Hydrocephalus is a common disease caused by the disorder of the physiological metabolism of cerebrospinal fluid.The damage mechanism is abnormal expansion of the ventricular system and impairment to the surrounding brain tissue.Hydrocephalus in children can show individual clinical symptoms along with the age of onset and different causes,leading to brain growth retardation.It is particularly important to understand its pathogenesis and etiology and put forward targeted treatment strategies by early diagnosis.This paper reviews the pathophysiology,etiology and characteristic manifestations of hydrocephalus in children.

The authers introduce the research and retrieve to a famous assistive technology database ABLEDATA,then analyse the application in work in the view of information technology.

本文介绍了著名的辅助技术数据库ABLEDATA的研究和检索，从信息技术的角度讨论了其在实践中的应用。

Aim To investigate the signaling mecha-nisms in endothelial monocyte-activating polypeptide-Ⅱ( EMAP-Ⅱ)-induced increase in blood-tumor barri-er ( BTB ) permeability. Methods Relatively pure cerebral microvessel fragments were obtained from the cortex of 3-5 days old Wistar rats by using careful dis-section, enzyme digestion, and dextran centrifugation. Then, these fragments were seeded on dishes and cul-tured primarily. In vitro BTB models were constructed by co-cultivation of rat brain microvascular endothelial cells ( BMECs) with C6 glioma cells. Confluent mono-layers of co-cultured BMECs were divided randomly in-to 5 groups ( each n=6 ): control, EMAP-Ⅱ, H7 +EMAP-Ⅱ, C3 exoenzyme + EMAP-Ⅱ, and C3 ex-oenzyme + H7 + EMAP-Ⅱ groups. Transendothelial electric resistance values and horseradish peroxidase flux were measured to evaluate changes in the BTB permeability . The expression levels of tight junction-re-lated protein occludin and ZO-1 in BMECs were meas-ured by Western blot. Immunofluorescence was used to identify the expression and distribution of occludin and ZO-1 in BMECs. Also, Western blot were used to de-tect the expression levels of myosin light chain ( MLC) and phosphomyosin light chain ( pMLC ) in BMECs. Results Compared with control group, the BTB per-meability of EMAP-Ⅱ group was increased significant-ly. The expression levels of occludin and ZO-1 in BMECs were significantly decreased, accompanied with marked increase in the expression level of pMLC. These above-mentioned effects of EMAP-Ⅱ were sig-nificantly inhibited by pretreatment with H7 ( an inhib-itor of PKC ) or/and C3 exoenzyme ( an inhibitor of RhoA ) . Conclusion Signaling molecules PKC and RhoA play important roles in EMAP-Ⅱ-induced in-crease in BTB permeability; signaling pathways PKC-pMLC and RhoA-pMLC are involved in this process.

Objective To investigate the clinical value of CT lymphangiography (CTL) combined with direct lymphangiography (DLG) in primary intestinal lymphangiectasia (PIL). Methods Sixteen patients diagnosed as PIL with intestinal enteroscopy were recruited in this retrospective study. All the patients were performed DLG and CTL one week before exploratory laparotomy. Subjective assessment in DLG included weak lymphatic fluid drainage, lymphangiectasia, lymphatic reflux, fistula and thoracic outlet reflux or obstruction. While for CTL combined with DLG, the intestinal and extra-intestinal lesions were evaluated, including lymph node, edema, lymphangiectasia and abnormal distribution, fistula, and lymphangiomatosis. All the diagnosis was compared with intestinal endoscopy results. Results For DLG, 16 weak lymphatic fluid drainages, 9 lymphangiectasia, 1 fistula with abdomen and 14 thoracic outlets weak lymphatic fluid drainage or obstruction were found. For DLG combined with CTL, 16 intestinal lumens dilatation and 14 circumferential intestinal thickening were found in intestinal lesions. While for extra-intestinal lesions, the imaging features included edematous findings (12 in mesentery, 7 ascites only, 2 hydrothorax and ascites, and 3 pericardial, thoracic and abdominal effusions), abdominal lymph nodes (6 cases), lymphangiectasia and abnormal distributions (14 cases), fistulas (lymph-intestinal luminal fistula in 4 cases, and lymph-abdominal fistula in 3 cases), lymphangiomatosis (3 cases), and thoracic duct outlet dysfunction and reflux (14 cases).The number of cases diagnosed as intestinal lymphangiectasia, intestinal luminal lymph exudation and lymph fistula were 16, 10 and 6 with intestinal endoscopy, while the number were 11, 0, and 4 with CTL combination with DLG. Conclusion Combination of CTL with DLG is valuable in the diagnosis of PIL.

