Objective To explore the application effect of blood pressure management based on the health belief model in patients with moyamoya disease after cerebral vascular reconstruction sur-gery.Methods From February to July 2024,210 patients with moyamoya disease who underwent cerebral vascular reconstruction surgery in our hospital were selected as study subjects.They were randomly divided into control group and intervention group,with 105 cases in each group.The control group received routine nursing care,while the intervention group applied blood pressure management based on the health belief model on the basis of routine nursing care.The postoperative cerebral hy-perperfusion syndrome and blood pressure control status of the two groups were compared,and the Health Belief Scale and the Mishel Uncertainty in Illness Scale were used to evaluate the effects before and after intervention.Results A total of 203 patients completed the study,including 100 cases in the control group and 103 cases in the intervention group.There were statistically significant differ-ences in the incidence of cerebral hyperperfusion syndrome and the proportion of patients with blood pressure higher than baseline data between the two groups(P＜0.05).After the intervention,there were statistically significant differences in the postoperative cerebral hyperperfusion syndrome status and blood pressure control status between the two groups(P＜0.05).After intervention,there were statistically significant differences in the scores of susceptibility and health motivation dimensions as well as the total score in the Health Belief Scale between the intervention group and the control group(P＜0.05).After the intervention,there were statistically significant differences in the scores of ambiguity and unpredictability dimensions as well as the total score in the Mishel Uncertainty in Ill-ness Scale between the intervention group and the control group(P＜0.05).Conclusion Blood pressure management based on the health belief model can effectively control blood pressure,reduce the incidence of cerebral hyperperfusion,improve health beliefs,and reduce the sense of uncertainty about the disease.

Objective: To analyze the current status of latent tuberculosis infection (LTBI) among freshmen in boarding middle schools in Longgang District, Shenzhen, so as to provide reference for formulating tuberculosis prevention and control strategies in the next stage. Methods: Data for tuberculosis health examination conducted among primary and secondary school students in Longgang District of Shenzhen in September 2022 to May 2023 were utilized to analyze the latent tuberculosis infection rate, and to explore the differences in latent tuberculosis infection rate among different grades, school nature, school categories and school levels. Results: The latent tuberculosis infection rate among freshmen in boarding secondary schools in Longgang District, Shenzhen in 2022 was 2.45%. The infection rate among full middle school (6.45%) and high school (3.37%) were higher than that in boarding junior high school (0.28%), nine year education school (0) and twelve year education school (1.00%) ( P <0.01). Moreover, the infection rate of high school freshmen (2.68%) was higher than that of bording junior high school (0.33%), and the rate of public schools (2.87%) and municipal schools (3.24%) were higher than those of private schools (1.78%) and distric-level schools (2.13%) respectively, with statistical significance observed for all differences( χ 2=43.58, 25.15, 22.69, P <0.01). Conclusions The latent tuberculosis infection rate among new boarding secondary students is relatively low in Longgang District of Shenzhen. However, the infection rate is higher in high school, public and municipal school. School should fully guarantee sports participation of students, enhance students awareness of tuberculosis through health knowledge lectures, and reduce the incidence of tuberculosis among students.

Humans ; Staphylococcus lugdunensis/genetics* ; Peptides, Cyclic ; Chromosomes ; Operon/genetics* ; Staphylococcal Infections/genetics* ; Bacterial Proteins/genetics* ; Anti-Bacterial Agents

Objective To observe the value of CT"cut-edge sign"for differentiating complex thymic cyst and thymic epithelial tumor(TET)with diameter less than 4 cm.Methods Data of 24 patients with complex thymic cyst(complex thymic cyst group)and 14 patients with TET(TET group)confirmed by surgical pathology who underwent plain and dual-phase enhanced chest CT scanning were retrospectively analyzed.CT"cut-edge sign"was evaluated by 2 physicians,and the inter-observer consistency was evaluated using intra-class correlation coefficient(ICC).The detection rate of CT"cut-edge sign"was compared between groups using logistic regression analysis.Receiver operating characteristic(ROC)curve was drawn,and the area under the curve(AUC)was calculated to evaluate the efficacy of CT"cut-edge sign"for differentiating complex thymic cyst and TET.Results The inter-observer consistency of CT"cut-edge sign"was good(ICC=0.94,95％CI[0.90,0.97]).The detection rate of CT"cut-edge sign"in complex thymic cyst group was 62.50％(15/24),higher than in TET group(2/14,14.29％)(P＜0.01).The sensitivity,specificity,accuracy and AUC of CT"cut-edge sign"for differentiating complex thymic cyst and TET was 62.50％(15/24),85.71％(12/14),71.05％(27/38)and 0.74,respectively.Conclusion CT"cut-edge sign"was helpful for differentiating complex thymic cyst and TET with diameter less than 4 cm.

