Objective:To explore the clinical value of computed tomography(CT)with three-dimensional(3D)reconstruction technique in diagnosis and selecting surgical methods for patients with pituitary tumor.Methods:A retrospective analysis was performed on the clinical data of 82 elderly patients with suspected pituitary tumor at Huanggang Central Hospital between January 2021 and December 2023.All of patients underwent CT examination with 3D reconstruction technique and MRI examination.The postoperatively pathological results were used as the golden standard to compare the diagnostic results and efficiency of CT with 3D reconstruction technique and MRI for pituitary tumor.The differences of the two examination methods were compared in images quality.The clinical value of CT with 3D reconstruction technique for the selection of surgical method was further analyzed.Results:In 82 elderly patients with suspected pituitary tumor,56 cases were confirmed by postoperatively pathological examination,and 49 cases were confirmed by CT with 3D reconstruction technique,and 60 cases were confirmed by MRI.The characteristics of CT imaging were:quasi-circular or circular tumors were the majority,which had clear boundaries,and tumors grew to the side of sella turcica and around of the sella turcica,which accompanied by enlarged pituitary fossa.MRI imaging characteristics of pituitary tumors were as follows:the most of them accompanied with equal T1 and slightly high T2 signals,and there was enhancement of obvious ring,and the snowman sign.There was no significant difference in diagnostic accuracy between CT with 3D reconstruction technique and MRI(P>0.05).The diagnostic specificity of CT with 3D reconstruction technique was 96.15%,which was higher than 76.92%of MRI,while its sensitivity was 85.71%,which was lower than 96.43%of MRI,and the differences were statistically significant(x2=4.413,3.953,P<0.05).There were no significant differences in the maximum transverse diameter and maximum vertical diameter of tumors between CT with 3D reconstruction technique and MRI(P>0.05).Compared with the results of CT with 3D reconstruction technique,all of 56 patients with pituitary tumor adopted resection for pituitary tumor through nasal sphenoid approach.After surgery,2 cases occurred diabetes insipidus,and 1 case occurred intracranial infection and 1 case occurred decline in olfactory function.Conclusion:Both CT with 3D reconstruction technique and MRI have higher diagnostic value for pituitary tumors in the elderly,which can display characteristics of pituitary tumors,and have direct guidance roles for the selection of surgical methods.The diagnostic specificity of CT with 3D reconstruction technique is better.

Objective:The association between air pollutants and the risk of sudden cardiac death (SCD) remains controversial. This study aimed to investigate the relationship between five air pollutants—PM 2.5, PM 2.5–10, PM 10, NO 2, and NO?—and the risk of SCD. Methods:We analyzed data from 460 862 participants in the UK Biobank cohort, all enrolled between 2006 and 2010, with no baseline SCD. Follow-up continued until the study endpoint. Annual average concentrations of the five pollutants were assessed. Associations between pollutants and SCD were evaluated using Cox proportional hazards models, followed by Mendelian randomization (MR) to assess causality.Results:Over a mean follow-up of 12.4 years, 2 662 SCD cases were recorded. After adjusting for confounders, no significant associations were found between air pollutants and SCD risk: PM 2.5 ( HR 1.03, 95% CI 0.99–1.07, P = 0.14), PM 2.5–10 ( HR 1.04, 95% CI 1.00–1.08, P = 0.08), PM 10 ( HR 1.01, 95% CI 0.99–1.03, P = 0.26), NO? ( HR 1.00, 95% CI 0.99–1.00, P = 0.26), and NO x ( HR 1.00, 95% CI 1.00–1.01, P = 0.19). MR analysis further supported the absence of causal relationships: PM 2.5 ( β = -0.149, P = 0.90), PM 2.5–10 ( β = 0.387, P = 0.62), PM 10 ( β = -0.994, P = 0.62), NO? ( β = –0.005, P = 0.99), and NO 2 ( β = –0.827, P = 0.25). Conclusions:This study found no evidence linking PM 2.5, PM 2.5–10, PM 10, NO?, or NO 2 to an increased risk of SCD. Mendelian randomization confirmed the lack of causal associations between these pollutants and SCD.

