Objective:To investigate the feasibility and clinical efficacy of side-to-side anastomosis of superficial temporal artery (STA) and middle cerebral artery (MCA) bypass using in-situ intravascular suture technique.Methods:A retrospective analysis was conducted on the clinical data of 10 adult patients who were treated with side-to-side microvascular anastomosis of STA-MCA bypass to improve intracranial blood supply, between February 2024 and September 2024 in the Department of Neurosurgery of the Fourth Affiliated Hospital of Soochow University. Among the patients, 2 were of symptomatic MCA occlusion and 8 of Moyamoya disease. Diameter of STA and MCA, length of anastomosis and blocking time of MCA were recorded. Indocyanine green video angiography (ICG-VA) was performed to evaluate the immediate patency of the STA-MCA side-to-side anastomosis. Digital subtracted angiography (DSA) was performed at 1 week after the surgery to evaluate the patency of the STA-MCA bypass anastomosis, then follow-up DSA was performed at 1, 3 and 6 months after surgery to further evaluate the postoperative anastomotic patency. Neurological function was evaluated regularly with the modified Rankin Scale (mRS).Results:All of the 10 side-to-side STA-MCA bypass anastomoses were successfully performed using in-situ intravascular suture technique. The scalps of all patients healed well. The diameters of STA and MCA were 1.4-2.0 (1.76±0.27) mm and 0.8-1.4 (0.98±0.20) mm, respectively. The average length of the anastomoses was 3.5-5.0 (4.45±0.60) mm. The blocking time of MCA was 12.0-29.0 (21.50±6.62) min. A 100% vessel patency rate was achieved immediately after vessel anastomosis and at 1 month after surgery. DSA examinations were performed at 3 months after surgery on 6 patients and at 6 months after surgery on 1 patient, and all the anastomoses were found in full patency. All patients were included in the postoperative follow-up that lasted for 3 to 7 months. All patients recovered well without new neurological dysfunction. The mRS of 8 patients remained at 0 point before and after surgery. Two patients had improved postoperative mRS of 1 point from that of 2 points before surgery.Conclusion:STA-MCA side-to-side microvascular bypass anastomosis can be performed safely and efficiently using in-situ intravascular suture technique. It could efficiently reduce the incidence of perioperative complications. Meanwhile, it can self-regulate the blood flow and maximise the potential capability of STA.

Objective To investigate the application value of clinical-radiomics nomogram in predicting the expression of liver kinase B1(LKB1)in non-small cell lung cancer(NSCLC)before surgery.Methods A total of 140 NSCLC patients were randomized into training group(n=106)and validation group(n=34)according to the ratio of 7∶3.The training group was used as the study cohort to screen the clinically independent predictors and radiomics characteristics related to LKB1 expression,and the clinical model,radiomics model and clinical-radiomics nomogram model were constructed,respectively.The predictive performance of the three models was analyzed using the receiver operating characteristic(ROC)curve in the training group,and validated in the validation group.The calibration curve was used to assess the consistency between the predicted results of nomogram model and the actual observations,and the decision curve was used to evaluate the clinical benefit of the nomogram model.Results The clinical model consisted of pathological type and hilal/mediastinal lymphadenopathy,the radiomics model consisted of Radiomics score(Radscore),and the nomogram model consisted of Radscore,pathological type and hilal/mediastinal lymphadenopathy.In the training group,the area under the curve(AUC)of the nomogram model,radiomics model and clinical model was 0.884,0.843 and 0.788,respectively.In the validation group,the AUC of the three models were 0.976,0.851,and 0.912,respectively.The calibration curve analysis showed good consis-tency between the predicted results of nomogram model and the actual observations,and the decision curve showed that the model had good clinical benefit.Conclusion Radiomics combined with clinical risk factors can effectively predict the expression of LKB1 in NSCLC patients before surgery,so as to contribute to the formulation of therapeutic strategies in clinical practice.

Objective To investigate the application value of clinical-radiomics nomogram in predicting the expression of liver kinase B1(LKB1)in non-small cell lung cancer(NSCLC)before surgery.Methods A total of 140 NSCLC patients were randomized into training group(n=106)and validation group(n=34)according to the ratio of 7∶3.The training group was used as the study cohort to screen the clinically independent predictors and radiomics characteristics related to LKB1 expression,and the clinical model,radiomics model and clinical-radiomics nomogram model were constructed,respectively.The predictive performance of the three models was analyzed using the receiver operating characteristic(ROC)curve in the training group,and validated in the validation group.The calibration curve was used to assess the consistency between the predicted results of nomogram model and the actual observations,and the decision curve was used to evaluate the clinical benefit of the nomogram model.Results The clinical model consisted of pathological type and hilal/mediastinal lymphadenopathy,the radiomics model consisted of Radiomics score(Radscore),and the nomogram model consisted of Radscore,pathological type and hilal/mediastinal lymphadenopathy.In the training group,the area under the curve(AUC)of the nomogram model,radiomics model and clinical model was 0.884,0.843 and 0.788,respectively.In the validation group,the AUC of the three models were 0.976,0.851,and 0.912,respectively.The calibration curve analysis showed good consis-tency between the predicted results of nomogram model and the actual observations,and the decision curve showed that the model had good clinical benefit.Conclusion Radiomics combined with clinical risk factors can effectively predict the expression of LKB1 in NSCLC patients before surgery,so as to contribute to the formulation of therapeutic strategies in clinical practice.

