Objective:To investigate the predictive value of MRI balanced steady-state free precession(b SSFP)synergistic voxel incoherent motion diffusion weighted imaging(IVIM-DWI)and Gd-DTPA enhanced scanning for the status of extramural vascular invasion(EMVI)in rectal cancer before surgery.Methods:A total of 105 rectal cancer patients from the People's Hospital of Lujiang County,Anhui Province,were retrospectively selected and included.All patients were confirmed by postoperative pathology and underwent preoperative b SSFP sequences,IVIM-DWI functional imaging,and Gd-DTPA-enhanced multiparameter MRI scans.Three seven-point schemes based on individual b SSFP sequences,IVIM-DWI functional imaging,and Gd-DTPA en-hancement,two-by-two synergy,and multi-sequence combined diagnosis were utilized in con-junction with conventional MRI sequences for preoperative prediction of EMVI status.The diag-nostic efficacy of T2WI and b SSFP sequences was compared with that of postoperative patho-logic results.ROC curves were plotted to obtain the corresponding area under the ROC curve(AUC),specificity,and sensitivity.Results:The AUC for predicting the preoperative vascular status outside the rectal wall was 0.572(95％CI:0.408～0.737)for the conventional T2 lipid sup-pression sequence,with a specificity of 0.811 and a sensitivity of 0.667.The AUC for the b SSPF sequence was 0.817(95％CI:0.680～0.954),with a specificity of 0.900 and a sensitivity of 0.733.All of the statistical parameters were higher than the diagnostic efficacy of conventional T2 lipid suppression sequences.The multi-sequence MRI co-diagnosis had an AUC of 0.961(95％CI:0.886～1.000),with a specificity of 0.988 and a sensitivity of 0.875(P＜0.05).Conclusion:Mag-netic resonance b SSFP sequence synergized with IVIM-DWI and Gd-DTPA-enhanced multipa-rameter scanning has high clinical application value for the preoperative prediction of EMVI inva-sion in rectal cancer.

Humans ; COVID-19 Vaccines/therapeutic use* ; COVID-19/prevention & control* ; SARS-CoV-2 ; China ; Antibodies, Viral

Objective:To explore the applications value of hospital elderly life program in cardiac surgery patients in intensive care unit, and provide reference for improving the prognosis of patients.Methods:This was a prospective study. A total of 84 cardiac surgery patients in intensive care unit from April 2020 to February 2022 in the People′s Hospital of Leshan by convenient sampling method, they were enrolled and divided into the observation group and the control group according to the admission time, each group was 42 cases. Routine nursing care was carried out in both groups, the control group implemented delirium and debility prevention nursing, the observation group adopted hospital elderly life program. The incidence of ICU-acquired delirium and weakness, mechanical ventilation time, duration of ICU stay, the total length of stay and intensive care experience were assessed between the two groups.Results:The 42 cases were included in the final control group and 39 cases in the observation group. The incidence of ICU-acquired delirium and weakness were 17.95% (7/39) and 7.69% (3/39) in the observation group, lower than in the control group 38.10%(16/42) and 23.81%(10/42), the differences were statistically significant ( χ2 = 4.04, 3.90, both P<0.05); the duration of ICU delirium were (1.71 ± 0.95) d in the observation group, shorter than in the control group (2.81 ± 1.05) d, the difference was statistically significant ( t = 2.38, P<0.05); the mechanical ventilation time, duration of ICU stay, the total length of stay, the total score of intensive care experience in hospital in the observation group were (193.54 ± 21.67) h, (9.49 ± 2.11) d, (18.10 ± 3.12) d, (2.72 ± 0.26) points, lower than those in the control group (214.50 ± 27.25) h, (10.90 ± 1.97) d, (20.59 ± 4.07) d, (3.15 ± 0.35) points, the differences were statistically significant ( t values were 3.11-6.35, all P<0.05). Conclusions:Hospital elderly life program can decrease the incidence of ICU-acquired delirium and weakness of cardiac surgery patients in intensive care unit, shorten mechanical ventilation time and hospitalization time, alleviate discomfort in the intensive care experience.

