Objective:To investigate the expression and role of DEAD-box RNA helicases 5(DDX5 helicases)in head and neck squamous carcinoma(HNSCC).Methods:Tissue microarray microarray was used to assess relevant mRNA expression profile data,and R software was used to screen differential mRNAs(DEGs).The expression level of DDX5 was predicted using GEPIA 2,TCGA databases,and detected by immunohistochemistry,western blot and RT-qPCR in the HNSCC tissue and cell lines.Based on high-throughput sequencing data of DECs,differentially expressed miRNAs(DEMIs)relevant DDX5 competitive endogenous RNA network(ceRNA)was constructed.The software cytoscape was used to visualize the ceRNA network map and further screen the regulatory ax-is.Results:The results of microarray screening revealed that DDX5 expression in HNSCC was upregulated.Immunohistochemistry ver-ified that DDX5 was stronger expressed in the nuclei of squamous carcinoma cells.qPCR results suggested that significant expression of DDX5 mRNA at the tissue and cellular levels(P＜0.05).Western blot results showed high expression of DDX5 protein in the tissues.The ceRNA network was constructed,from which the relevant HNSCC axis circRNA-039626-miR-222-5p-DDX5 was identified.Con-clusion:DDX5 is highly expressed in HNSCC,and the circRNA-039626-miR-222-5p-DDX5 axis may be a potential regulatory axis for the development of HNSCC.

In recent years,with the rapid development of minimally-invasive interventional therapy technology,the effectiveness of neurointerventional therapy through radial artery puncture has been highlighted in clinical application.Compared with the commonly-used femoral artery puncture,transradial access can let the patients have a better comfort and willingness to accept the operation,which can also reduce postoperative complications and improve the quality of diagnosis and treatment.However,the perioperative nursing measures have always been based on the measures used in coronary interventional therapy,the nursing measures of neurointerventional therapy are still in the experience summary stage,and there is still a lack of unified,normative and guiding documents for formulating the clinical nursing care.This paper reviews the perioperative nursing measures of neurointerventional procedures via radial artery puncture,focusing on the advantages of radial artery puncture approach,the key points of preoperative care assessment,the intraoperative nursing strategy,the prevention and treatment of postoperative complications,etc.so as to provide evidence-based references for clinical nursing practice.

With the development of interventional technology and the innovation of interventional instruments,neurointerventional surgery has become one of the treatments for cerebrovascular diseases.Neurointervention has the advantages of less trauma,quick recovery and fewer complications.However,due to the complexity of cerebrovascular diseases and the vascular bending and variation,neurointerventional procedures often take a long time and require general anesthesia,which makes patients prone to hypothermia during surgery.At present,clinical studies on intraoperative hypothermia mainly focus on the surgical general anesthesia,and there are few studies related to hypothermia occurring in neurointerventional procedures,to which the clinical attention has not been highly paid.This paper aims to make a comprehensive review about the hypothermia during surgery,focusing on the effect of hypothermia on the body,the characteristics of neurointerventional therapy,the causes of hypothermia,and the prevention and treatment measures of intraoperative hypothermia,so as to provide reference for the medical staff working in the neurointerventional therapy department.

