Non-contrast enhanced MR angiography(NCE-MRA)has been widely used in clinic since advantages of non-radiation and non-contrast media.The image quality of NCE-MRA could be effectively improved using ultra-high field MR scanner,yet 7.0T devices were limited by coils and usually used for cerebrovascular scanning.The invention of 5.0T ultra-high field MR system brings new opportunities for whole body NCE-MRA.The preliminary application of 5.0T whole body NCE-MRA in human body were explored in this article.

Brugada syndrome presents mainly in adulthood,and sudden death occurs mainly at rest or during sleep.It is uncommon in childhood,especially with atrial flutter as the first manifestation.In this article,we report a case of a 13-year-old child with atrial flutter as the first manifestation,without underlying cardiac disease,who developed Brugada-like electrocardiographic changes during the treatment of propafenone,and genetic testing revealed the suspected mutant genes SCN5A(c.2834A＞G[p.D945G]).Present case and related literature review might improve the awareness of clinicians on the inducing factors of Brugada syndrome and related a variety of cardiac arrhythmias,the importance of electrocardiogram monitoring during the application of antiarrhythmic drugs,and provide guidance and close follow-up strategies to this high-risk group,so as to avoid the occurrence of adverse events in these patients.

Wasp sting refers to a series of clinical syndromes caused by the venom in the tail poison sac of the poisonous bee when attacking the attacked body, mainly manifested as local skin damage, systemic allergic reaction and multi-organ dysfunction syndrome (MODS) . Wasp venom can also act on the nervous system, and cause rare complications such as cerebral hemorrhage, subarachnoid hemorrhage, cerebral infarction, epilepsy, encephalitis, and Parkinson's disease, which can seriously affect the prognosis. This review will elaborate the above complications for clinical reference.

Wasp sting refers to a series of clinical syndromes caused by the venom in the tail poison sac of the poisonous bee when attacking the attacked body, mainly manifested as local skin damage, systemic allergic reaction and multi-organ dysfunction syndrome (MODS) . Wasp venom can also act on the nervous system, and cause rare complications such as cerebral hemorrhage, subarachnoid hemorrhage, cerebral infarction, epilepsy, encephalitis, and Parkinson's disease, which can seriously affect the prognosis. This review will elaborate the above complications for clinical reference.

Objective:To investigate the application value of manual anastomosis of gastro-duodenum in totally laparoscopic distal gastrectomy.Methods:The retrospective cohort study was conducted. The clinicopathological data of 55 patients with gastric cancer who underwent totally laparoscopic distal gastrectomy combined with gastrointestinal anastomosis in the Tianjin Medical University Cancer Institute & Hospital from January 2020 to October 2022 were collected. There were 34 males and 21 females, aged 61(range, 29?75)years. Of 55 patients, 25 patients undergoing manual anastomosis of gastroduodenum were divided into the manual anastomosis group, 30 patients undergoing modified Delta anastomosis of gastroduodenum were divided into the modified Delta anastomosis group. Observation indicators: (1) surgical situations; (2) postoperative complications. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers, and comparison between groups was conducted using chi-square test or Fisher exact probility. Results:(1) Surgical situations. All 55 patients underwent surgery successfully, without conversion to laparotomy. The distance from the superior margin of tumor to the upper margin, anastomosis time, number of bookings used were (48±4)mm, (22.6±2.3)minutes, 3.2±0.5 in the manual anastomosis group, versus (41±4)mm, (14.0±1.4)minutes, 5.2±0.4 in the modified Delta anastomosis group, showing significant differences in the above indicators between the two groups ( t=5.04, 16.38, ?17.13, P<0.05). The location of tumor (antrum, gastric angle) was 18, 7 in the manual anastomosis group, versus 29, 1 in the modified Delta anastomosis group, showing a significant difference between the two groups ( P<0.05). (2) Postoperative complications. There was no patient undergoing anastomotic fistula in both of manual anastomosis group and modified Delta anastomosis group, and there was 1 patient undergoing anastomotic stenosis in the modified Delta anastomosis group. Conclusion:Compared with modi-fied Delta anastomosis of gastroduodenum,totally laparoscopic distal gastrectomy with manual anas-tomosis of gastroduodenum can remove more gastric tissue, and decrease the number of bookings used.

