The lymphonodus cervicothoracious and lumbaris of 19 Pekin ducks were studied using the histological methods. The lymph nodes are consisted of the capsule, loose areas, and dense areas. There are lymphatic tissue cords, connective tissue cords and intercord lymph sinus and lymphatic nodules also in the loose areas. The dense area are consisted of lymphatic nodules and mass of lymphoid cells. The lymphatic nodules are irregularly distributed and no germinal centers. The lymph sinuses may be classified into the central sinus and peripheral sinus. The latter may be subdivided into subcapsule sinus, paralymphonodular sinus and the intercord lymph sinus. There are reticular cells in the intercord lymph sinus. No true trabeculae are present but there are many blood vessels and nerves in the lymph nodules.

The prosthesis fitting were discussed in this paper for 48 un-reoperation of 91 cases the non-ideal stump of the lower limb amputees hospitalized in the past six years. The author suggests that silicon socks,the supplementary hang band,a combinative use of the prosthesis and orthosis,adjustment aligment of the prosthesis provide a good method for prosthesis fitting of the non-ideal stump of the lower limbamputees. It was able to wearing a good prosthesis and bring the compensatory functions into full play.

Only by dressing the prosthesis can they play their compensatory functions for the amputees.The effectiveness of the compensatory is closely related to the condition of the stumps.Because of the complications,it is impossible to dress prosthesis to some stumps.This paper is a studying discussion on the rehabilitation of the non ideal stumps impairing prosthesis dressing,which of the 81 cases among the 164 amputees hospitalized in China Rehabilitation Research Center during the last 8 years.The paper advances the conception of the non ideal stumps impairing prosthesis dressing;the categories of non ideal stumps and their impairment to the prosthesis dressing and the principle and methods of the rehabilitation and the improvement of the making of the prosthesis and the method of the operations. To improve the conditions of the non ideal stumps,a good and comfortable prosthesis will be dressed.The compensatory functions will be satisfactorily played.

The standardization of acupuncture and moxibustion in Canada is increasingly flouring nowadays:on one hand,acupuncture industry in legislated provinces is in the charge of direct administrative departments and associations of acu-moxi; on the other hand,according to the local situations,relevant regulations have been made,which are concentrated on two aspects-technical and administrative standards.Undoubtedly,Canadian Alliance of Regulatory Bodies for TCM Practitioners and Acupuncturist (CARB),united by each provincial TCM/Acupuncture Administration,is the first step to issue federal standards and establish federal level management institution.However,now the releasing of a fundamental regulatory file is in need of active corporation and publicity from each province and association.Therefore,it shows that the body of standardization in Canada is still not relatively perfect.Through introducing and analyzing the relevant information,the author expects that the readers can know the current development of acupuncture and moxibustion standardization in Canada.

Objective To investigate the application of low-dose adaptive sequence scan of dual-source CT coronary angiography in patients with high heart rate and evaluate the image quality.Methods Seventy-two patients who underwent coronary CT angiography with heart rate> 70 bpm were divided into 2 groups.Group A was adaptive sequence scan, and Group B was retrospective ECG-gating helical scan.Examinations were performed on a dual-source CT scanner (Somatom Definition) .All images were transferred to a workstation for further processing and analysis.The image quality was evaluated using same criteria.The image quality of coronary artery segments was compared in two groups using rank sum test, and the radiation dose was compared using t test Results A total of 501 coronary artery segments were evaluated in group A and 400 segments in group B.The mean ranks in image quality of coronary artery segments in group A was 475.42, whereas 420.41 in group B.There was a statistical difference in image quality between the two groups (Z= - 3.509,P=0.000).The effective dose was on average (6.2±0.9) mSv in group A, whereas on average (14.7±1.9) mSv in group B, there was a statistical difference between the two groups(t= - 27.011, P=0.000).Conclusions Adaptive sequence scan in dual-source CT coronary angiography is feasible in patients with high heart rates.This scan mode can substantially reduce radiation dose and maintain the diagnostic image quality.

