To evaluate the application value of metal clip combined with suture and rubber coil as a simple traction device in endoscopic submucosal dissection (ESD) for intestinal mucosal lesions, a total of 56 patients with early colonic cancer and precancerous lesions who received ESD in Jiangyin People's Hospital from January 2021 to July 2022 were randomly divided into the control group ( n=28, conventional ESD) and the traction group ( n= 28, suture and rubber coil as a simple traction device). The total time of ESD, mucosal dissection time, number of submucosal injections, complete resection rate and complications were compared between the two groups. The operation time of the traction group was shorter than that of the control group (74.64±33.25 min VS 117.18±35.75 min, t=4.61, P<0.001). The desection time of mucosa in the traction group was shorter than that in the control group (51.61±24.87 min VS 99.11±32.73 min, t=6.11, P<0.001). The number of submucosal injection in the traction group was less than that of the control group with significant difference (1.68±1.16 VS 4.96±1.41, t=9.57, P<0.001). There was no significant differences in operation area, complete resection rate or complication between the two groups ( P>0.05). The traction assistance technology of metal clip combined with suture and rubber coil can reduce the technical difficulty of colonic ESD and shorten the operation time.

【Objective】 To evaluate the effectiveness of Roche Cobas s 201 in detecting HBV by analyzing its blood nucleic acid testing (NAT) results. 【Methods】 The results were grouped according to the enzyme-linked immunosorbent assay (ELISA) and NAT minipool test (MP), NAT individual test (ID) and repeated NAT ID test (rID), and categorized into 4 groups as ELISA+ /NAT(ID)+ , ELISA+ /NAT(rID)+ , ELISA-/NAT(ID)+ and ELISA-/NAT(rID)+ . The data were statistically analyzed to explore whether there was a difference in the detection of reactive results by repeated NAT, and the correlation between cycle threshold (Ct) and nucleic acid detection rate for NAT-reactive samples with different ELISA results. The true infection status of blood donors was further analyzed by supplementary tests, including NAT systems and chemiluminescence serological marker assays using other methodologies. 【Results】 A total of 1 691 groups of 766 293 blood donor samples were HBV NAT(MP)+ , of which 1 418 groups(83.86%) were detected with reactive results (1 418 HBV NAT+ , 7 090 NAT-), and there were still 273 groups (16.14%) that remained undetected after repeated testing[a total of 1 638 NAT-, Ct(MP): 39.49±3.62]. Of the HBV NAT+ , 881(62.13%) were ELISA+ /NAT(ID)+ , 19(1.34%) were ELISA+ /NAT(rID)+ , 451(31.81%) were ELISA-/NAT(ID)+ , and 67(4.72%) were ELISA-/NAT(rID)+ . For samples with different ELISA results, difference was found in the detection of HBV by repeated NAT (P<0.05). There was no difference in Ct(ID) values between groups ELISA+ /NAT(rID)+ and ELISA-/ NAT(ID)+ , and groups ELISA+ /NAT(rID)+ and ELISA-/ NAT(rID)+ (P>0.05), but there were significant differences between other groups compared pairwise (P<0.05). Supplementary tests were performed on 228 ELISA-/ NAT(MP)+ (ID)- samples, 56 (24.56%) were reactive by chemiluminescent detection of HBsAg+ and 7 (3.07%) by other NAT systems. Among the remaining 221 NAT- samples/donors (96.93%), 53 (23.98%) HBsAg+ donors were likely to have chronic infection, 40 (18.10%) anti-HBe+ and/or anti-HBc+ donors might have previous infections, and the remaining 128 (57.92%) donors who were non-reactive were NAT (MP) pseudo-reactive, with significant differences in anti-HBs levels \'between groups (P<0.05). 【Conclusion】 Repeated NAT has differential detection of donor samples with different reactivity categories or different serologic results, especially within a certain interval, and repeated NAT for ELISA- samples can significantly improve the detection rate. Ct values can assist in assessing the stability and accuracy of the NAT system. For ELISA-/NAT(MP)+ (ID)- donors, the combination of other highly sensitive assays can reduce the risk of viral residuals and safeguard clinical blood safety.

