ObjectiveTo explore the clinical potential of magnetic resonance elastography （MRE） for assessing the stiffness of common intracranial tumors. MethodsA retrospective analysis was conducted on 47 patients with brain tumors who underwent surgical treatment at The First Affiliated Hospital of Sun Yat-sen University between April 2023 and September 2024. The cohort included 10 cases of glioma， 12 cases of vestibular schwannoma， and 25 cases of meningioma. All patients underwent multiparameter MRI and MRE preoperatively. After co-registering MRE images with contrast-enhanced 3D T1-weighted images， three regions of interest （ROIs） were placed in the areas of maximum and minimum tumor stiffness respectively to measure the shear stiffness values， and the mean was calculated as the average shear stiffness. Additionally， one ROI was placed in the white matter and one in the grey matter of the posterior horn of the lateral ventricle at the basal ganglia level to obtain normal reference values. A neurosurgeon， blind to the MRE results， graded the intraoperative tumor stiffness based on surgical videos using a 5-point scale （1： soft； 5： hard）. Intraclass correlation coefficient （ICC） was used to assess inter-observer consistency. Analysis of variance （ANOVA） and nonparametric tests were employed to compare the differences of shear stiffness values between groups. Spearman correlation analysis was used to examine the correlation between elasticity values and clinicopathological parameters. The discriminatory efficacy of shear stiffness values for tumor types was evaluated with receiver operating characteristic （ROC） curves. ResultsThe ICCs for elasticity values measured by two physicians in the hardest and softest tumor areas were 0.868 and 0.831， respectively （both P＜ 0.01）. The maximum， minimum， and average shear stiffness values of meningiomas［（1.91±0.28） m/s， （1.66±0.25） m/s， （1.78±0.26） m/s， respectively］ were significantly higher than those of gliomas［（1.59±0.23） m/s， （1.42±0.23） m/s， （1.50±0.22） m/s， respectively （P＜0.05）］. The shear stiffness values of vestibular schwannomas［（1.70±0.30） m/s， （1.51±0.23） m/s， （1.61±0.26） m/s， respectively） were lower than those of meningiomas and higher than those of gliomas， but these differences were not statistically significant （both P＞0.05）. The shear stiffness values of white matter were significantly higher than that of grey matter［（1.63±0.08） m/s vs. （1.39±0.12） m/s， P＜0.05）］. In the overall sample， the maximum， minimum， and average shear stiffness values were significantly positively correlated with the intraoperative hardness grade （r_s = 0.591， r_s = 0.541， r_s = 0.571， respectively； all P＜0.001）， negatively correlated with WHO grade （r_s = -0.458， r_s = -0.458， r_s = -0.480， respectively； all P＜0.01）， but showed no correlation with Ki-67 （all P＞0.05）. ConclusionMRE can be used to assess the stiffness of intracranial tumors and to some extent differentiate between tumor types， which aids in formulating more individualized preoperative surgical plans.

