Objective To explore the efficacy of intraductal chilled saline perfusion (ICSP) to reduce the thermal bile duct injury during the treatment of radiofrequency ablation (RFA) associating with occlusion of hepatic blood supply in rabbits.Methods 16 healthy New Zealand white rabbits were divided into 2 groups.Rabbits of the ICSP group were placed tubes in the common bile duct after laparotomy,and ICSP was performed during the RFA procedure accompanied with hepatic blood occlusion.While for rabbits of the non-ICSP group,hepatic blood occlusion and RFA were performed without ICSP.RFA electrodes were placed about 5 mm away from the hilus hepatis approximately.Contrast-enhanced ultrasonography (CEUS) was administrated to evaluate the sizes of the ablative zones after the procedure.On post-procedure 6 week,ultrasonography was prerformed to evaluate the changes of the biliary structure,and liver specimens of rabbits wcrc obtained for histopathologic observation of main bile ducts.Results Post-procedure CEUS examination showed that there was no significant difference in the size of the ablative zone between the groups (P ＞0.05).On post-procedure 6 week,rabbits of the ICSP group appeared with biliary dilatation more frequently by ultrasonography (P ＜0.05),and a higher degree of the injury of main bile duct by histopathologic observation (P ＜0.05).Conclusions In treatment of RFA accompanied with hepatic blood occlusion,RFA-induced bile duct injury may be decreased significantly with ICSP.

Objective To retrospectively analyze the treatment results and prognostic factors in patients with primary bone lymphomas (PBL).Methods Thirty-one patients with PBL treated between April 1994 and May 2009 at Sun Yat-sen University Cancer Center were analyzed.All patients were diagnosed by pathology.Twenty-two patients had stage Ⅰ E, 4 patients had stage Ⅱ E and 5 patients had stage ⅣE diseases.One patient was treated with surgical resection alone, 1 patient with radiotherapy (RT) alone, 2 patients with chemotherapy (CT) alone and 4 patients with resection followed by chemotherapy.The remaining 23 patients received CT combined with RT.The median radiation dose was 50 Gy.Results The median follow-up time was 45.2 months.The follow-up rate was 83.9%.Nine patients had a follow-up time of 10 years.The 5-year and 10-year overall survival rates were 92% and 92%, respectively.The 5-year and 10-year disease-free survival rates were 79% and 70%, respectively.In the group who received non-combined chemoradiotherapy, the complete response rate was 50%, the incidence of progression or recurrence was 2/8 and the median recurrence time was 6.8 months.In the group who received combined chemoradiotherapy, the complete response rate was 65%, the incidence of progression or recurrence was 13% and the median recurrence time was 39.1 months.In univariate analyses, favorable prognostic factors for survival included age≤50 years (χ2=5.32,P=0.021) and ECOG PS score 0-1(χ2=5.48,P=0.019).Favorable prognostic factors for DFS included IPI score≤1(χ2=7.81,P=0.005) and ECOG PS score 0-1(χ2=18.70,P=0.000).Conclusions Treatment results of patients with PBL can be generally well.CT combined with RT appears to be the treatment of choice.RT dose ≥40 Gy is safe and feasible.Younger age and better performance status are associated with a better outcome.

Objective To learn the current status of family doctor service at pilot communities in Guangzhou, and discover existing problems and influencing factors by investigating the residents who have contracted such service , those have not and the family doctors . Methods This study chose typical community health centers of six communities in Guangzhou in January 2016 .In random sampling , residents who visited doctors during the survey and all the family doctors were surveyed .EpiData was used to doubly inputdata,withSPSS20.0forstatisticalanalysis.Results 66.0％ofthoseresidentswhohavenot contracted the service are willing to contract a family doctor .According to the binary logistic regression analysis after eliminating the interference factors , there are two factors affecting their willingness:gender and whether needing a family doctor for themselves and their family for health management .According to the binary logistic regression analysis after eliminating the interference factors , the influencing factors of renewing contract are overall satisfaction and necessity for signing family doctors .Conclusions The smooth development of the family doctor service is faced with many bottlenecks , while improving willingness to contract and renew contract to family doctors are the cornerstone for sustainability of the family doctor system.

