Objective To explore the imaging characteristics of the ovarian thecoma-fibroma.Methods The clinical imaging characteristics of 25 patients with thecoma-fibroma were retrospectively analyzed. Results A total of 27 lesions were seen in 25 patients, and the maximum diameter of the tumors was 1.2 - 15.0 cm, with an average diameter of 6.9 cm. The tumors whose maximum diameter larger than 6 cm were mainly as cysticsolid. Twenty-six lesions were well-defined margin, and 14 lesions were round and oval masses, 9 lesions were lobulated masses, 3 lesions were irregular masses, and 1 lesion presented with unclear boundary. A total of 10 lesions in 9 cases were performed with CT scan, and the density was similar to uterine muscle density. In MRI scan of a total of 17 lesions of 16 cases, all lesions showed hypointensity on T1WI. On T2WI, 8 lesions showed slightly hyperintensity, 7 lesions appeared slight hypointensity, and 2 lesions appeared significantly hypointense. Eight lesions showed slit hyperintensity. Enhancement scanning was performed in seven cases. Five cases showed mild to moderate enhancement, 1 case was enhanced obviously, and 1 case was not strengthened. Conclusions The imaging findings of the ovarian thecoma-fibroma have somewhat features and can indirectly reflect pathology of tumor. Combined with the clinical data, imaging characteristics are is helpful to the diagnosis and differential diagnosis of the disease.

Objective:To investigate the relationship between Watchman occluder and structure of mitral valve apparatus in patients with nonvalvular atrial fibrillation after left atrial appendage closure(LAAC) by transesophageal echocardiography.Methods:From January 2018 to December 2020, 29 patients [20 male, 9 female, (69.55±10.06)years old] with nonvalvular atrial fibrillation underwent LAAC in Zhongshan Hospital (implanted Watchman occluder), and all patients underwent pre-operative and follow-up two and three dimensional transesophageal echocardiography(2DTEE, 3DTEE) at 60 days after the operation. The quantitative parameters of mitral valve apparatus were obtained by offline analysis using the MVA module in QLab 13.0 (Philips Healthcare, Andover, MA), the differences between pre-operation and post-operation were compared, and the relationship between occluder compression ratio and mitral valve parameters with significant changes after operation was analyzed.Results:①The values of AL-PM diameter(AL-PM), 3D annulus circumference(3DAC), 2D annulus area(2DAA), 3D annulus area(3DAA), tenting volume(TnV), tenting area(TnA) and commissural diameter(CD) decreased significantly compared with pre-operative values(all P<0.05), while the annulus sphericity index(SPI) increased significantly ( P<0.05). ②In the quantitative mitral value parameters with significant pre- and post-operation changes, TnV was correlated with the occluder compression ratio ( r=0.403, P=0.030), but AL-PM, SPI, 3DAC, 2DAA, 3DAA, TnA, CD were not correlated with it(all P>0.05). Conclusions:3DTEE can accurately evaluate the effect of Watchman occluder on the morphology of mitral valve device. Implanting Watchman occluder in left atrial appendage can make three-dimensional mitral valve apparatus flat and decrease annulus left-right diameter and annulus area; the pre-operative TnV, the more susceptible to the occluder implantation, and TnV is correlated with the compression ratio.

Objective:To summarize the evidence related to the guidance and management of breastfeeding in pregnant women with gestational diabetes mellitus.Methods:UpToDate, BMJ Best Practice, CINAHL, PubMed, Cochrane Library, Embase, Wanfang database, China National Knowledge Infrastructure, and other databases and professional websites were searched by computer for evidence on breastfeeding guidance and management for pregnant women with gestational diabetes mellitus, including clinical decisions, guidelines, evidence summaries, systematic reviews, expert consensus and randomized controlled trials. The search period was from database establishment to April 1, 2023. Two researchers independently conducted literature quality evaluation, evidence extraction, and integration.Results:A total of 23 articles were included, including 4 clinical decision-making articles, 4 guidelines, 4 evidence summaries, 6 systematic reviews, 1 expert consensus and 4 randomized controlled trials. A total of 21 best pieces of evidence were summarized from six aspects of support and education, knowledge and skills, safety issues, feeding issues, dietary care, and blood glucose monitoring.Conclusions:This study summarizes the best evidence on breastfeeding guidance and management for pregnant women with gestational diabetes and suggests that the medical staff should apply the proof according to the clinical situation and the patient's wish.

