Objective:To investigate the diagnosis, treatment, prognosis and aeromedical assessment of nasopharyngeal non-Hodgkin lymphoma (NHL) in civil aviation pilots.Methods:The clinical data of a civil pilot with nasopharyngeal NHL was retrospectively analyzed while related literature was reviewed. The clinical characteristics, diagnosis, treatment, prognosis and identification of nasopharyngeal NHL were traced.Results:A civil pilot was diagnosed with nasopharyngeal NHL in January 2016 before being grounded by aviation physicians. After treatment with systematic chemoradiation and chemotherapy by the Department of Oncology, West China Hospital of Sichuan University, the patient′s results of blood routine tests, blood biochemistry, EB virus DNA detection, electrical audiometry, and sound immittance returned to normal as evidenced by multiple outpatient examinations between June 2016 and April 2017. No signs of malignant tumor were found by fiber nasopharyngoscopy, nasopharyngeal MRI or positron emission tomography/computed tomography. In June 2017, he applied for specially-permitted assessment for the first time, and the aeromedical assessment conclusion was waiver to flight, but his flight was limited to 60 h or less. The pilot was able to perform flight duties ever since. EB virus DNA detection, nasopharyngeal MRI, fiber nasopharyngoscopy and other related examinations were repeated in each physical examination, and the pilot was given specially-permitted eligibility for fight missions annually for 6 consecutive years, but the monthly flying hours was limited to 60 h or less. So far, the disease neither recurred nor progressed.Conclusions:Nasopharyngeal NHL is rare in civil aviation pilots, so missed diagnosis and misdiagnosis should be avoided. Patients with nasopharyngeal NHL who have recovered after treatment may apply for specially-permitted health assessment and resume their work after comprehensive assessment by related experts.

Objective:To investigate the diagnosis, treatment, prognosis and aeromedical assessment of nasopharyngeal non-Hodgkin lymphoma (NHL) in civil aviation pilots.Methods:The clinical data of a civil pilot with nasopharyngeal NHL was retrospectively analyzed while related literature was reviewed. The clinical characteristics, diagnosis, treatment, prognosis and identification of nasopharyngeal NHL were traced.Results:A civil pilot was diagnosed with nasopharyngeal NHL in January 2016 before being grounded by aviation physicians. After treatment with systematic chemoradiation and chemotherapy by the Department of Oncology, West China Hospital of Sichuan University, the patient′s results of blood routine tests, blood biochemistry, EB virus DNA detection, electrical audiometry, and sound immittance returned to normal as evidenced by multiple outpatient examinations between June 2016 and April 2017. No signs of malignant tumor were found by fiber nasopharyngoscopy, nasopharyngeal MRI or positron emission tomography/computed tomography. In June 2017, he applied for specially-permitted assessment for the first time, and the aeromedical assessment conclusion was waiver to flight, but his flight was limited to 60 h or less. The pilot was able to perform flight duties ever since. EB virus DNA detection, nasopharyngeal MRI, fiber nasopharyngoscopy and other related examinations were repeated in each physical examination, and the pilot was given specially-permitted eligibility for fight missions annually for 6 consecutive years, but the monthly flying hours was limited to 60 h or less. So far, the disease neither recurred nor progressed.Conclusions:Nasopharyngeal NHL is rare in civil aviation pilots, so missed diagnosis and misdiagnosis should be avoided. Patients with nasopharyngeal NHL who have recovered after treatment may apply for specially-permitted health assessment and resume their work after comprehensive assessment by related experts.

Objective To observe the expression and trends of tight junction proteins Occludin and zonula occlu-den-1(ZO-1)in blood-brain barrier(BBB)of rats with traumatic brain injury(TBI),and to explore the interven-tion effect of cannabidiol(CBD)on the BBB.Methods The TBI model of rat was prepared by modified"Feeney free fall method"and randomly divided into three groups:the sham-operated group(Sham group),the model group(TBI+vehicle group)and the CBD intervention group(TBI+CBD group),with 24 rats in each group.Each group was subdivided into six time points:8 h,1,2,3,5 and 7 d after injury.The expression of Occludin and ZO-1,which are closely related to the permeability of BBB,was detected by immunohistochemistry,immuno-fluorescence staining and Western blot at different points.The permeability of BBB was detected by sodium fluores-cein assay.Results The results of immunohistochemistry showed that compared with Sham group,the positive ex-pression of Occludin and ZO-1 decreased with time after brain trauma(P<0.05),and both reached the lowest level at 2 d.The expression levels of Occludin and ZO-1 were up-regulated after 1 d of CBD intervention(P<0.05).Immunofluorescence staining showed a similar trend to Western blot results,with Occludin and ZO-1 fluo-rescence expression intensity and protein expression reduced after TBI compared with Sham group(P<0.05).And the expression levels of Occludin and ZO-1 were up-regulated after 2 d of CBD intervention(P<0.05).The results of fluorescein sodium experiment showed that the BBB integrity of brain tissue was destroyed after TBI,and the permeability increased after TBI(P<0.01).The permeability of BBB decreased after CBD intervention(P<0.05).Conclusion The expression of tight junction proteins Occludin and ZO-1 decreases after TBI,and the permeability of BBB is disrupted,and CBD intervention reverses the disruption of the BBB by TBI.

