Cerebral venous thrombosis (CVT) refers to thrombosis of the intracranial veins and sinuses, which is a rare type of cerebrovascular disease.Due to this highly variable and nonspecific clinical presentations, CVT can be difficult to diagnose.Understanding the pathophysiology and etiology of CVT helps to understand its clinical symptoms and imaging findings and guide the treatment.This article reviews the related advances in the pathophysiology and etiology of CVT.

Objective To study the relationship between the expression of nm23- H1 gene product and early distant metastases in nasopharyngeal carcinoma (NPC). Methods The S- P immunohistochemical method was used to detect the expression of nm23- H1 in 95 cases of NPC. Results The positive rate of nm23- H1 was 47.4 % (45/95). The positive rate of nm23- H1 in early distant metastases group (26.7 %) was much lower than those without distant metastases group (60.0 %) (P

Objective To develop the knee osteoarthritis (KOA) TCM syndrome evaluation scale. Methods Resrarch team collected subjective symptoms from all kinds of syndrome types of KOA and classified the subjective symptoms, which formed the first version of item pool containing 24 subjective symptoms. Expert questionnaires were conducted to calculate the weight coefficient of items, and formed the item pool of the Knee Osteoarthritis TCM Syndrome Evaluation Scale. According to the patient's attention to the 11 items, the items were weighted.Results The Knee Osteoarthritis TCM Syndrome Evaluation Scale contained 11 items, including pain, swelling and stiffness with different weighted scores.Conclusions The Knee Osteoarthritis TCM Syndrome Evaluation Scale were introduced to assess the KOA outcomes on the basis of TCM syndromes. It showed the characteristic of TCM and TCM syndrome.It could provide an objective and standardized measurement for TCM treating KOA.

Objective To study the effects of living environment conditions and animal-animal interaction on the blood hormone levels and psychological behavior in Chinese tree shrews .Methods Chinese tree shrews were raised in ca-ges of different space sizes or were administered reserpine for 15, 30, 60, 120, 180 days, respectively.Then the animals were anesthetized by ether inhalation , and blood samples were taken from the heart to detect the levels of blood testosterone (T), estradiol (E2), endothelin (ET), adrenaline (A) and noradrenaline (NA) by radioimmunoassay (RIA).Results 1.Chinese tree shrews were bred in large cage (D1group) or small cage (X1 group) for 15, 30, 60, 120, 180 days, re-spectively.Compared with the animals bred in the large cage (D1 group), the level of blood testosterone (T) was signifi-cantly reduced (P<0.01), and the levels of adrenaline , noradrenaline and endothelin were significantly increased in the small cage group (P<0.01 for all).2.The animals raised in small cages in close neighborhood with large cages for 15, 30, 60, 120, 180 days, respectively.The levels of testosterone, adrenaline and noradrenaline in the large cage group (X2 group) were significantly higher than those of the small cage group (X1 group) (P<0.01 for all).3.The adrenaline and noradrenaline levels were significantly lower in all the reserpine groups (P<0.01 for all).4.The animals bred in small cages (X1 group) and in small cages in close neighborhood with large cages showed sudden loss , reduced appetite, testicu-lar atrophy , penile prolapse and stress symptoms .The animals of the reserpine groups appeared gentle temperament , signif-icantly reduced activity and reduced appetite .However , after stopping the reserpine administration and feeding them in large cages , the animals gradually returned to normal behavior .Conclusion Both animals living environment conditions and animal-animal interaction may cause changes of blood hormone levels and psychological behavior in Chinese tree shrews.

A total of 189 stool samples from swine with diarrhea, collected in various porcine farms in the central region of China were tested for porcine enteric caliciviruses (PEC) member porcine sapoviruses (SaV) by reverse transcription polymerase chain reaction (RT-PCR) amplification using primers designed to detect porcine SaV. Selected amplicons were sequenced to establish phylogenetic relationships with reference strains. Porcine SaV were detected in 12.70% (24/189) of the samples. Phylogenetic studies based on partial RNA polymerase gene sequences indicated that the field strains of viruses isolated in China were closely related (75.6 88.3% identity) to the porcine SaV Cowden reference strain. These results provide evidence that caliciviruses of the genus sapovirus circulate in piglets in China, but further studies are needed to clarify their importance as cause of diarrhea. This is the first report of PEC in China.

Objective To explore the effect of intravenous dexmedetomidine (0.4 μg·kg 1 ·h 1) on the recovery period in obese patients undergoing laparoscopic Roux-en-Y surgery.Methods Thirty patients (ASA Ⅰ to Ⅱ,body mass index ≥ 30 kg/m2) presenting for laparoscopic Roux-en-Y surgery under general anesthesia were randomly assigned 1:1 to the dexmedetomidine group (group D) or control group (group C).Dexmedetomidine was infused at 0.4 μg·kg-1·h-1 at the beginning of the operation and was discontinued 30 minutes before the end of the surgery in group D.Simultaneously,normal saline was infused at 0.4 μg· kg-1· h-1 in group C.The two groups received the same method of induction and maintenance anesthesia.The intraoperative variables measured included heart rate (HR),mean blood pressure (MBP),low frequency (LF),high frequency (HF),LF/HF ratio extubation time,Silverman-Andersen score (SAS) at the time of extubation,level of agitation during the recovery period,and adverse events.Results HR,MBP,and LF/HF of group C were higher than the baseline values and that of group D (P ＜ 0.05) during the recovery period.LF was higher in group C those in group D (P ＜ 0.05) during the recovery period.MBP was lower than the baseline values (P ＜ 0.05) and SAS at the time of extubation and level of agitation during the anesthesia recovery period were lower in group D (P ＜ 0.05) than in group C.There was no significant difference in HF and extubation time between the two groups (P ＞ 0.05).Conclusion Infusion of dexmedetomidine during anesthesia in obese patients may improve the quality of emergence from anesthesia without increasing the duration of the anesthesia recovery period.

