Objective To investigate the clinical value of 3.0 T functional magnetic resonance imaging in evaluating postoperative recurrence and treatment efficacy of glioma. Methods A retrospective analysis was conducted on the general clinical data of 67 patients who underwent glioma surgery at the Second Affiliated Hospital of Xingtai Medical University. All patients received chemotherapy for more than one month post-surgery. Recurrence of glioma was diagnosed based on secondary surgery or pathological biopsy results as the gold standard. From 3 to 6 months post-surgery, computerized tomography was used to measure cerebral blood volume (CBV), three-dimensional arterial spin labeling was used to measure cerebral blood flow (CBF) and relative CBF (rCBF), and diffusion-weighted imaging with and without contrast enhancement was used to measure apparent diffusion coefficient (ADC). Data were analyzed using SPSS 26.0 statistical software, and the t test or χ² test was used for inter-group comparisons based on data type. The receiver operating characteristic (ROC) curve was applied to evaluate the value of CBV, rCBF, and ADC in assessing postoperative recurrence and treatment efficacy of glioma. Results Patients with high-grade gliomas showed significantly higher CBV and rCBF and significantly lower ADC compared to those with low-grade gliomas (P < 0.05). The area under the ROC curve (AUC) of CBV, rCBF, and ADC in combination for grading glioma was 0.960, which was higher than those of individual indicators (0.790, 0.955, and 0.795, P < 0.05). The recurrence group had significantly higher CBV and rCBF and lower ADC compared to the non-recurrence group (P < 0.05). The AUC of CBV, rCBF, and ADC in combination for predicting postoperative glioma recurrence was 0.965, which was significantly higher than those of individual indicators (0.729, 0.929, and 0.941, P < 0.05). CBV and rCBF were lower and ADC was higher in the effective treatment group than in the ineffective treatment group (P < 0.05). The AUC of CBV, rCBF, and ADC in combination for evaluating glioma treatment efficacy was 0.985, which was higher than those of individual indicators (0.842, 0.898, and 0.961, P < 0.05). Conclusion The CBV, rCBF, and ADC in combination has shown high diagnostic accuracy and predictive efficacy in the evaluation of postoperative recurrence and treatment efficacy of glioma, which has important clinical application value.

BACKGROUND:Tyrosine kinase inhibitors,as well as other types of small-molecule cancer drugs,can cause severe cardiotoxicity. OBJECTIVE:To perform a heart safety re-evaluation by observing the effects of antitumor drugs on isolated heart electrocardiograph,cardiac action potential and associated ion channels and cytotoxicity. METHODS:Extracorporeal cardiac perfusion was given to the isolated rabbit heart using Langendorff perfusion:Sunitinib(0.3,3,10 μmol/L),Crizotinib(0.3,1,3 μmol/L),and Doxorubicin(1,30 μmol/L)were perfused sequentially for 120 minutes to record electrocardiograph and left ventricular pressure.A blank control group was set for comparison.Manual patch clamp was used to record the effects of Crizotinib,Sunitinib,Doxorubicin on hERG,Cav1.2,Nav1.5 channel currents and action potential in human induced pluripotent stem cell derived cardiomyocytes.Adenosine triphosphate level in human induced pluripotent stem cell derived cardiomyocytes was detected by CellTiter-Glo luminescent cell viability assay. RESULTS AND CONCLUSION:Isolated rabbit heart using Langendorff perfusion:Compared with the blank ontrol group,Sunitinib and Crizotinib at≥3 μmol/L decreased heart rate(P<0.01)and prolonged QT/QTc interval(P<0.01),and reduced left ventricular pressure to different extents.Manual patch clamp recording:Compared with the blank control group,Sunitinib and Crizotinib at 3 μmol/L inhibited the activities of hERG,Nav1.5 and Cav1.2 channels and significantly prolonged the duration of action potential(P<0.01).According to the analysis of the test article,the difference between the labeled concentration and the measured concentration of the recovered solution was not significant.Cell viability assays:Compared with the blank control group,adenosine triphosphate content in human induced pluripotent stem cell derived cardiomyocytes significantly decreased after treatment with Sunitinib(IC50=4.64 μmol/L),Doxorubicin(IC50=4.21 μmol/L)and Crizotinib(IC50=2.87 μmol/L),indicating that cell viability significantly decreased(P<0.01).To conclude,this study successfully established an early cardiac safety evaluation method for antitumor drugs,which provides good support and help for the subsequent development of antitumor drugs.