Objective:To investigate the relationship between medical students' employment intention in primary healthcare unit and their learning and psychological state through a questionnaire survey among clinical undergraduates.Methods:A cross-sectional survey was conducted among 821 graduates of a Medical University in 2017 to investigate their employment intention, learning and psychological status and employment plan. The learning and psychological status was evaluated by a self-designed questionnaire. Independent sample t-test, variance analysis and multiple linear regression analysis were used to examine the relevant factors affecting medical students' employment intention in primary healthcare by SPSS 21.0 version.Results:A total of 810 questionnaires were distributed and 753 questionnaires were included in the analysis. The employment intention of working in primary healthcare units of medical students was 4.61±2.24. Students in the advanced class had lower willingness to work in primary healthcare unit (the group of students with higher entrance examination scores) ( P<0.05), and students with higher learning pressure and greater pressure of doctor-patient relationship were more reluctant to work in primary healthcare units ( P<0.05). In terms of the employment plan, students who focus on their professional counterparts are more willing to work in primary healthcare unit, while those who pay more attention to salary are less willing to work in primary healthcare unit ( P<0.05). Conclusion:Improving the incentive policies for working in primary healthcare unit, actively relieving psychological pressure of medical students, and increasing the training of doctor-patient communication can have a positive effect on improving the willingness of medical students to have an employment intention in primary healthcare unit.

Objective:To investigate the relationship between medical students' employment intention in primary healthcare unit and their learning and psychological state through a questionnaire survey among clinical undergraduates.Methods:A cross-sectional survey was conducted among 821 graduates of a Medical University in 2017 to investigate their employment intention, learning and psychological status and employment plan. The learning and psychological status was evaluated by a self-designed questionnaire. Independent-sample t test, variance analysis and multiple linear regression analysis were used to examine the relevant factors affecting medical students' employment intention in primary healthcare by SPSS 21.0 version. Results:A total of 810 questionnaires were distributed and 753 questionnaires were included in the analysis. The employment intention of working in primary healthcare units of medical students was (4.61±2.24). Students in the advanced class had lower willingness to work in primary healthcare unit (the group of students with higher entrance examination scores) ( P<0.05), and students with higher learning pressure and greater pressure of doctor-patient relationship were more reluctant to work in primary healthcare units ( P<0.05). In terms of the employment plan, students who focus on their professional counterparts are more willing to work in primary healthcare unit, while those who pay more attention to salary are less willing to work in primary healthcare unit ( P<0.05). Conclusion:Improving the incentive policies for working in primary healthcare unit, actively relieving psychological pressure of medical students, and increasing the training of doctor-patient communication can have a positive effect on improving the willingness of medical students to have an employment intention in primary healthcare unit.

