Hypertensive intracerebral hemorrhage (ICH) is mostly single in basal ganglia, thalamus and pons. Simultaneous hemorrhage in other brain regions is relatively rare, accounting for only 5.6% of all hemorrhagic strokes, while bilateral symmetrical hemorrhage is extremely rare. A case of bilateral basal ganglia symmetrical hemorrhage is reported for clinical reference.

Cadmium exposure during pregnancy is a non-negligible public health problem which may increase the risk of shortened telomere length in newborns and cardiovascular metabolic health damage in children, and has attracted attention from many researchers in recent years. This article reviewed recent studies both domestically and internationally on the associations among cadmium exposure during pregnancy, shortened telomere length in newborns, and cardiovascular metabolic abnormalities in children, and briefly outlined possible mechanisms of shortened telomere length in newborns by cadmium exposure during pregnancy. Current research results showed that cadmium exposure during pregnancy is related to shortened telomere length in newborns and cardiovascular metabolic abnormalities in children, and shortened telomere length in newborns is also related to cardiovascular metabolic abnormalities in children. It suggested that telomere length in newborns may be a biomarker reflecting cardiovascular metabolic abnormalities in children caused by cadmium exposure during pregnancy. In addition, the current potential mechanisms of cadmium exposure during pregnancy accelerating neonatal telomere length shortening include inflammatory reaction, mitochondrial dysfunction, antioxidant consumption/antioxidant enzyme inactivation, and DNA methylation, and these biological mechanisms are associated with cardiovascular metabolic abnormalities through certain factors, such as obesity, elevated blood pressure, impaired fasting blood glucose, and dyslipidemia in children, suggesting that cardiovascular metabolic abnormalities in children may be programmed in early life, but there are still few relevant studies. In the future, research should be conducted on the association among cadmium exposure during pregnancy, telomere length, and offspring cardiovascular metabolism, as well as possible mediating efficacy and related biological mechanisms of telomere length, aiming to provide early-life biological information for the prevention of cardiovascular and metabolic diseases.

Objective:To explore the relationship between the maternal dietary patterns during pregnancy and the early childhood BMI change trajectory.Methods:The subjects were 1 241 pairs of pregnant women and their children in Ma'anshan maternal and infant health cohort. The food frequency questionnaire was used to collect the maternal diet data during pregnancy. The cohort children were followed up at birth, month 3, 6, 12, 18 and 24, respectively. The body height and weight data of the cohort children were collected. The principal component analysis was used to determine the categories of maternal dietary patterns during pregnancy, group-based multi-trajectory modeling was used to fit the early childhood BMI change trajectory, and the multiple classification logistic regression model was used to evaluate the relationship between the maternal dietary patterns during pregnancy and the early childhood BMI change trajectory.Results:The maternal dietary patterns during pregnancy included protein type, healthy type, vegetarian type, processing type and beverage type, which could explain 50.04% of the total dietary variation. Among them, the protein type, main dietary pattern, could explain 21.34% of the total dietary variation. The early childhood BMI change trajectory was from thinnish stature to average stature, then to mild obesity, accounting for 42.9%, 45.6% and 11.5% respectively. After controlling the potential confounding factors, it was found that there was a statistical correlation between healthy type and beverage type of maternal dietary patterns during pregnancy and early childhood BMI change trajectory ( P<0.05). Comparison of change trajectories between thinnish type and average stature type, children in the low-level group of healthy diet pattern tended to have a thinnish type change trajectory in early life ( OR=1.286, 95% CI: 1.002-1.651). Comparison of change trajectories between mild obesity type and average stature type, children in the high-level group of beverage diet pattern tended to have a mild obesity type change trajectory in early life ( OR=0.565, 95% CI: 0.342-0.935). The other dietary patterns had no statistical correlation with the early childhood BMI change trajectory. Conclusions:Maternal dietary patterns during pregnancy can affect the early childhood BMI change trajectory, and the low-level healthy type diet is an independent risk factor for thinnish type change trajectory, and the high-level beverage type diet is an independent risk factor for the mild obesity type change trajectory.

