Percheron artery infarct (PAI) is uncommon clinically.One case had an acute onset of coma,impaired left limb activities,verbal incoherence,drinking cough and vertical gaze palsy after regaining consciousness.Magnetic resonance imaging (MRI) showed symmetrical high signal intensity on diffusion-weighted imaging (DWI) in bilateral paramedian thalami and a distinct pattern of V-shaped midbrain hyperintensity on DWI.Magnetic resonance angiography (MRA) showed left-sided embryonal posterior cerebral artery (PCA) from ipsilateral internal carotid artery (ICA).Systemic treatment yielded a poor prognosis.

Objective:To investigate the acceptance of advance care planning and its influencing factors in heart failure patients.Methods:A total of 208 patients with heart failure were surveyed by general data questionnaires and advance care planning acceptance questionnaires.Results:The total score of advance care planning acceptance of heart failure patients was (44.26 ± 11.73), the score of feeling dimension was (13.67 ± 5.72), the score of attitude dimension was (30.59 ± 6.33). 53.4%(111/208) of patients were willing to accept the talking about advance care planning. Regression analysis results showed that education level, New York Heart Association (NYHA) classification, communication status with medical staff and whether they had received life-sustaining treatment were important factors influencing of the acceptance of advance care planning in patients with heart failure.Conclusion:Patients with heart failure had higher acceptance of advance care planning. In clinical work, it is necessary to strengthen the scientific popularization of advance care planning in patients with low education level, low NYHA grade and no exposure to life-sustaining treatment. And strengthen the daily communication with patients to prepare for the follow-up advance care planning related communication.

Objective To investigate the relationship between various loop electrosurgical excision procedure (LEEP) margin status and residual high grade squamous intraepithelial lesion (HSIL) or worse at hysterectomy following conization. Methods The relevant clinicopathological data were collected in the Obstetrics and Gynecology Hospital, Fudan University from Jan. 2014 to Dec. 2015, including 947 cases who underwent hysterectomy within 6 months of LEEP. The residual HSIL or worse at hysterectomy were analyzed among the groups. (1) Clear margins, involved margins, and without 1 mm negative margins. (2) Only one positive margin, two positive margins and three positive margins. (3) A positive margin of internal ostium of cervix, of external ostium of cervix and of the basement. Results (1) The histological evaluation of the uterine specimens showed residual HSIL or worse in 234 cases (24.7％, 234/947). The proportion of residual lesions was 7.3％ (21/286) in population with clear margins, 33.2％ (211/635) with involved margins, 7.7％ (2/26) without 1 mm negative margins, respectively. The positive margins group had significant difference at the aspect of residual rate in contrast to the negative margins group and the without 1 mm negative margins group (P<0.01). Further studies conclusively showed that the proportion of residual lesions was very similar between the negative margins group and the without 1 mm negative margins group (P>0.05). (2) The involved margins were interpretable in 621 cases. This was detected in 25.3％(111/438) patients with only one positive margin, 47.4％(74/156) with two positive margins and 77.8％(21/27) among three positive margins, respectively (P<0.01). (3) Furthermore, there were 418 cases only one positive margin was definite, and the proportion of residual lesions was 31.0％(62/200) in population with a positive margin of internal ostium of cervix, 18.2％(31/170) of external ostium of cervix and 33.3％(16/48) of the basement. The residual rates were higher in the endocervical and basal margin groups than that in the ectocervical margin group, and the differences were significant (P<0.05). Conclusions The risk of residual HSIL or worse is significantly greater with involved margins at hysterectomy following LEEP. Both the positive endocervical and basal margin are excellent predictors of residual diseases, while the without 1 mm negative margin may be not. Clinicians should avoid treating it as positive margin and prevent overtreatment.

Radiotherapy is one of the important methods for treating malignant tumors. However, due to the limitation of normal tissue tolerance dose, it is impossible to give a sufficient irradiation dose to the tumor, which causes treatment failure. Therefore, how to improve the sensitivity of the tumor to radiation is a prominent problem in tumor radiotherapy. Radiosensitizers can enhance the sensitivity of tumor radiotherapy and improve the efficacy of radiotherapy, through accelerating DNA damage, producing free radicals and regulating key molecular targets. This paper summarized the applications of radiosensitizers in radiotherapy, the development status of radiosensitizers and research progresses in the related fields.Furthermore, the possible mechanisms of how radiosensitizers enhance the sensitivity of tumors were also briefly reviewed. This review will elucidate the detailed molecular mechanisms of radiosensitization regulation, promote the development of radiosensitizers, and facilitate the development of new strategies to improve radiotherapy efficiency.