Objective To explore the application effect of Interactive continuing nursing intervention model with three subjects and two tracks,which is based on internet and applied to chronic heart failure patients.Methods During January 1 to December 30,2017,110 chronic heart failure patients,who were going to discharge from the Second People's Hospital of Guangdong Province,were selected for this research.Participants were equally divided into control group and observation group with random number table with 55 cases each.Participants were adopted conventional medication and traditional care,while patients in control group were given extra interactive continuing nursing intervention with three subjects and two tracks,which was relied on internet-based cardiovascular disease management platform.Comparing patients' scores of life quality,self-care ability,anxiety and depression degree before intervention and that in 6 months after intervention with Minnesota Living with Heart Failure Questionnaire (MLHFQ),Self Care of Heart Failure Index (SCHFI),Self-rating Anxiety Scale(SAS)and Hamilton Depression Scale (HAMD) respectively.Moreover,6 minute walk test was conducted,simultaneously,the incidence of cardiovascular events was calculated respectively before intervention,3 months after intervention and 6 months after intervention.Results It showed that total scores of MLHFQ,SCHFI,SAS and HAMD for patients in observation group before intervention were (49.05 ± 4.39),(101.57 ±21.04),(58.3 ± 5.2) and (40.1 ± 3.5) points respectively while that for patients in observation group after 6 months intervention were (43.03 ± 6.85),(123.17 ± 18.23),(42.3 ± 4.2) and (24.4 ± 4.3) points respectively.The difference was statistically significant (t =5.49-20.60,all P ＜0.01).In comparison,intervention effect of observation group was better than that of control group,although,the SAS scores of the control group were statistically significant.Furthermore,after intervention,the difference of MLHFQ,SCHFI,SAS and HAMD scores were statistically significant(t =3.48-17.79,all P ＜0.01).Moreover,6 months after intervention,6 minute walk test evaluation showed that there was statistical significance between observation group and control group (~=8.11,P ＜0.05).Besides,The death rate in observation group was lower than that in control group after 6 months intervention (~=6.30,P ＜0.05).Meanwhile,readmission rate after 3 months and 6 months indicates that there was statistical significance between observation group and control group(x2=5.25,6.30,P ＜0.05).Conclusions Interactive nursing intervention model with three subjects and two tracks which based on internet is able to enhance chronic heart failure patients' self-care ability and life quality,decrease the incidence of cardiovascular events and negative emotion of patients.

Objective To investigate the clinical effect of anterior internal fixation plus vacuum sealing drainage in the treatment of ulnar and radial fractures of Gustilo type Ⅲ.Methods Twenty-eight patients with open ulnar and radial fracture of Gustilo type Ⅲ were managed from April 2007 to March 2014,and were divided into four groups(n =4).Group A were managed with external fixator and conventional changing dressings.Group B were managed with internal fixation and vacuum sealing drainage.Group C were managed with external fixator and vacuum sealing drainage.Group D were managed with internal fixation and conventional changing dressings.Result Twenty-eight cases were adopted telephone follow-up for 6 to 27 months.The soft tissue recovery time of each group respectively was (20.5 ± 2.37) days,(14.7 ±2.16) days,(15.6 ±2.17) days and(19.7 ±2.18) days.The hospital stay of each group respectively was (9.7 ± 2.54) weeks,(4.7 ± 1.46) weeks,(5.2 ± 2.34) weeks and 8.6 ± 2.16) weeks.The fracture healing time of each group respectively was (19.6 ± 2.74) weeks,(13.1±1.84) weeks,(18.1 ±2.54) weeks and (14.7 ± 1.74) weeks.There was significant difference of these data between the two groups(P ＜ 0.05).Conclusions Anterior internal fixation plus vacuum sealing drainage is a better way to treat ulnar and radial fractures of Gustilo type Ⅲ.The technique has short period,less complications,less painful and less expense.

Objective To investigate the mechanisms of Chinese traditional medicine mixture protection of vascular endothelial cell from apoptosis in cerebral ischemia-reperfusion injury. Methods Healthy, clean SD rats were randomly divided into 4 groups: Sham opera-tion group (SOG), cerebral ischemia reperfusion injury group (IRG), cerebral ischemia preconditioning group (IPG) and Chinese tradi-tional medicine mixture preconditioning group (CPG). Furthermore, IRG, IPG and NPC were divided into 4 sub-groups: 1 d, 7d, 14d, 21d subgroup, according to the different time point since ischemia-reperfusion took place. And in CPG, Naotai formula extract was used. Cere-bral vascular endothelial cells of rats were removed and Hoechst 33258 staining and the DNA gradient bands were used to detect the apoptosis of these cells. Then the influence of Naotai formula extract on caspase-3, 8 and 9 activation, and Bid lysis was examined by Western-blot, and the mechanisms of Chinese traditional medicine mixture protection of vascular endothelial cell were investigated from apoptosis signal pathway. Result Naotai formula extract can inhibit the apoptosis of endothelial cells in ischemia-reperfusion injury, and it also can inhibit the activation of caspase-3, 8 and 9, thus inhibit the lysis of Bid into tBid. Conclusion Naomi formula extract inhibit the apoptosis of endo-thelial ceils in ischemia-reperfusion injury via apoptosis signal pathway.