Background Manganese is an essential trace element for the human body and maintains normal development of many organs including the brain. However, long-term exposure to a high manganese environment or excessive manganese intake will lead to manganese poisoning and result in neurological diseases, and currently no effective treatment plan is available. Objective To develop an animal model for subchronic manganese exposure and assess the impact of Dendrobium nobile Lindl. alkaloids (DNLA) on manganese associated behavioral and hippocampal effects in rats. Methods Fifty male SPF SD rats were randomly allocated into a control group (0.9% normal saline by intraperitoneal injection), two experimental groups [7.5 mg·kg⁻¹ (low) or 15 mg·kg⁻¹ (high) of MnCl₂·4H₂O by intraperitoneal injection], and two DNLA antagonistic groups [15 mg·kg⁻¹ MnCl₂·4H₂O by intraperitoneal injection then either 20 mg·kg⁻¹ (low) or 40 mg·kg⁻¹ (high) DNLA by oral administration]. All groups of rats were adminaistered 5 d per wek, once a day, for consecutive 13 weeks. Following modeling, neurobehavioral assessments were conducted using open field, Morris water maze, and Y maze. Inductively coupled plasma mass spectrometry (ICP-MS) was utilized to measure manganese levels in the blood and brain tissues of the rats, and hematoxylin-eosin (HE) staining was employed to examine neuronal morphological changes in the hippocampal tissues of the rats. Results The neurobehavioral tests revealed that the manganese-exposed rats exhibited decreased total movement distance, prolonged central zone dwelling time, and reduced motor activity in the open field test, indicating tendencies toward depression and anxiety (P<0.05). In the Y-maze test, the mean exploration distance in the novel arm, the number of entries into the novel arm, and the time spent in the novel arm of the managanses-exposed rats were all reduced, while the latency period increased, suggesting impaired spatial exploration and learning-memory functions (P<0.05). In the Morris water maze navigation test, the escape latency was significantly longer in the manganese-exposed rats compared to the control group, and the number of platform crossings decreased in the spatial probe test, indicating a significant decline in spatial learning and memory (P<0.05). The ICP-MS analysis showed elevated manganese concentrations in the blood and hippocampus of the exposed rats (P<0.05), and the histopathological observation revealed hippocampal damage. Following the DNLA intervention, the manganese-exposed rats showed increased total movement distance and reduced central zone dwelling time in the open field test (P<0.05). In the Y-maze test, the mean exploration distance in the novel arm, the number of entries into the novel arm, and the time spent in the novel arm increased, while the latency period decreased, suggesting alleviation of anxiety and improved exploratory behavior (P<0.05). In the Morris water maze test, the escape latency gradually shortened, and both the number of platform crossings and the percentage of time spent in the target quadrant increased, indicating improved spatial learning and memory (P<0.05). Additionally, the manganese levels in the blood and hippocampus decreased (P<0.05), and the hippocampal pathological changes were partially restored. Conclusion DNLA demonstrates the ability to counteract multiple neurotoxic effects following the elevation of manganese levels in the blood and hippocampal tissues of rats induced by subchronic manganese exposure. Specifically, DNLA is shown to ameliorate the behavioral alterations observed in rats after manganese exposure, and mitigate the hippocampal damage in manganese-exposed rats.

Objective:To compare image quality and diagnostic parameters of whole-brain CT perfusion scans under different scanning conditions and assess the utility of deep learning image reconstruction algorithm (DLIR) in reducing tube current during low-dose scans.Methods:Method A total of 105 patients with suspected acute ischemic stroke (AIS) were prospectively enrolled in the First Affiliated Hospital of Zhengzhou University from March, 2022 to March, 203 and their baseline information was recorded. All patients underwent head non-contrast CT and CT perfusion (CTP) examinations. CTP scanning was performed at 80 kV in two groups with the tube current of 150 mA (regular dose) and 100 mA (low dose), respectively. The CTP images of 150 mA group were reconstructed using filtered back-projection algorithm as well as adaptive statistical iterative reconstruction-V (ASIR-V) at 40% and 80% strength levels, which were denoted as groups A-C. The CTP images of 100 mA group were reconstructed using ASIR-V80%, DLIR-M, and DLIR-H, which were denoted as groups D-F. Clinical baseline characteristics and radiation doses were compared between the two groups under different scanning conditions. Furthermore, we assessed the subjective and objective image quality, conventional perfusion parameters, and abnormal perfusion parameters of AIS patients across the six groups of reconstructed CTP images.Results:Under the scanning conditions of 150 mA and 100 mA, 47 and 48 patients were diagnosed with AIS, respectively. There were no significant differences in the baseline characteristics between the two groups. However, there was a significant difference in the mean effective radiation dose (5.71 mSv vs. 3.80 mSv, t = 2 768.30, P < 0.001). The standard deviation (SD) of noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) of gray matter (GM) and white matter (WM) were significantly different among the six groups of reconstructed images ( F = 40.58-212.13, P < 0.001). In GM, the SD values in groups C, D, and F were lower than those in other groups ( P < 0.05), and the SNR values in groups C and F were higher than those in other groups ( P < 0.05). In WM, the SD and SNR values in groups C and F were significantly different from those in other groups ( P < 0.05). Additionally, CNR values in groups C and F were higher than those in other groups ( P < 0.05). There was no significant difference in subjective scores among groups B, C, and F ( P > 0.05). Regarding perfusion parameters in the brain GM, groups D and E had lower cerebral blood volume (CBV) values compared to groups A to C ( P < 0.05), and group F had lower CBV values than group B ( P < 0.05). In the brain WM, group D had consistently lower mean transit time (MTT) values compared to the other groups ( P < 0.05). Notably, there were no significant differences in AIS lesion detection rates and relevant diagnostic parameters across the six image groups. Conclusions:Low-tube current CTP scan combined with the DLIR-H algorithm can enhance image quality without affecting perfusion parameters such as CBV and MTT, while reducing radiation dose by 30%. This algorithm can be routinely applied in brain CTP examinations.

