Objective To determine the intrahepatic portal blood flow distribution by using dynamic contrast-enhanced CT(DCE-CT)scan,and to evaluate its application value in preventing overt hepatic encephalopathy(OHE)after transjugular intrahepatic portosystemic shunt(TIPS).Methods The clinical data of 110 patients with digestive tract hemorrhage due to cirrhotic portal hypertension,who received TIPS at Henan Provincial Hospital of Traditional Chinese Medicine of China from July 2017 to November 2023,were retrospectively analyzed.Preoperative DCE-CT was performed to evaluate the type of intrahepatic portal blood flow distribution.In patients with different types of intrahepatic portal blood flow distribution,the incidence of post-TIPS OHE was compared between the patients receiving portal vein left branch shunting and the patients receiving portal vein right branch shunting.Results In patients with the right splenic vein type,the incidences of post-TIPS OHE in left portal branch shunting and right portal branch shunting were 58.3％and 21.1％respectively,and the difference was statistically significant(P=0.022).In patients with the left splenic vein type and the diffuse distribution type,there was no statistically significant difference in the incidence of post-TIPS OHE between left portal branch shunting and right portal branch shunting(P=0.246 and 0.846 respectively).Further subgroup analysis results showed that the incidences of OHE in patients receiving splenic vein dominant branch shunting and in patients receiving superior mesenteric vein dominant branch shunting were 20.8％and 57.9％respectively,and the difference was statistically significant(P=0.008).Conclusion Pre-TIPS DCE-CT evaluation of intrahepatic portal blood flow distribution and intraoperative selective portal vein branch shunting can reduce the risk of postoperative OHE to a certain extent.

Objective Aiming to develop a distance-adaptive visual function self-examination system based on tablet computers and evaluate its accuracy.Methods Utilizing ArUco technology on a tablet device equipped with the camera,a system was developed to assess visual functions by identifying QR codes within a 2-meters range for real-time ranging.This system integrates various visual function tests,including visual acuity test(conventional visual acuity test and high-pass visual acuity test with varying contrasts),accommodative amplitude test,and visual field test at the foveal(5°).A total of 22 healthy subjects(44 eyes)participated in visual function assessments,with 6 subjects undergoing visual acuity tests at varying distances(1 m,1.25 m,1.6 m,2 m)and accommodative amplitude tests under both refractive correction and simulated undercorrection of-3.00D.The program distance and actual distance were compared,the consistency of visual acuity outcomes for identical optotype at different distances were assessed,the accommodative amplitude under refractive correction and undercorrection were analyzed,the repeatability of accommodative amplitude outcomes was evaluated using Intraclass Correlation Coefficient(ICC),and the contrast threshold and efficacy of visual field test outcomes were analyzed.Results The program distance and actual distance showed good agreement.High-pass visual acuity tests with the same contrast showed no significant differences at different distances(P?>?0.05),while conventional visual acuity tests showed significant differences at distances of 0.9 to 1.1 meters compared to other distances(P?

Objective:To explore the effect of standardized pain assessment and peer education on self-efficacy, quality of life and pain control of cancer pain patients.Methods:From January 2019 to January 2020, convenience sampling was used to select 162 inpatient cancer patients admitted to Henan Cancer Hospital as the research object. Patients were divided into observation group ( n=82) and control group ( n=80) based on the odd and even numbers of the patient's ward end number. Patients in control group received regular health education and traditional pain assessment. Observation group carried out standardized pain assessment and peer education. We compared self-efficacy, quality of life, pain control of two groups of patients before and after intervention. Results:Before intervention, there was no statistically significant difference between the two groups of patients in terms of dimension scores and total scores of self-efficacy, quality of life ( P>0.05) . After intervention, dimension scores and total scores of self-efficacy and quality of life of cancer pain patients' pain between two groups were higher than those before intervention, and the differences were statistically significant ( P<0.01) . Dimension scores and total scores of self-efficacy and quality of life of cancer pain patients in observation group were higher than those in control group with statistical differences ( P<0.01) . The overall pain control effect of cancer pain patients in observation group was better than that in control group, and the difference was statistically significant ( Z=-3.721, P<0.01) . Conclusions:Standardized pain assessment and peer education applied to the pain management of cancer pain patients can effectively improve the pain control effect and self-efficacy as well as the quality of life.