Objective:To investigate the feasibility and clinical efficacy of side-to-side anastomosis of superficial temporal artery (STA) and middle cerebral artery (MCA) bypass using in-situ intravascular suture technique.Methods:A retrospective analysis was conducted on the clinical data of 10 adult patients who were treated with side-to-side microvascular anastomosis of STA-MCA bypass to improve intracranial blood supply, between February 2024 and September 2024 in the Department of Neurosurgery of the Fourth Affiliated Hospital of Soochow University. Among the patients, 2 were of symptomatic MCA occlusion and 8 of Moyamoya disease. Diameter of STA and MCA, length of anastomosis and blocking time of MCA were recorded. Indocyanine green video angiography (ICG-VA) was performed to evaluate the immediate patency of the STA-MCA side-to-side anastomosis. Digital subtracted angiography (DSA) was performed at 1 week after the surgery to evaluate the patency of the STA-MCA bypass anastomosis, then follow-up DSA was performed at 1, 3 and 6 months after surgery to further evaluate the postoperative anastomotic patency. Neurological function was evaluated regularly with the modified Rankin Scale (mRS).Results:All of the 10 side-to-side STA-MCA bypass anastomoses were successfully performed using in-situ intravascular suture technique. The scalps of all patients healed well. The diameters of STA and MCA were 1.4-2.0 (1.76±0.27) mm and 0.8-1.4 (0.98±0.20) mm, respectively. The average length of the anastomoses was 3.5-5.0 (4.45±0.60) mm. The blocking time of MCA was 12.0-29.0 (21.50±6.62) min. A 100% vessel patency rate was achieved immediately after vessel anastomosis and at 1 month after surgery. DSA examinations were performed at 3 months after surgery on 6 patients and at 6 months after surgery on 1 patient, and all the anastomoses were found in full patency. All patients were included in the postoperative follow-up that lasted for 3 to 7 months. All patients recovered well without new neurological dysfunction. The mRS of 8 patients remained at 0 point before and after surgery. Two patients had improved postoperative mRS of 1 point from that of 2 points before surgery.Conclusion:STA-MCA side-to-side microvascular bypass anastomosis can be performed safely and efficiently using in-situ intravascular suture technique. It could efficiently reduce the incidence of perioperative complications. Meanwhile, it can self-regulate the blood flow and maximise the potential capability of STA.

Objective To investigate the preoperative predictive value of clinical-radiomics nomogram on N1-N2 lymph node metastasis in patients with stage Ⅰ to Ⅲ A primary lung adenocarcinoma(PL A).Methods A total of 164 PLA patients were divided into a training set(n=114)and an validation set(n=50).Three logistic regression models were created separately and the predictive efficacy of the model was evaluated using the receiver operating characteristic(ROC)curve and area under the curve(AUC)respectively.The AUC difference between models was tested by the DeLong test.The calibration degree was evaluated by the calibration curve.Decision curve analysis was performed to evaluate the benefits of clinical application.Results The radiomics model consisted of 8 imaging features[Radiomics score(Radscore)].The clinical model was composed of tumor type(central or peripheral)and tumor size.The tumor type,tumor size and Radscore formed the nomogram model.In the training set,the prediction of the nomogram model was more effective(AUC=0.909)than the clinical model(AUC=0.748)and the radiomics model(AUC=0.814),while the differences in AUC were statistically significant(P＜0.05).In the validation set,the prediction of the nomogram model was more effective(AUC=0.875)than the clinical model(AUC=0.682),and the difference in AUC was statistically significant(P＜0.05).The prediction of the nomogram model was also more effective than the radiomics model(AUC=0.799),but the difference in AUC was not statistically significant(P＞0.05).The calibration curve showed that the clinical-radiomics nomogram had a high level of calibration and the decision curve analysis showed good benefits from clinical application.Conclusion The clinical-radiomics nomogram is proven to be more effective than radiomics or clinical factors alone in the preoperative prediction of stage Ⅰ to Ⅲ A PLA N1-N2 lymph node metastasis.

