Neuroendocrine tumors of the gallbladder(GB-NET) are rare, and it lacks early clinical manifestations and has no specific tumor markers, it is difficult to distinguish GB-NET from gallbladder adenocarcinoma. The diagnosis of GB-NET is based on histopathology of the tumor and the assessment of proliferation fraction, which makes it difficult to achieve early diagnosis. GB-NET has a high degree of malignancy, 32.39% of patients have liver metastases at diagnosis, and 51.60% of patients have lymph node metastases, the median survival time is 9 to 10 months.There are currently no specific guidelines or consensus for the treatment of GB-NET. The treatment strategies are choosen mainly by the principles of gallbladder adenocarcinoma. We reviews the clinical and basic researches of GB-NET and case reports from China and across the world, as well as the data from SEER database, and we discuss the research progress on the classification, clinicopathological features, diagnosis, treatment advances and the prognosis.

Objective To investigate the CT and MRI findings of Coats’disease in comparison with pathology.Methods CT,MRI and ultrasonic features,FFA findings of eight patients of Coats’disease with histo-pathologically confirmed were analyzed retrospectively.CT scanning,routine MRI scanning and ultrasonic examination were performed in all eight patients.Results Unilateral eyeball was involved in all eight cases.On CT scanning,the density of the vitreous body was increased homogeneously which boundary was clear(n=8).The retina was thick(n=8).The anterior chamber depth was shallow(n=5).Multiple calcified foci occured in lens and vitreous body(n=1).The volume of affected eyeball increased(n=1).The affected eyeball shrinked(n=1).The difference of volume of bilateral eyeball was not obvious(n=6). Lens were thick and dislocation(n=5).On MRI scanning,the lesions in the vitreous body showed iso T1 and iso T2 signal (n=6),short T1 and long T2 signal(n=1),long T1 and long T2 signal(n=1).The retina showed short T2 signal(n=3).The vitreous body was filled with lesions(n=5).The lesions looked like‘V’sticked to retina(n= 3).On ultrasonic examination low echo was showed in the vitreous body(n=6),the ball wall bulged(n=8),retinal detachment(n=8).The echo of the ball wall was obviously enhanced,which indica-ted ossification(n=1).Strong echo calcified plaque was showed in one case.FFA showed retinal telangiectasia(n=8),retinal capillary zone(n=2),mutiple chestnut shaped aneurysms(n= 6),retinal neovascularization(n= 1 ).Pathological examination showed retinal telangiectasia with foam macrophages and lipid deposition.Conclusion Coats’disease carries some typical CT and MRI features.To summarize the radiologic features,the findings of FFA and ultrasonic inspection are helpful to diagnosis.

Objective: To analyze the effect of rapid convalescence surgery on plasma radical prostatectomy in elderly patients with prostate hyperplasia. Methods: A total of 140 elderly patients with prostate hyperplasia who underwent plasma prostatectomy in our hospital from January 2016 to August 2017 were selected as subjects. Divide them into control group (70 cases) and observation group (70 cases) according to random number table method. Patients in the control group were given routine care. The observation group gave a nursing model based on the concept of rapid rehabilitation surgery on the basis of the control group. Compared the bladder irrigation time, postoperative hospitalization time, catheter removal time, anal exhaust time, first time out of bed time, complication rate, postoperative Numerical Rating Scale (NRS) pain score, bladder spasm symptom score and quality of life score between the two groups. Results: The bladder irrigation time, postoperative hospital stay, urinary catheter removal time, anal exhaust time and first time to get out of the observation group were (23.94±3.75) h, (3.49±0.46) d, (3.11±1.50) d, 6.23±3.07) h and (24.70±3.62) d, while the control group were (76.42±9.55) h, (7.06 ±0.44) d, (6.74±2.06) d, (17.41±3.48) h and (90.58±9.75) d, the above observation indexes of the observation group were significantly lower than the control group, the difference was statistically significant (t=11.918-52.998, P<0.01). The incidence of postoperative bladder spasm, bloating, hemorrhage, lung infection and urinary tract infection in the observation group were 1.429% (1/70), 2.857% (2/70), 0, 2.857% (2/70) and 7.143% (5/70), respectively, while the control group were 11.429% (8/70), 14.286% (10/70), 8.571% (6/70), 15.714% (11/70) and 24.143% (19/70), respectively. The incidence of the above complications in the observation group was significantly lower than that of the control group, the difference was statistically significant (χ²=4.275-8.499, P<0.05 or 0.01). The NRS pain score, quality of life score and bladder spasm score were observed in the observation group (31.48±3.60), (1.89±1.03), (2.25±0.47) points, while the control group were (36.20±4.22), (2.77±1.84), and (3.79±0.81) points, respectively. The above three scores in the observation group were significantly lower than those in the control group, the difference was statistically significant (t=7.119, 3.491, 13.756, P<0.01).The nursing satisfaction of patients in the observation group was 95.71% (67/70) which was significantly higher than 80.00% (56/70) of the control group, the difference was statistically significant (χ²=6.695, P<0.05). Conclusions Rapid rehabilitation surgery for patients with advanced prostatic hyperplasia with plasma prostatectomy can speed up the recovery process, relieve postoperative pain, reduce the incidence of postoperative complications, harmonious doctor-patient relationship, improve the quality of life of patients, it is worthy of extensive clinical promotion.