Objective To investigate the safety and clinical value of using ExoSeal vascular closure device (VCD) in interventional management via antegrade femoral access.Methods Clinical and imaging data of 303 patients (316 affected limbs) who were received interventional procedure via antegrade femoral access closure were retrospectively analyzed.ExoSeal VCD (VCD group,n=127) and manual compression (MC group,n =176) were performed to make femoral artery puncture point hemostasis.The time of hemostasis,actual immobilization time,technical success rate and vascular related complications were recorded and compared between the two groups.Results In VCD group and MC group,the time of hemostasis were (3.68 ± 2.40) min and (18.32 ± 4.54) min,the actual immobilization time were (3.45±5.30) h and (10.44±14.68) h,the technical success rates were 98.52％ (133/135) and 93.92％ (170/181),and the complication rates were 2.22％ (3/135) and 8.84％ (16/181),respectively.There were statistically significant differences between two groups (all P＜0.05).In VCD group,there were 2 cases of subcutaneous hematomas,and 1 case of retroperitoneal hematoma.In MC group,there were 15 cases of subcutaneous hematomas and 1 case of acute thrombosis in the puncture side limb.Conclusion Regarding hemostasis of puncture site in interventional management via antegrade femoral access,the use of ExoSeal VCD is safe and effective.

Objective:The characteristics and prognosis of ear fullness feeling in patients with all-frequency sudden deafness were explored.Method:104 patients (104 ears) with unilateral all-frequency sudden deafness were collected in study from June 2015 to March 2019, including 50 males and 54 females, the mean age ranged from 23-65 years, and the disease duration ranged from 1-9 days. Of those, 56 patients accompanied with the feeling of ear fullness (FEF) were enrolled into'the ear fullness group′, and 48 patients without FEF were included in'the without ear fullness group′. Patients′ treatment strategy followed the Chinese Medical Association Guidelines for the diagnosis and treatment of sudden deafness (2015). Moreover, VAS scale scores and subjective grading of FEF were acquired in patients with FEF. We analyzed the clinical characteristics and prognosis of FEF with SPSS 23.0 software.Results:There were no differences between the two groups in terms of age, gender, duration of disease, the side of deaf ear, degree of hearing loss, and auditory brainstem evoked potential results (age, t=1.566; gender,χ 2=0.001; duration, t=0.057; side,χ 2=0.033; degree of hearing loss Z=-0.180; ABR,χ 2=0.001;all P>0.05) . There was a positive correlation between the subjective grading of FEF and the degree of hearing loss in patients with FEF ( r=0.599, P<0.001) . The total rate of hearing improvement following one month of treatments in patients with FEF vs with no FEF was 35/56(62.5%) vs 28/48(58.3%) ( Z=-0.641, P=0.521). After one month of treatment, the total effective rate of FEF was 94.6%(53/56), and the improvement of FEF had nothing to improvement of hearing ( r=0.040, P=0.769) . Conclusions:The degree of hearing loss is positively correlated with the degree of FEF in patients with all-frequency sudden deafness. Hearing recovery is not related to FEF. The recovery effect of FEF is good, and has no correlation with hearing recovery.

Objective The purpose of writing the"Expert consensus on the prevention and control of intracranial hypertension in adult critical illness"(here in after referred to as the"Consensus")aimed to standardize the nursing work related to the prevention and control of elevated intracranial pressure in adult critical illness,and prevent the occurrence of complications such as cerebral herniation.Methods Guided by evidence-based practice,domestic and foreign databases were searched for guidelines,expert consensuses,systematic evaluation,evidence summaries,and original research related to increased intracranial pressure.The search period is from database establishment to March 2024.The high-quality evidence and suggestions in the field was evaluated,extracted,and summarized to form a preliminary consensus.27 experts were invited to conduct 2 rounds of expert inquiry and 8 experts were invited to conduct 2 expert discussion meetings,to revise and improve the content of the initial draft,and to ultimately form a final consensus.Results The effective response rates for both rounds of inquiry questionnaires were 100％,with expert authority coefficients of 0.884,judgment coefficients of 0.964,and familiarity levels of 0.804.The Kendall harmony coefficients for 2 rounds of inquiry were 0.107 and 0.083(P＜0.01),respectively.The consensus includes 4 aspects,including identification,monitoring,prevention and control strategies,emergency treatment and care for increased intracranial pressure.Conclusion This"Consensus"has strong scientific validity and can provide reference basis for nurses to carry out prevention and control of intracranial pressure increase.