Objective:To investigate the feasibility and clinical efficacy of side-to-side anastomosis of superficial temporal artery (STA) and middle cerebral artery (MCA) bypass using in-situ intravascular suture technique.Methods:A retrospective analysis was conducted on the clinical data of 10 adult patients who were treated with side-to-side microvascular anastomosis of STA-MCA bypass to improve intracranial blood supply, between February 2024 and September 2024 in the Department of Neurosurgery of the Fourth Affiliated Hospital of Soochow University. Among the patients, 2 were of symptomatic MCA occlusion and 8 of Moyamoya disease. Diameter of STA and MCA, length of anastomosis and blocking time of MCA were recorded. Indocyanine green video angiography (ICG-VA) was performed to evaluate the immediate patency of the STA-MCA side-to-side anastomosis. Digital subtracted angiography (DSA) was performed at 1 week after the surgery to evaluate the patency of the STA-MCA bypass anastomosis, then follow-up DSA was performed at 1, 3 and 6 months after surgery to further evaluate the postoperative anastomotic patency. Neurological function was evaluated regularly with the modified Rankin Scale (mRS).Results:All of the 10 side-to-side STA-MCA bypass anastomoses were successfully performed using in-situ intravascular suture technique. The scalps of all patients healed well. The diameters of STA and MCA were 1.4-2.0 (1.76±0.27) mm and 0.8-1.4 (0.98±0.20) mm, respectively. The average length of the anastomoses was 3.5-5.0 (4.45±0.60) mm. The blocking time of MCA was 12.0-29.0 (21.50±6.62) min. A 100% vessel patency rate was achieved immediately after vessel anastomosis and at 1 month after surgery. DSA examinations were performed at 3 months after surgery on 6 patients and at 6 months after surgery on 1 patient, and all the anastomoses were found in full patency. All patients were included in the postoperative follow-up that lasted for 3 to 7 months. All patients recovered well without new neurological dysfunction. The mRS of 8 patients remained at 0 point before and after surgery. Two patients had improved postoperative mRS of 1 point from that of 2 points before surgery.Conclusion:STA-MCA side-to-side microvascular bypass anastomosis can be performed safely and efficiently using in-situ intravascular suture technique. It could efficiently reduce the incidence of perioperative complications. Meanwhile, it can self-regulate the blood flow and maximise the potential capability of STA.

Objective:To investigate the feasibility and clinical efficacy of side-to-side anastomosis of superficial temporal artery (STA) and middle cerebral artery (MCA) bypass using in-situ intravascular suture technique.Methods:A retrospective analysis was conducted on the clinical data of 10 adult patients who were treated with side-to-side microvascular anastomosis of STA-MCA bypass to improve intracranial blood supply, between February 2024 and September 2024 in the Department of Neurosurgery of the Fourth Affiliated Hospital of Soochow University. Among the patients, 2 were of symptomatic MCA occlusion and 8 of Moyamoya disease. Diameter of STA and MCA, length of anastomosis and blocking time of MCA were recorded. Indocyanine green video angiography (ICG-VA) was performed to evaluate the immediate patency of the STA-MCA side-to-side anastomosis. Digital subtracted angiography (DSA) was performed at 1 week after the surgery to evaluate the patency of the STA-MCA bypass anastomosis, then follow-up DSA was performed at 1, 3 and 6 months after surgery to further evaluate the postoperative anastomotic patency. Neurological function was evaluated regularly with the modified Rankin Scale (mRS).Results:All of the 10 side-to-side STA-MCA bypass anastomoses were successfully performed using in-situ intravascular suture technique. The scalps of all patients healed well. The diameters of STA and MCA were 1.4-2.0 (1.76±0.27) mm and 0.8-1.4 (0.98±0.20) mm, respectively. The average length of the anastomoses was 3.5-5.0 (4.45±0.60) mm. The blocking time of MCA was 12.0-29.0 (21.50±6.62) min. A 100% vessel patency rate was achieved immediately after vessel anastomosis and at 1 month after surgery. DSA examinations were performed at 3 months after surgery on 6 patients and at 6 months after surgery on 1 patient, and all the anastomoses were found in full patency. All patients were included in the postoperative follow-up that lasted for 3 to 7 months. All patients recovered well without new neurological dysfunction. The mRS of 8 patients remained at 0 point before and after surgery. Two patients had improved postoperative mRS of 1 point from that of 2 points before surgery.Conclusion:STA-MCA side-to-side microvascular bypass anastomosis can be performed safely and efficiently using in-situ intravascular suture technique. It could efficiently reduce the incidence of perioperative complications. Meanwhile, it can self-regulate the blood flow and maximise the potential capability of STA.

