Objective To study the CT and MRI features of peripheral primitive neuroectodermal tumor(PNET).Methods CT and MRI appearances of 10 patients with PNET pathologically proved were analyzed retrospectively.All cases underwent CT scan and 2 cases underwent MR imaging examination.There were 5 men and 5 women,the age ranged from 11 years to 54 years old(mean 24 years).Results The tumors were located in the chest wall(n=4),abdomen and sinus(n=2,each),cervical vertebra and humerus(n=1,each).The lesions in the chest wall and abdomen appeared as larger masses(5~16 cm in diameter).The masses were circular and lobulated with heterogeneous density and in company with bone destruction or periosteal reaction.The solid masses were enhanced after contrast medium administration.The lesions in the sinus showed the soft tissue mass with bone erosion.The lesions in bone demonstrated local iso-intensity on T1WI,hyper-intensity on FSE T2WI and on FATSAT T2WI.There were distant metastasis in 3 cases.Conclusion The clinical and imaging features of pPNET in chest wall were more specific than in other locations.CT and MRI can showed intra-tumor structure,and are helpful in delineated the extent of tumor,predicting resectability and monitoring treatment.

Objective To investigate the indications, techniques and results of laparoscopic hepatectomy. Methods The clinical data and follow-up results of 463 patients who received laparoscopic hepatectomy at our institute were retrospectively analyzed. Results From March 1, 2007 to March 31, 2011, 463 cases of laparoscopic hepatectomy were successfully carried out. Of the 463 patients,165 were with primary liver cancer, 29 with metastatic liver cancer, 143 with hepatic hemangioma, 81with hepatolithiasis and 45 with other benign liver diseases (including hepatic angiomyolipoma, hepatocellular adenoma, focal nodular hyperplasia and chronic liver abscess). The surgical approaches included laparoscopic left lateral lobectomy (93 cases), left hepatectomy (71 cases), extended left hepatectomy (4 cases), right hepatectomy (29 cases), right posterior lobectomy (24 cases), hepatectomy of segment Ⅵ (56 cases), extended right hepatectomy (2 cases), central hepatectomy (8 cases) and hepatectomy of segments Ⅶ/Ⅷ, Ⅳa, caudate lobe and the junction of segment Ⅵ and Ⅶ (41 case).Nonanntomic and wedge resection were performed on 121 patients, and combined resection on 14 patients. The mean operation time, blood loss, length of hospital stay and incidence of postoperative complications were (244.71 ± 105. 07) minutes, (460. 26±425.81) ml, (15.51 ±4.36) days and 9.29%, respectively. And no operative death occurred. In the 194 cases with malignant liver lesions,185 cases were followed up for 2 to 50 months. The 1 year and 3 year overall and disease free survival rate were 90. 8% and 87.9% , 84.2% and 73. 7% respectively. Conclusions As a means of minimally invasive surgical approach, laparoscopic hepatectomy can be selectively adopted for the treatment of all kinds of liver diseases which located at different parts of the liver, with the advantages of smaller trauma, quick recovery and cosmetic benefits. The short-term results of laparoscopic hepatectomy is superior to and its long-term results is equal to that of open surgery. Benign liver diseases, small hepatocellular carcinoma and metastatic liver cancer are the good indications for laparoscopic hepatectomy.

{L-End}Objective To analyze the spectrum characteristics of noise hazards in the metal products industry. {L-End}Methods A total of six metal product industries were selected as research subjects using stratified sampling method. The noise intensity (A/C-weighted) and noise spectrum (Z-weighted) of workplaces and job positions were detected. The characteristics of the noise spectrum of each job position were analyzed using the difference between equivalent continuous C-weighted sound pressure level (L_Ceq)-equivalent continuous A-weighted sound pressure level (L_Aeq), the dominant frequency of the noise spectrum, and cluster analysis methods. {L-End}Results The workplace noise and job position noise of 11 main noise positions in the metal products industry were exceeded national standard, with incidence of 69.2% and 78.1%, respectively. The average of normalization of equivalent continuous A-weighted sound pressure level to a normal 40 hours working week exceeded the national standard in 100.0% of hydraulic workers, welders, and ultrasonic cleaning workers. The result of spectrum analysis showed that the noise in the metal product industry was mainly broadband. The noise of the collision welder position was classified as low-frequency broadband noise, while the noise of the painter position was classified as low-frequency narrowband noise. The noise spectrum characteristics of other positions were similar and classified into one category, all of which were broadband noise. Among them, numerical control lathe workers, welders, threaders, machinists, and cutters were exposed to high-frequency broadband noise, while press workers were exposed to mid-frequency broadband noise, and grinders, hydraulic workers, and ultrasonic cleaning workers were exposed to low-frequency broadband noise. The detection rate of binaural high-frequency hearing threshold improvement among workers was 61.7%, and there was no statistical correlation between the detection rate of binaural high-frequency hearing threshold improvement and the noise level intensity of each spectrum. {L-End}Conclusion The level of noise hazards in the metal products industry is severe. Effective engineering control measures and hearing protection measures should be implemented based on the spectral characteristics of noises.

