ObjectiveTo evaluate the myocardium damage of myocardial contrast echocardiography (MCE) and the impact on regional left ventricular mechanics by imaging and pathology techniques.Methods Eleven open-chest animal models of Beagle were employed to collect the short-axis views of mitral annular,papillary muscle and apical level of three complete cardiac cycles using gray-scale imaging at the baseline and blank irradiation 5 min later(transmitting frequency 1.7/3.4 M Hz,mechanical index 1.0).After that,5 ml of SonoVue was gotten a shot by intravenous bolus injection,the heart was exposed by ultrasonic wave for 5 min continuously,and then the same images collected were at the point-in-time irradiation immediately,20 min,40 min and 60 min later.The short-axis circumferential strain and strain rate,radial strain and strain rate were measured and calculated by EchoPAC multi-parameter workstation,meanwhile including conventional of cardiac function.All the dogs were killed after the experiments and the myocardium was harvested for HE staining and observed with transmission electron microscope for the tissue microstructure.Results①Conventional parameters of cardiac function:there was no significant difference before and after MCE in the heart rate,blood pressure,ejection fraction,left ventricular end-systolic volume and end-diastolic volume,stroke volume,cardiac output,mitral flow spectrum prior to the E/A,tissue Doppler mitral annular e/a and E/e ( P ＞0.05).During the whole process of experiment,the dogs’ vital signs were stable.②Compared the segmental circumferential strain and strain rate,radial strain and strain rate between baseline and each treatment groups,these parameters had a trend of increase in most segments,but the difference was not statistically significant in most segments (P ＞0.05).③HE staining at the light microscope demonstrated a small amount of myocardial cell infiltration of inflammatory cells near the outer membrane (21.2％),and very few part of the muscle fibers dissolved and fractured (6.1％).④The section of transmission electron microscope showed all the structures were normal except that a small amount of endothelial cells were mild swelling,some red blood cells were leaked,some myofilaments were regional dissolved,the relevance ratio were 28.6 ％,42.9 ％ and 21.4 ％ respectively,and the abnormal area was less than 10％ of the entire field of vision.ConclusionsMCE has no significant impact for the global function of heart and the regional mechanical state,and furthermore there is no serious pathological damage on the myocardium.

Obesity is one of the metabolic diseases that affect psychosomatic health of people and is a risk factor of many chronic diseases. In recent years, the incidence of obesity continues to rise, thus effective weight control and healthy weight loss have become the focus and difficulty of medical research today. Studies have shown that internal microecological changes are related to the occurrence of obesity. Comprehensive health education and nursing play an important role in weight management by adjusting intestinal microecological environment. This paper comprehensively describes the effect of intestinal microecological environment on obesity. The intestinal microecology induces obesity by regulating the nervous system, participating in energy metabolism, regulating immunity and other mechanisms. Interventions such as diet, emotion, exercise and traditional Chinese medicine nursing techniques can regulate the intestinal microecological environment and effectively manage body weight.

Objective To investigate the influence of different contrast agent injection schemes on imaging quality in neck enhanced CT examination.Methods A total of 150 patients who underwent neck enhanced CT examination were selected and randomly divided into three groups:groups A,B,and C,with 50 cases in each group.Group A adopted individualized injection scheme,group B used three-phase dual-flow contrast agent injection scheme,and group C used measured constant-speed injection scheme,respectively.The objective and subjective evaluation methods were used to assess the image quality of cervical vessel and non-vessel structures.Results Among the three groups of contrast agent injection schemes,the CT values of group A and group B were higher than those of group C except for the aortic arch and submandibular gland in objective evaluation,and the contrast-to-noise ratio(CNR)of group A and group B except for the left common carotid artery and right common carotid artery bifurcation was higher than that of group C.In subjective evaluation,there was no statistically significant difference in image quality among the three groups(P＞0.05),and group B effectively reduced the impact of hardening artifacts.Conclusion The post-injection dual-flow contrast agent injection scheme can achieve the same enhancement effect as other injection schemes while ensuring image quality and reducing the amount of contrast agent used in the examination.

