Brain arteriovenous malformation (bAVM) is a common cerebrovascular disease in clinical practice. Compared with adults, children with bAVM are more prone to rupture and bleeding, and have a higher mortality and disability. Therefore, it is very important to accurately evaluate the bleeding risk of children with bAVM and reasonably select intervention measures to improve the prognosis. The treatment methods of children with bAVM mainly include conservative treatment, microsurgical treatment, endovascular embolization, stereotactic radiosurgery, and multimodal combined treatment. At present, the treatment indications and specific treatment options for children with bAVM are controversial.

Objective:To explore the application effect of structural formula based continuous nursing in colorectal cancer patients with ostomy.Methods:Using the convenient sampling method, a total of 128 patients with colorectal cancer stoma who were admitted to Liuzhou Worker's Hospital from July 2019 to September 2021 were selected as the research objects. According to the random number table method, they were divided into the observation group and the control group, with 64 cases in each group. Patients in the observation group received structural continuous nursing, while patients in the control group received traditional continuous care. Exercise of Self-Care Agency Scale (ESCA) and the Medical Outcomes 36-items Short Form Health Survey (SF-36) scores were compared between the two groups.Results:After 3 months of intervention, ESCA and SF-36 scores in the observation group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Structural formula based continuous nursing can improve the self-care ability and quality of life of colorectal cancer patients with ostomy.

Objective: In view of the difficulty of the shortage of new coronavirus nucleal acid test in the early COVID-19 outbreak, to explore the application value of chest CT in screening COVID-19 patients. Methods: Retrospective analysis was performed on the data of patients with fever who received chest CT and new coronavirus nucleal acid test during January 25, 2020 to February 2, 2020 in Zhongnan Hospital of Wuhan University. A total of 587 patients were enrolled, including 290 males and 297 females, aged from 11.0 to 96.0 (51.3±17.1) years old. Take the nucleic acid test results as the gold standard, the sensitivity, specificity and rate of missed diagnosis of CT screening COVID-19 were calculated. Results: Among the 587 patients, there were 433 positive cases (73.8%, 433/587) and 154 negative cases (26.2%, 154/587) of novel coronavirus nucleic acid test. Using CT screening, 494 cases (84.2%, 494/587) were positive and 93 cases (15.8%, 93/587) were negative. The sensitivity of CT screening COVID-19 was 97.7% (423/433), specificity was 53.9% (83/154) and rate of missed diagnosis was 2.3% (10/433). Conclusions In the early COVID-19 outbreak, CT screening has the advantages of high sensitivity and low rate of missed diagnosis of COVID-19, which can compensate for the shortage of new coronavirus nucleal acid test and can be used as the basis for rapid screening for early prevention and control of COVID-19 outbreak.