Objective:To explore the clinical value of computed tomography(CT)with three-dimensional(3D)reconstruction technique in diagnosis and selecting surgical methods for patients with pituitary tumor.Methods:A retrospective analysis was performed on the clinical data of 82 elderly patients with suspected pituitary tumor at Huanggang Central Hospital between January 2021 and December 2023.All of patients underwent CT examination with 3D reconstruction technique and MRI examination.The postoperatively pathological results were used as the golden standard to compare the diagnostic results and efficiency of CT with 3D reconstruction technique and MRI for pituitary tumor.The differences of the two examination methods were compared in images quality.The clinical value of CT with 3D reconstruction technique for the selection of surgical method was further analyzed.Results:In 82 elderly patients with suspected pituitary tumor,56 cases were confirmed by postoperatively pathological examination,and 49 cases were confirmed by CT with 3D reconstruction technique,and 60 cases were confirmed by MRI.The characteristics of CT imaging were:quasi-circular or circular tumors were the majority,which had clear boundaries,and tumors grew to the side of sella turcica and around of the sella turcica,which accompanied by enlarged pituitary fossa.MRI imaging characteristics of pituitary tumors were as follows:the most of them accompanied with equal T1 and slightly high T2 signals,and there was enhancement of obvious ring,and the snowman sign.There was no significant difference in diagnostic accuracy between CT with 3D reconstruction technique and MRI(P>0.05).The diagnostic specificity of CT with 3D reconstruction technique was 96.15%,which was higher than 76.92%of MRI,while its sensitivity was 85.71%,which was lower than 96.43%of MRI,and the differences were statistically significant(x2=4.413,3.953,P<0.05).There were no significant differences in the maximum transverse diameter and maximum vertical diameter of tumors between CT with 3D reconstruction technique and MRI(P>0.05).Compared with the results of CT with 3D reconstruction technique,all of 56 patients with pituitary tumor adopted resection for pituitary tumor through nasal sphenoid approach.After surgery,2 cases occurred diabetes insipidus,and 1 case occurred intracranial infection and 1 case occurred decline in olfactory function.Conclusion:Both CT with 3D reconstruction technique and MRI have higher diagnostic value for pituitary tumors in the elderly,which can display characteristics of pituitary tumors,and have direct guidance roles for the selection of surgical methods.The diagnostic specificity of CT with 3D reconstruction technique is better.

PURPOSE: This cone-beam computed tomography (CBCT) study aimed to analyze the anatomical characteristics of alveolar bone at mandibular first molar (MFM) and their implications for immediate implant placement surgery. MATERIALS AND METHODS: 100 patients with 140 MFMs were reviewed retrospectively. We first performed a 3D reconstruction of the patient’s CBCT data to determine a reference plane with ideal implant placement and orientation. The following parameters of MFM region were analyzed: mesial-distal socket size (MDSS), buccal-lingual socket size (BL-SS), root furcation fornix to inferior alveolar nerve (IAN) distance (RF-I), interradicular bone thickness (IRB), mesial/distal root apex to the IAN distance (MRA-I/DRA-I), thickness of the buccal/lingual bone of the mesial root (MR-B/MR-L), thickness of the buccal/lingual bone of the distal root (DR-B/DR-L). RESULTS: The MD-SS of MFM was 8.74 ± 0.76 mm, and the BLSS was 8.26 ± 0.72 mm. The MR-B, DR-B was 1.01 ± 0.40 mm and 1.14 ± 0.50 mm, and the difference was statistically significant (P = .001). The values of the MR-L, DR-L were 2.71 ± 0.78 mm and 3.09 ± 0.73 mm, and the difference was also statistically significant (P < .001). The mean distance of RF-I was 15.68 ± 2.13mm, and the MRA-I was 7.06 ± 2.22 mm, which was greater than that of DRA-I (6.48 ± 2.30 mm, P < .001). The IRB at 2 mm, 4 mm apical from the furcation fornix, and at apex level was 2.81 ± 0.50 mm, 3.30 ± 0.62 mm, and 4.44 ± 1.02 mm, respectively. CONCLUSION There is relatively sufficient bone mass in interradicular bone in height, but an adequate width is lacking for the bone between the mesial and distal root after the extraction of the MFM for immediate implantation. The thickness of the MFM buccal bone is relative thin, especially for the mesial root.