Fetal STR typing of aborted tissue has long been a major problem in forensic DNA.Especially for the first trimester abortion tissue,it is difficult to isolate the embryonic components by histomorphological means,resulting in the inability to accurately obtain the STR typing of the fetus.The mixed STR typing results of mother and fetus can provide a key basis for the identification of suspects in cases of rape-induced pregnancy.In this study,next generation sequencing was used to successfully detect mixed STR typing of mother and suspected fetus or single STR typing of suspected fetus in 4 rape-induced early pregnancy abortion tissues.Combined with Y-STR and flank sequence information,it provides a more comprehensive and reliable genetic basis for the identification of suspects.

Objective:To explore the clinical value of quantitative parameters on spectral CT in predicting the invasiveness of lung adenocarcinoma manifesting as ground-glass nodules (GGN).Methods:The clinical and imaging data of 129 patients with pathologically confirmed lung adenocarcinoma who were surgically resected in the First Affiliated Hospital of Zhengzhou University from March to October 2022 were retrospectively analyzed, including 45 males and 84 females, aged from 33 to 81. According to the pathological results, they were divided into the minimally invasive adenocarcinoma (MIA) group ( n=64) and the invasive adenocarcinoma (IAC) group ( n=65). All patients underwent enhanced spectral CT within two weeks before surgery. The iodine density map, Z-Effective (Z eff) map, and electron density (ED) map were reconstructed on the post-processing workstation, and the spectral parameters, including normalized iodine concentration (NIC), arterial enhancement fraction (AEF), Z eff, and ED were measured and calculated. Conventional CT features were analyzed, including maximum diameter, CT value, nodule types, margin, lobulation sign, spiculation sign, bubble sign, pleural retraction sign, abnormal vascular sign, and air bronchial sign. The clinical features, conventional CT characteristics and spectral CT parameters of two groups were compared using the independent sample t test, the Mann-Whitney U test, and the χ 2 test. Multivariate logistic regression analysis was used to evaluate the independent risk factors of lung adenocarcinoma invasiveness, and the model was constructed. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the performance of parameters and models in predicting the invasiveness of lung adenocarcinoma. Results:There were significant differences between the MIA group and IAC group in maximum diameter, CT value, nodule type, margin, spiculation sign, pleural retraction sign, air bronchial sign, venous phase NIC, AEF, venous phase Z eff, arterial phase ED, venous phase ED ( P<0.05). Multivariate logistic regression analysis showed that the maximum diameter (OR=1.183, 95%CI 1.062-1.318), CT value (OR=1.004, 95%CI 1.001-1.007), venous phase NIC (OR=1.185, 95%CI 1.083-1.298), AEF(OR=0.975, 95%CI 0.957-0.994), venous phase Z eff (OR=0.031, 95%CI 0.005-0.196) were independent influence factors for the invasiveness of lung adenocarcinoma. The conventional CT model was established with the maximum diameter and CT value, and the spectral CT model was established with venous phase NIC, AEF, and venous phase Z eff. The combined model was established with all the parameters above. Areas under the ROC curve of the conventional CT model, the spectral CT model, and the combined model for predicting the invasiveness of lung adenocarcinoma were 0.828, 0.854, and 0.902, respectively. Conclusion:The quantitative parameters of double-layer detector spectral CT can be used as an indicator to predict the invasiveness of lung adenocarcinoma manifesting as GGN, and AEF has the highest diagnostic efficacy. Spectral CT combined with conventional CT features can further improve the diagnostic efficiency.

