Transverse sinus is an important pathway of intracranial venous reflux,which is also crucial for maintaining cerebral circulation and stabilizing intracranial pressure.Transverse sinus stenosis(TSS)is the most common variation of transverse sinus,which might lead to changes in sinus hemodynamics and pressure and closely related to idiopathic intracranial hypertension,pulsatile tinnitus and chronic headache.The progresses in imaging researches of transverse sinus stenosis were reviewed in this article.

Objective:To investigate the hemodynamic characteristics of transverse sinus with sigmoid sinus wall dehiscence (SSWD) of pulsatile tinnitus (PT) based on 4D flow MRI.Methods:Retrospective analysis was performed on all patients admitted to Beijing Friendship Hospital, Capital Medical University from January 2019 to January 2021 for dehiscent sigmoid plate pulsatile tinnitus. A total of 26 patients (sides) who met the criteria and underwent 4D flow MRI were included. A total of 26 subjects (46 sides), matched 1∶1 according to gender and age, were included in the normal healthy control group. Nonparametric rank sum test, Student′s t test, and ANOVA were performed by SPSS 19.0 software. Binary Logistic regression was applied to the data with statistical significance. Results:There were more patients with dominant drainage on the affected side in PT group than in control group (73.1% vs. 42.3%). The incidence of transverse with a focal intraluminal filling defect and tapered stenosis was higher than that in control group (21.7% vs. 69.2%; 17.4% vs. 42.3%). Average through-plane velocity and maximum through-plane velocity in PT group were higher than those in control group [(33.75±13.88) cm/s vs. (15.84±7.21) cm/s; (93.19±33.55) cm/s vs. (40.40±14.40) cm/s]. The middle part and proximal end of Flow avg (ml/s) in PT group were larger than those in control group [4.69 (2.87; 5.62) ml/s vs. 2.76 (1.67; 4.99) ml/s; 3.41 (2.16; 5.47) ml/s vs. 2.67 (1.68; 4.41) ml/s]. In control group, the velocity of transverse sinus changed relatively gently, while in PT group, the velocity of proximal sinus increased significantly. Binary Logistic regression showed that SSWD PT was independently correlated with proximal maximum flow velocity [ OR=1.086(1.029-1.146), P=0.003]. Conclusion:4D flow MRI showed that the dominant drainage and higher velocity at the proximal end of the transverse sinus might be an important hemodynamic characteristics of dehiscent sigmoid plate pulsatile tinnitus.

Odontogenic keratocyst(OKC)is a common jaw cyst with a high recurrence rate.OKC combined with basal cell carcinoma as well as skeletal and other developmental abnormalities is thought to be associated with Gorlin syndrome.Moreover,OKC needs to be differentiated from orthokeratinized odontogenic cyst and other jaw cysts.Because of the different prognosis,differential diagnosis of several cysts can contribute to clinical management.We collected 519 cases,comprising a total of 2157 hematoxylin and eosin-stained images,to develop digital pathology-based artificial intelligence(AI)models for the diagnosis and prognosis of OKC.The Inception_v3 neural network was utilized to train and test models developed from patch-level images.Finally,whole slide image-level AI models were developed by integrating deep learning-generated pathology features with several machine learning algorithms.The AI models showed great performance in the diagnosis(AUC=0.935,95%CI:0.898-0.973)and prognosis(AUC=0.840,95%CI:0.751-0.930)of OKC.The advantages of multiple slides model for integrating of histopathological information are demonstrated through a comparison with the single slide model.Furthermore,the study investigates the correlation between AI features generated by deep learning and pathological findings,highlighting the interpretative potential of AI models in the pathology.Here,we have developed the robust diagnostic and prognostic models for OKC.The AI model that is based on digital pathology shows promise potential for applications in odontogenic diseases of the jaw.

