Objective To evaluate the absence of corpus callosum(ACC)and intracranial accompanying abnormalities in fetus via prenatal MRI.Methods A total of 61 cases of fetal ACC diagnosed by prenatal MRI were analyzed retrospectively.The types and numbers of intracranial accompanying abnormalities were observed,and the probability of accompanying abnormalities was counted.According to whether the corpus callosum was completely absent,all cases were divided into complete ACC and partial ACC.Statistical differences of probability of accompanying abnormalities between the two groups were analyzed.Results A total of 54.1%(33/61)patients were complicated with other intracranial abnormalities,among which the most common was cerebral cortical dysplasia,accounting for 26.2%(16/61).The probability of complete ACC and partial ACC complicated with other intracranial abnormalities was 63.4%(26/41)and 35.0%(7/20),respectively,and there was statistical difference in intracranial abnormalities between complete ACC and partial ACC(χ2=4.37,P=0.037).The probability of complete ACC and partial ACC complicated with cerebral cortical dysplasia was 39.0%(16/41)and 5.0%(1/20),respectively,and there was statistical difference in cerebral cortical dysplasia between complete ACC and partial ACC(χ2=7.74,P=0.005).Conclusion MRI can accurately diagnose the fetal ACC and intracranial accompanying abnormalities.Complex ACC is more common than isolated ACC.Compared with partial ACC,complete ACC is more likely to be complicated with other intracranial abnormalities,and cerebral cortical dysplasia is the most common,which provides reliable diagnostic basis for fetal prognosis in clinical practice.

Objective:To investigate the knowledge, attitudes, and practices (KAP) of pulse oximetry among pediatric healthcare providers in China and analyze the factor influencing the KAP.Methods:A self-developed questionnaire was used for an online research on the KAP of 11 849 pediatric healthcare providers from 31 provinces, autonomous regions, and municipalities of China from March 11 to 14, 2022.The factors influencing the KAP of pulse oximetry among pediatric healthcare providers were examined by Logistic regression. Results:The scores of KAP, of pulse oximetry were 5.57±0.96, 11.24±1.25 and 11.19±4.54, respectively.The corresponding scoring rates were 69.61%, 74.95%, and 55.99%, respectively. Logistic regression results showed that the gender and working years of pediatric healthcare providers, the region they were located, and whether their medical institution was equipped with pulse oximeters were the main factors affecting the knowledge score (all P<0.05). Main factors influencing the attitude score of pediatric healthcare providers included their knowledge score, gender, educational background, working years, region, medical institution level, and whether the medical institution was equipped with pulse oximeters (all P<0.05). For the practice score, the main influencing factors were the knowledge score, gender, age, and whether the medi-cal institution was equipped with pulse oximeters (all P<0.05). Conclusions:Chinese pediatric healthcare providers need to further improve their knowledge about and attitudes towards pulse oximetry.Pulse oximeters are evidently under-used.It is urgent to formulate policies or guidelines, strengthen education and training, improve knowledge and attitudes, equip more institutions with pulse oximeters, and popularize their application in medical institutions.

Objective:To investigate the etiology of necrotizing pneumonia (NP) in children and the clinical characteristics of NP caused by different pathogens in China.Methods:A retrospective, case-control study was performed in children with NP who were admitted to 13 hospitals in China from January 2008 to December 2019. The demographic and clinical information, laboratory data, etiological and radiological findings were analyzed. The data were divided into three groups based on the following years: 2008-2011, 2012-2015 and 2016-2019, and the distribution characteristics of the pathogens in different period were compared. Meanwhile, the pathogens of pediatric NP in the southern and northern China were compared. And the clinical characteristics of the Mycoplasma pneumoniae (MP) NP and the bacterial NP were also compared. T-test or Mann-Whitney nonparametric test was used for comparison of numerical variables, and χ 2 test was used for categorical variables. Results:A total of 494 children with NP were enrolled, the median ages were 4.7 (0.1-15.3) years, including 272 boys and 222 girls. Among these patients, pathogens were identified in 347 cases and the pathogen was unclear in the remaining 147 cases. The main pathogens were MP (238 cases), Streptococcus pneumoniae (SP) (61 cases), Staphylococcus aureus (SA) (51 cases), Pseudomonas aeruginosa (13 cases), Haemophilus influenzae (10 cases), adenovirus (10 cases), and influenza virus A (7 cases), respectively. MP was the most common pathogen in all three periods and the proportion increased yearly. The proportion of MP in 2016-2019 was significantly higher than that in 2012-2015 (52.1% (197/378) vs. 36.8% (32/87), χ 2= 6.654, P=0.010), while there was no significant difference in the proportion of MP in 2012-2015 and that in 2008-2011 (36.8% (32/87) vs. 31.0% (9/29), χ2=0.314, P=0.575).Regarding the regional distribution, 342 cases were in the southern China and 152 in the northern China. Also, MP was the most common pathogen in both regions, but the proportion of MP was higher and the proportion of SP was lower in the north than those in the south (60.5% (92/152) vs. 42.7% (146/342), χ 2=13.409, P<0.010; 7.9% (12/152) vs. 14.3% (49/342), χ 2= 4.023, P=0.045). Comparing the clinical characteristics of different pathogens, we found that fever and cough were the common symptoms in both single MP and single bacterial groups, but chest pain was more common (17.0% (34/200) vs. 6.1% (6/98), χ 2=6.697, P=0.010) while shortness of breath and wheezing were less common in MP group (16.0% (32/200) vs. 60.2% (59/98), χ 2=60.688, P<0.01; 4.5% (9/200) vs. 21.4% (21/98), χ 2=20.819, P<0.01, respectively). The white blood cell count, C-reactive protein and procalcitonin in the bacterial group were significantly higher than those in the MP group (14.7 (1.0-67.1)×10 9/L vs. 10.5 (2.5-32.2)×10 9/L, 122.5 (0.5-277.3) mg/L vs. 51.4 (0.5-200.0) g/L, 2.13 (0.05-100.00) μg/L vs. 0.24 (0.01-18.85) μg/L, Z=-3.719, -5.901 and -7.765, all P<0.01). Conclusions:The prevalence of pediatric NP in China shows an increasing trend during the past years. MP, SP and SA are the main pathogens of NP, and the most common clinical symptoms are fever and cough. The WBC count, C-reactive protein and procalcitonin in bacterial NP are significantly higher than those caused by MP.