The prosthesis fitting and the rehabilitation are discussed in this paper for 6 cases double above knee amputees hospitalized in the past six years. The author suggest that the prosthesis fitting and rehabilitation training are different between double and single above knee amputees. This paper expounds particularly the structure of temporary stubbie with peculiarity of rocker feet; the distinct demand of double knee joint of permanent prosthesis with peculiarity of artificial feet;the use of permanent stubbie in daily living. The important of physical strength training, the standing balance training, the walking functional training, some relative functional movement training and on problem of the amputees sitting wheelchair backward fall with preventive measures has been emphasized.Keyworks:amputation; prosthesis; rehabilitation

ObjectiveTo observe effects of the nonunion of stale humeral shaft fracture treated by using the interlocking medullary nail.Methods21cases with the stale fracture of humeral shaft were treated with the interlocking medullary nail. The effect over post operation 1 year was evaluated.ResultsAll cases were recovery after treated by the interlocking medullary nail. Conclusions It shows that the effect of treating the fracture of humeral shaft with the interlocking medullary nail is very satisfactory.

Objective:To select the differential prognostic lactic acid metabolism-related genes(LRGs)of the head and neck squamous cell carcinoma(HNSCC)to construct the LRGs prognostic model of HNSCC,and to clarify the potential mechanism.Methods:The HNSCC gene expression and clinical data were obtained from The Cancer Genome Atlas(TCGA)and Gene Expression Omnibus(GEO)Databases,the LRGs were identified through GeneCards Database,and R software was used to screen out the LRGs of HNSCC;univariate Cox regression analysis was used to identify prognosis-related genes;two different subtypes were identified based on the prognostis-related LRGs;Kaplan-Meier(K-M)curve analysis was used to compare the prognosis of the patients between two groups;CIBERSORT algorithm was used to perform the immuno-correlation analysis between two groups;multivariate Cox regression analysis and LASSO regression analysis were used to construct the prognostic model;receiver operating characteristic curve(ROC)and K-M survival curve were used to assess the relationship between LRGs and survival and prognosis of the HNSCC patients.The prognostic model was validated by GSE27020,GSE41613,and GSE65858 datasets.The experiment were grouped based on risk score,and immune-related analysis and tumor score analysis were performed.Results:The TCGA Database differential analysis results showed that 1 196 LRGs were identified from HNSCC samples;univariate Cox regression analysis selected 27 differentially expressed genes(DEGs)associated with the prognosis of the HNSCC patients.Two different LRGs subtypes(Group 1 and Group 2)were identified according to the prognosis-related genes.The K-M survival curves results showed that the overall survival(OS)of the patients in Group 2 was significantly higher than that in Group 1,and the immune cell expression amount of the patients in Group 2 was also higher than that in group 1.The multivariate Cox regression and LASSO regression analysis results screened out 9 LRGs,including hypoxanthine phosphoribosyltransferase 1(HPRT1),amyloid precursor protein(APP),glycogen phosphorylase L(PYGL),urokinase-type plasminogen activator(PLAU),cannabinoid receptor 2(CNR2),stanniocalcin 2(STC2),nucleotide binding oligomerization domain-like receptor protein 1(NLRP1),integrin-linked kinase(ILK),and forkhead box B1(FOXB1);the prognostic model was constructed.The K-M and ROC curve results indicated that the expression levels of above 9 genes were associated with the survival and prognosis of the HNSCC patients,providing good 1-year,2-year,and 3-year survival prediction effect,and the area under ROC curve(AUC)values were all greater than 0.650.Furthermore,the predictive ability of the prognosis model was validated in GSE27020,GSE41613,and GSE65858 datasets.The patients classified based on the risk scores had distinguishable immune statuses.Conclusion:The differentially expressed LRGs of HNSCC screened by bioinformatics methods are related to the survival and prognosis of the HNSCC patients;the prognostic model constructed by 9 LRGs can predict the survival status and treatment response of the HNSCC patients.

