Objective To evaluate the value of high-resolution magnetic resonance vessel wall ima-ging(HRMR-VWI)in assessment of the severity of vascular stenosis in elderly patients with acute cerebral infarction(ACI).Methods A total of 127 elderly ACI patients admitted to our department between May 2021 and January 2024 were retrospective enrolled,and according to the degree of vascular stenosis by digital subtraction angiography(DSA),they were divided into a normal group(31 cases),a mild group(40 cases),a moderate group(40 cases),and a severe group(16 cases).DSA and HRMR-VWI were performed to evaluate the plaque and severity of vascular stenosis.ROC curve was plotted to evaluate the diagnostic value of HRMR-VWI parame-ters for the degree of vascular stenosis in the elderly ACI patients,and the AUC values of these parameters were calculated.Results Significant differences were observed in the HRMR-VWI pa-rameters such as plaque area and plaque burden among the normal,mild,moderate and severe groups(P＜0.01).ROC curve analysis showed that the AUC value of the combined plaque area and plaque burden in diagnosis of mild,moderate and severe vascular stenosis in elderly ACI pa-tients was obviously higher than that of the two parameters alone(0.964 vs 0.822,0.843,P＜0.05;0.930 vs 0.795,0.776,P＜0.05;0.917 vs 0.786,0.792,P＜0.05).Conclusion HRMR-VWI can effectively evaluate vascular stenosis in elderly ACI patients,which providing important refer-ence for early treatment and prognosis improvement.

Objective To evaluate the value of high-resolution magnetic resonance vessel wall ima-ging(HRMR-VWI)in assessment of the severity of vascular stenosis in elderly patients with acute cerebral infarction(ACI).Methods A total of 127 elderly ACI patients admitted to our department between May 2021 and January 2024 were retrospective enrolled,and according to the degree of vascular stenosis by digital subtraction angiography(DSA),they were divided into a normal group(31 cases),a mild group(40 cases),a moderate group(40 cases),and a severe group(16 cases).DSA and HRMR-VWI were performed to evaluate the plaque and severity of vascular stenosis.ROC curve was plotted to evaluate the diagnostic value of HRMR-VWI parame-ters for the degree of vascular stenosis in the elderly ACI patients,and the AUC values of these parameters were calculated.Results Significant differences were observed in the HRMR-VWI pa-rameters such as plaque area and plaque burden among the normal,mild,moderate and severe groups(P＜0.01).ROC curve analysis showed that the AUC value of the combined plaque area and plaque burden in diagnosis of mild,moderate and severe vascular stenosis in elderly ACI pa-tients was obviously higher than that of the two parameters alone(0.964 vs 0.822,0.843,P＜0.05;0.930 vs 0.795,0.776,P＜0.05;0.917 vs 0.786,0.792,P＜0.05).Conclusion HRMR-VWI can effectively evaluate vascular stenosis in elderly ACI patients,which providing important refer-ence for early treatment and prognosis improvement.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective:To investigate the changes in symptoms of inflammatory bowel disease (IBD) patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the coronavirus disease 2019 (COVID-19) pandemic, as well as the situation of IBD treatment medication use.Methods:A cross-sectional survey study method was used. A questionnaire survey was conducted on a voluntary sampling basis for IBD patients of multiple centers nationwide from December 1st to 31st 2022, collecting clinical data of patients diagnosed with COVID-19 through nucleic acid/antigen testing. Patients were divided into symptomatic exacerbation group and asymptomatic exacerbation group based on whether they felt an exacerbation of IBD symptoms including abdominal discomfort, increased bloody stool or the appearance of purulent bloody stool, increased frequency of diarrhea, etc. And the differences in age, gender, body mass index (BMI) , underlying disease conditions, SARS-CoV-2 vaccination status, IBD type, disease activity, COVID-19 symptoms, and treatment medication between the two groups were compared.Results:A total of 497 patients were included, 317 males and 180 females; age (35.27±11.54) years; 355 CD patients and 142 UC patients; more than 50% of patients exhibited respiratory system symptoms such as fever, muscle soreness, fatigue, cough, expectoration, nasal congestion, and some IBD patients exhibited digestive system symptoms and nervous system symptoms. The symptomatic exacerbation group consisted of 104 patients (20.93%) , and the asymptomatic exacerbation group consisted of 393 (79.07%) . There were no statistically significant differences in gender, age, BMI, underlying diseases, IBD type, and SARS-CoV-2 vaccine doses between the two groups (all P>0.05) . Compared with the asymptomatic exacerbation group, the proportion of patients in the disease active phase was higher [47.12% (49/104) vs. 24.68% (97/393) , P<0.001], and the proportion of patients using mesalazine/sulfasalazine was higher (35.58% vs. 23.41%, P = 0.012) , and the proportions of COVID-19 symptoms such as diarrhea, headache, and dizziness were all higher (all P<0.05) in the symptomatic exacerbation group. Among the 237 IBD patients using biologics, there was a statistically significant difference in the types of biologics used between the symptomatic and asymptomatic exacerbation groups (χ 2 = 9.351, P = 0.031) . Among the 240 patients using biologics, the proportion of delaying or interrupting the use of biologics was higher in symptomatic exacerbation group than that of the asymptomatic exacerbation group, and the difference was statistically significant [45.45% (20/44) vs. 23.98% (47/196) , χ 2 = 8.235, P = 0.004]. Among the 47 patients using immunosuppressants, there was no statistically significant difference in the proportion of stopping immunosuppressants between the symptomatic and asymptomatic exacerbation groups ( P = 0.263) . Conclusion:The main symptoms of IBD patients infected with COVID-19 are respiratory and systemic symptoms, and those in the active phase of the disease or those delaying or withdrawing biologics are more likely to experience an exacerbation of IBD symptoms during the infection.

