This report describes a 72-year-old male patient with occipitotemporal cavernous hemangioma(CCH).The patient presented with persistent pain in the right occipital and retro auricular areas for over one year.Physical examination detected a tender mass in the right occipital region.Imaging studies showed destruction of the right occipitotemporal bone with a heterogeneous signal mass and irregular enhancement on magnetic resonance imaging(MRI).Positron emission tomography/computed tomography(PET/CT)examination revealed increased fluorodeoxyglucose(FDG)uptake(SUVmax=5.9),suggesting a benign lesion.Complete surgical excision of the tumor and involved skull was performed,with pathological diagnosis confirming cavernous hemangioma.The patient's symptoms completely resolved with no recurrence during three months of follow-up.This case represents the first report of PET/CT application in diagnosing occipitotemporal CCH,providing valuable reference for improving diagnostic accuracy and reducing misdiagnosis rates for this rare condition.

Objective:To investigate the efficacy and safety of transcatheter arterial embolization(TAE)in the treatment of refractory bleeding caused by head,neck,and maxillofacial trauma.Methods:The clinical data of 26 patients with refractory bleeding caused by head,neck and maxillofacial trauma who were treated with TAE in The First Affiliated Hospital of Zhengzhou University and The Third People's Hospital of Henan Province were analyzed retrospectively,including 16 males and 10 females,with an average age of 57.96±15.52 years.All patients were treated with TAE because of the poor effect of medication,packing,and other measures and repeated bleeding.The clinical data,operation success rate,effective hemostasis rate,30-day clinical success rate,and postoperative complica-tions were analyzed.The patients were followed up for 3 to 6 months.Results:The operation success rate of TAE was 100%.The bleed-ing symptoms of all patients were effectively controlled,and the effective hemostasis rate was 100%.The hemoglobin level was in-creased from(96.21±12.42)g/L before operation to(111.38±7.70)g/L at 3 days after operation(P<0.001).After operation,3 pa-tients had slight swelling,pain,or skin color changes in the head,neck,and maxillofacial region,which were effectively relieved or dis-appeared after symptomatic treatment;2 patients died of severe traumatic brain injury and cerebral edema.No serious complications such as cerebral infarction occurred in any patients.There was no rebleeding in any patients within 3 to 6 months of post-discharge follow-up.Conclusion:TAE has definite curative effect and good safety for refractory bleeding caused by head,neck,and maxillofa-cial trauma,and has high clinical application value.

This report describes a 72-year-old male patient with occipitotemporal cavernous hemangioma(CCH).The patient presented with persistent pain in the right occipital and retro auricular areas for over one year.Physical examination detected a tender mass in the right occipital region.Imaging studies showed destruction of the right occipitotemporal bone with a heterogeneous signal mass and irregular enhancement on magnetic resonance imaging(MRI).Positron emission tomography/computed tomography(PET/CT)examination revealed increased fluorodeoxyglucose(FDG)uptake(SUVmax=5.9),suggesting a benign lesion.Complete surgical excision of the tumor and involved skull was performed,with pathological diagnosis confirming cavernous hemangioma.The patient's symptoms completely resolved with no recurrence during three months of follow-up.This case represents the first report of PET/CT application in diagnosing occipitotemporal CCH,providing valuable reference for improving diagnostic accuracy and reducing misdiagnosis rates for this rare condition.

