Objective To observe the value of contrast-enhanced ultrasound(CEUS)for evaluating DeBakey Ⅰ aortic dissection involved renal artery.Methods Totally 137 patients with DeBakey Ⅰ aortic dissection involved renal artery were retrospectively enrolled,including 132 cases involved unilateral and 5 cases involved bilateral renal arteries.The opening of totally 274 renal arteries in bilateral kidneys were observed.Taken CT angiography(CTA)as reference standard,the renal artery opened in true lumen was considered as unaffected,while opened in false lumen or true-false lumen were both considered as affected.Relative CEUS manifestations were observed,and their value for evaluating involved renal artery or not were analyzed.Results CTA showed that 132 renal arteries opened in true lumens,90 opened in false lumens and 52 opened in true-false lumens.CEUS diagnosed 131 renal arteries opened in true lumens,111 opened in false lumens and 32 opened in true-false lumens,and the sensitivity for diagnosing DeBakey Ⅰ aortic dissection involved renal artery was 90.84％,81.08％and 90.63％,respectively.The consistency between CEUS and CTA for evaluating renal artery opened in true lumen or false lumen was good(Kappa=0.786).Logistic regression analysis showed that the time to peak(TTP)and peak intensity(PI)of time intensity curve(TIC)were both impact factors for differentiating renal artery opened in true lumen or false lumen,as well as true lumen or true-false lumen(both P＜0.05),while the area under the curve(AUC)of TIC was impact factor for differentiating renal artery opened in true lumen or false lumen(P＜0.05).The AUC of receiver operating characteristic curve of the combination of TTP,PI and AUC of TIC for differentiating renal artery opened in true lumen or false lumen,true lumen or true-false lumen and false lumen or true-false lumen was 0.703,0.686 and 0.493,respectively.Conclusion CEUS was helpful for evaluating DeBakey Ⅰ aortic dissection involved renal artery.

The clinical data of a child with neurodevelopmental disorders caused by a new mutation in the POLR2A gene were retrospectively analyzed.The patient was a 4-year and 2-month-old girl who presented at Xiamen Hospital, Children′s Hospital of Fudan University in June 2024 with clinical manifestations of early infantile hypotonia, muscle atrophy of both lower limbs, global developmental delay (including delays in motor and language development, mental retardation, etc.), sleep difficulties, feeding difficulties, autistic behaviors (namely, social withdrawal), epilepsy, and auditory deficits.The child had one seizure at the age of 2 years and 8 months and one at the age of 4 years, but seizures are currently controlled by drugs.Cranial magnetic resonance imaging and CT showed agenesis of the corpus callosum, bilateral ventricular widening and cerebellar hypoplasia.Whole exome sequencing showed a new mutation c. 3364C>T (p.P1122S) in the POLR2A gene (NM_000937) in the child, and no related gene variants were found in either parental lineage.According to the American College of Medical Genetics and Genomics rating guidelines, it was determined to be a suspected pathogenic variant (PS2+ PM2+ PP3+ PP4).The mutation site has not been reported at home and abroad.The c. 3364C > T ( p. P1122S ) mutation of the POLR2A gene can cause neurodevelopmental disorders, severe phenotypes and poor long-term prognosis.

