Objective To observe the curative effects of Mailuoning oral liquid combined with Mecobalamin tablets in treating aged diabetic peripheral neuropathy (DPN).Methods Forty-nine patients with DPN were randomly divided into treatment group (n=25) and control group (n=24).The patients in two groups were given Mecobalamin tablets,and the treatment group was added treated with Mailuoning oral liquid.The period of treatment was 3 months.Scores of Toronto clinical scoring system (TCSS) and traditional Chinese medicine (TCM) symptoms quantitative scale were compared between the two groups.The curative effects of all the patients were judged by the TCM symptoms quantitative scores.Results The TCSS levels in two groups after treatment were both significantly lower than those before treatment (all P<0.05).The TCSS level after treatment in treatment group was significantly lower than that in control group (P<0.05).The TCM symptoms quantitative score after treatment in treatment group was significantly lower than that before treatment (P<0.05).The TCM symptoms quantitative score after treatment in treatment group was significantly lower than that in control group (P<0.05).The total effective rate in treatment group (88%) was significantly higher than that in control group (50%) (χ2=6.631,P=0.01).Conclusion Mailuoning oral liquid combined with Mecobalamin tablets is safe and effective for treating DPN.

To elucidate possible mechanisms and targets of honokiol(Hnk)for hte treatment of pain, the effects of Hnk on tetrodoxin-senstive(TTX-S)sodium current(INa)were studied in acutely dissociated mouse dorsal root ganglion(DRG)neurons with whole-cell patch clamp technique. Hnk inhibited TTX-S INa currents in a concentration-dependent manner. At 30 μmol/L, Hnk obviously shifted the steady state activation of TTX-S INa toward more positive potentials by 10. 2 mV and prolonged the time course of recovery of sodium current, yet with no significant difference on recovery from inactivation of TTX-S sodium channel.

Objective To evaluate the application of high-throughput shell vial assay in a clinical laboratory for detection of respiratory viruses from patients with ILI in Guangzhou between January and June, 2009. Methods Six hundred and fifty-two pharyngeal swab specimens were taken from ILI patents. Centrifugation-enhanced shell vials including 4 cell lines (MDCK, Hep-2, LLC-MK2 and MRC-5) were used for culture of respiratory viruses for 2-3 days. The cultures were identified by observation of cytopathic effect (CPE) , hemmaglution or hemmadsorption test as well as immunofluorescence staining. Results A total of 161 swab samples (24.69% ,161/652) were shown to have any one of the 5 common respiratory viruses including influenza A viruses ( 38. 51% , 62/161 ), influenza B virus ( 54. 65% , 88/161 ), parainfluenza viruses (4. 96% , 8/161 ) , adenovirus ( 1. 24% , 2/161 ), and respiratory syncytial virus (0. 62% ,1/161). The turnaround time was 2d for influenza viruses, 3d for adenovirus and parainfluenza viruses respectively. Conclusions (1) The shell vial method was effective, rapid and high throughout for the detection of respiratory viruses in clinical laboratories.(2)Influenza viruses were dominant in the swab samples from patients with ILI in Guangzhou between January and June with the highest appearance in the summer influenza B vires was the most common pathogen in patients with ILI in this study.

Objective To explore the value of contrast-enhanced ultrasound (CEUS) in differential diagnosis of different molecular subtypes of breast cancer . Methods Sixty-two cases breast cancer patients with 62 breast lesions confirmed as breast cancer by postoperative pathology were selected . Referencing of St . Gallen standard and according to immunohistochemical markers of estrogen receptor ( ER) ,progesterone receptor(PR)andhumanepidermalgrowthfactorreceptor2(Her-2)expression,allthecasesweredivided into Luminal epithelium A or B ( Luminal A/B) subtype( 26 patients ) ,Her-2 over-expression subtype( 16 patients) and triple negative ( TN ) subtype ( 20 patients ) . CEUS and routine ultrasonography were performed for all patients before surgery ,and the contrast enhancement patterns and perfusion parameters were recorded . Whether there was a difference between the contrast enhancement patterns and perfusion parameters in different subtypes of breast cancer was analyzed . Results ① The contrast enhancement pattern showed more radioactive gathering( 76 .9% , P ＜0 .05) ,lower perfusion(69 .2% , P ＜ 0 .05) ,and lower maximum intensity ( IMAX) in the Luminal epithelium subtype than those in the Her-2 over-expression subtype and the TN subtype(all P ＜0 .05) ;② The contrast enhancement pattern showed more cardiac enhancing (93 .8% , P ＜0 .05) ,perfusion defect(75 .0% , P ＜0 .05) ,and shorter peak time (TTP) in Her-2 over-expression subtype than those in the Luminal epithelium subtype and the TN subtype(all P ＜0 .05) ;③The pattern of the TN subtype contrast enhancement showed more clear boundary( 80 .0% ,P＜0 .05) ,comparing to the other two types ,the perfusion parameters was no significant different( P ＞0 .05). Conclusions Different molecular subtypes of breast cancer have different contrast enhancement patterns and perfusion parameters ,CEUS can provide valuable imaging information for the diagnosis of breast cancer molecular typing before surgery .