The dynamic polar polymers actin filaments and microtubules are usually employed to provide the structural basis for establishing cell polarity in most eukaryotic cells. Radially round and immotile spermatids from nematodes contain almost no actin or tubulin, but still have the ability to break symmetry to extend a pseudopod and initiate the acquisition of motility powered by the dynamics of cytoskeleton composed of major sperm protein (MSP) during spermiogenesis (sperm activation). However, the signal transduction mechanism of nematode sperm activation and motility acquisition remains poorly understood. Here we show that Ca(2+) oscillations induced by the Ca(2+) release from intracellular Ca(2+) store through inositol (1,4,5)-trisphosphate receptor are required for Ascaris suum sperm activation. The chelation of cytosolic Ca(2+) suppresses the generation of a functional pseudopod, and this suppression can be relieved by introducing exogenous Ca(2+) into sperm cells. Ca(2+) promotes MSP-based sperm motility by increasing mitochondrial membrane potential and thus the energy supply required for MSP cytoskeleton assembly. On the other hand, Ca(2+) promotes MSP disassembly by activating Ca(2+)/calmodulin-dependent serine/threonine protein phosphatase calcineurin. In addition, Ca(2+)/camodulin activity is required for the fusion of sperm-specifi c membranous organelle with the plasma membrane, a regulated exocytosis required for sperm motility. Thus, Ca(2+) plays multifunctional roles during sperm activation in Ascaris suum.
Animals ; Ascaris suum ; metabolism ; Calcineurin ; metabolism ; Calcium ; metabolism ; Calmodulin ; metabolism ; Cytoskeleton ; metabolism ; Cytosol ; metabolism ; Egtazic Acid ; analogs & derivatives ; pharmacology ; Helminth Proteins ; metabolism ; Inositol 1,4,5-Trisphosphate Receptors ; metabolism ; Male ; Membrane Potential, Mitochondrial ; physiology ; Mitochondria ; metabolism ; Pseudopodia ; metabolism ; Signal Transduction ; Sperm Motility ; Spermatids ; drug effects ; physiology ; Spermatogenesis ; Type C Phospholipases ; metabolism

Objective:To construct the Patient Version of Guideline for Ketogenic Diet Therapy in Children with Refractory Epilepsy. Methods:This guideline was based on the theoretical framework of A Guideline Adaptation and Implementation Planning Resource (CAN-IMPLEMENT) and patient-oriented knowledge tools, forming the research roadmap. The Patient Version of Guideline for Ketogenic Diet Therapy in Children with Refractory Epilepsy was constructed by clarifying research questions, evidence integration, guideline formation and other normative steps. Results:A total of 17 research questions on ketogenic diet therapy in children with refractory epilepsy were formed. A total of 11 papers were included, including 4 guidelines and 7 consensuses. The final patient version of guideline included 4 themes, involving assessment, pre-implementation preparation, implementation and monitoring, follow-up, evaluation and termination, and 29 recommended items.Conclusions:The patient version of guideline constructed in this study is based on a scientific construction framework and method, and fully considers the needs of patients, which can provide a reference for the management of ketogenic diet therapy in children with refractory epilepsy.

