A 36-year-old male presented to the Department of Neurosurgery of the Second People′s Hospital of Hunan Province on February 12, 2024, due to "10 days of aggravated paroxysmal headache and 1 day of mental abnormality". Ten days ago, after catching a cold, the patient developed persistent low fever and paroxysmal headache. On February 12, 2024, acuted mental and behavioral abnormalities developed, including slow response, self-talk, defecation and urination, no sense of shame and other mental and behavioral abnormalities. On February 22nd, metagenomic next-generation sequencing (mNGS) in cerebrospinal fluid confirmed feline rickettsia infection. One week after doxycycline anti-rickettsia treatment, cerebrospinal fluid mNGS results indicated that the etiology turned negative, and the clinical symptoms improved. Mental disorders caused by rickettsial encephalitis in cats are rare but clinically significant. This case highlights the diagnostic value of mNGS in critical and difficult cases, and supports its integration with traditional diagnostic techniques to achieve precision medicine.

A 36-year-old male presented to the Department of Neurosurgery of the Second People′s Hospital of Hunan Province on February 12, 2024, due to "10 days of aggravated paroxysmal headache and 1 day of mental abnormality". Ten days ago, after catching a cold, the patient developed persistent low fever and paroxysmal headache. On February 12, 2024, acuted mental and behavioral abnormalities developed, including slow response, self-talk, defecation and urination, no sense of shame and other mental and behavioral abnormalities. On February 22nd, metagenomic next-generation sequencing (mNGS) in cerebrospinal fluid confirmed feline rickettsia infection. One week after doxycycline anti-rickettsia treatment, cerebrospinal fluid mNGS results indicated that the etiology turned negative, and the clinical symptoms improved. Mental disorders caused by rickettsial encephalitis in cats are rare but clinically significant. This case highlights the diagnostic value of mNGS in critical and difficult cases, and supports its integration with traditional diagnostic techniques to achieve precision medicine.

Objective: To investigate the correlation between Ca, Al, As, Co, Mg, P, Fe, parathyroid hormone (PTH), Ct levels and primary familial brain calcification (PFBC). Methods: We recruited 17 PFBC families from July, 2015 to October, 2016. Groups were divided according to clinical symptoms, the serum concentrations of Ca, P, Fe, Al, As, Co, PTH and Ct were compared among different family groups. Results: There was no significant difference in serum levels of Ca, P, Fe, Al, As, Co, PTH and Ct among the healthy and patient groups or the symptomatic and asymptomatic groups, symptomatic and asymptomatic groups in movement disorder families and in psychiatric families (P>0.05). Conclusions Among the 17 PFBC families, neither serum concentrations of Ca, Al, As, Co, Mg, P, and Fe nor the levels of PTH and Ct were associated with PFBC.

Objective To investigate the level of vascular endothelial growth factor (VEGF), homocysteine (HCY), fibronectin (Fn) and apolipoprotein E (ApoE) in the serum and cerebrospinal fluid patients with stroke to inquire into patients′endothelial function damage.Methods We chose standard stroke patients in Brain Hospital of Hu′nan Province from August 2015 to August 2016, divided into ischemic stroke (IS) group (52 cases) and hemorrhagic stroke (HS) group (33 cases), and chose patients with the cerebrospinal fluid for diagnosis and treatment and ruled out infections, the nervous system and cardiovascular system diseases as control group (20 cases).The serum VEGF, HCY, Fn, and ApoE levels of the patients on the 1 th, 5 th and14 th day after admission were monitored and compared with those in cerebrospinal fluid expression, NIHSS and Barthel were also performed for assessment of severity and prognosis of HS.Results The serum levels of VEGF, HCY and ApoE in HS group were higher than those in IS group, and the Fn level was lower than that in IS group and control group.At the same time, the Fn levels gradually increased on the 5 th and 14 th day after admission (P＜0.05), close to the control group.Cerebrospinal fluid of VEGF, HCY, Fn, and ApoE levels in HS group were higher than those in the control group, while Fn level was lower, and these indexes were lower in cerebrospinal fluid than those in the serum, and the differences were statistically significant (P＜0.05).In correlation analysis, HCY level of cerebrospinal fluid was positively correlated with ApoE in HS patients (r=0.645, P=0.001), HCY and ApoE levels in HS patients were positively correlated with patients′NIHSS score (r=0.547, P=0.006;r=0.720, P＜0.001), and negatively correlated with Barthel index score (r=-0.703, P＜0.001, r=-0.765, P＜0.001, respectively).Conclusion There were vascular endothelial injury and neuroprotective function decreased in brain tissue of stroke patients.The level of Fn was related to the patient′s prognosis, which was conducive to the differentiation of IS and HS.The cerebrospinal fluid levels of HCY and ApoE can be used to evaluate the prognosis of HS patients.

