Objective To explore clinical manifestations, image findings, histopathological characteristics and surgical treatment for glomus tumor. Methods Clinical data of 18 patients with glomus tumor, who underwent surgical treatment from 1992 to 2002 was analysed retrospectively. Results There were 11 males and 7 females. The mean age was (39?7) years old, with 11.1% (2/18) cases of multiple tumors. Glomus tumor was located in the subungual region or extremities of limbs in 61.1% (11/18) cases, the diameter of the tumor was less than 10 mm in 88.9% (16/18) cases. The clinical misdiagnosis rate was as high as 61.1% (13/18).B ultrasound made correct diagnosis in 85.7% (6/7) cases with tumor location other than in the subungual region or extremities of limbs, while radiological finding rate was only 33.3% (4/12).There were 16 glomus tumors histopathologically classified as the glomangiomatous type, and 2 the solid type. The immunochemistry in 10 cases were all positive for Vementin. Conclusions Glomus tumor in the subungual region or extremities of limbs could be diagnosed without difficulty, while it was usually difficult to make correct diagnosis in cases with tumor at the other site for lack of specific symptoms and physical signs. Surgical removal should be the golden standard for the treatment of this tumor.

Objective To explore the feasibility of endovascular intervention for the treatment of Klippel-Trenaunay-Weber syndrome ( KTWS ). Methods Fourteen KTWS patients underwent arteriography followed by endovascular intervention with bleomycin( A5) + extraliquid lipiodol, PVA, NBCA, steel coil, respectively. Results Both haemangioma ( nevus) lesion and varicosities of the superficial vein in the involved limb improved in all 14 patients significantly. Main complications were pain, swelling of the embolized area. Severe swelling of the whole limb occurred in 3 cases, which subsided spontaneously within 7 - 9 days. At one month follow-up limb girth at the middle part of the thigh and at the point of 10 cm below the knee reduced by 2. 1 ?0. 3 cm and 2.0 ?0.2 cm respectively. Preoperative lymphatic edema of the limb in 3 cases (3/4) and the regurgitation of the superficial femoral vein in 3 cases also improved significantly. Conclusion Endovascular intervention of KTWS leads to symptomatic improvement of patients with KTWS.

Pulmonary edema is associated with pancreatic enzymes released into the blood stream during acute pancreatitis.Acute hemorrhagic pancreatitis in rats was established by injecting 5%sodium taurocholate into the pancreatic duct.Before and at the time of induction,SMS201-995 2?g/kg was injected subcutaneously,and followed by 3 h continuous I.V.infusion of NS solution containing SMS201-995 5?g?kg-1?h-1 at a rate of 6ml?kg-1?h-1.The results of this experiment showed that SMS201-995 could:(1) decrease the serum levels of amylase and lipase effectively;(2)reduce lung index and lung extravascular water volume siginficantly;(3)ameliorate the pathologic changs of lung and pancreas evidently.These results also suggested that SMS201-995 could both prevent and treat acute pancreatitis and pulmonary edema induced by it in rats.Therefore,it is theoretically sound that evidence can be proviede by the results obtained in this experiment for the application of SMS201-995,a long acting analogue of somatostatin,to treat clinical acute pancreatitis by its inhibitory effect towards pancreatic exocrine secretion.

Objective To explore the clinical characteristics of huge pancreatic pseudocysts and to evaluate the effect of different surgical treatments. Method We retrospectively analyzed the clinical data of 27 patients with huge pancreatic pseudocyst managed from Feb 1991 to Feb 2008. Result Among a total of 129 patients with pancreatic pseudocyst treated during this period of time,27 (20.9% ) patients were diagnosed as with huge pancreatic pseudocyst (diameter > 10cm). As to the etiology, 51.9% of the psudoeyst was caused by acute pancreatitis, 33.3% by pancreatic trauma and previous surgery, 11.1% by chronic pancreatitis. Pseudoeysts in the majority of cases(21/27)had a history less than 6 weeks. Upper GI obstruction complicated 30% cases (8/27). Imaging showed that all huge pancreatic pseudocysts were single. ERCP showed communication with the main pancreatic duct in 9 out of 11 cases. Nine cases underwent catheter drainage, 10 cases underwent cystogastrostomy,2 cases underwent endoscopic drainage of pancreatic pseudocyst via ERCP, 17 cases underwent Roux-en-Y cystojejunostomy including 11 cases in which other previous procedures failed. All 27 cases were finally cured. Conclusions Huge pancreatic pseudocyst might have unique clinical characteristics. Anatomical changes of main pancreatic duct were found in most cases under ERCP. The proper time and indication for surgical intervention might be different from minor pancreatic pseudocyst.