BackgroundSleep disorder can adversely affect human physical and mental health， with important implications for socioeconomic development. And higher vocational college students are subject to various pressures and stimuli exerted by academic studies， job seeking and family socioeconomic status， which may contribute to the onset insomnia symptom or sleep disorder. ObjectiveTo discuss the sleep status and influencing factors among higher vocational college students， and to provide references for improving their sleep status. MethodsIn January and February， 2022， a stratified random sampling method was utilized to enroll 3 300 students from five higher vocational colleges in Wenjiang district of Chengdu city. All the participants were assessed using Insomnia Severity Index （ISI）， Patient Health Questionnaire Depression Scale-9 item （PHQ-9） and Generalized Anxiety Disorder Scale-7 （GAD-7）. Pearson correlation analysis was conducted to test the correlation of ISI with PHQ-9 and GAD-7 scores， and the Logistic regression analysis was performed to identify the influencing factors of insomnia symptom in higher vocational college students. ResultInsomnia symptom was detected in 81.90% （2 497 / 3 300） of higher vocational college students. The detection rate of insomnia symptom among vocational college students yielded statistical difference in terms of gender， family socioeconomic status， being an only child or having siblings， degree of psychological pressure exerted by academic studies or job seeking， amount of hours spent on Internet per day， frequency of physical exercise， and the presence or absence of anxiety symptom and depression symptom （χ²=21.032， 22.172， 8.983， 75.939， 36.781， 32.350， 54.512， 86.561， P<0.01 or 0.05）. Among higher vocational college students， ISI score was positively correlated with GAD-7 and PHQ-9 scores （r=0.620， 0.714， P<0.01）， and GAD-7 score was positively correlated with PHQ-9 score （r=0.824， P<0.01）. Gender， family socioeconomic status， degree of psychological pressure exerted by academic studies or job seeking， amount of hours spent on Internet per day， frequency of physical exercise， and the presence or absence of anxiety symptom and depression symptom were effective factors in predicting the insomnia symptom in higher vocational college students （P<0.01 or 0.05）. ConclusionFemale gender， average and below average family socioeconomic status， moderate-to-severe degree of psychological pressure exerted by academic studies or job seeking， spending 2~5 h， 5~7 h or >7 h on Internet per day， inadequate physical exercise and presence of depressive symptom are the risk factors for insomnia symptom in higher vocational college students.［Funded by Sichuan Provincial Primary Health Development Research Center in 2022， North Sichuan Medical College （number， SWFZ22-C-89）］

Objective: To analyze the association between the concentration of metalloestrogens ( MEs ) in seminal plasma and sperm quality in infertile patients, so as to provide the basis for the study of MEs on human sperm quality. Methods: The spermatozoa concentration, progressive rate ( PR ), normal morphology rate ( NMR ) and DNA fragmentation index ( DFI ) were determined in the infertile male patients from Zhejiang Provincial People's Hospital from March to April, 2020. The contents of As, Cd, Co, Cr, Cu, Hg and Ni in seminal plasma were determined by inductively coupled plasma mass spectrometry ( ICP-MS ). The distribution of MEs in seminal plasma and the sperm quality in different concentration of MEs ( grouped by quartiles ) were analyzed. Results: Among 105 cases recruited, 28 cases were normal in sperm parameters and 77 cases were abnormal, including 22 cases of oligospermia, 47 cases of asthenospermia, 54 cases of dysspermia and 30 cases of abnormal DFI. As, Cr, Cu, Hg and Ni were detected in all samples, the detection rates of Cd and Co were 78.57%-90.91%. Compared with the normal group, the concentration of As in oligospermia group was higher [( 18.96±12.56 ) µg/L vs. (13.67±4.19) µg/L, P<0.05],the concentration of Cr was higher in asthenospermia, dysspermia and abnormal DFI in Q3 and Q4 groups groups [( 386.62±81.92 ), ( 378.02±81.46 ), ( 393.88±77.03 ) µg/L vs. ( 343.12±55.08 ) µg/L,P<0.05]. The PRs in Q3 and Q4 groups of Cr were lower than that in Q2 group [( 32.95±18.22 )%, ( 27.74±22.77 )% vs. ( 54.18±24.64 )%, P<0.05], the DFI in Q3 and Q4 groups was higher than that in Q2 group [( 26.91±14.77 )%, ( 29.91±16.93 )% vs. ( 9.87±10.93 )%, P<0.05], and the NMR in Q4 group was lower than that in Q2 group [( 1.62±1.72 )% vs. ( 3.36±1.97 )%, P<0.05]. The concentration of sperm in Q3 group of Cu was higher than that in Q2 group [( 115.87±88.22 )×106/mL vs. (61.91±66.16)×106/mL, P<0.05]. Conclusion As and Cu in seminal plasma are associated with abnormal sperm concentration, and Cr is associated with NMR, PR and DFI.