Objective: To understand the current situation and trends of anemia among kindergarten children in urban area of Suzhou from 2018 to 2022, so as to provide a theoretical basis for prevention and intervention in anemia among kindergarten children. Methods: From March 2023, a total of 24 178 person times of children from 59 kindergartens selected by random number table method were enrolled, and their physical examination data from 2018 to 2022 were collected, including hemoglobin (Hb), height, gender, weight. The period of 2018-2019 was defined as before the COVID-19 epidemic, and period of 2020-2022 was defined as the COVID-19 epidemic. Data were analyzed using the Mann Whitney U test, χ 2 test and Spearman s correlation analysis. Results: From 2018 to 2019, the M ( P 25 ， P 75 ) of Hb levels of children in nursery, middle, and senior class were 118 (112, 129), 120 (112, 132) and 122 (113, 134)g/L, respectively, which were higher than that of during 2020-2022 [116(110, 123), 117(111, 124) , 119(112, 126)g/L, Z =-10.7, -12.7, -12.9, P <0.05]. A total of 4 584 person times of children were anemic, with a detection rate of 19.0%. The overall anemia detection rate of kindergarten children during 2018-2019 was lower than that in 2020-2022 (15.3% vs 20.7%, χ 2=100.8, P <0.05). The anemia detection rate of kindergarten children in 2022 (24.5%) was higher than that in 2020 (20.6%) and in 2021 (17.0%) ( χ 2=93.9, P <0.05). The anemia prevalence of children in the nursery, middle, and senior class were 13.9%, 14.7% and 17.1% during 2018-2019, 19.3%, 15.9% and 26.6% during 2020-2022, and 17.6%, 15.5% and 23.6% during 2018-2022, respectively ( χ 2=10.7, 204.6, 186.8, P <0.01). There was no statistically significant correlation between Hb values and body mass index (BMI) in boys and girls with anemia, and all children in kindergarten ( r=0.03, 0.03, 0.09, P ＞0.05). Conclusion The prevalence of anemia among kindergarten children in the urban area of Suzhou is relatively high. The COVID-19 pandemic may have increased the risk of anemia among children.

Objective:To explore the value of radiomics model based on intratumoral and peritumoral early dynamic contrast-enhanced (DCE) MRI for identifying benign and malignant in breast imaging reporting and data system (BI-RADS) 4 tumors.Methods:A total of 191 patients diagnosed with BI-RADS 4 breast tumors by breast MRI examination with clear pathological diagnosis from January 2016 to December 2020 in the First Affiliated Hospital of Bengbu Medical College were analyzed retrospectively, including 77 benign and 114 malignant cases, aged 23-68 (46±10) years. The one-slice image with the largest area of the lesion of the second stage DCE-MRI images was selected to outline the region of interest, and automatically conformal extrapolated by 5 mm to extract the intra-tumoral and peritumoral radiomics features. The included cases were randomly divided into training and testing cohorts in the ratio of 8∶2. The statistical and machine learning methods were used for feature dimensionality reduction and selection of optimal radiomics features, and logistic regression was used as the classifier to establish the intratumoral, peritumoral, and intratumoral combined with peritumoral radiomics models. The independent risk factors that could predict the benignity and malignancy of breast tumors were retained as clinical-radiological characteristics by univariate and multivariate logistic regression to establish a clinical-radiological model. Finally, the intratumoral and peritumoral radiomics features were combined with clinical-radiological features to develop a combined model of the three. The receiver operating curve was used to analyze the predictive performance of each model and calculate the area under the curve (AUC),the AUC was compared by DeLong test. The stability of the three-component combined diagnostic model was tested by 10-fold cross-validation, and the model was visualized by plotting nomogram and calibration curves.Results:In the training cohort, the AUC of the three-component combined model for identifying benign and malignant BI-RADS 4 breast tumors was significantly higher than that of the intratumoral radiomics model ( Z=3.38, P<0.001), the peritumoral radiomics model ( Z=4.01, P<0.001), the intratumoral combined with peritumoral radiomics model ( Z=3.11, P=0.002), and the clinical-radiological model ( Z=3.24, P=0.001). And the AUC, sensitivity, specificity, accuracy, and F1-score of the three-component combined model were 0.932, 91.2%, 86.9%, 87.0% and 0.89, respectively. In the testing cohort, the three-component combined model also had the highest AUC value (0.875), and diagnostic sensitivity, specificity, accuracy and malignancy F1-score were 95.7%, 62.5%, 76.9%, and 0.89, respectively. The AUC calculated by 10-fold cross-validation was 0.90 (0.85-0.92), and the predicted curve of the three-component combined model in the calibration curve was in good agreement with the ideal curve. Conclusion:The three-component combined diagnostic model based on the intratumoral and peritumoral radiomics features and clinical-radiological features of early DCE-MRI has good performance and stability for identifying the benign and malignant in BI-RADS 4 breast tumors, and it can provide guidance for clinical decision non-invasively.

