Objective To analyse and summarize the MRI characteristics of tumor‐like inflammatory demyelinating diseases (TIDD) .Methods MRI findings of 10 cases with pathologically proved TIDD were analyzed retrospectively ,all patients received plain and enhanced MRI scan .Results 3 cases showed multiple lesions in bilateral frontal and parietal lobes ,and 7 cases showed soli‐tary mass ,in which 2 lesions located in the occipital lobe ,2 in the basal ganglia ,2 in the second to fifth segment of cervical cord ,and 1 lesion located in the left frontal parietal lobe .The shape of 7 lesions were irregular ,2 were stripped ,while 1 lesion was oval .6 cases had clear boundary ,while 4 showed ambiguous .Solitary lesions were 1 .7 cm -5 .6 cm in diameter(mean 4 .0 cm ± 1 .48 cm) .8 cases manifested mild edema while 2 had no edema .On MRI plain scan ,lesions were hypointensity on T1WI and hyperintensity on T2WI in 8 cases ,isointensity on T1 WI and hyperintensity on T2 WI in 2 cases ,and all lesions were hyperintensity on FLAIR sequence .DWI were performed in 3 cases ,all lesions showed hyperintensity ,2 of them had patchy hypointensity signal .Hemorrhage was detected in 3 lesions ,cystic lesions or calcification were not found in all cases .On post‐contrast scan ,3 lesions showed ring like enhancement ,2 showed obviously heterogeneous enhancement ,2 had mild enhancement and 2 cases had no enhancement ,1 presented with open ring like enhancement .Conclusion TIDD shows some specific MRI features ,and MRI is helpful to the diagnosis of TIDD .

Objective: To report on a case of maternally derived 45, X mosaicism detected by non-invasive prenatal testing (NIPT). Methods: Fetal sex chromosomal abnormality was detected by NIPT. Maternally derived 45, X mosaicism was confirmed by chromosome karyotype analysis. Fetal sex chromosome aneuploidy was detected by amniotic fluid chromosome microarray analysis. Results: A maternal 45, X mosaicism was diagnosed. The fetus was confirmed to be normal. Conclusion Maternal 45, X masaicism can be diagnosed by NIPT.

Objective To investigate the failure reasons of children scalp vein in the clinic infusion therapy applications and put forward relevant nursing. Methods A total of 780 infusion children in the outpatient from January 2011 to November 2014 were randomly admitted to either intervention group ( n=380 ) or control group ( n=400 ) . The patients of control group adopted straight-safe intravenous catheter and the patients of intervention group received Y-shaped needle retraction safety intravenous catheter. The patients of two groups were given positively nursing intervention. Results The successful puncture rates in the treatment group were 97. 3%, and it were 85. 3% in the control group (χ2 =8. 377,P<0. 05). The failure of 67 children in both groups were main due to the nurses, children and family factors. During the infusion, the complication rates of fluid extravasation, needles prolapse, phlebitis, catheter blockage in the treatment group were significantly lower than that of the control group (5. 5% vs 21. 1%,χ2 =8. 137,P <0. 05). The puncture satisfaction for the families was 98. 5% in the treatment group, so that it was 91. 1% in the control group (Uc=6. 398,P<0. 05). Conclusions Taking appropriate countermeasures according to the reasons can improve the success rate and reduce the incidence of complications, thereby increase the puncture satisfaction.