Vagus nerve is the main undertaker of the parasympathetic nervous system,participating in the regulation of inflammatory response and playing the role of organ function protection.Stimulation such as perioperative operation and anesthesia can often lead to a relative decrease in vagus nerve tension and in-crease in perioperative circulation,respiration,digestion,nerve,and other system-related complications.This article mainly reviews the effects of reduced vagal tone on perioperative multiple organ functions and va-gus nerve stimulation in organ function,aiming to provide new ideas for reducing various perioperative com-plications.

Objective To investigate the correlation between oral frailty and POD in elderly patients undergoing non-cardiac surgery.Methods A total of 268 elderly patients,115 males and 153 fe-males,aged ≥ 65 years,BMI 14-36 kg/m2,ASA physical status Ⅱ or Ⅲ,undergoing elective non-cardiac surgery from February 2023 to July 2023 were selected.The oral frailty index-8(OFI-8)was used to measure the oral frailty status of patients one day before surgery.The 3-minute delirium diagnostic scale(3D-CAM)was used to evaluate the occurrence of POD 1,2,3 days after surgery.The patients were divid-ed into delirium group(POD group)and non-delirium group(non-POD group)according to whether POD occurred 3 days after surgery.Multivariate logistic regression model was used to analyze the relationship be-tween oral frailty and POD.Results POD occurred in 61 patients(22.7％).Multivariate logistic regression analysis showed that postoperative use of analgesic pump(OR=2.298,95％CI 1.034-5.108,P=0.041)and oral frailty(OR=2.295,95％CI 1.193-4.415,P=0.012)are significantly correla-ted with the occurrence of POD,after adjusting for age,ASA physical status,hemoglobin,anesthesia time and infusion volume.Conclusion The incidence of postoperative POD in elderly patients with preoperative oral weakness is significantly increased undergoing non-cardiac surgery,and preoperative oral weakness is correlated with the occurrence of POD.

Objective To explore the mechanism by which soybean isoflavone(SI)reduces calcium overload induced by cerebral ischemia-reperfusion(I/R).Methods Forty-eight SD rats were randomized into 4 groups to receive sham operation,cerebral middle artery occlusion for 2 h followed by 24 h of reperfusion(I/R model group),or injection of adeno-associated virus carrying Frizzled-2 siRNA or empty viral vector into the lateral cerebral ventricle after modeling.Western blotting was used to examine Frizzled-2 knockdown efficiency and changes in protein expressions in the Wnt/Ca2+signaling pathway.Calcium levels and pathological changes in the ischemic penumbra(IP)were measured using calcium chromogenic assay and HE staining,respectively.Another 72 SD randomly allocated for sham operation,I/R modeling,or soy isoflavones pretreatment before modeling were examined for regional cerebral blood flow using a Doppler flowmeter,and the cerebral infarct volume was assessed using TTC staining.Pathologies in the IP area were evaluated using HE and Nissl staining,and ROS level,Ca2+level,cell apoptosis,and intracellular calcium concentration were analyzed using immunofluorescence assay or flow cytometry;the protein expressions of Wnt5a,Frizzled-2,and P-CaMK II in the IP were detected with Western blotting and immunohistochemistry.Results In rats with cerebral I/R,Frizzled-2 knockdown significantly lowered calcium concentration(P<0.001)and the expression levels of Wnt5a,Frizzled-2,and P-CaMK II in the IP area.In soy isoflavones-pretreated rats,calcium concentration,ROS and MDA levels,cell apoptosis rate,cerebral infarct volume,and expression levels of Wnt/Ca2+signaling pathway-related proteins were all significantly lower while SOD level was higher than those in rats in I/R model group.Conclusion Soy isoflavones can mitigate calcium overload in rats with cerebral I/R by inhibiting the Wnt/Ca2+signaling pathway.