The study is to explore the diagnostic value of magnetic resonance imaging (MRI) for endometrial carcinoma. Clinical data of 199 patients with endometrial cancer confirmed by diagnostic uterine curettage in the Second Hospital of Jilin University and the People′s Hospital of Xinjiang Uygur Autonomous Region from June 2017 to December 2019 were reviewed retrospectively. The data were analyzed by SPSS 21.0 software. MRI scan was performed before operation, the diagnostic accuracy of MRI for the preoperative staging of endometrial carcinoma was 85.9%(171/199) with postoperative pathological results as gold standard. The Kappa values of muscular infiltration, cervical infiltration and lymph node metastasis were 0.353, 0.574 and 0.573, respectively ( P<0.05). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy for myometrial invasion on MRI were 45.2%(19/42), 88.5%(139/157), 51.4%(19/37), 85.8%(139/162) and 79.4%(158/199), respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy for cervical invasion on MRI were 58.3% (14/24), 96.0%(168/175), 66.7% (14/21), 94.4%(168/178)and 91.5%(182/199), respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy for lymph node metastasis on MRI were 12/18, 95.6%(173/181), 60.0%(12/20), 96.6%(173/179)and 93.0%(185/199), respectively. The results indicate that MRI has high accuracy and negative predictive rate in evaluation of preoperative staging of endometrial cancer.

Objective To study the effects of Xihuang pills combined with sodium cantharidinate and vitamin B6 injection in the treatment of tumor-induced fever. Methods A total of 100 patients with tumor-induced fever in our hospital from March 2015 to January 2017 were enrolled in this study. The subjects were divided into the control group (n=50) and the treatment group (n=50) randomly. The control group were treated with aspirin-D L-Lysine injection, and the treatment group were treated with Xihuang pills combined with sodium cantharidinate and vitamin B6 injection. The two groups were treated for 2 periods. The clinical effects of the two groups after treatment were compared. The life quality of the two groups after treatment were compared. The serum TNF-α and IL-1β of the two groups before and after treatment were compared. The adverse reaction rates of the two groups during treatment were compared. Results The total efficacy rate of defervescence of the treatment group was 88.0％(44/50) significantly higher than 56.0％(28/50) of the control group (χ2=12.698, P=0.000). After treatment, the daily life score (1.10 ± 0.18 vs. 2.47 ± 0.21, t=35.025), social communication score (1.21 ± 0.13 vs. 2.53 ± 0.25, t=33.124), mental state score (1.08 ± 0.15 vs. 2.75 ± 0.21,t=45.758), appetite score (1.13 ± 0.16 vs. 2.56 ± 0.19, t=40.708), sleep score (1.22 ± 0.17 vs. 2.71 ± 0.20, t=40.139) of the treatment group were significantly lower than those of the control group (P<0.05). After treatment, the serum TNF-α (1.98 ± 0.07 μg/L vs. 2.86 ± 0.13 μg/L, t=42.144), IL-1β (9.20 ± 1.89 μg/L vs. 13.51 ± 2.36 μg/L, t=10.080) of the treatment group were significantly lower than those of the control group (P<0.05). There was no significantly differences of the adverse reaction rates of the two groups during treatment (χ2=0.211, P=0.646). Conclusions The Xihuang pills combined with sodium cantharidinate and vitamin B6 injection for patients with tumor-induced fever has a good efficacy and low incidence of adverse reactions, can improve the quality of life and reduce the serum levels of TNF-α and IL-1β.

