Objective To analyze the MRI manifestations of meningeal carcinomatosis, and to investigate the value of MRI in diagnosis of meningeal carcinomatosis.Methods The MRI data of 28 cases with proven meningeal carcinomatosis were reviewed retrospectively.Results 11, 8 and 25 cases were detected respectively on pre-contrast T 2WI and T 1WI of SE sequence , and post-contrast T 1WI.According to the manifestations of post-contrast MRI, meningeal carcinomatosis were divided into two types: dura-arachnoid enhancement(7 cases) and pia-subarachnoid space enhancement(18 cases) in accordance with the standard of Meltzer.Conclusion MRI, especially the post-contrast MRI is a reliable modality in diagnosis of meningeal carcinomatosis. Double dosage of contrast medium and thin slice thickness can provide more informations.

Objective To study the characteristics of MR imaging and proton MR spectrscopy(~1H MRS)of stroke-like lesions in MELAS.Methods Clinical,MR imaging and proton spectroscopic findings of stroke-like lesions in 7 patients with confirmed MELAS were analyzed retrospectively.Results A total of 12 MR investigations had been performed in 7 patients.Stroke-like lesions showed by MR imaging included superacute in 12,acute in 12,subacute in 10 and chronic stage in 6.Early stroke-like lesions were demonstrated as focal edematous foci mainly involved cortex/subcotical areas of occipital,temporal and parietal lobes.At MR diffusion imaging,stroke-like lesions in the superacute(＜3 days)stage were showed as well-circumscribed lesions with high signal intensities for cytotoxic edema.During the acute(4～7 days),sub-acute(2～4 weeks)and chronic(＞4 weeks)stages,the lesions gradually expanded,and became blur,and presented with vasogenic edema mainly.Proton spectroscopy showed a prominently elevated lactate,varied decrease of NAA concentration and other brain motabolites in the stroke-like lesions early after onset,and depicted gradual decrease of lactate level and partial recovery of NAA concentration subsequently.Conclusion Stroke-like lesions in MELAS mainly involve the cerebral cortex and subcortical areas,in which cytotoxic edema appears early but for a short period.In ~1H MRS,the lesions are characterized by a double lactate peak with decrease of NAA concentration.

Objective To investigate the effect of cyanidin-3-glucopyranoside extracted from Chinese bayberry on proliferation and apoptosis of human gastric cell line SGC7901.Methods After cocultured with C3G on different concentrations,cell proliferation was determined by MTT assay; morphology of apoptosis were observed by laser confocal microscopy; TUNEL assay was applied to measure the apoptoic rate; The expression of Bcl-2,Bax,Caspase-3,ICAD protein were observed by Western blot assay.Results C3G significantly inhibited the proliferation of SGC7901 cells in a concentration-and timedependent manner as measured by MTT method(P ＜ 0.01).After cells were treated with C3G,the presence of typical morphological changes of apoptosis was confirmed with laser confocal microscopy after Hoechst 33258 fluorescence staining.TUNEL assay indicated that the number of apoptotic cells in C3G-treated group was greater than that in the gastric cancer cells group(P ＜ 0.01).The expression level of Bcl-2 was down-regulated while the expression level of Bax was up-regulated by C3G,the ratio of Bcl-2 protein and Bax protein decreased.C3G may accelerate the activation of procaspase-3 and down-regulate the expression of ICAD(P ＜ 0.01).Conclusions C3G inhibits SGC7901 cell growth and induces apoptosis in a concentraion-and time-dependent manner.This action may be mediated by down-regulating Bcl-2/Bax,resulting in Caspase-3 activition and decreased ICAD protein expression.

Objective To discuss the emergency management and treatment measures of critically severe craniocerebral trauma.Methods A retrospective study was conducted on the emergency management in 82 patients with critically severe craniocerebral trauma admitted to our hospital from September 2005 to May 2011.Results According to the Glasgow Outcome scale ( GOS),there were 10 patients with good recovery (12％),17 with moderate disability (21％),12 with severe disability (20％),four in vegetable status (2％) and 39 deaths (48％).Conclusion The success rate in the treatment of critically severe craniocerebral injury can be enhanced through rapid and effective pre-hospital care,prompt surgical intervention,standardized subsequent therapy,adherence to damage control surgery concept,and emphasis on prevention and cure of secondary brain injury.

Fluorescent carbon quantum dots ( CQDs) were synthesized by one-step hydrothermal treatment of apple juice. Experiments showed that Hg2+could quench the fluorescence of the CQDs with specificity. Based on this phenomenon, a selective and sensitive sensor was constructed for Hg2+ detection. In a NaH2 PO4-Na2HPO4 buffer solution (pH 7. 0), their fluorescence intensity showed good linear relationship with the concentrations of Hg2+ from 5 to 100 nmol/L and 1 to 50 μmol/L, respectively, with the detection limit of 2. 3 nmol/L (S/N=3). Its practical application was further demonstrated by the detection of Hg2+ in real water samples.

