Objective To study the value of transfer constant(Ktrans)derived from dynamic contrast-enhanced MRI (DCE-MRI) for quantitative evaluation of Ki-67 labeling index (Ki-67 LI) in glioma. Methods Twenty patients with glioma who underwent DCE-MRI and operation were retrospectively reviewed. The Ktrans value and Ki-67 LI were acquired and correlated using the Spearman correlation test. Also, the Ktrans values were compared between high(larger than 10%)and low(no more than 10%)Ki-67 LI group with Mann-Whitney U test, receiver operating characteristic curves was performed to evaluate the diagnostic value. Results The Ktrans value(0.0165 to 0.8048, median 0.1252)was significantly associated with Ki-67 LI(5%to 50%, median 20%) (r=0.721,P<0.001), and the Ktrans value was significantly higher in high Ki-67 group(0.0810 to 0.8048, median 0.1810)than that in low Ki-67 LI group(0.0165 to 0.1456, median 0.0697)(Z=-3.209, P=0.001). The most predictive Ktrans value differentiated high Ki-67 LI and low Ki-67 LI with an area under the curve(AUC) of 0.945 at a sensitivity of 92.3% and specificity of 85.7%. Conclusion Ktrans value could be used for quantitative evaluation of Ki-67 LI in glioma.

Objective To explore optimal initial the best screening time for newborns with different delivery methods using AABR.Methods A total of 550 newborns who were born from August 1, 2016 to October 31, 2016 at our hospital participated in the study.AABR was used to accomplish the initial hearing screening.The newborns were divided into 2 groups according to the delivery methods.There were each 100 neonates born in vaginal during <24 h, 24~48 h and 48~72 h after birth, respectively.The numbers of neonates delivered by cesarean section during the 3 separate periods were 50, 100 and 100, respectively.The newborns who failed the preliminary hearing screening proceeded to the re-screening and diagnostic procedures.Results There were 300 newborns were born in vaginal, and the pass rate in 24~48 h after birth group was significantly higher than that in 24 h group (93.00% vs 83.00%,x2=4.735,P=0.03<0.05), but it was not significantly different from that of 48~72 h group (95.00% vs 93.00%,x2=0.355,P=0.56>0.05).There were 250 newborns in cesarean section, the pass rate of 24~48 h after birth group was significantly higher than that in 24 h group (83.00% vs 68.00%,x2=4.437, P=0.04<0.05), and significantly lower than that of 48~72 h group (94.00% vs 83.00%,x2=5.944, P=0.02<0.05).Conclusion Taking into account of hospitalization time, the screening time for the vaginal delivery newborn hearing screening can be advanced to 24~48 h after birth with the application of AABR, but not for the cesarean section group.

Purpose: MicroRNAs play key regulatory roles in the tumorigenesis of hepatitis B virus-related hepatocellular carcinoma (HBVHCC). This study aimed to explore the regulatory effects of microRNA-98-5p (miR-98-5p) on the proliferation, migration, invasion, and apoptosis of HBV-HCC cells, as well as the underlying mechanisms involving nuclear factor-κB-inducing kinase (NIK). Materials and Methods: The expressions of miR-98-5p and NIK in HBV-HCC tissues and cells, and the level of HBV DNA in HBVHCC cells were measured by quantitative real-time polymerase chain reaction (qRT-PCR). The proliferation, migration, invasion, and apoptosis of HBV-HCC cells were analyzed by cell counting kit-8, wound healing, transwell, and flow cytometry assay, respectively. The targeting relationship between miR-98-5p and NIK was predicted by StarBase3.0 and verified by dual-luciferase reporter assay. HBV-HCC xenograft tumor model was constructed in mice to observe the tumor growth in vivo. Results: The expression of miR-98-5p was declined in HBV-HCC tissues and cells. Overexpression of miR-98-5p markedly reduced the level of HBV DNA; inhibited the proliferation, migration, and invasion; and promoted the apoptosis of HBV-HCC cells. NIK was a target of miR-98-5p. Overexpression of miR-98-5p markedly decreased the protein expression of NIK in MHCC97H-HBV cells. NIK reversed the tumor-suppressing effect of miR-98-5p on HBV-HCC cells. Furthermore, overexpression of miR-98-5p significantly inhibited the xenograft tumor growth and decreased the expression of NIK in mice. Conclusion MiR-98-5p inhibits the secretion of HBV, proliferation, migration, and invasion of HBV-HCC cells by targeting NIK.

