A patient with anti-MDA5-positive dermatomyositis complicated by hepatic dysfunction developed rhabdomyolysis after an intravenous injection of gadopentetate dimeglumine for magnetic resonance imaging.Analysis of clinical manifestations and medication correlation confirmed gadopentetate dimeglumineinduced rhabdomyolysis.Gadopentetate dimeglumine can cause rhabdomyolysis in dermatomyositis patients.Clinical conditions should be closely monitored when using gadopentetate dimeglumine to guard against adverse reactions.

A patient with anti-MDA5-positive dermatomyositis complicated by hepatic dysfunction developed rhabdomyolysis after an intravenous injection of gadopentetate dimeglumine for magnetic resonance imaging.Analysis of clinical manifestations and medication correlation confirmed gadopentetate dimeglumineinduced rhabdomyolysis.Gadopentetate dimeglumine can cause rhabdomyolysis in dermatomyositis patients.Clinical conditions should be closely monitored when using gadopentetate dimeglumine to guard against adverse reactions.

Objective To analyze the effectiveness and safety of bisphosphonates in the treatment of pa-tients with calcification defense.Methods PubMed,Embase databases,CNKI and Wanfang were searched to collect the case reports and clinical studies of bisphosphonates for calcification defense.Then,the relevant infor-mation of patients was extracted for statistical analysis.Results A total of 18 case reports were selected involving 20 patients.Thirteen patients(65.0％)were treated with pamidronate,four(20.0％)were treated with etidr-onate,two(10.0％)were treated with alendronate,and one(5.0％)was treated with zoledronic acid.Thirteen patients(65.0％)recovered completely,the recovery time of whom ranged from half month to nine months.The tolerance of bisphosphonates in most patients(90.0％)was good,while one patient who did not tolerate pamidr-onate recovered after the frequency of administration was adjusted and one patient with high dosage of etidronate returned to normal after the discontinuation of the usage.Conclusions Bisphosphonates,an inhibitor of bone resorption,is effective and safe in the treatment of patients with calcification defense.

The related symptoms of patients with congenital microtia after ear reconstruction surgery mainly include pain, psychological problems, fatigue, and sleep disorders. Measures of chest strap compression bandage, diversion of attention and use of analgesics; psychological counseling, establishment of WeChat communication group, and organizing communication meetings; proper lying position, earmuffs, emotional reassurance were taken to improve symptoms. This article provides a summary review of the management measures for related symptoms, aiming to draw more attention from healthcare professionals and to provide a reference for constructing symptom management programs in the future, promoting the patients’ physical and mental health recovery and enhancing their quality of life.

Objective To establish a lipid differentiation model of primary rat bone marrow mesenchymal stem cells(rBMSCs)in vitro using homocysteine(Hcy),and analyze the specific effects of Hcy on lipid and bone differentiation of BMSCs;to comprehensively explore the effects of mangiferin on lipid and bone differentiation of BMSCs,and further reveal the potential mechanism of mangiferin in the treatment of osteoporosis through the inter-vention of Hcy-induced BMSCs by different concentrations of mangiferin.Methods First,rBMSCs were extracted and isolated.The rBMSCs that were well-cultured to a certain generation were placed in culture medium containing different concentrations of Hcy(0.125,0.250,0.5,1,2,4 mmol/L)to establish lipid differentiation model of rBMSCs.Then,different concentrations of mangiferin(37.5,75,150 μmol/L)were applied to the experimental cells for intervention.After culture for a certain period of time,the cells were collected for the following tests:The accumulation of lipids in the cells was detected by semi-quantitative method of oil red 0 dye solution to evaluate the degree of lipid differentiation;The activity of alkaline phosphatase(ALP)was measured by pNPP method;The expression of bone morphogenetic protein-2(BMP-2)and type Ⅰ collagen(Col Ⅰ)were detected by western blot assay to evaluate the degree of bone differentiation.Results Mangiferin could significantly up-regulate the expression of BMP-2 and Col Ⅰ in vitro,increase the level of ALP,and promote bone differentiation of rBMSCs.Hcy promoted lipid differentiation of rBMSCs by increasing lipid accumulation,and down-regulated the expression of BMP-2 and Col Ⅰ,reduced the intracellular ALP level,thereby inhibiting bone differentiation of rBMSCs.How-ever,the above Hcy-related effects could be successfully reversed by mangiferin.Conclusion Mangiferin can sig-nificantly promote bone differentiation of rBMSCs in vitro,while Hcy can inhibit bone differentiation of rBMSCs and promote its lipid differentiation.Mangiferin has the ability to reverse this effect,indicating that mangiferin has certain potential in the treatment of osteoporosis-related diseases.

The related symptoms of patients with congenital microtia after ear reconstruction surgery mainly include pain, psychological problems, fatigue, and sleep disorders. Measures of chest strap compression bandage, diversion of attention and use of analgesics; psychological counseling, establishment of WeChat communication group, and organizing communication meetings; proper lying position, earmuffs, emotional reassurance were taken to improve symptoms. This article provides a summary review of the management measures for related symptoms, aiming to draw more attention from healthcare professionals and to provide a reference for constructing symptom management programs in the future, promoting the patients’ physical and mental health recovery and enhancing their quality of life.