Objective To evaluate the sensitivity, repeatability and accuracy of microarray digital PCR system in detecting JAK2 V617F mutation, which was closely related to myeloproliferative neoplasms (MPN).Methods All of the 31 MPN patients with JAK2 V617F mutation, including 18 cases of polycythemia vera(PVs),11 primary thrombocythemias (ETs) and 2 primary myelofibrosis (PMFs), were collected from Huashan Hospital, Fudan University during 2014 -2015, while 10 normal controls and 6 cases with abnormal increased hemoglobin were involved.Human erythroleukemia cell line ( HEL ) and colorectal cancer cell SW480 were used as the mutant and the wild type control, respectively.The sensitivity of microarray digital PCR were verified by detecting the gradient diluted mutation standard harboring 30%, 10%, 1%, 0.1%and 0.01%mutant allele burden, respectively .Repeatability was evaluated by detecting 1%and 10% mutated samples for 5 times, respectively.MGB probe real time PCR was selected as the reference method to verify the accuracy of the digital PCR.Results With digital PCR, the accurate quantitation of JAK2 V617F mutation was achieved down to 0.1%, which is approximate to 0.16 copies per microliter.The results obtained from the two kinds of technique showed a high correlation by linear regression analysis (R2 =0.998 3).The results of repeated samples showed CVs as 17.18% for 1%mutant allele burden and 7.50%for 10%.Among all cases, the 31 patients known mutated were detected as positive and 10 controls as negative by both digital PCR and Real time PCR.In another 6 cases, 2 were found JAK2 V617F mutation of low allele burdens of 0.37% and 0.18% by digital PCR but detected as negative by real time PCR.Conclusions Microarray digital PCR offers a higher sensitivity and better repeatability than real time PCR which could help detect rare JAK2 V617F mutations in MPNs accurately.

Objective:To translate the 16-item version of Quality of Life in Children with Epilepsy (QOLCE-16) into Chinese, and conduct reliability and validity analysis in Chinese children with epilepsy.Methods:The International Functional Assessment of Chronic Illness Therapy (FACIT) translation method was adopted. Three bilingual translators pre-translated the source scale, and another three bilingual translators performed back translation. The QOLCE-16 was adjusted through the cognitive interview and expert consultation. This study was a cross-sectional study. Convenience sampling was used to select 256 children with epilepsy who were admitted to the Department of Neurology of Children's Hospital of Shanghai from June to December 2020. All questionnaires were filled out by long-term caregivers, and 256 copies were finally recovered effectively to analyze the reliability and validity of the QOLCE-16 after cultural adjustment in the evaluation of the health-related quality of life of children with epilepsy. A total of 40 subjects were selected from the sample, and the Chinese version of QOLCE-16 was filled out again at an interval of 2 to 3 weeks. Finally, 32 samples were effectively recovered to evaluate the test-retest reliability of the scale.Results:The Chinese version of QOLCE-16 had 16 items in total, including 4 dimensions of cognition, emotion, social interaction, and physical function. Each item had a good degree of discrimination, and there was a statistical correlation with the total score of the scale ( P<0.05) . The scale-level content validity index ( S- CVI) was 1.00, and the item-level content validity index ( I- CVI) was from 0.89 to 1.00. The KMO value of exploratory factor analysis was 0.909, the eigenvalues of each dimension were 3.482, 3.223, 3.136, 2.955 respectively, and the cumulative variance contribution rate was 79.976%. The Cronbach's α coefficient of the scale was 0.938, and the Cronbach's α coefficient of each dimension was from 0.866 to 0.939. The split-half reliability was 0.814, and the split-half reliability of each dimension ranged from 0.840 to 0.942. The test-retest reliability of the scale was 0.724, and the test-retest reliability of each dimension was from 0.615 to 0.716. Conclusions:The Chinese version of QOLCE-16 has good reliability and validity, and can be used as a simple tool for evaluating the health-related quality of life of children with epilepsy between 4 and 18 years of age.