Objective:To investigate the changes in symptoms of inflammatory bowel disease (IBD) patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the coronavirus disease 2019 (COVID-19) pandemic, as well as the situation of IBD treatment medication use.Methods:A cross-sectional survey study method was used. A questionnaire survey was conducted on a voluntary sampling basis for IBD patients of multiple centers nationwide from December 1st to 31st 2022, collecting clinical data of patients diagnosed with COVID-19 through nucleic acid/antigen testing. Patients were divided into symptomatic exacerbation group and asymptomatic exacerbation group based on whether they felt an exacerbation of IBD symptoms including abdominal discomfort, increased bloody stool or the appearance of purulent bloody stool, increased frequency of diarrhea, etc. And the differences in age, gender, body mass index (BMI) , underlying disease conditions, SARS-CoV-2 vaccination status, IBD type, disease activity, COVID-19 symptoms, and treatment medication between the two groups were compared.Results:A total of 497 patients were included, 317 males and 180 females; age (35.27±11.54) years; 355 CD patients and 142 UC patients; more than 50% of patients exhibited respiratory system symptoms such as fever, muscle soreness, fatigue, cough, expectoration, nasal congestion, and some IBD patients exhibited digestive system symptoms and nervous system symptoms. The symptomatic exacerbation group consisted of 104 patients (20.93%) , and the asymptomatic exacerbation group consisted of 393 (79.07%) . There were no statistically significant differences in gender, age, BMI, underlying diseases, IBD type, and SARS-CoV-2 vaccine doses between the two groups (all P>0.05) . Compared with the asymptomatic exacerbation group, the proportion of patients in the disease active phase was higher [47.12% (49/104) vs. 24.68% (97/393) , P<0.001], and the proportion of patients using mesalazine/sulfasalazine was higher (35.58% vs. 23.41%, P = 0.012) , and the proportions of COVID-19 symptoms such as diarrhea, headache, and dizziness were all higher (all P<0.05) in the symptomatic exacerbation group. Among the 237 IBD patients using biologics, there was a statistically significant difference in the types of biologics used between the symptomatic and asymptomatic exacerbation groups (χ 2 = 9.351, P = 0.031) . Among the 240 patients using biologics, the proportion of delaying or interrupting the use of biologics was higher in symptomatic exacerbation group than that of the asymptomatic exacerbation group, and the difference was statistically significant [45.45% (20/44) vs. 23.98% (47/196) , χ 2 = 8.235, P = 0.004]. Among the 47 patients using immunosuppressants, there was no statistically significant difference in the proportion of stopping immunosuppressants between the symptomatic and asymptomatic exacerbation groups ( P = 0.263) . Conclusion:The main symptoms of IBD patients infected with COVID-19 are respiratory and systemic symptoms, and those in the active phase of the disease or those delaying or withdrawing biologics are more likely to experience an exacerbation of IBD symptoms during the infection.