Objective:To systematically integrate qualitative research on the psychological experience of non-suicidal self-injury (NSSI) in adolescents.Methods:A comprehensive literature search was conducted in databases including China National Knowledge Infrastructure, WanFang data, VIP, China Biology Medicine disc, PubMed, Web of Science, Embase, and Cochrane Library for qualitative studies on the psychological experience of NSSI in adolescents and the search period covered the inception of the databases until June 27, 2023. The methodological quality of the included studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research (2016 edition). The results were integrated using the Meta-synthesis method.Results:A total of 15 studies were included, comprising ten phenomenological studies, one descriptive qualitative study, one mixed-method study, one narrative study, one exploratory study, and one grounded theory study. Thirty-one findings were extracted and synthesized into ten categories, resulting in three main themes: triggers of adolescent NSSI, NSSI as a coping strategy, and the internal conflict and struggle of adolescents engaging in NSSI.Conclusions:Adolescents engaging in NSSI experience complex psychological and sensory responses. Healthcare professionals should closely monitor adolescents' emotional changes, enhance psychological assessments, and guide them in coping with negative emotions effectively to improve their physical and mental health.

OBJECTIVE To analyze the data of non-invasive prenatal testing based on specific loci of circulating cell-free fetal DNA (cffDNA). METHODS Selected loci of target chromosomes were analyzed by sequence capture and sequencing. Meanwhile, 600 loci were selected from other chromosomes for determining the concentration of cffDNA. RESULTS A total of 768 specific loci were captured on chromosomes 21 and 18, and used to determine whether the two were abnormal. When the minimum concentration of detected cffDNA was set at 3% and the threshold of Z score was set to [-6,6], the specificity of the analysis was 99.37% and the sensitivity was 100%. CONCLUSION A reliable, convenient and low-cost analytical method has been developed. The method requires less sequencing data for non-invasive prenatal testing, and can accurately detect abnormalities of fetal chromosomes 21 and 18, and simultaneously determine the concentration of cffDNA.

Objective To investigate the changes of peroxisome proliferator-activated receptor-γ coactivator-1 α (PGC-1 α) mRNA and cytoapoptosis in the rats' masseter muscle which had been influenced by unilateral chewing,and to explore the theoretical foundation of changes in masticatory muscles induced by unilateral chewing.Methods The animal models were established by extracting the Wistar rats' left maxillary molars.Thirty-six female Wistar rats were randomly divided into four groups of 2,4,6 and 8 weeks,nine each.In each group there were six rats with molar extracted and three as control.The Ca2+ level was detected by atomic spectrophotometric method.The relative expression of PGC-1α mRNA was detected by real-time fluorescent quantitative PCR.The apoptosis index was detected by Hoechst staining.Results The Ca2+ level in the muscle on the extraction side were significantly higher than that in the controls in the beginning stage of unilateral chewing,and reached the peak at the 4th week [(43.62 ± 2.36) μg/g].The relative expressions of PGC-1α increased from the beginning and reached the maximum level at the 4th week [extraction side:(1.57±0.10); non-extraction side:(1.92±0.06)],while the relative expressions of PGC-1α in 6 and 8 weeks decreased gradually [extraction side:(1.06 ±0.08),(1.08 ±0.07); non-extraction side:(1.09±0.10),(1.11 ± 0.08)].The changes of apoptosis index on non-extraction side increased continually and peaked at the 6th week [(38.56± 1.64)％].Conclusions PGC-1α and cytoapoptosis played important roles in different stages of tissue remodeling induced by unilateral chewing.

