Objective:To investigate whether intestinal rehabilitation therapy (IRT)could optimize the effectiveness of IRT in patients with short bowel syndrome (SBS) caused by acute mesenteric ischemia (AMI) with chronic multivessel lesions.Methods:Clinical data of 18 hospitalized patients diagnosed with AMI leading to SBS and undergoing IRT at the Eastern Theater General Hospital of the People's Liberation Army from Jan 2012 to Oct 2023 was retrospectively analyzed.Result:Following IRT, the revascularization group showed significantly greater increases in ASMI and grip strength compared to the control group [(0.28±0.26) kg/m 2vs. (0.02±0.21) kg/m 2, P=0.033, and (0.97±0.33) kg vs. (0.48±0.34) kg, P=0.007, respectively]. Similarly, the increase in EN intake was significantly higher in the revascularization group compared to the control group [(572.5±93.6) ml/d vs. (375.2±176.3) ml/d, P=0.012], accompanied by a greater improvement in intestinal nitrogen absorption rate [(25.06±14.06)% vs. (13.84±4.62)%, P=0.034] and a more substantial decrease in GSRS scores [(-15.88±3.94) vs. (-6.33±5.13), P=0.030]. Moreover, there were significant differences in the composition of EN formulations between the two groups after IRT ( P=0.046). Additionally, SF-36 scores at discharge were significantly higher in the revascularization group than that in the control group for five indicators including BP, GH, VT, SF, and MH ( P<0.05). Conclusions:For patients with SBS resulting from AMI by chronic multivessel lesions, revascularization therapy may not leading to higher growth in weight and hematological nutritional indicators during IRT, but it is beneficial for improving muscle function, improving EN absorption, increasing the likelihood of PN independence, relieving gastrointestinal symptoms, and enhancing overall quality of life.

Objective:We aimed to develop a novel visualized model based on nomogram to predict postoperative overall survival.Methods:This was a multicenter, retrospective, observational cohort study, including participants with histologically confirmed gastric and colorectal cancer who underwent radical surgery from 11 medical centers in China from August 1, 2015 to June 30, 2018. Baseline characteristics, histopathological data and nutritional status, as assessed using Nutrition Risk Screening 2002 (NRS 2002) score and the scored Patient-Generated Subjective Global Assessment, were collected. The least absolute shrinkage and selection operator regression and Cox regression were used to identify variables to be included in the predictive model. Internal and external validations were performed.Results:There were 681 and 127 patients in the training and validation cohorts, respectively. A total of 188 deaths were observed over a median follow-up period of 59 (range: 58 to 60) months. Two independent predictors of NRS 2002 and Tumor-Node-Metastasis (TNM) stage were identified and incorporated into the prediction nomogram model together with the factor of age. The model's concordance index for 1-, 3- and 5-year overall survival was 0.696, 0.724, and 0.738 in the training cohort and 0.801, 0.812, and 0.793 in the validation cohort, respectively.Conclusions:In this study, a new nomogram prediction model based on NRS 2002 score was developed and validated for predicting the overall postoperative survival of patients with gastric colorectal cancer. This model has good differentiation, calibration and clinical practicability in predicting the long-term survival rate of patients with gastrointestinal cancer after radical surgery.

Objective: This study aims to explore the influence of birth order and age difference on the emotional and behavioral problems among children from two-child family, so as to provide advice on parenting. Methods: A total of 482 students in grades 2 to 5 from the 5 primary schools in Guangzhou were selected, all of whom came from two-child families (excluding twin children). Emotional and behavioral problems were investigated by using the Conner’s Parental Symptom Questionnaire (PSQ). Results: Among children from two-child families, higher prevalence of behavioral problems, learning problems, impulsive hyperactivity and hyperactivity index in older compared with younger children (β=-0.09，-0.16，-0.09，-0.10,P<0.05). The scores of behavioral problems and hyperactivity index were significantly higher among those of children who were 6-9 years older than young siblings, compared to those who were 0-3 years older than younger siblings(β=0.20,0.21,P<0.05). No similar pattern was found among the younger siblings(P>0.05). Conclusion Among school-age children from two-child families, emotional and behavioral problems of the elder ones were more serious than the younger ones’. Age difference between siblings shows impact on the emotional and behavioral development among elder children, however no significant impact is noticed among the younger ones.

