A case of multiple intracranial venous sinus thrombosis caused by a calreticulin(CALR)gene mutation in essential thrombocythemia is reported including the diagnosis,treatment process and outcome.The patient was a 39-year-old female presenting with headache,slurred speech and limb weakness.Physical examination revealed unclear speech,dysarthria and decreased muscle strength in the left limb.On the basis of anticoagulation therapy,mechanical thrombectomy,intrasinus contact thrombolysis,decompressive craniectomy and cytoreductive therapy targeting the cause were performed.After treatment,the venous sinuses were completely recanalized and the prognosis was good.There are no relevant literature reports on intracranial venous sinus thrombosis caused by CALR gene mutation in essential thrombocythemia.The diagnosis and treatment strategy of this case provide a reference for the identification and treatment of similar cases in clinical practice.

A case of multiple intracranial venous sinus thrombosis caused by a calreticulin(CALR)gene mutation in essential thrombocythemia is reported including the diagnosis,treatment process and outcome.The patient was a 39-year-old female presenting with headache,slurred speech and limb weakness.Physical examination revealed unclear speech,dysarthria and decreased muscle strength in the left limb.On the basis of anticoagulation therapy,mechanical thrombectomy,intrasinus contact thrombolysis,decompressive craniectomy and cytoreductive therapy targeting the cause were performed.After treatment,the venous sinuses were completely recanalized and the prognosis was good.There are no relevant literature reports on intracranial venous sinus thrombosis caused by CALR gene mutation in essential thrombocythemia.The diagnosis and treatment strategy of this case provide a reference for the identification and treatment of similar cases in clinical practice.

ObjectiveTo observe the effects of electroacupuncture at Zhongwan （CV12） on gastric nociceptive response induced by gastric acid stimulation and explore the underlying mechanisms associated with nuclei of the medullary viscerosensory and visceral motor neurons. MethodsTwenty SD rats were given intragastric administration of 0.5 mol/L diluted hydrochloric acid （0.5 ml/100 g） to induce gastric nociceptive response induction. Eight rats were randomly selected to record the gastric slow wave （GSW） area under the curve， and extracellular discharge frequency of neurons in the nucleus of the solitary tract （NTS） and dorsal motor nucleus of the vagus nerve （DMV） before intragastric administration and at 1， 5， 10， 15， 20， 25， 30， 35， 40， 45， 50， 55， and 60 minutes after intragastric administration. The remaining 12 rats received electroacupuncture intervention at Zhongwan within 5 to 25 minutes after intragastric administration of diluted hydrochloric acid， with a duration of one minute. The GSW area under the curve and extracellular discharge frequency of NTS and DMV neurons were compared between the 1-minute intervals before and after electroacupuncture intervention. ResultsCompared to the baseline before intragastric administration， the area under the curve of GSW significantly increased at 1， 5， 10， 15， 20， and 25 minutes after intragastric administration， and the extracellular discharge frequency of excitatory neurons in the NTS （accounting for 90%， 57/63） significantly increased at 1， 5， 10， 15， 20， 25， 30， 35， and 40 minutes， both reaching peak values at 1 minute after intragastric administration （P＜0.01 or P＜0.05）. The extracellular discharge frequency of inhibitory neurons in the DMV （accounting for 91%， 20/22） showed a non-significant increase at 1 minute after intragastric administration （P＞0.05）， but significantly decreased at other timepoints （P＜0.05）. Compared to the baseline before electroacupuncture intervention， the GSW area under the curve and the extracellular discharge frequency of excitatory neurons in the NTS significantly decreased （P＜0.05）， while the extracellular discharge frequency of inhibitory neurons in the DMV showed no significant difference （P＞0.05）. ConclusionElectroacupuncture at Zhongwan can improve gastric nociceptive response induced by gastric acid stimulation， possibly by reducing the transmission of visceral sensation and decreasing the excitability of NTS neurons in the medulla.