Objective To observe the glymphatic system functional changes of bilateral cerebral hemispheres in early-stage Parkinson disease(PD)patients complicated with unilateral limb motor symptoms.Methods A total of 52 early-stage PD patients complicated with unilateral limb motor symptoms were prospectively enrolled,including 21 cases of left-onset PD(LPD group),31 cases of right-onset PD(RPD group).Meanwhile,28 healthy individuals were recruited as healthy controls(HC group).Clinical data and indices of diffusion tensor imaging analysis along the perivascular space(DTI-ALPS)were compared among 3 groups and between each 2 groups.The correlations of DTI-ALPS indices and clinical scales were analyzed.Results Significant difference of Hamilton depression scale(HAMD)score was found among 3 groups(P＜0.05).HAMD score of LPD group and RPD group were higher than that of HC group(both P＜0.017).There were significant differences of left and right cerebral hemispheres DTI-ALPS(DTI-ALPS_L,DTI-ALPS_R)indices among 3 groups(both P＜0.05).DTI_ALPS_R in LPD group was lower than that in HC group(P＜0.017),and DTI_ALPS_L in RPD group was lower than that in HC group(P＜0.017).No obvious correlation of bilateral cerebral hemisphere DTI-ALPS indices with clinical scales was detected in PD patients(all P＞0.05).Conclusion Like that of motor symptoms,glymphatic system dysfunction of PD patients had characteristics of laterality,manifested as DTI_ALPS_R decreased in LPD patients while DTI_ALPS_L decreased in RPD patients.

Objective To analyze the clinicopathological data of patients with papillary thyroid microcarcinoma(PTMC)and papillary thyroid non-microcarcinoma(non-PTMC)who received 131I therapy retrospectively,and compare the therapeutic response of the two groups of patients,so as to guide 131I therapy decisions for PTMC patients.Methods A total of 1 118 patients with papillary thyroid carcinoma(PTC)underwent 131I therapy in the Department of Nuclear Medicine,Tianjin Medical University General Hospital from January 2015 to December 2020 were enrolled.Chi-square test and Mann-Whitney U test were used to compare the differences of clinicopathological features and 131I therapy,therapeutic response between two groups.The incomplete response(IR)rate curves of the two groups were plotted by Kaplan-Meier analysis.Results The proportion of patients with multifocal,involvement of bilateral thyroid lobes in PTMC group were higher than those in non-PTMC group,and the proportion of patients with extra-thyroid extension,T4,N1b,stimulated thyroglobulin(sTg)>10 μg/L,and high risk stratified were lower than those in non-PTMC group(P<0.05).Most patients in PTMC group received remnant ablation for the first time,while more patients in non-PTMC group received adjuvant therapy and therapy for known disease(P<0.05).There was no statistically significant difference in 131I therapeutic response,the rates of excellent response(ER)and IR in two groups,and the differences in curves of IR rate between the two groups were also no statistically significance(P>0.05).Conclusions PTMC has a certain degree of invasiveness.As long as the patients were comprehensively evaluated and the standard 131I therapy was adopted,the treatment outcomes of patients with PTMC and non-PTMC were roughly the same.Therefore,the clinical value of the definition of PTMC is extremely limited in the formulation of 131I therapeutic dose regimens.

Objective:To summarize the best evidence for spasticity management in spinal cord injury patients, so as to provide references for clinical practice.Methods:PubMed, Embase, CLINICAL, BMJ Best Clinical Practice website, JBI Evidence-based Health Care Center database, National Institute for Health and Clinical Excellence, Ontario Guidelines Network, US National Guidelines Network, Scottish Interhospital Guidelines Network, UpToDate, Cochrane Library, CNKI, Wanfang Database, Medlive, China Biology Medicine disc and professional association websites were syatematically searched for clinical decisions, guidelines, evidence summary, systematic reviews and expert consensus or opinions on spasm management. The quality of the included studies was evaluated and the evidence content was extracted. The search period was from the establishment of the databases to February 28, 2023.Results:A total of 15 articles were included, including 2 clinical decision-making articles, 1 guideline, 3 expert consensus or opinions articles and 9 systematic evaluations. A total of 18 pieces of evidence were summarized from 4 aspects, such as regular evaluation, intervention measures, intervention principles, and effectiveness evaluation of patients with spinal cord injury.Conclusions:This study summarizes the best evidence for spasticity management in patients with spinal cord injury and provides an evidence-based basis for clinical work. It is recommended that when applying the evidence, an individualized spasticity treatment plan should be developed according to the needs of the patient and the actual clinical situation.