Objective To analyze MRI features of intracranial solitary fibrous tumors (SFT)and hemangiopericytomas (HPC)and combined with pathology to improve recognition of the diseases.Methods MRI and pathologic data of 13 intercranial SFT and 9 HPC were analyzed retrospectively.Results The intracranial SFT were round or oval,well-defined,with internal hypointensity and obviously enhanced area on T2and enhanced MRI-so called"yin-yang"pattern,rare hemorrhage,slight peritumoral edema and rare skull destruction.The HPC were lobulated or irregular,unclear margin,hyperintensity on T2,common hemorrhage,obvious peritumoral edema and common skull destruction.The differences between the two tumors were significant in relation to the tumor shape,T2signal,"yin-yang"pattern, hemorrhage and skull destruction(P<0.05).There were no significant differences in relation to the internal cystic necrosis,peritumoral edema, dural attachment and dural tail sign (P>0.05).Both of them showed the similar immunohistochemical features:the expression of Vim,CD34,CD99 and Bcl-2 were positive,and the expression of EMA was negative.Conclusion The MRI features of intracranial SFT and HPC are different in tumor shape,T2signal,"yin-yang"pattern,hemorrhage and skull destruction.MRI features are helpful to diagnosis and judge prognoses preliminary.

Objective To analyze the CT and MR manifestations and the diagnosis of primary malignant melanoma in the nasal cavity and paranasal sinuses.Methods CT,MR features and clinical data of 1 6 cases of malignant melanoma in the nasal cavity and paranasal sinuses,which were confirmed by biopsy or surgical pathology and immunohistochemistry were analysed retrospectivelly. CT routine and enhanced scan were performed in all patients,MR routine and enhanced scan were performed in 9 cases.Results CT findings of 1 6 patients were unilateral,in which 8 cases were located in the nasal cavity,4 cases in the paranasal sinuses,and 4 cases were both in the nasal cavity and paranasal sinuses.All lesions were irregular shape with soft tissue densityand without calcification and cystic degeneration and demonstrated invasiveness to the surrounding tissue.Lesions were nonuniformly moderate to severe en-hancement.Among 9 patients with MR examination,lesions were mainly unilateral in which 4 cases were in the nasal cavity,3 cases in the paranasal sinuses,2 cases both in the nasal cavity and paranasal sinuses.Lesions were irregular in 9 cases,in which 1 case had typical high signal on T1 WI,low signal on T2 WI,while 3 cases equal signal on T1 WI,equal or slightly higher signal on T2 WI and 5 cases mixed signal.On MR enhanced scan,unevenly slight-medium enhancement were showed in the lesion and surrounding tissues. Conclusion Primary malignant melanoma of the nasal cavity and paranasal sinuses is lack of specificity on CT imaging.Typical ma-lignant melanoma,a type of rare to finding,has certain characteristics on MR,non-pigment type and mixed type are more common. CT combined with MRI can better show the site of the tumor,and the relation with surrounding tissues and adjacent bones.

Objective To investigate the health care workers'(HCWs) knowledge and attitude towards perioperative warming as well as patients' warming status, provide reference for warming in perioperative period and reduce surgical site infection(SSI).Methods Convenience sampling was used to select 198 HCWs in surgical department and operating room as well as 160 patients undergoing operation.HCWs were investigated by referring foreign literatures and designing questionnaires, on-site observation method was used to collect information about warming measures implemented for surgical patients.Results The median (quartile range) of scores of HCWs' knowledge and attitude towards patients' perioperative warming were 9 (2.25) and 25 (1.25) respectively.There was no statistical significance in scores of knowledge and attitude among HCWs with different age, education degree and occupation(all P>0.05).The awareness rates of hypothermia, active warming, and passive warming modes were 21.21%, 43.94%, and 30.81% respectively.80.30%, 89.90%, and 86.36% of HCWs thought that it was essential to keep warming before, during and after surgery.68.13% of surgical patients were warmed by covering cotton quilt and shoulder pad during operation.Conclusion HCWs hold positive attitude towards perioperative warming, but they lack sufficient knowledge about perioperative warming, it is necessary to improve facilities of perioperative warming.