Objective: To investigate the predictive value of ¹⁸F-FDG PET-CT scan for occult lymph node metastasis in patients with stage ⅠA lung adenocarcinoma. Methods: The image and pathological data of 272 patients with stage ⅠA lung adenocarcinoma from October 2006 to September 2015 were retrospectively analyzed. All patients underwent preoperative ¹⁸F-FDG PET-CT scan followed by lobectomy and systematic lymph node dissection. The correlation between occult lymph node metastasis and the maximum standardized uptake value (SUV_max) of primary tumor as well as other clinicopathological factors was analyzed to screen the risk factors of occult lymph node metastasis in stage ⅠA lung adenocarcinoma. Results: Occult lymph node metastasis was detected in 50 patients (18.4%), with 24 (8.8%) patients of pN1 involvement and 26 (9.6%) of pN2 involvement. Among the 272 patients enrolled, 39 had pure ground glass nodule, 59 had part-solid nodule and 174 had solid nodule. All patients with pure ground glass nodule or nodule≤1 cm were pN0. For the 233 patients with part-solid and solid nodule, no lymph node metastasis was found in T1a stage (tumor length ≤1 cm). Primary tumor SUV_max (Z=-5.663, P<0.001), nodule type (χ²=21.586, P<0.001), tumor location (χ²= 12.790, P< 0.001), histological grade (χ²= 22.784, P< 0.001) and visceral pleural invasion (χ²=5.357, P=0.021) showed significant differences between occult lymph node metastasis group (pN+ ) and non-lymph node metastasis group (pN0). With SUV_max=2.405 as cut-off value, the sensitivity and specificity for predicting occult lymph node metastasis were 90.0% and 61.7%, the area under curve was 0.761(95%CI=0.700~0.823), and the negative predictive value was 95.8%. Multivariate analysis revealed that SUV_max >2.405 (P<0.001), central location (P=0.030) and higher histological grade (P=0.024) were independent predictors of occult lymph node metastasis. Conclusions For clinical stage ⅠA adenocarcinoma, primary tumor SUV_max > 2.405, central location and higher histological grade were independent risk factors for occult lymph node metastasis. Systematic lymph node dissection may be avoided in lung adenocarcinoma with pure ground glass density, tumor length ≤1 cm or SUV_max ≤ 2.405, due to the very low probability of nodal involvement.

Objective To investigate the predictive value of 18F?FDG PET?CT scan for occult lymph node metastasis in patients with stageⅠA lung adenocarcinoma. Methods The image and pathological data of 272 patients with stage ⅠA lung adenocarcinoma from October 2006 to September 2015 were retrospectively analyzed. All patients underwent preoperative 18F?FDG PET?CT scan followed by lobectomy and systematic lymph node dissection. The correlation between occult lymph node metastasis and the maximum standardized uptake value (SUVmax) of primary tumor as well as other clinicopathological factors was analyzed to screen the risk factors of occult lymph node metastasis in stage ⅠA lung adenocarcinoma. Results Occult lymph node metastasis was detected in 50 patients (18.4%), with 24 (8.8%) patients of pN1 involvement and 26 (9.6%) of pN2 involvement. Among the 272 patients enrolled, 39 had pure ground glass nodule, 59 had part?solid nodule and 174 had solid nodule. All patients with pure ground glass nodule or nodule≤1 cm were pN0. For the 233 patients with part?solid and solid nodule, no lymph node metastasis was found in T1a stage (tumor length≤1 cm). Primary tumor SUVmax(Z＝－5.663, P＜0.001), nodule type (χ2＝21.586, P＜0.001), tumor location (χ2＝ 12.790, P＜ 0.001), histological grade ( χ2＝ 22.784, P＜0.001) and visceral pleural invasion (χ2＝5.357, P＝0.021) showed significant differences between occult lymph node metastasis group (pN+) and non?lymph node metastasis group (pN0). With SUVmax＝2.405 as cut?off value, the sensitivity and specificity for predicting occult lymph node metastasis were 90.0% and 61.7%, the area under curve was 0.761(95%CI＝0.700～0.823), and the negative predictive value was 95.8%. Multivariate analysis revealed that SUVmax＞2.405 (P＜0.001), central location ( P＝0.030) and higher histological grade ( P ＝ 0.024 ) were independent predictors of occult lymph node metastasis. Conclusions For clinical stage ⅠA adenocarcinoma, primary tumor SUVmax＞ 2.405, central location and higher histological grade were independent risk factors for occult lymph node metastasis. Systematic lymph node dissection may be avoided in lung adenocarcinoma with pure ground glass density, tumor length≤1 cm or SUVmax≤2.405, due to the very low probability of nodal involvement.