Objective:To evaluate the test-retest reliability of MRI criteria in the 2019 Bosniak classification of cystic renal masses (CRMs) and to analyze the impact of lesions′ property, size and readers′ experience on the test-retest reliability.Methods:From January 2009 to June 2019, 207 patients with 207 CRMs were included in this retrospective study. All of them underwent renal MRI and surgical-pathologic examination. According to Bosniak classification, version 2019, all CRMs were independently classified twice by eight radiologists with different levels of experience. All radiologists were blinded to the pathology of the lesions. By using intraclass correlation coefficient (ICC), test-retest reliability was evaluated for all CRMs and for subgroups with different pathological properties (benign and malignant) and different sizes (≤40 mm and>40 mm). The test-retest reliability of 4 senior readers (≥10 years of experience) and 4 junior readers (<10 years of experience) were evaluated respectively. The comparison of ICC was performed using Z test. Results:The 207 CRMs included 111 benign lesions (83 benign cysts, 28 benign tumors) and 96 malignant tumors. There were 87 lesions with maximum diameter ≤40 mm and 120 with maximum diameter>40 mm. The test-retest reliability (ICC) of each reader for all lesions was 0.776-0.888, the overall ICC was 0.848 (95%CI 0.821-0.872). The ICCs of senior and junior readers were 0.853 (95%CI 0.824-0.880) and 0.843 (95%CI 0.811-0.871) respectively, without significant difference between the two groups ( Z=0.85, P=0.374). The ICC of all readers was 0.827 for benign lesions and 0.654 for malignant lesions, showing significant difference ( Z=2.80, P=0.005). The ICC was 0.770 for lesions ≤40 mm and 0.876 for lesions>40 mm, which was significantly different ( Z=-2.36, P=0.018). For CRM subgroups with different pathological properties and different sizes, there was no significant difference in test-retest reliability between senior and junior readers (all P>0.05). Conclusion:The test-retest reliability of MRI criteria in the 2019 Bosniak classification of CRMs is excellent and unaffected by readers′ experience. The reliabilities are not consistent among CRMs of different pathological properties and different sizes, but all reached the level of good and above.

Objective:To explore the efficacy and safety of intraarterial microguidewire electrocoagulation in arterial aneurysms.Methods:(1) SilverSpeed, a kind of microguidewire used in clinical intravascular treatment for intracranial aneurysms, was used to conduct in vitro electrolysis gas generation experiment with isolated arterial blood of anticoagulant New Zealand white rabbits as medium, and thrombus attachment on the surface of microguidewire was observed under scanning electron microscope. (2) Rabbit common carotid artery aneurysm models were established by using vein bag transplantation method, and divided into microguidewire electrocoagulation treatment groups ( n=40) and blank control group ( n=10). The number of closured tumor cavity and the quality of formed thrombus were observed after electrocoagulation simulation treatment with SilverSpeed microguidewire (charging at 6, 9, 12, 15, and 18 V voltage, respectively for 1, 3, 6, 9, 12, and 15 min). DSA was used to observe whether there was ruptured aneurysms or thrombosis of parent artery. Twelve h later, head MRI diffusion weighted sequence scan was performed to detect whether there were new cerebral ischemia foci in the distal cerebral blood supply area of the parent artery. DSA was performed again 6 months after surgery to observe whether the aneurysms recurred. Results:(1) Electrolytic gas generation experiment results showed that bubbles were generated after electrification of SilverSpeed microguidewire; the higher the voltage, the more severe the reaction. Scanning electron microscope showed that thrombus attached to the surface of the microguidewire after electrification in isolated blood; and the higher the voltage, the denser the thrombus. (2) Under the same charging time, the higher the voltage, the larger the number of closured tumor cavity in rabbits of the microguidewire electrocoagulation treatment groups. Under the same voltage, the longer the charging time, the better the quality of thrombosis. Ischemic events occurred only in the microguidewire electrocoagulation treatment group with voltage>9 V, and the charging duration was not associated with the incidence of embolic events. When the voltage was 15 V, 2 experimental rabbits died due to aneurysm rupture 3 min after electrification. When the voltage was 18 V, 4 experimental rabbits died of cardiac arrest 9 min after electrification, and another 2 rabbits died of aneurysm rupture 6 min after electrification.Conclusions:High voltage is the main cause of adverse events in the microguidewire electrocoagulation treatment of aneurysms. After setting the appropriate voltage, prolonging the electrification time can improve the electrocoagulation effect without increasing the safety risk.

Objective : To investigate the association between adiposity rebound and metabolic abnormalities in pre- schools． Methods : A prospective cohort study was designed on the basis of the Maanshan birth cohort． Venous blood samples were collected at 5 to 6 years of age to detect metabolic indicators．2022 children aged 0 to 6 years with ≥8 consecutive measurements were enrolled. χ2 test and Logistic regression model were used to analyze the data. Results : The detection rate of abnormal metabolism in preschool children was 16. 9% ，and the risk of meta- bolic abnormalities in preschool children with high BMI level at the AR time point and earlier AR time phase was 2. 59 and 1. 82 times that of the normal group respectively． Conclusion High AR level and earlier AR phase can increase the prevalence of metabolic abnormalities in preschool children.