Objective: To investigate the impact of comprehensive geriatric assessment(CGA)on treatment outcomes of chronic heart failure(CHF)complicated with emotional disorders in the elderly. Methods: A total of 216 CHF patients with emotional disorders at Henan Provincial People’s Hospital were recruited from September 2017 to March 2019 and were randomly divided into a CGA group and a control group with 108 cases in each group.The control group was given standard drug treatment and psychological counseling, whereas individualized treatment was given to participants in the CGA group in compliance with CGA guidelines.The clinical effects after intervention for 8 weeks in the two groups were examined, using measures such as Hamilton Depression Rating Scale for Depression(HAMD)-24, Hamilton Anxiety Scale(HAMA)-14, amino-terminal pro-brain natriuretic peptide(NT-proBNP), the 6 minute walk test(6MWT)and left ventricular ejection fraction(LVEF). The changes of cognitive status, nutritional status, fall risk and other indicators in patients were comprehensively assessed and statistically analyzed. Results: Compared with pre-treatment data, 8 weeks of treatment for both the control group and the CGA group resulted in decreased HAMD-24 scores(Control group: 31.78±9.08, 23.69±10.16; CGA group: 32.09±8.98, 15.35±7.91; P<0.05), HAMA-14 scores(Control group: 22.38±7.09, 15.28±6.54; CGA group: 21.99±8.12, 10.48±6.82; P<0.05)and NT-proBNP levels[Control group: (4672±392)ng/L, (3279±282)ng/L; CGA group: (4861±378)ng/L, (2387±215)ng/L; P<0.05], and increased LVEF(%)[Control group(34.5±6.2)%, (39.8±7.5)%; CGA group(35.1±3.9)%, (42.5±6.1)%; P<0.05]and 6MWT scores[Control group(298±79±7.5)m, (358±102)m; CGA group(305±98)m, (402±178)m; P<0.05], with more marked changes in all the measures in the CGA group than in the control group(P<0.05). Conclusions The early application of CGA can improve the condition and prognosis in elderly heart failure patients complicated with emotional disorders.

OBJECTIVE:To provide reference for improving the rationality of perioperative prophylactic application of antibiotics in typeⅠincision operation of neurosurgery. METHODS:Medical records of 794 patients with typeⅠincision operation of neurosurgery were collected from our hospital during Jan.-Dec. 2016 in order to retrospectively investigate the perioperative prophylactic application of antibiotics and evaluate the rationality of drug use. RESULTS:Among all the 794 cases,433 used antibiotics for prophylaxis (single type was used in all cases),with utilization rate of 54.53％. Cefazolin(51.73％)and cefuroxime(21.48％)were the most frequently used antibiotics. The prophylactic application rate of 30 min-1 h before surgery was 85.45％ in 433 patients. Patients with prophylactic medication course≤24 h accounted for 68.36％. The main irrational drug use manifestations were long medication time(31.64％)and improper antibiotics selection(26.10％);other manifestations included improper medication timing(14.55％),etc. CONCLUSIONS:Unreasonable perioperative prophylactic application of antibiotics in typeⅠincision operation of neurosurgery exists in our hospital,such as improper drug selection,improper medication timing,long medication course. It is necessary to further strengthen the comprehensive interventions,so as to promote the rational use of antibiotics.

[Objective] To describe a case of a rare,novel mutation causing recurrent chorioamniotic membrane separation in a Chinese family with combined next-generation sequencing (NGS) and Sanger sequencing.[Methods] For the affected fetus,potential mutation were detected by the conbinedcombined next-generation sequencing (NGS) and Sanger sequencing.And the prenatal diagnosis were identified by Sanger sequencing.[Results] A frameshifting mutation c.1389_1390delAG (inherited from mother),and a missense mutationc.1006 G ＞ C (inherited from mother) have been identified in the affected fetus (the second pregnancy).The prenatal diagnosis of the third fetus turns out to be a carrier,the mutation was inherited from father.[Conclusions] We describe a novel mutation in gene ZMPSTE24,which was considered with mandibuloacral dysplasia with type B,and that may be the cousecoursecausing of recurrent chorioamniotic membrane separation.This rare mutation constitutes an additional heterogeneous defect causing chorioamniotic membrane separation.And the conbinedcombined next-generation sequencing (NGS) and Sanger sequencing allows high resolution characterization of novel mutions that are not readily detected by present methods.