Objective To investigate the predictive value of 18F?FDG PET?CT scan for occult lymph node metastasis in patients with stageⅠA lung adenocarcinoma. Methods The image and pathological data of 272 patients with stage ⅠA lung adenocarcinoma from October 2006 to September 2015 were retrospectively analyzed. All patients underwent preoperative 18F?FDG PET?CT scan followed by lobectomy and systematic lymph node dissection. The correlation between occult lymph node metastasis and the maximum standardized uptake value (SUVmax) of primary tumor as well as other clinicopathological factors was analyzed to screen the risk factors of occult lymph node metastasis in stage ⅠA lung adenocarcinoma. Results Occult lymph node metastasis was detected in 50 patients (18.4%), with 24 (8.8%) patients of pN1 involvement and 26 (9.6%) of pN2 involvement. Among the 272 patients enrolled, 39 had pure ground glass nodule, 59 had part?solid nodule and 174 had solid nodule. All patients with pure ground glass nodule or nodule≤1 cm were pN0. For the 233 patients with part?solid and solid nodule, no lymph node metastasis was found in T1a stage (tumor length≤1 cm). Primary tumor SUVmax(Z＝－5.663, P＜0.001), nodule type (χ2＝21.586, P＜0.001), tumor location (χ2＝ 12.790, P＜ 0.001), histological grade ( χ2＝ 22.784, P＜0.001) and visceral pleural invasion (χ2＝5.357, P＝0.021) showed significant differences between occult lymph node metastasis group (pN+) and non?lymph node metastasis group (pN0). With SUVmax＝2.405 as cut?off value, the sensitivity and specificity for predicting occult lymph node metastasis were 90.0% and 61.7%, the area under curve was 0.761(95%CI＝0.700～0.823), and the negative predictive value was 95.8%. Multivariate analysis revealed that SUVmax＞2.405 (P＜0.001), central location ( P＝0.030) and higher histological grade ( P ＝ 0.024 ) were independent predictors of occult lymph node metastasis. Conclusions For clinical stage ⅠA adenocarcinoma, primary tumor SUVmax＞ 2.405, central location and higher histological grade were independent risk factors for occult lymph node metastasis. Systematic lymph node dissection may be avoided in lung adenocarcinoma with pure ground glass density, tumor length≤1 cm or SUVmax≤2.405, due to the very low probability of nodal involvement.

Objective To analyze the survival curves of ASIC3 -/-and TRPV1 -/-mice, and provide a reference for further breeding of these strains of mice.Methods Forty-four ASIC3 -/-mice and sixty-one TRPV1 -/-mice were included in this study.The survival of the mice was observed in normal feeding for 500 days, survival curves were drawn, and their survival was analyzed.Results With the passing of time, the survival probability was decreased in ASIC3 -/-mice and TRPV1 -/-mice.The survival probability of TRPV1 -/-mice was significantly better than that of ASIC3 -/-mice (P =0.004, P <0.01).No significant difference was observed between the males and females of the same strain. Conclusions The survival probability of TRPV1 -/-mice is better than that of ASIC3 -/-mice.There is no significant gender difference in the two strains of mice.