Objective:To investigate the clinicopathological features, diagnosis and differential diagnosis of pseudocarcinomatous hyperplasia of the fallopian tubes.Methods:Sixteen cases of pseudocarcinomatous hyperplasia of the fallopian tubes diagnosed at Obstetrics and Gynecology Hospital of Fudan University from January 2011 to January 2024 were collected.The pathological sections were reviewed, the clinical and pathological data were consulted, and immunohistochemical examination was conducted along with follow-up.Results:The patients were aged from 19 to 57 years, with an average age of 41 and a median age of 38. Among the 16 cases, 4 were located in the right fallopian tubes, 6 in the left fallopian tubes, while the remaining cases presented bilaterally. The general manifestations were tubal edema, crispness and purulent secretion in the lumen. Morphologically, the fallopian tube mucosa exhibited a significant infiltration of neutrophils, lymphocytes and plasma cells. The epithelial cells of the fallopian tube displayed evident proliferation, stratification and disorganized arrangement leading to formation of small glandular cavity with back-to-back, fissure-like and sieve-like structures. Immunohistochemical analysis revealed positivity for CK7 and WT1, along with wild-type p53 expression, Ki-67 index ranged from 5% to 20%. During the follow-up period ranging from 1 to 156 months, all the patients remained free of disease.Conclusions:Pseudocarcinomatous hyperplasia of the fallopian tube is a rare non-neoplastic lesion, which can lead to epithelial hyperplasia and atypical hyperplasia. The most important significance of recognizing this lesion lies in avoiding misdiagnosis of fallopian tube cancer during intraoperative and postoperative pathological examination. This ensures that clinicians can administer correct clinical interventions.

Objective:To explore the effective chemical constituents and target genes of the Sanhan-Qushi-Wenjing-Tongluo formula through the method of network pharmacology, and to further analyze the mechanism of treatoffing psoas fasciitis. Methods:The TCMSP database was used to search and screen the chemical active substances of Sanhan-Qushi-Wenjing-Tongluo formula and its target proteins acting on the human body. At the same time, the GeneCards database platform was used to predict the target of disease and the active ingredient-target network was constructed. Construct a PPI network through the STRING database, search for PPI core genes, and then perform GO enrichment analysis and KEGG enrichment analysis to find the signal pathways involved and construct a target-path network. Results:Through screening, a total of 23 key chemical components and 25 common target proteins was obtained in Sanhan-Qushi-Wenjing-Tongluo formula treating psoas fasciitis; gene analysis of enrichment analysis results include antibiotic response, cyclin-dependent proteins kinase holoenzyme complex, cytokine receptor binding, etc. Kyoto Encyclopedia of Genes and Genomes enrichment analysis results include AGE-RAGE signaling pathway, measles, endocrine resistance, inflammatory bowel disease, etc; the target genes gained which have a higher degree of matching with the above mentioned pathways include IL6, JUN, IL1B, CDK4, CCND1. Conclusion:Sanhan-Qushi-Wenjing-Tongluo formula could treat psoas fasciitis by regulating the target genes such as IL6, JUN, IL1B, CDK4 and CCND1.