Objective:To investigate the optimal monochromatic level for evaluation of in-stent lumen after transjugular intrahepatic portosystemic shunt (TIPS) by dual-layer detector CT.Methods:Twenty-nine patients after TIPS were retrospectively enrolled who underwent abdomen enhanced examinations with portal venous phases by a dual-layer detector CT between December 2019 and July 2021. The mixed iterative image (conventional group) and monochromatic images (40 keV group, 50 keV group, 60 keV group and 70 keV group) were obtained by reconstruction. Circular regions of interest were placed in the in-stent of the cross-sectional reconstructed image and in the vertical spinal muscle on the same plane to obtain the corresponding average CT value and noise. The contrast to noise ratio (CNR) and signal to noise ratio (SNR) were calculated. Then 4-point scale was performed to evaluate image quality subjectively by 2 physicians blindly and separately. One-way ANOVA or Kruskal Wallis H rank-sum test was used for the overall analysis between groups, and LSD test or Dunn′s Bonforoni test was used for pairwise comparison within groups. Results:There was no significant difference in noise values among the 5 groups ( P>0.05). The difference of CNR and SNR between the 5 groups was statistically significant ( F=72.28, 56.45, P<0.001). The CNR and SNR in the 40 keV group were the highest, which were 50.4±15.7 and 59.3±18.4 respectively, and the difference was statistically significant ( P<0.001). Subjective scores showed statistically significant differences among the 5 groups (χ2=101.61, P<0.001). The score of the 40 keV group was higher than that of the 60 keV group, 70 keV group, and conventional group ( P<0.001), and there was no significant difference when compared with the subjective score of the 50 keV group ( P>0.05). Conclusions:The 40 keV monochromatic image of dual detector spectral CT is the best image to observe the lumen of the stent after TIPS.

Background::High-dose dual therapy (HDDT) with proton pump inhibitors (PPIs) and amoxicillin has attracted widespread attention due to its favorable efficacy in eradicating Helicobacter pylori ( H. pylori). This study aimed to compare the efficacy and safety of high-dose PPI–amoxicillin dual therapy and bismuth-containing quadruple therapy for H. pylori rescue treatment. Methods::This was a prospective, randomized, multicenter, non-inferiority trial. Patients recruited from eight centers who had failed previous treatment were randomly (1:1) allocated to two eradication groups: HDDT (esomeprazole 40 mg and amoxicillin 1000 mg three times daily; the HDDT group) and bismuth-containing quadruple therapy (esomeprazole 40 mg, bismuth potassium citrate 220 mg, and furazolidone 100 mg twice daily, combined with tetracycline 500 mg three times daily; the tetracycline, furazolidone, esomeprazole, and bismuth [TFEB] group) for 14 days. The primary endpoint was the H. pylori eradication rate. The secondary endpoints were adverse effects, symptom improvement rates, and patient compliance. Results::A total of 658 patients who met the criteria were enrolled in this study. The HDDT group achieved eradication rates of 75.4% (248/329), 81.0% (248/306), and 81.3% (248/305) asdetermined by the intention-to-treat (ITT), modified intention-to-treat (MITT), and per-protocol (PP) analyses, respectively. The eradication rates were similar to those in the TFEB group: 78.1% (257/329), 84.2% (257/305), and 85.1% (257/302). The lower 95% confidence interval boundary (–9.19% in the ITT analysis, –9.21% in the MITT analysis, and –9.73% in the PP analysis) was greater than the predefined non-inferiority margin of –10%, establishing a non-inferiority of the HDDT group vs. the TFEB group. The incidence of adverse events in the HDDT group was significantly lower than that in the TFEB group (11.1% vs. 26.8%, P < 0.001). Symptom improvement rates and patients’ compliance were similar between the two groups. Conclusions::Fourteen-day HDDT is non-inferior to bismuth-containing quadruple therapy, with fewer adverse effects and good treatment compliance, suggesting HDDT as an alternative for H. pylori rescue treatment in the local region. Trial registration::Clinicaltrials.gov, NCT04678492.

