Objective:To investigate intraoperative pathological findings and the interventional effects of "deep cervical lymphaticovenous anastomosis+" (dcLVA+) on deep cervical lymphatic drainage as well as the blood flow of carotid artery and jugular vein in elderly patients with cognitive impairment, and to put forward the thoughts based on the findings from the surgery.Methods:Between May 2024 and December 2024, retrospective analysis of Microsurgery Hospital, Fengcheng Hospital, Xi'an Medical College performed dcLVA+ between the deep cervical lymphatics or lymph nodes and jugular veins in 50 elderly patients with cognitive impairment (19 males and 31 females, aged 55-88 years with 69.94 years in average). Nine patients were found with Clinical Dementia Rating (CDR) score at 1 (mild), 7 with CDR score at 2 (moderate) and 34 with CDR score at 3 (severe). Intraoperative observations based on literature reviews had identified anatomical relationships between the lymphatic sacs containing cervical lymphatic chain and the carotid sheath. The lymph node count, size, distribution, thickness of fat tissue and conditions of lymphatic vessels were documented. Ultrasound was used to compare the blood flow of carotid artery and jugular vein as well as the cross-sectional areas at the planes of hyoid and cricoid cartilage before and after the closure of incisions under anaesthesia in 39 patients. Correlation analyses for Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCa), Activities of Daily Living (ADL) and Agitation behavior score before and 1 week after surgery were performed using Spearman's correlation and Wilcoxon paired tests. P<0.05 was considered statistically significant. Postoperative follow-ups were conducted via the visit of outpatient clinic and WeChat and telephone interviews. Results:In surgery, the cervical lymphatic chain was found running within an almost enclosed sac surrounding the carotid sheath. There were enlarged lymph nodes, increased fat deposition, lymphatic dilation or fibrosis in the sac. The preoperative blood flow in the carotid artery at the planes of hyoid and cricoid cartilage in the 39 patients was recorded at 150.52 ml/min±40.33 ml/min and 358.29 ml/min±129.30 ml/min, while that in the jugular vein was at 172.50 ml/min±63.94 ml/min and 317.00 ml/min±105.21 ml/min, respectively, both were far lower than the normal blood flow. There were statistically significant differences in the blood flow of carotid artery and jugular vein before and after surgery ( P<0.01). It was found that the preoperative blood flow of the internal carotid artery at the plane of hyoid was positively correlated with the preoperative scores of MMSE ( P<0.01), MoCa ( P<0.05) and ADL ( P<0.01). The blood flow of the common carotid artery at the plane of cricoid cartilage was found significantly and positively correlated with the preoperative scores of MMSE ( P<0.05). It was also noted that the blood flow of the internal carotid artery at the plane of hyoid was significantly and positively correlated with the postoperative ADL ( P<0.01) but negatively correlated with the Agitation behavior score ( P<0.05). The blood flow of the common carotid artery at the plane of cricoid cartilage was significantly and positively correlated with the postoperative scores of MMSE and MoCa ( P<0.05). The blood flow of the internal jugular vein at the plane of hyoid was negatively correlated with the Agitation behavior score ( P<0.01). The cross-sectional area of carotid artery at the plane of left hyoid was significantly and positively correlated with the MMSE score ( P<0.05). Statistically significant differences were observed in MMSE, MoCa, ADL and Agitation behavior score before and after surgery ( P<0.01). Conclusion:dcLVA+ shows a certain therapeutic benefit to the elderly patients with cognitive impairment. The intraoperatively observed pathological changes in cervical lymphatic sacs affect deep cervical lymphatic drainage and the blood flow of carotid artery and jugular vein. Further studies are necessary to find out whether the findings from this study would be the specific pathological changes and the morbidity mechanisms among the elderly patients with cognitive impairment.

