Objective·To summarize the clinical features,imaging features,and diagnosis and treatment experience of primary mediastinal yolk sac tumor(YST).Methods·Data of 29 patients with primary mediastinal YST,who attended Shanghai Chest Hospital,Shanghai Jiao Tong University School of Medicine from September 2016 to May 2023,were collected and comprehensively analyzed,including imaging examination results,serum indicators,pathology reports and treatment methods.Results·There were 22 cases of pure YST and 7 cases of mixed YST comprising 28 males and 1 female.The mean age of onset was(24.5±5.9)years.The initial symptoms were chest tightness(34.5%),chest pain(27.8%),cough(34.5%),expectoration(34.5%)and no specific symptoms(24.1%).Chest computerized tomography(CT)enhancement showed that all the 29 lesions were located in the anterior mediastinum.The maximum diameter of the lesions ranged from 5.6 cm to 18.2 cm.The lesions were irregular in shape,uneven in density,partially cystic and solid in density.The enhancement scan showed the solid part was slightly and moderately enhanced,and the low-density area was not enhanced.Tumor boundary was not clear because tumors often compressed and invaded surrounding tissues.Among the 29 newly diagnosed patients,serum alpha-fetoprotein(AFP)was significantly increased in 28 cases(1 case was not tested).Patients received multidisciplinary comprehensive treatment,including chemotherapy(25/29),surgery(26/29),and radiotherapy(8/29).Seven patients directly received surgery after diagnosis.Nineteen patients received chemotherapy first and then surgery;16(84.2%)cases were evaluated as lesion shrinkage after chemotherapy.After surgery,73.1%(19/26)patients had a significant decrease in serum AFP.After chemotherapy,56.0%(14/25)patients had decreased serum AFP.Conclusion·Primary mediastinal YST usually occurs in middle-aged and young men,with certain clinical and radiographic features and elevated serum AFP,which requires multidisciplinary comprehensive treatment.

Objective:To evaluate the effect of intravenous infusion of dexmedetomidine before induction of anesthesia on concentrations of blood potassium and blood glucose in the patients with gastrointestinal tumors.Methods:One hundred and twenty patients, irrespective of gender, aged 18-75 yr, with body mass index of 18-28 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅲ, scheduled for elective radical gastrointestinal tumor surgery, were divided into 3 groups ( n=40 each) using a random number table method: control group (group C), dexmedetomidine 0.5 μg/kg group (group D 1), and dexmedetomidine 1.0 μg/kg group (group D 2). Dexmedetomidine 0.5 and 1.0 μg/kg were intravenously infused prior to anesthesia induction over 10 min in D 1 and D 2 groups, while the equal volume of normal saline 20 ml was intravenously infused instead in group C. Before intravenous infusion (T 0), at 15 min after intravenous infusion (T 1), and at 30 min after intravenous infusion (T 2), blood samples from the radial artery were collected for blood gas analysis, and concentrations of blood potassium and blood glucose were recorded. The occurrence of complications such as hyperglycemia, hypoglycemia, hyperkalemia, hypokalemia, hypotension, hypertension, tachycardia and bradycardia was also recorded. Results:Compared with C group, the blood glucose concentrations were significantly increased at T 1 in D 1 and D 2 groups and at T 2 in D 2 group ( P<0.05). The blood glucose concentrations were significantly higher at T 1, 2 in D 2 group than in D 1 group ( P<0.05). There was no significant difference in blood potassium concentrations at T 0-T 2 among the three groups ( P>0.05). No patients presented with complications such as hyperglycemia, hypoglycemia, hyperkalemia, hypokalemia, hypotension, hypertension, tachycardia and bradycardia. Conclusions:Intravenous infusion of dexmedetomidine before induction of anesthesia exerts no marked effect on blood potassium concentrations and can increase glucose concentrations to a certain extent, but the elevation has no clinical significance in the patients with gastrointestinal tumors.

Chronic cerebral hypoperfusion (CCH) is a potential important pathological factor leading to cognitive impairment in vascular dementia (VaD). The pathological mechanisms are complex and diverse,with cerebral white matter lesions being the main pathological feature,which is present throughout the entire progression of cognitive impairment caused by CCH. Dysfunction of the blood-brain barrier and neuroinflammatory responses caused by chronic cerebral hypoperfusion are important causes of cerebral white matter lesions. This article discusses the relationship between cerebral white matter lesions and VaD and the improvement of cerebral white matter lesions in VaD to slow down its development and progression,and explores the mechanism and therapeutic methods for VaD,aiming to find therapeutic targets of VaD to prevent its occurrence and improve symptoms.