With the promulgation of a series of laws and regulations in our country, the requirement for stand-ardized management of clinical research process are gradually clear, and higher requirements on the following-up review management of ethics committee also are put forward. Through concluding and summarizing 128 noncompli-ance/violation or protocol deviation reports accepted by a hospital in recent two years, this paper analyzed four main problems including that the researchers at management level failed to report or report timely; the researchers reported in irregular filling;the same type of violation/deviation program happened repeatedly and the rectification to the review opinions of ethics committee was ineffective, and also put forward the corresponding suggestions, in order to strengthen and perfect the standard management of noncompliance/violation or protocol deviation report.

Xerostomia, as a common symptom in surgical patients, is mainly caused by factors such as strict food and liquid fasting, body change in metabolism and secretion function during the operation period, and decrease of patients' comfort during perioperative period. In this paper, Chinese and foreign researches on current status, influencing factors, assessment methods and mechanisms of secondary xerostomia during perioperative period were reviewed, and current nursing interventions were described, so as to arouse attention of medical staff to the symptom of xerostomia in surgical patients and to provide references for conducting quality nursing.

Objective To investigate the factors affecting non-neoplasma touch technology operation by operation room nurses for malignant tumor patients.Methods The qualitative methods was used in the study to interview 15 operation room nurses phenomenologically using semi-structured interviews.Colaizzi principles were used for data analysis and summarization of themes.Result The themes brought out from the data included lack of knowledge of no-neoplasma touch technology operation,huge workload,less importance attached to the management,over-consideration of medical costs.Conclusions It is a need to improve the level of knowledge of operating room nurses on non-neoplasma technology operations.The importance should be attached to management of the technology operation.The training on the operation should be strengthened so as to improve their operation of the technology.

Objective To better understand the clinical characteristics of Familial Idiopathic Basal Ganglia Calcifi?cation (FIBGC), including at the perspective of hereditary pattern, clinical test results, onset age, clinical heterogeneity and the volume of basal ganglia calcification (VBGC). Method 8 Eight FIBGC families were collected and draw family pedigrees were draw. Analysis of was conducted on the patient's clinical test results, head CT and MRI changes, onset ag?es, relationship of clinical manifestations with VBGC. Results No significant difference was found in serum calcium, alu?minum, arsenic, cobalt, magnesium, phosphorus, iron, parathyroid hormone and calcitonin concentration between the fam?ily members of patients and healthy controls (P>0.05). Family members from 8 FIBGC families including the two with consanguineous marriage manifested autosomal dominant heredity. The severity of , symptomatic s was correlated with VBGCpatients showed the same clinical manifestations in the dyskinesia family. The psychiatric symptoms was not asso? ciated with VBGC whereas patients with dyskinesia had a large VBGC. There was a significant difference in onset age be?tween patients with psychiatric symptoms and those with dyskinesia. P.atients with dyskinesia suffer larger VBGC, and is characterized by Patients with dyskinesia had relatively later onset age (43.95 ± 2.47 y) whereas those with. psychiatric symptoms hadsymptomatic patients with early onset age (31.32±10.16y). The comparison of the onset age (43.954±2.473 vs. 31.319±10.156 y, t=4.438, P=0.001) and VBGC (1.748±0.622 vs. 0.392±0.276 cm3, t=2.518, P=0.028) with symptom?atic patients between dyskinesia and psychogenic families was significant. Conclusions Eight FIBGC families manifested autosomal dominant heredity. Patients with dyskinesia suffer have a larger VBGC and are associated with a, and is char?acterized by relatively later onset age. In contrast, patients with psychiatric symptomspsychogeny is not related withhave a the small VBGC and showedand their age of onset is young. earlier onset age.

Objective To evaluate the effectiveness of bio-safety theory intensive training before laboratory medicine intern-ship.Methods Collected 220 students of three universities in human before laboratory medicine internship,according to dif-ferent university,and the different grade of the same university,and the same class grouping pre-and post-the bio-safety in-tensive training,the obj ects of study in accordance with the training scheme to do on-site questionnaire survey by secret way in three universities,comparing the effectiveness pre-and post-training.Results Three universities had no difference before training of laboratory medicine students (χ2=0.081~3.135,P>0.05).However,in the same university,pre-training,the basic concepts and microbiological hazards assessment could be better grasped (respectively,P=0.000,0.000).Post-train-ing,the basic concepts and bio-safety operation specification could be promoted (respectively,P=0.000,0.002).In the same class between pre-and post-training,test results had no difference (χ2=0.096~2.408,P>0.05)except personal protec-tive equipmentin 2008 grade students,while in 2009 grade test performance was improved (χ2=4.821~12.27,P<0.05) except the basic concepts.Conclusion Bio-safety intensive training has good effects to operation skills,according to the spe-cific situation of students targeted training,which made students real benefit,and ensure laboratory medicine students’labo-ratory safety.

Anoikis,a specific form of programmed cell death,is triggered by cell detachment from extracellular matrix or adjacent cell.Studies have found that the most kinds of tumor cells had anoikis resistance characteristic,which may inhibit pro-apoptosis protein,block anoikis inside and outside pathways,up-regulate pro-survival factor signals,and promote survival,invasion and metastasis of tumor cells in the end.The review summarized the mechanism of anoikis and the relationship between anoikis and tumor invasion and the metastasis.