Objective To investigate the clinical and CT findings features of nonaneurysmal perimesencephalic subarachnoid hem-orrhage(NAPSAH).Methods A retrospective analysis was conducted on 19 cases of NAPSAH confirmed by clinical treatment and follow-up,and their clinical and CT findings features were summarized.Results All patients exhibited mild clinical symptoms and had a good prognosis without complications.The sites of NAPSAH involved the anterior cistern in 17 cases,the suprasellar cistern in 8 cases,the interpeduncular cistern in 7 cases,the anterior cistern only in 1 case,and the suprasellar cistern only in 1 case;Among them,4 cases had vertebrobasilar dolichoectasia(VBD)and 3 cases had tortuous prolongation of vertebrobasilar artery.Conclusion The incidence of NAPSAH is low,the clinical symptoms are mild and good prognosis.It has typical imaging features.Most of its hemorrhage sites are confined to the anterior cistern,suprasellar cistern and interpeduncular cistern.Combining clinical and CT find-ings helpful to improve the accuracy of diagnosis.

Objective To investigate the clinical and CT findings features of nonaneurysmal perimesencephalic subarachnoid hem-orrhage(NAPSAH).Methods A retrospective analysis was conducted on 19 cases of NAPSAH confirmed by clinical treatment and follow-up,and their clinical and CT findings features were summarized.Results All patients exhibited mild clinical symptoms and had a good prognosis without complications.The sites of NAPSAH involved the anterior cistern in 17 cases,the suprasellar cistern in 8 cases,the interpeduncular cistern in 7 cases,the anterior cistern only in 1 case,and the suprasellar cistern only in 1 case;Among them,4 cases had vertebrobasilar dolichoectasia(VBD)and 3 cases had tortuous prolongation of vertebrobasilar artery.Conclusion The incidence of NAPSAH is low,the clinical symptoms are mild and good prognosis.It has typical imaging features.Most of its hemorrhage sites are confined to the anterior cistern,suprasellar cistern and interpeduncular cistern.Combining clinical and CT find-ings helpful to improve the accuracy of diagnosis.

The aim of this study is to identify the cause of death of a South China tiger cub at the Meihuashan breeding institute of Fujian Province.Pathogenic bacteria were isolated and cultured from liver,spleen,lung and other tissue samples of the dead South China tiger aseptically.The iso-lated bacteria were identified through morphological observation,biochemical characterization,sequence analysis of housekeeping gene gyrB,virulence gene detection,animal pathogenicity test and drug sensitivity test.A pathogenic Aeromonas hydrophila strain,designated FJ/Tiger-201809 was successfully isolated from the trachea of dead South China tiger.The nucleotide sequence ho-mology between the isolate and 11 strains of Aeromonas gyrB ranged from 91.2％to 99.1％,with the highest homology of 99.1％observed with Aeromonas hydrophila(AF208251.1).Genetic evo-lution analysis showed that the isolated strain FJ/Tiger-201809 was in the same evolutionary branch as other reference strains of Aeromonas hydrophila and was closely related.The pathoge-nicity test in mice showed artificial infection of mice with the strain resulted in varying degrees of lesions in several organs of the mice,and the median lethal dose(LD50)was 1 × 107.8 CFU/mL.Virulence gene test results showed that the isolate FJ/Tiger-201809 carried two virulence genes,aer and act.The results of drug sensitivity test showed that FJ/Tiger-201809 was highly sensitive to enrofloxacin and ampicillin among 18 commonly used antibiotics,relatively sensitive to penicil-lin G and doxycycline,and resistant to the other 14 antibiotics.In conclusion,this study isolated and identified a strain of Aeromonas hydrophila from a dead South China tiger with multiple drug resistance and strong pathogenicity,which provided an important reference for the prevention and control of bacterial diseases in South China tiger.