Objective:To explore the feasibility and advantages of planned initiation of extracorporeal membrane oxygenation(ECMO)prior to liver transplantation.Methods:From November 2017 to July 2021, clinical data were retrospectively reviewed for 3 liver transplantation recipients assisted by ECMO.There were such preoperative symptoms of right ventricular dysfunction as fatigue, chest tightness and palpitations.In the first case, right heart catheterization was not performed due to patient refusal; another two patients were screened by transthoracic Doppler echocardiography(TDE)and diagnosed through right heart catheterization as portopulmonary hypertension(POPH)and pulmonary hypertension.Results:Three recipients with pulmonary hypertension received catheterization in right femoral artery and vein.After freeing of diseased liver and before blocking inferior vena cava, V-A ECMO support was performed.The dose of heparin was adjusted according to activated clotting time(ACT)and perioperative vital signs remained stable.They were ventilated for 54, 12 and 62 hours and supported by ECMO for 27, 61 and 14 hours.All were smoothly discharged.During a mean follow-up period of 26(9-22)months, liver functions were normal.Conclusions:Patients with end-stage liver disease with pulmonary hypertension should undergo routine TDE examinations during waiting period before liver transplantation.Those with pulmonary hypertension should undergo further right heart catheterization to confirm the diagnosis and severity of the disease.Planned application of ECMO through multidisciplinary consultations can expand surgical indications for liver transplantation, maintain intraoperative hemodynamic stability and facilitate smooth liver transplantation and postoperative patient recovery.

Objective To identify risk factors of perforation in acute appendicitis. Methods Patients with acute appendicitis who underwent surgical treatment from 2016 January to 2017 December were retrospectively reviewed. According to clinical and pathological records, patients were divided into perforation group (including 150 patients) and non-perforation group (including 157 patients). The progress of disease, duration from occurrence to surgery, preoperative highest temperature and pulse rate, and a series of indicators including WBC, NCP, LCP, HCT, CRP, TP through blood routine or biochemical assays. Logistic regression analysis was adopted to analyze the risk factors of perforation were compared. Results Preoperative highest temperature, pulse rate, WBC, NCP, LCP and CRP in perforation and non-perforation group were (37.98 ± 0.54) ℃ vs. (37.58 ± 0.52) ℃, (94.94 ± 20.74) times/min vs. (87.41 ± 15.35) times/min, (15.25 ± 4.71)×109/L vs. (11.04 ± 4.29)×109/L, (83.06 ± 9.84)% vs. (75.27 ± 13.71)%, (11.76 ± 3.73)% vs. (18.23 ± 5.72)%, (89.35 ± 23.10) mg/L vs. (52.16 ± 18.46) mg/L, respectively. There existed significant differences between the two groups (P＜0.05). Logistic regression analysis showed that WBC ( OR＝1.185, 95% CI 1.090-1.280), CRP( OR＝2.043, 95% CI 1.243-2.843), the preoperative highest temperature ( OR＝2.007, 95% CI 1.114-3.616), and pulse rate ( OR＝1.160, 95% CI 1.124-1.196) were risk factors of perforation in patients with acute appendicitis (P＜0.05). The Hosmer-Lemeshow test proved that the predictive accuracy rate of the Logistic model was up to 79.1%. Conclusions WBC, CRP, the preoperative highest temperature and pulse rate are risk factors, which contributes to predict the risk of perforation in patients with acute appendicitis.

Objective To investigate the value of high resolution CT (HRCT) in displaying the anatomic relationship between labyrinth segment of facial canal and cochlea.Methods Totally 110 patients (220 ears) who underwent HRCT were collected.The original images were transferred to workstation for image processing.MPR images were acquired.The anatomic relationship between labyrinth segment of facial canal and cochlea was observed in oblique coronal MPR images.The bony septum between labyrinth segment of facial canal and cochlea was assessed as definite defect (Type Ⅰ),doubtful defect (Type Ⅱ) or complete (Type Ⅲ),respectively.Results There were 71 ears (71/220,32.27％) of Type Ⅰ,diameters of bone fissure ranged from 0.3-1.3 mm (average diameters [0.64±0.26]mm),86 ears (86/220,39.09％) of Type Ⅱ and 63 ears (63/220,28.64％) of Type Ⅲ,with bony septum thickness ranged from 0.3-1.0 mm (average thickness [0.68±0.15]mm).No statistical difference of rates of the above three types was found between different genders,among age groups and between both side of ears (all P＞0.05).Conclusion HRCT is a reliable method to show the anatomic relationship between labyrinth segment of facial canal and cochlea.