Objective:To establish a predictive model of acute physiological and chronic health status score (APACHEⅡ) and the British Thoracic Society modified pneumonia score (CURB-65) score on the prognosis of patients with emergency severe pneumonia complicated with acute respiratory distress syndrome (ARDS) and to evaluate the predictive effect.Methods:The relevant clinical data of patients with severe pneumonia combined with ARDS admitted to the Emergency Intensive Care Unit (EICU) of General Hospital of Ningxia Medical University from January 2017 to December 2021 were retrospectively collected, and different logistic regression models were established. On this basis, three prediction models (model 1: APACHE Ⅱ score, model 2: CURB-65 score, Model 3: APACHE Ⅱ score combined with CURB-65 score) were established and the accuracy of the prediction model was evaluated by repeating 50 times of 10-fold cross-validations. The efficacy of the prediction model was evaluated by C statistics, Kendall's tau-a rank correlation coefficient, R2, Brier score, calibration curve, net reclassification index (NRI), composite discriminant improvement index (IDI) and decision curve (DCA).Results:The study eventually included 108 patients, including 81 males and 27 females, with mean age (57.92 ± 16.56) years. Forty-eight patients survived and 60 patients died. The age of the death group was older, and APACHEⅡ score and CURB-65 score of the death group were all greater than those in the survival group, and the differences were statistically significant ( P<0.05). Different logistic regression models showed that the OR value of model 1 was 1.12 (95% CI: 1.06 -1.20), that of model 2 was 2.21 (95% CI: 1.43 - 3.40), and that of model 3 was 1.10 (95% CI: 1.03 - 1.18) and 1.95 (95% CI: 1.24 - 3.07). The average accuracy of model 1, model 2, and model 3 were 0.68±0.14, 0.66±0.11, and 0.72±0.13, respectively. The C statistic, Kendall's Tau-a rank correlation coefficient, R2 and Bril score of model 3 were better than those of model 1 and model 2, and the different models fit well ( P<0.05). The calibration curve results of 500 resampling showed that the calibration degree of model 2 was better than that of model 1 and model 3, and the predictive ability of model 3 was improved compared with model 1, and the IDI was increased by 0.08 ( P<0.01). Compared with model 2, the reclassification ability of cases and the comprehensive discrimination ability of model 3 were improved ( P<0.01). The decision curves of different models showed that the net benefit of model 3 was higher than that of single model 1 and model 2 when the prediction probability was about 25% to 55%, while the benefits of model 1, model 2 and model 3 in other probability prediction intervals were basically equal. Conclusions:Both APACHE Ⅱ score and CURB-65 score have certain predictive power for prognosis of patients with emergency severe pneumonia and ARDS, and their combination has the best prediction effect. CURB-65 score has fewer parameters, and its prognostic benefit in emergency patients with severe pneumonia complicated with ARDS is basically equivalent to APACHE Ⅱ score, which may be more suitable for the prognosis evaluation of emergency patients with severe pneumonia complicated with ARDS.

Objective:To observe the relationship between inducible carbon monoxide synthase (iNOS) and delayed encephalopathy after acute carbon monoxide poisoning (DEACMP), and explore its mechanism of action in DEACMP.Methods:This study was designed as prospective cohort study. Patients with acute carbon monoxide poisoning who met the diagnostic criteria and were admitted to Emergency Intensive Care Unit(EICU) of our hospital from June 2019 to June 2021 were selected as subjects. Patients were divided into the DEACMP group and non-DEACMP group according to the occurrence of DEACMP. Serum samples were collected on the first 24 h after admission and on day 7 and 14 after admission, and the serum nitric oxide (NO), neuronal nitric oxide synthase (nNOS), inducible carbon monoxide synthase (iNOS), and endothelial nitric oxide synthase (eNOS) level were measured by enzyme-linked immunosorbent assay. The generalized estimating equation was used to estimate the difference of NO, nNOS, iNOS and eNOS between DEACMP and non-DEACMP patients.Results:A total of 78 patients with carbon monoxide poisoning were included in our study finally, including 49 (62.82%) males and 29 (37.18%) females, with an average age of (53.96±14.95) years, 20 (25.64%) patients with DEACMP, and 1 (1.28%) death. Univariate analysis showed that patients with DEACMP had an average increase of 3 h (95% CI: 1.00, 5.00) in carbon monoxide exposure time and a 5-point decrease in GCS score (95% CI: 1.00, 6.00) than the patients without DEACMP, and the proportion of patients with severe carbon monoxide poisoning in the DEACMP group was higher than that of the non-DEACMP group (90.00% vs. 32.76%). According to the analysis of generalized estimation equation, on day 7 and 14 after admission, Compared with non-DEACMP patients, neither by performing unadjusted nor adjusted analysis with the iNOS of DEACMP patients was significantly higher than that in non-DEACMP patients regardless of whether exposure time, GCS score, coma time or severity of carbon monoxide poisoning were adjusted or not ( P <0.01 or P <0.05). Except for the level of nNOS in the GEE model adjusted with carbon monoxide exposure time, the levels of NO, nNOS and eNOS showed no significant difference between DEACMP and non-DEACMP patients ( P >0.05). Conclusions:The expression of iNOS level is increased in DEACMP patients, and its continuous expression may be involved in the pathogenesis of DEACMP.