Objective:To investigate the effects of positive end-expiratory pressure (PEEP) setting of mechanical ventilation guided by esophageal pressure in the treatment of patients with traumatic craniocerebral injury combined with acute respiratory distress syndrome (ARDS).Methods:The retrospective cohort study was conducted. From June 2016 to June 2018, 55 patients with traumatic craniocerebral injury combined with ARDS who met the inclusion criteria were admitted to Zhengzhou Central Hospital Affiliated to Zhengzhou University. According to PEEP setting method, 28 patients were allocated to esophageal pressure group (17 males and 11 females, aged (40±13) years) and 27 patients were allocated to PEEP-fractional concentration of inspired oxygen (FiO 2) table group (18 males and 9 females, aged (38±10) years). Patients in the 2 groups were treated with mechanical ventilation guided by lung protective ventilation strategy, and the optimal PEEP at 0 (immediately), 24, 48, and 72 h after treatment was determined according to esophageal pressure and PEEP-FiO 2 table, respectively. The mechanical ventilation parameters in the 2 groups were adjusted according to the optimal PEEP. The transpulmonary end-expiratory pressure, pulmonary compliance, oxygen index, central venous pressure, mean arterial pressure, and intracranial pressure at 24, 48, and 72 h after treatment were recorded. Data were statistically analyzed with analysis of variance for repeated measurement, chi-square test, independent sample t test, and Bonferroni correction. Results:The optimal PEEP of patients in esophageal pressure group at 0, 24, 48, and 72 h after treatment was (12.4±3.9), (11.2±3.5), (13.4±2.6), and (13.2±3.6) cmH 2O (1 cmH 2O=0.098 kPa), respectively, which was significantly higher than (8.2±2.5), (7.4±2.2), (8.3±2.3), and (8.5±2.5) cmH 2O in PEEP-FiO 2 table group, respectively ( t=4.702, 4.743, 7.849, 5.623 , P<0.01). The transpulmonary end-expiratory pressure and pulmonary compliance at 24, 48, and 72 h after treatment and oxygen index at 48 and 72 h after treatment of patients in esophageal pressure group were significantly higher than those in PEEP-FiO 2 table group ( t=17.852, 20.586, 19.532, 4.752, 5.256, 7.446, 2.342, 4.178, P<0.05 or P<0.01). The central venous pressure of patients in esophageal pressure group at 24, 48, and 72 h after treatment was significantly higher than that in PEEP-FiO 2 table group ( t=12.632, 5.247, 8.994, P<0.01), and there was no statistically significant difference in mean arterial pressure of patients between the 2 groups at 24, 48, and 72 h after treatment ( P>0.05). The intracranial pressure of patients in esophageal pressure group was higher than that in PEEP-FiO 2 table group at 24, 48, and 72 h after treatment, but there was no statistically significant difference between the 2 groups ( P>0.05). Conclusions:For patients with traumatic craniocerebral injury combined with ARDS, the optimal PEEP can be set under the guidance of esophageal pressure method, and the mechanical ventilation parameters adjusted according to the optimal PEEP can improve lung compliance and accelerate recovery of lung function more effectively, with no adverse effect in mean arterial pressure and intracranial pressure.

This article reported two fetuses diagnosed with Pallister-Killian syndrome (PKS). Amniotic fluid samples of one pregnant woman (case 1), with an abnormal result of non-invasive prenatal test, were analyzed by karyotyping and copy number variation-sequencing (CNV-seq), and samples of the other one (case 2), with a prenatal ultrasound of a lowered spinal conus and an enhanced echo of the renal cortex, were tested for CNV-seq. The chromosome karyotype of case 1 showed 47,XN,+mar[30]/46, XN[10]. CNV-seq results revealed three to four copies of repetition of the p13.33p11.1 segment of chromosome 12, suggesting 12p tetrasomy chimerism in both fetuses. The diagnosis of fetal PKS was confirmed through the combination of multiple technologies (ultrasound, chromosomal karyotype analysis, and CNV-seq). The two pregnancies were terminated after genetic counseling.