Objective:To evaluate the efficacy and safety of focused radiofrequency in facial wrinkle and laxity.Methods:Seventeen female patients (47.71±1.56 years of age) were involved in our study during January to June 2018, treated with focused radiofrequency on the whole face. The treatments were performed monthly for three consecutive months. Their photographs were taken before treatment and one week after the last treatment, and then the wrinkle severity rating scale (WSRS) and global aesthetic improvement scale (GAIS) were evaulated.Results:After three times＇ treatment, the wrinkle was improved, WSRS of 1 week after the last treatment (2.71±0.47) was much lower than the baseline (3.00±0.79) ( P<0.05). 88.24% patients were satisfied with the improvement. There was no severe adverse effects during this whole procedure. Conclusions:Focused radiofrequency therapy for facial wrinkle and laxity is effective and safe.

Objective To investigate the safety and feasibility of thoracoscopic lobectomy without mechanical suture. Methods The data of 28 consecutive patients (a non-mechanical suture group, 16 males and 12 females at age of 61.23±11.10 years) who underwent non-mechanical suture anatomic thoracoscopic lobectomy performed by the same surgeon from March 2015 to March 2018 were analyzed retrospectively, and 28 patients (18 males and 10 females at age of 59.45±13.39 years) who underwent completely anatomic thoracoscopic lobectomy with endoscopic stapler (a mechanical suture group) in the same period were matched. The clinical effectiveness of the two groups was compared. Results The operation time between the non-mechanical suture group (136.30±53.46 min) and the mechanical suture group (109.63±44.61 min) showed a statistical difference (P<0.05). While in term of intraoperative bleeding volume (65.00 mlvs. 50.00 ml), postoperative thoracic drainage time (3.73 days vs. 3.56 days), thoracic drainage volume (538.60 ml vs. 563.70 ml), postoperative hospital stay (5.58 days vs. 5.35 days) and postoperative complication rate (5/28 vs. 6/28), there was no statistical difference between the two groups. Hospitalization expense was significantly different between the two groups (35 438.30 yuan vs. 51 693.60 yuan). Conclusion Non-mechanical suture thoracoscopic anatomic lobectomy is safe and feasible, and can significantly reduce the medical cost but prolong the operation time.

Objective To evaluate the effect of recurrent laryngeal nerve detector on the operation of upper or middle-thoracic esophageal carcinoma. Methods A total of 60 patients with resectable esophageal carcinoma in Beijing Tsinghua Changgung Hospital from January 2015 to December 2017 were recruited. These patients were randomly divided into experimental group and control group by using random number table method.The experimental group used recurrent laryngeal nerve detector to assist in the nerve exploration and separation. The control group was treated by routine operation method, and the operation effect of the two groups was compared. Results In the experimental group, the time spent on the confirmation of recurrent laryngeal nerve was significantly shorter than that in the control group [right side: 1.50 min (1.00, 1.63 min) vs. 5.50 min(4.88, 6.50 min), Z= -6.715, P < 0.05; left side: 1.75 min (1.50, 2.00 min) vs. 7.85 min (6.50, 9.00 min), Z= -6.726, P< 0.05]. The rate of recurrent laryngeal nerve injury in the experimental group was significantly lower than that in the control group [3.3 % (1/30) vs. 20.0 % (6/30), χ 2= 4.043, P < 0.05]. Conclusion The use of recurrent laryngeal nerve detector in the neck anastomosis of upper or middle-thoracic esophageal carcinoma can significantly shorten the time spent on confirming of the recurrent laryngeal nerve and reduce the rate of recurrent laryngeal nerve injury.

Objective To explore the feasibility of establishing a tree shrew model of chronic gastrointestinal mucosal injury. Methods A total of 12 adult male tree shrews were randomly divided into 3 groups. The experimental groups 1 and 2 were administered with intraperitoneal injection of 2 mg/(kg·d)and 1 mg/(kg·d)of 1-methyl-4-phenyl-1,2, 3,6-tetrahydropyridine(MPTP)once every day for 56 days, respectively. The control group was given the same volume of sterile saline at the corresponding time points. Changes in the body weight of the tree shrews were observed. The contents of dopamine in the cerebrospinal fluid were detected. Gastrointestinal morphology was observed by stereoscope and histopathological changes of the gastrointestinal mucosa were examined by HE staining. Results The body weight and the contents of dopamine in the cerebrospinal fluid of the tree shrews in the model group were significantly decreased(P< 0.05 for both). Pathological changes to some extent of the gastric antrum, the gastric body and the duodenum were observed, without obvious differences between the 2 mg/kg group and the 1 mg/kg group. No obvious changes were found in the control group. Conclusions Long-term intraperitoneal injection with a low dose of MPTP is a feasible method for the establishment of a tree shrew model of chronic gastrointestinal mucosal injury. The optimal dose is 2 mg/(kg·d)every day for 56 days.