Objective:To explore the brain function changes in patients with cervical vertigo using functional MRI.Methods:Twenty-two patients who were diagnosed with cervical vertigo were recruited in this study for functional MRI (fMRI) analysis, while 25 age- and sex-matched adult healthy individuals were chose forhealthy controls. The Visual Analogue Scale(VAS) and Dizziness Handicap Inventory (DHI) were used to access the severity of cervical vertigo, and the six-point categorical rating scale was used to measure the frequency of vertigo. Functional MRI was used to investigate the regions with brain functional changes between the cervical vertigo group and the control group. All the data was analyzed using low-frequency oscillation amplitude (ALFF) to explore local brain function changes. The ALFF values between the two groups were tested by two independent samples t-tests. Finally, the ALFF values in abnormal brain regions were extracted using the REST software package and correlated with the diseaseduration of cervical vertigo and thevertigo scores (VAS and DHI) using Pearson correlation analysis. P <0.05 was considered statistically significant. Results:Compared to healthy controls, patients with cervical vertigo haddecreased ALFF valuesin the left superior temporal gyrus (voxel=45, t=-3.36), right superior temporal gyrus (voxel=32, t=-2.82) and left supramarginal gyrus (voxel=57, t=-4.85), and increased ALFF values in the left and right cerebellum (voxel=41, t=4.26; voxel=33, t=4.57; respectively)(AlphaSim Rest, all P values >0.05). The ALFF values of left and right superior temporal gyrus were negatively correlated with the disease duration of vertigo (left R2=0.437, right R2==0.259), the VAS score (left R2==0.453, right R2==0.341) and DHI score (left R2=0.553, right R2=0.594), respectively, and there were significant differences (all P values < 0.05). The ALFF values of left and right cerebellum were positively correlated with the disease duration of vertigo (left R2==0.555, right R2=0.490) and the VAS score (left R2=0.307, right R2=0.282) and DHI score (left R2=0.632, right R2=0.591), respectively, and the differences were significant (all P values < 0.05). Conclusion:Patients with cervical vertigo have reduced spontaneous nerve activity in bilateral Vestibular cortex, and increased spontaneous nerve activity in the bilateral cerebellum. The brain functional changes were correlated with the disease duration and the severity of vertigo.

Objective To evaluate the safety and efficacy of fenestrated endovascular aortic repair (fEVAR) using physician-modified stent grafts(PMSGs) to repair aortic dissection aneurysm.Methods Nine consecutive patients who underwent fEVAR using PMSGs from Jan 2018 to Jun 2018 were retrospectively reviewed.Results Nine PMSGs (6 Ankura stent grafts,3 COOK Zenith stent grafts) were deployed.Initial technical success rate was 97.0％ (32 of 33).Mean operative time was (303 ± 51) min.There were no in-hospital death and no perioperative neurology complications.All the patients survived at a median follow-up of 6.1 mouths (ranging 3-10 months).During follow up,no postoperative complications occurred,all target vessels remained patent and no fenestration-related type Ⅰ endoleak were observed.There are 3 cases of type Ⅱ and 2 cases of type Ⅲ endoleaks respectively.Conclusions FEVAR using PMSGs may be a viable alternative for patients with post aortic dissection aneurysm.