Objective To investigate cartilage oligomeric matrix protein( COMP) gene mutation in a three-generation pedigree with two cases of pseudoachondroplasia, and to definitize genotype-phenotype correlation. Methods The clinical data and peripheral blood were collected from the patients with pseudoachondroplasia and their family members. All the 19 exons and their flanking sequences of COMP gene in two patients and three unaffected family numbers and 50 unrelated individuals were analyzed by PCR amplification and direct sequencing. Results The proband, a 6-year-old girl presented with typical clinical features of pseudoachondroplasia, including disproportionate short limb dwarfism, staggering gait, double genu varus deformity, and wider clinical and imaging long bone metaphysis. The 33-year-old father showed a similar manifestation including disproportionate short limb dwarfism and double genu varus deformity, and was performed correcting operation on lower limbs for double genu varus at the age of 10 years. DNA sequencing analysis of the COMP gene revealed a del mutation ( c. 1417 1419delGAC)in exon 13 in two patients with pseudoachondroplasia, but not in the other unaffected members from the pedrgree and 50 control subjects. Conclusion A del mutation c. 1417 1419delGAC of COMP gene may contribute to the disease in the pedigree.

Objective On the basis of developing a new animal model for oxyhemoglobin (OxyHb) injection into subarachnoid space in mice, this research was to explore the temporal dependence and spatial distribution of OxyHb- induced apoptosis in the mouse brain cells in vivo and the mechanism of neurocyte injury induced by OxyHb. Methods The animal model for OxyHb injection into subarachnoid space in mice was developed. Mice were divided randomly into the experimental group (n=40) and the control group (n= 35). The control group received saline injection (50 μL ) and the experimental group received OxyHb injection (50 μL ), both into the subarachnoid space. The mice of the two groups were subdivided according to different postoperative time (3 h, 6 h, 12 h, 24 h and 48 h). The apoptosis or necrosis of cells was distinguished with microscopy (HE staining), transmission electron microscopy and TUNEL method. Results The distribution of apoptosis was mainly in the ipsilateral neocortex and bilateral hippocampal gyrus. The apoptotic mouse brain cells showed morphological changes in the experimental group by HE staining and transmission electron microscopy. The count of TUNEL-positive cells showed substantial increase in the experimental group, and there was a significant difference between the control and experimental groups, and the number of OxyHb- induced apoptotic cells decreased with time. Conclusion OxyHb in subarachnoid space in mice can induce apoptasis, but not necrosis of mouse brain cells in viro. The apoptotic brain cells show the pattern of temporal dependence and spatial distribution. It is suggested that the early treatment should be the method of first choice for treating the hemorrhagic brain injury.

