BACKGROUND:Ca2+expression in astrocytes has been found to be closely related to cognitive function,and the Ca2+signaling pathway regulated by inositol 1,4,5-trisphosphate receptors(IP3R2)and ryanodine receptor(RYR)2 receptors has become a hot spot in the study of cognitive disorder-related diseases. OBJECTIVE:To investigate the expression of Ca2+signals mediated by IP3R2 and RYR2 in hippocampal astrocytes in animal models of delayed encephalopathy after acute carbon monoxide poisoning,and to explore the possible pathogenesis of delayed encephalopathy after acute carbon monoxide poisoning. METHODS:C57BL mice with qualified cognitive function were selected by Morris water maze experiment and randomly divided into control group and experimental group.An animal model of delayed encephalopathy after acute carbon monoxide poisoning was established by static carbon monoxide inhalation in the experimental group,and the same amount of air was inhaled in the control group.Behavioral and neuronal changes,astrocyte specific marker glial fibrillary acidic protein,IP3R2,RYR2 receptor and Ca2+concentration in astrocytes of the two groups were detected using Morris water maze,hematoxylin-eosin staining,western blot,immunofluorescence double labeling and Ca2+fluorescence probe at 21 days after modeling. RESULTS AND CONCLUSION:In the Morris water maze,the escape latency of the experimental group was significantly longer than that of the control group(P<0.05).Hematoxylin-eosin staining results showed that in the experimental group,the number of hippocampal pyramidal cells decreased,the cell structure was disordered,and the nucleus was broken and dissolved.Immunofluorescence results showed that IP3R2 and RYR2 were co-expressed with glial fibrillary acidic protein in the hippocampus,and the expressions of IP3R2,RYR2 and glial fibrillary acidic protein were up-regulated in the hippocampus of the experimental group(P<0.05).Western blot analysis showed that the expressions of IP3R2,RYR2,and glial fibrillary acidic protein in the hippocampus of the experimental group were increased(P<0.05).Ca2+concentration in hippocampal astrocytes increased significantly in the experimental group(P<0.05).To conclude,astrocytes may affect Ca2+signals by mediating IP3R2 and RYR2 receptors,then impair the cognitive function of mice with carbon monoxide poisoning,and eventually lead to delayed encephalopathy after acute carbon monoxide poisoning.

Objective To explore the value of high-frequency ultrasound in the detection of metastatic hepatocellular carcinoma and displaying lesion characteristics. Methods A total of 38 paitients with hepatocellular carcinoma satellite lesions within 40 mm of subcutaneous tissue were underwent low-frequency (1-5 MHz) and high-frequency (6-9 MHz) ultrasound. Detection rates and ultrasonic features were compared. Results High-frequency grayscale ultrasound had a higher detection rate (71.1% vs. 36.8%, P＜0.001). Subgroup analysis showed higher detection rates with chemotherapy history (88.9% vs. 33.3%, P＝0.002), fatty liver (71.9% vs 31.3%, P＜0.001) or superficial lesion (within 20 mm, 76.5% vs 41.2%, P＝0.031). High-frequency ultrasound also showed clearer margins (P＝0.004) and more arterial-phase rim enhancement (P＝0.007). Conclusions 6-9 MHz ultrasound detects metastatic hepatocellular carcinoma, especially superficial lesions, more effectively than 1-5 MHz ultrasound and better visualizes characteristics.

Malignant tumors have surpassed stroke and coronary heart disease to become the main cause of death before the age of 70 in the world. The incidence of malignant tumors is increasing year by year， which seriously affects the living standards and social and economic development of Chinese people. Surgery， radiotherapy， chemotherapy， targeted therapy， and immunotherapy are the main means of Western medicine to intervene in tumors， which are of great significance for prolonging the survival time of patients. However， there are many disadvantages such as adverse reactions and drug resistance. Traditional Chinese medicine has become a research hotspot in recent years because of its definite curative effect and wide application in tumor treatment. Xiao Chaihutang is derived from the Treatise on Febrile and Miscellaneous Diseases. It is composed of Bupleuri Radix， Scutellariae Radix， Ginseng Radix， Pinelliae Rhizoma， Glycyrrhizae Preparata Radix， Ginger， and Jujube. It has the effects of reconciling Shaoyang， reconciling cold and heat Yin and Yang， soothing the liver， and relieving depression. This prescription and the prescriptions based on it are widely used in various stages of tumors. This study summarized the Chinese and foreign research of Xiao Chaihutang in the field of tumors in the past 10 years and explored the role and mechanism of Xiao Chaihutang in blocking precancerous lesions， controlling the development of malignant tumors， reducing the occurrence of adverse reactions after intervention， and alleviating common complications， with a view to expanding the clinical medication ideas.