Objective:To establish a quantitative detection method for the main components of dust mite allergens Der p 1, Der p 2 specific immunoglobulin E (sIgE) by using the nano-magnetic particle chemiluminescence immunoassay.Methods:The performance indexes of the established method were evaluated after setting up and optimizing the chemiluminescence detection system and immune reaction conditions of sIgE for dust mite allergen. Serum sIgE levels of 50 suspected allergic patients with dust mite were determined by this chemiluminescence method. At the same time, this method was compared with the Phadia kit and the consistency was analyzed by Kappa test. Results:The optimal amount of magnetic beads was 25 μg, the optimal reaction buffer (pH=7.4) contained 0.1 mol/L Tris-HCl and 0.25%( W/ W) casein, the optimal coating solution contatined 20 mmol/L phosphate buffer (PB) and 1%( W/ W) bovine serum albumin (BSA), and the luminescence enhancement solution contained 0.05%( V/ V) Triton X-100. The two-step immunoreaction was adopted, and the detection could be completed with 20 μl sample at the optimal reaction temperature of 37℃. The limit of detection (LOD) of the established nano-magnetic particle chemiluminescence system in detecting Der p 1 and Der p 2 sIgE antibodies were both less than 0.01 kU/L, with the linear range of 0.2-100.0 kU/L, the precision of less than 7%, and the cross contamination rate of 0.19% and 0.21%. Compared with the Phadia system, the positive and negative coincidence rate of Der p 1 were 78.0%(32/41) and 9/9 with good consistency ( Kappa=0.65, P=0.008), and the positive and negative coincidence rate of Der P 2 were 93.3%(28/30) and 85.0%(17/20) with good consistency ( Kappa=0.79, P=0.003). Conclusion:The nano-magnetic particle chemiluminescence immunoassay is successfully established for detecting dust mite allergen sIgE, which has good detection performance and good consistency with Phadia system.

Objective:To explore the application of Omaha system-based specialized precise nursing intervention in patients with acute coronary syndrome (ACS).Methods:This study recruited 120 hospitalized patients with ACS in the Department of Cardiology, the First Affiliated Hospital of Xi′an Jiaotong University from June 2019 to December 2019. These patients were randomly allocated into the experimental ( n=60) or control group ( n=60) by using a random number table. Patients in the control group received routine care only, while those in the experimental group also received the Omaha system-based specialized precise nursing intervention. Results:After the intervention, compared with the control group, the score of cognitive and behavioral status in the experimental was significantly improved. In particular, the cognitive scores of pain, chest tightness, arrhythmia, hypertension, edema, dizziness, constipation, wound bleeding, swelling, fatigue, insomnia, diet, medication, smoking, drinking, overweight, exercise, mental stress, social regression, and awareness were significantly improved ( t values were 1.39-5.06, P<0.05). The behavioral scores of pain, chest tightness, arrhythmia, hypertension, edema, dizziness, constipation, wound bleeding, swelling, fatigue, diet, medication, overweight, exercise, mental stress, and social regression were significantly improved ( t values were 1.41-4.80, P<0.05). The fatigue, insomnia, exercise compliance, mental stress, and social regression were significantly improved ( t values were 1.44-4.27, P<0.05). Conclusions:Omaha system-based specialized precise nursing intervention can comprehensively evaluate the nursing problems of patients with ACS, can implement precision specialized nursing, can effectively solve the nursing problems of patients, and can promote the recovery of heart function and rehabilitation of patients with ACS.

Objective: To construct a nursing intervention program for patients with coronary heart disease based on the theory of Omaha intervention system, and to provide evidence for the specialist nursing of patients with coronary heart disease. Methods: Based on the Omaha intervention system, the specialist nursing intervention plan for patients with coronary heart disease was preliminarily established on the basis of reviewing the medical records, and was modified by the Delphi method. Results: Reviewing the medical records combined with the Omaha intervention system, preliminary development of nursing intervention programs for patients with coronary heart disease. The expert inquiry letter of the intervention program was 2 rounds, and the expert positive coefficients of the 2 rounds of inquiry letters were 91.67% and 93.94%, the authoritative coefficient was 0.92, and the Kendall Harmony Coefficient was 0.34 and 0.47 respectively. The specialist nursing intervention for patients with coronary heart disease was finally determined. Conclusion The nursing intervention plan for patients with coronary heart disease based on Omaha theory has a good theoretical basis and has been unanimously recognized by experts.