Objective:To observe any effect of transcranial direct current stimulation (tDCS) on the cognition of stroke survivors and the integrity of their white matter fibers.Methods:Thirty persons with post-stroke cognitive impairment (PSCI) were randomly divided into an experimental group ( n=15) and a control group ( n=15). In addition to basic drug therapy and routine cognition training, the experimental group received 20 minutes of tDCS daily, 5 days per week for 3 weeks, while the control group received sham tDCS stimulation. Before and after the treatment, both groups′ cognitive functioning was evaluated using the mini-mental state examination (MMSE) and the Montreal cognitive assessment scale (MoCA). Their ability in the activities of daily living (ADL) was quantified using the modified Barthel index (MBI). Diffusion tensor imaging (DTI) was employed to observe any changes in the integrity of their white matter fibers. Results:The average MMSE, MOCA and MBI scores of both groups had improved significantly after the treatment, but the improvement in the experimental group was significantly greater than among the controls. The average fractional anisotroposy value of the affected inferior fronto-occipital fasciculus in both groups was positively correlated with the group′s average MMSE score and MoCA score.Conclusion:tDCS can effectively improve the cognition and functioning in the activities of daily living of stroke survivors. Its mechanism may be related to improving the integrity of the white matter fibers involved.

Objective:To investigate the additional value of unenhanced computed tomography (CT) in the differential diagnosis of brain tumors and non-neoplastic lesions.Methods:A total of 237 cases [140 males and 97 females; (49±16) years old; including 48 cases of low-grade glioma, 134 cases of high-grade glioma, 38 cases of primary central nervous system lymphoma, 9 cases of medulloblastoma, 5 cases of germinoma, and 3 cases of central neurocytoma] of brain tumors (diffuse gliomas and non-glial tumors) diagnosed by biopsy or surgery and pathology in the Affiliated Hospital of Qingdao University from September 2016 to October 2020 were collected retrospectively. Sixty-six cases [46 males and 20 females; (42±13) years old; including 12 cases of abscesses, 5 cases of infarcts, 33 cases of demyelinating lesions, 11 cases of autoimmune encephalitis, and 5 cases of central nervous system vasculitis] of brain non-neoplastic lesions were confirmed by biopsy or clinic. All patients underwent routine magnetic resonance imaging (MRI) scan and unenhanced CT before the treatment. The images were reviewed by two neuroradiologists together blind to the final diagnosis with and without CT images respectively. The diagnostic results and reliability scores were recorded, and the accuracy of the two evaluations was compared.Results:CT hyperattenuation exhibited a higher specificity (95%) than conventional MRI scan (86%), and a lower diagnostic sensitivity (34% vs 86%). Compared to MRI alone, the combined modality of MRI and unenhanced CT significantly improved diagnostic accuracy (94% vs 86%). Additionally, the CT attenuation ratio of non-neoplastic lesions was significantly lower than that of neoplastic lesions [0.69 (0.61,0.78) and 1.14 (1.00,1.25), W=2 123, P<0.05]. The CT attenuation ratio in the non-glial origin tumor group was significantly higher than that in the diffuse glioma group [1.28 (1.18,1.41) and 1.13 (0.97,1.21), W=1 858, P<0.05]. There was no significant difference in grade Ⅲ and Ⅳ groups of diffuse glioma [1.11 (0.99,1.20) vs 1.16 (1.09,1.24), P>0.05 (Nemenyi test)]. However, both were significantly higher than that of grade Ⅱgroup of diffuse glioma [0.89 (0.76,1.07), P<0.05 (Nemenyi test)]. No significant difference was observed between astrocytic tumors and oligodendroglial tumors at the same grade. Conclusions:Hyperattenuation on unenhanced CT is highly specific for the diagnosis of brain tumors. Unenhanced CT plus MRI is more accurate for distinguishing the two entities in hypoattenuation lesion on unenhanced CT.

Objective To survey the community elderly′s Alzheimer′s disease knowledge, behavior and attitude and provide basis for targeted health education and service. Methods Self-design Alzheimer′s disease knowledge, behavior, cognitive and attitude questionnaire was used to survey 168 community elderly people by the convenience sampling method and the information of survey applied SPSS 17. 0 software for statistical analysis. Results The Alzheimer′s disease knowledge, behavior cognition and attitude scores were (11. 20 ± 4. 39), (5. 83 ± 2. 50), (6. 20 ± 2. 13) in community elderly; education was the main influence factor, and age, gender, marital status, care experiences had impacts on different items (P<0. 05). Conclusions In the different population characteristics of the community elderly, the Alzheimer′s disease knowledge, behavior cognition and attitudes are different, thus we should arrange health education according to different characteristics of the elderly in the community, so as to help them to understand and handle Alzheimer′s disease disease correctly.