Objective To explore the mechanism by which soybean isoflavone(SI)reduces calcium overload induced by cerebral ischemia-reperfusion(I/R).Methods Forty-eight SD rats were randomized into 4 groups to receive sham operation,cerebral middle artery occlusion for 2 h followed by 24 h of reperfusion(I/R model group),or injection of adeno-associated virus carrying Frizzled-2 siRNA or empty viral vector into the lateral cerebral ventricle after modeling.Western blotting was used to examine Frizzled-2 knockdown efficiency and changes in protein expressions in the Wnt/Ca2+signaling pathway.Calcium levels and pathological changes in the ischemic penumbra(IP)were measured using calcium chromogenic assay and HE staining,respectively.Another 72 SD randomly allocated for sham operation,I/R modeling,or soy isoflavones pretreatment before modeling were examined for regional cerebral blood flow using a Doppler flowmeter,and the cerebral infarct volume was assessed using TTC staining.Pathologies in the IP area were evaluated using HE and Nissl staining,and ROS level,Ca2+level,cell apoptosis,and intracellular calcium concentration were analyzed using immunofluorescence assay or flow cytometry;the protein expressions of Wnt5a,Frizzled-2,and P-CaMK II in the IP were detected with Western blotting and immunohistochemistry.Results In rats with cerebral I/R,Frizzled-2 knockdown significantly lowered calcium concentration(P<0.001)and the expression levels of Wnt5a,Frizzled-2,and P-CaMK II in the IP area.In soy isoflavones-pretreated rats,calcium concentration,ROS and MDA levels,cell apoptosis rate,cerebral infarct volume,and expression levels of Wnt/Ca2+signaling pathway-related proteins were all significantly lower while SOD level was higher than those in rats in I/R model group.Conclusion Soy isoflavones can mitigate calcium overload in rats with cerebral I/R by inhibiting the Wnt/Ca2+signaling pathway.

OBJECTIVESince 1986, the reference of birth weight for gestational age has not been updated. The aim of this study was to set up Chinese neonatal network to investigate the current situation of birth weight in China, especially preterm birth weight, to develop the new reference for birth weight for gestational age and birth weight curve.

METHODA nationwide neonatology network was established in China. This survey was carried out in 63 hospitals of 23 provinces, municipalities and autonomous regions. We continuously collected the information of live births in participating hospitals during the study period of 2011-2014. Data describing birth weight and gestational age were collected prospectively. Newborn's birth weight was measured by electronic scale within 2 hours after birth when baby was undressed. The evaluation of gestational age was based on the combination of mother's last menstrual period, ultrasound in first trimester and gestational age estimation by gestational age scoring system.

STATISTICAL ANALYSISthe growth curve was drawn by using LMSP method, which was conducted in GAMLSS 1.9-4 software package in R software 2.11.1.

RESULTA total of 159 334 newborn infants were enrolled in this study. There were 84 447 male and 74 907 female. The mean birth weight was (3 232 ± 555) g, the mean birth weight of male newborn was (3 271 ± 576) g, the mean weight of female newborn was (3 188 ± 528) g. The test of the variables' distribution suggested that the distribution of gestational age and birth weight did not fit the normal distribution, the optimal distribution for them was BCT distribution. The Q-Q plot test and worm plot test suggested that this curve fitted the distribution optimally. The male and female neonatal birth weight curve was developed using the same method.

CONCLUSIONUsing GAMLSS method to establish nationwide neonatal birth weight curve, and the first time to update the birth weight reference in recent 28 years.