BACKGROUNDDiabetic nephropathy is a common complication of diabetes mellitus. This study aimed to explore whether mesenchymal stem cells (MSCs) transplantation could attenuate diabetic nephropathy in experimental diabetic rats.

METHODSSprague-Dawley rats received a single intraperitoneal injection of streptozotocin (STZ) (60 mg/kg). Diabetic rats were randomized to four groups: diabetes control group (DC), ciclosporin A group (CsA), MSC group, and MSC + CsA group (MSCA). Bone marrow mesenchymal stem cells were cultured, identified and labeled by 5-bromo-2'-deoxyuridine (BrdU) in vitro. Then they were transplanted to diabetic rats via introcardiac infusion. Ciclosporin A was administered daily at 5 mg/kg. At 1, 2, 4, 8 weeks after transplantation, random blood glucose, urine albumin/creatinine ratio (Alb/Cr), endogenous creatinine clearance rate and renal mass index were tested. Renal morphology and labeled cells were examined.

RESULTSCultured MSCs expressed mesenchymal cell phenotype, and could be multidifferentiated to osteogenic and adipogenic cells. Labeled MSCs could be detected in the kidney of nephropathic rats, mainly in renal interstitium, but they did not propagate after engrafting in kidney. Over the course of the experiment, MSCA group showed a significant decrease in blood glucose compared with MSC group, CsA group and DC group (P < 0.05, respectively). The Alb/Cr in MSCA group and MSC group were significantly lower than CsA group and DC group (P < 0.05). And the Alb/Cr in MSCA group showed a significant decrease compared with MSC group (0.74 vs 0.84, P < 0.05). There was a significant difference in renal mass index between the MSCA group and DC group (5.66 vs 6.37, P < 0.05). No significant difference was found in creatinine clearance rate among 4 groups (P > 0.05). Treatment with MSC + CsA significantly ameliorated the morphology of diabetic kidney.

CONCLUSIONMSC could mildly ameliorate diabetic nephropathy by decreasing blood glucose, Alb/Cr ratio and renal mass index.

Animals ; Blood Glucose ; Diabetic Nephropathies ; blood ; metabolism ; therapy ; Flow Cytometry ; Immunohistochemistry ; Kidney ; metabolism ; pathology ; Male ; Mesenchymal Stem Cell Transplantation ; methods ; Microscopy ; Rats ; Rats, Sprague-Dawley

Objective To investigate the pathogens spectrum and epidemiological characteristics of rash and fever illness (RFIs) from January 2010 to December 2017 in Pudong New Area, in order to provide scientific evidence for the prevention and control ofRFIs.Methods Enzyme-linked immunosorbent assay and real-time fluorescence quantitative polymerase chain reaction were used to detect the pathogens of enterovirus, measles virus, rubella virus and others from 2 831 clinical samples, and statistical analysis was performed.Results Pathogens were found in 1 633 samples in total, accounting for 68.59%. The top 4 viruses in the pathogen spectrum were enterovirus (52.54%), measles virus (28.54%), rubella virus (13.04%), and varicella-zoster virus (3.37%). There was significnat difference in the detection rate of rubella pathogens among patients of different genders(P=0.026). In the pathogen spectrum of infections of different age groups, the detection rate of enteroviruses at the age of 3-6 years was higher than that of other age groups. The detection rate of varicella-zoster virus at the age of 6-18 years old was higher than that of other age groups. The detection rate of virus including measles virus, rubella virus, dengue virus and small DNA virus in age of 18 and older was higher than that of other age groups. There was significant difference in the detection rate of pathogens in different age groups (all P<0.05).The incidence of RFIs was the highest in spring (41.52%) and the lowest in winter (15.00%). There was a statistical difference in the detection rate of enterovirus, measles, rubella and dengue virus in different seasons (P<0.05).Conclusions Enteroviruses and measles viruses are the main pathogens leading to RFIs in Pudong New Area, and the activity level of RFIs pathogens should be monitored for a long time.