Objectives:To investigate the current willingness of depressive outpatients and their doctors in China to engage in shared decision-making (SDM), and to analyze the factors influencing this willingness.Methods:A questionnaire survey was conducted among doctors and patients with depression in 12 tertiary psychiatric hospitals and general hospitals by scanning two-dimensional code and filling in the questionnaire on the mobile terminal. The questionnaire covered patient demographics, emotional state scores, initial diagnosis and treatment, treatment expectations and concerns, symptom improvement needs, medication safety requirements, and diagnosis details (completed by the attending physician). Doctors provided basic information, current depression diagnosis and treatment status, and concerns regarding medications. Logistic regression analysis (univariate and multivariate) was used to identify factors influencing patients′ and doctors′ willingness to engage in SDM.Results:A total of 622 valid patient questionnaires and 45 valid physician questionnaires were collected. Both patients and doctors had a strong willingness to make shared decisions (80.39% (500/622) vs. 60.00% (27/45)). Multivariate binary logistic regression analysis showed that residential location (town versus rural areas: OR (95% CI)=1.895 (1.087-3.305)), acceptable monthly medical expenses (≥1 000-<2 000 CNY vs.<300 CNY: OR (95% CI)=0.194 (0.088-0.427);≥2 000 CNY vs.<300 CNY: OR (95% CI)=0.267 (0.094-0.754)), acceptance of online treatment and consultation (accept versus not accept: OR (95% CI)=3.196 (2.024-5.046)), and knowing about psychotherapy (yes versus no: OR (95% CI)=1.711 (1.003-2.921)) were the factors influencing the willingness of shared decision-making in patients (all P<0.05). For the doctors, the time spent on initial consultation was the factor influencing the willingness to engage in SDM ( OR (95% CI)=1.090 (1.004-1.184), P=0.040). Conclusions:Both depression patients and doctors in tertiary outpatient clinics in China show a strong willingness to engage in SDM, providing a solid foundation for clinical application. However, it is necessary to pay attention to the influence of residential location, acceptable monthly medical expenses, acceptance of online treatment and consultation, and knowledge of psychotherapy should be considered for patients, while the time spent on initial consultations should be considered for doctors.

Objectives:To investigate the current willingness of depressive outpatients and their doctors in China to engage in shared decision-making (SDM), and to analyze the factors influencing this willingness.Methods:A questionnaire survey was conducted among doctors and patients with depression in 12 tertiary psychiatric hospitals and general hospitals by scanning two-dimensional code and filling in the questionnaire on the mobile terminal. The questionnaire covered patient demographics, emotional state scores, initial diagnosis and treatment, treatment expectations and concerns, symptom improvement needs, medication safety requirements, and diagnosis details (completed by the attending physician). Doctors provided basic information, current depression diagnosis and treatment status, and concerns regarding medications. Logistic regression analysis (univariate and multivariate) was used to identify factors influencing patients′ and doctors′ willingness to engage in SDM.Results:A total of 622 valid patient questionnaires and 45 valid physician questionnaires were collected. Both patients and doctors had a strong willingness to make shared decisions (80.39% (500/622) vs. 60.00% (27/45)). Multivariate binary logistic regression analysis showed that residential location (town versus rural areas: OR (95% CI)=1.895 (1.087-3.305)), acceptable monthly medical expenses (≥1 000-<2 000 CNY vs.<300 CNY: OR (95% CI)=0.194 (0.088-0.427);≥2 000 CNY vs.<300 CNY: OR (95% CI)=0.267 (0.094-0.754)), acceptance of online treatment and consultation (accept versus not accept: OR (95% CI)=3.196 (2.024-5.046)), and knowing about psychotherapy (yes versus no: OR (95% CI)=1.711 (1.003-2.921)) were the factors influencing the willingness of shared decision-making in patients (all P<0.05). For the doctors, the time spent on initial consultation was the factor influencing the willingness to engage in SDM ( OR (95% CI)=1.090 (1.004-1.184), P=0.040). Conclusions:Both depression patients and doctors in tertiary outpatient clinics in China show a strong willingness to engage in SDM, providing a solid foundation for clinical application. However, it is necessary to pay attention to the influence of residential location, acceptable monthly medical expenses, acceptance of online treatment and consultation, and knowledge of psychotherapy should be considered for patients, while the time spent on initial consultations should be considered for doctors.

