Objective To preliminarily discuss the technical points and clinical efficacy of the pressure cooker technique (PCT)for embolization of intracranial arteriovenous malformation (AVM). Methods From April 2015 to May 2015,7 patients with AVM were treated at the Department of Neurosurgery, Shanghai Deji Hospital. The AVMs of 2 patients were embolized with PCT. (both were Spetzler-Martin gradeⅡ). A sonic and an echelon microcatheter were implanted side by side into the same blood supply artery of an AVM. A coil + α-isobutyl cyanoacrylate (NBCA)plug was formed between the sonic microcatheter tip and the detachable point through the echelon microcatheter in order to prevent Onyx reflux when the glue was injected into a nidus via a sonic microcatheter,achieving the embolization effect of sustained,rapid and high efficient. Results Two patients achieved complete embolization immediately. The symptoms of the patients improved or disappeared within 1 month. The whole brain DSA showed the AVM of one patient did not have recurrence at 4 month after embolization. Two patients did not have any complications or sequelae at the follow-up study. Conclusion PCT can improve the efficiency of embolization. It is suitable for small, medium,superficial,non-major functional area,less feeding artery AVMs,and AVMs with less blood flow in nidus. Its safety and clinical effect still need to be observed with more samples.

Objective To explore the effects of microwave irradiation on the proliferation of keloid-derived fibroblasts so as to analyze the expression of collagen-1 and the activation of the signaling pathway involved.Methods Cells from a human keloid scar were cultured in vitro and randomly divided into a control group withont any intervention,a 10 mW/cm2 microwave irradiation (10-MI) group and a 20 mW/cm2 microwave irradiation (20-MI) group.Aliquots of the latter 2 groups were irradiated at their corresponding intensities for 5 min,15 min and 30 min.The growth of fibroblasts was evaluated using MTT assay.The expression of collagen-1 and changes in the phosphorylation of protein JNK were detected using western blotting.Results Compared with the control group,no significant differences in the average growth of the keloid-derived fibroblasts were observed in the 10-MI group,but significant differences were observed in the 20-MI group and among the three sub-groups irradiated for different durations.The expression of type 1 collagen was significantly down-regulated after irradiation in a time-dependent manner.After microwave radiation at 20 mW/cm2,JNK was significantly activated compared to the control group at the different time points.Conclusions Microwave irradiation at 20 mW/cm2 can significantly inhibit the proliferation of keloid-derived fibroblasts and the down-regulalion is correlated with the irradiation's duration.It can also significantly inhibit collagen-1 expression and relieve scar formation through activating the JNK signal pathway.

Objective To observe the effect of saikosaponin-d on transcriptional activation of estrogen receptor in rat hepatic stellate cells(HSC-T6), and to explore its pharmacological mechanism. Methods The rat HSC-T6 were cultured in vitro for the study. After transient transfection of HSC-T6 with the ER-specific reporter gene ERE-tk-Luc by liposome, the effect of saikosaponin-d and estradiol on luciferase activity was observed by Dual-Luciferase Reporter Assay System under the conditions of various drug concentrations, various treatment time and addition of estrogen receptor inhibitor ICI182. 780. Results When the concentrations of saikosaponin-d and estradiol were in the range of 0.01-5 μmol/L, 0.01-1 μmol/L respectively, luciferase activity was increased in a dose-dependent manner . Luciferase activity arrived the highest when saikosaponin-d concentration was 5 μmol/L and estradiol concentration was 1 μmol/L, but the effect was weakening when estradiol concentration reached 5μmol/L. In respect of the effect of treatment time, when HSC-T6 were separately treated with 5μmol/L of saikosaponin-d and 1 μmol/L of estradiol for 24 h, the luciferase activity was the highest. And ICI182.780 could significantly inhibit the induction of saikosaponin-d and estradiol for luciferase activity. Conclusion Saikosaponin-d has an effect on promoting the transcriptional activation of estrogen receptor in HSC-T6.