Objective To investigate the expression of the Toll-like receptor-4 (TLR-4) in temporomandibular joint synovitis in rats,and to discuss the correlation between the expression of TLR-4 and the synovitis.Methods Sixty male wistar rats were randomly divided into five groups,12 each.Group A was the control group in which the rats were given normal diet.In Group B,the rats' bilateral masseter muscles were cut off (masseter resection group).In Group C,An cast metal crown were bonded on the mandibular right first molar of each rat (occlusal interference group).In Group D,occlusal pad were bonded on maxillary molars of each rat (occlusal dimension increase group).In Group E,rats' bilateral masseter muscles were resected and occlusal pads were bonded on their maxillary molars (masseter resection and occlusal dimension increase group).Pathological changes of synovium were observed using hematoxylin and eosin (HE) stains and pathology scores were evaluated.The expression of TLR-4 were determined by immunohistochemical stains,and the expression of TLR-4 mRNA were determined by real-time PCR.The correlation between the expression of TLR-4,TLR-4 mRNA and the pathological score were analyzed using Spearman analysis.Results The pathological scores of Group A-E were 0.5±0.5,2.5±1.0,2.7±1.0,3.0±0.9,5.3±1.2 respectively.The expression of TLR-4 were (3.2±1.5) ％,(16.0±2.6) ％,(15.8±2.1) ％,(17.5±2.4) ％,(38.2±4.4) ％.The expression of TLR-4 mRNA were 1.07±0.09,2.12±0.33,2.07±0.29,2.17±0.34,4.53±0.46.Compared with group A,groups B-E showed significant higher pathology score (P＜0.05) and increased expression of both TLR-4 (P＜0.05) and TLR-4 mRNA (P＜0.05).An significant positive correlation was found between the expression of TLR-4 and the pathology score (r=0.785,P＜0.05),and between the expression of TLR-4 mRNA and the pathology score (r=0.720,P＜0.05).Conclusions TLR-4 may be closely associated with the development of the synovitis of TMJ of rats.

Objective To investigate the prognostic factors of multi?drug resistant organism (MDRO) infection in patients with infected pancreatic necrosis(IPN). Methods A retrospective study was performed to assess the MDRO in IPN patients. The clinical data of 104 IPN patients admitted to the Department of Pancreatic and Biliary Surgery, the First Affiliated Hospital of Harbin Medical University from June 2013 to January 2019 were analyzed. Fifty?six patients were allocated in the MDRO group and 48 patients in the non?MDRO group depended on drug sensitivity test. There were 37 males and 19 females in the MDRO group with age of 40 (23) years. The duration time was 3(5) days between onset and admission. In the non?MDRO group,34 males and 14 females were included with age of (42±14)years. The duration time was 3(4) days between onset and admission. Normally distributed quantitative variables was represented by , non?normally distributed quantitative variables was represented by M ( QR). Wilcoxon rank?sum test and χ2 test were used to analyze the data. Univariate and multivariable Logistic regression analytic model were used to figure out the risk factors associated with MDRO infection. Results The mean duration of hospital stay was 29.5(31.8) days and hospitalization expenses were CNY 166 991(270 692), which were much higher than those in non?MDRO group (16.5(15.7) days, CNY 56 789(62 354)) (W=1 889, 2 019, both P<0.01). Gram?negative isolates(67.2%, 80/119) were commonly detected in IPN patients. Acinetobacter baumannii was the most common MDRO(27.0%, 20/74). Initial use of carbapenem(OR=2.22, 95%CI: 1.02-4.96, P=0.047) and open necrosectomy(OR=10.00, 95%CI: 3.14-44.77, P<0.01) were the potential risk factors for MDRO?induced infections in IPN. Furthermore, the Logistic regression analysis revealed that open necrosectomy was the independent variable for MDRO infections(OR=9.42, 95%CI:2.92-42.42, P<0.01). Conclusion Open necrosectomy is the independent risk factor for the infection of MDRO.