On January 22, 2020, China National Center for Bioinformation (CNCB) released the 2019 Novel Coronavirus Resource (2019nCoVR), an open-access information resource for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). 2019nCoVR features a comprehensive integra-tion of sequence and clinical information for all publicly available SARS-CoV-2 isolates, which are manually curated with value-added annotations and quality evaluated by an automated in-house pipeline. Of particular note, 2019nCoVR offers systematic analyses to generate a dynamic landscape of SARS-CoV-2 genomic variations at a global scale. It provides all identified variants and their detailed statistics for each virus isolate, and congregates the quality score, functional annotation,and population frequency for each variant. Spatiotemporal change for each variant can be visualized and historical viral haplotype network maps for the course of the outbreak are also generated based on all complete and high-quality genomes available. Moreover, 2019nCoVR provides a full collection of SARS-CoV-2 relevant literature on the coronavirus disease 2019 (COVID-19), including published papers from PubMed as well as preprints from services such as bioRxiv and medRxiv through Europe PMC. Furthermore, by linking with relevant databases in CNCB, 2019nCoVR offers data submission services for raw sequence reads and assembled genomes, and data sharing with NCBI. Collectively, SARS-CoV-2 is updated daily to collect the latest information on genome sequences, variants, hap-lotypes, and literature for a timely reflection, making 2019nCoVR a valuable resource for the global research community. 2019nCoVR is accessible at https://bigd.big.ac.cn/ncov/.

Objective To study the effect of enhancer of rudimentary homolog (ERH) gene on migration and invasion in human bladder cancer T24 and 5637 cells.Methods After knocking out the ERH gene of human bladder cancer T24 and 5637 cells,Wound healing assay,Transwell cell migration assay and Transwell cell invasion assay were used to verify the migration and invasion function.Cell migration related protein was detected by Western blot.Nude mouse tail vein transfer assay was used to study the metastasis ability of bladder cancer cells in vivo.Results (1) The Wound healing assay showed that there were significant differences in the migration cell counts of human bladder cancer 5637 and T24 (P ＜ 0.05).(2) There were significant differences in migration and invasion cell counts of Transwell assay (P ＜0.05).(3) Western blot showed that the expression of E-Cadherin in human bladder cancer 5637 cells and T24 cells was significantly increased (P ＜ 0.05) after knocking out ERH gene,while the expression of Fibronectin,Twist,Vimentin and Snail2 protein were significantly decreased (P ＜ 0.05).(4) Nude mouse tail vein transfer assay showed that lung metastases were significantly reduced in the ERH knockout group compared with the normal ERH group.Conclusions Both in vitro and in vivo experiments suggest that ERH knockout affects the migration and invasion of human bladder cancer T24 and 5637 cells.

Objective: To explore the feasibility of applying Omaha system theory to patients with coronary heart disease (CHD) through comparative analysis of nursing description. Methods: Using content extraction analysis method, the nursing records, nursing plans and nursing measures of discharged patients with CHD were retrieved from the medical records, and then the conceptual consistency of the extracted records and the problem classification system and intervention measures in the Omaha system were evaluated by cross mapping method. Results: A total of 2 609 nursing problems and intervention measures were extracted from the medical records of 68 patients with CHD. Among them, 1 844 (70.68%) records were labeled as "perfect fit", 608 records (23.30%) as "partial fit", and 157 (6.02%) recordsas "not fit at all". The total fit rate was 93.98% (perfect fit and partial fit). The most frequently reported problems were in physiological domain, followed by health-related behaviors domain, psychosocial domain and environmental domain. The nursing interventions extracted accounted for 26.67% (1 968 sentences) of directions and l00.00% (4 kinds) of categories in the intervention scheme of Omaha system. Conclusions The conceptual congruence between the medical records of patients with CHD and the Omaha System is quite high. It can help to improve nursing problems of patients of CHD in health-related behavioral domain, psychosocial domain and environmental domain, and can be applied to such patients after appropriate adjustment, so as to help clinical nursing staff to provide specialized and all-round guidance for patients with CHD.

Objective? To use near-infrared spectroscopy (NIRS) to monitor the effects of peripheral artery catheterization on limb muscle oxygen saturation (SmO2) in infants and children. Methods? Totally 60 children aged under 36 months receiving selective operation in Children's Hospital, Capital Institute of Pediatrics between March and September 2017 were selected. NIRS was used to monitor and record the SmO2 of muscle of thenar or gastrocnemius muscle on the limbs of both sides before and after trachea cannula and artery cannulation under general anesthesia. The original SmO2 values of the limbs with or without cannulation were taken as controls to observe the changes of SmO2 of the limbs with cannulation after cannulation. Results? There was no statistically significant difference in original SmO2 values of the limbs with or without cannulation before cannulation (P＞0.05). The SmO2 values of the limbs with cannulation dropped after cannulation, which were lower than the values of the limbs without cannulation (P＜0.001). The decreasing range of SmO2 values of the children aged under 6 months were larger than those of the children aged between 6 and 12 months and between 12 and 36 months; and the decreasing range of SmO2 values of the children weighing under 10 kg were larger than those of the children weighing between 10 and 20 kg (P＜ 0.001). Conclusions? NIRS can accurately reflect the changes of SmO2 after artery cannulation in real time. NIRS used in monitoring helps to assess limb perfusion more precisely. Monitoring should be enhanced for limb perfusion in children aged under 6 months and weighing under 10 kg.