Objective:To explore the detection rate, clinical characteristics of vulvar squamous intraepithelial lesion (SIL).Methods:Women diagnosed with vulvar high-grade squamous intraepithelial lesions (HSIL) through colposcopy-guided biopsy from January 1, 2018 to August 31, 2022 in Obstetrics and Gynecology Hospital of Fudan University were included in a 1∶1 ratio with patients diagnosed with vulvar low-grade squamous intraepithelial lesions (LSIL) during the same period. Clinical characteristics including human papillomavirus (HPV) infection rate, genotype, cytology result, colposcopy impression, and lesion location were retrospectively analyzed.Results:(1) The proportion of vulvar SIL detected by colposcopy-guided biopsy increased annually from 2018 to 2022, with rates of 1.64% (740/45 057), 2.34% (1 110/47 402), 2.68% (1 108/41 335), 3.26% (1 536/47 078), 3.31% (667/20 155), with an average rate of 2.57% (5 161/201 027). (2) A total of 1 096 cases of vulvar HSIL and 1 096 cases of vulvar LSIL were included. The overall infection rate of HPV was 92.7% (1 993/2 150), with higher infection rate in vulvar HSIL patients than that in vulvar LSIL patients [96.0% (1 012/1 054) vs 89.5% (981/1 096); χ2=33.62, P<0.001]. Among vulvar HSIL patients, the common HPV genotype from high to low were HPV 16 (66.7%), HPV 52 (14.3%), and HPV 58 (10.0%). For vulvar LSIL patients, the most common HPV genotype were respectively HPV 16 (24.9%), HPV 6 (20.1%) and HPV 52 (17.1%). The overall sensitivity rate of cytology was 53.6%, with no significance difference between vulvar LSIL and HSIL groups (54.3% vs 52.9%; χ2=0.40, P=0.526). The accuracy of colposcopy impression for vulvar HSIL was lower than that for vulvar LSIL [40.2% (163/405) vs 81.7% (380/465); χ2=158.72, P<0.001]. About 57.3% (1 257/2 192) of the patients had concomitant cervical and vaginal lesions, with a higher rate in vulvar HSIL group than that in vulvar LSIL group [62.6% (686/1 096) vs 52.1% (571/1 096); χ2=24.67, P<0.001]. Unifocal lesion was the main type, with no significance difference between vulvar LSIL and HSIL groups [81.4% (381/468) vs 82.5% (386/468); χ2=0.18, P=0.671]. The most common lesion locations were the posterior commissure, followed by labia minora, vaginal vestibule, labia majora, perianal and clitoris. Conclusions:The detection rate of vulvar SIL under colposcopy is about 3%, and the infection rate of HPV is 92.7%. Vulvar SIL, especially vulvar HSIL, is likely to cause concomitant cervical and vaginal lesions. The accuracy of colposcopy in diagnosing vulvar HSIL is low. Therefore a comprehensive and careful examination of the vulva is necessary and suspicious vulvar lesions should be undergone colposcopy-guided biopsy for diagnosis.

To summarize the nursing experience of an adolescent with early repolarization syndrome who had implanted a subcutaneous implantable cardioverter defibrillator(ICD)and experiences frequent ventricular fibrillation.The main nursing care were as follows:recognizing a ventricular fibrillation attack and emergency care;risk prevention and handling in transportation;prevention of iatrogenic infection and strengthening protective isolation;promoting the recovery of brain function;personalized health education;pre-hospital first aid skills training for families.After careful treatment and nursing,the patient did not recur arrhythmia,and heart function had improved significantly,and the pulmonary inflammation disappeared.No medical-acquired infections occurred during hospitalization.The patient's motor ability and language expression ability recovered to the baseline,and was discharged on the 20th day of admission.A month after discharge,the patient recovered well and could study and live normally.

Objective:To explore the effect of eCASH nursing model on the prevention of delirium and quality of care for patients with coronary heart disease in ICU after percutaneous coronary intervention (PCI) .Methods:A total of 188 patients with coronary heart disease who underwent PCI in Henan Provincial People's Hospital from January 2019 to December 2020 were selected by the convenient sampling method and they were admitted to ICU after surgery. Patients admitted from January to December 2019 were set as the control group ( n=94) and received routine care. Patients admitted from January to December 2020 were set as the observation group ( n=94) and received eCASH nursing mode. The incidence of delirium [Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) ], hospitalization (bed time, ICU stay time, total length of stay) , nursing quality (Inpatient Nursing Job Satisfaction Scale) and complications during hospitalization were compared between the two groups. Results:The incidence of delirium, bed time, length of stay in ICU and total length of stay in observation group were lower than those in control group and the score of Inpatient Nursing Job Satisfaction Scale was lower than that in control group, and the differences were statistically significant ( P<0.05) . During hospitalization, there was no statistically significant difference in the incidence of puncture site hematoma, skin blister, infection and limb venous thrombosis between 2 groups ( P>0.05) . The incidence of urinary retention in observation group was lower than that in control group, and the difference was statistically significant ( P<0.05) . Conclusions:The eCASH nursing mode can help ICU patients with coronary heart disease to prevent delirium after PCI, shorten the length of hospital stay, improve quality of nursing and help to reduce complications during the hospital stay.