The levels of ?_2-m、IgG and Alb in CSF of 13 patients with cerebral haemorrhage and 20 patients with cerebral thrombosis and the levels of ?_2-m in CSF of control group consisting of 14 eases were measured. It Was showed that the levels of ?_2-m in CSF of the two groups of the patients with cecrebrovascular disease were obviously higher than that of the control group and the levcls of ?_2-m in CSF of the two groups of the patients with cerebrovascular discase also had rclation to the levels of ?_2-m in serum of the groups of the patients themselves, the valucs of ?_2-m did not corre- lated with the valucs of IgG or Alb in CSF of the paticnts with cerebral hacmorrhage, but there existed a strong correlation between IgG and Alb in CSF of these patients. The values of ?_2-m, IgG and Alb in CSF of patients with cerebral thrombosis were exactly inversdy correlated with that of patients with cerebral haemorrhage. Reviewing some other data about ?_2-m the authors suggest that the clevated ?_2-m in CSf may indicate an increased cell-mediated immune phenomenon of central nervous system in teh pathological process of cerebral haemorrhage, but this phenomenon in the pathological process of cerebral thrombosis is not obviuos.

Objective To evaluate carbon nanoparticles suspension in protection and identification of parathyroid in total thyroidectomy for thyroid papillocarcinoma.Methods This retrospective analysis included the clinical and pathological data of 97 patients from January 2014 to December 2014,52 cases injected carbon nanoparticles suspension (the test group).Serum calcium and parathyroid hormone (PTH) were measured preoperatively and on lst,3rd,7th day and one month postoperatively.Results Incidental parathyroidectomy occurred in 1 case (1.9％,1/52) in test group and in 7 cases (15.6％,7/45) in control group(P ＜0.05).The mean numbers of parathyroid glands identified intraoperatively were 3.1 ± 0.4/case and 2.6 ± 0.3/case respectively (P ＜ 0.05).The occurrence of temporary PTH hypofunction was 19.2％ (10/52) and 42.2％ (19/45) respectively (P ＜ 0.05).Also,test group had a higher level of PTH on postoperative day 1,3,7 and one month (P ＜ 0.05).Conclusions Carbon nanoparticles suspension significantly improved the identification of parathyroid gland during thyroid cancer surgery and reduced the risk of incidental parathyroid ectomy in total thyroidectomy.

Purpose:It is the authors' intention to improve the diagnostic and differential diagnostic accuracy of ultrasound for acute tes-tis diseases by analyzing the sonographic features.Materials and Methods:The sonographic features of 78 acute testis diseasess were analyzed.The results were compared with the clinical,surgical and pathological results.Results:78 patients had obviously different sonographic features between different types of acute testis diseases.12 testicular tumors were big mass with uneven internal echoes and often with calcification.The distributions of the vessels in the lesions were irregular or branch-like.26 cases of testicular contusion had scrotal wall edema and thickening,with low echo and liquid collection in the lesions.21 cases of acute orchitis usually intumesced with color ball-shaped rich blood flow signals.18 cases with testicular torsion had blood flow on the affected side decreased or disappeared,lcase of tuberculocele showed extremely uneven and various echoes mixed in testis.Conclusion: A fast and exact diagnosis or differential diagnosis of acute testis diseases can be obtained with ultrasound.

Objective The aim of this study is to evaluate clinical outcomes of patients with acute type A intranural hematoma of the aorta(IMH) received surgical treatment.Methods We analyzed 40 consecutive patients with acute type A aortic IMH in Fuwai hospital.The patients are from 2012.1.1 to 2015.12.31.The average age of patients is(56 ± 11) years.Clinical outcomes and morphological evolution by CT were analyzed for 2 years.Results Most of the patients were treated medically during their initial hospitalization.There were 2 patients died in in-hospital and no 2-year mortality.16 patients (40％) were received acute surgery,24 patients(60％)were received normal surgery.Conclusion Surgical treatment would be a favorable treatment option in type A acute IMH.

OBJECTIVETo evaluate facial morphology characteristics of patients with unilateral complete cleft lip and palate (UCCLP) after cleft palate repair in different periods.