Objective:To explore the imaging changes of lung lesions in patients with imported COVID-19 when reaching the discharge standard.Methods:The clinical and CT imaging data of 60 cured patients with imported COVID-19 and discharged from January to February 2020 in Anhui Province were retrospectively collected. At the initial diagnosis, 5 cases were mild, 53 were ordinary, and 2 were severe. The clinical characteristics of the patients and the characteristics of chest CT images at discharge were analyzed.Results:Fever (57 cases) and cough (55 cases) were the main symptoms in 60 patients. In 5 mild patients, 3 cases were negative in the whole course of CT examination, 2 cases were negative in the first time and abnormal in the second time. The first CT imaging features of 55 patients (53 common type and 2 severe type) were mainly bilateral lung involvement (51 cases), multiple lesions (33 cases), more common under the pleura (40 cases), and ground glass opacities were the most common (55 cases). The features of chest CT in clinical outcomes were that the ground glass shadow in the lung gradually faded and was completely absorbed (19 cases); the scope of ground glass shadow in the lung expanded and progressed to crazy-paving, consolidation shadow, and the lesion gradually absorbed again followed by fibrous cord shadows (27 cases); ground-glass opacities in the lungs quickly progressed to a consolidation and then slowly absorbed. Most of the lesions were accompanied by more residual fibrous cord shadows (4 cases). In 2 severe patients, the lesions in the lungs were larger ground glass, and a large amount of fibrous foci remained after slow absorption.Conclusions:Chest CT plays an important role in the diagnosis and treatment of imported COVID-19, and the degree of lung involvement seen on CT images is in good agreement with clinical outcome.

Objective: To explore the imaging changes of lung lesions in patients with imported COVID-19 patients when reaching the discharge standard. Method: The clinical and CT imaging data of 60 patients with imported COVID-19 cured and discharged from January to February 2020 in Anhui Province were retrospectively collected. The clinical characteristics of the patients and the characteristics of chest CT images at discharge were analyzed. Results: Fever (57 cases) and cough (55 cases) were the main symptoms in 60 patients. At the initial diagnosis, 5 cases were mild, 53 were ordinary, and 2 were severe. In 5 light patients, 3 cases were negative in the whole course of CT examination, 2 cases were negative in the first time and abnormal in the second time. . The first CT imaging features of 55 patients (53 common type and 2 severe type)were mainly bilateral lung involvement (51 cases), multiple lesions (33 cases), more common under the pleura (40 cases), and ground glass opacities were the most common. (55 cases). The clinical features of chest CT in clinical outcomes are that the ground glass shadow in the lung gradually fades and was completely absorbed (19 cases); the scope of ground glass shadow in the lung expanded and progressed to crazy-paving, consolidation shadow, and the lesion gradually absorbs again followed by Fibrous cord shadows (27 cases); ground-glass opacities in the lungs quickly progressed to a consolidation and then slowly absorbed . Most of the lesions were accompanied by more residual fibrous cord shadows (4 cases). In 2 severe patients, the lesions in the lungs were larger ground glass, and a big amount of fibrous foci remained after slowly absorption. Conclusion Chest CT plays an important role in the diagnosis and treatment of imported COVID-19, and the degree of lung involvement seen on CT images is in good agreement with clinical outcome.

Fibroblast growth factor 21 (FGF21) has been only reported to prevent type 1 diabetic nephropathy (DN) in the streptozotocin-induced type 1 diabetes mellitus (T1DM) mouse model. However, the FVB (Cg)-Tg (Cryaa-Tag, Ins2-CALM1) 26OVE/PneJ (OVE26) transgenic mouse is a widely recommended mouse model to recapture the most important features of T1DM nephropathy that often occurs in diabetic patients. In addition, most previous studies focused on exploring the preventive effect of FGF21 on the development of DN. However, in clinic, development of therapeutic strategy has much more realistic value compared with preventive strategy since the onset time of DN is difficult to be accurately predicted. Therefore, in the present study OVE26 mice were used to investigate the potential therapeutic effects of FGF21 on DN.

The hospital improved its rationality of medication by means of better pharmaceutical management ,full-course supervision of drug use ,and clarified responsibility system. It holds that IT means can play an early warning role for the rational medication ,while orchestrated work of section , departments and measured can improve the rationality and ensure patient safety .

There are various contents about diagnosis and treatment of low back pain in(), which are closely related to meridians and collaterals, forming a complete theoretical system of meridian differentiation for low back pain. Its theory and application are interpreted in this paper from five main aspects, including 18 meridians and collaterals densely distributing in the tendons and bones of the waist, the pathogenesis of low back pain lying in the disorders of the meridianand blood, the nature of low back pain being reflected by the color and shape of meridians and collaterals, the disordered meridians of low back pain being first identified based on syndrome differentiation, the acupuncture prescription being selected according to meridian differentiation. The purpose of this paper is to guide clinical practice, explore the advantages and characteristics of meridian differentiation, and provide theoretical reference and evidence for promoting the standardization of TCM.