Objective: To investigate the effect of allogeneic red blood cell transfusion on T lymphocyte subsets and natural killer (NK) cells in peripheral blood of patients with gastric cancer during perioperative period. Methods: 50 patients with gastric cancer in our hospital from January 2017 to December 2017 were randomly divided into control group (n=25) and observation group (n=25). Perioperative allogeneic erythrocyte transfusion was performed in the observation group, while no allogeneic erythrocyte transfusion was performed in the control group. Blood samples were taken from two groups before and after operation 3 d, and serum T lymphocyte subsets (CD3⁺, CD4⁺, CD8⁺, CD4⁺ /CD8⁺ ) and NK cell levels were measured. T cell subsets and NK cell levels of patients in observation group, control group and observation group at different clinical stages before and after operation were counted. According to blood transfusion volume, the patients in the observation group were divided into <4 U group and <4 U group. T cell subsets and NK cell levels before and after operation were compared between the two groups. Results: There was no significant difference in CD3⁺, CD4⁺, CD8⁺, CD4⁺ /CD8⁺, NK cells between the two groups before operation (P>0.05). The levels of CD3⁺, CD4⁺, CD4⁺ /CD8⁺, NK cells in the two groups after operation were lower than those before operation and CD8⁺ levels were higher than those before operation. The levels of CD3⁺, CD4⁺, CD4⁺ /CD8⁺, NK cells in the observation group were lower than those in the control group, and the levels of CD8⁺ in the observation group were higher than those in the control group (P<0.05). The levels of CD3⁺, CD4⁺, CD8⁺, CD4⁺ /CD8⁺, NK cells in patients with stage Ⅰ-Ⅱ and stage Ⅲ-Ⅳ had no significant difference before operation (P>0.05). After operation, the levels of CD3⁺, CD4⁺, CD4⁺ /CD8⁺, NK cells in the two groups were lower and CD8⁺ levels were higher than those before operation. The levels of CD3⁺, CD4⁺, CD4⁺ /CD8⁺, NK cells in stage Ⅰ-Ⅱ patients were higher than those in stage Ⅲ-Ⅳ patients, and CD8⁺ levels were lower than those in stage Ⅲ-Ⅳ patients (P< 0.05); There was no significant difference in the levels of CD3⁺, CD4⁺, CD8⁺, CD4⁺ /CD8⁺, NK cells between the <4 U group and <4 U group before operation (P>0.05). After operation, the levels of CD8⁺ in the two groups were higher than those before operation, while the levels of CD3⁺, CD4⁺, CD4⁺ /CD8⁺, NK cells were lower than those before operation; The levels of CD3⁺, CD4⁺, CD4⁺ /CD8⁺, NK cells in the <4 U group were higher than those in >4 U group, and CD8⁺ levels were lower than those in >4 U group (P<0.05). Conclusions Perioperative allogeneic red blood cell transfusion can affect T cell subsets and NK cell content in peripheral blood of patients with gastric cancer, and there are some differences in the effects of different clinical stages of gastric cancer patients, which can cause the suppression of cellular immune function.

Objective: To observe effects of exogenous high mobility group protein box 1 (HMGB1) on angiogenesis in ischemic zone of early scald wounds of rats. Methods: Thirty-six Sprague-Dawley rats were divided into HMGB1 group and simple scald (SS) group according to the random number table, with 18 rats in each group. Comb-like copper mould was placed on the back of rats for 20 s after being immersed in 100 ℃ hot water for 3 to 5 min to make three ischemic zones of wound. Immediately after scald, rats in HMGB1 group were subcutaneously injected with 0.4 μg HMGB1 and 0.1 mL phosphate buffer solution (PBS), and rats in SS group were subcutaneously injected with 0.1 mL PBS from boarders of ischemic zone of scald wound. At post scald hour (PSH) 24, 48, and 72, 6 rats in each group were collected. Protein expressions of vascular endothelial growth factor (VEGF) in ischemic zone of wound at PSH 24, 48, and 72 and protein expressions of CD31 in ischemic zone of wound at PSH 48 and 72 were detected by immunohistochemistry. The number of microvessel in CD31 immunohistochemical sections of ischemic zone of wound at PSH 48 and 72 was calculated after observing by the microscope. The mRNA expressions of VEGF and CD31 in ischemic zone of wound were detected by real-time fluorescence quantitative reverse transcription polymerase chain reaction at PSH 24, 48, and 72. Data were processed with analysis of variance of factorial design, t test, and Bonferroni correction. Results: (1) At PSH 24, 48, and 72, protein expressions of VEGF in ischemic zone of wound of rats in HMGB1 group were significantly higher than those of rats in SS group (t=7.496, 4.437, 5.402, P<0.05 or P<0.01). At PSH 48 and 72, protein expressions of CD31 in ischemic zone of wound of rats in HMGB1 group were 0.038 8±0.007 9 and 0.057 7±0.001 2 respectively, significantly higher than 0.013 4±0.004 9 and 0.030 3±0.004 0 of rats in SS group (t=10.257, 15.055, P<0.01). (2) At PSH 48 and 72, the number of microvessel in ischemic zone of wound of rats in HMGB1 group was obviously more than that of rats in SS group (t=3.536, 4.000, P<0.05). (3) At PSH 24, 48, and 72, mRNA expressions of VEGF in ischemic zone of wound of rats in HMGB1 group were significantly higher than those of rats in SS group (t=4.406, 3.821, 3.356, P<0.05). At PSH 24 and 48, mRNA expressions of CD31 in ischemic zone of wound of rats in HMGB1 group were significantly higher than those of rats in SS group (t=4.113, 3.466, P<0.05). At PSH 72, mRNA expressions of CD31 in ischemic zone of wound of rats in 2 groups were close (t=0.010, P>0.05). Conclusions Exogenous HMGB1 can promote angiogenesis in ischemic zone of early scald wounds of rats by increasing expressions of VEGF and CD31.

