Objective To explore the MRI features of primary spinal lymphoma,and aim at improving the understanding of the disease.Methods The MRI data of primary spinal lymphoma in 8 cases were analyzed retrospectively,which were confirmed by op-eration and pathology,all cases were experienced by the plain MRI scan and enhancement scan.Results There were 6 cases located in thoracic vertebra,5 cases located in lumbar spine,and 2 cases located in sacral vertebral,the MRI performance were the bone damage and bone marrow infiltration in vertebral bodies and accessories,which were showed low signal on T1 WI ,high signal on T2 WI;Compared to adjacent muscles,a obscure boundary of soft tissue masses were also showed low signal on T1 WI ,high signal on T2 WI,and were significantly enhanced.Conclusion MRI is helpful for localization and qualitative diagnosis of the primary spinal lymphoma.

Objective:To explore influence of evidence -based nursing mode on lifestyle and negative emotion in aged pa‐tients with coronary heart disease (CHD) .Methods:A total of 88 CHD patients treated in our department of cardiology were selected .According to random number table ,they were randomly and equally divided into routine nursing group and evidence-based nursing group (received evidence -based nursing based on routine nursing ) . Unhealthy lifestyle status , negative emotion score ,nursing satisfaction and incidence rate of adverse events were recorded and compared between two groups before and four weeks after intervention .Results:Compared with routine nursing group after intervention ,there were significant reductions in percentages of smoking (40.9% vs .22.7% ) ,drinking (54.5% vs .38.6% ) ,high fat diet (43.2% vs .29.5% ) ,physical inactivity (45.5% vs .25.0% ) and overweight or obesity (52.3% vs .29.5% ) in evidence‐based nursing group , P<0.05 all;compared with before intervention ,there were significant reductions in scores of self -rating anxiety scale (SAS) and self-rating depression scale (SDS) in both groups after intervention(P<0.05 or <0.01) , and compared with routine nursing group ,scores of SAS and SDS significantly reduced in evidence -based nursing group , P<0.05 all .Compared with routine nursing group ,there was significant rise in nursing satisfaction (86.4% vs .97.7% ) and significant reduction in incidence rate of adverse events (25.0% vs .11.4% ) in evidence -based nursing group , P<0.05 all .Conclusion:Evidence-based nursing can effectively reduce unhealthy lifestyle and remit the negative emotional state in aged CHD patients ,which is worth extending in clinic .

Objective:To investigate the relationship between serum free triiodothyronine (FT 3) and the severity and prognosis of elderly patients with coronavirus disease 2019 (COVID-19). Methods:Clinical data of the elderly patients aged≥65 years old with COVID-19 who were admitted to the Ninth People′s Hospital of Wuxi from December 27, 2022 to January 18, 2023 were collected. The laboratory examinations of the non-severe and the severe/critical groups were compared. Patients were divided into group T1 (FT 3<2.51 pmol/L), group T2 (FT 3=2.51 to 2.95 pmol/L, ), and group T3 (FT 3>2.95 pmol/L) according to the FT 3 level. Independent sample t test was used for comparison between groups. Logistic regression analysis was performed to evaluate the risk factors for severe/critical disease, and to analyze the risk of severe/critical COVID-19 in elderly patients with different FT 3 levels. The receiver operator characteristic (ROC) curve was drawn to analyze the predictive value of FT 3 on the occurrence of severe/critical disease in patients. Kaplan-Meier survival curve and log-rank test were used to analyze the 30-day survival rate of elderly COVID-19 patients. Results:Among the 190 patients, the FT 3 level in the severe/critical group was (2.54±0.30) pmol/L, which was significantly lower than that in the non-severe group ((2.91±0.69) pmol/L), and the difference was statistically significant ( t=-3.42, P=0.001). Elevated serum FT 3 level was a protective factor for severe/critical disease in elderly COVID-19 patients (odds ratio ( OR)=0.139, 95% confidence interval ( CI) 0.034 to 0.577, P=0.007). There were 66 patients in the T1 group, 61 in the T2 group and 63 in the T3 group, respectively. After adjusted for sex, age, history of lung diseases, history of cardiac diseases, history of hypertension, history of diabetes mellitus, history of cerebral infarction, white blood cell count, lactate dehydrogenase, D-dimer, free thyroxine and thyrotropin, the risk of developing severe/critical disease in group T1 and group T2 were 10.982 folds and 3.695 folds of that in group T3, respectively (both P<0.05). The area under ROC curve of FT 3 of predicting severe/critical COVID-19 in the elderly patients was 0.731. The sensitivity and specificity were 0.733 and 0.659, respectively. The cut-off value was 2.53 pmol/L. The 30-day survival rate in patients with FT 3<2.53 pmol/L was significantly lower than that in patients with FT 3≥2.53 pmol/L ( χ2=13.49, P<0.001). Conclusions:The elevated level of FT 3 is a protective factor for progression to severe/critical disease in elderly patients with COVID-19. The evaluation of serum FT 3 could predict the severity and prognosis of elderly COVID-19 patients.