Metal elements are widely present in people's daily environment. With the increase of industrial activities, people are facing more metal exposures than ever before, and even several metal elements have been detected in follicular fluid. Most people live with environmental background levels of metal exposure rather than occupational long-term exposure. Therefore, the term "environmental metals" in this paper refers specifically to the metals in people's daily background environment. It is important to investigate the potential effects of environmental metal exposure on female fertility. In this paper, we summarize the latest research progress on the effects of environmental metal element exposure on women's reproductive health, discuss the toxicity mechanisms of metal elements, and propose possible detoxification and intervention strategies to provide scientific evidence for the protection of women's reproductive health.

Objective Compared with patients with insomnia,the clinical characteristics and polysomnography(PSG)results from patients with co-morbid insomnia and obstructive sleep apnea(COMISA)were analyzed.The analysis was conducted to investigate clinical manifestations,sleep physiological characteristics,and related risk factors of COMISA patients.Methods A total of 134 patients with insomnia were enrolled and divided into two groups based on whether their apnea-hypopnea index(AHI)was≥5 events/hour:the COMISA group(69 patients)and the insomnia-only group(65 patients).The COMISA group was further divided into a mild OSA subgroup of 41 cases and a moderate-to-severe OSA subgroup of 28 cases;and then into a mild insomnia subgroup of 37 cases and a moderate-to-severe insomnia subgroup of 32 cases.The demographic characteristics,Pittsburgh sleep quality index(PSQI),self-rating depression scale(SDS),self-rating anxiety scale(SAS),Epworth sleepiness scale(ESS)and PSG results were analyzed.Results Compared with the insomnia-only group,the COMISA group had a higher proportion of men,a higher age,a higher body mass index(BMI),a higher proportion of smoking,a higher proportion of snoring,a lower average blood oxygen saturation and lowest blood oxygen saturation,a higher proportion of N2 stage,and a lower proportion of N3 stage and R stage(P<0.05).Compared with the mild OSA subgroup,the moderate-to-severe OSA subgroup had a higher BMI index,a higher proportion of snoring,a higher SAS score,a lower average blood oxygen saturation and lowest blood oxygen saturation,a higher proportion of N1 stage,and a lower proportion of N3 stage(P<0.05).Compared with the subgroup of mild insomnia,the subgroup of moderate-to-severe insomnia in the COMISA group had a higher proportion of hypnotic drug use(P<0.01),but there was no significant difference between the two groups in PSG results(P>0.05).Logistic regression analysis showed that older age(OR=1.07,P<0.01)and higher BMI(OR=1.41,P<0.01)were risk factors for the co-occurrence of OSA in insomnia patients.Conclusion Patients with COMISA have worse objective sleep quality at night than those with insomnia-only,and patients with more severe OSA have poorer objective sleep quality.In clinical practice,it is important to be aware of the risk of comorbid OSA for patients with insomnia who are older and have a higher BMI.

Objective To analyze the application of combined respiratory training in Mycoplasma-associated bronchopneumonia children and its effect on pulmonary function under family-centered model.Methods A total of 150 Children with Mycoplasma-associated bronchopneumonia treated at Hangzhou Children's Hospital from April 2023 to April 2024 were selected as subjects.The children were divided into control group(n=75)and study group(n=75)using a randomized digital table method.The control group received standard interventions,while the study group received family-centered combined respiratory training in addition to control group's treatment.The two groups were compared in terms of pulmonary function,symptom improvement duration,treatment compliance,and patient satisfaction.Results After intervention,compared with the control group,children in study group had higher forced vital capacity(FVC),forced expiratory volume in one second(FEV1),FEV1/FVC levels,total treatment compliance and satisfaction,the improvement time of cough,fever and dyspnea were shorter,the difference were statistically significant(P＜0.05).Conclusion The use of family-centered combined respiratory training can improve the pulmonary function of children with mycoplasma infection and bronchopneumonia,shorten the time for symptom improvement,and improve the treatment compliance and satisfaction of children.