Objective To analyze the current patient satisfaction levels and their influencing factors from the perspective of medical experience in private rehabilitation hospitals in Chongqing.This analysis aimed to provide references for these hospitals to improve the quality of medical services.Methods A questionnaire survey of 467 inpatients from three private rehabilitation hospitals in Chongqing was conducted,using convenience sampling.The x2 test and logistic regression analysis were used to i-dentify factors influencing patient satisfaction.Results The overall satisfaction rate of inpatient care was 78.6％,with an aver-age satisfaction score of 3.84±0.52.The complaint and advice service scored the higher,while logistics and environmental serv-ice and rehabilitation treatment service were assessed with lower scores.Regression analysis showed that the per capita monthly household income ranged between 2 001 and 4 000 yuan(OR=0.221,95％CI:0.077-0.635),and between 4 001 and 6 000 yuan(OR=0.296,95％CI:0.125-0.700).Additionally,out-of-pocket payment(OR=4.198,95％CI:1.035-17.027),and others payment methods,including commercial insurance(OR=9.591,95％CI:1.767-52.049)were identified as influential factors.Conclusion Inpatients'overall satisfaction with their medical experience is acceptable,but still has considerable room for improvement.It is recommended that a multidimensional approach be adopted to improve patient satisfaction.

Objective:To compare the consistency of lymphoma multigene detection panels based on next-generation sequencing (NGS) with FISH detection of B-cell lymphoma gene rearrangement.Methods:From January 2019 to May 2023, fusion genes detected by lymphoma-related 413 genes that targeted capture sequencing of 489 B-cell lymphoma tissues embedded in paraffin were collected from Henan Cancer Hospital, and the results were compared with simultaneous FISH detection of four break/fusion genes: BCL2, BCL6, MYC, and CCND1. Consistency was defined as both methods yielding positive or negative results for the same sample. The relationship between fusion mutation abundance in NGS and the positivity rate of cells in FISH was also analyzed.Results:Kappa consistency analysis revealed high consistency between NGS and FISH in detecting the four B-cell lymphoma-related gene rearrangement ( P<0.001 for all) ; however, the detection rates of positive individuals differed for the four genes. Compared with FISH, NGS demonstrated a higher detection rate for BCL2 rearrangement, a lower detection rate for BCL6 and MYC rearrangement, and a similar detection rate for CCND1 rearrangement. No correlation was found between fusion mutation abundance in NGS and the positivity rate of cells in FISH. Conclusions:NGS and FISH detection of B-cell lymphoma gene rearrangement demonstrate overall good consistency. NGS is superior to FISH in detecting BCL2 rearrangement, inferior in detecting MYC rearrangement, and comparable in detecting CCND1 rearrangement.

Objective To establish the reference interval of glycosylated serum protein(GSP)and glycosylated hemoglobin(HbA1c)in healthy pregnant women in Korla region at 24-28 weeks of gestation,so as to provide a basis for clinical screening of gestational diabetes mellitus(GDM).Methods A total of 795 pregnant women who underwent obstetric examination and delivery in Korla Hospital of the Second Division of Xinjiang Production and Construction Corps were selected as the study objects.According to the results of oral glucose tolerance test at 24-28 weeks,pregnant women were divided into healthy study group(n=627)and GDM group(n=168).The pregnant women in health study group were divided into appropriate age group(age<35 years,n=491)and elderly group(age≥35 years,n=136)according to the age of delivery.A total of 131 healthy non-pregnant women were selected as control group.The levels of GSP and HbA1c in each group were detected,and the reference interval was established by percentile method(P2.5-P97.5).Receiver operating characteristic(ROC)curve was used to evaluate the efficacy of GSP and HbA1c in screening GDM.Results There were statistically significant differences in GSP and HbA1c in appropriate age group,elderly group and control group(P<0.05).There was no significant difference in GSP and HbA1c between appropriate age group and elderly group(P>0.05).The reference interval of GSP and HbA1c was 188.15-257.75 μmol/L and 4.50%-5.70%in healthy pregnant women at 24 to 28 weeks of gestation,respectively.ROC curve results showed the area under the curve of GSP and HbA1c screening GDM alone was 0.803 and 0.708,respectively.Conclusion The reference interval of GSP and HbA1c were 188.15-257.75 μmol/L and 4.5%-5.7%in 24 to 28 weeks of gestation of healthy pregnant women in Kuerla region,respectively,and GSP and HbA1c had great application value in screening GDM population.

Objective To evaluate the safety and efficacy of CT-guided needle puncture biopsy of pancreatic lesions through gastrointestinal space.Methods Data of 96 patients with single pancreatic lesion who underwent CT-guided needle puncture biopsy through gastrointestinal space were retrospectively analyzed,and the success rate of puncture biopsy was recorded.The diagnostic efficacy of biopsy pathology was evaluated based on surgical pathology and follow-up results,and the relative complications were observed.Results Puncture biopsy was successfully completed in all 96 cases(96/96,100%).The sensitivity of biopsy pathology diagnosis was 97.75%(87/89),with specificity of 100%(7/7),positive predictive value of 100%(87/87),negative predictive value of 77.78%(7/9)and accuracy of 97.92%(94/96).Complications were noticed in 6 cases,including small amount of peripancreatic effusion in 3 cases,small amount of abdominal effusion in 1 case and intermittent fever in 2 cases,which were all improved.No other complication occurred.Conclusion CT-guided needle puncture biopsy of pancreatic lesions through gastrointestinal space was safe and effective.