Chronic refractory wound (CRW) is one of the most challengeable issues in clinic due to complex pathogenesis, long course of disease and poor prognosis. Experts need to conduct systematic summary for the diagnosis and treatment of CRW due to complex pathogenesis and poor prognosis, and standard guidelines for the diagnosis and treatment of CRW should be created. The Guideline forthe diagnosis and treatment of chronic refractory wounds in orthopedic trauma patients ( version 2023) was created by the expert group organized by the Chinese Association of Orthopedic Surgeons, Chinese Orthopedic Association, Chinese Society of Traumatology, and Trauma Orthopedics and Multiple Traumatology Group of Emergency Resuscitation Committee of Chinese Medical Doctor Association after the clinical problems were chosen based on demand-driven principles and principles of evidence-based medicine. The guideline systematically elaborated CRW from aspects of the epidemiology, diagnosis, treatment, postoperative management, complication prevention and comorbidity management, and rehabilitation and health education, and 9 recommendations were finally proposed to provide a reliable clinical reference for the diagnosis and treatment of CRW.

Abstract: Objective　The main aim of the study is to sequence the complete genome of two Getah virus strains (GS11-155 and HNDZ1712-1) isolated in Gansu Province and Hainan Province in 2011 and 2017 respectively and analyze the molecular and genetic evolution of the two strains compared with M1, which was first isolated in 1964 in Hainan Province, China. Methods　Genome of two newly isolated Getah viruses were sequenced by virus gene amplification technique, and the genomic database of Getah viruses was established. The molecular characteristics and genetic evolution of the viruses were analyzed by bioinformatics software. Results　The genome length of two new isolated Getah virus strains (GS11-155 and HNDZ1712-1) was 11 690 nt and 11 621 nt, respectively. Both strains had the structural characteristics of Alphavirus genome. Although the nucleotide sequence lengths of structural genes, non-structural genes and non-coding junction regions of the two strains were identical, the nucleotide sequence lengths of the 5' and 3' non-coding regions of the viral genomes were a few different. The 3'UTR repeats elements in the genomes of the two virus strains did not change. It was 97.7% and 98.1% different of nucleotide and amino acid homology between both strains of Getah virus, HNDZ1712-1 isolated in 2017 and M1 isolated in 1964 in Hainan Province. Interesting, Gansu 2011 cluster and Hainan 2017 cluster were emerged leading by both strains GS11-155 and HNDZ1712-1 respectively, those two clusters totally independent with M1 virus isolated from Hainan in 1964 in whole genome phylogenetic analysis first. Conclusions　Although the HNDZ1712-1 was also isolated from mosquito samples in Hainan Province, it was in a completely different evolutionary branch from the M1 isolated from Hainan Island in 1964, and was closely related to the strain isolated from Gansu Province (GS11-155) thousands of kilometers away. It is suggested that the two new strains of Getah virus are different from the Getah virus isolated in 1964.

Objective:To disclose the molecular genetic differences of Culex flavivirus among mosquitoes in Gansu province in 2011 and 2019.Methods:Reverse transcriptase-polymerase chain reaction (RT-PCR) was used to obtain the nucleotide sequences of Culex flavivirus genomes from mosquitoes in Gansu province in 2011 and 2019, and viral molecular biology and bioinformatics method were used to analyze the genetic differences of the viruses.Results:Nucleotide sequences of 10 strains of Culex flavivirus were obtained, including 8 strains (all from Culex pipiens pallens) obtained in 2011 and 2 strains ( from Culex tritaeniorhynchus and Anopheles sinensis) in 2019. Homology analysis of nucleotide and amino acid sequences of virus E gene showed that the nucleotide sequence similarity and amino acid similarity of viruses isolated from Gansu in 2019 and 2011 ranged from 98.3%-100% and 95.4%-97.3%, respectively. Phylogenetic analysis of Culex flavivirus E gene sequence showed that two strains of Culex flavivirus isolated in Gansu province in 2019 (GS1975 and GS1976) and eight strains of Culex flavivirus isolated in 2011 all belonged to group B of genotype 1 of Culex flavivirus. Further analysis found that GS1975 virus isolated in 2019 was in a common evolutionary cluster with viruses isolated from Liaoning (2010 and 2011) and Inner Mongolia (2018), while GS1976 virus isolated in 2019 formed a coevolutionary cluster with viruses isolated from Inner Mongolia (2018) and Gansu (2011). Conclusions:Although both Culex flaviviruses isolated in Gansu province in 2011 and 2019 are genotype 1 virus, the two viruses isolated in 2019 distributed in two different evolutionary clusters, suggesting that the local mosquito virus genome changes over time, therefore, long-term monitoring of molecular differences is needed to carry out.