Objective:To understand the symptom clusters of patients with indwelling tracheal cannula after head and neck cancer surgery, and to identify the sentinel symptoms of different symptom clusters.Methods:A total of 197 patients with head and neck cancer who underwent surgical treatment in Department of Head, Neck and Thyroid Surgery in Cancer Hospital Affiliated to Zhengzhou University (Henan Cancer Hospital) from June 2020 to December 2021 were selected as the research objects by the convenient sampling method. On the 7th day after surgery, general information questionnaire and Anderson Symptom Inventory, Head and Neck Module were used, and exploratory factor analysis was used to extract symptom clusters. Apriori association analysis was used to identify sentinel symptoms in the symptom clusters.Results:There were 4 symptom clusters in patients with indwelling tracheal cannula after head and neck cancer surgery, including head and neck cancer-specific symptom cluster, pain-digestive tract symptom cluster, voice/swallowing disorder symptom cluster and fatigue-sleep-emotional symptom cluster. Oral and throat mucus was the sentinel symptom of head and neck cancer-specific symptom cluster, nausea was the sentinel symptom of pain-digestive tract symptom cluster, numbness and needling sensation were the sentinel symptom of voice/swallowing disorder symptom cluster, sadness was the sentinel symptom of fatigue-sleep-emotional symptom cluster.Conclusions:Patients with indwelling tracheal cannula after head and neck cancer surgery have more symptoms, which are combined into symptom clusters, and sentinel symptoms exist in each symptom cluster, suggesting that medical workers should take sentinel symptoms as the entry point for symptom cluster management to achieve effective management of symptoms.

Objective:To explore the symptom cluster characteristics of early postoperative patients with head and neck cancer and analyze its influencing factors.Methods:From June 2020 to June 2022, convenience sampling was used to select 230 head and neck cancer patients who underwent surgery in the Head and Neck Thyroid Surgery of Henan Cancer Hospital as the research subject. The questionnaire survey was conducted using the Demographic and Disease Characteristics Questionnaire, Chinese version of M.D. Anderson Symptom Inventory-Head & Neck, Self-perceived Burden Scale for Cancer Patient, and Medical Outcome Study Social Support Scale. Exploratory factor analysis and multiple linear regression analysis were used for statistics.Results:A total of 230 questionnaires were distributed, and 215 qualified questionnaires were collected, with an effective rate of 93.48%. Postoperative patients with head and neck cancer had four symptom clusters, including pain-gastrointestinal symptom cluster, fatigue-sleep-emotional symptom cluster, head and neck cancer-specific symptom cluster, and vocal/swallowing disorders symptom cluster. Medical social support, per capita monthly income of families, type of head and neck cancer, self-perceived burden and complications were the influencing factors of pain-gastrointestinal symptom cluster ( P<0.05). Medical social support, disease staging, complications, self-perceived burden, and per capita monthly income of families were the influencing factors of fatigue-sleep-emotional symptom cluster ( P<0.05). Medical social support, complications, treatment methods, and type of head and neck cancer were the influencing factors of head and neck cancer-specific symptom cluster ( P<0.05). Medical social support, complications, treatment methods, course of disease, and per capita monthly income of families were the influencing factors of vocal/swallowing disorders symptom cluster ( P<0.05) . Conclusions:Postoperative patients with head and neck cancer have multiple symptom clusters and are influenced by psychological, social, and disease factors. Medical and nursing staffs should pay attention to the symptom cluster of postoperative head and neck cancer patients with low levels of social support, heavy self-perceived burden, and complications, and scientifically formulate interventions to reduce the burden of patient symptom cluster and promote rehabilitation.

ObjectiveTo understand the epidemiological characteristics of severe fever with thrombocytopenia syndrome （SFTS）， and the association with seasonal fluctuation in tick density， so as to provide scientific evidence for better control and prevention measures. MethodsDescriptive epidemiological methods were used to analyze the SFTS epidemic situation in Chongyang County from 2013 to 2021. The cloth flag method was used to investigate the seasonal fluctuation in tick density and determine the association with the SFTS. ResultsA total of 71 SFTS cases were reported in Chongyang County from 2013 to 2021 including 8 deaths， with the annual morbidity rate of 1.88/10^-5. The majority were mainly from June to August， accounting for 61.97% of the total reported cases. The cases were geographically distributed in 41 administrative villages and 4 urban areas in 11 towns. The highest incidence was in Lukou town （n=26） and Baini town （n=12）， which accounted for 53.52% of the total reported cases. Furthermore， the cases were mainly 50‒69 years old， accounting for 57.75% of the total reported cases. The ratio of male to female was 1.84∶1， and most were farmers. Blood samples during acute phase in 41 cases were collected for examination of SFTS virus， of which 25 cases tested positive （60.98%）. There was a positive association between tick density and the number of reported SFTS cases （r=0.78， P=0.003）. ConclusionSeasonal density of free adult ticks and nymphs is associated with the number of reported SFTS cases in Chongyang County.