Objective To analyze the situation of table tennis competitions in emergency public health events, find the possible weak links in the emergency rescue and care work, put forward the hospital in response to emergency public health emergency preparedness plan, health emergency drills and emergency rescue personnel training and so on targeted reference views. Methods A total of four public health emergencies such as traffic accident, mass food poisoning, fire and bird flu were selected as the theme of the competition to simulate the emergency rescue process after the emergency,the examination of each team is divided into pre-hospital disposal and hospital disposal links. Results The score of Crash in Batches was 225.13 ± 8.38, followed by Fire accident 222.78 ± 16.57, Avian Influenza 210.32 ± 11.19, Group Food poisoning 204.80 ± 6.77, the difference was statistically significant (F=8.706,P=0.000). The scores of pre-hospital treatment in all four subjects were109.04±4.80, 108.62±10.12, 98.24±6.95, 101.14± 8.85,lower than those in hospital, which were 116.09±4.79, 114.16±7.61, 106.56±5.31, 109.18±4.24, the difference was statistically significant (t=-6.130--2.338,P＜0.01 or 0.05). Conclusions On the different topics exposed in the desktop exercise competition and the differences between the pre-hospital treatment and the hospital disposal, the nursing managers should strengthen the training and practice of public health emergencies with different themes, and pay attention to the pre-hospital emergency public health emergencies training and rehearsal,the emergency response plans for public health emergencies were revised and improved through the health emergency drills.

Objective:This study aimed to compare the detection efficacy of transrectal ultrasound-guided transrectal cognitive fusion targeted+ systematic prostate biopsy and transperineal cognitive fusion targeted + systematic biopsy in patients with suspected prostate cancer (PCa). In addition, the relative clinical characteristics of PCa were evaluated.Methods:A total of 385 patients with suspected prostate cancer in the affiliated hospital of Qingdao University from May 2019 to November 2019 were retrospectively analyzed. All patients met the prostate biopsy criterion, who underwent transrectal(n=275)and transperineal(n=110)prostate biopsy respectively. There were no significant differences of mean age [(70.7±7.3)years vs.(69.2±8.4) years], PSA [(55.12±116.96)ng/ml vs. (63.41±315.34)ng/ml], prostate volume [(55.96±35.26)ml vs. (64.35±55.99)ml] between two groups. According to preoperative prostate magnetic resonance imaging combined with intraoperative ultrasound, 2-4 needles targeted puncture of suspected lesion were performed, followed by 12 needle systematic prostate biopsy. The detection rate of prostate cancer between two biopsy ways were compared. The related factors of PCa including age, prostate volume and PSA level were collected for univariable and multivariable logistic analysis. The cancer detection rate was compared and logistic regression was used to assess the impact of patient characteristics on PCa detection.Results:For all patients, the detection rate with cancer between transrectal group and transperineal group were 121/275(40.0%) and 67/110(60.9%), respectively. The transperineal group detected a higher rate of PCa ( P=0.003)and more clinically significant prostate cancers (csPCa) (54.6% vs.36.7%, P=0.001) than that of the transrectal group, there were significant differences between two groups ( P<0.05). Univariate and multivariate logistic regression analysis revealed that PSA( OR=1.025, P=0.001) and prostate volume( OR=0.984, P=0.001)were two independent factors for the detection rate of prostate cancer between two biopsy ways( P<0.05). The effect of age on the detection rate of PCa in the transperieal group was significantly lower than that of the transrectal group( OR=0.037, P=0.238 vs. OR=0.053, P=0.002). Conclusion:The transperieal biopsy could find more PCa than the transrectal biopsy. PSA level and prostate volume could affect the detection rate of cancer between two prostate biopsy ways.