Objective:To explore the clinical features and survival of newly diagnosed follicular lymphoma (FL) patients with diffuse large B-cell lymphoma (DLBCL) component.Methods:1845 newly diagnosed FL patients aged ≥ 18 years with grades 1-3a in 11 medical centers in China from 2000 to 2020 were included, and patients with DLBCL component were screened. The clinical data and survival data of the patients were retrospectively analyzed, and the prognostic factors were screened by univariate and multivariate analysis.Results:146 patients (7.9% ) with newly diagnosed FL had DLBCL component. The median age was 56 (25-83) years, 79 males (54.1% ) . The pathology of 127 patients showed the proportion of DLBCL component. Patients were divided into two groups according to whether the proportion of DLBCL component was ≥ 50% . The study found that patients with DLBCL component ≥ 50% had higher grade 3 ratio (94.3% vs 91.9% , P=0.010) , Ki-67 index ≥ 70% ratio (58.5% vs 32.9% , P=0.013) and PET-CT SUVmax ≥ 13 ratio (72.4% vs 46.3% , P=0.030) than patients with DLBCL component<50% . All patients received CHOP or CHOP like ± rituximab chemotherapy. The overall response rate (ORR) was 88.2% , and the complete response (CR) rate was 76.4% . In the groups with different proportions of DLBCL component, there was no significant difference in the remission rate after induction treatment and the incidence of disease progression within 2 years after initiation of treatment (POD24) ( P<0.05) . The overall estimated 5-year progression free survival (PFS) rate was 58.9% , and the 5-year overall survival (OS) rate was 90.4% . The 5-year OS rate of POD24 patients was lower than that of non POD24 patients (70.3% vs 98.5% , P<0.001) . Compared with non maintenance treatment of rituximab, maintenance treatment of rituximab could not benefit the 5-year PFS rate (57.7% vs 58.8% , P=0.543) , and the 5-year OS rate had a benefit trend, but the difference was not statistically significant (100% vs 87.8% , P=0.082) . Multivariate analysis showed that failure to reach CR after induction treatment was an independent risk factor for PFS ( P=0.006) , while LDH higher than normal was an independent risk factor for OS ( P=0.031) . Conclusion:FL patients with DLBCL component ≥50% have more invasive clinical and pathological features. CHOP/CHOP like ± rituximab regimen can improve the clinical efficacy of patients. Rituximab maintenance therapy can not benefit the PFS and OS of patients. Failure to reach CR after induction therapy was the independent unfavorable factor for PFS.

Objective:To explore the effects of apatinib on the proliferation and apoptosis of FLT3-ITD mutant acute myeloid leukemia (AML) cells, and to explore the related mechanisms.Methods:The logarithmic growth phase FLT3-ITD mutant AML cell lines MV4-11 and MOLM-13 were treated with different concentration of apatinib for 48 hours. The cell proliferation was detected by CCK-8 method. Flow cytometry was performed to examine the effect of apatinib on apoptosis. The cell mitochondrial membrane potential changes were detected by JC-1. Then the expression changes of vascular endothelial growth factor receptor 2 (VEGFR2) pathway-related proteins were examined by Western blot.Results:Apatinib had proliferation inhibitory effects on both MV4-11 and MOLM-13 cells, and the half-maximal inhibitory concentration (IC 50) at 48 hours was (2.23±0.42) μmol/L and (4.08±2.62) μmol/L, respectively. After exposure to apatinib with increasing concentrations (10, 20, 30, and 40 μmol/L) for 48 h hours, the percentage of apoptotic cells was significantly increased in MV4-11 cells [(81.95±1.15)%, (88.80±0.23)%, (97.46±0.49)%, and (99.29±0.05)%] and MOLM13 cells [(47.30±0.87)%, (67.00±3.71)%, (82.60±2.89)%, and (98.06±5.34)%] in a dose-dependent manner, and the differences were statistically significant ( F = 6 915.0, P < 0.01; F = 5 385.0, P < 0.01). Detection of mitochondrial membrane potential by JC-1 method showed that after MV4-11 and MOLM-13 cells were treated by 10, 20, 30, and 40 μmol/L apatinib for 24 hours, the JC-1 aggregate/monomer mean fluorescence intensity (MFI) ratios were 0.45±0.06, 0.19±0.07, 0.12±0.03, 0.09±0.01, and 0.84±0.05, 0.66±0.13, 0.35±0.11, 0.27±0.02, which were different from the control group (0.67±0.15 and 0.97±0.42), and the differences were statistically significant ( F = 372.3, P < 0.05; F = 276.4, P < 0.05). Western blot was performed to detect different concentration of apatinib (2.5, 5.0 and 10.0 μmol/L) on the MV4-11 cells for 24 hours, the results showed that apatinib could down-regulate the phosphorylation of VEGFR2, Src and Stat3 in a dose-dependent manner. Conclusions:Apatinib can inhibit cell proliferation and induce apoptosis in AML with FLT3-ITD mutation. The possible mechanism is related to the down-regulation of phosphorylation of VEGFR2 and its downstream targets Src and Stat3.