Objective To investigate the causes of hypothermia in severe trauma patients as well as the effects of warming nursing.Methods Toally 100 severe trauma patients with hypothermia were engaged in the study during January to December 2014.Their temperature was monitored and recorded,the causes analyzed so that the warming nursing measures were done to them.Results Among the 100 patients,59 contracted hypothermia,with the rate of 59.0％ before operation,28 contracted hypothermia during operation,with the incidence rate of 28.0％.The causes of hypothermia included injury,anaesthesia,exposure and fluid resuscitation.The nursing measures included pre-treatment before anaesthesia,avoidance of more exposure and intraoperative warming.Conclusions For the patients with severe trauma,the hypothermia during the operation can be caused by injury,anaesthesia,exposure and fluid resuscitation.The warming nursing can reduce the incidence of hypothermia so as to increase their survival rate.

Spectrophotometry and single factor test were used in the investigation of effects on extraction results of total flavonoids from the fruit ofVernonia esculenta Hemsl. from aspects of ethanol concentration, frequency of extraction, length of extraction time, and the solid-liquid ratio. The extraction conditions were optimized by orthogonal test. The results showed that the optimum extraction conditions were ethanol concentration of 70%, extracted for 4 times, 1 h for each time, and the solid-liquid ratio of 1:20. Under these extraction conditions, the content of total flavonoids in the fruit ofVernonia esculenta Hemsl. was 103.55 mg·g-1.

Objective To research the clinical outcome of atypical glandular cell (AGC)according to various subtypes of HPV infection and histological pathology results.Methods The data of the liquid-bases cytology (LBP),HPV infection and histology in 102 cases of AGC at the gynecology outpatient department of our hospital from January 1 ,2009 to February 28,2014 were collected and performed the analysis on their clinical outcomes.Results Among 67 218 cases of LBP detection,102 cases were AGC with the total incidence rate of 0.15%.In the cases of AGC-NOS,67 cases were normal or benign lesions,11 cases were precancerous lesion and malignant lesions;in the cases of AGC treading to tumor,the benign,precancerous and malignant lesions were in 7,14 and 3 ca-ses respectively.At the same time in the cases of AGC-NOS,HPV infection was in 64 cases,in which 57 cases were high risk infec-tion(type 16,52,45)and 7 cases were low risk infection(type 6,11 ).The single infection,double infection and multiple infection were in 54,6 cases respectively;in the cases of AGC trends to neoplasm,HPV infection was in 19 cases,in which 18 cases were high risk infection(type 52,16,18)and 1 case was low risk infection(type 6),single infection and double infection were in 15 cases and 4 cases respectively.Conclusion AGC may play an important role for the forecast of cervical malignant lesions.The results of differ-ent HPV subtypes infection in AGC related tumors also play a certain role in the prediction of cervical neoplasia.Their combined a-nalysis is the important signal for judging the occurrence of gynecological cervical precancerous lesion and malignant tumor,i.e., AGC combining with the corresponding HPV subtype infection not only can make a judgement for the cervical lesions,but also pro-vides the basis for predicting the high risk existence of gynecological malignant tumor and provides constructive suggestions for Chi-na regional cervical carcinoma vaccine manufacturing and promotion.

Objective To explore the effective measures for the stability of micro-environmental indicators in clean operating department.Methods Professionals of clean technology were invited to participate in unit operation and maintenance of management.Besides, operating room managers conducted regular sampling analysis of five micro-environmental indicators, including temperature, humidity, differential pressure, illumination and decibel, in 100-level, 1 000-level, 10 000-level, 100 000-level clean operating rooms, and compared the test results with parameters of target environmental indicators regulated in national standards.Then the test results of annual bacteria subsidence from different operating rooms in clean operating department were compared.Results Under the management of professionals, the values of temperature, humidity, differential pressure, illumination and decibel from micro-environment in 100-level, 1 000-level, 10 000-level, 100 000-level clean operating rooms were in accordance with rated values in the industry with ( P>0.05);the annual bacteria subsidence in 100-level, 1 000-level, 10 000-level, 100 000-level clean operating rooms in 2013 was in accordance with the standards specified in GB50333 and clearly less than rated values.Conclusions Professional participating in the management and maintenance of micro-environment in clean operating department and irregular supervision and sampling test by operating room managers, the micro-environmental indicators in operation department can be well controlled.