Objective To investigate the prognostic risk factors for surgery in patients with cirrhotic portal hypertension.Methods One hundred and sixty one patients with cirrhotic portal hypertension who received surgery in our hospital in the past 10 years were studied.The data were entered into a pre-designed form.24 predictors including patients′ age,sex,degree of liver atrophy,ChildPugh classification,coagulation profile,splenic size,renal function,blood pH,base excess (BE),operative time,volume of ascites,and intraoperative and postoperative hemorrhage were recorded and analyzed.For each of the predictors,2-3 subgroups were compared.Results Seven predictors were clearly related to surgical prognosis:postoperative bleeding within 30h (B0.356,P＜0.001) and a bleeding volume ＞2 L were awarded 3 points; liver volume (B-0.160,P＜0.001) and severe liver atrophy (antero-posterior diameter of the left liver lobe ≤55 mm,oblique diameter of the right lobe ≤110 mm) were awarded three points; blood pH (B0.141,P＜0.001),pH＜7.35 was awarded 2 points; BE (B-0.123,P＜0.001),BE＜-3 (mmol/L) was awarded 2 points; decrease in PLT (B0.065,P =0.015),PLT＜ 3 (T/L) was awarded 2 points; intraoperative bleeding (B0.062,P=0.014),bleeding volume ＞2 L was awarded 2 points; decrease in RBC (B0.053,P=0.024),＜3(G/L) was awarded 1 point.Of the 147 patients who recovered from surgery,all had ≤3 points,except one who had 4 points.Of the 14 patients who died,all had ≥5 points except one who had 4 points.Conclusions Postoperative bleeding (＞2 L),severe liver atrophy (antero-posterior diameter of the left live lobe ≤55 mm,oblique diameter of the right lobe ≤110 mm),blood PH＜7.35,BE ＜-3 (mmol/L),PLT＜30 000(T/L),intraoperative major bleeding (＞2 L) and RBC＜3 (G/L) were significant prognostic risk factors for surgery.For patients who had a score of 5-6 points; death was likely following surgery.A score ≥8 points should be considered as a contraindication to surgery.To reduce operative mortality,active treatment should be given before surgery to keep the score to be 4 points or less.

The Qinghai⁃Tibet Plateau is known as one of the highest endemic areas of echinococcosis However，the dog infection rates of Echinococcus granulosus in the plateau regions were similar to other non⁃Tibetan areas with the high endemic，and most of the rates were below 40%. The infected dogs with E. multilocularis were ubiquitous in Ganzi Prefecture of Sichuan Province and Qinghai Province where many survey data were done and available，which was much different from those in non⁃Ti⁃betan areas where the geographical distribution of dogs infected with E. multilocularis was sporadic. The total infection rates of Echinococcus in dogs kept stable from 1983 to 2009 in Ganzi Prefecture of Sichuan Province and did not show much variation from 2000 to 2014 in Qinghai Province as well. Since 2006，the national comprehensive prevention and control strategy and mea⁃ sures against echinococcosis have been launched in China，and significant progress has been made. In the endemic Tibetan area of Sichuan，the general Echinococcus infection rates in dogs were 28.10%，15.87%，19.22%，3.28% and 1.11% from 2009 to 2013，respectively，and the Echinococcus coproantigen⁃positive rate in Gannan Prefecture of Gansu Province and parts of Qing⁃ hai Province also decreased. This paper reviews the literature on the characteristics of dog infections in the Qinghai⁃Tibetan Plateau，so as to provide useful information to support echinococcosis control and prevention there.