Objective:To observe the efficacy of pars plana vitrectomy (PPV) in the treatment of different types of chorioretinal coloboma with retinal detachment (RD).Methods:A single-center, retrospective clinical study. From April 2021 to March 2023, 24 eyes of 23 patients who were diagnosed as chorioretinal coloboma with RD in Henan Provincial Eye Hospital were included in this study. There were 11 males with 12 eyes and 12 females with 12 eyes. The mean age was (33.3±13.7) years old. Best corrected visual acuity (BCVA), spectral domain optical coherence tomography were performed. The BCVA examination was performed using a international standard logarithmic visual acuity chart, which was converted into logarithm of the minimum angle of resolution (logMAR) visual acuity during statistics. According to the types of chorioretinal coloboma, the affected eyes were divided into the coloboma involved the optic disc group and the coloboma not involved the optic disc group, with 15 eyes and 9 eyes. According to whether the RD containing the coloboma area, the affected eyes were divided into RD containing the coloboma area group and the RD not containing the coloboma area group, with 15 eyes and 9 eyes. All eyes underwent standard pars plana three-channel 25G PPV, retinal laser photocoagulation combined with silicone oil tamponade. The follow-up time after surgery was (19.5±16.3) months. The last follow-up was the time point for efficacy determination. The retinal reattachment, BCVA recovery and postoperative complications were observed. Paired t-test or t test was performed for comparison of quantitative data. Fisher's exact test was performed for comparison of qualitative data. Results:At the last follow-up, retinal reattachment was achieved in 20 eyes (83.3%, 20/24). The logMAR BCVA of the coloboma involved the optic disc group before and after surgery were 1.85±0.62 and 1.71±0.71, the difference was no significant ( t=0.845 , P=0.412). The logMAR BCVA of the coloboma not involved the optic disc group before and after surgery were 1.75±0.45 and 0.84±0.26, the difference was statistically significant ( t=6.153 , P<0.001). The improvement of BCVA in the coloboma not involved the optic disc group was significantly higher than that in the coloboma involved the optic disc group after surgery, with statistically significant differences ( t=3.024 , P=0.006). There was no significant difference in the retinal reattachment rate between the two groups ( P=0.615). There was no significant difference in the retinal reattachment rate between the RD containing the coloboma area group and the RD not containing the coloboma area group ( P=0.259). Postoperative complications included elevated intraocular pressure in five eyes, cataract progression in ten eyes, recurrent RD in two eyes, bullous keratopathy in one eye and band-shaped keratopathy in one eye. Conclusion:PPV combined with silicone oil tamponade is safe and effective in the treatment of chorioretinal coloboma with RD, the improvement of visual acuity in the coloboma not involved the optic disc group is better than that in the coloboma involved the optic disc group after surgery.

Objective:To evaluate the nutritional status of patients with decompensated liver cirrhosis and explore the correlation with malnutrition and the risk factors of depressed mood.Methods:190 cirrhotic patients admitted to the Department of Gastroenterology of the First Hospital of Shanxi Medical University from June to September 2023 were selected according to the inclusion and exclusion criteria. Eligible patients were divided into subgroups based on the presence or absence of malnutrition as determined by subjective global assessment (SGA). The Center for Epidemiological Studies Depression (CES-D) scale was used to assess patients' propensity for depressed mood. Relevant clinical data were also collected and analyzed.Results:A total of 185 patients were included, of which 126 were in the non-malnutrition group and 59 malnutrition group. There were significant between-group differences in terms of CES-D results, age, body mass index, platelets, D-dimer, serum sodium, third lumbar skeletal muscle index, grip strength, triceps skinfold thickness, and upper arm muscle circumference (all P<0.05). Correlation analysis showed that grip strength, triceps skinfold thickness, upper arm muscle circumference, serum sodium, and depressed mood tendency status were correlated with the development of cirrhotic malnutrition ( P<0.05). The diagnostic model for malnutrition in cirrhosis using these five indicators showed the area under the curve of 81.9%. Conclusions:Depression is closely related to the development of malnutrition in patients with liver cirrhosis. Independent risk factors for malnutrition in cirrhosis include serum sodium≤135 mmol/L, grip strength, triceps skinfold thickness, lower-than-normal upper arm circumference , and the tendency of depression , which demonstrate the combined contribution to the diagnosis of malnutrition in cirrhosis.