future research on readability evaluation. Methods? In July 2017, 310 students from 147 hospitals (secondary and above) from all over Anhui Province were trained at Anhui Medical University. This study utilized the first stage of this training opportunity (July 3-14, 2017) to conduct an investigation of all participants. Surveys were conducted using a general survey, a printed health education material quality questionnaire, and a readability perception questionnaire. A total of 310 questionnaires were distributed in this study, and 283 valid questionnaires were returned. The effective response rate was 91.3%. Results? The results of the readability evaluation of the printed health education materials showed that 36 participants reported that there were no health education resources for the patients in their departments. 247 participants reported that they provided printed health education materials in their departments, 56.7% of them believed that the health education materials of their departments had too many medical terminologies, 53.8% thought that the key information was not summarized or emphasized, and 61.9% thought that the content was too old. Compared with the tertiary hospitals, the nurses working in the secondary hospitals thought that the health education materials in their hospitals had "too many medical terms" and "old content", and the difference was statistically significant (P＜0.05). The results of the evaluation of the application of health education materials showed that 247 clinical nurses reported that the existing health education materials were mainly obtained from the following channels, of which 64.8% were self-designed, 79.4% were from external institutions, and 68.4% were from online resources. Compared with the nurses in the tertiary hospitals, the nurses in the secondary hospitals reported more of the fact that their departments provided the same health education materials to patients with different stages, and the difference was statistically significant (P＜ 0.05); Regarding the perception of readability, 48.8% of the participants had heard of the concept of readability; 94.7% considered it necessary to assess the readability of health education materials; but only 20.5% understand the readability assessment method and have readability evaluation ability. Conclusions? At present, the health education materials used in clinical practice have to be improved in terms of readability and application methods, but the ability to evaluate readability is low. Developers of clinical education materials should pay attention to the readability evaluation of materials, learn from the methods and experience of foreign readability research, actively explore the evaluation methods suitable for the readability of health education materials in China, and improve the material based on the readability evaluation results. Hospital administrators should also strengthen the training of first-line health education nurses, improve their ability to assess the readability of health education materials and optimize the health education outcomes.

Objective:To understand the status quo and influencing factors of evidence-based nursing competencies among oncology nurses and provide a reference for enhancing this competency among oncology nurses.Methods:From September 2022 to January 2023, totally 300 practicing nurses from Zhejiang Cancer Hospital were selected by convenience sampling and surveyed with the Chinese version of the Evidence-Based Practice Belief-Knowledge-Practice Scale. Univariate analysis and multiple linear regression were employed to analyze factors affecting the evidence-based nursing competencies of these nurses.Results:The evidence-based nursing competency scores of the 300 oncology nurses were (44.50±10.78) . Among the three dimensions, the belief dimension had the highest average item score, while the practice dimension had the lowest. Multiple linear regression analysis revealed that gender, age, evidence-based training, participation in evidence-based projects, reading professional literature, publication of papers within the last five years and medical statistical level were influencing factors of their evidence-based nursing competencies (all P<0.05) . Conclusions:The evidence-based nursing competencies of oncology nurses are at a relatively low level. Nursing managers and educators should focus on female nurses, older nurses, intensify evidence-based nursing training efforts, and thus enhance the evidence-based nursing competencies and overall research quality of the nursing team.

Objective To investigate the feasibility and clinical significance of sentinel lymph node biopsy(SLNB) after neoadjuvant chemotherapy (NAC) for axillary lymph node-positive breast cancer.Methods Enrolled for a prospective cohort study were 167 patients from Jan 2016 to Jan 2018 with axillary lymph node-positive breast cancer admitted to the Cancer Hospital of Chinese Academy of Medical Sciences.SLNB was performed after NAC by lymphatic dual mapping,followed by axillary lymph node dissection.The primary end point was sentinel lymph node identification rate (IR) and false negative rate (FNR).Results 62 patients (37.1％) had complete pathological response of axillary lymph nodes.There was a significant difference of NAC response in patients with different subtypes (P ＜0.001).The IR of SLNB after NAC was 94.6％,the FNR was 6.7％,the sensitivity was 93.3％,the specificity was 100％,and the accuracy was 95.8％.Univariate analysis showed that there was no significant difference between tumor stage,hormone receptor status,HER2 expression,and pathological remission in SLN detection group and the SLN undetected group (P ＞ 0.05).The proportion of patients who received breast conserving surgery in the undetected group was significantly higher than that in the test group (P =0.006).Conclusions Sentinel lymph node biopsy after breast neoadjuvant chemotherapy by lymphatic dual mapping is highly accurate with a high identification rate and a low false negative rate.