Objective To compare the benefits and harms of cervical disc arthroplasty ( CDA) with anterior cervical discectomy and fusion( ACDF) for symptomatic cervical disc disease at mid? to long?term follow?up? Methods Electronic searches were made in PubMed,EMBASE,and the Cochrane Library for randomized controlled trials with at least 48 moths follow?up?Outcomes were reported as relative risk or standardized mean difference?Meta?analysis was carried out using Revman version 5?3 and Stata version 12?0. Results Seven trials were included, involving 2 302 participants?The results of this meta?analysis indicated that CDA brought about fewer secondary surgical procedures,lower neck disability index (NDI) scores,lower neck and arm pain scores,greater SF?36 Physical Component Summary (PCS) and Mental Component Summary( MCS) scores,greater range of motion ( ROM) at the operative level and less superior adjacent?segment degeneration ( P<0?05 ) than ACDF?CDA was not statistically different from ACDF in inferior adjacent?segment degeneration,neurological success,and adverse events (P>0?05)? Conclusions CDA can significantly reduce the rates of secondary surgical procedures compared with ACDF?Meanwhile, CDA is superior or equivalent to ACDF in other aspects?As some studies without double?blind are included and some potential biases exites,more randomized controlled trials with high quality are required to get more reliable conclusions.

Objective To compare the benefits and harms of cervical disc arthroplasty ( CDA) with anterior cervical discectomy and fusion( ACDF) for symptomatic cervical disc disease at mid? to long?term follow?up? Methods Electronic searches were made in PubMed,EMBASE,and the Cochrane Library for randomized controlled trials with at least 48 moths follow?up?Outcomes were reported as relative risk or standardized mean difference?Meta?analysis was carried out using Revman version 5?3 and Stata version 12?0. Results Seven trials were included, involving 2 302 participants?The results of this meta?analysis indicated that CDA brought about fewer secondary surgical procedures,lower neck disability index (NDI) scores,lower neck and arm pain scores,greater SF?36 Physical Component Summary (PCS) and Mental Component Summary( MCS) scores,greater range of motion ( ROM) at the operative level and less superior adjacent?segment degeneration ( P<0?05 ) than ACDF?CDA was not statistically different from ACDF in inferior adjacent?segment degeneration,neurological success,and adverse events (P>0?05)? Conclusions CDA can significantly reduce the rates of secondary surgical procedures compared with ACDF?Meanwhile, CDA is superior or equivalent to ACDF in other aspects?As some studies without double?blind are included and some potential biases exites,more randomized controlled trials with high quality are required to get more reliable conclusions.

Objective? To explore the hope among acute cardiovascular events (ACE) patients with different family types. Methods? From December 2015 to December 2016, we selected 110 outpatients underwent ACE of Department of Cardiovascular Medicine in the First Affiliated Hospital of Zhengzhou University as subjects by convenience sampling. All of the patients were investigated with the Chinese Version of Family Cohesion and Adaptability Scale (FACESⅡ-CV) and Herth Hope Index (HHI) to compare hope among patients with different family types. Results? Subjects were divided into the balance type family (30 cases), the intermedius type (32 cases) and the extreme type (48 cases) according to the survey findings of FACESⅡ-CV. There were statistical differences in hope among ACE patients with different family types (P＜ 0.01). Conclusions? After ACE,hope of patients of the extreme type family is higher than that of intermedius type and balance type. Nursing workers should guide family types after ACE to transform into extreme type so as to improve hope and promote recovery of patients.

Objective:To explore the effects of nursing based on health belief model on respiratory function exercise compliance and respiratory function among lung cancer patients.Methods:From September 2017 to August 2018, we selected 84 lung cancer patients planed surgery at the First Affiliated Hospital of Zhengzhou University as subjects by convenience sampling. All of patients were divided into two groups according to admission time, 40 cases in control group (from September 2017 to February 2018) and 44 in experimental group (from March to August 2018) . Control group carried out routine nursing and health education. On the basis of that, experimental group implemented nursing care based on health belief model. Respiratory function of patients between two groups after surgery was compared with the percentage of predicted value of forced expiratory volume in one second shared by forced vital capacity (FEV1%) and percentage of predicted value of forced vital capacity (FVC%) ; respiratory function exercise compliance after surgery was compared with the Breathing Exercise Compliance Questionnaire.Results:One week after surgery, the scores of respiratory function exercise compliance of patients in experimental group and control group were (42.1±8.4) and (36.8±10.2) with a statistical difference ( t=-2.609, P<0.05) ; the FEV1% and FVC% of patients in experimental group were (63.8±12.1) and (57.5±11.3) , higher than those in control group with statistical differences ( t=-2.167, -2.617; P<0.05) . Conclusions:Nursing based on health belief model can improve respiratory function exercise compliance and respiratory function among lung cancer patients, which is worthy of clinical popularization.

