Objective:To compare the efficacy of body posture combined with pharmacotherapy and pharmacotherapy alone in the treatment of chronic subdural hematoma(CSDH).Methods:Firstly, retrospective case series study was conducted. Thirty cases of CSDH that had received body posture combined with pharmacotherapy at Department of Neurosurgery, Huashan Hospital Affiliated to Fudan University from December 2016 to October 2020 were studied retrospectively. Twenty-seven patients were male, and 3 patients were female. The age of patients ( M(IQR)) was 66(16) years (range:28 to 84). Nineteen patients had unilateral hematoma, and 11 patients had bilateral hematoma. All patients received pharmacotherapy and body posture therapy that was to raise their lower limbs 20 to 30 cm with leg lift pad and get abdominal compressed with customized abdominal belt in supine position. Patients were required to maintain the body posture as much as possible, with the maximum to 16 to 18 hours per day. Patients with unilateral hematoma should tilt the head to the affected side and avoid tilting it to the opposite side. For patients with bilateral hematoma, there was no need for head lateralization. Patient were treated with oral dexamethasone and atorvastatin simultaneously. The preliminary efficacy of body posture combined with pharmacotherapy was determined by hematoma improvement rate which was analyzed by Clopper-Pearson method. Then, the multi-center, prospective, randomized controlled trial had carried out in 9 medical centers from August 2020 to November 2021. The stratified block randomization method was adopted. Patients were randomized in a ratio of 1∶1 to either receive pharmacotherapy alone(the control group) or body posture combined with pharmacotherapy(the experiment group) for 3 months and followed up for 6 months. Effective treatment was defined as complete absorption of hematoma, or the hematoma volume decreased by more than 10 ml and Markwalder grading scale score had improved by more than 1 point compared to the baseline. The efficacy rate and surgery conversion rate at 3 months and recurrence at 6 months were observed. Comparison between groups was performed with paired sample t test, Mann-Whitney U test, χ2 test, corrected χ2 test, or Fisher exact probability method. Logistic regression was used to compare the effective rate and operation rate between the two groups. Results:In the respective study, 30 patients completed follow-up 13 to 353 days after treatment. At the last follow-up, the incidence of almost complete absorption or significantly absorption of hematoma (hematoma volume was significantly reduced accompanied by symptom improvement) was 93.3%. The 95% CI for the incidence that analyzed by the Clopper-Pearson method was 77.9% to 99.2%. One hundred and six patients were enrolled in the multicenter study. Fifty-five patients underwent body posture combined with pharmacotherapy. The age was 74(17) years (range:26 to 92). Thirty-nine patients were males and 16 were females. Fifty-one patients underwent pharmacotherapy alone. The age was 69(12) years (range:48 to 84). Thirty-seven patients were males and 14 were females. The length of body posture recorded in diary card was (15.7±2.3) hours(range:7.6 to 19.3 hours). The efficacy rate in the body posture combined with pharmacotherapy group and pharmacotherapy alone group were 83.6% (46/55) and 56.9% (29/51), respectively at 3 months. The result of the logistic regression analysis showed that the efficacy of body posture combined with pharmacotherapy group was better than that of pharmacotherapy alone group ( OR=3.88,95% CI:1.57 to 9.58, P=0.003). Surgery rate in the body posture combined with pharmacotherapy group and pharmacotherapy alone group were 5.5% (3/55) and 21.6% (11/51) respectively. The result of Logistic regression showed that the pharmacotherapy alone group was more likely to be converted to surgery ( OR=0.21,95% CI:0.05 to 0.80, P=0.023). At the 6 months, no recurrence of cases was found in the body posture combined with pharmacotherapy group. However, the recurrence rate of pharmacotherapy alone group was 6.3% (3/48), there was no significant difference between the two groups ( P>0.05). Conclusion:The effect of body posture combined with pharmacotherapy for chronic subdural hematoma is better than that of pharmacotherapy alone.