Objective:To provide theoretical basis for exploring risk factors for injuries and formulating preventive measures by studying the epidemiological characteristics of injuries in specific populations based on the pre-hospital emergency data.Methods:A retrospective analysis was conducted on injury cases of children and adolescents treated by the Zhengzhou Emergency Medical Rescue Center（120）over the past five years.Analyzed factors related to injuries such as age，gender，injury type，location of call，and time of call.Results:Over the past five years，there were a total of 22 160 pre-hospital emergency injury patients in Zhengzhou，including 22 059 cases whose information were complete.The median age was 13（2，17）years-old，with the highest proportion being 13-18 years-old，accounting for 11 515 cases（52.5%）.The top three types of injuries were trauma 10 094（45.8%），followed by traffic accidents 9 465（42.9%），and poisoning 2 080（9.4%）.Trauma mainly occurred from 17:00 to 22:00，traffic injuries mainly occurred from 17:01 to 20:00，12:01 to 15:00，and 07:01 to 08:00，while poisoning mainly occurred from 20:01 to 03:00 the next day.Trauma was most common in May，September，and November，and least common in January to March；traffic injuries were most common from June to August，and least common from December to February；there was no significant difference in the distribution of poisoning by month.The main call locations for injuries were residential areas，roads，recreational places，and schools.Conclusion:Pre-hospital emergency data of injury patients can supplement research data on injuries.The injury among children and adolescents requires attention from society and families.

Objective:To investigate intraoperative pathological findings and the interventional effects of "deep cervical lymphaticovenous anastomosis+" (dcLVA+) on deep cervical lymphatic drainage as well as the blood flow of carotid artery and jugular vein in elderly patients with cognitive impairment, and to put forward the thoughts based on the findings from the surgery.Methods:Between May 2024 and December 2024, retrospective analysis of Microsurgery Hospital, Fengcheng Hospital, Xi'an Medical College performed dcLVA+ between the deep cervical lymphatics or lymph nodes and jugular veins in 50 elderly patients with cognitive impairment (19 males and 31 females, aged 55-88 years with 69.94 years in average). Nine patients were found with Clinical Dementia Rating (CDR) score at 1 (mild), 7 with CDR score at 2 (moderate) and 34 with CDR score at 3 (severe). Intraoperative observations based on literature reviews had identified anatomical relationships between the lymphatic sacs containing cervical lymphatic chain and the carotid sheath. The lymph node count, size, distribution, thickness of fat tissue and conditions of lymphatic vessels were documented. Ultrasound was used to compare the blood flow of carotid artery and jugular vein as well as the cross-sectional areas at the planes of hyoid and cricoid cartilage before and after the closure of incisions under anaesthesia in 39 patients. Correlation analyses for Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCa), Activities of Daily Living (ADL) and Agitation behavior score before and 1 week after surgery were performed using Spearman's correlation and Wilcoxon paired tests. P<0.05 was considered statistically significant. Postoperative follow-ups were conducted via the visit of outpatient clinic and WeChat and telephone interviews. Results:In surgery, the cervical lymphatic chain was found running within an almost enclosed sac surrounding the carotid sheath. There were enlarged lymph nodes, increased fat deposition, lymphatic dilation or fibrosis in the sac. The preoperative blood flow in the carotid artery at the planes of hyoid and cricoid cartilage in the 39 patients was recorded at 150.52 ml/min±40.33 ml/min and 358.29 ml/min±129.30 ml/min, while that in the jugular vein was at 172.50 ml/min±63.94 ml/min and 317.00 ml/min±105.21 ml/min, respectively, both were far lower than the normal blood flow. There were statistically significant differences in the blood flow of carotid artery and jugular vein before and after surgery ( P<0.01). It was found that the preoperative blood flow of the internal carotid artery at the plane of hyoid was positively correlated with the preoperative scores of MMSE ( P<0.01), MoCa ( P<0.05) and ADL ( P<0.01). The blood flow of the common carotid artery at the plane of cricoid cartilage was found significantly and positively correlated with the preoperative scores of MMSE ( P<0.05). It was also noted that the blood flow of the internal carotid artery at the plane of hyoid was significantly and positively correlated with the postoperative ADL ( P<0.01) but negatively correlated with the Agitation behavior score ( P<0.05). The blood flow of the common carotid artery at the plane of cricoid cartilage was significantly and positively correlated with the postoperative scores of MMSE and MoCa ( P<0.05). The blood flow of the internal jugular vein at the plane of hyoid was negatively correlated with the Agitation behavior score ( P<0.01). The cross-sectional area of carotid artery at the plane of left hyoid was significantly and positively correlated with the MMSE score ( P<0.05). Statistically significant differences were observed in MMSE, MoCa, ADL and Agitation behavior score before and after surgery ( P<0.01). Conclusion:dcLVA+ shows a certain therapeutic benefit to the elderly patients with cognitive impairment. The intraoperatively observed pathological changes in cervical lymphatic sacs affect deep cervical lymphatic drainage and the blood flow of carotid artery and jugular vein. Further studies are necessary to find out whether the findings from this study would be the specific pathological changes and the morbidity mechanisms among the elderly patients with cognitive impairment.