METHODS46 nonsyndromic UCCLP patients were chosen as test group and divided into three kinds (under 4-year-old, 4-7-year-old, over 7-year-old) according to periods of palate repair. 38 age and gender matched non-clefts children were involved as control group. 26 cephalometric measurements were measured to evaluate facial morphology of four groups.

RESULTSCompared with patients who received palate repair before 4-year-old, patients who received repair after 4-year-old had more protrusive ANS point (Ba-N-ANS, Ba-ANS) and less Y-axis angle. Patients who received palate repair after 7-yesr-old had greater A-PMP and ANS-PMP than patients who received palate repair before 4-year-old, patients who received palate repair before 7-year-old had smaller ANS-Me but after had no significant difference when compared with non-clefts.

CONCLUSIONWhenever palate repair is undertaken in the period of maxillary growth and development, patients' maxillary growth would be restrained, the delayed repair sample have better lower face height, maxillary protrusion, maxillary sagittal length and mandible growing direction when compared with the early repair sample, that is to say, the delayed repair sample have preferable head-face morphology.

Exposure to ionizing radiation intervenes in genomic stability and gene expression,resulting in the disruption of normal metabolic processes in cells and organs by causing complex biolog-ical responses.Altered genomic variations,gene expression and metabolite concentrations in blood or tissue samples reflect systemic radiation damage.With the application of new techniques and exten-sive study on the mechanisms for ionizing radiation damage,related indicators such as chromosomal variation,gene expression,lipid and metabolism are being recognized and promise to be the markers for early diagnosis and prognosis of radiation exposure.Therefore,this article reviews recent progress in and potential applications of biomarkers related to ionizing radiation injury.

Objective:To explore the status quo of the readiness of evidence-based nursing practice for the maintenance and removal of children's central venous catheter (CVC) in 6 domestic medical institutions Pediatric Intensive Care Unit (PICU), analyze the obstacles faced by the application of CVC maintenance and removal evidence in PICU, so as to provide basis for formulating reform strategies.Methods:This study was a cross-sectional survey. In December 2019, 169 nurses from PICU of 6 medical institutions in Shanghai, Guangzhou, Shenzhen, Hangzhou, Xiamen and Hefei were selected by convenience sampling for investigation. The General Information Questionnaire and Clinic Readiness to Evidence-based Nursing Assessment (CREBNA) were used to evaluate the readiness of clinical nurses to evidence, organizational environment and promoting factors in the process of evidence-based practice. A total of 169 questionnaires were issued, and 169 valid questionnaires were recovered, with a valid recovery rate of 100%.Results:A total of 169 nurses were investigated in 6 evidence application sites. The total score of the multi center CREBNA was (136.96±15.33), which was 88.36% of the full score. The scores of the three dimensions were as follows: organizational environment (40.31±4.45), evidence dimension (53.43±6.14), and promoting factors (43.22±5.81). Four of the last five items in the score ranking were from the promoting factor, and the low score items in four places were all from the promoting factor.Conclusions:The best practice project of children's CVC maintenance in PICU is feasible. However, there are still some deficiencies in the preparation of various evidence application sites, especially in the promoting factors, which should be constantly improved to further promote and maintain the implementation of change.

Objective: By detecting the expression of interleukin-13 (IL-13) and periostin in the airway of asthmatic patients, the pathological changes and pulmonary functions of airway tissues in asthmatic patients were evaluated, and the role of IL-13 and periostin airway remodeling in bronchial asthma was preliminarily explored. Methods: The bronchial tissues adjacent to tumor nest were obtained from 12 patients with lung cancer complicated with bronchial asthma (asthmatic group) and 12 lung cancer patients without bronchial asthma (non-asthmatic group) after lung cancer resection. Pulmonary function was measured for all subjects before surgery. Pathological changes of airway tissues and degree of airway remodeling were assessed by hematoxylin-eosin (H&E) staining, masson′s trichrome staining, and periodic acid-silver methenamine (PASM) staining of paraffin-embedded sections. The expression of IL-13 and periostin in bronchial tissues were evaluated by immunohistochemistry. Results: Values of the forced expiratory volume in 1 second of the predicted value (FEV1% pred) and FEV1/forced vital capacity (FEV1/FVC%) in asthmatic patients were significantly decreased compared with the non-asthmatic patients (P<0.05), indicating that lung function was impaired in asthmatic patients. There was more severe airway remodeling representing as thickening of basement membranes, collagen deposition, and increasing of goblet cells and fibroblasts in asthmatic patients than in non-asthmatic patients (all P<0.05). The expression of IL-13 and periostin were higher in asthmatic tissues than in non-asthmatic tissues (P<0.05). The immunohistochemical expression of IL-13 and periostin in bronchial tissues were positively correlated with the degree of airway remodeling in asthmatic patients, and the expression of IL-13 and periostin in bronchial tissues were positively correlated with each other. Conclusions The expression of IL-13 and periostin were increased in bronchial tissue in patients with asthma. They work together to promote the occurrence of airway remodeling, which eventually lead to a decline in lung function.