Objective To explore the clinical efficacy of different ligation methods in laparoscopic radi-cal resection of rectal cancer and sigmoid colon cancer and the influencing factors of anastomotic leakage.Methods A total of 82 patients who underwent laparoscopic radical resection of rectal cancer and sigmoid co-lon cancer in this hospital from December 2022 to December 2023 were selected and divided into the low-liga-tion group(n=42)and the high-ligation group(n=40)according to different surgical methods.The inferior mesenteric artery(IMA)classification,IMA length,operation time,intraoperative blood loss,total number of lymph node dissections,number of lymph node dissections in group 253,postoperative hospital stay,exhaust time,incidence of urinary retention,incidence of anastomotic leakage,and incidence of preventive stoma were compared between the two groups.Univariate and multivariate logistic regression analyses were conducted to analyze the influencing factors of anastomotic leakage in patients undergoing radical resection of rectal cancer and sigmoid colon cancer.Results There was no statistically significant difference in IMA length,IMA classi-fication proportion,operation time,intraoperative blood loss,the total number of lymph node dissections,the number of lymph node dissections in group 253,and the postoperative hospital stay between the two groups(P>0.05).Compared with the high-ligation group,the low-ligation group had a shorter exhaust time,lower incidence of anastomotic leakage and preventive ostomy,the differences were statistically significant(P<0.05).Anastomotic leakage occurred in 7 patients.Univariate analysis showed that whether left colic artery(LCA)was preserved,tumor location,presence of underlying diseases,and preventive stoma were associated with anastomotic leakage in patients undergoing radical resection of rectal cancer and sigmoid colon cancer(P<0.05).Multivariate logistics analysis showed that whether LCA was preserved,tumor location,presence of underlying diseases,and presence of preventive stoma were not influencing factors for anastomotic leakage in patients undergoing radical resection of rectal cancer or sigmoid colon cancer(P>0.05).Conclusion In laparoscopic radical resection of rectal and sigmoid colon cancer,the clinical efficacy of preserving LCA is com-parable to that of not preserving LCA,and it can reduce the risk of anastomotic leakage and the probability of preventive stoma,promoting the early recovery of intestinal function.

Objective To investigate the relationship between morphometric parameters of the cerebral cortex and the efficacy of repetitive transcranial magnetic stimulation(rTMS)in the treatment of tardive dyskinesia(TD).Methods A total of 105 schizophrenic patients with TD undergoing basic treatment were enrolled,and randomly divided into group A(n=35),group B(n=35)and group C(n=35).Group A received rTMS at 1 Hz,group B received rTMS at 10 Hz,and group C received sham stimulation.All groups were treated for 12 weeks.The severity of TD was assessed using the Ab-normal Involuntary Movement Scale(AIMS)before and after treatment.The Repeatable Battery for the Assessment of Neuropsychological Status(RBANS)and the Positive and Negative Syndrome Scale(PANSS)in Chinese were used to evaluate patients'neuropsychological status and symptom severity.magnetic resonance imaging(MRI)was employed to scan the left prefrontal cortex of patients to obtain parameters of cortical thickness,surface area and volume.Pearson correlation analysis was used to an-alyze the relationship between cortical morphological parameters and the efficacy of rTMS for TD in pa-tients.Results After treatment,AIMS scores in the three groups were significantly lower than before treatment,and the group A was significantly lower than the group B and group C(P＜0.05).After treatment,RBANS scores were significantly higher and PANSS scores were significantly lower in three groups than before treatment(P＜0.05).After treatment,the RBANS score of the group A was significantly higher than that of the group B and group C,and the group B was significantly higher than the group C(P＜0.05);the PANSS score of the group A was significantly lower than that of the group B and group C,and the group B was significantly lower than the group C(P＜0.05).Af-ter treatment,cortical morphological parameters(cortical thickness,surface area and volume)in the group A and group B were significantly higher than before treatment,and the group A was signif-icantly higher than the group B(P＜0.05).The therapeutic effect of the group A was positively correlated with cortical thickness,surface area and volume(P＜0.05).Conclusion The morpho-metric parameters of the left prefrontal cortex are associated with the efficacy of rTMS in treating TD.The rTMS at 1 Hz can facilitate structural remodeling of the motor cortex,thereby improving treat-ment outcomes for TD patients.