Objective To investigate testicular damage in traumatic brain injury(TBI)rats and to analyze the in-terventional effects of cannabidiol(CBD)on TBI-induced testicular damage.Methods 18 Sprague Dawley(SD)rats were randomly divided into three groups:the sham operation group(Sham group),model group(TBI group)and treatment group(TBI+CBD group).HE staining was used to observe the testicular histopathological changes in the rat testis.ELISA was used to detect testosterone level in rat serum.TUNEL staining was utilized to observe apoptosis,while immunofluorescence staining,Western blot and RT-qPCR were employed to evaluate Bax,Bcl-2,Cleaved Caspase-3 and TNF-α protein and mRNA expression.Results HE staining showed pathological changes in the testes of TBI rats compared with those in the Sham group.ELISA assay showed a decrease in testosterone levels in the TBI group compared to the Sham group,but there was no significant difference(P＞0.05).Immunofluores-cence results showed that the intensity of Bax fluorescence expression increased in the TBI group compared with the Sham group(P＜0.01),whereas the intensity of Bax fluorescence decreased and the intensity of Bcl-2 fluorescence increased in the rats after the CBD intervention(P＜0.01).Western Blot results showed that CBD treatment in rats decreased the protein levels of testicular apoptosis-related proteins(Bax and Cleaved Caspase-3,all P＜0.05)and inflammation-related proteins(TNF-α,P＜0.01),and increased the protein level of the anti-apoptotic protein,Bcl-2(P＜0.05).The trend of RT-qPCR results was similar,with mRNA expression of Bax(P＜0.05)and TNF-α(P＜0.01)decreased and mRNA expression of Bcl-2 increased after CBD intervention compared with the TBI group(P＜0.05).Conclusion TBI induces testis injury,and CBD treatment effectively repairs apoptosis and in-flammatory in testicular tissue of TBI rats.

Objective:To explore the clinical characteristics and genetic variant in a child with neurodevelopmental disorders (NDDs).Methods:Clinical data of a child who had presented at Xiaogan Hospital Affiliated to Wuhan University of Science and Technology in December 2020 due to intermittent convulsions for over a year were retrospectively analyzed. Peripheral blood samples of the child and his parents were collected and subjected to whole exome sequencing. Candidate variants were verified by Sanger sequencing and bioinformatic analysis. " HNRNPU gene", "epilepsy", "epileptic encephalopathy", "hereditary epilepsy", "neurodevelopmental disorder", "neurodevelopmental syndrome", " HNRNPU", and "NDDs" were used as the key words to search the CNKI, Wanfang and PubMed databases dated from January 1, 1994 to February 10, 2022. Results:The patient was a 2-year-old boy who had developed seizure at the age of 5 months. His clinical features had included abnormal appearance, recurrent seizures, and low developmental quotients of each functional area as evaluated by the Gesell scale. The child was given sodium valproate for the antiepileptic treatment and rehabilitation training. He had become seizure-free within half a year of follow-up, but his intelligence and motor development did not improve significantly. Genetic testing revealed that he has harbored a heterozygous c. 1720_1722delCTT (p.Lys574del) variant of the HNRNPU gene, which was not found in either of his parents. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), the variant was rated as likely pathogenic (PS2+ PM2_Supporting+ PM4). A total of 13 articles were retrieved, and the types of HNRNPU gene mutations have included splice site mutation, nonsense mutation, missense mutation, in-frame deletion, gene duplication, frameshifting mutation, and multiple exon deletion. The main clinical manifestations have included mental retardation, language delay, global developmental delay, epilepsy, craniofacial deformity, mental and behavioral abnormalities. Conclusion:The c. 1720_1722delCTT variant of the HNRNPU gene probably underlay the NDDs in this child. Above finding has enriched the mutational spectrum of the HNRNPU gene.

Objective:To explore the psychological experience and demand of parents of children with delayed recovery after congenital heart disease surgery.Methods:This study adopted phenomenological research methods from qualitative research. Using the purposive sampling method, parents of postoperative delayed recovery children with congenital heart disease who met the inclusion criteria were selected as the research objects from October to November 2019 at Fuwai Hospital, Chinese Academy of Medical Sciences. Semi-structured interviews were conducted with the parents of the children, and the data were analyzed by Colaizzi 7-step analysis method.Results:Finally, 13 parents of children with delayed recovery after congenital heart disease surgery were included. According to the interview results, four themes were extracted, which were negative psychological experience of parents of children with delayed recovery, positive psychological experience and expectation change of parents, heavy economic burden of parents and diversified needs of parents.Conclusions:During the delayed recovery period, psychological experience of parents is complex and their needs are diverse. The nursing staff should identify and pay attention to the causes of the negative psychological experience of the parents of the children, timely channel their negative emotions and strengthen the positive psychological experience in many aspects. They can assist parents to seek social help to reduce physical and mental pressure and meet the diverse needs of parents by providing high-quality nursing services and multi-channel information support.