Objective To investigate the traditional Chinese medicine(TCM) syndromes distribution rule of nonalcoholic fatty liver disease(NAFLD) and its correlation with related clinical indexes.Methods The general condition,TCM four diagnostic methods,biochemical and CT results in 1950 cases of NAFLD in Chongqing City were investigated for analyzing the TCM syndromes distribution rule and its correlation with biochemistry and CT.Results In 1950 cases,the accumulation and binding of damp-heat,congestion of dampness turbidity,stagnation of liver-QI with spleen deficiency,intermin-gled phlegm and blood stasis and yin deficiency of both liver and kidney accounted for 36.62 ％,27.69 ％,19.38 ％,10.10 ％ and 6.21 ％ respectively;there was statistically significant difference in age among different TCM syndromes(P＜0.05);the vin deficiency syndrome of both liver and kidney and intermin-gled phlegm and blood stasis in severe fatty liver were maximal;glutamic-pyruvic transaminase(ALT) and glutamic-oxalacetic transaminase(AST) level was higher in the accumulation and binding of damp-heat;the level of fasting plasma gluco se(FBG) was higher in the yin deficiency syndrome of both liver and kidney;the total cholesterol(TC),triglyceride(TG) and FBG levels were lower in the stagnation of liver-QI with spleen deficiency,the differences were statistically significant(P＜0.05).Conclusion In NAFLD patients,the accumulation and binding of damp-heat distribution is maximal,the proportion of severe fatty liver with vin deficiency syndrome of both liver and kidney is higher.Different dialectical types may play an important role in the clinical indexes and disease development.

OBJECTIVETo explore the diagnosis, treatment and long-term outcome of late acute rejection (LAR) following adult orthotropic liver transplantation (OLT).

METHODSA total of 398 consecutive adult patients who underwent OLT in Organ Transplant Center, the First Affiliated Hospital, Sun Yat-sen University between January 2007 and December 2012 were reviewed retrospectively. There were 48 patients (12. 1%) developed to LAR, including 43 male patients and 5 female patients, with an average age of (52 ± 13) years(18 - 70 years). The mean body mass index was (22.1 ± 4. 5) kg/m2 (15. 4 - 30. 4 kg/m2). The indications of the liver transplantation recipients included 16 cases of end-staged liver cirrhosis after hepatitis B or C(33. 3%), 14 cases with severe hepatitis (29. 2%), 9 cases of primary liver cancer(18. 5%), 5 cases of alcoholic liver cirrhosis (10. 4%), 1 case with autoimmune liver disease (2. 1%) , the other 3 cases (6. 3%). They were followed up by outpatient service, telephone and other means. Survival curves were generated with the Kaplan-Meier method and Cox proportional hazards modeling was used for predictors of mortality. Statistically significant variables found by single factor regression analysis were put into the Cox proportional hazards regression model of multivariate analysis.

RESULTSThe time-to-event was 23. 6 months after OLT which were more common in the first year to the third year post-transplant (26/48,52. 4%). Thirty-five cases were assessed as mild, 11 cases were assessed as moderate, and 2 cases were assessed as severe ,based on the Banff schema. After adjustment to the immunosuppressive regimen, the overall recovery rate reached to 81. 3%. The rate of steroid-resistant acute rejection was 11. 8% (4/34). Inadequate immunosuppression and steroid pulsation were two independent risk factors affecting the prognosis of LAR (P = 0. 008, P = 0. 003, respectively).