The aim of this study is to identify the cause of death of a South China tiger cub at the Meihuashan breeding institute of Fujian Province.Pathogenic bacteria were isolated and cultured from liver,spleen,lung and other tissue samples of the dead South China tiger aseptically.The iso-lated bacteria were identified through morphological observation,biochemical characterization,sequence analysis of housekeeping gene gyrB,virulence gene detection,animal pathogenicity test and drug sensitivity test.A pathogenic Aeromonas hydrophila strain,designated FJ/Tiger-201809 was successfully isolated from the trachea of dead South China tiger.The nucleotide sequence ho-mology between the isolate and 11 strains of Aeromonas gyrB ranged from 91.2％to 99.1％,with the highest homology of 99.1％observed with Aeromonas hydrophila(AF208251.1).Genetic evo-lution analysis showed that the isolated strain FJ/Tiger-201809 was in the same evolutionary branch as other reference strains of Aeromonas hydrophila and was closely related.The pathoge-nicity test in mice showed artificial infection of mice with the strain resulted in varying degrees of lesions in several organs of the mice,and the median lethal dose(LD50)was 1 × 107.8 CFU/mL.Virulence gene test results showed that the isolate FJ/Tiger-201809 carried two virulence genes,aer and act.The results of drug sensitivity test showed that FJ/Tiger-201809 was highly sensitive to enrofloxacin and ampicillin among 18 commonly used antibiotics,relatively sensitive to penicil-lin G and doxycycline,and resistant to the other 14 antibiotics.In conclusion,this study isolated and identified a strain of Aeromonas hydrophila from a dead South China tiger with multiple drug resistance and strong pathogenicity,which provided an important reference for the prevention and control of bacterial diseases in South China tiger.

Objective Compared with patients with insomnia,the clinical characteristics and polysomnography(PSG)results from patients with co-morbid insomnia and obstructive sleep apnea(COMISA)were analyzed.The analysis was conducted to investigate clinical manifestations,sleep physiological characteristics,and related risk factors of COMISA patients.Methods A total of 134 patients with insomnia were enrolled and divided into two groups based on whether their apnea-hypopnea index(AHI)was≥5 events/hour:the COMISA group(69 patients)and the insomnia-only group(65 patients).The COMISA group was further divided into a mild OSA subgroup of 41 cases and a moderate-to-severe OSA subgroup of 28 cases;and then into a mild insomnia subgroup of 37 cases and a moderate-to-severe insomnia subgroup of 32 cases.The demographic characteristics,Pittsburgh sleep quality index(PSQI),self-rating depression scale(SDS),self-rating anxiety scale(SAS),Epworth sleepiness scale(ESS)and PSG results were analyzed.Results Compared with the insomnia-only group,the COMISA group had a higher proportion of men,a higher age,a higher body mass index(BMI),a higher proportion of smoking,a higher proportion of snoring,a lower average blood oxygen saturation and lowest blood oxygen saturation,a higher proportion of N2 stage,and a lower proportion of N3 stage and R stage(P<0.05).Compared with the mild OSA subgroup,the moderate-to-severe OSA subgroup had a higher BMI index,a higher proportion of snoring,a higher SAS score,a lower average blood oxygen saturation and lowest blood oxygen saturation,a higher proportion of N1 stage,and a lower proportion of N3 stage(P<0.05).Compared with the subgroup of mild insomnia,the subgroup of moderate-to-severe insomnia in the COMISA group had a higher proportion of hypnotic drug use(P<0.01),but there was no significant difference between the two groups in PSG results(P>0.05).Logistic regression analysis showed that older age(OR=1.07,P<0.01)and higher BMI(OR=1.41,P<0.01)were risk factors for the co-occurrence of OSA in insomnia patients.Conclusion Patients with COMISA have worse objective sleep quality at night than those with insomnia-only,and patients with more severe OSA have poorer objective sleep quality.In clinical practice,it is important to be aware of the risk of comorbid OSA for patients with insomnia who are older and have a higher BMI.