Objective: To investigate the relationship between health literacy and sports injuries among high school students with athletic specialization, so as to provide theoretical basis for the intervention of sports injury occurrence of sports special students. Methods: A total of 443 high school students with athletic specialization aged 16-18 years old from 21 urban and rural areas in Shangrao City, Ganzhou City and Nanchang City of Jiangxi Province were selected by convenient sampling method from March to April 2023, and the health literacy and sports injury incidence were investigated. The assessment of sports injury was based on the Monitoring Method of Child and Adolescent Injury, and the assessment of health literacy level was conducted using the Interactive Health Literacy Questionnaire of Chinese Adolescents. χ 2 test was used to compare the reported rate of sports injuries among the demographic and sports training groups and the correlation between health literacy and sports injuries. Binary Logistic regression analysis was used to infer the correlation between the health literacy level of high school students with athletic specialization and the occurrence of sports injuries. Results: The prevalence of sports injury was 49.4% in high school students with athletic specialization. Binary Logistic regression analysis showed that the risk of sports injury of high school students with athletic specialization with medium and low level of health literacy was significantly increased compared with high level (medium level: OR = 1.98,95% CI =1.12-3.51; low level: OR =2.08, 95% CI =1.18-3.68), high school students with athletic specialization in low level of health awareness of sports injury risk was higher than other dimensions of health literacy level (middle level: OR =2.77, 95% CI =1.48-5.19; low level: OR =2.01, 95% CI =1.04-3.88)( P <0.05). The results of stratified analysis showed that among male students with athletic specialization and students with track and field, students with moderate/low overall health literacy had a higher risk of sports injuries compared to high level students (male students: low level, OR =2.46, 95% CI =1.15-5.28; track and field: intermediate level, OR =2.17, 95% CI =1.06-4.43, low level, OR =2.09, 95% CI =1.02-4.30; P <0.05). Conclusions There is a correlation between the health literacy level of high school students with athletic specialization and the occurrence of sports injuries. Students health awareness should be improved to reduce the risk of sports injuries.

At present, there are still some problems in the standardized residency training. Some standardized training bases often regard the resident trainees as ordinary practitioners, and devote their time and energy to the daily medical procedural work without giving enough training and teaching, ignoring the basic skills training of resident trainees. Therefore, this study constructed an active knowledge push system based on business scenarios. The system mainly includes three parts: sensitive operation identification layer, knowledge index layer and resource push layer in order to cultivate the norms of diagnosis and treatment of standardized training students and reasonably solve the problem of inconvenient resource acquisition in clinical work. Through the preliminary application, it was found that the system has effectively improved the mini-clinical evaluation exercise (Mini-CEX) score of the trainees and achieved good results.

BACKGROUND: Postoperative cholangitis is a common but severe complication after Kasai portoenterostomy for biliary atresia (BA). This study aimed to identify its prognostic factors. METHODS: Two sets of liver paraffin-embedded tissue samples were collected from BA patients who received Kasai portoenterostomy (n = 25 and n = 31, respectively). Patients were divided into non-cholangitis and cholangitis groups. The infiltration of CD4+, CD8+, CD45RO+, CD68+ cells and expression of Beclin1 were quantitatively evaluated in immunohistochemical analysis. RESULTS: Cholangitis group had a significantly lower CD8+ T cell infiltration but a higher CD45RO+ cell infiltration, and a lower Beclin1 level than non-cholangitis group (all P < 0.01). Multivariate logistic regression analysis indicated that infiltration of CD8+ cells (odds ratio [OR], 0.112; 95% confidence interval [CI], 0.022–0.577) and CD45RO+ cells (OR, 3.88; 95% CI, 1.37–11.03), and Beclin1 level (OR, 0.088; 95% CI, 0.018–0.452) were independent influence factors for early postoperative cholangitis. Receiver operating characteristic (ROC) analysis showed that area under ROC curve (AUROC) values for CD8+ cells, CD45RO+ cells and Beclin1 were 0.857, 0.738 and 0.900, respectively. CONCLUSION: Our findings demonstrated the CD8+ cells, CD45RO+ cells and Beclin1 level possessed the prognostic value for early postoperative cholangitis following Kasai operation, which may be helpful to develop new prevention and treatment strategies for postoperative cholangitis.
Biliary Atresia* ; Cholangitis* ; Humans ; Liver ; Logistic Models ; ROC Curve ; T-Lymphocytes*