Objective:To evaluate the value of radiomics based on contrast-enhanced spectral mammography (CESM) of internal and peripheral regions combined with clinical factors in predicting benign and malignant breast lesions of breast imaging reporting and data system category 4 (BI-RADS 4).Methods:A retrospective analysis was performed on the clinical and imaging data of patients with breast lesions who were treated in Yantai Yuhuangding Hospital (Center 1) Affiliated to Qingdao University from July 2017 to July 2020 and in Fudan University Cancer Hospital (Center 2) from June 2019 to July 2020. Center 1 included 835 patients, all female, aged 17-80 (49±12) years, divided into training set (667 cases) and test set (168 cases) according to the "train-test-split" function in Python software at a ratio of 8∶2; and 49 patients were included from Center 2 as external validation set, all female, aged 34-70 (51±8) years. The radiomics features were extracted from the intralesional region (ITR), the perilesional regions of 5, 10 mm (PTR 5 mm, PTR10 mm) and the intra-and perilesional regions of 5, 10 mm (IPTR 5 mm, IPTR 10 mm) and were selected by variance filtering, SelectKBest algorithm, and least absolute shrinkage and selection operator. Then five radiomics signatures were constructed including ITR signature, PTR 5 mm signature, PTR 10 mm signature, IPTR 5 mm signature, IPTR 10 mm signature. In the training set, univariable and multivariable logistic regressions were used to construct nomograms by selecting radiomics signatures and clinical factors with significant difference between benign and malignant BI-RADS type 4 breast lesions. The efficacy of nomogram in predicting benign and malignant BI-RADS 4 breast lesions was evaluated by the receiver operating characteristic curve and area under the curve (AUC). Decision curve and calibration curve were used to evaluate the net benefit and calibration capability of the nomogram.Results:The nomogram included ITR signature, PTR 5 mm signature, PTR 10 mm signature, IPTR 5 mm signature, age, and BI-RADS category 4 subclassification for differentiating malignant and benign BI-RADS category 4 breast lesions and obtained AUCs of 0.94, 0.92, and 0.95 in the training set, test set, and external validation set, respectively. The calibration curve showed good agreement between the predicted probabilities and actual results and the decision curve indicated a good net benefit of the nomogram for predicting malignant BI-RADS 4 lesions in the training set, test set, and external validation set.Conclusion:The nomogram constructed from the radiomics features of the internal and surrounding regions of CESM breast lesions combined with clinical factors is attributed to differentiate benign from malignant BI-RADS category 4 breast lesions.