Objective To explore the predictive value of radiomics nomogram based on multiparameter MRI for the status of human epidermal growth factor receptor 2(HER-2)in endometrial cancer(EC).Methods A total of 154 patients with pathologically proved EC were retrospectively selected and randomly divided into training set(108 cases)and validation set(46 cases)according to the ratio of 7∶3.Radiomics features were extracted from the preoperative multiparameter MRI images of the patients.The predictive performance of different machine learning algorithms was evaluated by receiver operating characteristic(ROC)curves,and the nomogram was constructed in combination with clinical risk factors.Results The degree of differentiation and depth of myometrial invasion were clinical risk factors for predicting HER-2 positivity in EC patients.The support vector machine(SVM)was selected as the best radiomics model.The nomogram showed the highest predictive performance in the training and validation sets,with area under the curve(AUC)of 0.926 and 0.897,respectively.Conclusion The radiomics nomogram based on multiparameter MRI can accurately predict the HER-2 status of EC patients before surgery and can be used to guide clinical treatment decisions.

Objective To explore the predictive value of radiomics nomogram based on multiparameter MRI for the status of human epidermal growth factor receptor 2(HER-2)in endometrial cancer(EC).Methods A total of 154 patients with pathologically proved EC were retrospectively selected and randomly divided into training set(108 cases)and validation set(46 cases)according to the ratio of 7∶3.Radiomics features were extracted from the preoperative multiparameter MRI images of the patients.The predictive performance of different machine learning algorithms was evaluated by receiver operating characteristic(ROC)curves,and the nomogram was constructed in combination with clinical risk factors.Results The degree of differentiation and depth of myometrial invasion were clinical risk factors for predicting HER-2 positivity in EC patients.The support vector machine(SVM)was selected as the best radiomics model.The nomogram showed the highest predictive performance in the training and validation sets,with area under the curve(AUC)of 0.926 and 0.897,respectively.Conclusion The radiomics nomogram based on multiparameter MRI can accurately predict the HER-2 status of EC patients before surgery and can be used to guide clinical treatment decisions.

Objective:To compare the efficacy of body posture combined with pharmacotherapy and pharmacotherapy alone in the treatment of chronic subdural hematoma(CSDH).Methods:Firstly, retrospective case series study was conducted. Thirty cases of CSDH that had received body posture combined with pharmacotherapy at Department of Neurosurgery, Huashan Hospital Affiliated to Fudan University from December 2016 to October 2020 were studied retrospectively. Twenty-seven patients were male, and 3 patients were female. The age of patients ( M(IQR)) was 66(16) years (range:28 to 84). Nineteen patients had unilateral hematoma, and 11 patients had bilateral hematoma. All patients received pharmacotherapy and body posture therapy that was to raise their lower limbs 20 to 30 cm with leg lift pad and get abdominal compressed with customized abdominal belt in supine position. Patients were required to maintain the body posture as much as possible, with the maximum to 16 to 18 hours per day. Patients with unilateral hematoma should tilt the head to the affected side and avoid tilting it to the opposite side. For patients with bilateral hematoma, there was no need for head lateralization. Patient were treated with oral dexamethasone and atorvastatin simultaneously. The preliminary efficacy of body posture combined with pharmacotherapy was determined by hematoma improvement rate which was analyzed by Clopper-Pearson method. Then, the multi-center, prospective, randomized controlled trial had carried out in 9 medical centers from August 2020 to November 2021. The stratified block randomization method was adopted. Patients were randomized in a ratio of 1∶1 to either receive pharmacotherapy alone(the control group) or body posture combined with pharmacotherapy(the experiment group) for 3 months and followed up for 6 months. Effective treatment was defined as complete absorption of hematoma, or the hematoma volume decreased by more than 10 ml and Markwalder grading scale score had improved by more than 1 point compared to the baseline. The efficacy rate and surgery conversion rate at 3 months and recurrence at 6 months were observed. Comparison between groups was performed with paired sample t test, Mann-Whitney U test, χ2 test, corrected χ2 test, or Fisher exact probability method. Logistic regression was used to compare the effective rate and operation rate between the two groups. Results:In the respective study, 30 patients completed follow-up 13 to 353 days after treatment. At the last follow-up, the incidence of almost complete absorption or significantly absorption of hematoma (hematoma volume was significantly reduced accompanied by symptom improvement) was 93.3%. The 95% CI for the incidence that analyzed by the Clopper-Pearson method was 77.9% to 99.2%. One hundred and six patients were enrolled in the multicenter study. Fifty-five patients underwent body posture combined with pharmacotherapy. The age was 74(17) years (range:26 to 92). Thirty-nine patients were males and 16 were females. Fifty-one patients underwent pharmacotherapy alone. The age was 69(12) years (range:48 to 84). Thirty-seven patients were males and 14 were females. The length of body posture recorded in diary card was (15.7±2.3) hours(range:7.6 to 19.3 hours). The efficacy rate in the body posture combined with pharmacotherapy group and pharmacotherapy alone group were 83.6% (46/55) and 56.9% (29/51), respectively at 3 months. The result of the logistic regression analysis showed that the efficacy of body posture combined with pharmacotherapy group was better than that of pharmacotherapy alone group ( OR=3.88,95% CI:1.57 to 9.58, P=0.003). Surgery rate in the body posture combined with pharmacotherapy group and pharmacotherapy alone group were 5.5% (3/55) and 21.6% (11/51) respectively. The result of Logistic regression showed that the pharmacotherapy alone group was more likely to be converted to surgery ( OR=0.21,95% CI:0.05 to 0.80, P=0.023). At the 6 months, no recurrence of cases was found in the body posture combined with pharmacotherapy group. However, the recurrence rate of pharmacotherapy alone group was 6.3% (3/48), there was no significant difference between the two groups ( P>0.05). Conclusion:The effect of body posture combined with pharmacotherapy for chronic subdural hematoma is better than that of pharmacotherapy alone.

