Objective To investigate the value of fluid resuscitation strategy in septic shock patients by pulse indicator continuous cardiac out ( PiCCO ) .Methods 42 septic shock patients were divided into the PiCCO group(n=26) and the control group(n=16).All patients measured heart rate(HR),mean artery pressure(MAP), central venous pressure(CVP);CI,GEDVI,SVRI,EVLWI,CVP as indicator of fluid resuscitation after 0h,6h,24h of the diagnosis were measured respectively in PiCCO group;CVP as guiding volume resuscitation was measured in the control group .The effect of fluid resuscitation was compared between two groups .To analyse the relationship between CVP,GEDVI and CI in PiCCO group .according to CVP increase 2mmHg ,GEDVI whether elevated 10%.Results After 6h EGDT treatment bundle HR ,MAP,APACHEII score and clearance rate of lactic in PiCCO group improved more than those in control group [(101.3 ±7.8) and (119.4 ±7.2),t=-7.520,P<0.05;(71.8 ±7.6) and (51.5 ±8.9),t=7.873,P<0.05;(17.0 ±3.4) and (22.7 ±4.1),t=-4.978,P>0.05;(53.6 ±11.5) and (-16.5 ±5.2),t =9.283,P <0.05].There were no differences in 28-Day mortality between two groups (t =-2.162,P>0.05),but ICU hospitalization time decreased in PiCCO group [(13.8 ±2.6) and (23.3 ±2.2),t=-5.075,P<0.05].Changes in GEDVI was positively correlated with Changes in CI (r=0.799,P<0.05),while changes in CVP was poorly correlated with CI (r=-0.446,P>0.05).Conclusion Hemodynamic monitoring by PiCCO directed fluid resuscitation strategy can elevate reversal rate .Compared with pressure index CVP ,GEDVI is a sensitive indicator of cardiac preload .Correlation between CVP and GEDVI can reflect cardiac function ,Especially for septic shock patients with cardiac depression .

Objective:To discuss the clinical significance of structural chest zones for gynecomastia.Methods:A total of 687 gynecomastia patients, aged from 14 to 45 years old, with an average age of 27.0, were admitted to the Department of Plastic Surgery, Huashan Hospital Fudan University from January 2012 to December 2018. Simon classification was used to record. Conduct Simon classification according to the preoperative measurement of the chest. Surgical area design, photo analysis, breast ultrasound examination and Derriford appearance scale evaluation were conducted as well. Six zones can be divided as follows: zone 0 nipple-areola zone, zone 1 gynecomastia zone, zone 2 accessory-breast zone, zone 3 lateral-roll zone, zone 4 IMF(inframammary fold) zone, zone T relative-contraindication zone. Positive and lateral images of the chest were taken before and one week, one month, three months, six months, and 12 months after the operation, and the preoperative and postoperative changes of each structural zone were compared. At the follow-up of 12 months after the operation, patients’ satisfaction was counted.Results:687 patients, according to Simon classification, were divided toⅠ degreein 65 cases, Ⅱa degree in 257 cases, Ⅱb degreein 194 cases, Ⅲ degree in 171 cases. Before operation, except for Simon Ⅰ degree in 65 cases showed just raised to 0 zone, most of the rest of the patients contains 1 zone raised, 2-4 zones come in different patients. After liposuction and glandular stripping were performed in different zones, postoperative follow-up was conducted one week, one month, three months, six months, and 12 months after the operation. The dynamic observation was made of the change process of chest shape shaping during the follow-up, whether there were postoperative complications, poor local shape, or bad regional shape. Evaluation results of patient satisfaction 12 months after surgery: among the 687 patients, there were 634 patients with 10 points of satisfaction, and 53 patients with 8-9 points, including 48 patients of zone 0 and zone 1, three patients of zone 3, and 2 patients of zone 4.Conclusions:The structural chest zones of gynecomastia provides plastic surgeons and male patients with simple, intuitive, and highly recognized preoperative evaluation, which can provide appropriate, simplified, and accurate guidance for the selection of surgical methods.

Objective:To discuss the clinical significance of structural chest zones for gynecomastia.Methods:A total of 687 gynecomastia patients, aged from 14 to 45 years old, with an average age of 27.0, were admitted to the Department of Plastic Surgery, Huashan Hospital Fudan University from January 2012 to December 2018. Simon classification was used to record. Conduct Simon classification according to the preoperative measurement of the chest. Surgical area design, photo analysis, breast ultrasound examination and Derriford appearance scale evaluation were conducted as well. Six zones can be divided as follows: zone 0 nipple-areola zone, zone 1 gynecomastia zone, zone 2 accessory-breast zone, zone 3 lateral-roll zone, zone 4 IMF(inframammary fold) zone, zone T relative-contraindication zone. Positive and lateral images of the chest were taken before and one week, one month, three months, six months, and 12 months after the operation, and the preoperative and postoperative changes of each structural zone were compared. At the follow-up of 12 months after the operation, patients’ satisfaction was counted.Results:687 patients, according to Simon classification, were divided toⅠ degreein 65 cases, Ⅱa degree in 257 cases, Ⅱb degreein 194 cases, Ⅲ degree in 171 cases. Before operation, except for Simon Ⅰ degree in 65 cases showed just raised to 0 zone, most of the rest of the patients contains 1 zone raised, 2-4 zones come in different patients. After liposuction and glandular stripping were performed in different zones, postoperative follow-up was conducted one week, one month, three months, six months, and 12 months after the operation. The dynamic observation was made of the change process of chest shape shaping during the follow-up, whether there were postoperative complications, poor local shape, or bad regional shape. Evaluation results of patient satisfaction 12 months after surgery: among the 687 patients, there were 634 patients with 10 points of satisfaction, and 53 patients with 8-9 points, including 48 patients of zone 0 and zone 1, three patients of zone 3, and 2 patients of zone 4.Conclusions:The structural chest zones of gynecomastia provides plastic surgeons and male patients with simple, intuitive, and highly recognized preoperative evaluation, which can provide appropriate, simplified, and accurate guidance for the selection of surgical methods.