Objective:To understand the symptom clusters and quality of life of patients with laryngeal cancer at different times, and to explore the correlation between the two.Methods:From June 2020 to June 2021, convenience sampling was used to select 155 laryngeal cancer patients with operation in the Head and Neck Thyroid Surgery of Affiliated Cancer Hospital of Zhengzhou University as the research object. The General Information Questionnaire, the Chinese version of Anderson Symptom Inventory-Head and Neck, and Functional Assessment of Cancer Therapy Generic Scale (FACT-G) were used to investigate on the day of admission, 3 days after operation, and 30 days after operation. Symptom clusters were extracted using exploratory factor analysis. Spearman correlation analysis was used to analyze the correlation between the severity of symptom clusters and quality of life in patients with laryngeal cancer.Results:A total of 4 symptom clusters were extracted, namely pain-gastrointestinal symptom cluster, fatigue-sleep-mood symptom cluster, laryngeal cancer-specific symptom cluster, and vocalization-dysphagia symptom cluster. The number and composition of symptom clusters were different on the day of admission, 3 days after operation and 30 days after operation. There were statistically significant differences in FACT-G scores on the day of admission, 3 days after operation and 30 days after operation in patients with laryngeal cancer ( P<0.01) . The FACT-G total score and physiological dimension score on the day of admission, 3 days after operation and30 days after operation of laryngeal cancer patients were negatively correlated with the severity of different symptom clusters ( P<0.05) . Conclusions:The number and composition of symptom clusters in patients with laryngeal cancer at different times are different. The more severe the symptom clusters, the worse the quality of life. Medical and nursing staff should manage patients' symptom clusters to improve the quality of life.

Objective:To investigate the nursing needs of elderly inpatients and analyze the evaluation differences between nurses and patients and the influencing factors.Methods:Using a combination of the convenient sampling and stratified sampling, taking the department as the unit, the elderly patients who were admitted to Inpatient Department of Beijing Tongren Hospital Affiliated to Capital Medical University from June 1 to October 1, 2021 were selected as the research objects. A questionnaire survey was conducted on patients and their responsible nurses. The multiple linear regression was used to analyze the influencing factors of nursing needs of patients.Results:In the self-assessment of nursing needs of elderly inpatients, the dimension of safety needs had the highest score, followed by physiological needs, self-esteem needs, love and belonging needs and self-actualization needs. The patients' self-assessed physiological needs, self-actualization needs and total score of needs were positively correlated with nurses' rating scores ( P<0.05) . The results of multiple linear regression analysis showed that the influencing factors of patients' self-assessment of nursing needs were patient's age, self-care situation, per capita monthly household income, self-assessment of health status and medical care expenditure ( P<0.05) . The influencing factors of nurses' rating scores were patients' age and self-care situation ( P<0.05) . Conclusions:The nursing needs of elderly inpatients are high, and there are differences in the cognition of both nurses and patients. Nursing measures should be formulated according to the actual nursing needs of patients to improve the nursing effect.

Computed tomography (CT) examination is the major measure for detecting and diagnosis of foreign bodies in human body. Although CT has high sensitivity in diagnosis of foreign body, some interference factors may still lead to missed diagnosis or misdiagnosis. Here we report a rare case that a bamboo stick accidentally pierced into the left chest of a young man who was drunk and unware of this hurt. The patient experienced cough, chest pain, fever, hemoptysis, and was misdiagnosed as primary and secondary tuberculosis based on chest CT examinations at a local hospital, although no tubercular bacillus detected by sputum smear. He subsequently received anti-tuberculous treatments in the following three years, but no improvement of his symptoms was observed. Until one month before his death, the bamboo stick was detected by spiral CT examination as well as three-dimensional image reconstruction at another hospital. Postmortem examination revealed pneumonia, pulmonary infarction, and abscess as the causes of his death. We analyze the potential reasons of misdiagnosis in this case, aiming to provide reference for the diagnosis and treatment of pulmonary inflammation associated with foreign body in the future.
Abscess ; Diagnostic Errors ; Humans ; Male ; Pneumonia ; Pulmonary Infarction ; Tuberculosis, Pulmonary