The paper reported a case of brachial artery ligation treatment of arteriovenous graft infection with arteriovenous graft exposure and bleeding. Based on the experience of vascular access center and the review of relevant literature, the causes and treatment options of this complication were analyzed, and the feasibility and safety of brachial artery ligation were elaborated for the treatment of this complication, to provide references for clinical diagnosis and treatment.

Objective:To explore risk factors of death in type A intramural hematoma (IMH) patients with conservative therapy and provide important information for clinical risks stratification and decisions-making.Methods:This retrospectively study enrolled 130 patients diagnosed with type A IMH in the first CT examination at Fuwai Hospital of Chinese Academy of Medical Sciences and only received conservative therapy between September 2009 and June 2018. Baseline clinical and CT characteristics were recorded. All patients enrolled were followed up. The endpoint was aortic disease-related death, patients were divided into endpoint group and non-endpoint group according to whether or not an endpoint event occurs. Difference between two groups of normally distributed continuous variables, non-normally distributed continuous variables and categorical variables were tested by independent sample t test, Mann-Whitney U test and chi-square test or Fisher′s exact test, respectively. Independent risk factors related to outcomes were assessed with Cox regression analysis and survival analysis. Results:In baseline CT data, the mean value of the maximum aortic diameter (MAD) was (49.2±6.9) mm, and the median value of the maximum hematoma thickness (MTH) was 11.0 (8.5, 13.2) mm. There were 56 and 30 patients with ulcer-like projection (ULP) and intramural blood pool (IBP), respectively, which including 36 patients with ULP of ascending aorta, 51 patients with pericardial effusion and 50 patients with pleural effusion. During a median follow-up time of 1 050 (242, 1 949) days, 26 patients experienced aortic disease-related death. Compared with non-endpoint group patients, patients who experienced aortic disease-related death showed older age and larger MAD( t=2.363, 3.640, P=0.020,<0.001), higher proportion of aortic atherosclerosis, ULP and pericardial effusion (χ 2=5.275, 6.596, 9.325, P=0.022, 0.010, 0.002).In Cox regression multivariate analysis shows that aortic atherosclerosis [hazard ratio (HR)=3.48, P=0.043], ULP (HR=2.66, P=0.019) and pericardial effusion (HR=2.49, P=0.030) were independent risk factors for aortic disease-related death. Conclusions:Aortic atherosclerosis, ULP and pericardial effusion are independent predictors of subsequent aortic disease-related death for type A IMH patients with conservative therapy, identifying these risk factors is helpful for further risk stratification and decisions-making.

Objective: To investigate the clinicopathological features and prognosis of malignant peripheral nerve sheath tumors (MPNST). Methods: We retrospectively reviewed the clinical data of MPNST patients who were treated at Cancer Institute & Hospital, Chinese Academy of Medical Science from January 1999 to January 2016. A total of 140 patients with 66 male and 74 female with MPNST were enrolled in the study. The median age was 40 at the time of diagnosis. Survival analysis were estimated by Kaplan-Meier method and Log rank test. Multivariate analysis were estimated by Cox proportional hazards regression model. Results: The median follow-up time was 43.0 months. The 3- and 5-year overall survival (OS) rates were 56.4% and 48.6%, respectively. The 3-year local recurrence (LR) rate and distant metastasis (DM) rates were 42.9% and 49.3%, respectively. Univariate analysis showed that the tumor location, AJCC stage, S-100, radiotherapy and margin status affected 5-year OS rate (all P<0.05). The tumor location, AJCC stage, S-100, Ki-67 staining, margin status, radiotherapy and chemotherapy affected 3-year LR rate (all P<0.05). The tumor location, AJCC stage, S-100, Ki-67 staining and margin status affected 3-year DM rate (all P<0.05). Multivariate analysis showed that the tumor location, AJCC stage, S-100 were independent factors for 5-year OS rate (all P<0.05). The tumor location, Ki-67 staining and chemotherapy were independent factors for LR (all P<0.05) while the AJCC stage, margin status and Ki-67 staining were independent factors for DM (all P<0.05). Conclusions MPSNT is an aggressive tumor with poor prognosis. Multiple factors were identified in this study. Patients with the tumor located at head and neck, advanced AJCC stage and negative S-100 usually have a low 5-year overall survival rate. Patients with the tumor located at head and neck, Ki-67 staining ≥ 20% and without chemotherapy had a higher tendency of local recurrence. Poor prognosis factors for DM were advanced AJCC stage, positive margin and Ki-67 staining ≥ 20%.