CONCLUSIONSLAR is an uncommon complication after OLT. Inadequate immunosuppression and steroid pulsation are the major risk factors for prognosis of LAR. Improving patient compliance and strengthening blood concentration surveillance can increase the patient survival.

Acute Disease ; Adolescent ; Adult ; Aged ; Female ; Graft Rejection ; diagnosis ; mortality ; therapy ; Hepatitis B ; Humans ; Immunosuppression ; Liver Cirrhosis ; Liver Neoplasms ; Liver Transplantation ; mortality ; Male ; Middle Aged ; Multivariate Analysis ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; Steroids ; Young Adult

Objective To explore the effect of ACE-inhibitor perindopril on the expression of scavenger receptor A (SR-A) gene in the kidney of diabetic rats.Methods Diabetes were induced in male Sprague-Dawley rats by peritoneal injection with streptozotocin (60mg/kg).The rats were then random di vided into normal control group, diabetes group and ACEI treatment group [4mg/(kg·d) for 24 weeks].Blood glucose concentration and 24h urinary albumin excretion were determined.The renal morphological change was observed.Immunohistochemistry was used to analyze CD68 positive macrophages,and the Mrna of SR-A in renal tissue was detected by quantitative real-time PCR.Results Compared with normal control group,blood glucose concentration,24h urinary albumin excretion and the number of CD68 positive macrophages were significantly increased [(5.3 ± 0.6) mmol/L vs (26.7 ± 3.3) mmol/L;(2.7 ± 1.3) mg/24h vs (26.7 ± 1.8)mg/24h;(0.77 ±0.24)/gcs vs (2.55 ±0.46)/gcs;(6.13 ±0.50)/HPF vs (11.9 ±2.12)/HPF;P ＜0.05],and the expression of SR-A Mrna were significantly up-regulated in diabetes group [ (5.6 ± 1.2 vs 1.5 ±0.2),P ＜0.05].After intervention with ACE-inhibitor,the up-regulations of the above mentioned parameters,except blood glucose concentration,were all significantly inhibited [ (3.6 ±1.4)mg/24h;(1.03±0.37)/gcs;(8.28±1.19)/HPF;3.4±0.7;P ＜0.05].Conclusion ACE-inhibitor might have renoprotective effects of diabetic nephropathy,it probably was associated with inhibiting the expression of SR-A gene.

The rats were assigned to blank control group, classical induction group, and drynaria total flavonoid group. Whole bone marrow culture method was applied to isolate and purify rats bone mesenchymal stem cells (BMSCs). Akaline phosphatase activity, calcium nodes, TGF-β1 and BMP-2 secretion in the process of bone mesenchymal stem cells osteogenic differentiation were detected. The results showed that compared to the blank group and classical group, drynaria total flavonoid promoted osteogenic differentiation accompanied with increased TGF-β1 and BMP-2 secretion (all P＜0. 05). Drynaria total flavonoid may promote osteogenic differentiation of BMSCs via upregulating TGF-β1 and BMP-2 expressions, and play an active role in the treatment of osteoporosis.

Objective To explore the teaching effects of the case study method in the comprehensive and designing experiments. Methods During the teaching process of the "Nursing Fundamentals", we organized students by groups to select medical samples, prepare and carry out experiment plans, as well as held sessions of experiment results reporting and teachers' comments. Results The experimental teaching plans designed by students covered the knowledge from 8 courses and 16 basic nursing operations. Teachers and students were all considering that the application of the case study method into the comprehensive and designing experiments of the "Nursing Fundamentals" had demonstrated the integration of both the teaching contents and the combination of knowledge, capability and quality. The exploration of students' creative thinking was paid attention to, their researching spirit when learning was also cultivated, the sense of professionalism and the awareness of "people-oriented ' nursing were strengthened, and the communication skills and adaptive capabilities were also trained. The teaching atmosphere was obviously activated, and the teaching effects were obviously improved. Conclusions The application of the case study method into the comprehensive and designing experiments enabled the students to well digest and completely understand knowledge from various subjects, as well as enhanced their capabilities of resolving practical problems, and it is also helpful to cultivate the overall quality of the nursing profession.