Objective By population survey,to explore the epidemiological characteristics of gastric precancerous lesions in Lishui District of Nanjing and provide objective basis for the prevention and treatment of early gastric cancer.Methods From July 2021 to December 2022,21 977 patients who received endoscopy and/or 13C-UBT in Lishui District People's Hospital and 6 medical community units in Nanjing City were retrospectively analyzed for demography characteristics,detection rate of gastric precancerous lesions,and H.Pylori infection rate.Results(1)590 cases of gastric precancerous lesions were detected(detection rate 2.68%);(2)The total detection rate of precancerous lesions and three pathological types in males were all higher than those in females(all P<0.001);(3)The minimum age for the total detection rate of precancerous lesions in males and the mini-mum age for each pathological type were lower than in females(P<0.001,0.009,0.005,0.002);(4)The popu-lation total H.pylori infection rate was 23.10%,the H.pylori infection rate in patients with precancerous lesions was higher than that in non-precancerous lesions(P<0.001),both H.pylori infection rate of male and female in precancerous lesions were all higher than those of non-precancerous lesions of the same sex(all P<0.001),in addition,the H.pylori infection rate of male whether in precancerous or non-precancerous lesions was higher than that of female(all P<0.001);(5)The precancerous lesions detection rate in male,female,and the overall age range of 20～29 to 70～79 years is positively correlated with age growth(P<0.001),and rapidly decreases after the age of 79,the of H.pylori infection rate was also positively correlated with age growth(P<0.001),and the trend of age change(P<0.001)was parallel to the precancerous lesions detection rate.Conclusions The detec-tion rate of gastric precancerous lesions in this region is above the average level in China;the total H.pylori infec-tion rate is at a relatively low level in China;the H.pylori infection rate is parallel to the age trend of the detection rate of gastric precancerous lesions,and increases with age.

Objective:To investigate the unqualified hepatitis C virus (HCV) detection result of blood donors from the served area of blood institutions.Methods:The data related to HCV markers detected of the first and repeat blood donors were collected from the system of practice comparison for the Chinese mainland blood institutions from 2017 to 2021. The anti-HCV reactive rate and the rates of anti-HCV negative but HCV-RNA reaction and all the relationship between rates and the annual, regional and different blood donors were statistically analyzed.Results:During 2017-2021, the number of anti-HCV reactive per 100 000 blood donors decreased from 444.3 to 250.44 in the served area of 22 blood institutions ( χ2=49.677, P<0.05). The number of HCV RNA detected positive per 100 000 anti-HCV negative increased from 0.69 to 2.05 year by year, but there was no statistical significance ( χ2=0.643, P>0.05). The anti-HCV unqualified rate was significantly different among regions ( χ2=3 260.283, P<0.05). The anti-HCV unqualified rate of the first blood donors was significantly higher than that of the repeated blood donors ( F=130.993, P < 0.05). The annual number of HCV RNA detected positive per 100 000 anti-HCV negative blood samples from donors ranged from 0 to 17.28. Conclusions:The anti-HCV unqualified rate of blood donors in the served area of 22 blood institutions decreased year by year. Compared with repeated blood donors, HCV infection should be emphasized in first-time blood donors. The implementation of HCV RNA test can detect out much more HCV infections and reduce the risk of transfusion transmitted infectious HCV.