Objective To compare the curative effect and safety of high-frequency and low-frequency repetitive tran-scranial magnetic stimulation(r-TMS) in the treatment of Parkinson's disease complicated with depressive disorder. Methods All 92 patients with Parkinson's disease complicated with depressive disorder were randomly allocated to three groups. High frequency group received antiparkinsonian drugs combined with high frequency r-TMS (5 Hz);Low frequency group received antiparkinsonian drugs combined with low frequency r-TMS (0.5 Hz);Sham group re-ceived antiparkinsonian drugs combined with sham r-TMS (s-rTMS). Each group received r-TMS twice a week for four weeks. UPDRS and HAMD-17 were assessed every two weeks , adverse events were recorded , and clinical global im-pression was carried out four weeks after the treatment. Results Upon enrollment, scores of HAMD and UPDRS among the three groups were not significantly different (P>0.05). During the second week of the intervention, the HAMD score in high frequency group improved significantly , and the differences between three groups were statistically signif-icant according to one-way ANOVA (P=0.0144). The differences changed larger in the fourth week, with greatly sig-nificant differences between the two groups (P=0.0000);During the second week of the intervention, the differences of UPDRSⅡscores in high frequency, low frequency and sham group were not statistically significant according to one-way ANOVA (P=0.1981). The differences appeared in the fourth week, but the differences between groups were not statistically significant according to one-way ANOVA (P=0.0219). During the second week and the fourth week of the intervention, UPDRS Ⅲ scores in the three groups were not significantly different (P=0.6105, 0.4248 respectively). Adverse events in the three groups were rare, and the differences were not statistically significant. Conclusion High-frequency stimulation on dorsal-lateral left prefrontal cortex is effective in alleviating depression for patients with Parkinson's disease, and is also effective in improving capabilities in daily life, which shows exact clinical effect and rare adverse events.

Objective? To investigate the current situation of the self-efficacy in the main caregivers of pediatric enterostoma patients and its influencing factors, to provide scientific basis for formulating continuing nursing intervention measures for children with enterostomy. Methods? A cross-sectional investigation was carried out. The primary caregivers of the pediatric enterostoma patients who were treated in a ClassⅢ Grade A children's specialized hospital in Shanghai during January 2016 to October 2017 were selected by convenience sampling method. A self-designed general information questionnaire, General Self-Efficacy Scale (GSES), and Hamilton Depression Rating Scale (HAMA) were applied in the investigation. Univariate analysis and multiple linear regression analysis were applied to analyze the influencing factors of self-efficacy. A total of 92 questionnaires were sent out, and 90 were recovered, with a valid rate of 97.83%. Results? The median score of GSES among the 90 primary caregivers of the pediatric enterostoma patients was 24, ranging from 13 to 36, which was at a median to low level. The result of univariate analysis showed that there were significant differences in the distribution of caregivers' self-efficacy scores in terms of education level, residence, family monthly income, health insurance, family structure type and doctor-patient communication level (P＜ 0.01). Multivariate linear regression analysis showed that caregivers' educational level, family type, anxiety level and family monthly income were the main factors affecting their self-efficacy. Conclusions? The self-efficacy level of the main caregivers of children with enterostoma needs to be improved. We should strengthen doctor-patient communication for caregivers with lower education, encourage seeking social support, expand information acquisition, enhance care ability and improve the quality of life of children.

Objective:To explore the mediating effects of parental perceptions of child vulnerability (PPCV) and child anxiety in the relationship between parental social support and the quality of life in children with epilepsy.Methods:This was a cross-sectional study. Totally 315 children with epilepsy and their 315 parents who visited the neurologic outpatient clinic for video EEG monitoring from September 2021 to April 2022 were selected by convenience sampling and investigated with General Information Questionnaire, Child Vulnerability Scale (CVS), Social Support Rating Scale (SSRS), PROMIS Parents Report Anxiety Short Form, and the Quality of Life in Children with Epilepsy-16 (QOLCE-16). Pearson correlation was used to analyze the relationships between quality of life in children with epilepsy and variables such as parental social support, PPCV, and child anxiety. AMOS 22.0 was utilized to establish a structural equation model to examine the relationships among the variables. A total of 315 questionnaires were distributed, with 295 valid questionnaires retrieved, yielding a response rate of 93.7%.Results:The scores for the 295 parents on the SSRS, CVS, PROMIS Parents Report Anxiety Short Form, and QOLCE-16 were (40.75±10.24), (8.08±4.84), (16.40±5.98), and (72.01±15.43), respectively. Parental social support was negatively correlated with PPCV and child anxiety ( P<0.01), and both PPCV and child anxiety were negatively correlated with the child's quality of life ( P<0.01), while parental social support had a positive correlation with the child's quality of life ( P<0.01). PPCV and child anxiety mediated the relationship between parental social support and the child's quality of life ( P<0.01), with the direct and indirect effects being 0.301 and 0.205 respectively. Conclusions:Parental social support can directly affect the quality of life of children with epilepsy, and also indirectly influence it through PPCV and child anxiety. Clinical nursing staff should provide more care and support for children with epilepsy and their parents, helping to deepen their understanding of the disease, reduce levels of PPCV and child anxiety, thereby enhancing the quality of life for children with epilepsy.