Rotator cuff injury often leads to shoulder pain and dysfunction. For the injured rotator cuff tendon without continuous interruption, conservative treatment is often used. However, the shoulder is used frequent in daily life, which makes that the rotator cuff injury generally shows gradual aggravation and eventually progresses to complete tear due to poor blood supply of the rotator cuff tendon tissue and weak repair ability. In order to reverse the pathophysiological changes after rotator cuff injury and promote the repair of injured rotator cuff tendon, a series of conservative treatments for rotator cuff injury have been explored. Extracorporeal shock wave therapy (ESWT) is one of the representative treatments, but its molecular biological mechanism in promoting rotator cuff repair is still unclear. Therefore, the authors review the progress of ESWT for rotator cuff injury from aspects of the molecular biological mechanism and clinical application status, so as to provide a reference for future researches and clinical application of ESWT.

Objective:To explore the association between polymorphism of Histone Deacetylase 2 (HDAC2) gene and alcohol use disorder (AUD) in male people of Han nationality for seeking suitable single nucleotide loci(SNP), and provide reference for early diagnosis and intervention of alcohol use disorder(AUD).Methods:A total of 194 male AUD patients of Han nationality (case group) and 310 normal men of Han nationality (control group) were selected for the study. The genomic DNA of peripheral blood of the subjects in the two groups was extracted, and 13 SNP loci of HDAC2 gene were obtained from HapMap database. The subjects in the two groups were genotyped by Agena MassARRAY SNP genotyping method.SPSS 25.0 was used to statistically analyze the differences of genotype frequency and allele frequency between the two groups, and Haploview 4.2 software was used for linkage disequilibrium and haploid analysis. The multiple test correction was carried out by the replacement test with 50 000 replacement times.Results:The genotype frequency of the 3 SNP loci(rs9481408, rs6568819, rs9488289) of HDAC2 gene were statistically significant different between the case group and the control group (all P<0.05). Further analysis found that the three loci were significantly correlated with AUD in the recessive genetic model between case group and control group(T/T vs C/C-C/T: OR=1.78, 95% CI: 1.05-3.03, P=0.033; T/T vs C/C-C/T: OR=1.79, 95% CI: 1.05-3.03, P=0.032; G/G vs C/C-C/G: OR=1.85, 95% CI: 1.09-3.13, P=0.022). Seven SNP haplotypes were constructed and the association odds ratio of GATCTGCAATAA between the case group and control group was 2.44, and the difference was statistically significant ( P<0.05). Conclusion:The SNP loci rs9481408, rs6568819, rs9488289 in the HDAC2 gene and haplotype GATCTGCCAATAA are associate with AUD in male people of Han nationality. These results indicated that the HDAC2 gene is one of the susceptibility genes of AUD.

Objective? To explore the effects of menu teaching and tradition teaching model in star student appraise among nursing students in clinical nursing teaching of neurosurgery department. Methods? From March 2017 to February 2018, we selected 128 nursing students in internship at the 81th Hospital, Affiliated to Nanjing University of Chinese Medicine. All of the nursing students were randomly divided into control group and experimental group, 64 cases in each group with one-to-one clinical teaching. Control group carried out tradition teaching model. On this basis, experimental group applied menu teaching. We compared the practice effects and the ratio of nursing students with 3-star or above. Results? The total score of examination performance of nurses in experimental group was (268.88±14.93) higher than that in control group with a statistical difference (t=-6.222, P＜ 0.05). There were 33 nursing students being deducted marks 0-2 and 8 nursing students being deducted 7-9 in medical ethics and clinical practical competency in experimental group; there were 24 and 18 nursing students in control group respectively; the difference was statistical (χ2=5.256, P＜0.05). There were 39.1% of nursing students being ranked as 4-stat or 5-star in experimental group and 14.1% in control group with a statistical difference (χ2=10.439, P＜0.05). Conclusions? In clinical nursing teaching of neurosurgery, menu teaching model can improve abilities and examination performance, stimulate the learning interest of nursing students.