Objective To observe the value of contrast-enhanced ultrasound(CEUS)for evaluating DeBakey Ⅰ aortic dissection involved renal artery.Methods Totally 137 patients with DeBakey Ⅰ aortic dissection involved renal artery were retrospectively enrolled,including 132 cases involved unilateral and 5 cases involved bilateral renal arteries.The opening of totally 274 renal arteries in bilateral kidneys were observed.Taken CT angiography(CTA)as reference standard,the renal artery opened in true lumen was considered as unaffected,while opened in false lumen or true-false lumen were both considered as affected.Relative CEUS manifestations were observed,and their value for evaluating involved renal artery or not were analyzed.Results CTA showed that 132 renal arteries opened in true lumens,90 opened in false lumens and 52 opened in true-false lumens.CEUS diagnosed 131 renal arteries opened in true lumens,111 opened in false lumens and 32 opened in true-false lumens,and the sensitivity for diagnosing DeBakey Ⅰ aortic dissection involved renal artery was 90.84％,81.08％and 90.63％,respectively.The consistency between CEUS and CTA for evaluating renal artery opened in true lumen or false lumen was good(Kappa=0.786).Logistic regression analysis showed that the time to peak(TTP)and peak intensity(PI)of time intensity curve(TIC)were both impact factors for differentiating renal artery opened in true lumen or false lumen,as well as true lumen or true-false lumen(both P＜0.05),while the area under the curve(AUC)of TIC was impact factor for differentiating renal artery opened in true lumen or false lumen(P＜0.05).The AUC of receiver operating characteristic curve of the combination of TTP,PI and AUC of TIC for differentiating renal artery opened in true lumen or false lumen,true lumen or true-false lumen and false lumen or true-false lumen was 0.703,0.686 and 0.493,respectively.Conclusion CEUS was helpful for evaluating DeBakey Ⅰ aortic dissection involved renal artery.

The clinical data of a child with neurodevelopmental disorders caused by a new mutation in the POLR2A gene were retrospectively analyzed.The patient was a 4-year and 2-month-old girl who presented at Xiamen Hospital, Children′s Hospital of Fudan University in June 2024 with clinical manifestations of early infantile hypotonia, muscle atrophy of both lower limbs, global developmental delay (including delays in motor and language development, mental retardation, etc.), sleep difficulties, feeding difficulties, autistic behaviors (namely, social withdrawal), epilepsy, and auditory deficits.The child had one seizure at the age of 2 years and 8 months and one at the age of 4 years, but seizures are currently controlled by drugs.Cranial magnetic resonance imaging and CT showed agenesis of the corpus callosum, bilateral ventricular widening and cerebellar hypoplasia.Whole exome sequencing showed a new mutation c. 3364C>T (p.P1122S) in the POLR2A gene (NM_000937) in the child, and no related gene variants were found in either parental lineage.According to the American College of Medical Genetics and Genomics rating guidelines, it was determined to be a suspected pathogenic variant (PS2+ PM2+ PP3+ PP4).The mutation site has not been reported at home and abroad.The c. 3364C > T ( p. P1122S ) mutation of the POLR2A gene can cause neurodevelopmental disorders, severe phenotypes and poor long-term prognosis.

Objective To explore the effect of the physician-nurse-social worker linkage rehabilitation model on the psychological status in patients receiving methadone maintenance treatment(MMT).Methods Ninety-four patients who received MMT were enrolled and randomly divided into experimental group(n = 48)and control group(n = 46).The experimental group received physician-nurse-social worker linkage rehabilitation model intervention,while the control group received conventional methadone treatment service.The anxiety,depression and quality of life of the two groups were evaluated before the intervention,3 months and 6 months after the intervention.Results After 6 months of physician-nurse-social worker linkage rehabilitation mode intervention,the depression status and the anxiety status of the experimental group subjects were significantly improved compared with those before intervention,and both BDI and BAI scores were significantly lower than those of the control group subjects(P＜0.05).Moreover,the proportion of"had depression"and"had anxiety"in the experimental group were significantly lower than those in the control group(P＜0.05).After 6 months of intervention,the QOL-DA score of the experimental group subjects(183.77±8.90)was significantly higher than that of the control group sub-jects(174.76±11.14)(P＜0.01).Conclusion The physician-nurse-social worker linkage rehabilitation model had certain advantages in improving the psychological state of MMT patients,which is worthy of promotion.