Objective To discuss the application of ankle pump exercise with colorful ring counting command in improving the blood hypercoagulable state in patients after hepatic arterial infusion chemotherapy(HAIC).Methods A total of 105 patients,who received HAIC at the Interventional Department of a certain Grade A general hospital in Fujian Province of China from January to December of 2023,were collected.The 53 patients who received treatment from January to June of 2023 were used as the control group,and the other 52 patients who received treatment from July to December of 2023 were used as the study group.The postoperative routine nursing and ankle pump exercise was employed for the patients of the control group,while ankle pump exercise with colorful ring counting command on the basis of postoperative routine nursing was carried out for the patients of the study group.The resting status of popliteal vein,the maximum and average systolic blood flow velocity at the end of exercise,the changes in coagulation index,the incidence of deep vein thrombosis,and the compliance of ankle pump were compared between the two groups.Results There were no statistically significant differences in the resting popliteal vein blood flow velocity and incidence of deep vein thrombosis between the two groups(P＞0.05).The maximum and average popliteal vein blood flow velocity at the end of exercise in the study group were higher than those in the control group.The levels of PT,APTT,FBG,TT and D-dimer(D-D)at 72 hours after HAIC were lower than those in the control group(all P＜0.05),and the compliance of ankle pump exercise in the study group was better than that in the control group(P＜0.05).Conclusion Ankle pump exercise with colorful ring counting command can accelerate lower limb blood flow velocity,improve the blood hypercoagulable state,and improve compliance with ankle pump exercise in patients after receiving HAIC.

Objective:To explore the effects and mechanisms of Shen-su-yin (SSY) on acute lung injury (ALI) in rats based on untargeted Metabolomics, network pharmacology, and experimental verification.Methods:Untargeted Metabolomics was performed to detect the ingredients of SSY by using ultra-high performance liquid chromatography-Q-exactive orbitrap mass spectrum, and the active ingredients were screened from the detected ingredients. Common targets of the active ingredient targets and ALI targets were utilized to screen hub targets to perform gene ontology (GO) and Kyoto encyclopedia of genes and genomes (KEGG) enrichment analysis. Then, key hub targets were selected from the hub targets, and the active ingredients-hub targets network was built to screen core ingredients. Subsequently, molecular docking was performed between the key hub targets and the core ingredients. 48 rats were randomly and equally divided into 4 groups by using a random number table: normal control group, lipopolysaccharide-induced ALI group, ALI+SSY group, and ALI+dexamethasone group. 24 hours after lipopolysaccharide induction, the levels of respiratory rate, blood lactate, lung wet/dry weight ratio, ALI score, inflammatory factors of bronchoalveolar lavage fluid, and oxidative stress mediators of lung tissue in each group were evaluated, and the expression of phosphatidylinositol 3-kinase (PI3K)-protein kinase B (AKT)-glycogen synthase kinase (GSK) 3β-nuclear factor erythroid 2-related factor 2 (Nrf2)/nuclear factor (NF)-κB signaling pathway was also detected by using Western blot. Finally, one-way analysis of variance, Welch test, or Kruskal-Wallis H test was used to compare data differences among groups. Results:A total of 415 ingredients were detected from the SSY. 66 of the detected ingredients