Objective : To observe the expression of glial fibrillary acidic protein (GFAP) in the brain tissue of rats with traumatic brain injury (TBI) and the differential changes between brain regions. Methods : The TBI model of rats was prepared by the modified Feeney free fall method , and it was randomly divided into the sham⁃operated qPCR were used to observe the morphological changes of activated astrocytes and the expression of GFAP in different brain regions after TBI. Results : Immunohistochemical staining showed that astrocytes were activated in all brain regions on the right side of TBI , and the only brain regions that spilled over to the contralateral side ( left) were cortical region 1 and midbrain regions. RT⁃qPCR results showed that GFAP mRNA was highly expressed in all brain regions on the right side of TBI , affecting the contralateral cortex and midbrain regions. Western blot results showed that GFAP protein was highly expressed in all brain regions on the right side of TBI , and it spread to the contralateral midbrain regions. Conclusion TBI can cause the activation of astrocytes and increase GFAP expression in the right brain regions , while also affecting the contralateral (left) cortex 1 and midbrain regions.

Objective:To explore the diagnosis, treatment and aeromedical assessment of parotid pleomorphic adenoma for civil pilot.Methods:The diagnosis, treatment and aeromedical assessment of a class I pilot with parotid pleomorphic adenoma were analyzed. Related literatures were reviewed.Results:The 54-year-old male pilot was found a mass behind the right earlobe in the routine annual physical examination. B-ultrasound examination showed solid nodule in the right parotid gland. The mass and superficial parotid glands were removed and the facial nerve was dissected. Pathology showed pleomorphic adenoma of the right parotid gland. No complications were found in physical examination 2 months after the operation. The masticatory function and facial nerve function were good and CT showed no obvious abnormalities. The pilot was finally qualified for flying. No tumor recurrence or other complications were found 5 months after returning flight. B-ultrasound showed changes after partial resection of the right parotid gland and no other abnormalities were found.Conclusions:Parotid pleomorphic adenoma may be ignored easily at its early stage. The pilot with proper treatment and good postoperative recovery can be qualified to flight.

Objective:To explore the diagnosis, treatment and aeromedical assessment of parotid pleomorphic adenoma for civil pilot.Methods:The diagnosis, treatment and aeromedical assessment of a class I pilot with parotid pleomorphic adenoma were analyzed. Related literatures were reviewed.Results:The 54-year-old male pilot was found a mass behind the right earlobe in the routine annual physical examination. B-ultrasound examination showed solid nodule in the right parotid gland. The mass and superficial parotid glands were removed and the facial nerve was dissected. Pathology showed pleomorphic adenoma of the right parotid gland. No complications were found in physical examination 2 months after the operation. The masticatory function and facial nerve function were good and CT showed no obvious abnormalities. The pilot was finally qualified for flying. No tumor recurrence or other complications were found 5 months after returning flight. B-ultrasound showed changes after partial resection of the right parotid gland and no other abnormalities were found.Conclusions:Parotid pleomorphic adenoma may be ignored easily at its early stage. The pilot with proper treatment and good postoperative recovery can be qualified to flight.

Objective:To compile Chinese version of Compliance with Annual Diabetic Eye Exams Survey (CADEES-C) and to evaluate its reliability and validity.Methods:According to the Brislin translation model, the English version of Annual Diabetic Eye Exams Survey was translated into Chinese and culturally adjusted. Using the convenient sampling method, a total of 287 patients with diabetes from a medical alliance in Guangzhou were selected from June to December 2019. The Chinese version of the questionnaire was tested for content validity, structure validity, internal consistency, criterion validity and test-retest reliability.Results:Five common factors were extracted, containing 25 items in total, and the cumulative variance contribution rate was 62.878%. The questionnaire and its dimensions were positively correlated. The total Cronbach's α coefficient of the questionnaire was 0.902. The total score of the questionnaire, score of each dimension and the criterion r value were from 0.472 to 0.658 ( P<0.01) . The retest reliability coefficients of the questionnaire and its dimensions ranged from 0.813 to 0.917 ( P<0.01) . Conclusions:Chinese version of Compliance with Annual Diabetic Eye Exams Survey has good reliability and validity and its item contents fit well with the theoretical framework, which can be used to measure ophthalmic follow-up compliance of diabetic patients in China.