ObjectiveTo observe the effects of modified Shenqiwan on renal function and fibrosis in diabetic nephropathy mice and explore the underlying mechanism based on the glycogen synthase kinase-3β （GSK-3β）/cyclic adenosine monophosphate （cAMP） response element-binding protein （CREB） signaling pathway. MethodFifty male db/db mice and 10 db/m mice were used in this study. The fifty db/db mice were randomly divided into model group， irbesartan group， and low-， medium-， and high-dose modified Shenqiwan groups. The 10 db/m mice were assigned to the normal group. The mice in the low-， medium-， and high-dose modified Shenqiwan groups were administered with modified Shenqiwan in the dosage form of suspension of Chinese medicinal granules by gavage， those in the irbesartan group were given irbesartan suspension by gavage， and those in the normal and model groups were given distilled water of equal volume by gavage. The intervention lasted for 12 weeks. The blood glucose levels， urine albumin-to-creatinine ratio （UACR）， and the protein expression levels of GSK-3β， CREB， transforming growth factor-β₁ （TGF-β₁）， E-cadherin， Vimentin， fibronectin （FN）， plasminogen activator inhibitor-1 （PAI-1）， and Collagen type Ⅳ （Coll Ⅳ） in the mouse kidneys were recorded before and after treatment. The extent of renal pathological damage was also observed. ResultCompared with the normal group， the model group showed significant increases in blood glucose levels， UACR levels， and the protein expression levels of GSK-3β， TGF-β₁， E-cadherin， Vimentin， FN， PAI-1， and Coll Ⅳ in the kidneys （P<0.05）， decreased protein expression level of CREB （P<0.05）， and severe renal pathological damage. Compared with the model group， the low-， medium-， and high-dose modified Shenqiwan groups and the irbesartan group showed varying degrees of decreases in blood glucose levels， UACR levels， and the protein expression levels of GSK-3β， TGF-β₁， E-cadherin， Vimentin， FN， PAI-1， and Coll Ⅳ in the kidneys （P<0.05）， increased expression level of CREB protein （P<0.05）， and improved renal pathological damage. ConclusionModified Shenqiwan can effectively reduce blood glucose levels， improve renal function， and alleviate fibrosis， and the mechanism of action is related to the inhibition of the GSK-3β/CREB signaling pathway.

OBJECTIVES: To study the effects of 17β-estradiol (E2) on the regulation of the proliferation of condylar chondrocytes and provide a preliminary discussion on the role of phosphorylate-mammalian target of rapamycin (p-mTOR) in this regulatory process. METHODS: Condylar chondrocytes were isolated from 6-week-old female rats for primary culture. Drug treatment with different concentrations of E2 and/or rapamycin (RAPA) was carried out on second-generation cells. Cell Counting Kit 8 was used to measure the cell viability of condylar chondrocytes after culture for 24, 48, or 72 h, and reverse transcription-polymerase chain reaction (RT-PCR) was applied to detect the relative gene expression of estrogen receptor alpha (ERα), estrogen receptor beta (ERβ), collagen type Ⅱ (COLⅡ), autophagy-related gene 6 (Beclin-1), and autophagy-related gene 5 (ATG-5). Western blot was employed to determine the relative protein expression of ERα, ERβ, Beclin-1, lipid-modified light chain 3B (LC3-Ⅱ), and p-mTOR. RESULTS: E2 could significantly promote the proliferation of chondrocytes cultured CONCLUSIONS At a concentration of 10
Animals ; Autophagy ; Cell Proliferation ; Chondrocytes ; Estradiol ; Estrogen Receptor alpha/metabolism* ; Estrogen Receptor beta ; Female ; Phosphorylation ; Rats

Since the outbreak of corona virus disease 2019(COVID 19), the epidemic has spread rapidly, which brings great challenge to the surgical diagnosis, treatment and management of lung neoplasm Sichuan International Medical Exchange &Promotion Association organized thoracic surgery experts to sum up experiences from experts in major hospital, and formulated the Guidance suggestion on surgical diagnosis, treatment and management of lung neoplasm during the outbreak of COVID-19 to provide references for thoracic surgeons.

Two cases of hypoglossal canal dural arteriovenous fistulas (HCDAVF) were reported. The clinical manifestation, radiological features, treatment and prognosis were reviewed. Both cases presented chemosis and pulsatile tinnitus. 3D-time-of-flight (TOF) magnetic resonance angiography (MRA) demonstrated abnormal high signal in hypoglossal canal. Cerebral digital subtraction angiography (DSA) showed that these HCDAVFs were supplied by multiple intracranial and extracranial arteries, and fistulas were located in hypoglossal canal. Fistulas were blocked by coils and Onyx-18 through transvenous approach, and the angiography after the embolism showed complete occlusion of fistula. No adverse events after treatment and no recurrence during the follow up were observed.

Objective To explore the expression level of OTUB1 and its clinical significance in breast cancer.Methods Immunohistochemistry was used to detect the expression level of OTUB1 in 78 cases of breast cancer tissues and 30 cases of normal breast tissue adjacent to carcinoma,and the relationships between OTUB1 and the clinical pathological features of breast cancer were analyzed.Results The positive expression rate of OTUB1 in breast cancer tissues [66.7％ (52/78)] was significantly higher than that in adjacent normal breast tissues [30.0％ (9/30)],with a statistically significant difference (x2 =11.851,P =0.001).OTUB1 expression level was related to the lymph node metastasis (x2 =5.029,P =0.025),postoperative TNM staging (x2 =4.478,P =0.034),expression of human epidermal growth factor receptor-2 (HER-2) (x2 =8.775,P =0.003),expression of P53 (x2 =4.708,P =0.030),expression of estrogen receptor (ER) (x2 =10.364,P =0.001) and molecular subtypes (x2 =10.934,P =0.012).However,OTUB1 expression level in breast cancer was not related to the age (x2 =2.194,P =0.139),menopausal status (x2 =1.843,P =0.175),tumor size (x2 =0.643,P =0.423),histological grade (x2 =3.580,P =0.167),expression of progestin receptor (PR) (x2 =3.371,P =0.066) and expression of Ki-67 (x2 =1.345,P =0.246).Conclusion OTUB1 expression level increases in breast cancer,which is associated with the lymph node metastasis,TNM staging,expressions of HER-2,P53,ER and molecular subtypes of breast cancer.It suggests that the expression of OTUB1 is related to the progression and metastasis of breast cancer.