Objective To investigate the current status of central obesity among young male soldiers on warships,and to analyze risk factors and its correlation with metabolic diseases,so as to provide a basis for managing body shape and improving fighting capacity.Methods A total of 531 young male soldiers on warships and 403 young male coast duty soldiers were randomly selected as research objects.Waist circumference(WC),fasting blood glucose,blood lipids and uric acid were measured.The incidences of central obesity and metabolic diseases were compared between soldiers on warships and coast duty soldiers.A questionnaire survey was conducted on the work and lifestyle of soldiers on warships.The risk factors of central obesity and their correlations with metabolic diseases were analyzed.Results The incidence of central obesity in soldiers on warships was higher than that in coast duty soldiers(22.79%vs 9.68%,P<0.001).The incidences of hypertension,hyperlipidemia and hyperuricemia in soldiers on warships were also higher than those in coast duty soldiers(all P<0.05).The duration of vessel stay,sailing time,exercise time,frequency of night meals,intake of beverages,intake of fresh water,intake of carbohydrates,and family history of obesity affected the prevalence of central obesity.More sailing time,less exercise time,higher frequency of night meals,more intake of beverage and carbohydrate,and family history of obesity were risk factors for central obesity among soldiers on warships.Central obesity was associated with many metabolic diseases such as hypertension,diabetes mellitus,hyperlipidemia,hyperuricemia,and fatty liver.Conclusion The incidence of central obesity in young male warship soldiers is higher than that in young male coast duty soldiers.WC is a simple indicator for central obesity.Central obesity is influenced by lifestyle and related to various metabolic diseases.We should strengthen health education of soldiers on warships,improve their lifestyle,manage their body shape reasonably,prevent the development of metabolic diseases,so as to ensure the fighting capacity of troops.

Polygona-polysaccharose is an important indicator to measure the quality of Polygonati Rhizoma. The polygona-polysaccharose has the effect of lowering blood sugar, regulating blood lipid, anti-fatigue, improving learning and memory ability. The Polygonati Rhizoma, as a Chinese herbal medicine with homology of medicine and food, has a good prospect and application value in the development of food and health products.