Objective To establish a lipid differentiation model of primary rat bone marrow mesenchymal stem cells(rBMSCs)in vitro using homocysteine(Hcy),and analyze the specific effects of Hcy on lipid and bone differentiation of BMSCs;to comprehensively explore the effects of mangiferin on lipid and bone differentiation of BMSCs,and further reveal the potential mechanism of mangiferin in the treatment of osteoporosis through the inter-vention of Hcy-induced BMSCs by different concentrations of mangiferin.Methods First,rBMSCs were extracted and isolated.The rBMSCs that were well-cultured to a certain generation were placed in culture medium containing different concentrations of Hcy(0.125,0.250,0.5,1,2,4 mmol/L)to establish lipid differentiation model of rBMSCs.Then,different concentrations of mangiferin(37.5,75,150 μmol/L)were applied to the experimental cells for intervention.After culture for a certain period of time,the cells were collected for the following tests:The accumulation of lipids in the cells was detected by semi-quantitative method of oil red 0 dye solution to evaluate the degree of lipid differentiation;The activity of alkaline phosphatase(ALP)was measured by pNPP method;The expression of bone morphogenetic protein-2(BMP-2)and type Ⅰ collagen(Col Ⅰ)were detected by western blot assay to evaluate the degree of bone differentiation.Results Mangiferin could significantly up-regulate the expression of BMP-2 and Col Ⅰ in vitro,increase the level of ALP,and promote bone differentiation of rBMSCs.Hcy promoted lipid differentiation of rBMSCs by increasing lipid accumulation,and down-regulated the expression of BMP-2 and Col Ⅰ,reduced the intracellular ALP level,thereby inhibiting bone differentiation of rBMSCs.How-ever,the above Hcy-related effects could be successfully reversed by mangiferin.Conclusion Mangiferin can sig-nificantly promote bone differentiation of rBMSCs in vitro,while Hcy can inhibit bone differentiation of rBMSCs and promote its lipid differentiation.Mangiferin has the ability to reverse this effect,indicating that mangiferin has certain potential in the treatment of osteoporosis-related diseases.

Objective To design an automated detection protocol for morphological detection of sperm head based on deep learning and evaluate its efficiency,accuracy and reliability.Methods Fourteen pictures for each of 1 000 samples were analyzed by using the pre-trained YOLO target detection model and VGG16 classification model.At least 200 sperm were detected for each sample.Equal amount of samples were analyzed by manual microscope examination,and the efficiency,accuracy and correlation between the two methods were compared.Results The morphology of sperm heads which were manually classified but untrained was detected by pre-trained classification model,and the prediction accuracy reached to 95.5％.The detection time for clinical each sample was only 10 seconds,and its accuracy and efficiency were higher than those of manual microscope examination.The percentages of the sperms with normal morphology were significantly positively correlated(r=0.84,P＜0.01)in the detections of both the methods.Conclusion The detec-tion protocol proposed in this study can greatly improve work efficiency,and its reliability and accuracy exceed those of manual micro-scope examination.

Objective To integrate the best available evidence of preoperative care for ophthalmic patients undergoing day surgery into clinical practice,so as to improve the quality of nursing.Methods This project was performed in an ophthalmic day surgery ward,guided by the Joanna Briggs Institute(JBI)Practice Application of Clinical Evidence System (PACES) program which includes 3 procedures:baseline audit,evidence implementation,and re-audit.Eight audit criteria were made based on evidences from JBI.Twelve nurses and 267 patients were enrolled in baseline audit,and 12 nurses and 234 patients were recruited for re-audit after evidence implementation.Results Six of the audit criteria that nurses showed poor compliance in the baseline audit(0％～28.5％),such as providing preoperative telephone screening and reducing preoperative waiting time through better preparation and planning,were significantly improved in the re-audit(71.43％～100％).The preoperative waiting time was shortened from 109.70±18.34 minutes to 88.22±9.91 minutes;the correct rates of operation-related knowledge in patients increased from 63.0％ to 85.09％;the patients' satisfaction scored 84.23±17.01 in baseline audit and 95.02±7.32 in the re-audit(P＜0.001).Conclusion Application of evidence-based preoperative care of ophthalmic patients undergoing day surgery can improve nurse's behavior and compliance with the implementation of evidence into clinical practice,and increase patient satisfaction.Continuous audits are needed to continuously improve clinical nursing quality.

Objective To evaluate the function of auditory nerve and brainstem in children with Bell's palsy by using brainstem auditory evoked potential ( BAEP) . Methods A retrospective study was car-ried in total of 69 patients with Bell's palsy admitted in the pediatric department of Shengjing Hospital of China Medical University from January 2017 to January 2018. There were 33 males and 36 females,aged 1 to 12 years old. Sixty healthy children served as control group. BAEP were determined in 69 patients and 60 healthy subjects. EEG and CT or MRI of brain were performed to exclud tumor,intracranial infection and so on. The patients in the case group were divided into 2 groups:1-3 years old group (38 cases) and 4-12 years old group (31 cases). Sixty healthy children were also divided into 2 groups:1-3 years old group (30 cases) and 4-12 years old group (30 cases). Results The hearing threshold was normal in the children of the control group. There was no significant difference not only in potential latency but also internal potential latency of BAEP between right and left ear. The abnormal rate of BAEP was 39. 1％ ( 27/69 ) in case groups,19 cases of them recovered(70. 4％,19/27) after 2 weeks of clinical treatment. Another 8 patients re-covered after 2 months. The abnormality rate of EEG was 5. 8％ (4/69),and the abnormality rate of CT or MRI in head was 14. 5％ (10/69). Both were nonspecific changes. In the two groups,Ⅰ-Ⅲinternal potential latency was significantly shortened ( P <0. 05 ) , and Ⅲ-Ⅴinternal potential latency was significantly pro-longed (P<0. 05)respectively,between the normal side and abnormal side. There were significant differences in the Ⅲ potential latency(P<0. 05),Ⅰ-Ⅲinternal potential latency (P<0. 01),and Ⅲ-Ⅴ internal poten-tial latency ( P <0. 01 ) respectively, between pretherapy and post-treatment. Conclusion Bell's palsy of children could cause abnormal of auditory nerve conduction,and BAEP could find the electro physiologic ab-normality in nervous system,and guide clinical intervention.