Objective:To investigate the relationship between vaccination doses and the duration of positive nucleic acid or antigen tests in Corona Virus Disease 2019 (COVID-19) patients during omicron epidemic.Methods:A cross-sectional study was conducted from December 26 to December 31, 2022 among COVID-19 patients from all community health service centers in 16 districts of Beijing municipality selected by multi-stage stratified cluster quota sampling method. A questionnaire was used to collect the basic information, vaccination doses, results of nucleic acid or antigen tests of all subjects. The subjects were divided into 5 groups according to the doses of COVID-19 vaccination: the non-vaccination group, the 1, 2, 3 and 4 doses vaccination group. The relationship between vaccination doses and the duration of positive nucleic acid or antigen tests was analyzed by univariate and multivariate logistic regression models.Results:A total of 10 506 COVID-19 cases were included in the study with the age of (43.3±13.7) years. The duration of positive nucleic acid or antigen tests was longer than 7 days in 59.4%(276/465), 51.5%(67/130), 50.6%(355/701), 46.1% (3 464/7 520) and 39.2%(662/1 690) of non-vaccination, and 1, 2, 3, 4 dose vaccination groups, respectively ( P<0.001). Multivariate logistic regression analysis showed that compared with non-vaccination patients, the vaccination dose was an independent protective factor for duration of positive nucleic acid or antigen tests>7 days, and the OR values were 0.7 (95% CI 0.5-0.9, P=0.015), 0.6 (95% CI 0.5-0.8, P<0.001) and 0.5 (95% CI 0.4-0.6, P<0.001) for 2, 3 and 4 doses of vaccination, respectively. Conclusion:The vaccination doses are independently related to the duration of positive nucleic acid or antigen tests in COVID-19 patients and the risk is gradually decreases with the increasing vaccination doses.

Clinical data of 15 patients diagnosed with acute renal infarction (ARI) in Affiliated Zhongshan Hospital of Dalian University from Jan 2011 to Dec 2021 were retrospectively analyzed. Of the included 15 patients, there were 14 cases of cardiac origin and 1 case of antiphospholipid syndrome. We found that there were 12 cases of atrial fibrillation, 2 cases of atrial premature beats, 12 cases of elevated level of D-dimer, 15 cases of elevated level of LDH, 11 cases of positive urine occult blood and positive urine protein. Among the 15 patients, catheter-directed thrombolysis was performed in 4 cases, of which 3 cases were revascularized successfully, intravenous thrombolysis in 2 cases and alone anticoagulation therapy in 9 cases. It is suggested that CECT or CTA can assist the early diagnosis of ARI especially in patients with acute onset and persistent abdominal pain with high risk factors of thromboembolism, high levels of LDH, microscopic hematuria and/or proteinuria. Despite prolonged embolic ischemia, try to reconstruct blood flow to save the kidney as much as possible. Late standardized anticoagulant therapy is of critical importance to prevent recurrent embolic episodes.