were identified as active ingredients, and 10 of them were selected as core ingredients. The number of common targets, hub targets, and key hub targets was 337, 50, and 10, respectively. Total of 285 biological processes, 32 cellular components, and 51 molecular functions were enriched though GO analysis, and 148 cell signaling pathways such as pathways in cancer and PI3K-AKT signaling pathway were enriched though KEGG analysis. Molecular docking studies revealed that all binding energies between the 10 key hub targets and the 10 core ingredients were less than -5 kcal/mol. Compared with the ALI group, the levels of the respiratory rate, blood lactate, and lung wet/dry weight ratio in ALI+SSY group were significantly decreased (all P<0.01), and the level of ALI score showed a downward trend, but the difference was not statistically significant ( P>0.05). In addition, the levels of interleukin-6, interleukin-1β, and tumor necrosis factor-α in bronchoalveolar lavage fluid and the levels of malondialdehyde, protein carbonyl, and 8-hydroxy-2-deoxyguanosine in lung tissue of rats in ALI+SSY group were significantly decreased in comparison with those in ALI group (all P<0.01). Moreover, compared with the ALI group, the phosphorylation levels of PI3K p85α, AKT1, and GSK3β and the expression level of Nrf2 in lung tissue of ALI+SSY group were significantly up-regulated (PI3K p85α phosphorylation and AKT1 phosphorylation, P<0.01; GSK3β phosphorylation and Nrf2, P<0.05), while the phosphorylation level of NF-κB p65 was significantly down-regulated ( P<0.01). Conclusions:Active ingredients detected from SSY via untargeted Metabolomics can inhibit oxidative stress and inflammation in ALI rats by regulating the PI3K-AKT-GSK3β-Nrf2/NF-κB signaling pathway, thereby alleviating lung lesions.

Objective To investigate the influence of repeated open field tests， novel object recognition tests， and Barnes maze behavioral tests within a short term on cognitive and anxiety assessment in 3xTg-AD mice.Methods Four groups of 3xTg-AD mice， aged 12 months， were obtained using different pretreatment regimens， and the mice in the experimental groups 1-3 were treated with different drugs， while those in the control group were treated with normal saline. The open field test， the novel object recognition test， and the Barnes maze test were performed on mice successively. A behavioral video analysis system was used to record the locomotor trajectories of the mice and analyze the parameters such as time spent in the central area， exploration time for novel versus familiar objects， and latency to reach the target hole. After one session of complete tests， three sessions were performed repeatedly， and all tests were completed within one month.Results With the increase in the number of repeated tests， there was a significant reduction in the time spent in the central area in the open field test （P<0.05）； in the novel object recognition test， there was an increase in the coefficient of variation for object recognition index and a reduction in exploratory behavior towards both the new environment and the novel objects； in the Barnes maze test， there was no significant difference in the latency to reach the target hole across the four tests， suggesting good reproducibility.Conclusion Repeated tests within a short term can interfere with the evaluation of anxiety status in 3xTg-AD mice in the open field test and their preference for novel objects in the novel object recognition test， but it has no obvious influence on the latency to reach the target hole in the Barnes maze test. Whether behavioral tests can be performed repeatedly in 3xTg-AD mice should be determined based on different tests.