Objective To investigate the potential roles of 14 -3 -3 in the pathogenesis of the cervical cancer.Methods Tissues from 107 patients with cervical cancer(cervical cancer group),50 cases of cervical intra-epithelial neoplasia (cervical intraepithelial neoplasia group)and 50 cases of chronic cervicitis (chronic cervicitis group)were obtained.Immunohistochemistry was performed to determine the expression of 14 -3 -3 protein in tissues of the three groups.Results The positive rate of 14 -3 -3 in cervical cancer group(75.70%)was signifi-cantly higher than that in cervical intraepithelial neoplasia group and chronic cervicitis group(42.00%,30.00%, respectively)(χ2 =17.00,29.96,all P <0.01),while there was no significant difference of 14 -3 -3 level between the cervical intraepithelial neoplasia group and chronic cervicitis group(χ2 =1.56,P >0.05).Moreover,in the cervi-cal cancer group,the positive rate of 14 -3 -3 in lymph node metastasis group was 88.89%,which was higher than that in negative lymph node metastasis group (63.16%)(χ2 =5.15,P <0.05).Conclusion The expression level of 14 -3 -3 protein in cervical cancer is increased,it may be correlated with cervical cancer cell malignant differenti-ation and metastasis.Perhaps,14 -3 -3 will play a key role as a novel target for tumor therapy.

Objective To investigate the continuous ambulatory peritoneal dialysis (CAPD) and daytime ambulatory peritoneal dialysis (DAPD) on sleep and quality of life. Methods In this is a multi-center cross-sectional survey, we used the Pittsburgh Sleep Index Scale (PSQI) and the Chinese version of peritoneal dialysis patient quality of life scale, the unified investigating time, the organized trained peritoneal dialysis nurses qualified to conduct research full-time. Survey content includes general information, sleep and quality of life, laboratory tests, dialysis adequacy and other indicators, and the results were pooled analysis. Results A total of 325 hospitalized peritoneal dialysis patients were included in the study, including 177 patients in CAPD, 148 patients in DAPD. The total scores of QOL, physical function, physical factors, psychological status, social function and life satisfaction were (72.61± 10.94), (19.44±3.65), (59.69±7.31), (32.65±5.65), (24.82±6.03), (15.42±5.47)and (74.06±13.59), (20.16± 2.95), (58.99 ± 5.86), (34.58 ± 6.17), (25.10 ± 5.01), (15.36 ± 4.28). The score of CAPD in the mental state dimension was significantly lower than that in DAPD patients (t=-3.715, P<0.01). Else, there was no significant difference between the two groups (P> 0.05). Conclusions Sleep and quality of life in peritoneal dialysis patients are lower than normal adults. Dialysis modes have an impact on sleep andquality of life of patients, health care workers should fully assess the physical and mental state of the patients in order to select the appropriate mode of dialysis.

Objective To compare the effectiveness of comprehensive rehabilitation therapy with that of surgical intervention for patients with recurrent lumbar disc herniation (LDH).Methods A total of 124 LDH patients were recruited antd randomly divided into an experimental group and a control group,each of 62.The experimental group was given comprehensive rehabilitation consisting of medicine,physical therapy,and spinal stabilization exercises,while the control group received lumbar spine surgery.The patients' back and leg pain scores and their Oswestry Disability Index (ODI) scores were compared at admission and discharge,as well as 3 and 12 months after discharge.Anxiety and depression were also assessed at admission and 3 months after discharge.Results At discharge and 3 and 12 months later the average back and leg pain scores and ODI ratings were significantly lower than that at admisshin for both groups.There were no significant inter-group differences.In terms of anxiety and depression,however,these had decreased signifieantly in both groups,but the experimental group's average rating was significantly better at diseharge.Conclusions Comprehensive rehabilitation is superior to surgical intervention in relieving the depression of patients with recurrent LDH.Comprehensive rehabilitation should be considered as the first ehoiee for patients with rccurrent LDH,and only supplemented by surgical intervention if it is not effective.

Objective To investigate the continuous ambulatory peritoneal dialysis ( CAPD) and daytime ambulatory perito-neal dialysis ( DAPD) on sleep quality. Methods This is a multi-center cross-sectional survey, we used the Pittsburgh Sleep Index Scale ( PSQI) ,the unified investigating time, the organized trained peritoneal dialysis nurses qualified to conduct research full-time. Survey content includes general information, sleep index, laboratory tests, dialysis adequacy and other indicators, and the results were pooled analysis. Results A total of eight hospitals of 325 patients undergoing peritoneal dialysis were included in this study,which CAPD patients and DAPD Pittsburgh Sleep Quality Index Scale scores were 6.88 ±2.43,6.71 ±2.69, the difference was not statisti-cally significant (P>0.01).DAPD patients had a lower sleep efficiency than CAPD patients, but it had no difference between subjec-tive feeling, CAPD patients were more likely to have more nocturnal cough, snoring and other symptoms and lower quality of life in mental status scores than DAPD patients(P<0.01). Conclusion Sleep quality of peritoneal dialysis patients scored lower than the norm.Dialysis modes have an impact on sleep quality of patients, health care workers should fully assess the physical and mental state of the patients in order to select the appropriate mode of dialysis.