Objective:To analyze the incidence and prognosis of epilepsy in frontotemporal lobe glioma.Methods:The clinical data of 208 patients with frontotemporal lobe gliomas in Sanbo Brain Hospital Capital Medical University from 2019 to 2021 were analyzed retrospectively. According to the 2016 World Health Organization (WHO) classification of tumors of the central nervous system, the incidence of epilepsy, Modified Rankin Scale (MRS) score, and Engel Outcome Scale of patients with different grades of tumors were calculated.Results:Among all the patients with frontotemporal lobe gliomas, there was more males than females, and it was more common in the 40 -59 age group. The incidence of epilepsy associated with WHO grade Ⅰand Ⅱ glioma was 100.0% (33/33) and 60.9% (14/23), respectively, while that of WHO grade Ⅳ glioma was 19.0%(19/100). The average follow-up time was (22 ± 9) months. During the follow-up period, the incidence of WHO grade Ⅰ, Ⅱ and Ⅲ glioma-related epilepsy decreased significantly. There was no significant difference in the incidence of glioma-related epilepsy between the total and subtotal resection groups ( P>0.05). There was no statistical correlation between the side of tumor occurrence and the occurrence of epilepsy ( P>0.05), also between the gene phenotype and the occurrence of epilepsy ( P>0.05). There was no significant difference in the Engel Outcome Scale among different grades of gliomas ( P>0.05). The prognosis of patients with Engel Outcome Scale Class 1 was significantly better than that of other grades. Conclusions:The incidence of glioma-related epilepsy is negatively correlated with tumor grade. Age and sex are risk factors for glioma-related epilepsy. The incidence of postoperative epilepsy in patients with low grade glioma is significantly lower than that in patients with high grade glioma, and the prognosis is better. However, there is no significant difference in the Engel Outcome Scale among different grades of gliomas.

Objective:To explore the characteristics of theory of mind(TOM) ability of adolescent depressive disorder patients with non-suicidal self-injury (NSSI) behavior, and analyze the relationship between NSSI behavior and TOM, so as to identify patients with NSSI behavioral risk early and give timely intervention.Methods:A total of 54 adolescent patients with depressive disorder who were hospitalized for the first time in Shenzhen Kangning Hospital from May to October 2021 were enrolled.They were divided into NSSI group( n=31)and non-NSSI group( n=23)according to DSM-5.Hamilton anxiety rating scale-14 item (HAMA-14) and Hamilton depression rating scale-17 item(HAMD-17)were used to evaluate the severity of anxiety and depression.Hinting task, Yoni task and reading the mind in the eyes test(RMET) were used to test TOM of the two groups.Binary Logistic regression analysis in SPSS 22.0 was used to explore the influence of TOM ability on NSSI behavior of adolescents with depressive disordor. Results:Compared with patients in non-NSSI group, patients in NSSI had significantly higher scores of HAMA-14(21.48±4.92 vs 16.35±5.61, t=3.57, P<0.05) and HAMD-17(25.61±4.08 vs 21.43±4.64)( t=3.51, P<0.05). The patients in NSSI group had lower scores on the hinting task(16.10±2.84 vs 18.17±1.15, t=-3.68, P<0.05), RMET task (21.61±2.58 vs 23.61±3.07)( t=-2.59, P<0.05), and second-order cognitive TOM((18.90±3.70) vs (20.96±2.72), t=-2.27, P<0.05) and second-order affective TOM(28.84±3.93 vs 31.04±3.04)( t=-2.24, P<0.05) in Yoni task than those in non-NSSI group.Binary Logistic regression analysis showed effective TOM ( β=-0.306, OR=0.736, 95% CI= 0.552-0.982, P=0.037)and cognitive TOM ( β=-0.485, OR=0.616, 95% CI=0.396-0.957, P=0.031) were associated with non-suicidal self-injury in patients with depressive disorder. Conclusion:The increased impairment of the emotional component (decoding component) and cognitive component (reasoning component) of TOM may be risk factors for the occurrence of NSSI behavior in adolescent depressive disorder patients.

Background/Aims: Endoscopic wound suturing is an important factor that affects the ability to remove large and full-thickness lesions during endoscopic resection. We aimed to evaluate the effect of a traction metal clip with a fishhook-like device on wound sutures after endoscopic resection. Methods: From July 2020 to April 2021, patients who met the enrollment criteria were treated with a fishhook-like device during the operation to suture the postoperative wound (group A). Patients with similar conditions and similar size wounds who were treated with a “purse-string suture” to suture the wounds were retrospectively analyzed as the control group (group B). Difference in the suture rate, adverse events, time required for suturing, and number of metal clips were compared between the two groups. Results: The time required for suturing was 7.72±0.51 minutes in group A and 11.50±0.91 minutes in group B. This difference was statistically significant (F=13.071, p=0.001). The number of metal clamps used in group A averaged 8.1 pieces/case, and the number of metal clamps used in group B averaged 7.3 pieces/case. This difference was not statistically significant (F=0.971, p>0.05). Conclusions The traction metal clip with the fishhook-like device is ingeniously designed and easy to operate. It has a good suture effect on the wound after endoscopic submucosal dissection and effectively prevents postoperative adverse events.