Objective To observe the acute pain service for analgesia effect and complications of postopera-tive analgesia and satisfaction after cesarean section.Methods 360 patients undergoing cesarean section and postop-erative continue analgesia were randomly divided into two groups.The control group (group C,n =178)was given with routine postoperative self -control analgesia give guidance.In the observation group (group A,n =182),a group for acute pain was founded,and the patients were explained about PCA self -control analgesia related knowledge before operation,together with the APS analgesia group people,the patients were given with postoperative pain management,observed self -control analgesia efficacy and side effects,and gives the corresponding treatment and guidance.The difference of analgesia incomplete and complication were observed such as nausea and vomiting,calm, itchy skin.Questionnaires that postoperative analgesia satisfaction survey were filled inafter discharged.The satisfac-tion of nurse with the APS were observed.Results Postoperative analgesia complication in group A were significantly lower than that in group C(P <0.01,P <0.05),APS analgesic incomplete in group C was significantly higher than groupA (χ2 =11,P <0.01).The satisfaction of PCA in group A were significantly higher than group C (P <0.01, P <0.05),ward nurses job satisfaction also increased significantly (t =2.63,P <0.05).Conclusion Acute pain service effectively improve analgesic quality and reduce related complications after cesarean section increase patients postoperative analgesia satisfaction,increase the ward nurses job satisfaction.

Objective To explore the mechanism of the rat hyperplasia suppressor gene (rHSG) inhibited proliferation in C6 rat glioma cells. Methods C6 cells were cultured in vitro and transduced with the adenovirus vector which carried rHSG gene (Adv-rHSG-GFP). The transduction efficiency of adenovirus vector was measured by inverted microscope and flow cytometry in C6 cells. Flow cytometry was used to analyze the C6 cells cycle. Western blot was adopted to test the change of rHSG protein expression, the protein of cancer suppressor gene P53, cell cycle control protein of P21cip1, phosphorylation and non-phosphorylation retinoblastoma proteins (p-Rb, Rb). Results The adenovirus can insert the target gene into the genome of C6 target cell efficiently. The expression level of rHSG protein of Adv-rHSG-GFP group is obviously higher than that of PBS Group and Adv-GFP group. Meanwhile, the over-expressed C6 cells of rHSG that arrest in G0/G1 phase are largely increased (P < 0.01). Besides, there is a large increase in the protein expression of P53 and P21cip1 (P < 0.01), decrease in the expression of p-Rb (P < 0.01) and no significant change in the expression of Rb (P < 0.05). Conclusion rHSG might inhibit the proliferation of C6 rat glioma cells through P53-P21cip1 pathway.

Objective To evaluate the effect of electrical stimulation of the pelvic floor muscles combined with bladder training on urinary dysfunctionafter incomplete spinal cord injury.Methods Sixty-two incomplete spinal cord injury patients who had received an operation between November 2009 and December 2014 were enrolled and divided randomly into a control group (n=32) and a treatment group (n =30).Both groups were treated with conventional intermittent catheterization,while the treatment group was additionally given electrical stimulation of the pelvic floor muscles combined with bladder training.The residual urine volume was recorded before and after the treatment.Uurodynamic examinations were conducted,and the rate of successful catheter extraction and of urinary tract infection on the 15th and 30th day of treatment,were recorded and analyzed.Results All of the patients were followed-up for an average of 18.5 months.Significant improvement was observed in the residual urine volume,the maximum or average urinary flow rate,and the detrusor pressure at peak flow of both groups.However,at the end of follow-up the treatment group recorded significantly better results on all these measures than the control group.The successful catheter extraction rate of the treatment group (96.7％) was significantly higher than that of the control group and their average number of catheterization days was significantly fewer.The urinary tract infection rates on the 15th and 30th day of treatment were 16.7％ and 6.7％ in the treatment group,significantly lower than in the control group.Conclusions Electrical stimulation of the pelvic floor combined with bladder training significantly improves urination function after an operation for incomplete spinal cord injury,decreases the days of catheterization and lowers the rate of urinary tract infection.Such combined therapy is worth promoting in clinical practice.