Objective To investigate the applied value of routine ultrasound and shear wave elastography (SWE) in the comparison between triple negative breast cancer ( TNBC) and non-triple negative breast cancer (non-TNBC) . Methods A total of 120 lesions in 120 patients with pathologically confirmed breast cancer were retrospectively reviewed ,which were examined by routine ultrasound and SWE before surgery . According to immunohistochemical analysis ,those were divided into TNBC group and non-TNBC group . The features of routine ultrasound ( including shape ,orientation ,margin ,boundary ,echo pattern ,microcalcification ,posterior features of each lesion and blood flow characteristics) and the SWE index[including the average value of the lesion stiffness(Emean) ,the maximum value (Emax) ,the minimum value (Emin) ,the standard deviation (SD) ,and the ratio of the normal breast gland tissue (Eratio)] in the two groups were analyzed and compared . Results ① Two-dimensional ultrasound :TNBC lesions mostly showed the margin of microlobulated ,abrupt boundaries and no internal microcalcification ,but non-TNBC lesions were more likely to have an angular or spiculated margin ,an echogenic halo of boundary and a few microcalcification in the interior ,which were statistically different( P ＜0 .05) . The grade of blood flow and resistance index between TNBC and non-TNBC group showed no statistical difference( P ＞0 .05) . ② The values of Emax ,Emean and Eratio were statistically different( P ＜0 .05) ,with AUCs of 0 .811 ,0 .781 ,and 0 .770 , respectively . Conclusions Routine ultrasound and SWE can comprehensively analyze the morphology ,blood flow and stiffness features of breast lesions ,which provides more valid information to identify T NBC and non-T NBC .

Objective:To construct a quantitatively diagnostic nomogram model by analyzing the clinical information of patients and the features of multi-modality ultrasound images of thyroid lesions, so as to preoperatively predict the malignant probability of suspicious thyroid nodules and provide effective references for clinical decision-making.Methods:A total of 933 patients, 1 121 thyroid nodules of C-TIRADS 3-5 categories, who underwent surgery in the Second Affiliated Hospital of Harbin Medical University from September 1, 2020 to June 10, 2021 were collected. The nodules were randomly divided into training ( n=897) and test groups ( n=224) in 8∶2 ratio. Finally, the diagnostic performance was evaluated by area under the curve (AUC). Results:①After preliminary screening by univariate analysis, multivariate analysis showed that age, echogenicity, orientation, echogenic foci, margin, posterior features, and elastic score were significantly correlated with benign and malignant nodules (all P<0.001), and the difference of halo between benign and malignant nodules was also statistically significant ( P=0.012). ②The AUC of nomogram was up to 0.903(95% CI=0.862-0.944) in the test set, and 0.889(95% CI=0.832-0.946) and 0.960(95% CI=0.925-0.994) in nodules with maximum diameter of ≤10 mm and of >10 mm respectively, which showed high diagnostic performance. Conclusions:The nomogram model could accurately differentiate malignant from benign thyroid nodules preoperatively, with the highest diagnostic performance for the nodules with maximum diameter of >10 mm, and effectively avoid the unnecessary fine-needle biopsy and surgical operation.

Objective:To investigate the comparative analysis of multimodal ultrasound features and clinicopathology of different molecular types of breast cancer, so as to improve the diagnostic accuracy of different types of breast cancer.Methods:A retrospective analysis of 112 patients with invasive breast cancer in the Second Affiliated Hospital and Affiliated Cancer Hospital of Harbin Medical Univeristy from August 2017 to November 2018 was carried out. With reference to St.Gallen standard, breast masses were divided into four subtypes, including Luminal A (LA), Luminal B (LB), Her-2 overexpression (Her-2+ ) and triple negative (TN). Two-dimensional greyscale, color Doppler flow imaging, shear wave elastography and contrast-enhanced ultrasound images were performed before operation. Complete clinicopathological data were collected. The differences between different subtypes of breast cancer in terms of multimodal ultrasound and clinicopathological features were analyzed.Results:①Luminal breast cancer showed posterior echo attenuation, low Alder grade, low Emax and Eratio value. LA was more likely to show a speculated or angular margin and concentric enhancement; LB was more frequently to show a indistinct margin, low enhancement and no perfusion defect (all P<0.05). ②Her-2+ cancers were characterized with a indistinct margin, enhanced posterior echo, a high Alder grade, Emax and Eratio value, and a high contrast enhancement and perfusion defect. The TTP value was lower than other subtypes (all P<0.05). ③TN cancers were associated with microlobulated margin, posterior echo enhancement, low Alder grade, high Emax and Eratio value and Ki67 expression, contrast concentric enhancement have and perfusion defect (all P<0.05). Conclusions:Different molecular subtypes of breast cancer have different multimodal ultrasound features and clinicopathological appearances, which can provide more imaging information for clinical diagnosis, treatment, and prognosis.