Objective To evaluate the applicability of the Chinese version of SF-36 ( v. 2 ) scale for evaluating the quality of life of hospitalized patients with chronic heart failure. Methods From September 2013 to December 2014, 159 patients with chronic heart failure(NYHA I-IV), who were older than 18 years, clear mind and well self-expressed, were selected as participants. Questionnaire surveys included general survey and SF-36(v. 2) scale. Internal consistency reliability, binary reliability and construct validity were all analyzed as indicators to evaluate SF-36 ( v. 2 ) scale. Results A total of 159 questionnaires were issued and 159 valid questionnaires were recovered. The eight dimensions of SF-36(v. 2) scale including physical function (PF), role-physical (RP), bodily pain (BP), general health (GH), social function (SF), vitality (VT), role-emotion(RE), and mental health (MH) score conversion were (41.57 ±24.86), (48.35 ±21.64), (69.18 ± 25. 68), (31. 28 ± 16. 01), (48. 90 ± 19. 53), (45. 05 ± 22. 76), (59. 43 ± 24. 31), (57. 55 ± 19. 03); the floor effects were 2. 5%, 4. 4%, 3. 1%, 4. 4%, 3. 1%, 6. 3%, 0. 6%, 1. 3%; the ceiling effects were 0. 0%, 3. 8%, 21. 4%, 0. 0%, 0. 0%, 1. 9%, 3. 1%, 0. 0%. The item-convergent validity all achieved the standard (r≥0. 4), and the total scaling success rate of item-convergent was 100. 00%; the dimensions′success rates of item-discriminant validity of RP, BP, RE and SF were all 100%, the rest of four dimensions were PF 95. 71%, GH 85. 71%, VT 89. 29%, MH 94. 29%, and the total success rate was 94. 69%. Internal consistency reliability ranged from 0. 738 to 0. 919; the binary reliability ranged from 0. 808 to 0. 963. Within factors analysis, two common factors were confirmed, separately representing physical health and mental health, altogether making contribution of 61. 66% cumulative variance. Conclusions As the revision of SF-36(v. 1), SF-36(v. 2) scale seemed more friendly in layout for questions and answers, the floor and ceiling effects significantly reduced. Additionally, it also shows good reliability and validity in the evaluation of quality of life of hospitalized patients with chronic heart failure, and the SF-36(v. 2) scale can be used to evaluate the quality of life ( QOL) of patients with chronic heart failure.

Objective To collect and summarize the opinions of experts on the improvement of China's disease prevention and control system published in the public media, so as to provide reference for the relevant construction planning of the government. Methods: Articles were collected from January to May, 2020, which were published on Chinese mainstream media. Based on the analysis of literature and the basic characteristics of experts, Analytic hierarchy process (AHP) was used to summarize the construction points of experts in different construction fields. Results: A total of 19 opinion articles were finally included in the study and 29 experts were involved. The suggestions of experts on the construction of China's disease prevention and control system were summarized into four aspects. Conclusion: The COVID-19 pandemic is a challenge to the existing public health epidemic prevention and control system in China, and also an important opportunity for the development and construction of the related system.

Mammals exhibit limited heart regeneration ability, which can lead to heart failure after myocardial infarction. In contrast, zebrafish exhibit remarkable cardiac regeneration capacity. Several cell types and signaling pathways have been reported to participate in this process. However, a comprehensive analysis of how different cells and signals interact and coordinate to regulate cardiac regeneration is unavailable. We collected major cardiac cell types from zebrafish and performed high-precision single-cell transcriptome analyses during both development and post-injury regeneration. We revealed the cellular heterogeneity as well as the molecular progress of cardiomyocytes during these processes, and identified a subtype of atrial cardiomyocyte exhibiting a stem-like state which may transdifferentiate into ventricular cardiomyocytes during regeneration. Furthermore, we identified a regeneration-induced cell (RIC) population in the epicardium-derived cells (EPDC), and demonstrated Angiopoietin 4 (Angpt4) as a specific regulator of heart regeneration. angpt4 expression is specifically and transiently activated in RIC, which initiates a signaling cascade from EPDC to endocardium through the Tie2-MAPK pathway, and further induces activation of cathepsin K in cardiomyocytes through RA signaling. Loss of angpt4 leads to defects in scar tissue resolution and cardiomyocyte proliferation, while overexpression of angpt4 accelerates regeneration. Furthermore, we found that ANGPT4 could enhance proliferation of neonatal rat cardiomyocytes, and promote cardiac repair in mice after myocardial infarction, indicating that the function of Angpt4 is conserved in mammals. Our study provides a mechanistic understanding of heart regeneration at single-cell precision, identifies Angpt4 as a key regulator of cardiomyocyte proliferation and regeneration, and offers a novel therapeutic target for improved recovery after human heart injuries.
Humans ; Mice ; Rats ; Cell Proliferation ; Heart/physiology* ; Mammals ; Myocardial Infarction/metabolism* ; Myocytes, Cardiac/metabolism* ; Pericardium/metabolism* ; Single-Cell Analysis ; Zebrafish/metabolism*