Objective:To explore the evaluation value of sequential organ failure assessment (SOFA) score at different time points in the prognosis of patients with severe pneumonia combined with acute respiratory distress syndrome (ARDS).Methods:A retrospective cohort study method was conducted, including patients with severe pneumonia and ARDS admitted to the emergency intensive care unit (ICU) of General Hospital of Ningxia Medical University from January 2015 to December 2019. General clinical data such as gender, age, and the SOFA scores at 1, 2, 3, and 7 days after admission were recorded. According to the diagnostic test, the prognostic evaluation value of SOFA score in patients with severe pneumonia combined with ARDS at different time points and different ages was analyzed.Results:A total of 88 cases were included in this study, eventually, 42 cases were survived and 46 cases died, the mortality was 52.27%. The age of the death group was significantly older than the survival group (years old: 60.67±14.66 vs. 51.91±15.97), the SOFA score at each time point were significantly higher than those in the survival group (9.83±3.50 vs. 7.54±2.67, 9.98±3.75 vs. 7.48±2.92, 10.84±4.14 vs. 7.23±2.94, 11.71±4.03 vs. 6.51±3.22, respectively at 1, 2, 3, 7 days after admission, all P < 0.01). The receiver operator characteristic curve (ROC curve) showed that the SOFA score at 1, 2, 3, and 7 days after admission had a certain predictive value for the prognosis of patients with severe pneumonia combined with ARDS (all P < 0.01), and with the prolong of ICU stay, the area under ROC curve (AUC) of SOFA score had gradually increased. On the 7th day after admission, the SOFA score had the highest sensitivity in predicting severe pneumonia combined with ARDS patients, which was 92.86%, and the specificity was the highest on the 3rd day after admission, which was 88.10%. The AUC in day 7 was significantly higher than day 2 (0.85 vs. 0.72) , there was no statistically significant difference of AUC at other time points. After stratifying by age, the diagnostic of sensitivity, specificity, accuracy, and AUC of SOFA score for the prognosis had gradually increased, and the predictive value was better. However, only on day 3 after admission, the AUC of SOFA score was significantly higher than day 1 (0.80 vs. 0.77, P < 0.05), and there was no significant difference in AUC at other time points. In patients older than 60 years old, the AUC of the SOFA score predicting the prognosis of patients was relatively small on day 1 and day 2 (0.67, 0.68, respectively), the ability was poor. There was no statistically significant difference in the AUC of SOFA scores at each time point in evaluating the prognosis of patients. The trends over time of patients at different ages and time points showed that regardless of age, the SOFA scores of the patients in the death group showed an upward trend, while showed a downward trend in the survival group, the difference reached the largest on the 7th day after admission, and the death group was significantly higher than the survival group (age < 60 years old: 12.50 vs. 6.69; age≥60 years old: 11.58 vs. 6.21). Conclusion:The initial SOFA score has a certain value in the evaluation of prognosis of severe pneumonia patients combined with ARDS, but the effect is poor for elderly patients.