Objective: To investigate the prevalence of biting pencils among pupils living in Harbin, Guangzhou, and Beijing and to compare the differences among these cases. Methods: Stratified sampling method was used to select four elementary schools in Harbin and Guangzhou from April 2015 to April 2016. Firstly, Simple random sampling method was used in every grade (grade 1-grade 5) to select 3 or 4 classes (71 classes in total).After the sample selection, questionnaire surveys were conducted among pupils and their guardians (anyone of their guardians) who belonged to these classes. Secondly, the study extracted part of these pupils to conduct a field survey. Every school was classified by grade, and every grade adopted the method of random sampling to select one classes (20 classes in total). Meanwhile, the study randomly selected pupils from 10 classes in 2 elementary schools in Beijing. All together, 1 627 pupils participated in the field survey. The questionnaire included general information about the students and their guardians, the situation of biting pencils, the awareness of the harm of biting pencils, etc.; the field survey considered if participates' pencils have tooth marks and the severity of the marks, etc. χ² was applied to test and compare the differences among pupils of different genders and different cities. The comparison focused on the proportion of students who bited pencils, the proportion of pencils with tooth marks and the proportion of students and guardians already awared of the harm of biting pencils, etc. Results: The number of the valid questionnaires in Harbin and Guangzhou were 1 842, and 1 210, respectively. The occurrence rate of pupils biting pencils in Harbin (18.0% (333/1 842)) was higher than that in Guangzhou (11.3% (137/1 210)) (χ²=29.16, P=0.001). Specifically, in Harbin, the rate of boys biting pencils was 21.9% (212/965), which was higher than girls (13.8% (121/877)) (χ²=27.04, P=0.001). Similarly, in Guangzhou, the rate of boys biting pencils was 14.5% (92/632), which was also higher than girls (7.7% (45/578)) (χ²=15.34, P=0.001). The awareness rate of the harm of biting pencils among students from these two cities were 88.5% (1 611/1 819), and 90.8% (1 098/1 208), respectively, and the difference was statistically significant as well (χ²=4.39, P= 0.020). Compared with these data, the awareness rate of the harm of biting pencils among guardians from these two cities were 74.7% (1 339/1 791), and 79.4% (832/1 047), respectively as well as the statistically significant difference appeared (χ²=9.83, P=0.007). The result of field survey showed the rate of tooth-marked pencils in Harbin, Guangzhou and Beijing was 30.5% (187/613), 14.8% (79/534), and 28.3% (136/480), respectively. The difference was also statistically significant (χ²=42.68, P=0.001). The degree of tooth marks was mainly mild, while the percentage of mild degree in Guangzhou (54.4%(43/79)) and Beijing (41.2% (56/136)) was apparently higher than that of Harbin (39.0% (73/187)). The difference was not statistically significant (χ²=7.01, P=0.136). Conclusion The behavior of biting pencils existed universally among pupils in Harbin, Guangzhou, and Beijing , which the situation of pupils biting pencils in Harbin and Beijing was more serious than that in Guangzhou. Pupils, parents and teachers should pay attention to such a behavior.

Objective To explore the factors influencing the image quality of thyroid CT and the application value of optimization schemes in reducing streak artifacts in thyroid CT examinations.Methods A retrospective review of the data of 141 patients who underwent thyroid enhanced CT examinations was conducted to analyze the factors affecting image quality.After determining the influencing factors,a self-controlled study was conducted on 48 patients who underwent thyroid CT examinations to analyze the feasibility of the optimization scheme.Results The patients'body mass index(BMI),neck circumference,pharynx-jaw angle,and pharynx-jaw angle-to-neck circumference ratio showed statistically significant differences in their impact on image quality(P<0.05).Compared to the conventional scheme,the optimization scheme showed significantly higher subjective and objective image evaluations.The optimization scheme also significantly improved the diagnostic performance of the images,with statistically significant differences(P<0.05).There was no statistically significant difference in radiation dose between the two positions(P>0.05).Conclusion The optimization scheme can effectively reduce streak artifacts in thyroid CT examinations.

Objective:To evaluate the quality and reporting standards of the ketogenic diet guidelines and consensuses in children with refractory epilepsy at home and abroad.Methods:A systematic search was conducted using the English and Chinese keywords for screening relevant guidelines and expert consensus on the Guidelines International Network, National Guideline Clearinghouse, Scottish Intercollegiate Guidelines Network, National Institute for Health and Clinical Excellence, the Joanna Briggs Institute (JBI) Center for Evidence-Based Health Care in Australia, DynaMed Evidence-Based Medicine Database, American Academy of Neurology, American Epilepsy Society, International League Against Epilepsy, Child Neurology Society, European Paediatric Neurology Society, International Ketogenic Diet Research Group, Cochrane Library, PubMed, CNKI, Wanfang Database, VIP, China Biology Medicine disc, etc. The search period was from establishment of databases to August 13, 2021. The quality of the guidelines was evaluated using the The Appraisal of Guidelines for Research and EvaluationⅡ, and the Reporting Items for Practice Guidelines in healthcare was used to evaluate the reporting standards of guidelines. The JBI Center for Evidence-based Health Care Quality Evaluation tool was used to evaluate the quality of expert consensuses, and the National Institutes of Health Reporting Standards was used to evaluate the reporting standards of expert consensuses.Results:A total of 1 864 literatures were searched initially. According to the inclusion and exclusion criteria and reading the literature content, 13 literatures were selected, and after manual search, 1 literature was supplemented. Finally, a total of 14 literatures were obtained, including 7 guidelines and 7 expert consensuses. The quality evaluation results showed that 2 guidelines were grade A, 2 guidelines were grade B and 3 guidelines were grade C. 5 expert consensuses were rated "Yes" in the six items of quality evaluation. The results of the evaluation of reporting norms showed that the seven expert consensus reports were of poor quality; the higher the methodological quality rating of the guidelines, the better their reporting quality.Conclusions:The overall quality of the 14 guidelines and expert consensuses included is high, and attention should be paid to research quality in terms of application and participants. The reporting standards need to be further improved, and in the future, researchers can pay more attention to the reporting standards in the process of formulating guidelines and expert consensus, achieving a more rigorous research process and better applying evidence to clinical practice.