Objective: To investigate the prevalence of depression and anxiety symptoms among middle school students in Taizhou, Zhejiang Province, and its associations with their educational burden, so as to provide a theoretical reference for making more targeted psychological interventional measures. Methods: A cross sectional study was conducted by multi stage cluster sampling from September to November 2022 from 30 schools in five districts and counties of Taizhou, with a final sample of 8 128 junior and senior high school students completing the online surveys on the Questionnaire Star platform. The Educational Stress Scale for Adolescents (ESSA) was used to measure academic stress; the Child Depression Inventory (CDI) and the Generalized Anxiety Disorder Scale (GAD-7) were used to screen students depression and anxiety, respectively. The relationships between educational burden and depression and anxiety symptoms were analyzed by Logistic regression models. Results: The prevalence of depression and anxiety were 19.3% and 11.1%, respectively. The average score of middle school students study pressure was (52.8±11.5). The number of extracurricular classes was <1, the time length of extracurricular courses was <1 hour per day, and students averagely spend 3.6 hours per day on homework assigned by school teachers. Nearly 30.0% students had ≤0.5 of discretionary time school days and 28.5% students had ≤2 on weekends. About 30.8% students though they do worse in their academic performance. According to the results of binary Logistic regression analysis, after controlling the demographic variables, the score in Study Pressure Scale, the number of extracurricular classes, the volume of homework and the time length of extracurricular courses were positively associated with depression and anxiety ( OR =1.09, 1.07, 1.08, 1.05, 1.04, 1.08, 1.08, 1.08, 1.06, 1.09, 1.07, 1.47, 1.34, 2.84 ; 1.08, 1.06, 1.08, 1.04, 1.03, 1.05, 1.05, 1.05, 1.05, 1.07, 1.06, 1.48, 1.23, 1.75, P <0.05). Students with overage grades had a higher risk of depression symptoms ( OR=1.34, P <0.05). Conclusions Academic burden has negative effects on depression and anxiety of students in Taizhou. It is advisable to alleviate academic stress, so as to improve the mental health of students.

Objective:To explore the effect path of death attitude and purpose in life on attitude toward hospice care of undergraduate intern nursing students.Methods:This study was a cross-sectional study. Using the convenient sampling method, a total of 229 undergraduate intern nursing students from two schools in Hefei, Anhui Province were selected as the research objects from October to December 2022. General data questionnaire, Chinese Version of Frommelt Attitudes Toward Care of the Dying Scale Form B (FATCOD-B-C), Chinese Version of Death Attitude Profile-Revised (DAP-R) Scale and Chinese Version of Purpose in Life Test (PIL-C) were used to investigate. Pearson correlation analysis was used to explore the correlation between death attitudes, purpose in life and attitude toward hospice care among undergraduate intern nursing students. Structural equation model was used to examine the path relationship between attitude towards death and purpose in life on attitude toward hospice care.Results:A total of 229 questionnaires were sent out in this study, and 214 were effectively recovered, with an effective recovery rate of 93.45% (214/229). Among 214 undergraduate intern nursing students, the scores of FATCOD-B-C, Chinese Version DAP-R Scale, and PIL-C were (101.06±8.16), (91.21±12.13) and (94.45±11.90), respectively. The results of Pearson correlation analysis showed that the purpose in life was positively correlated with attitude toward hospice care ( r=0.290, P<0.01), while the attitude to death was negatively correlated with attitude toward hospice care ( r=-0244, P<0.01). The results of structural equation model path analysis showed that the purpose in life (life goal, life attitude) can affect attitude toward hospice care through death attitude (escape acceptance, natural acceptance, fear of death) . Conclusions:Effective interventions on purpose in life and attitude towards death of undergraduate intern nursing students can improve their attitudes toward hospice care .

Osteonecrosis of the femoral head (ONFH) is one of the common and difficult-to-treat orthopedic diseases caused by a variety of factors that lead to abnormal blood flow to the femoral head, which in turn leads to deformation and collapse of the femoral head and eventually results in severe hip joint dysfunction. The key to the treatment is early diagnosis and correct treatment according to the stage classification and active prevention of further aggravation of ONFH aiming to delay or avoid hip replacement surgery in young and middle-aged patients. At present, there are various non-surgical and surgical hip-preserving modalities for early ONFH, designed to slow down the progression of the disease, prevent the femoral head from collapsing and stop the mild collapse. In recent years, with the emergence and development of bone reconstruction biomaterials, artificial bone reconstruction after scraping of ONFH lesions has shown great potential in the treatment of early ONFH. The authors review the research progress in hip-preserving modalities for early ONFH in young and middle-aged patients from non-surgical and surgical perspectives, hoping to provide a reference for clinical treatment of early ONFH.