Objective To explore the clinical effect of Buqi Huayu prescription on chronic atrophic gastritis with intestinal metaplasia.Methods A total of 60 patients with chronic atrophic gastritis and intestinal metaplasia in the Department of Spleen and Stomach Diseases,Jinhua Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University from April 2019 to June 2020 were selected and randomly divided into Buqi Huayu prescription group and control group,with 30 cases in each group.Patients in Buqi Huayu prescription group were treated with Buqi Huayu prescription;Patients in control group were treated with folic acid tablets.After 6 months of treatment,the clinical comprehensive efficacy,traditional Chinese Medicine syndrome score,pathological change score,serum pepsinogen(PG)Ⅰ,PGⅡ,PGⅠ/PGⅡ(PGR)were observed before and after treatment in two groups.Results The clinical curative effect of Buqi Huayu prescription group was significantly better than that of control group(90%vs.70%,P<0.05).After treatment,traditional Chinese Medicine syndrome score and gastric mucosa pathology score of two groups were lower than before treatment(P<0.05).The intestinal metaplasia score of Buqi Huayu prescription group was significantly higher than that of control group(P<0.05).The levels of PGⅠ and PGR were higher than before treatment,while the levels of PGⅡ were lower than before treatment(P<0.05).All the indexes in Buqi Huayu prescription group were better than those in control group(P<0.05).Conclusion Buqi Huayu prescription is effective in the treatment of chronic atrophic gastritis with intestinal metaplasia.It can not only improve the pathological changes of patients,but also increase the level of serum PGⅠ and PGR,and decrease the level of PGⅡ.

ObjectiveTo explore the inhibitory effect of water extract of Broussonetiae Fructus on hepatocellular carcinoma （HCC） induced by diethyl nitrosamine （DEN） in mice based on homologous phosphatase and tensin homolog/phosphatidylinositol 3-kinase/protein kinase B （PTEN/PI3K/Akt） signaling pathway. MethodThe primary HCC mouse model was constructed by intraperitoneal injection of DEN solution， and the HCC mice were randomly divided into model group， sorafenib group （0.01 g·kg^-1·d^-1）， low-dose Broussonetiae Fructus water extract group （0.9 g·kg^-1·d^-1）， medium-dose Broussonetiae Fructus water extract group （1.8 g·kg^-1·d^-1）， and high-dose Broussonetiae Fructus water extract group （3.6 g·kg^-1·d^-1）， with 10 mice in each group. Another 10 C57BL/6 mice were selected as a control group and intraperitoneally injected with an equal volume of normal saline. Mice were treated with different concentrations of Broussonetiae Fructus water extract when liver cancer-like white nodules appeared. sorafenib group was treated with sorafenib. The control group and model group were intraperitoneally injected with normal saline. The activities of alkaline phosphatase （ALP）， aspartate aminotransferase （AST）， alanine aminotransferase （ALT）， and γ-glutamyl transferase （γ-GT） in the serum of mice were detected by the biochemical analyzer. The expression levels of alpha-fetoprotein （AFP） and carcinoembryonic antigen （CEA） were detected by enzyme-linked immunosorbent assay （ELISA）. The degree of hepatocyte canceration and hepatocyte injury were observed by Hematoxylin-eosin （HE） and Masson staining. The proliferation of HCC cells was observed by immunohistochemical staining. The apoptosis of HCC cells in mice was observed by erminal-deoxynucleotidyl transferase mediated nick end labelling （TUNEL） staining. The expression levels of PTEN， PI3K， Akt， and p-Akt proteins related to the PTEN/PI3K/Akt signaling pathway were detected by Western blot. ResultCompared with the control group， the activities of ALP， AST， ALT， and γ-GT， as well as the expression levels of AFP and CEA in the model group were significantly increased （P<0.01）. Carcinogenesis and inflammatory cell infiltration were obvious in liver tissue of mice， and a large number of blue collagen fiber hyperplasia was found. The number of Ki67 positive cells was significantly increased （P<0.01）， and the expression level of PTEN protein was significantly decreased， while PI3K and p-Akt protein expression was increased （P<0.01）. Compared with the model group， the activities of ALP， AST， ALT， and γ-GT， as well as the expression levels of AFP and CEA in the medium-dose and high-dose Broussonetiae Fructus water extract groups were significantly decreased （P<0.05， P<0.01）. The degree of carcinogenesis and inflammatory cell infiltration in liver tissue were reduced， and the collagen fiber hyperplasia was significantly reduced. The number of Ki67 positive cells was significantly decreased， and the number of TUNEL positive apoptotic cells was significantly increased （P<0.05， P<0.01）. PTEN protein expression was increased， while p-Akt protein expression was significantly decreased （P<0.05， P<0.01）. ConclusionThe water extract of Broussonetiae Fructus has a significant inhibitory effect on DEN-induced primary HCC in mice， and its mechanism may be related to the regulation of key protein expressions in the PTEN/PI3K/Akt signaling pathway.

Objective: To know the genetic characteristics of nucleoprotein(N)of wild type measles virus in Xi’an, 2013-2017. Methods: We used the pharyngeal swab specimens of suspected measles cases which were tested positive for measles virus (MV) nucleic acid by Real-time RT-PCR to isolate MV strains with Vero-SLAM cells, extracted RNA of the strains, amplified the N genes of MV strains and the pharyngeal swab specimens which had lower Ct values by One-Step RT-PCR, and analyzed the result after sequencing. Results: Thirty carboxyl terminal sequences of the N genes of MV endemic strains were obtained and identified as genotype H1a. The nucleotide and amino acid homology among the epidemic strains were 97.3%-100% and 96.7%-100%, among the epidemic strains and S191 were 91.3%-92.2% and 87.3%-90.0%, while among the epidemic strains and C47 were 92.2%-92.7% and 88.0%-90.7%. The nucleotide homology among the epidemic strains and wild strains of same period in Anhui, Gansu, Shandong, Henan, Jilin were higher than that in Shanxi, Sichuan, Hunan and Guangdong. The most different amino acid sites among the epidemic strains and the two vaccine strains which had high level of entropy were 422, 457 and 497, secondly 467, thirdly 500. The mutations at the 467 site only existed in 2017. dN/dS=0.199 and no positive selection site was found. Conclusions The dominant genotype of the epidemic MV strains in Xi’an was H1a in 2013-2017, the genetic diversity of viruses decreased in 2016-2017. We should strengthen the surveillance of etiology of MV to provide evidence for elimination of measles.