Objective:To evaluate the clinical effect of microbotox injection of botulinum toxin type A in improving the fine lines of lower eyelid skin and achieving the rejuvenation of the eye area.Methods:The clinical data of patients with mildly sagging lower eyelid skin and fine wrinkles admitted to Facial and Neck Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College; Deparment of Plastic and Cosmetic Surgery, Guangyuan Central Hospital; Department of Dermatology, People’s Hospital of Qingshen County; Department of Plastic and Cosmetic Surgery, Dujiangyan People’s Hospital; Devision of Women’s Healthcare, Panzhihua Maternal and Child Hospital; Chengdu Badachu Cosmetic Hospital from August 2022 to January 2023 were analyzed retrospectively. Using the microbotox injection method, the botulinum toxin type A with a diluted concentration of 8 U/ml was micro-injected into the dermis layer or between the dermis and the superficial muscle layer at an interval of 0.6 cm, and a single point injection of 0.2 U. The injection range was the anatomical distribution range of the orbicularis oculi muscle. After treatment, patients were followed up to investigate patient satisfaction, which was divided into very satisfied, satisfied, dissatisfied and very dissatisfied, and to calculate subjective satisfaction (percentage of the number of very satisfied and satisfied cases in the total number of cases). At the same time, a independent physician used the global aesthetic improvement scale (GAIS) to evaluate the effect based on the patient’s photos before treatment and during follow-up. 5 indicates as worse than before, 4 as no improvement, 3 as were slight improvement, 2 as moderate improvement, and 1 as significant improvement. SPSS 24.0 software was used for descriptive analysis of the data.Results:A total of 23 patients were enrolled, including 1 male and 22 females, aged (36.4±2.5) years old. The follow-up was 1-6 months, with an average of 1.4 months, and the subjective satisfaction of patients was 100% (23/23). The result of the independent physician evaluation were as follows: the overall cosmetic improvement score of the observers was 1.26±0.54, 100% (23/23) of the patients reached the standard of obvious or moderate improvement. In terms of complications, 2 patients presented local epidermis bruises after injection, who recovered within 1 week; 1 patient complained of pain after injection, which was significantly relieved 12 hours later. No ectropion, symblepharon, facial palsy, dry eyes, or other complications were observed.Conclusion:Application of botulinum toxin type A microbotox injection can improve periorbital wrinkles and improve skin texture at the same time, and the therapeutic effect is definite.

Objective:To evaluate the clinical effect of microbotox injection of botulinum toxin type A in improving the fine lines of lower eyelid skin and achieving the rejuvenation of the eye area.Methods:The clinical data of patients with mildly sagging lower eyelid skin and fine wrinkles admitted to Facial and Neck Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College; Deparment of Plastic and Cosmetic Surgery, Guangyuan Central Hospital; Department of Dermatology, People’s Hospital of Qingshen County; Department of Plastic and Cosmetic Surgery, Dujiangyan People’s Hospital; Devision of Women’s Healthcare, Panzhihua Maternal and Child Hospital; Chengdu Badachu Cosmetic Hospital from August 2022 to January 2023 were analyzed retrospectively. Using the microbotox injection method, the botulinum toxin type A with a diluted concentration of 8 U/ml was micro-injected into the dermis layer or between the dermis and the superficial muscle layer at an interval of 0.6 cm, and a single point injection of 0.2 U. The injection range was the anatomical distribution range of the orbicularis oculi muscle. After treatment, patients were followed up to investigate patient satisfaction, which was divided into very satisfied, satisfied, dissatisfied and very dissatisfied, and to calculate subjective satisfaction (percentage of the number of very satisfied and satisfied cases in the total number of cases). At the same time, a independent physician used the global aesthetic improvement scale (GAIS) to evaluate the effect based on the patient’s photos before treatment and during follow-up. 5 indicates as worse than before, 4 as no improvement, 3 as were slight improvement, 2 as moderate improvement, and 1 as significant improvement. SPSS 24.0 software was used for descriptive analysis of the data.Results:A total of 23 patients were enrolled, including 1 male and 22 females, aged (36.4±2.5) years old. The follow-up was 1-6 months, with an average of 1.4 months, and the subjective satisfaction of patients was 100% (23/23). The result of the independent physician evaluation were as follows: the overall cosmetic improvement score of the observers was 1.26±0.54, 100% (23/23) of the patients reached the standard of obvious or moderate improvement. In terms of complications, 2 patients presented local epidermis bruises after injection, who recovered within 1 week; 1 patient complained of pain after injection, which was significantly relieved 12 hours later. No ectropion, symblepharon, facial palsy, dry eyes, or other complications were observed.Conclusion:Application of botulinum toxin type A microbotox injection can improve periorbital wrinkles and improve skin texture at the same time, and the therapeutic effect is definite.