Objective:To analyze the relationship between physical appearance perfectionism, negative body self, fear of negative evaluation and social appearance anxiety in female patients with psoriasis.Methods:A total of 251 female patients with psoriasis in Xinhua Hospital Affiliated to Medical College of Shanghai Jiaotong University from June 2019 to June 2020 were selected as the subjects. Physical Appearance Perfectionism Scale (PPAS), Social Appearance Anxiety Scale (SAAS), Brief Fear of Negative Evaluation Scale (BFNES) and Negetive Physical Self Scale (Npss) were used in the survey. The correlation of negative body self and negative evaluation fear between the appearance perfectionism and social appearance anxiety of female psoriasis patients was analyzed.Results:The score of physical appearance perfectionism was 49.42±5.32, the score of social appearance anxiety was 58.72±6.24, the score of fear of negative evaluation was 30.59±7.21 and the score of negative physical self was 29.21±6.24. Pearson correlation analysis showed that there was a significant positive correlation among physical appearance perfectionism, social appearance anxiety, fear of negative evaluation and negative physical self ( r value was 0.402-0.488, P<0.01). The mediating effect of negative physical self between physical appearance perfectionism and social appearance anxiety was 0.164 (95% CI 0.082-0.227), the mediating effect of negative body self between physical appearance perfectionism and social appearance anxiety was 0.152 (95% CI 0.079-0.214) and the chain mediating effect of fear of negative evaluation and negative physical self was 0.067 (95% CI 0.025-0.108). Conclusions:Female patients with psoriasis have a high level of physical appearance perfectionism, which can directly affect their social anxiety, while fear of negative evaluation and negative physical self indirectly affect the correlation between appearance perfectionism and social appearance anxiety. Psychological intervention measures should be taken to reduce their psychological burden on their own appearance defects and carry out social anxiety and fear.

The competitive sports are beneficial to cardiovascular system and brain health. However, physical exercise is accompanied with risks. Severe trauma is possible in competitive sports that may impact on the head and body. In recent years, more interests are aroused in sports-related traumatic brain injury(TBI), especially the mild TBI(mTBI). Repetitive mTBI can cause persistent cognitive, behavioral and mental problems, leading to chronic traumatic encephalopathy(CTE) and eventually resulting in neurodegeneration. In this study, the authors summarize the pathological characteristics and mechanism of CTE induced by mTBI due to competitive exercise so as to reveal the pathogenesis of CTE and provide valuable information for early diagnosis, development of disease biomarkers and explore effective therapeutic targets.

Objective: To examine the association of sedentary behaviors with visual acuity among primary school children, and to provide a reference basis for the prevention and control of poor vision. Methods: Using stratified random cluster sampling method, a total of 4 969 students in grade 1-4 were selected from 5 primary schools in Guangzhou in 2017, and then were followed up in 2019. A validated questionnaire was used to collect data on children s sedentary behaviors, including doing homework, watching TV, playing computer/video games, and taking the bus/car between home and school. Visual acuity was measured in the baseline and the follow up using a 5 m standard logarithmic visual acuity chart. Multiple linear regression and Logistic regression were conducted to analyze the relationship between sedentary behaviors and visual changes. Results: The two year cumulative incidence of poor vision was 48.74%. Homework time was inversely associated with visual acuity of left eye( β=-0.012, 95%CI =-0.023- -0.002 ). Homework time was positively correlated with poor vision( OR =1.16, 95% CI =1.05-1.27). However, total sedentary time, screen time and bus/car time were not statistically associated with changes in visual acuity( P >0.05). Conclusion Increased homework time was associated with poorer vision in primary school students. Interventions to reduce the academic burden should be taken.

Objective: To explore the longitudinal association of the levels of plasma irisin among children with changes in obesity related parameters and newly onset obesity, and to explore whether physical activity (PA) and sedentary behavior(SB) have regulatory effects, to provide a scientific basis for the prevention and control of childhood obesity work. Methods: Cluster random sampling method was used to select 521 children from five schools in Guangzhou in 2017 at baseline and were followed up in 2019. A based on baseline PA and SB, children who meet the following criterion were selected:moderate vigorous intensity PA≥60 min/d or <150 min/week; and gender , age specific SB≥ P 75 or SB < P 25 . Plasma irisin concentration was measured in all the selected children. Multiple linear regression and Logistic regression were conducted to analyze the association. Results: The two year cumulative incidence of obesity, overweight and obesity, and central obesity was 2.82%, 6.57%, and 6.81%, respectively. There was no statistically significant association between plasma irisin levels and changes in obesity related parameters, newly onset overweight obesity or central obesity among children ( P >0.05). After stratified by PA, the irisin concentration in the low PA group was positively associated with weight change ( B=0.229, P =0.03). After stratified by SB, the irisin concentration in the low SB group was positively associated with the height change ( B=0.210, P <0.05). In addition, PA level and SB level both had a moderating effect on the association between plasma irisin levels and the weight change ( P PA=0.01, P SB =0.05). Conclusion PA and SB show moderating effect on plasma irisin concentration and weight gain. No association of irisin concentration with newly onset overweight or obesity among children has been found.