Objective To study mechanical properties of traditional trajectory (TT) and modified cortical bone trajectory (MCBT) on osteoporotic vertebrae through finite element analysis. Methods The three-dimensional model of L4 segment was established, and pedicle screw (PS) (diameter 6.0 mm, length 45 mm) and MCBT screw (diameter 4.5 mm, length 40 mm) were placed on both sides of the lumbar spine. The pull-out strength and the load-displacement ratio of screws in two different screw trajectories under up, down, left, right working conditions were analyzed, and the stability between the screw and vertebral body under osteoporotic conditions was evaluated. Results Compared with TT, the pull-out strength of MCBT screw was increased by 13.1%. Compared with PS, the load-displacement ratio of MCBT screw under up, down and left working conditions was increased by 57.2%, 32.4%, and 31.6%. Under right working condition, although the load-displacement ratio of MCBT screw was higher than that of PS, no statistical difference was found. The load-displacement ratio of vertebral body in MCBT group under lateral bending and axial rotation was significantly higher than that in TT group. The load-displacement ratio of vertebral body in MCBT group under flexion was lower than that in TT group. Although the load-displacement ratio of vertebral body in MCBT group under extension was higher that that in TT group, no statistical difference was found. Conclusions MCBT is superior to TT in pull-out strength, screw stability and vertebral body stability under lateral bending and axial rotation, but its vertebral body stability under flexion and extension was weaker than that of TT. The research findings demonstrate the superiority of MCBT under osteoporotic conditions and lay the foundation for clinical application of MCBT.

Mental fatigue is the subjective state of people after excessive consumption of information resources. Its impact on cognitive activities is mainly manifested as decreased alertness, poor memory and inattention, which is highly related to the performance after impaired working memory. In this paper, the partial directional coherence method was used to calculate the coherence coefficient of scalp electroencephalogram (EEG) of each electrode. The analysis of brain network and its attribute parameters was used to explore the changes of information resource allocation of working memory under mental fatigue. Mental fatigue was quickly induced by the experimental paradigm of adaptive N-back working memory. Twenty-five healthy college students were randomly recruited as subjects, including 14 males and 11 females, aged from 20 to 27 years old, all right-handed. The behavioral data and resting scalp EEG data were collected simultaneously. The results showed that the main information transmission pathway of the brain changed under mental fatigue, mainly in the frontal lobe and parietal lobe. The significant changes in brain network parameters indicated that the information transmission path of the brain decreased and the efficiency of information transmission decreased significantly. In the causal flow of each electrode and the information flow of each brain region, the inflow of information resources in the frontal lobe decreased under mental fatigue. Although the parietal lobe region and occipital lobe region became the main functional connection areas in the fatigue state, the inflow of information resources in these two regions was still reduced as a whole. These results indicated that mental fatigue affected the information resources allocation of working memory, especially in the frontal and parietal regions which were closely related to working memory.
Adult ; Aged ; Brain ; Female ; Frontal Lobe ; Humans ; Male ; Memory, Short-Term ; Mental Fatigue ; Resource Allocation ; Young Adult

Rupture and bleeding of accessory hepatic aneurysms is clinically rare. Computed tomography angiography (CTA) or multislice reconstruction can provide reliable basis for clinical diagnosis. Interventional surgery is the main treatment method. A successful case of interventional embolization of ruptured accessory hepatic aneurysm in our hospital was reported. The accessory hepatic artery variation of this patient belongs to Michels type 4. The bleeding site of the variant artery was identified by CTA and digital subtraction angiography. Satisfactory results were obtained after interventional embolization and follow-up.

Hydrocephalus is often treated with a cerebrospinal fluid shunt (CFS) for excessive amounts of cerebrospinal fluid in the brain. However, it is very difficult to distinguish whether the ventricular enlargement is due to hydrocephalus or other causes, such as brain atrophy after brain damage and surgery. The non-trivial evaluation of the consciousness level, along with a continuous drainage test of the lumbar cistern is thus clinically important before the decision for CFS is made. We studied 32 secondary mild hydrocephalus patients with different consciousness levels, who received T1 and diffusion tensor imaging magnetic resonance scans before and after lumbar cerebrospinal fluid drainage. We applied a novel machine-learning method to find the most discriminative features from the multi-modal neuroimages. Then, we built a regression model to regress the JFK Coma Recovery Scale-Revised (CRS-R) scores to quantify the level of consciousness. The experimental results showed that our method not only approximated the CRS-R scores but also tracked the temporal changes in individual patients. The regression model has high potential for the evaluation of consciousness in clinical practice.