AIM To compare liver-protective and anti-inflammatory effects of extracts from root,stem,leaf,and flower of Gentiana rigescens.METHODS The mouse model for the immunological liver injury induced by Concanavalin A,and mouse ear swelling model for inflammation caused by dimethylbenzene were used for the comparison of the liver-protective or anti-inflammatory effects of four parts individually.RESULTS Four aqueous extracts of Gentiana rigescens showed the dose-dependent decrease in the activity of ALT and AST in serum and liver index,and alleviation of hepatic tissue injury induced by Concanavalin A in mice.The effects of the extracts from the leaf and root were better than those from the stem and flower.These extracts presented dose-dependent inhibition against the ear swelling caused by dimethylbenzene in mice.The effects of the extracts from the leaf and stem were better than those from the flower and root.CONCLUSION Extracts from the root and leaf of G.rigescens have liver-protective effect,and parts from the stem and leaf have anti-inflammatory effect.

ObjectiveTo investigate the immunity and seroprevalence of hepatitis A and to identify the risk factors of hepatitis A infection in 0-18 year-old children and adolescents in Shanghai.MethodsSubjects were enrolled by stratifying and clustering random sampling method.Questionnaire interview was applied to investigate the socio-demographic and behavioral factors related to hepatitis A virus (HAV),and information on HAV immunization was abstracted from the immunization registration book of each subject.The enzyme-linked immunosorbent assay (ELISA) was used to qualitatively detect HAV IgM and quantitatively measure total HAV antibody in all subjects.Risk factors associated with HAV among the subjects without HAV vaccination were analyzed.ResultsA total of 2431 subjects were enrolled in the present study with negative HAV IgM antibody and total HAV antibody in 1483 subjects were sero-positive with positivity rate of 61％.Total HAV antibody positivity rates were declined with age increasing and were significantly higher in subjects with HAV vaccination than those without HAV vaccination records.Salad food,eating together without food separation in school and endoscopy inspection were risk factors for HAV infection.ConclusionsHAV vaccination strategies remarkably improve the total HAV antibody seropositive rate in children and adolescents in Shanghai.The risk of HAV infection exists if HAV vaccination is not administrated comprehensively.Therefore,strengthening HAV vaccination and health education are important for children and adolescents to prevent and control of hepatitis A in Shanghai.

Renal cell carcinoma is a malignant tumor originating from renal tubular epithelial cells. Its pathogenesis is complicated, with no typical early clinical symptoms. Most patients are already in the advanced stage at the time of diagnosis and have a high mortality rate. The development mechanism and treatment strategy of renal cell carcinoma are the current research focus. In recent years, non-coding RNA has been proved to play a crucial role in regulating tumor progression. Among them, circular RNA plays a unique role in tumor development due to its nonlinear structure. The dysregulation of circular RNA is closely related to the progression of a series of diseases including metabolic diseases and cancer. Similarly, circular RNA plays a key role in the progression, treatment, and prognosis prediction of renal cell carcinoma. This article briefly reviews role of circular RNA in renal cell carcinoma, hoping to bring new research directions for the diagnosis and treatment of renal cell carcinoma.