OBJECTIVE:To establish a method for the content determination of polymer in cefatrizine propylene glycol. METHODS:High performance sephadex gel chromatography was performed on the column of Sephadex G-10 with mobile phase A of 0.01 mol/L phosphate buffer [0.01 mol/L Disodium hydrogen phosphate solution-0.01 mol/L Sodium dihydrogen phosphate solution (61∶39,V/V)](pH7.0)and mobile phase B of water at a flow rate of 1.0 ml/min,the detection wavelength was 254 nm,column temperature was 30℃,and volume injection was 200μl. RESULTS:The linear range of polymer was 2.07-103.30 mg/ml(r=0.999 4);the limit of quantitation of 10.4 ng,limit of detection was 4.1 ng;RSDs of precision and reprodicibility tests were lower than 3%. CONCLUSIONS:The method is specific with high sensitivity and good reproducibility,and can be used for the content determination of polymer in active pharmacentical ingredient cefatrizine propylene glycol.

Objective To investigate the predictive value of clinical and radiographic features in fungal pathogen identification in immunocompromised patients with pulmonary invasive fungal infection (IFI).Methods All consecutive immunocompromised adult patients with pulmonary IFI in respiratory intensive care unit (ICU)in the First Affiliated Hospital of Xinjiang Medical University were recruited during a 2 year period.All patients met the 2008 European Organization for Research and Treatment of Cancer and Mycoses Study Group (EORTC /MSG) criteria were studied for proved or probable IFI responding to antifungal agents.The data of demographic,clinical and radiographic features,as well as serological test results of the patients were collected.Differences in the clinical and radiographic features of pulmonary IFIs caused by yeasts and molds were compared by χ2 test.A logistic regression model was used to perform discriminant analysis,and the effect of discrimination was assessed for accuracy.Results The study included 143 patients with a probable diagnosis of IFI who had the following risk factors:diabetes mellitus (43.4%),chronic lung disease (32.2%),broad-spectrum antibiotics administration (≥14 days;35.7%),malignancy (23.1%),corticosteroid therapy (≥14 days;23.1%),chronic renal failure and renal replacement therapy (16.1%),and immunological disease (10.5%).Frequent broad-spectrum antibiotics administration was associated with yeast infection (P <0.05 ),while mold infection was associated with chronic lung disease (P <0.05 ) .Yeast was more often isolated from patients with concurrent bacterial infection and on mechanical ventilation (P <0.05 ) . Thoracic high-resolution computed tomography (HRCT)showed the following images:bronchial pneumonia/pulmonary consolidation (53.1%),massive shadowing (29.4%),small nodules (24.5%),large nodules (18.9%),pleural effusion (18.9%),halo sign (14%),and cavity (9.8%).Imaging showed that mold was more common than yeast in patients with pleural and pericardial effusions (P <0.05).Logistic regression modeling showed that broad-spectrum antibiotics administration,prolonged mechanical ventilation,and pleural and pericardial effusions were statistically significant in fungal identification (P <0.05 ),with a predictive accuracy of 77.6%.Conclusions For immunocompromised patients with pulmonary IFI,most of the risk factors ,the main clinical and chest HRCT features did not help to predict the type of fungal pathogen,and yeast but not cryptococcus may be accompanied or colonized.