Objective Investigated the treatment effect of ISCOM leukemia vaccine combination with 1-methyl tryptophan on tumor burden mice .Methods Saponin was added lipase protein (1 mg/mL) 7 ℃ for 12 h ,adding 80 μL lipid mixed solution and 5 mL saponin solution (1 mg/mL ) to prepare ISCOM leukemia vaccine .C57BL /6 mice were randomly divided into model group , ISCOM leukemia vaccine group ,1-methyl tryptophan group and combination group ,Mice were injected FBL-3 cell to built leukemia tumor-burdened mice model .After treatment for 4 weeks ,tumors weight ,NK and Mφ and CTL cell killing activity ,serum levels of IL-10 ,IL-12 were detected .Results Tumor weight in combination group was less than 1-methyl tryptophan and ISCOM leukemia group [(0 .64 ± 0 .26)g vs .(2 .49 ± 0 .91)g ,P< 0 .01 ,(0 .64 ± 0 .26)g vs .(1 .28 ± 0 .73)g ,P< 0 .05] ;NK cell killing activity in com-bination group was higher than 1-methyl tryptophan group[(38 .41 ± 8 .27)% vs .(67 .22 ± 12 .74)% ,all P< 0 .01)] ;M φ activity in combination group was significantly higher than 1-methyl tryptophan group[(55 .69 ± 13 .69)% vs .(69 .47 ± 14 .79)% ,P< 0 .01] ;CTL activity in combination group was significantly higher than 1-methyl tryptophan group and ISCOM leukemia group[(43 .77 ± 8 .89)% vs .(69 .68 ± 11 .44)% ,P< 0 .01 ,(58 .87 ± 9 .45)% vs .(69 .68 ± 11 .44)% ,P < 0 .05] ;IL-10 in combination group were significantly lower than 1 - methyl tryptophan group and ISCOM leukemia group [(76 .2 ± 6 .82)pg /L vs .(98 .3 ± 13 .4)pg/L ,P<0 .01 ,(76 .2 ± 6 .82)pg/L vs .(202 .3 ± 44 .5)pg/L ,P < 0 .01] ;IL-12 in combination group were significantly higher than 1-methyl tryptophan group and ISCOM leukemia group[(381 .2 ± 47 .3)pg/L vs .(332 .1 ± 30 .2)pg/L ,P < 0 .05 ,(381 .2 ± 47 .3)pg /L vs . (291 .2 ± 17 .3)pg/L ,P< 0 .01] .Conclusion Combination with 1-methyl tryptophan and ISCOM leukemia vaccine has a well anti-tumor effect ,its mechanism may be through mediated and the expression of IL-12 and IL-10 .

Objective To explore the value of dual energy CT displaying knee joint torn posterior cruciate ligament (PCL). Methods Ten cases with single knee joint torn PCL were scanned by 1.5 TMR and dual energy CT. By the use of postprocessing technique of muhiplanar reformation (MPR) and volume rendering technique (VRT), the CT value,length,thickness of PCL were assessed by paired t test respectively. Results MPR and VRT clearly displayed the PCL. The CT value of the patient sides and normal sides were(60.10±3.21), (72.98±7.35) HU(t=4.33,P=0.006), the length were(4.42±0.56),(4.14±0.49) cm (t=-1.20,P=0.285), the thickness of the attachment site and middle sire were (0.88±0.19), (0.58±0.10), (0.38±0.12) cm and (0.43±0.07), (0.39±0.03), (0.43±0.12) cm (t=-6.89,P=0.001;t=-4.38,P=0.007;t=0.85,P=0.587) respectively. Conclusion Dual energy CT can demonstrate clearly the ligament with three-dimension display,and may provide important information for diagnosis and per-surgical evaluation.

Objective To explore the influence on isthmic spondylolisthesis (IS) from lumbar vertebras facet joint orientation (FJO) variation. Methods The lumbar vertebras of 60 patients scanned by 16-slices spiral CT were collected, 30 cases with IS was defined as isthmic group;30 cases with normal lumbar vertebras was defined as control group, the FJO at L3-4, L4-5 and L5-S1 were measured in two groups. The difference between two groups were compared at three levels, the difference between both sides of the facet joint orientation also was compared;the measured data and the data of 60 patients from foreign literature were compared at three levels. Results The FJO in isthmic group were (47.9±6.3)° ,(37.5±7.3)° , (37.9±7.7)° at the right of L3-4, L4-5, L5-S1 levels respectively,the FJO in control group were (53.1 ± 7.3)° , (40.5±6.3)° , (38.5±7.3)° respectively, the FJO in isthmic group were (48.1±6.0)° , (37.9 ± 7.4)° , (37.6 ± 7.6)° at the left of L3-4, L4-5, L5-S1 levels respectively, the FJO in control group were (52.3 ± 7.6)° , (41.6 ± 6.0)° , (38.2 ± 7.2)° respectively. The significant difference was found at L3-4 and L4-5 levels (P < 0.05), the orientation was similar at L5-S1 level (P > 0.05). The difference between the both sides FJO of lumbar vertebras was not found at L3-4,L4-5 and L5-S1 levels (P >0.05). The same as the measured data and the corresponding data from foreign literature(P > 0.05 ). Conclusions It seems possible that the coronal FJO may be the phenotypic representation of the familial etiology of IS. It is helpful for the measurement of lumbar vertebras FJO to find IS early,it is important to reduce and release the IS.