Objective To observe the effects of hyperbaric oxygen in the treatment of the rats with optic nerve crush. Methods In this study, 24 rats with traumatic optic nerve injury were recruited. The rats'left eyes were injured in the optic nerve and the right eyes as the controls were applied with sham-operation. The rats were divided into the treatment group and the control group in accordance with the random number table. The experimental group was treated with two-course hyperbaric oxygen one hour a day, 10 days a course. The control group breathed fresh air under standard atmospheric pressure. F-VEP was detected on day 3, 10, 20 during the experiment. Results In the control group, latency of F-VEP delayed (P＜0.05) and the amplitude of P100 decreased (P＜0.05) in the injured eye compared to the normal eye. In the experimental group, no obvious difference was found in the latency of F-VEP and the amplitude of P100 in the injured eye compared to the normal eye (P＞ 0.05) . The comparison of F-VEP data of the injured eyes showed that incubation period was in advance (P＜ 0.05) and amplitude increased (P＜0.05) in the experimental group. The comparison of F-VEP data tested at different time points was statistical significant. Conclusion The rat model of optic nerve injury was successful. Hyperbaric oxygen therapy showed no interference with the F-VEP data of the injured eye by causing no damage to the normal eye and was proved effective. Longer treatment provided better results.

Objective To investigate the concentration of interleukin-32 (IL-32) in serum,and the expression of IL-32 mRNA in placenta,subcutaneous fat and great epiploon adipose tissue,and explore the relationship between IL-32 and gestational diabetes mellitus (GDM).Methods The concentrations of serum IL-32 in 42 GDM (GDM group) and 38 non-GDM (control group) pregnant women were examined by enzyme linked immunosorbent assay (ELISA).The level of the IL-32mRNA in the placenta,subcutaneous fat and great epiploon adipose tissue was examined by quantitative realtime reverse-transcription polymerase chain reaction (RT-qPCR).The expression levels of IL-32 protein in the placenta and umbilical cord were measured by immunohistochemical staining (IHC) and analyzed by ImagePro Plus 9.0.Results The serum level of IL-32 in the GDM group was significantly higher than that in the control group [(129.3 ± 5.78) pg/mL vs.(105.6 ± 8.61) pg/mL,P＜0.05].The level of IL-32 mRNA was increased 1.32 and 1.66 fold in the placenta (P＜0.05) and the great epiploon adipose tissue (P＜0.05) from GDM women,compared with that from control group.No significant difference was found in the levels of IL-32mRNA in the subcutaneous adipose tissue between the two groups [(3.78 ± 0.53) vs.(3.61 ± 0.35),P＞0.05].The expression of IL-32 in the placenta from GDM group was 1.27 times higher than that from control group (P ＜0.05).The IL-32 in the umbilical artery and umbilical vein of GDM group increased by 1.30 and 1.32 (P＜0.05).But there was no significant difference of IL-32 expression in the umbilical interstitial between the two groups.Conclusions Overexpression of IL-32 in the serum and tissue may be involved in the pathogenesis of GDM.