Objective:To investigate the effect of ultrasound measurement of optic nerve sheath diameter (ONSD) in adult patients with elevated intracranial pressure (ICP).Method:From June 2017 to March 2020, A total of 64 patients (32 patients with elevated ICP and 32 patients with normal ICP) were placed with invasive intracranial pressure monitoring probe in Beijing Pinggu Hospital. Their ICP and ONSD were continuously monitored. Thirty-two healthy volunteers were recruited as control group to check ONSD. The correlation between ONSD and ICP, and the changes of ICP and ONSD after osmotic therapy were observed.Results:The ONSD in ICP increased group was significantly higher than that in normal ICP group: (5.77 ± 0.3) mm vs. (5.01 ± 0.1) mm, with statistical difference ( P<0.05), and there was a positive correlation between ONSD and ICP. There was no significant difference in ONSD between normal ICP group and control group ( P>0.05). Conclusions:Ultrasound monitoring ONSD can reflect the level of ICP and evaluate the effect of osmotic therapy and the prognosis of patients. Bedside ultrasound examination of optic nerve sheath diameter could be used to judge ICP and to evaluate the curative effect of osmotic therapy, with high clinical application value.

Objective:To evaluate the clinical effect of anterior clinoid process grinding in the treatment of ophthalmic / superior clinoid process aneurysms and sellar tumors.Methods:The clinical data of 16 patients who underwent anterior clinoid process grinding in Sanbo Brain Hospital, Capital Medical University from January 2015 to July 2021 were analyzed retrospectively. There were 1 patient with recurrent craniopharyngioma, 1 patient with recurrent pituitary adenoma, 13 patients with aneurysms, and 1 patient with suprasellar granulosa cell tumor combined with ophthalmic aneurysm of right internal carotid artery. The Modified Rankin Scale (mRS) score was used to evaluate the situation at discharge and in the medium-and-long term.Results:Sixteen patients underwent anterior clinoidprocess grinding. At discharge and the latest follow-up, the mRS scores of the patients were 0-2. A total of 15 aneurysms were treated, and there were no symptoms of visual loss or visual field defect after operation. No cerebrospinal fluid leakage occurred in all patients.Conclusions:The grinding of anterior clinoid process can effectively and fully stretch the optic nerve and internal carotid artery, and can observe the tumor neck at the lower end of pituitary stalk and the ocular segment/superior clinoid process of internal carotid artery under direct vision. It is one of the important auxiliary methods for the treatment of sellar lesions.

Objective:To retrospectively summarize the imaging and clinical features of craniopharyngioma in order to improve the preoperative diagnosis level.Methods:One hundred and twenty-seven patients with craniopharyngioma diagnosed by pathology in Sanbo Brain Hospital, Capital Medical University from March 2019 to June 2021 were selected and the pathological coincidence rate of imaging diagnosis were analyzed.Results:The coincidence rate of MRI diagnosis was 89.3%. The coincidence rate of CT diagnosis was 71.5%. On T 2WI and T 1WI enhanced sequences, the solid portion of the tumor may showed uneven hyperintensity, diffuse striation and spotty hyperintensity. MRI sagittal view was helpful in showing small tumors, but less sensitive to calcification than CT. MRI enhancement was very important, especially for patients with solid lesions. Conclusions:The imaging findings of craniopharyngioma are diverse. Some characteristic manifestations provide important information for the diagnosis and differential diagnosis of craniopharyngioma, which can improve the diagnostic accuracy combined with clinical data.