Objective:To compare the effectiveness of venous flap and the flap based on superficial palmar branch of radial artery (SPBRA) in the reconstruction of the defect of finger with segmental defect of proper digital artery.Methods:From July, 2014 to March, 2018, 40 patients with soft tissue defects of finger and the proper arteries were treated by the venous flaps (18 cases, group A) and the flaps based on SPBRA (22 cases, group B). The operative time, postoperative 2-PD of the flaps, appearance, patient satisfaction, flaps donor site complications, flaps survival rate and the motion of digital joints were observed and compared by software SPSS 17.0. P<0.05 was considered statistically significant. Results:Forty flaps all survived, and the wounds healed primarily. The operative time of group A was (78.89±7.36) min, which was shorter than that of group B (97.27±9.26) min, with statistically significant difference ( P<0.05) between the two groups. At end of followed-up, there was a statistically significant difference in the 2-PD of the flaps between the 2 groups [(7.94±1.55) mm in group A, (6.59±1.65) mm in group B, P<0.05)]. The overall active motion of the digital joints: 13 cases were excellent, and 5 cases were good in group A. And 17 cases were excellent, 5 cases were good in group B. The satisfactory was 100% in both groups. Of patient satisfactory, group A: 4 cases were great satisfactory, 13 were satisfactory, and 1 was fair; Group B: 17 cases were great satisfactory and 5 were satisfactory. The appearance of flaps: in group A, 16 cases were good and 1 was bad, while in group B, 21 cases were good and 1 was bad. And there was no statistically significant difference between the 2 groups ( P>0.05). Conclusion:A higher survival rate and satisfactory clinical efficacy can be achieved by the venous flaps and the flap based on SPBRA while the area of defect in hand soft tissue, where there exists a segmental defect of proper arteries, is small. In terms of the recovery of sensing, the first choice is the flap based on SPBRA. In considering of the difficulty in surgical operation, the venous flap is a relatively simple procedure.

Objective To evaluate the therapeutic effects of bridging the proper digital artery and the radial artery with a vein graft in replantation of an amputated thumb with obstinate arteriospasm.Methods From June 2011 to May 2017,9 patients received replantation of an amputated thumb at Department of Hand Surgery,The Second Hospital of Tangshan.They were all male,aged from 21 to 55 years (average,39.2 years).Two right thumbs were involved in 2 cases and 7 left thumbs in 7 cases.During replantation,obstinate arteriospasm which could not be alleviated occurred of their bilateral proper digital arteries.A free forearm superficial vein graft was used to bridge the distal end of ulnar proper digital artery of thumb and the radial artery in tabatiere anatomique to establish blood supply by end-to-end or end-to-side anastomosis.At final follow-up,the outcomes were assessed by the tentative criteria set by The Hand Surgery Society of Chinese Medical Association.Results All the 9 replanted thumbs survived with primary wound healing.They were followed up for 6 to 12 months (mean,7.9 months).All the patients were satisfied with the appearance and function of the replanted thumb except that mild atrophy was observed in 2 digits with preoperative rotatory avulsion.According to the tentative criteria set by The Hand Surgery Society of Chinese Medical Association at final follow-up,the outcomes were rated as excellent in 7 cases and as good in 2.The pulp two-point discrimination was between 3 and 8 mm,with an average of 5.3 mm.Conclusions An amputated thumb with obstinate arteriospasm can be replanted by bridging the ulnar proper digital artery of thumb and the deep branch of radial artery using a vein graft to establish adequate blood supply to the replanted thumb,leading to satisfactory efficacy.As the technique is easy,it is worthy of popularization.

Clench beating or other direct violent action often leads to neck fracture combined with typical dorsal angulation deformity because of the special anatomical structure of the fifth metacarpal neck.There are various treatment methods for the fifth metacarpal neck fracture with their own advantages and disadvantages.Conservative treatment can achieve good fracture healing and has slight effect on function,yet often leaving appearance deformity.Kirschner wire fixations are varied and can obtain satisfactory results,but the drawbacks include obvious tendon adhesion and pin track infection.Microplate screw fixation can obtain good stability that allows early functional exercise.However,its disadvantages include scars,multiple surgeries,and higher medical expenses.External fixation has good curative effect on comminuted joint fracture.With the development of bioengineering technology,absorbable internal fixation is gradually applied to clinical treatment with satisfactory therapeutic effect,but its application is still limited due to the huge cost.Therefore,there is still no unified optimal therapeutic regimen.The author reviews the anatomical characteristics,fracture characteristics,treatment principles,and treatment methods so as to provide reference for formulation of clinical therapy.