Objective To investigate the prognostic factors of multi?drug resistant organism (MDRO) infection in patients with infected pancreatic necrosis(IPN). Methods A retrospective study was performed to assess the MDRO in IPN patients. The clinical data of 104 IPN patients admitted to the Department of Pancreatic and Biliary Surgery, the First Affiliated Hospital of Harbin Medical University from June 2013 to January 2019 were analyzed. Fifty?six patients were allocated in the MDRO group and 48 patients in the non?MDRO group depended on drug sensitivity test. There were 37 males and 19 females in the MDRO group with age of 40 (23) years. The duration time was 3(5) days between onset and admission. In the non?MDRO group,34 males and 14 females were included with age of (42±14)years. The duration time was 3(4) days between onset and admission. Normally distributed quantitative variables was represented by , non?normally distributed quantitative variables was represented by M ( QR). Wilcoxon rank?sum test and χ2 test were used to analyze the data. Univariate and multivariable Logistic regression analytic model were used to figure out the risk factors associated with MDRO infection. Results The mean duration of hospital stay was 29.5(31.8) days and hospitalization expenses were CNY 166 991(270 692), which were much higher than those in non?MDRO group (16.5(15.7) days, CNY 56 789(62 354)) (W=1 889, 2 019, both P<0.01). Gram?negative isolates(67.2%, 80/119) were commonly detected in IPN patients. Acinetobacter baumannii was the most common MDRO(27.0%, 20/74). Initial use of carbapenem(OR=2.22, 95%CI: 1.02-4.96, P=0.047) and open necrosectomy(OR=10.00, 95%CI: 3.14-44.77, P<0.01) were the potential risk factors for MDRO?induced infections in IPN. Furthermore, the Logistic regression analysis revealed that open necrosectomy was the independent variable for MDRO infections(OR=9.42, 95%CI:2.92-42.42, P<0.01). Conclusion Open necrosectomy is the independent risk factor for the infection of MDRO.

Objective:To analyze the differential expressions of ferroptosis related genes (FRGs) in proliferative lupus nephritis and its correlation with clinical indices (PLN) by analyzing the gene expression omnibus (GEO) database.Methods:The GSE65391 dataset was downloaded from GEO database, differential FRGs of PLN were screened by limma package of R language. Wilcoxon rank-sum test was used to analyze the differentially expressed genes in peripheral blood between 514 PLN patients and 72 healthy controls. Gene ontology (GO) and Kyoto encyclopedia of genes and genomes (KEGG) enrichment analysis of differential FRGs were determined with the clusterProfiler package. Hub genes were determined using random forest (RF), support vector machine (SVM), xgboost (XGB) and generalized linear model(GLM) machine learning algorithms. Finally, Spearman rank correlation analysis was used to analyze the correlation between hub genes and clinical indices.Results:A total of 38 differential FRGs of PLN patients were screened out, of which 16 were up-regulated and 22 were down-regulated. Biological process was enriched in cellular response to chemical stress, cellular component was enriched in transcription regulator complex, molecular function was enriched in DNA-binding transcription factor binding. KEGG enrichment analysis showed that FRGs were mainly involved in NOD-like receptor signaling pathway. GLM algorithm was selected to predict gene essentiality according to the area under the receiver operating characteristic (ROC) curve, 10 hub genes were determined, of which MYB was the most important. MYB was positively correlated with SLEDAI ( r=0.21, P<0.001), ALT ( r=0.20, P<0.001), AST ( r=0.18, P<0.001), LDH ( r=0.31, P<0.001), Cr ( r=0.24, P<0.001) and ESR ( r=0.22, P<0.001) and negatively correlated with albumin ( r=-0.28, P<0.001). Conclusion:FRGs may provide new insight into the potential mechanisms of the pathogenesis of PLN.