Transcranial magneto-acoustic electrical stimulation (TMAES) is a novel method of brain nerve regulation and research, which uses induction current generated by the coupling of ultrasound and magnetic field to regulate neural electrical activity in different brain regions. As the second special envoy of nerve signal, calcium plays a key role in nerve signal transmission. In order to investigate the effect of TMAES on prefrontal cortex electrical activity, 15 mice were divided into control group, ultrasound stimulation (TUS) group and TMAES group. The TMAES group received 2.6 W/cm ² and 0.3 T of magnetic induction intensity, the TUS group received only ultrasound stimulation, and the control group received no ultrasound and magnetic field for one week. The calcium ion concentration in the prefrontal cortex of mice was recorded in real time by optical fiber photometric detection technology. The new object recognition experiment was conducted to compare the behavioral differences and the time-frequency distribution of calcium signal in each group. The results showed that the mean value of calcium transient signal in the TMAES group was (4.84 ± 0.11)% within 10 s after the stimulation, which was higher than that in the TUS group (4.40 ± 0.10)% and the control group (4.22 ± 0.08)%, and the waveform of calcium transient signal was slower, suggesting that calcium metabolism was faster. The main energy band of the TMAES group was 0-20 Hz, that of the TUS group was 0-12 Hz and that of the control group was 0-8 Hz. The cognitive index was 0.71 in the TMAES group, 0.63 in the TUS group, and 0.58 in the control group, indicating that both ultrasonic and magneto-acoustic stimulation could improve the cognitive ability of mice, but the effect of the TMAES group was better than that of the TUS group. These results suggest that TMAES can change the calcium homeostasis of prefrontal cortex nerve clusters, regulate the discharge activity of prefrontal nerve clusters, and promote cognitive function. The results of this study provide data support and reference for further exploration of the deep neural mechanism of TMAES.
Acoustics ; Animals ; Brain ; Calcium ; Electric Stimulation ; Mice ; Prefrontal Cortex ; Transcranial Direct Current Stimulation ; Transcranial Magnetic Stimulation

Objective:The clinical features, laboratory indices, and imaging data of patients with Pneumocystis jirovecii pneumonia (PJP) were described and analyzed, aiming to provide helpful information for the diagnosis and treatment of PJP. Methods:A retrospective study were conducted with data from 154 PJP patients who visited China-Japan Friendship Hospital from May 2017 to August 2020. Their clinical characteristics, laboratory and imaging data, and clinical outcomes were collected for analysis. The patients were further divided into the death group (51 cases) and the survival group(103 cases). The differences between the groups were compared by using t-test, nonparametric test, and chi-square test. Results:Of the 154 PJP patients, there were 89 males and 65 females, with a mean age of (53.7±14.8) years. Among them, 85.7% (132/154) were on immunosuppressive/glucocorticoids agents within the past month. Besides, 27.9% (43/154) and 33.1% (51/154) had kidney diseases and connective tissue diseases, respectively. The major clinical manifestations in these patients involved fever 82.9% (126/154), cough 59.7% (92/154), and dyspnea 52.6% (81/154). For the laboratory data, the lactate dehydrogenase (LDH) was 561.0 (434.3, 749.0) IU/L and the value increased in 91.3% (95/104) of the patients. The CD4+T-cell lymphocytes in 88.0% (95/108) and 57.4% (62/108) of patients were lower than 400/μl and 200/μl, respectively. Furthermore, (1, 3)-β-D glucan (BG) increased in 74.4% (67/90) of PJP patients (≥100.0 ng/L). For the imaging results, chest computed tomography (CT) showed diffuse ground-glass shadows/grid shadows in 90% (117/130) patients. Compared with the survival group, higher LDH [690.5 (528.8, 932.3) IU/L vs 502.5 (381.8, 657.0) IU/L, Z=-3.375, P=0.001], white blood cell count (WBC) [9.8 (5.8, 12.6) ×10 9/L vs 7.3 (5.0, 10.1) ×10 9/L, Z=-2.392, P=0.017], and age [(69.8±14.5) years vs (50.6±14.0) years, t=-3.756, P=0.001] were found in the death group. Lower lymphocyte ratio [5.3 (3.2, 9.3) % vs 9.6 (5.6, 17.2) %, Z=?3.262, P=0.001] and oxygen partial pressure (PaO 2) levels [(73.2±20.5) mmHg vs (64.8±17.7) mmHg (1 mmHg=0.133 kPa), t=2.345, P=0.021] were also observed in the death group. Furthermore, in the death group, the bacterial and fungal infection rate was higher than the rates in the survival group [55.1% (27/51) vs 21.5% (22/103), χ 2=15.372, P=0.001]. Conclusions:Long-term use of immunosuppressive agents or glucocorticoids predispose to PJP. CD4+T-lymphocytes, LDH, and BG might be used as important auxiliary examinations for PJP patients. Age, LDH, WBC, lymphocyte ratio, PaO 2 and possible combinations with bacterial or fungal infections are more closely related to the prognostic of PJP patients.