Objective: To investigate the relationship between adverse childhood experiences with depression and anxiety prevention and intervention among middle school students, so as to provide evidence for preventing and intervening in depression and anxiety among adolescents. Methods: From October to November 2020, a total of 4 861 middle school students from 12 schools in a province in central China, including junior high schools, senior high schools, secondary vocational schools, and vocational high school selected by using convenient sampling method. Demographic information, adverse childhood experiences, depression and anxiety symptoms were collected. The Chi square test and multivariate Logistic regression analysis were used to analyze the data. Results: The detection rates of depression and anxiety of students in middle school were 39.0% and 52.3%, respectively. Univariate analysis showed that the total scores of adverse childhood experiences and dimensions of childhood maltreatment and neglect, family dysfunction, parent absence, and violence outside the home were significantly associated with depressive and anxiety symptoms ( χ 2=105.36, 147.12, 43.69, 46.61, 196.48; 100.06, 132.28, 26.53, 24.32, 169.94, P <0.01). After controlling variables such as age, only child, sex and economic status of family, Logistic regression showed that childhood maltreatment and neglect, family dysfunction,family absence and violence outside the home were positively associated with depressive symptoms ( OR =1.61, 1.62, 1.06,2.08, P <0.01) and anxiety symptoms ( OR =1.66, 1.50, 1.98, P <0.05). Conclusion Depressive and anxiety symptoms among middle school students are associated with adverse childhood experiences, and those who experienced childhood maltreatment and neglect and violence outside the home are at higher risk.

Objective To evaluate the effect of applying sitting posture corrector on improving reading and writing posture of elementary school students， and provide scientific evidence for prevention and control of myopia in children and adolescents. Methods One elementary school each in urban and suburban areas of Shanghai was selected using a convenience sampling strategy. Furthermore， two classes each in Grade 3 and 4 were selected as the intervention group （282 students were included in the study）， and the other two classes each in Grades 3 and 4 were selected as the control group （294 students were included in the study）. Students in the intervention group used the sitting posture corrector in the classrooms for 4 months （from September 2020 to January 2021）， while those in the control group did not use the sitting posture corrector. Relevant data were collected before and after the intervention through a self-administered questionnaire and visual examination. Statistical analysis was performed using chi-square test and generalized estimating equation. Results Before the intervention， 13.5% （38/282） of students in the intervention group and 12.2% （36/294） in the control group had good reading and writing posture （ χ ² = 0.195， P >0.659）. After the intervention， 18.4% （52/282） of students in the intervention group had good reading and writing posture， which was higher than that （11.2%， 33/294） in the control group （ χ ²=5.957， P =0.015）. Before and after the intervention， there was no significant differences in the prevalence of myopia between students in the intervention and control groups （all P >0.05）. Generalized estimating equation analysis showed that students in the intervention group were 1.502 times more likely to have good reading and writing posture than those in the control group after the intervention （ P =0.043）. Conclusion Applying sitting posture corrector in schools could improve students' reading and writing posture.

Objective To observe the features of fetus unilateral pulmonary agenesis in antenatal ultrasonography and analyse the causes of misdiagnosed,so that fetus unilateral pulmonary agenesis can be known more deeply.Methods From January 2012 to October 2017,8 fetuses underwent prenatal ultrasound examination of fetal system in Guangdong Maternal and Child Health Hospital.The prenatal ultrasound data and postnatal clinical data were retrospectively analyzed.Results Among 8 cases of unilateral pulmonary agenesis,there were 4 males and 4 females,5 cases involving right lung,3 cases involving left lung,3 cases of single lung absence,and 5 cases combined with other deformities.There were 4 cases of induced labor,and 4 cases of surviving children were confirmed unilateral pulmonary agenesis by chest computed tomography (CT) examination.2 cases of missed prenatal diagnosis were left pulmonary agenesis,including 1 case only found left pulmonary artery absence and 1 case only found left axis deviation and cardiac enlargement before delivery.Conclusions Cardiac displacement and absence of left or right pulmonary artery are important clues for prenatal ultrasound diagnosis of fetal unilateral pulmonary absence.Prenatal ultrasound is the preferred method to detect and diagnose fetal unilateral pulmonary absence.