Objective:To compare the efficacies of MRI, X-ray mammography (XMG) and Ultrasound (US) in detecting and diagnosing breast ductal carcinoma in situ (DCIS).Methods:Two hundred and forty one consecutive patients with pathology-confirmed DCIS were retrospectively recruited from January 2011 to December 2017 in PLA General Hospital. The imaging examination modalities included MRI and/or XMG and/or US.The breast imaging reporting and data system (BI-RADS) categorizations by MRI, XMG and US were compared and their sensitivities of detecting DCIS were calculated. The causes of underestimation on MRI were interpreted with the information of XMG and US. Chi-square test was used to compare the differences.Results:The diagnostic sensitivity of XMG, US and MRI was 65.9% (29/44), 71.6% (101/141) and 91.2% (145/159), respectively, with statistical significant differences (χ2 =24.034, P<0.001). Breast density and lesion type would influence the sensitivity of XMG. And the sensitivity of US was decreased because of non-mass lesion. Of the 14 cases under-evaluated as BI-RADS category 1 to 3 on MRI, 5 were corrected by XMG and/or US to BI-RADS category 4. The cause of underestimation on MRI was the coexistence of DCIS with adenoma or other benign lesion. Conclusion:The retrospective comparison of MRI, XMG and US in this study showed that MRI had significant higher sensitivity in detecting breast DCIS, while the false negative rates of XMG and US were un-negligible.

Objective:To investigate the protective effect of interfering peptide TAT-GluA2CT on hippocampal neurons in the Lithium chlorine-Pilocarpine status epilepticus model and the optimal time of administration.Methods:Male SD rats (72 cases) were induced to status epilepticus by using Lithium chlorine-Pilocarpine, while a control group ( n=12) was established.The 72 rats were divided into epilepsy group ( n=12), TAT-sham peptide group ( n=12), TAT-GluA2CT peptide group ( n=48) according to the random number table method, and the TAT-GluA2CT peptide group were further divided into the pre-1 h group ( n=12), the post-2 h group ( n=12), the post-4 h group( n=12), and the post-6 h group ( n=12) according to the administration time of the TAT-GluA2CT peptide.Nissl staining and terminal dUTP nick end labeling (TUNEL) assay were performed on 6 rats each from control group, epilepsy group, TAT-shampeptide group, pre-1 h group, post-2 h group, post-4 h group, and post-6 h group to observe the morphological changes and apoptosis of neurons in the CA1 region of the rat hippocampus.Western blot and co-immunopercipitation test were used to detect the expression of GluA2[second subunit of α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) recepter] and the coupling of GluA2/transmembrane AMPA receptor regulatory protein (TARP γ-8) complex in control group, epilepsy group, pre-1 h group, post-2 h group, post-4 h group and post-6 h group.The t-test was used to compare the data differences between 2 groups, and one-way ANOVA was adopted to compare the differences between the groups. Results:Compared with the epilepsy group, the number of neurons in each TAT-GluA2CT peptide group increased significantly, and the difference was statistically significant( epilepsy group 20.07±3.51, pre-1 h group 39.40±2.39, post-2 h group 38.43±2.42, post-4 h group 30.30±2.55, and post-6 h group 27.93±3.20, F=235.28, P<0.05). Compared with the epilepsy group, the number of apoptotic cells in each TAT-GluA2CT peptide group was significantly reduced, and the difference was statistically significant(epilepsy group 31.47±3.19, pre-1 h group 7.30±3.45, post-2 h group 9.27±3.81, post-4 h group 12.86±3.08, and post-6 h group 14.43±3.13, F=248.60, P<0.05). Compared with the control group, the expression of hippocampal GluA2 decreased after epilepsy induction, and the difference was statistically significant(control group 21 626.53±2 700.58, epilepsy group 14 578.16±2 917.02, pre-1 h group 13 375.47±3 180.54, post-2 h group 15 244.10±1 390.41, post-4 h group 15 799.16±4 559.49, post-6 h group 15 722.95±1 756.01, F=3.83, P<0.05). No statistical difference was observed in the expression of GluA2 between the TAT-GluA2CT peptide group and the epilepsy group( F=0.45, P=0.77). Compared with the epilepsy group, GluA2/TARPγ-8 complex coupling was decreased in each TAT-GluA2CT peptide group, and the difference was statistically significant(epilepsy group 24 509.80±3 718.54, pre-1 h group 12 055.18±5 847.11, post-2 h group 9 630.51±5 805.17, post-4 h group 12 749.35±7 108.45, post-6 h group 11 092.98±7 330.08, F=10.68, P<0.05). Compared with the epilepsy group, the incubation period of seizures in the pre-1 h group was prolonged and the seizure rating was decreased, with statistically significant differences[epilepsy group (18.58±3.99) min, pre-1 h group (103.25±9.21) min, t=29.23, P<0.05]. Conclusions:TAT-GluA2CT peptide can attenuate the neuronal damage in hippocampus of epileptic rats.The neuroprotective effect of TAT-GluA2CT peptide was most obvious at 1 h before or 2 h after administration of Pilocarpine.