Objective To evaluate biomechanical properties of the personalized titanium alloy short femoral prosthesis by finite element analysis. Methods Based on the validated femoral finite element model, the base of the femoral neck was simulated, and by inserting different short femoral prostheses, four total hip replacement (THR) models, namely, the SMF stem model (Model A), BE1 stem model (Model B), MINI stem model (Model C) and personalized stem model (Model D) were established, respectively. The same loads and constraints were applied to four groups of models, and the von Mises stress distribution and deformation were calculated and analyzed, so as to compare mechanical stability of each model. Results The deformation of all THR models was smaller than that of the femur model under physiological state. The deformation of Model B was close to that of Model C, and the deformation of Model A was close to that of Model D. The peak stress of Model C was higher than that of the other 3 models, reaching 9555 MPa. The overall stress trend was Model C > Model B > Model D> Model A > Model under physiological state. Conclusions The peak stress, stress distribution of personalized short femoral stem were similar to that of SMF stem, with reasonable stress distribution, small stress shielding of the proximal femur, minimum overall deformation and shear stress of the prosthesis, and its effectiveness and stability could meet the requirements of human biomechanics, which could provide references for joint surgeons and prosthesis researchers.

Objective To investigate the effects of skin/muscle incision and retraction(SMIR)on mechanical paw withdrawal threshold and the ability of spatial learning and memory in immature rats after adulthood. Methods 27 male SD rats aged 3 weeks and weighing 60 ~ 80 g were randomly divided into 3 groups(n = 9):control group(group C),sham operation group(group Sham)and skin/muscle incision and retraction group (group SMIR). Group SMIR received operation for skin/muscle incision and retraction. Sham group received skin/muscle incision but no retraction.No surgery was operated on C group. Pain behavior was assessed by mechanical paw withdrawal threshold(MWT)to von Frey filament stimulation before and 1,3,7,12,22 and 32 days after operation.The effects of spatial learning and memory function were assessed by Morris water-maze test at 33 days after operation. Results Mechanical paw withdrawal threshold of group SMIR decreased 1 day after operation (P<0.05)and showed no significant difference before and 3,7,12,22,32 days after operation in 3 groups(P >0.05). In Morris water-maze test,compared with Sham and C group,the average escape latency in SMIR was sig-nificantly longer in the water maze navigation experiment(P < 0.01);the ratios of time and path in the quadrant of the platform were obviously lower in SMIR(P < 0.01). There was no statistical difference between sham and C group(P>0.05).Conclusion SMIR did not cause chronic pain but may cause a decrease in the ability of spatial learning and memory in immature rats.

Objective To investigate the correlation between the insertion torque values and primary stability of dental implants using different insertion torque values ,and search for the best insertion torque values that can acquire good primary stability. Methods Six male pure beagles were selected, and the first molars and four premolars of bilateral mandibulars were extracted. Three months later, a total of 48 XIVE dental implants were inserted. All implants were divided into group A, group B, group C, and group D based on the insertion torque value (ITV): group A, 0 < ITV < 20Ncm; group B, 20 ≤ ITV < 40Ncm; group C,40Ncm ≤ ITV < 60Ncm;group D,ITV≥60Ncm The dental implant stability was measured by Resonance frequency analysis when implanrs were placed immediately. Results No complications occured.There was significant difference between group A and grop B (P=0.012), group A and grop C (P=0.037), group A and grop D (P=0.001). There are no ignificant difference among group B,group C and grop D(P>0.05). Conclusion With the limitations of the study, it was concluded the primary stability does not simply depend on the insertion torque;When the insertion torque value was no less than 20Ncm, the dental implant can acquire good primary stability.

Objective To offer reference that the hospital governors use RCA quality improvement method. Methods Carries on the case analysis according to the case using RCA methods of reality, such as promethazine special to the wrong medicine drug approaches pathways leading to patient consciousness change, put forward the improvement pro-posal for quality improvement. Results During the period from June 2012 to January 2014 , the hospital did not happen because the drugs special route of administration way wrong phenomenon. Conclusion Application of RCA techniques can help us find the system reasons for the incident, and then analyze the reasons, to take practical action to improve the corresponding. And share the case method, put an end to these events.