FcγRIIB, the only inhibitory IgG Fc receptor, functions to suppress the hyper-activation of immune cells. Numerous studies have illustrated its inhibitory function through the ITIM motif in the cytoplasmic tail of FcγRIIB. However, later studies revealed that in addition to the ITIM, the transmembrane (TM) domain of FcγRIIB is also indispensable for its inhibitory function. Indeed, recent epidemiological studies revealed that a non-synonymous single nucleotide polymorphism (rs1050501) within the TM domain of FcγRIIB, responsible for the I232T substitution, is associated with the susceptibility to systemic lupus erythematosus (SLE). In this review, we will summarize these epidemiological and functional studies of FcγRIIB-I232T in the past few years, and will further discuss the mechanisms accounting for the functional loss of FcγRIIB-I232T. Our review will help the reader gain a deeper understanding of the importance of the TM domain in mediating the inhibitory function of FcγRIIB and may provide insights to a new therapeutic target for the associated diseases.
Autoimmune Diseases ; drug therapy ; genetics ; immunology ; Humans ; Protein Domains ; Receptors, IgG ; chemistry ; immunology

There are various contents about diagnosis and treatment of low back pain in(), which are closely related to meridians and collaterals, forming a complete theoretical system of meridian differentiation for low back pain. Its theory and application are interpreted in this paper from five main aspects, including 18 meridians and collaterals densely distributing in the tendons and bones of the waist, the pathogenesis of low back pain lying in the disorders of the meridianand blood, the nature of low back pain being reflected by the color and shape of meridians and collaterals, the disordered meridians of low back pain being first identified based on syndrome differentiation, the acupuncture prescription being selected according to meridian differentiation. The purpose of this paper is to guide clinical practice, explore the advantages and characteristics of meridian differentiation, and provide theoretical reference and evidence for promoting the standardization of TCM.

PurposeTo explore the correlation between apparent diffusion coefficient (ADC) value on MR diffusion-weighted imaging (DWI) and prognostic factors in breast invasive ductal carcinomas.Materials and Methods 103 patients with pathology-proven invasive breast ductal carcinomas underwent DWI MR scan using b=1000 s/mm2. The minimum ADC values of the lesions were determined. Histopathological specimens were analyzed for tumor size, lymph node metastasis, pathological grade (traditional prognostic factors) and the expression of prognostic factors including Ki-67, ToPo-IIα, P53 and CyclinD1. The correlations between ADC values and these prognostic factors were evaluated.Results In 103 breast invasive ductal carcinomas, there was no significant relationship between tumor size, lymph node metastasis, pathological grade and mean ADC values (P>0.05). The correlations between mean ADC values and the biological prognostic factors were not significant (P>0.05). However, positive correlations were observed between pathological grade and the expression of Ki-67 as well as ToPo-IIα(P<0.05).Conclusion ADC values cannot serve as a prognostic factor for invasive ductal breast carcinomas. However, the expression of Ki-67 and ToPo-IIα in breast invasive ductal carcinomas may be important in evaluating prognosis of the tumor and guiding clinical therapy.

Objective:To explore the preparation procedure of pediatric Kechuan black plasters. Methods:A single factor method was used to observe and study the preparation process of pediatric Kechuan black plaster from the following aspects: the selection of matrix raw material and refined equipment, and the temperature of refinery, “Xiadan”, pouring white wax and adding fine material powder in production processing. Results:The best temperature of“Xiadan” for pure sesame oil and mineral orange with the purity a-bove 95% was 313 ℃. The “Xianzha” temperature was 264 ℃, the temperature of “Houxia” was between 180 ℃ and 200 ℃, and white wax instead of the traditional method was used to eliminate fire toxin. Conclusion:The research is helpful to improving the quali-ty of the black plasters. The preparation process is stable and feasible, and suitable for the industrial production.