Objective:To investigate the clinical application and surgical effect of minimal invasive liposuction system (MILS) method in the thighs liposuction.Methods:From July 2019 to March 2021, 868 patients were selected for thigh liposuction. Local anesthesia and intravenous anesthesia were used in all operations. The preoperative design and intraoperative procedures were carried out according to the requirements of MILS ? method. There was an average of 2 154.4 ml fat aspirated, and the average operation time was 156.8 min. Results:After 2-18 months of follow-up, 83.3% of the patients were discharged on the day of operation. The thigh line curve of the patients was fluent and the perimeter of upper thigh was significantly reduced. The satisfactory rate was 92.3%, and the incidence of complications was 2.8%. No severe complication occurred.Conclusions:MILS method is a safe and effective procedure to partition thighs liposuction area scientifically and finely. The MILS method makes the lumbar abdominal liposuction operation standardized, reduces unnecessary operation, shortens the liposuction learning curve, reduces the occurrence of complications, and achieves the best aesthetic effect.

Objective:To understand the current situation of care needs for disabled elderly people, analyze the impact of the family environment and community services on the care needs and care pathways of older people with disabilities and to formulate effective interventions.Methods:A cross-sectional survey was conducted from August 2022 to March 2023 in five tertiary-level hospitals in Tangshan city. The survey included 332 elderly people who were disabled before hospitalization and their primary caregivers, who were selected using a convenience sampling method. The survey investigated their general information, degree of disability, family members′ support, children′s filial piety and old age ethical level, family relationships, and the care needs of the elderly people who were disabled. SPSS 22.0 was used for one-way and correlation analyses as well as multiple linear regression analyses, and AMOS 22.0 was used for the development of structural equations for path analysis.Results:Among 332 disabled elderly individuals, there were 166 males and 166 females each. The care needs score for elderly people with disabilities was 101.54 ± 16.38. The care needs of this population can be influenced by several factors, including the level of disability, number of chronic conditions, presence of chronic pain, filial piety and old age ethical level of caregivers, family relationships, and the availability of care services in the community or village. These factors had direct effects of 0.468, 0.155, -0.083, -0.350, -0.094, and 0.104, respectively.Chronic diseases and chronic pain indirectly affected the demand for care through the degree of incapacity (with respective indirect effect values of 0.065 and 0.049). Additionally, the demand for care was indirectly influenced by the level of filial piety and ethics of the caregiver through the degree of incapacity and the family relationships (an indirect effect value of -0.162).Conclusions:The care needs of the disabled elderly are high, and the personal physiology, family environment and community support of the disabled elderly will directly or indirectly affect their care needs. Therefore, many factors should be considered comprehensively considered to improve the quality of care of the disabled elderly.

Objective:To investigate the clinical application and surgical effect of minimal invasive liposuction system (MILS) in lumbar abdominal liposuction.Methods:From July 2019 to March 2021, 985 patients were selected for lumbar and abdominal liposuction. Local anesthesia and intravenous anesthesia were used in all operations. The preoperative design and intraoperative procedures were carried out according to the requirements of MILS method. An average of 2 425 ml fat was aspirated, and the average operation time was 142.4 min.Results:After 3-18 (average 3.85 months) months of follow-up, 857 patients (87% of the patients) were discharged on the day of operation. The waist line curve of the patients was clear and the bulge of the upper and lower abdomen was significantly reduced. The satisfactory rate was 93.5%, and the incidence of complications was 2.8%. No severe complication occurred.Conclusions:MILS is a safe and effective method to perform the waist and abdominal liposuction scientifically and finely. The MILS method makes the lumbar abdominal liposuction standardized, reduces unnecessary procedure, shortens the liposuction learning curve, reduces the occurrence of complications, and achieves the best aesthetic effect.