Objective:To investigate the effects of acupuncture combined with hyperbaric oxygen on neurological function and cerebral blood flow of pediatric patients with severe viral encephalitis.Methods:A total of 100 pediatric patients with severe viral encephalitis admitted to the Department of Pediatrics of the Second Affiliated Hospital of Zhengzhou University from August 2016 to December 2018 were selected as research objects and randomly divided into the observation group ( n=50) and the control group ( n=50) by the random number table method. Patients in both groups received conventional medical treatment. The patients in the control group were supplemented with hyperbaric oxygen, while the patients in the observation group were treated with acupuncture on the basis of the treatment in the control group. The clinical symptoms, the recovery time of body signs, the score of National Institute of Health stroke scale (NIHSS), the score of Glasgow coma scale (GCS), and the cerebral blood flow indexes were compared between the two groups. Results:The defervescence period, the time required for headache and vomiting to subside, the recovery time of consciousness, and the improvement time of electroencephalogram in the observation group were all shorter than those in the control group, the differences were statistically significant ( P<0.05). After treatment, the NIHSS score of the observation group was lower than that of the control group, but the GCS score of the observation group was higher than that of the control group ( P<0.05). After treatment, the systolic blood flow velocity (Vs), mean flow velocity (Vm), and pulsatility index (PI) in the two groups were lower than those before treatment, and the above-mentioned indexes of the observation group were lower than those of the control group, the differences were statistically significant ( P<0.05). Conclusion:In the treatment of severe viral encephalitis in children, acupuncture combined with hyperbaric oxygen can improve the clinical symptoms and signs, alleviate the severity of neurologic impairment, promote the recovery of consciousness, decrease the cerebral blood flow indexes, and speed up rehabilitation.

Objective:To investigate the effects of acupuncture combined with hyperbaric oxygen on neurological function and cerebral blood flow of pediatric patients with severe viral encephalitis.Methods:A total of 100 pediatric patients with severe viral encephalitis admitted to the Department of Pediatrics of the Second Affiliated Hospital of Zhengzhou University from August 2016 to December 2018 were selected as research objects and randomly divided into the observation group ( n=50) and the control group ( n=50) by the random number table method. Patients in both groups received conventional medical treatment. The patients in the control group were supplemented with hyperbaric oxygen, while the patients in the observation group were treated with acupuncture on the basis of the treatment in the control group. The clinical symptoms, the recovery time of body signs, the score of National Institute of Health stroke scale (NIHSS), the score of Glasgow coma scale (GCS), and the cerebral blood flow indexes were compared between the two groups. Results:The defervescence period, the time required for headache and vomiting to subside, the recovery time of consciousness, and the improvement time of electroencephalogram in the observation group were all shorter than those in the control group, the differences were statistically significant ( P<0.05). After treatment, the NIHSS score of the observation group was lower than that of the control group, but the GCS score of the observation group was higher than that of the control group ( P<0.05). After treatment, the systolic blood flow velocity (Vs), mean flow velocity (Vm), and pulsatility index (PI) in the two groups were lower than those before treatment, and the above-mentioned indexes of the observation group were lower than those of the control group, the differences were statistically significant ( P<0.05). Conclusion:In the treatment of severe viral encephalitis in children, acupuncture combined with hyperbaric oxygen can improve the clinical symptoms and signs, alleviate the severity of neurologic impairment, promote the recovery of consciousness, decrease the cerebral blood flow indexes, and speed up rehabilitation.

Because clinical oncology course for undergraduates is related to many clinical specialties, traditional teaching of this course is likely to lead to repetition and contradiction of knowledge. Clinical medical college carried out integrated curriculum in clinical oncology for three years during the implementation of teaching reform to overcome the above-mentioned disadvantages. Teaching and research sections related to clinical oncology were horizontally integrated under the guidance of teaching affairs office; On the premise of meeting the requirements of teaching outlines, the clinical oncology in internal medicine, surgery and gynecology was systematically improved in accordance with cognitive laws. Following the previous year, PBL teaching program in clinical oncology still focused on the integration of theoretical course and probation course. After integration, the sub-specialty teacher team was gradually shaped, the teaching quality was significantly improved and the clinical thinking of medical students was enhanced.

OBJECTIVE： To prepare Resveratrol-hydroxypropyl-β-cyclodextrin-chitosan sustained-release pellets （RES-HP-β- CD-Chitosan）， and to characterize it. METHODS： Resveratrol raw material， HP-β-cyclodextrin and chitosan were collected with ratio of 1 ∶ 7 ∶ 0.25. Resveratrol-HP-β-cyclodextrin inclusion compound were prepared by solvent method， and then added into chitosan， RES-HP-β-CD-Chitosan were prepared by spray drying method. Particle size of prepared sustained-released pellets were observed by optical microscope. X-ray， DSC， IR and SEM were used to characterize RES-HP-β-CD-Chitosan. The contents of resveratrol in prepared sustained-released pellets were determined by UV spectrum， and drug-loading amount and encapsulation efficiency were calculated. RESULTS： Particle size of prepared RES-HP-β-CD-Chitosan was （2.23±0.35） μm （n＝300）. Characterization results show that RES-HP-β-CD-Chitosan was spherical in shape； shrinkage was found on the surface of microspheres， and resveratrol was included in HP-β-cyclodextrin in molecule or amorphous state. Drug-loading amount of prepared RES-HP-β-CD-Chitosan was 11.67％ （n＝3）， encapsulation efficiency was 96.27％ （n＝3）. CONCLUSIONS： RES-HP-β-CD- Chitosan is prepared successfully.