Objective:To investigate the correlation between fluid-attenuated inversion recovery (FLAIR) vascular hyperintensities (FVHs) and outcomes after endovascular mechanical thrombectomy (EMT) in patients with anterior circulation large vessel occlusive stroke.Methods:Using " Nanjing First Hospital Stroke Database" , consecutive patients with anterior circulation large vessel occlusive stroke received EMT treatment from June 2015 to December 2018 were enrolled retrospectively. Before EMT treatment, the distal FVH grade and the American Society of Intervention and Therapeutic Neuroradiology/Society of Interventional Radiology (ASITN/SIR) collateral circulation grade were evaluated. The modified Rankin Scale was used to evaluate the functional outcome of patients at 3 months after onset, and 0-2 was defined as a good outcome. Spearman correlation analysis was used to analyze the correlation between the distal FVH grade and the ASITN/SIR collateral circulation grade. Multivariate logistic regression analysis was used to identify the independent predictors of the outcomes. Results:A total of 117 patients with acute anterior circulation large vessel occlusive stroke were enrolled, aged 70.74±12.50 years, 72 (61.5%) were male. The baseline National Institutes of Health Stroke Scale (NIHSS) score was 13.73±4.91. Seventy-four patients (63.2%) had a good outcome and 43 (36.8%) had a poor outcome. The distal FVH grade was grade 0 in 8 cases (6.84%), grade 1 in 34 cases (29.06%), and grade 2 in 75 cases (64.10%). Compared with the distal FVH low-grade group (grade 0-1), the high-grade group (grade 2) had a higher ASITN/SIR collateral circulation grade ( P<0.001) and lower baseline National Institutes of Health Stroke Scale (NIHSS) score ( P=0.026). Spearman correlation analysis showed that the distal FVH grade was significantly positively correlated with the ASITN/SIR collateral circulation grade ( r=0.620, P<0.001). Multivariate logistic regression analysis showed that the high distal FVH grade (odds ratio [ OR] 0.336, 95% confidence interval [ CI] 0.128-0.879; P=0.026) was independently associated with the good outcomes, while the higher baseline NIHSS score ( OR 1.036, 95% CI 0.988-1.229; P=0.048) and symptomatic cerebral hemorrhage ( OR 5.597, 95% CI 1.052-29.761; P=0.043) were independently associated with the poor outcomes. Conclusion:The distal FVHs can reflect the state of collateral circulation. The high grade of distal FVHs is associated with the good outcomes after EMT in patients with anterior circulation large vessel occlusive stroke.