Objective To explore the mediating effect of facial emotion recognition on prosocial behavior of medical students in mask-obscured scenes.Methods Fifty-three medical students from a medical university in Chongqing were enrolled from July to September 2023 to complete the facial emotion recognition task,the dictator gaming task and the state empathy test.Spearman correlation analysis was used to examine the correlation between mask wearing and state empathy,trait empathy and prosocial behaviours,and the PROCESS procedure was used to test the mediation of state empathy and the moderating effect of mask wearing or not.Results ①mask wearing,state empathy and prosocial behaviour were significantly correlated(P＜0.01);② State empathy exerted mediated effect between facial emotion recognition and prosocial behavior,with the largest effect size(47％)for the relative mediating effect of sadness;③The interaction terms of facial emotion recognition and mask wearing had a significant effect on state empathy(P＜0.05).Conclusion Facial emotion recognition can influence prosocial behavior directly and also exert indirect effect on prosocial behavior through state empathy.Compared to the condition without mask wearing,mask wearing can significantly facilitate the effect of happy,sad and neutral emotions on state empathy.

⁶³Ni is predominantly generated through neutron activation in nuclear reactors and is classified as a pure beta-emitting radionuclide with a half-life of 101.1 a. During decay, ⁶³Ni emits a beta ray with an energy of 65.87 keV. ⁶³Ni can be used in the manufacture of beta radiation sources, which are utilized as reference and working sources for beta activity measurement and beta energy response calibration. Additionally, it is used in electron capture detectors for chromatography, ionization sources in electron tubes, and electron capture probes in gas chromatography. These instruments have extensive applications in food safety, public health and epidemic prevention, soil pollution monitoring, and security. ⁶³Ni is an artificial radionuclide not commonly found in the natural environment under normal conditions. However, the ⁶³Ni generated during routine operations of nuclear power plants, as well as residual materials and wastes contaminated with ⁶³Ni during plant decommissioning, may be released into the environment through liquid effluents or solid wastes. This can pose potential radiation risks to both the public and the environment. Hence, it is necessary to monitor the activity concentration of ⁶³Ni. Currently, reports on this subject are limited in China, and there is a lack of established standards for the determination of ⁶³Ni in nuclear power plants. This article reviews the global literature on the pretreatment and purification measurement processes of ⁶³Ni. The merits and demerits are summarized for pretreatment methods such as acid leaching, mixed acid digestion, ashing acid leaching/dissolution, and alkali fusion, and for separation and purification methods like solvent extraction, precipitation, and extraction chromatography. The article also highlights the advantages of measurement using liquid scintillation counters. This review provides a reference for the establishment of the determination method of ⁶³Ni in liquid effluents and solid wastes from nuclear power plants.

Objective To investigate the relationship between disrupted corticospinal tract (CST) and motor recovery after stroke by using diffusion tensor tracking (DTT). Methods From March, 2012 to June, 2013, 15 chronic stroke patients with left subcortical lesions and 15 age- and sex- matched healthy subjects were performed diffusion tensor imaging (DTI) examination. The CST was tracked by DTT technique, and the damaged values of the CST caused by the stroke lesions were quantified using a CST template generated from healthy controls. Furthermore, the correlations of the damaged values of the CST with Fugl-Meyer Assessment (FMA) were performed. Results The range of the damaged values of CST in stroke patients was 0.00% to 29.6%. There were very strong negative correlation between the damaged values of the CST and FMA scores (the wrist, r = -0.660; hand, r = -0.813; wrist plus hand, r = -0.795, respectively, P < 0.01). It also showed strong negative correlation between the damaged values of the CST and FMA scores (upper limb, r = -0.614; upper limb plus lower limb, r = -0.563, respectively, P < 0.05). Whereas, there was no correlation between the damaged values of the CST and FMA scores of lower limb (r = -0.270, P = 0.331). In addition, the lesion volumes of stroke and FMA scores were not significantly correlated (P > 0.05). Conclusion The severity of motor deficit after stroke was closely related to the overlap of lesions with CST. The damaged values of the CST based on DTT may be used as a potential biomarker to assess motor impairments of upper limbs, especially hand and wrist in stroke patients.