Objective To summarize the screening Methods for human parvovirus (HPV) B19 infection after liver transplantation and analyze the related risk factors. Methods Clinical data of 86 recipients were retrospectively analyzed. According to the Results of next generation sequencing (NGS), all recipients were divided into the HPV B19 infection group and control group. Clinical characteristics, treatment regime and clinical prognosis of patients infected with HPV B19 were analyzed. The risk factors of HPV B19 infection were analyzed using univariate and multivariate Logistic regression model by forward LR step method. Results Nine of the 86 recipients developed fever and progressive anemia with unexplained reasons at approximately 2 weeks after liver transplantation. NGS detection demonstrated that HPV B19 was positive and they were diagnosed with pure red cell aplasia (PRCA) caused by HPV B19 infection. After intravenous immunoglobulins (IVIG) was given and the immunosuppressant therapy was adjusted, the hemoglobin levels in all patients were significantly increased. The Results of multivariate analysis revealed that low serum globulin level in peripheral blood at postoperative 7 d [odds ratio (OR) =0.749, P=0.040] and young age (OR=0.937, P=0.038) were the independent risk factors of HPV B19 infection after liver transplantation. Conclusions HPV B19 infection should be considered in relatively young patients with unexplained hemoglobin decline early after liver transplantation. NGS screening is an effective method for early diagnosis of HPV B19 infection. Low serum globulin level in peripheral blood at postoperative 7 d and young age may be independent risk factors of the incidence of HPV B19 infection.

We present a case of a postmenopausal women with hyperandrogenic symptoms and virilization signs , such as hirsutism, alopecia, acne and clitoromegaly, which was pathologically confirmed to be an ovarian steroid cell tumor, not otherwise specified(NOS). The levels of testosterone, dehydroepiandrosterone sulfate and estradiol in serum were increased, while the levels of luteinizing hormone and follicle stimulating hormone were decreased. Computed tomography(CT) scan and magnetic resonance imaging(MRI) identified a solid, left ovarian tumor and detected an additional tumor of hypodensity in the left adrenal gland. ACTH stimulation test, hCG stimulation test, adrenal and ovarian vein sampling indicated that excessive androgens were derived from the ovary. After the injection of gonadotropin hormone analogues(GnRHa), testosterone levels dropped to the normal range. Laparoscopic bilateral adnexectomy was performed, and pathology indicated NOS. The purpose of this report is to improve the understanding of NOS with hyperandrogenic presentation.

Objective To analyze the anxiety level of parents and influencing factors in patients with phenylketonuria ( PKU) , in order to provide references for providing good psychological intervention methods for patients′parents.Methods Totally 122 parents of patients with PKU in China-Japan Frieadship hospital from March 2014 to March 2015 were selected and investigated. The anxiety level of patients and the proper influencing factors were surveyed by self-designed questionnaires and self-rating anxiety scale ( SAS ) . The influencing factors were analyzed by Logistic regression analysis. Results The results showed that the mean score of anxiety level of the PKU parents was (61.3±12.4) points, in which 66.4% were beyond 50 points, while 2. 5% was beyond 75 points. The proper influencing factors included the children′ recent clinical manifestation, parents′ understanding of disease and the social support degree. Conclusions The parents′anxiety level is significantly higher than normal people, and their anxiety level is associated with many influencing factors. So the health nursing workers should pay more attention to the parents′mental states and give necessary interventions to encourage their actively cooperation with doctors to achieve the common goals.

Objective:To systematically evaluate the qualitative research on human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients′experience of participating in advance care planning (ACP), so as to provide reference for the application of ACP in HIV/AIDS patients.Methods:Computer searched qualitative studies on HIV/AIDS patients′participation in ACP experience in Web of Science, PubMed, Cochrane Library, Embase, CINAHL, China National Knowledge Infrastructure, Wanfang, VIP, China Biomedical Literature Database. The search time limit was from inception to December 1, 2023, and the research results were integrated using Meta integration method after quality evaluation.Results:A total of 10 articles were included, and 58 research results were extracted, forming 12 new categories, and 4 integrated results were obtained: HIV/AIDS patients′understanding of ACP; attitudes of HIV/AIDS patients towards ACP; the influencing factors of HIV/AIDS patients′participation in ACP; suggestions for implementing ACP for HIV/AIDS patients.Conclusions:Medical staff should promptly identify the needs of HIV/AIDS patients for ACP, help them increase their awareness and acceptance of ACP. At the same time, based on China′s unique cultural background and healthcare system, relevant laws and regulations should be continuously improved to promote the development and improvement of ACP in China.