Objective: To analyze the application effect of water circulation blanket combined with warming flushing fluid in patients with percutaneous nephrolithotomy. Methods: A total of 86 patients with percutaneous nephrolithotomy who underwent surgery from January 2015 to August 2018 were enrolled in Gaochun People's Hospital of Nanjing. The prospective study was used and the patients were randomly divided into treatment group and control group for 43 patients in each group. The control group used conventional heat preservation measures and warming flushing fluid, and the treatment group used water circulation blanket combined with warming flushing fluid. The stress response, coagulation function, and adverse reactions were compared between the two groups. Results: The body temperature, mean arterial pressure and heart rate of the treatment group 1 hour after surgery were (37.04±0.30) °C, (94.12±8.24) mmHg, (82.06±7.82) times/min, respectively, after the completion of the operation, the indexes were (36.97±0.40) °C, (95.36±8.15) mmHg, and (82.78±8.21) times/min. The control group 1 hour after surgery indexes was (36.74±0.36) °C, (90.12±8.21) mmHg, (85.78±8.32) times/min, after the completion of the operation, the indexes were (35.76±0.42) °C, (90.42±6.54) mmHg, and (90.32±7.43) times/min. The difference between the two groups was statistically significant (t=2.136-13.680, P<0.05 or 0.01). The serum fibrinogen, activated partial thrombin time and thrombin time in the treatment group were (3.10±0.52) g/L, (30.08±1.85) s, (17.02±1.60) s, respectively, and the control group was (3.85±0.60) g/L, (33.42±1.74) s, (19.56±1.75) s. The difference between the two groups was statistically significant (t=6.194, 8.624, 7.024, P<0.05 or 0.01).The incidence of adverse reactions such as hypothermia in the treatment group was 6.98% (3/43), which was significantly lower than that in the control group 27.91% (12/43). The difference was statistically significant (χ²=6.541, P<0.05). Conclusions The water circulation blanket combined with warming flushing fluid can help relieve the stress response of patients with percutaneous nephrolithotomy, maintain the body's coagulation function stable, and reduce adverse reactions such as intraoperative hypothermia.

Objective To investigate the clinical value of serum γ-glutamyl transferase (GGT) and alkaline phosphatase ( ALP) in the diagnosis of bile duct stones .Methods One hundred and fifty suspected patients with common bile duct stones complicat-ed with gallstone admitted into the hospital for treatment from January 2013 to December 2016 were selected as research subjects .The pa-tients underwent cholecystectomy , during which intraoperative bile duct exploration was performed to determine the presence of common bile duct stones.In addition, 50 healthy subjects from normal examinees were selected as the control group .Both the patients with gall-stones before surgery and the control group subjects were all detected for the levels of serum GGT and ALP .Statistical analysis was made to found out the positive results of GGT and ALP detection .By using surgical diagnostic results as the gold standards , GGT and ALP were applied to identify the diagnostic results of common bile duct stones .The patients diagnosed to be small common bile duct calculi by sur-gery were designated as the positive group and the remaining patients were assigned as the negative group .Then, the expression levels of serum GGT and ALP were compared between the 3 groups.Results In the 150 gallstone patients, there were a total of 98 patients who were diagnosed by surgical exploration to have small common bile duct calculi .There was no statistical significance in the diagnostic sensi-tivity, specificity and accuracy of bile duct stones , when comparisons were made between surgical diagnostic results and GGT and ALP re-sults (P>0.05), and there was good agreement between these two diagnostic methods (Kappa=0.735, 0.719).There was statistical significance in the expression levels of GGT and ALP , when comparisons were made between the control group , the negative group and the positive group(P<0.05).Conclusion In the diagnosis of bile duct stones, the detection of serum γ-glutamyl transferase and alkaline phosphatase could be used to effectively identify bile duct stones , and be applied as an auxiliary diagnostic indicator of bile duct stones .

Objective To investigate the correlation between MRI characteristics and tumor pathologic manifestitions of ovarian tumors.Methods 38 cases of benign ovarian tumor with clinic and MRI data were enrolled in this study.The correlation between the results of postoperative pathology and MRI characteristics was analyzed.Results 38 cases showed as ovarian tumor by MRI was diagnosed as ovarian tumor by pathology.So the accuracy of qualitative diagnosis was 100%;48 lesions were detected by surgery and pathology, of which one case had 3 lesions.The detection rate was 87.5%(42/48).Conclusion MRI is a relatively reliable method for the localization and qualitative diagnosis of ovarian tumor,which provides the guidance for surgery.