ObjectiveTo explore the effects of the Tai Chi training on bone density， bone turnover markers， and heart rate variability for people with high-risk osteoporosis， and to provide evidence for the prevention of osteoporosis at early stage. MethodsSixty-six cases of people with high risk of osteoporosis were included， and they were divided into 33 cases each in the intervention group and the control group using the random number table method. The control group received osteoporosis health education three times a week， and the intervention group received Tai Chi training under the guidance of a trainer three times a week for 40 mins each time on the basis of the control group， and both groups were intervened for 12 weeks. Dual-energy X-ray absorptiometry was used to measure the bone density of L₁~L₄ vertebrae， bilateral femoral necks and bilateral total hips in the two groups before and after the intervention； enzyme-linked immunosorbent assay was used to determine bone turnover markers before and after the intervention， including pro-collagen type Ⅰ pro-amino-terminal prepropyl peptide （P1NP） and β-collagen type Ⅰ cross-linking carboxy-terminal peptide （β-CTX）. Seven cases with good compliance in the intervention group were selected. After wearing the heart rate sensor， they successively performed Tai Chi training and walking activities recommended by the guideline for 20 mins each， and the heart rate variability （HRV） during exercise was collected， including time-domain indexes such as standard deviation of normal sinus intervals （SDNN）， root-mean-square of the difference between adjacent RR intervals （RMSSD）， frequency-domain metrics such as low-frequency power （LF）， high-frequency power （HF）， and low-frequency/high-frequency power ratio （LF/HF）， as well as nonlinear metrics such as approximate entropy （ApEn）， sample entropy （SampEn）. ResultsFinally， 63 cases were included in the outcome analysis， including 30 cases in the intervention group and 33 cases in the control group. After the intervention， the differences of L₁~L₄ vertebrae， bone density of bilateral femoral neck and bilateral total hip in the intervention group were not statistically significant when compared with those before intervention （P＞0.05）， while the bone density of all parts of the control group decreased significantly compared with that before intervention （P＜0.05）， and the difference in the bone density of the L₁~L₄ vertebrae， bilateral femoral neck， and the right total hip before and after the intervention of the intervention group was smaller than that of the control group （P＜0.05）. The differences in P1NP and β-CTX between groups before and after intervention was not statistically significant （P＞0.05）. Compared with walking exercise， LF decreased， HF increased and LF/HF decreased during Tai Chi exercise （P＜0.05）； the time domain indexes and non-linear indexes between groups had no statistically significant difference （P＞0.05）. ConclusionTai Chi exercise can maintain lumbar， hip， and femoral bone density and improve sympathetic/parasympathetic balance in people at high risk for osteoporosis， but cannot significantly improve bone turnover markers.

Objective To analyze the activity concentrations of gross α, gross β, and radionuclides in atmospheric fallout around Daya Bay Nuclear Power Plant from 2019 to 2022, and provide foundational scientific data for the healthy development of nuclear energy. Methods Five monitoring sites were set up at different distances (1.2, 6.9, 12.4, 42.3, and 69.2 km) from Daya Bay Nuclear Island 1. Stainless steel sampling barrels were used to collect atmospheric fallout, with a monitoring cycle of three months. The collected samples were ashed using radiochemical method. Subsequently, the gross α and gross β radioactivity were quantified using a low-background α/β measurement instrument. The remaining ash samples were mixed with water and left to equilibrate for over three weeks before γ-nuclide analysis using a low-background, high-purity germanium γ-spectrometer. Results The gross α activity concentration in atmospheric fallout around Daya Bay Nuclear Power Plant from 2019 to 2022 averaged (25.3 ± 10.6) Bq/m²/season and ranged from 5.8 to 73.4 Bq/m²/season. The gross α activity concentrations in sampling sites #1 to #5 were 5.8-34.4, 11.9-35.2, 14.4-46.4, 7.2-73.4, and 13.1-43.1 Bq/m²/season, respectively. The gross β activity concentration averaged (50.5 ± 23.4) Bq/m²/season and ranged from 13.9 to 139.3 Bq/m²/season. The gross β activity concentrations of sampling sites #1 to #5 were 17.1-107.4, 17.6-87.5, 25.8-102.0, 13.9-139.3, and 23.4-99.2 Bq/m²/season, resprctively. The activity concentrations of ²³⁸U, ²²⁶Ra, ²³²Th, ⁴⁰K, ²¹⁰Pb, and ⁷Be in atmospheric fallout were < lower limit of detection (LLD)-4.2, < LLD-5.8, < LLD-6.3, < LLD-42.1, < LLD-514.0, and 35.7-1761.0 Bq/m²/season, respectively. Gross α and gross β activity concentrations were significantly positively correlated with ²¹⁰Pb activity concentration (r=0.770, α < 0.001; r=0.882, α < 0.001, respectively). Gross β activity concentration showed a significant positive correlation with ⁷Be (r=0.833, α < 0.001). The activity concentrations of ⁵⁴Mn, ⁵⁷Co, ⁵⁸Co, ⁶⁰Co, ⁵⁹Fe, ⁹⁵Zr, ¹⁰³Ru, ¹⁰⁶Ru, ^110mAg, ¹³¹I, ¹³⁴Cs, ¹³⁷ Cs, ¹⁴⁰Ba and ¹⁹²Ir were lower than the LLD of the instrument, and no artificial radionuclides were detected. Conclusion The gross α and gross β radioactive activity concentrations in the atmospheric fallout in the surrounding area of Daya Bay Nuclear Power Plant during 2019-2022 were affected by natural radionuclides ²¹⁰Pb and ⁷Be, and were in the normal fluctuation ranges. No artificial radionuclides were found in the atmospheric fallout, and the Daya Bay Nuclear Power Plant was in a safe and stable state of operation.