Objective: To investigate the clinical effects of the " rectangle plus triangle flaps" methods to repair the post-burn pseudo anal stenosis. Methods: From Oct. 2014 to Jan. 2017, five cases of pseudo anal stenosis were hospitalized and the durations of their scar contraction were 0.5 to 2 years. Flaps were located: at 3 o′clock and 9 o′clock directions of anus with prone position. Flaps were designed as one rectangle flap plus two triangle flaps. Rectangle flap was located from the exit of the diverticulum (pedicle) to the anus (distal end). Triangle flaps were located between the anus and the distal end of the rectangle flap, perpendicular to the rectangle flap. Flap transfer: ① the rectangle flap was advanced to the anus direction and sutured with the incision edge of the triangle flap closer to the anus; ② the two triangle flaps were rotated by 90 degrees and transferred to the two longitudinal incisions of the rectangle flap. Results: This design could enlarge the diverticulum exit and shorten its distance to the anus. All flaps survived and were well-healed. The follow-ups at 0.5 to 2 years presented favorable clinical results. No flap contracture, recurrent stenosis, unobstructed defecation or cleaning convenience occurred. Conclusions The " rectangle plus triangle flaps" methods was an effective way to repair the post-burn pseudo anal stenosis, which could enlarge the diverticulum exit and relocate the anus by making use of the perianal scar tissue.

Objective To compare the results of TEOAE and DPOAE in the same population of normal newborns, to provide information on choosing appropriate screening tools.Methods A two-steps protocol was taken with the first screening during the first 48 to 72 hours of birth and rescreened from one to two months old if the newborns failed the first screening.For each step of screening, TEOAE and DPOAE were performed simultaneously using AccuScreen hearing screening instrument (Madsen-GN Otometrics, Taastrup, Denmark).A total of 1 062 normal newborns (F/M=508/554) delivered in Peking Union Medical College Hospital were enrolled in this research for the first screening.Infants who failed either TEOAE or DPOAE screening in the first screening were referred to a second screening.Among them, 135 performed both DPOAE and TEOAE in the second step.The newborns who failed the second screening would receive ABR when they were 3 months old.Results In the first screening,the failure rate for TEOAE was 11.0% (117/1 062) and 13.7% (145/1 062) for DPOAE.In the second screening step, the failure rates were 17.8% (24/135) and 20.7% (28/135) for TEOAE and DPOAE, respectively.Chi-square and Fisher's test showed that the failure rates of DPOAE were significant higher than TEOAE for both steps (P<0.001).The agreements between TEOAE and DPOAE were 96.0% and 95.6% for the first and second steps respectively, and the kappa values were 0.817 and 0.857.As to the average time taken to accomplish the screening for one ear, TEOAE was 24±25 s and DPOAE was 40±34 s during the first screening;in the rescreening, TEOAE was 52±41 s and DPOAE was 73±62 s.Paired-t tests showed that the differences between DPOAE and TEOAE testing time were statistically significant (P=0.000) in both screening steps.Finally, 7 newborns (10 ears) were diagnosed conductive hearing loss(except 1 ear was sensorineural hearing loss).Conclusion As a screening tool, TEOAE got lower refer rates and took less time than DPOAE implicating TEOAE a better screening tool for normal neonates.

Objective To observe the intervention effect of electro-acupuncture(EA) on mammalian target of rapamycin(mTOR) expression in hypoxic-ischemic encephalopathy(HIE) newborn rats. Methods Seven-day-old SD rats were randomly assigned into 3 groups, namely sham-surgery group, HIE model group, and EA group. All of the groups were subdivided into 4 subgroups in terms of 4 time periods of 1, 3, 7 and 21 day(s). Hematoxylin-eosin staining was used for the observation of histological changes in the affected cerebral region. Expression levels of cerebral mTOR were detected with Western blotting method. Results The results of HE staining showed that EA group at experimental day 21 had clear organizational structure, ordered arrangement of neurons, relieved cellular swelling, well cell integrity with clear nucleolus and proliferative glial cells. Compared with the sham-surgery group, mTOR level of the model group was dramatically increased on the 1st, 3rd, 7th and 21st day(P<0.05), and the mTOR expression level of EA group was significantly higher than that in the model group at the above time points (P < 0.05). Conclusion EA can promote mTOR expression in brain tissue and can protect the brain of newborn rats from HIE.