Objective:To explore the protective effect and underlying mechanism of hyperbaric oxygen (HBO) on delayed encephalopathy after carbon monoxide poisoning (DEACMP) in mice.Methods:Totally 225 adult male Kunming mice were selected to establish CO poisoning model via intraperitoneal injection carbon monoxide (CO), and were randomly divided into the air control group, CO poisoning group, and HBO group. Each group was further divided into five time points group, that was 1, 3, 7, 14 and 21 d. The mice in the air control group were injected intraperitoneally with the same amount of air, and the HBO group received HBO treatment at the same time every day. DEACMP mice model was screened by behaviors using the open field test, new object recognition test and nesting test, and the content of myelin basic protein (MBP) were assayed. The mouse brain tissue and mitochondrial were prepared and malonialdehyde (MDA) and adenosine triphosphate (ATP) content were measured with ultraviolet spectrophotometer. MBP content in brain tissue and cytochrome C (CytC) content in the mitochondrial were measured by ELISA. The mitochondria membrane potential (MMP) was measured by flow cytometry.Results:Compared with the air control group, the content of carboxyhemoglobin (COHB) in blood increased significantly and the content of MBP in brain tissue decreased significantly in CO poisoning mice. CO poisoning mice showed motor ability and cognitive dysfunction. Compared with the air control group, the contents of MMP, CytC and ATP were significantly decreased ( P<0.01) in the CO poisoning group; while the MDA content was significantly increased ( P<0.01). Compared with the CO poisoning group, mice behaviors were improved significantly ( P<0.05), the content of MBP, MMP, CytC and ATP were increased ( P<0.05), while the MDA content decreased significantly ( P<0.01) in the HBO group. Conclusions:The abnormal mitochondrial function might be closely related to the occurrence and development of DEACMP, and HBO therapy plays an effective role in preventing and treating the DEACMP mice model via the mitochondrial pathway.

Objective:To explore the status quo and influencing factors of spiritual health in children with acute leukemia during treatment.Methods:The children with leukemia admitted in the First Affiliated Hospital of Zhengzhou University from August 2018 to April 2019 were selected. The general data questionnaire and Functional Assessment of Chronic Illness Therapy-Spiritual-12 (FACIT-Sp-12) were used to investigate the status quo of their spiritual health and analyze its influencing factors. A total of 150 questionnaires were distributed and 147 valid questionnaires were recovered, with an effective recovery rate of 98%.Results:The total score of spiritual health among 147 children with acute leukemia was (25.21±6.62) , including (10.17±3.92) for belief, (8.72±2.58) for meaning, and (9.39±3.28) for peace. There were statistically significance differences in spiritual health scores between children with different age, disease type and educational background of their guardians ( P<0.05) . Multiple linear regression analysis showed that age, type of disease, and education background of the guardian were factors affecting the spiritual health level of children with leukemia ( P<0.05) . Conclusions:The spiritual health of children with acute leukemia is at a medium level, which is related to the age, type of disease and educational background of the guardian. Medical staff should provide spiritual care to children with leukemia and improve the quality of life of children.

Objective:To investigate breast ultrasound imaging and pathological characteristics of patients with hereditary breast cancer-ovarian cancer syndrome (HBOC).Methods:A total of 12 patients with HBOC admitted to Shanxi Province Cancer Hospital from January 2012 to 2021 April were retrospectively analyzed. All patients were pathologically diagnosed as invasive breast cancer based on the preoperative puncture or surgical specimens, including 3 patients with double primary cancers of breast and ovary. The clinical, breast ultrasound imaging and pathological data of patients were analyzed.Results:The ultrasound imaging of HBOC usually showed regular morphology in 8 cases, clear border in 9 cases, no burr sign in 10 cases, no calcification in 10 cases, rear echo in 10 cases; the maximum blood flow velocity was (0.21±0.09) m/s, the vascular resistance index was 0.72±0.17, and aspect ratio ≤ 1 in 8 cases. Among 12 cases of HBOS, 9 cases were invasive ductal carcinoma, 3 cases were breast cancer with medullary features; histological grade: 7 cases of grade Ⅱ, 5 cases of grade Ⅲ; molecular classification: Luminal B type in 2 cases, human epithelial receptor 2 (HER2) type in 4 cases, and triple-negative type in 6 cases. The histological types of 3 patients with double primary cancers of breast and ovary were all high-grade serous carcinoma.Conclusions:HBOC is a type of neoplastic disease with a special genetic background. Ultrasound and pathological manifestations have certain characteristics. Sonographers should improve the understanding of the disease and pay attention to the medical history and family history in order to reduce the rate of misdiagnosis and increase the rate of diagnosis.