Objective To investigate indoor radon concentrations and environmental cumulative doses in residential and office units in Shenzhen, and estimate the average annual effective dose, and to provide data for assessing public health risks. Methods Within the 11 administrative districts of Shenzhen (including the Shenzhen-Shanwei Special Cooperation Zone), 17 residential units and 3 office units were randomly selected as monitoring sites in each district. The units selected represented buildings of different ages and various floors on which the units were located. Radon detectors and environmental cumulative dosimeters were deployed for monitoring. Results The indoor radon concentrations in Shenzhen during the two monitoring periods were (36.6 ± 16.5) Bq/m³ and (19.8 ± 15.3) Bq/m³, respectively. The environmental cumulative doses for the two monitoring periods were (0.33 ± 0.07) mSv and (0.25 ± 0.04) mSv, respectively. The estimated average annual effective dose due to indoor radon in Shenzhen was 0.92 mSv. Conclusion All monitored indoor radon concentrations in Shenzhen were below the national standard of China. The indoor radon concentrations exhibited significant regional variations, were higher in spring than in summer, and showed no statistically significant differences across buildings of different ages or units of various floors. The trends in indoor radon concentrations and environmental cumulative doses were highly consistent. The average indoor radon concentration in Shenzhen was lower than both the global and national levels, indicating a low risk of internal radiation exposure from radon.

Objective:To improve the understanding of acute lymphoblastic leukemia (ALL) secondary to Burkitt lymphoma (BL) in children.Methods:The clinical data of a child with ALL secondary to BL who was admitted to Children's Hospital Affiliated to Zhengzhou University in June 2024 were retrospectively analyzed, and the relevant literature was reviewed.Results:The patient was a boy with the age of 8 years and 8 months. He presented with a neck mass at the age of 4 years and 6 months, and pathological examination revealed a diagnosis of BL with clinical stage Ⅲ. The patient was given regular chemotherapy according to the Chinese Children's Lymphoma Group non-Hodgkin lymphoma mature B-cell 2017 protocol-B2 regimen. PET-CT showed recurrence of lymphoma in 6 months after the suspension of treatment. The patient was given with placement of 125I particles, oral etoposide and dexamethasone, and traditional Chinese medicine. The patient was admitted to hospital at the age of 8 years and 8 months with fever and skin hemorrhagic spots, bone marrow morphology, immunology, cytogenetics and molecular biology typing indicated a diagnosis of B-ALL with TCF3::PBX1 fusion gene. The patient received induction chemotherapy according to the Chinese Children's Leukemia Group-ALL 2018 protocol. A review of bone marrow cytology achieved complete remission on the 33rd day of chemotherapy, and minimal residual disease detected by flow cytometry indicated less than 0.01%. TCF3::PBX1 fusion gene was negative. Conclusions:ALL secondary to BL in children is rare, and the ALL treatment regimens are effective.