Objective To investigate the value of Chlamydia trachomatis antigen in patients with tubal infertility and its effect on the prevention of infection. Methods 80 patients with tubal infertility who were admitted in our hospital from January 2016 to October 2017 were selected as the study group and 80 patients with tubal patency by hysterosalpingography in our hospital were selected as the control group. The study group underwent Chlamydia trachomatis antigen detection. The relevant indicators were observed and clinical diagnostic effect and the effect of infection prevention of patients was recorded in detail. Results The diagnostic results showed that there were 77 cases diagnosed in the study group, and the diagnostic coincidence rate was 96. 2％, of which the diagnostic coincidence rates of tubal blockage, genital tract infection, tubal effusion, acute salpingitis were 100. 0％, 96. 1％, 96. 6％, 93. 8％. The positive rate of Chlamydia trachomatis antigen in the study group was 82. 5％ (66/80). The positive rate of Chlamydia trachomatis antigen in the control group was 15. 0％ (12/80). The positive rate of the study group was significantly higher than that of the control group (P＜0. 05). The test results showed that the incidence of abortion, preterm birth, dead fetus, stillbirth, ectopic pregnancy and other symptoms was significantly higher in the positive patients' study group. In the aspect of infection prevention, the number of patients infected at each time period in the study group gradually reduced with the growth of time and the increase of number of infected people. Conclusion The detection of Chlamydia trachomatis antigen in patients with tubal infertility can achieve high coincidence rate of clinical diagnosis, earlier detection of tubal disease in patients and timely treatment measures, reduce the incidence of postoperative infection in patients, which should be further applied in clinical.

Objective To investigate the clinical characteristics and treatment strategies of arachnoid cyst combined with chronic subdural hematoma.Methods Seventeen patients with arachnoid cyst combined with chronic subdural hematoma,who received treatment in our hospital from February 2008 to March 2016,were chosen in our study;13 of them were performed burr hole irrigation and drainage,2 received craniotomy for removing hematoma and cystectomy,and 2 received endoscopic cyst excision and hematoma removal surgery.A retrospectively analysis of clinical characteristics and treatment strategies of these patients was performed.Results Follow up for 0.5-2 years was performed in the 13 patients performed burr hole irrigation and drainage,and no hematoma relapse was noted;one was found rebleeding in the cyst associated with a small amount of subdural hematoma on the 5th d of surgery,and the subdural hematoma was absorbed during the follow-up observation;one was found that the cyst and subdural hematoma both disappeared in the postoperative check,while the cyst reappeared 40 days after surgery,and during the follow-up observation,the cyst was not enlarged and the chronic subdural hematoma was not relapsed.Two patients recovered after receiving the craniotomy for removing hematoma and cystectomy;two patients recovered after receiving the endoscopic cyst excision andhematoma removal surgery.Conclusion For patients with arachnoid cyst associated with chronic subdural haematoma,burr-hole irrigation and drainage are generally selected;for patients with reappeared cyst or hematoma,there is no need to burr hole again or perform the surgery aiming at the cyst in a haste,and follow-up observation is suggested;for patients whose symptoms in the cyst have appeared before hemorrhage or whose hemorrhage appeared recurrently in the cyst,surgery of hematoma removal and cyst excision can be chosen at the same time.

To summarize the continued nursing management of a patient with combined liver-lung transplantation.Nursing points:regular review and joint remote guidance;dynamic optimization of the rehabilitation program;strict control of blood concentration of Tacrolimus;the strengthening of infection prevention and control;standardized management of post-transplant diabetes mellitus;active interventions in osteoporosis;helping patients to self-empower and achieve all-round rehabilitation.In 2 years and 8 months after surgery,the follow-up showed that the patient had normal transplant organ function and good quality of life.

The nursing experience of a patient with right-to-left inverted lung transplantation was summarized.The key points of nursing care:closely monitoring frequent arrhythmiac;developing excessive pulmonary rehabilitation strategies based on heart rate;being alert to carbon dioxide retention caused by pulmonary insufficiency;performing non-invasive ventilation combined with nitric oxide inhalation for pulmonary hypertension care;early identification and management of gastrointestinal dysfunction;and strengthening the prevention and management of complications.After fine care,the patient recovered well,and the transplanted lung function was normal,and he was discharged smoothly.