Objective:To explore the short-term and long-term prognostic outcomes of anatomical liver resection(AR)for patients with perihilar cholangio-carcinoma. Methods:This is a retrospective study.All data were obtained from 4 centers,including The First Affiliated Hospital of Army Medical University,Eastern Hepatobiliary Hospital of Naval Medical University,Sichuan Provincial People's Hospital and Affiliated Hospital of Qinghai University,of a multi-center database.A total of 305 consecutive perihilar cholangiocarcinoma patients receiving radical resection between January 2013 and June 2021 were included in this study.According to the method of liver resection,all patients were divided into the AR group(n=205)and the non-anatomical liver resection(NAR)group(n=100).The baseline characteristics,short-term prognosis and long-term prognosis of the 2 groups were compared. Results:The perioperative transfusion rate and the 30-day complication rate were significantly lower in the AR group than those in the NAR group(P＜0.05).There was no statistically significant difference in the survival rates between the AR and the NAR groups(P＞0.05). Conclusion:The 2 hepatic resection modalities had no obvious effect on the long-term prognosis of perihilar cholangiocarcinoma patients after radical resection,but choosing AR tends to achieve a better short-term prognosis and is worth promoting in clinical practice.

Objective:To investigate the influencing factors of textbook outcomes in liver surgery (TOLS) after radical resection of gallbladder carcinoma.Methods:The retrospective case-control study was conducted. The clinicopathological data of 530 patients who underwent radical resection of gallbladder carcinoma in 15 medical centers, including the First Affiliated Hospital of Army Medical University et al, from January 2014 to January 2020 were collected. There were 209 males and 321 females, aged (61±10)years. Patients underwent radical resection of gallbladder carcinoma, including cholecystectomy, hepatectomy, invasive bile duct resection, and lymph node dissection. Observation indicators: (1) situations of TOLS; (2) influencing factors of TOLS. Measure-ment data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test. Comparison of ordinal data between groups was conducted using the Mann-Whitney U test. The univariate analysis was conducted using the corresponding statistical methods based on data type, and variables with P<0.10 were included in multivariate analysis. Multivariate analysis was conducted using the Logistic stepwise regression model. Results:(1) Situations of TOLS. All 530 patients underwent radical resection of gallbladder carcinoma, and there were 498 cases achieving R 0 resection, 508 cases without ≥grade 2 intra-operative adverse events, 456 cases without postoperative grade B and grade C biliary leakage, 513 cases without postoperative grade B and grade C liver failure, 395 cases without severe com-plications within postoperative 90 days, 501 cases did not being re-admission caused by severe com-plications within postoperative 90 days. Of the 530 patients, 54.53%(289/530) of patients achieved postoperative TOLS, while 45.47%(241/530) of patients did not achieve postoperative TOLS. (2) Influencing factors of TOLS. Results of multivariate analysis showed that American Society of Anesthesiologists classification >grade Ⅱ, preoperative jaundice, T staging as T3?T4 stage, N staging as N2 stage, liver resection as right hemi-hepatectomy, and neoadjuvant therapy were independent factors influencing TOLS in patients undergoing radical resection of gallbladder carcinoma ( odds ratio=2.65, 1.87, 5.67, 5.65, 2.55, 3.34, 95% confidence interval as 1.22?5.72, 1.18?2.95, 2.51?12.82, 2.83?11.27, 1.41?4.63, 1.88?5.92, P<0.05). Conclusion:American Society of Anesthesiologists classification >grade Ⅱ, preoperative jaundice, T staging as T3?T4 stage, N staging as N2 stage, liver resection as right hemi-hepatectomy, and neoadjuvant therapy are independent factors influencing TOLS in patients undergoing radical resection of gallbladder carcinoma.