Objective:To screen serum protein markers and evaluate their diagnostic application value in hepatitis B-related acute-on-chronic liver failure (HBV-ACLF).Methods:Serum samples of patients with HBV-ACLF, chronic hepatitis B (CHB) and normal healthy volunteers ( n = 5/group) were determined by cytokine antibody chip in line with the Chinese Diagnostic Standards Study for HBV-ACLF (COSSH-ACLF) cohort. The differentially expressed proteins significance were identified by microarray analysis and prediction. The preliminary serological markers of HBV-ACLF were screened for diagnosis. The potential markers were determined by enzyme-linked immunosorbent assay (ELISA), area under the receiver operating characteristic curve (AUROC) analysis and liver tissue immunohistochemistry for the diagnosis of HBV-ACLF. Student t-test or Mann-Whitney U test were used to compare the continuous measurement data between the two groups, and analysis of variance and Kruskal-Wallis test were used to compare the continuous measurement data between multiple groups. Results:Cytokine antibody chip preliminary screening results showed that the expression levels of these six cytokines, namely, macrophage inflammatory protein 3α (MIP-3α), hepatocyte growth factor, E-selectin, osteopontin, growth differentiation factor 15 and carcinoembryonic antigen-related cellular adhesion molecule 1 were significantly increased in the HBV-ACLF group. Among them, the expression level of MIP-3α was significantly higher in the HBV-ACLF group (99.6 times higher than CHB group and 146.9 times higher than healthy volunteers’ group, respectively, P < 0.0001) as validated by serum ELISA in 132 HBV-ACLF cases, 91 CHB cases and 72 healthy volunteers. AUROC analysis showed that the high expression of MIP-3α could be used as a marker to distinguish patients with HBV-ACLF from CHB. The AUROC was 0.995 (95% CI: 0.990 ~ 1.000), with sensitivity and specificity of 95.5% and. 98.9%, respectively. Immunohistochemistry showed that MIP-3α was positively expressed in HBV-ACLF-derived liver tissues, and negatively expressed in CHB-derived liver and normal liver tissues. Conclusion:Serum MIP-3α level is closely related to the pathological characteristics of HBV-ACLF. Therefore, it may be used as a potential serological marker for the diagnosis of HBV-ACLF.

【Objective】 To investigate the variation of ferric metabolism indexes in male regular platetpheresis donors (MRPDs) with the low iron storage (plasma ferritin <30 μg/L). 【Methods】 The ferric metabolism indexes of 137 MRPDs with ferritin <30 μg/Lwere detected, including serum free iron (sFI), hemoglobin (Hb), unsaturated iron binding capacity (UIBC), total iron binding capacity (TIBC), transferrin (TRF) and prealbumin (PALB). The correlation between these indexes and the level of ferritin, the total number of platelet donation and the number of platelet donations in the previous year were analyzed. 【Results】 The UIBC of MRPDs with ferritin <30 μg/L showed a significant upward trendin comparison with the normal reference value, with the median level of UIBC at 55.1 μmol / L. The level of serum iron decreased significantly, with the median level at 10.9 μg / L. The level of ferritin was correlated with UIBC and Hb, and the indexes of iron metabolism were generally correlated to each other. The number of platelet donation in the previous year was correlated with TIBC, UIBC and TRF. The total number of platelet donation was correlated with TIBC and TRF. 【Conclusion】 MRPDs with ferritin <30 μg/L showed abnormalferric metabolism. It is necessary to detect both ferritin and ferric metabolism indexes to evaluate the iron deficiency in MRPDs.