Objective:To investigate the value of intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) parameters combined with T 2WI texture analysis of primary lesions of rectal adenocarcinoma in preoperative prediction of lymph node metastasis with short diameter ≤9 mm. Methods:Retrospective analysis was performed on 115 cases of rectal adenocarcinoma confirmed by surgical pathology in Affiliated Provincial Hospital of Anhui Medical University from June 2015 to October 2020. All patients underwent total mesorectal resection and received conventional rectal MRI and IVIM-DWI scan before surgery. According to the pathological results of lymph node, the patients were divided into lymph node metastatic group ( n=44) and non-metastatic group ( n=71). IVIM-DWI parameters of primary rectal adenocarcinoma were measured including apparent diffusion coefficient (ADC), diffusion coefficient (D), pseudo diffusion coefficient (D *) and perfusion fraction (f). The region of interest (ROI) of the whole lesion of rectal adenocarcinoma was delineated on axial T 2WI; then the ROIs were imported into GE Analysis Kit software to extract 3D texture feature. The differences of IVIM-DWI parameters and texture feature parameters were compared between two groups using independent sample t test or Mann-Whitney U test. The optimal texture feature parameters with independent predictive function were screened by multivariate logistic regression. Then the texture feature model and combined model based IVIM-DWI and texture feature parameters were established. The receiver operating characteristic (ROC) curves were used to evaluate the performances of IVIM-DWI, texture feature parameters, texture feature model and combined model in predicting lymph node metastasis in patients with rectal adenocarcinoma. The area under the ROC curve (AUC) were compared with DeLong test. Results:Among all the IVIM-DWI parameters, the D * and f values of primary rectal adenocarcinoma were significantly different between the lymph node metastasis group and the non-lymph node metastasis group ( Z=3.39, P=0.001, Z=-3.06, P=0.002); no statistical significance was found in the ADC and D values between two groups (both P>0.05). A total of 828 texture feature parameters were obtained based on T 2WI of primary lesion of rectal adenocarcinoma, among which 3 optimal texture feature parameters were selected, including firstorder_Skewness, shape_Sphericity and glcm_Idn. The ROC curve results showed that the AUC of D * and f were 0.689 and 0.670, respectively. The AUC of 3 texture feature parameters were 0.651, 0.628, 0.631, respectively. The AUC of texture feature model and the combined model were 0.775 and 0.803. The AUC of combined model was larger than D *, f and the three texture feature parameters (all P<0.05). Conclusion:IVIM-DWI parameters combined with T 2WI texture feature parameters in primary lesion of rectal adenocarcinoma show good diagnostic efficacy in preoperative prediction of lymph node metastasis with short diameter≤9 mm.

Objective To retrieve,evaluate and summarize the best evidence of early mobilization in awake patients on extracorporeal membrane oxygenation,and to provide a reference for clinical practice.Methods UpToDate,BMJ Best Practice,Registered Nurses'Association of Ontario,National Guideline Clearinghouse,National Institute for Health and Care Excellence,Yimaitong,Joanna Briggs Institute Library,Cochrane Library,CINAHL,PubMed,SinoMed,CNKI,Wanfang Database,Vip Database and Extracorporeal Life Support Organization Website were researched to collect the literature,including clinical guidelines,expert consensuses,evidence summaries,systematic reviews,and well-designed original studies.The time limit for retrieval was until June 2023.The quality of literature and the level of evidence were evaluated by the evaluation criteria and evidence grading system of J BI Evidence-Based Health Care Center.Results 14 pieces of the literature were included,including 2 clinical guidelines,4 expert consensuses,5 systematic reviews,2 cohort studies and 1 case series.Totally 33 pieces of evidence were summarized,covering 7 aspects:adaptation conditions for the implementation of awake ECMO,team composition,comprehensive assessment,pre-mobilization preparation,mobilization content,prevention and control of adverse events,and effect evaluation.Conclusion The study summarizes the best evidence of early mobilization in awake patients on extracorporeal membrane oxygenation.It is suggested that medical institutions establish a professional team for the early mobilization of awake ECMO patients,apply the best evidence to standardize the early mobilization process,and formulate an individualized mobilization program.

Objective To identify the factors associated with frailty in lung transplant patients by a meta-analysis.Methods Computerized search was performed for studies on the influencing factors of frailty in lung transplant patients in the CNKI,WanFangData,VIP,CBM,PubMed,Web of Science,Embase,Elsevier ScienceDirect and CINAHL databases.The search was conducted from the time of database construction to November 2023.Literature screening,quality assessment,and data extraction were performed independently by 2 investigators,and Meta-analysis was performed using Stata 17.0 software.Results 10 cohort studies,including 1 999 patients,were finally included,and 13 influencing factors were extracted,including advanced age(OR=1.05),female(OR=2.50),BMI(OR=0.38),diagnosis of primary pulmonary disease(OR=2.90),6MWD(OR=0.34),and lung allocation score(OR=0.69),FVC(OR=0.60),pre-transplant frailty(OR=0.81),hypoproteinemia(OR=4.12),hemoglobin(OR=0.50),anemia(OR=4.37),length of ICU stay(OR=1.24),and total length of stay(OR=1.05).Short Physical Performance Battery is an assessment tool for frailty in lung transplant patients,with an incidence of frailty in 24％before transplantation and 50％in post-transplantation.Fried Frailty Phenotype is an assessment tool for frailty in lung transplant patients,with a pre-transplant frailty incidence of 30％.Conclusion There are many factors involved in the incidence of frailty in lung transplant patients,and nursing staff should dynamically evaluate the frailty of lung transplant patients,and give individualized and precise interventions in combination with a multidisciplinary model to improve or delay the progression of frailty.