Objective:To investigate key differential expressed genes(DEGs),enriched biological functions and signaling pathways in exosomes derived from angiosarcoma cells ISOHAS and angiosarcoma stem-like cells Sphere by bioinformatics analysis,to provide new therapeutic targets for angiosarcoma.Methods:Transcriptome sequencing of exosomes derived from ISOHAS and Sphere were performed to screen for DEGs by|log2FC|>2 and FDR<0.05 as criteria.Bioinformatics analysis was used to enrich GO and KEGG pathways of DEGs to identify biological functions and signaling pathways of enriched DEGs.STRING database was used to screen key DEGs,and iPath was used to visualize to identify metabolic pathways enriched by DEGs.Results:Transcriptome sequencing results showed that 91 DEGs were identified in exosomes derived from ISOHAS and Sphere.GO and KEGG pathway enrichment analysis demonstrated that main biological functions and signaling pathways enriched by DEGs were response to glucocorticoid and TNF signaling pathway,respectively.STRING database demonstrated that TNF and IL-6 were key DEGs.iPath metabolic network analysis demonstrated that DEGs were mainly identified in lipid metabolism and nucleotide metabolism.Conclusion:Sphere-derived exosomes may influence occurrence and development of angiosarcoma by carrying key genes TNF and IL-6 to interfere with glucocorticoid response,TNF signaling pathway,lipid metabolism,nucleotide metabolism and other biological functions and signaling pathways,providing new ideas for therapeutic targets for angiosarcoma.

Objective:To retrospectively analyze the contrast-enhanced ultrasound(CEUS) features of primary hepatic lymphoepithelioma-like carcinoma (LELC) and investigate the value of CEUS in the diagnosis of hepatic LELC.Methods:The images of CEUS of 12 cases with hepatic LELC were retrospectively analyzed. The perfusion patterns and time of enhancement were observed.Results:During the arterial phase, 11 lesions showed diffuse enhancement, while 1 lesion showed rim-like enhancement. The mean time of begin enhancement, time to peak, time to iso-enhancement and slightly hypo-enhancement were (17.92±5.81)s, (24.50±5.52)s, (29.55±6.25)s, (45.50±25.15)s, respectively. Compared with adjacent liver parenchyma, rapid enhancement was observed in 11 lesions and synchronous enhancement was observed in 1 lesion.As to time of peak enhancement, hyper-enhancement and iso-enhancement were observed in 11 lesions and 1 lesion, respectively. In portal phase, 8 lesions manifested slight hypo-enhancement, 3 lesions with marked hypo-enhancement and 1 lesion with iso-enhancement.And in delayed phase, 10 lesions showed marked hypo-enhancement and 1 lesion with slight hypo-enhancement. Ten lesions showed peripheral hyper-enhancement like a bright ring in the portal and delayed phase.Conclusions:CEUS is valuable for the diagnosis and differential diagnosis of hepatic LELC.

Objective:To explore the morphological characteristics of the pectoralis major muscle and the anatomical relationship of adjacent structures .Methods:A total of 156 patients undergoing thyroid surgery at the First Hospital of Anhui University of Science & Technology and the First Affiliated Hospital of University of Science and Technology of China from Dec 2020 to Sep 2022 were includeed. Those adopting routine endoscopic thyroidectomy by gasless unilateral axillary approach were assigned to group A,and searching for the sternocleidomastoid muscle through the pectoralis major muscle gap on this basis to group B.Results:Among the 78 patients in group B, a total of 71 (91%) cases were found to have a typical sternocleidomastoid muscle gap, and in 7 (9%) cases were not found. The morphology phenotypes of the gap between the clavicular part and thoracic ribs part of the pectoralis major muscle was found in 3 types: obvious separation type (typeⅠ), inconspicuous separation-partially overlapped type (typeⅡa), and inconspicuous separation-completely anastomosed type (type Ⅱb). The mean duration of surgery in group B was less (105±15) min than that in group A (156±27) min ( t=14.523, P<0.01); postoperative one day drainage in group B was less (49±6) ml than that in group A (51±6) ml ( t=2.273, P=0.024). There was no statistically significant difference in intraoperative bleeding, postoperative hospital stay and complication rate between the two groups ( t=0.557, P=0.578; t=0.134, P=0.894; χ2=1.844, P=0.174). Conclusion:The search for the sternocleidomastoid muscle through the pectoralis major muscle gap in the endoscopic thyroidectomy by gasless unilateral axillary approach can shorten the duration of surgery and improve the efficiency of surgery.