Objective To observe the value of intratumoral and peritumoral radiomics based on diffusion weighted imaging(DWI)for predicting histological grade of breast cancer.Methods Preoperative DWI data of 700 patients with single breast cancer diagnosed by pathology were retrospectively analyzed.The patients were divided into training set(n= 560,including 381 of grade Ⅰ+Ⅱ and 179 of grade Ⅲ)and test set(n=140,including 95 of grade Ⅰ+Ⅱ and 45 of grade Ⅲ)at the ratio of 8∶2.Intratumoral ROI(ROIintra)was manually delineated on DWI,which was automatically expanded by 3 mm and 5 mm to decline peritumoral ROI(ROIperi,including ROI3 mm and ROI5 mm),then intratumoral-peritumoral ROI(ROIintra+3 mm,ROIintra+5 mm)were obtained.The optimal radiomics features were extracted and screened,and the radiomics model(RM)for predicting the histological grade of breast cancer were constructed.Receiver operating characteristic curves were drawn,and the areas under the curve(AUC)were calculated to evaluate the predictive efficacy of each model.Calibration curve method was used to evaluate the calibration degree,while decision curve analysis(DCA)was performed to explore the clinical practicability of each model.Results AUC of RMintra,RM+3 mm,RM+5mm,RMintra+3 mm and RMintra+5 mm was 0.750,0.724,0.749,0.833 and 0.807 in training set,while was 0.723,0.718,0.736,0.759 and 0.782 in test set,respectively.In training set,significant differences of AUC was found(all P＜0.01),while in test set,no significant difference of AUC was found among models(all P＞0.05).The calibrations of models were all high.DCA showed that taken 0.02-0.88 as the threshold,the clinical net benefit of RMintra+per were greater in training set,while taken 0.40-0.72 as the threshold,the clinical net benefit of RMintra+per was greater in test set.Conclusion Both DWI intratumoral and peritumoral radiomics could effectively predict histological grade of breast cancer.Combination of intratumoral and peritumoral radiomics was more effective.

To analyze the positivity rate and titer of antinuclear antibody (ANA), as well as nuclear pattern and target antigen of ANA in healthy pregnant women during early pregnancy in Qingdao area. A prospective cohort study design was used to include a total of 9 528 healthy pregnant women registered at the Women and Children′s Hospital Affiliated to Qingdao University from March 2023 to June 2024.Indirect immunofluorescence assay (IIF) was used to detect ANA, its titer and cell staining pattern. Fifteen specific antibodies were tested using the magnetic bar code immunofluorescent luminescence method. Logistic regression model was used to analyze the risk factors of pregnancy with autoimmune disease(AID). The results showed that among 9 528 pregnant women in early pregnancy, 1 346 cases (14.1%) were positive of ANA, including 1 011 cases with a titer of 1∶100 (10.6%), 236 cases (2.5%) with a titer of 1∶320, and 99 cases (1.0%) were detected at a titer >1∶320. Among the 1 346 ANA-positive pregnant women, nuclear granular type accounted for the highest proportion (483 cases, 35.9%), followed by speckled type (347 cases, 25.8%) and cytoplasmic type (176 cases, 13.1%).Then, pregnant women with ANA titers ≥1∶100 were detected 15 specific antibodies.Anti-SSA was tested in 121 cases accounted for the majority, followed by 110 cases with anti-Ro-52, 56 cases with anti-SSB, 51 cases with anti-mitochondrial M2 subtype antibodies and 37 cases with anti-centromere B. In conclusion,in healthy pregnant women in Qingdao area, ANA positivity rate was 14.1%, and the titer of ANA was mainly at 1∶100.The predominant nuclear patterns were nuclear granular and speckled types.The specific autoantibodies were mainly anti-SSA antibodies and anti-Ro-52 antibodies.The detection of ANA and specific autoantibodies is of great significance for early prediction, diagnosis, and intervention of autoimmune diseases during pregnancy.