Objective:To compare the effectiveness of awake prone positioning (APP) care combined with standardized nursing and standardized nursing care in the prevention of early postoperative pulmonary complications (PPCs) in elderly patients with hip fracture.Methods:A retrospective cohort study was conducted to analyze the clinical data of 84 elderly patients with hip fracture Admitted to Zhongda Hospital Affiliated to Southeast University from February 2021 to August 2021. There were 31 males and 53 females, aged 67-96 years [(82.3±6.3)years]. Fracture types were femoral neck fracture ( n=45) and intertrochanteric fracture ( n=39). Surgical procedures included closed reduction internal fixation ( n=39), hip hemiarthroplasty ( n=35), and total hip arthroplasty ( n=10). Among them, 42 patients received standardized nursing care and APP intervention (APP combined with standardized nursing care group), while the remaining 42 patients received standardized nursing care only (standardized nursing care group). The incidence rate of PPCs (including pneumonia, respiratory failure, pleural effusion, atelectasis and pulmonary edema) within 30 postoperative days, arterial oxygen pressure (PaO 2), arterial carbon dioxide pressure (PaCO 2), arterial oxygen saturation (SaO 2) on the 4th postoperative day, difference in PaO 2 between the 4th postoperative day and emergency visit, clinical pulmonary infection score (CPIS) on the 4th postoperative day, and number of adverse events related to APP were compared between the two groups. Results:All the patients were followed up for 30-90 days [(86.1±16.5)days]. The incidence rates of PPCs and type 1 postoperative respiratory failure in the APP combined with standardized nursing care group were 16.7% (7/42) and 4.8% (2/42), and were 35.7% (15/42) and 21.4% (9/42) in the standardized nursing care group (all P<0.05). The PaO 2 and SaO 2 on the 4th postoperative day, and difference in PaO 2 between the 4th postoperative day and emergency visit were (82.0±8.8)mmHg, 0.96±0.01, and 3.2 (-1.9, 8.0)mmHg in the APP combined with standardized nursing care group, and were (74.3±12.1)mmHg, 0.94±0.03, and -7.6 (-17.2, 1.1)mmHg in the standardized nursing care group (all P<0.01). The CPIS on the 4th postoperative day was 2.0 (1.0, 3.0)points in the APP combined with standardized nursing care group and 4.0 (1.0, 7.0)points in the standardized nursing care group ( P<0.05). No statistically significant differences were observed in the incidence of pneumonia, type I respiratory failure, pleural effusion, atelectasis and pulmonary edema within 30 postoperative days, as well as PaCO 2 on the 4th postoperative day between the two groups (all P>0.05). None of the patients experienced adverse events related to APP. Conclusion:For elderly patients with hip fracture, compared with standardized nursing care, application of APP combined with standardized nursing care can significantly decrease the incidence rate of early PPCs, especially type I respiratory failure, and improve postoperative oxygenation.

Aim To investigate the molecular mechanisms of alcohol extracts of Euphorbia fischeriana steud. against hepatocellular carcinoma (HCC) through a combination of network pharmacology analysis and experimental validation. Methods The active ingredients and targets of alcohol extracts of Euphorbia fischeriana steud. were determined through TCMSP, Swiss ADME, Swiss Target Prediction database and references. The databases DisGeNET and GeneCards were employed to screen potential HCC-related genes. Venny platform, STRING platform and Cytoscape software were applied to construct active ingredient-target-disease and protein-protein interaction (PPI) network maps. Gene ontology (GO) and kyoto encyclopedia of genes and genomes (KEGG) enrichment analyses were performed using the DAVID database. To assess the effects of Euphorbia fischeriana steud. alcohol extracts on BEL-7402 cells, the proliferation and apoptosis were detected by CCK-8, EdU and flow cytometry assays, and the related protein levels of JAK2/STAT3 pathway were analyzed by Western blot. Additionally, H22 hepatocellular carcinoma mouse model was used to evaluate the in vivo efficacy of Euphorbia fischeriana steud. alcohol extracts. Results A total of 916 HCC targeted genes, 30 active ingredients containing the related 567 potential targeted genes, and 115 intersection targets of disease and compounds were obtained. KEGG enrichment analysis identified JAK2/STAT3 signaling as a critical pathway. In vitro experiments showed the alcohol extracts of Euphorbia fischeriana steud. could inhibit proliferation, promote apoptosis and suppress JAK2/STAT3 signaling pathway in a dose-dependent manner in BEL-7402 cells. In addition, the alcohol extracts of Euphorbia fischeriana steud., either alone or in combination with sorafenib, dramatically blocked tumor growth in in vivo tests. Conclusions Euphorbia fischeriana steud. alcohol extracts have anti-cancer effects in HCC, and the molecular mechanisms may be connected to the regulation of JAK2/STAT3 signaling pathway.