Objective? To explore the effects of WeChat combined with module teaching in minimally invasive surgery nursing training. Methods? From July 2016 to June 2018, 56 junior nurses in operating room were randomly divided into control group and experimental group, 28 nurses in each group by random table. Control group carried out routine teaching combined with module teaching, while experimental group adopted WeChat combined with module teaching. We compared the theoretical achievements, skills performance and satisfaction of surgeons with nursing. Results? Twelve months after training, the theoretical achievements and skills performance of experimental group were (76.93±5.31) and (78.79±4.86) respectively, higher than those of control group with statistical differences (t=-3.34, -3.13;P＜ 0.05). Satisfaction of surgeons with nursing provided by nurses was (94.68±3.37) in experimental group and (72.26±4.67) in control group with a statistical difference (t=-35.64,P＜ 0.05). Conclusions? The application of WeChat combined with module teaching in minimally invasive surgery nursing training for junior nurses can stimulate the enthusiasm of autonomous learning, raise the theoretical achievements and skills performance and improve satisfaction of surgeons with nursing for surgeries.

Objective: To analyze the morbidity, clinical characteristics, therapeutic outcomes and prognosis of cardiac lymphoma. Methods: Individual patient data were obtained from pathology defined 10 cases of cardiac lymphoma from Jan 2000 to Jun 2016. The patient’s general information, clinical manifestation, pathological diagnosis, laboratory examination, cardiac involvement feature, cardiac complications, treatment, therapeutic effect and prognosis were analyzed. Results: Of 3 918 cases of lymphoma patients, 10 cases of cardiac involvement were identified, including primary cardiac lymphoma (PCL) in 1 case, secondary cardiac lymphoma (SCL) in 9 cases. Of the 10 patients in our analysis, the male-to-female ratio was 3∶2, with a median age of 55 (19-88) years old. The most presenting complaints were dyspnea in 7 cases, followed by chest pain in 5 cases, fatigue in 2 patients and edema in 2 cases. Pathological types included diffuse large B cell lymphoma (DLBCL) in 7 cases, T cell lymphoma (T-LBL) in 1 case, Hodgkin’s lymphoma (HL) in 1 case, and Burkitt lymphoma (BL) in 1 case. The sites of the heart affected by lymphoma in the PCL patient were right and left atriums with multiple nodules; and for SCL, the sites were mainly pericardium associated with a pericardial effusion in 5 cases, a pericardial mass in 2 cases. Congestive heart failure affects 7 patients and cardiac arrhythmias were identified in 4 cases mainly sinus tachycardia, atrial fibrillation and atrioventricular block. Except one untreated because of old age and poor performance, the rest of 9 patients were treated by either chemotherapy in 4 cases or chemotherapy combined radiotherapy (including the extracardiac sites) in 5 patients. With the median follow-up of 9 months, the one PCL patient achieved partial response (PR) , progress free survival (PFS) for 6 months and the overall survival (OS) for 21 months; in the cohort of 6 SCL patients cardiac involved at diagnosis, complete response (CR) was achieved in 1 case (16.7%) , PR in 3 cases, progressing disease (PD) in 2 cases, with the median PFS for 5 months and the median OS for 19 months; and for the other 3 SCL patients cardiac involved at progression, PR was achieved in 2 case and death in 1 case, with the median PFS for 4 months and the median OS unavailable because of censored data. Conclusion Cardiac lymphoma represents a rare subset of lymphoma, the most common type is DLBCL, and the main clinical manifestations are dyspnea and chest pain, always combined by arrhythmia and congestive heart failure. The main therapeutic regimen for cardiac lymphoma includes combined chemotherapy and the prognosis for patients with either PCL or SCL is usually poor.