We used the Brucella data in Xinjiang between year 2009 to 2010 to explore and analyze the spatial clustering fea‐tures of brucellosis in Xinjiang ,and provided the basis for prevention and control on brucellosis in Xinjiang ,China .The time and population distribution of brucellosis in Xinjiang was analyzed for statistical analysis with descriptive epidemiology .Mean‐while ,we also used quartile classification methods to map the incidence of brucellosis in Xinjiang spatial distribution ,and calcu‐lated the Global Moran’s I index on the spatial clustering analysis .Results showed that brucellosis in Xinjiang had obvious sea‐sonal differences (peaked in May‐September) ,more cases for male than that for female (gender ratio‐‐2 .96∶1) ,and the total incidence of 74% were farmer and herdsman ,mainly concentrated at th e age of 40 to 60 years old .Compared with the onset range of brucellosis in 2009 ,there were clear tendency to spread in 2010 .The Global Moran’s I index was 0 .116 4 (P=0 .017) ,showing the spatial clustering on the incidence of brucellosis in Xinjiang .The incidence of hot spots concentrated in Tacheng and Altay ,and the incidence of cold spots concentrated in Kashi .The incidence level brucellosis has significant spatial aggregation in the area of Xinjiang ,which should be strengthened the prevention and control of high‐risk areas .

Objective This study aimed to investigate the effect of splenic CD11clow CD45RBhigh dendritic cell (DC)derived from endotoxin tolerance (ET)mice on the expression of zinc finger protein A20 in acute liver failure (ALF)and to clarify the possible mechanism.Methods ET mice were modeled. CD11clow CD45RBhigh DC were isolated from spleen by magnetic activated cell sorting (MACS).One hundred and twenty-six healthy male BALB/c mice were randomly divided into four groups:control group (group A,n=6),ALF group (group B,n =40),normal CD11clow CD45RBhigh DC-treated group (group C,n=40),ET-CD11clow CD45RBhigh DC-treated group (group D,n=40).Mice in group B,C and D were injected with D-galactosamine (D-GalN)600 mg/kg and lipopolysaccharides (LPS)10 μg/mouse.Mice in group A were given the same volume of normal saline (NS).Half an hour after the D-GalN/LPS injection,mice in group C were treated with splenic CD11clow CD45RBhigh DC derived from normal mice (1 ×10 6/mouse,0.2 mL/mouse).Mice in group D were treated with splenic CD11clow CD45RBhigh DC derived from ET mice (1 × 10 6/mouse,0.2 mL/mouse).Mice in group A and B were given the same volume of 0.9% NaCl solution (0.2 mL/mouse).Alanine aminotransferase (ALT)and aspartate aminotransferase (AST)levels were measured at each time point.Liver histopathological changes were confirmed by hematoxglin and eosin methods.Expressions of tumor necrosis factor-α (TNF-α),nuclear factor-kappa B (NF-κB),and zinc finger protein A20 were measured by reverse transcriptase polymerase chain reaction(RT-PCR)and Western blot.One-way analysis of variance was used to compare means between groups.Normal distribution and homogeneity of variance were tested.LSD test was conducted in patients accorded with homogeneity of variance.Results ALT and AST levels increased 2 h after modeling in group B and peaked at 24 h,which were significantly higher than groups A (t = 31 .00, 11 .52,both P <0.05).ALT and AST levels also increased after 2 h after modeling and peaked at 24 h in group C and group D,which were both significantly higher than group B (t =14.60,26.43,both P <0.05).The mRNA levels and protein expressions of TNF-αand NF-κB in group B increased gradually and peaked at 12 h after D-GalN/LPS injection.Compared to that of group A,the differences were both statistically significant (t = 427.58,122.42,179.35 ,165 .98,all P < 0.05 ).The mRNA level and protein expression of zinc finger protein A20 in group B decreased gradually and reached the minimum at 12 h after D-GalN/LPS injection,which was statistically different compared to group A (t = 90.80, 160.43,both P <0.05).On the contrary,the levels of zinc finger protein A20 in group C and D increased gradually and peaked at 12 h after D-GalN/LPS injection.The expression level of zinc finger protein A20 in group D was significantly higher than group C (t = 11 .21 ,24.80,both P < 0.05 ).Conclusion Treatment of splenic CD11clow CD45RBhigh DC derived from ET mice contributes to liver protection against D-GalN/LPS-induced ALF.