Objective To summarize the cutaneous branches of the superficial branch of radial artery distribution were dissected and to discuss the operational technique and clinical efficacy of repairing hand tissue defect by the flap based on the superficial branch of radial artery.Methods From May,2014 to February,2017,8 fresh hand specimens perfused with red latex to observe the distribution and characteristics.And 24 cases of fingers tissue defects (3 thumbs,6 index fingers,5 middle fingers,9 ring fingers,and 1 litter finger) which were repaired with the free wrist crease flap based on the cutaneous branches of superficial palmar branch of the radial artery.Combined fracture in 5 cases.Combined rupture or defect of the flexor tendon in 8 cases.Combined vascular nerve injury in 6 cases.The maximum area of the flap was 5.5 cm × 3.2 cm,and the minimum was 2.0 cm × 1.5 cm.Regular followedup was performed after operation.Results Superficial palmar branch of the radial artery came from the level of radial styloid process ulnar palmar then through ulnar of tubercle of scaphoideum and tended to the thenar muscle.It gave 1-3 branches of the direct skin perforators at distal wrist crease and the anatomical location was constant.The vascular pedicle length could achieve 2.0-3.2 cm.All flaps were survived uneventfully.Twenty-four cases were followed-up for 6-29 months (mean,18.6 months),and the appearance and functional recovered satisfactorily.Flap sensation recovered to S3+.The 2 point discrimination was 8-13 mm.There was no complication in donor area.According to the fingers total active motion (TAM) method to assess:excellent in 17 cases,good in 5 cases,fair in 2 cases.The excellent and good rate was 91.7％.Conclusion The wrist crease cutaneous branches of superficial palmar branch of the radial artery anatomical location is constant.And the flap based on the artery has a reliable blood supply.The vascular pedicle flap is long enough and the operational technique is easy and safe.The postoperative effect is satisfied.It is an ideal method for repairing finger tissue defect.

Objective To analyze and investigate the risk factors for intraoperative and postoperative bleeding complications of stent implantation for ruptured intracranial aneurysms(from rupture to operation time ≤14 d). Methods A total of 249 consecutive patients with aneurysmal subarachnoid hemorrhage (aSAH)treated with stent intravascular interventional therapy at the Department of Neurosurgery,Tangdu Hospital,the Second Hospital Affiliated to Air Force Medical University(the Fourth Military Medical University)from August 2014 to July 2017 were enrolled retrospectively.According to whether having intraoperative and postoperative bleeding complications,they were divided into either a hemorrhage complication group(n=33)or a non-complication group(n=216).The baseline data,clinical data,and aneurysm characteristics,including age,sex,hypertension,Glasgow Coma Scale(GCS)score,aSAH to the patients were documented and analyzed,and multivariate logistic regression analysis was used to analyze the risk factors for bleeding complications. Results (1)The incidence of perioperative bleeding complications was 13. 3% (33 /249). (2)There was significant difference in GCS scores between the bleeding complication group and the non-complication group (P < 0. 05). There were no significant differences in age,male,hypertension,and aSAH to operation time between the two groups (all P >0. 05). (3)There were significant differences in Hunt-Hess grade (χ2 = 10. 392,P = 0. 001),Fisher score (χ2 = 7. 370,P =0. 007),number of aneurysms (χ2 = 4. 825,P = 0. 028),and aneurysm location (χ2 = 6. 818, P = 0. 033)between the bleeding complication group and the non-complication group. There were no significant differences in Raymond grade between the two groups (P > 0. 05). (4)Taking the occurrence of bleeding complications as a dependent variable,a further multivariate logistic regression analysis on Hunt- Hess grades Ⅲ-Ⅴ and multiple aneurysms was performed after variable screening,the results showed that Hunt-Hess grades Ⅲ-Ⅴ(OR,3. 658,95% CI 1. 660 -8. 061)and multiple aneurysms (OR,2. 667,95% CI 1.178-6.036)were the independent risk factors for stent placement in the treatment of bleeding complications of ruptured intracranial aneurysms(all P <0.05). Conclusions The single stent and stent-assisted coils can be used for endovascular treatment of rupture intracranial aneurysms,but preoperative Hunt-Hess grades Ⅲ-Ⅴ and multiple aneurysms are easy to cause perioperative bleeding complications in patients with aSAH.