Objective To investigate the morphological changes of whole brain gray matter in patients with postherpetic neuralgia(PHN),and evaluate the correlation between morphological changes of whole brain gray matter,visual analogue scale (VAS) and duration of PHN.Methods By using VBM-DARTEL method,firstly the 3D T1WI structure images of 17 patients with PHN and 17 normal control were preprocessed,then the segmented gray matter volume was compared between the two groups, and the correlation between difference of cerebral gray matter volume,VAS and duration of PHN were analyzed.Results Compared with the normal control, gray matter decrease in PHN group was found in bilateral orbital frontal regions(orbital gyrus,rectus gyri),left inferior frontal gyrus,left insular lobe, left caudate, right cingulate gyrus,left superior temporal gyrus, left cuneus, bilateral cerebellum posterior lobe and bilateral cerebellum anterior lobe.And gray matter increase in PHN group was found in bilateral superior frontal gyri, left middle frontal gyrus, vermis, pons.The gyrus volume change for two hemispheres was asymmetric (the left side greater than the right side).These different brain region changes in gray matter volume for patients with PHN were not correlated with VAS and duration of PHN.

Objective To investigate the clinical and MRI characteristics of reversible splenial lesion syndrome (RESLES).Methods The clinical data,MRI features and follow-up results of 18 patients with RESLES were analyzed retrospectively.Results The average age of the patients was younger,and 5 cases were below 1 5 years old.Clinical history and MRI features were characterized.About 67%(12/18)patients had fever,headache,encephalitis,history,without long history of alcohol abuse.MRI revealed that the lesions of splenial of corpus callosum were solitary nodule with clear boundary.The lesions were slightly hyperintensity on T2 WI and obviouslyhyperintensity on FLAIR and DWI,while the they show hypointensity on ADC with the ADC value <1×10-3 mm2/s.No edema or significant enhancement were observed.The lesions may completely disappear or relief on DWI after short treatment.Conclusion RESLES is a rare entity with a broad clinicoradiological spectrum.The MRI features are characteristic,and it will provide helpful information for diagnosis, differential diagnosis and clinical treatment.

Objective To observe the changes of whole brain function in idiopathic generalized epilepsy(IGE).Methods Three-dimensional structure scan and resting-state functional scan were performed in 23 cases of IGE patients and 23 health controls at 3.0T super-conducting MRI scanner.Brain functional analysis by fALFF and ReHo methods were obtained and the changes of brain areas were compared.Correlation analysis between different brain regions of IGE patients with the course of disease were performed.Results Compared with normal controls,IGE group showed increasd fALFF in the bilateral precentral gyrus,left supplementary motor area, left cingulate gyrus,left paracentral lobule,left superior occipital gyrus,left calcarine cortex,left middle occipital gyrus and right precuneus;decreased fALFF in the bilateral inferior temporal gyrus,right parahippocampa gyrus,right insula,right precuneus and left inferior parietal lobule(P<0.005).IGE group showed increasd ReHo in the left calcarine cortex,left superior parietal lobule, left postcentral gyrus,right precentral gyrus;decreased ReHo in the right fusiform gyrus,left lentiform nucleus,right inferior frontal gyrus,right superior medial frontal gyrus,left middle occiptal gyrus,right insula and bilateral inferior parietal lobule(P<0.005). These different brain regions in fALFF and ReHo results for IGE patients were no correlated with the course of disease.Conclusion IGE patients having wide range of brain areas with abnormal changes in function is the basis of the IGE complex clinical manifestations of the nerve.Combined application of two analysis methods of RS-fMRI can evaluate the change of brain function more comprehensively, and provide functional neuroanatomical evidence for the researches on neuro pathogenesis mechanism of IGE.

Purpose To observe white matter structure features of patients with early stage (Hoehn-Yahr 1-2 phase) Parkinson''s disease (PD) by using diffusion tensor imaging (DTI) based on the fiber bundle analysis tract-based spatial statistics (TBSS); and to explore the brain regions of PD patients in which DTI parameters are significantly correlated with unified Parkinson''s disease rating scale (UPDRS) score elevation. Materials and Methods DTI sequence was performed on 27 cases of PD and 30 cases of healthy volunteers. DTI parameters including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were analyzed in all participants by using TBSS technique, and the parameters of two groups were compared. The correlation of clinical UPDRS score with FA value, MD and RD value in the PD group were analyzed.Results Compared with that in the control group, FA values of several brain regions in PD group decreased, while MD and RD value increased (P<0.05). AD showed no obvious change (P>0.05). UPDRS score of PD group was correlated with FA, MD and RD value (P=0.001). The brain regions that showed FA value decreased, MD and RD value increased included corpus callosum, left anterior limb of internal capsule, bilateral anterior radial crown, bilateral superior radial crown and left posterior thalamic radiation (P=0.001).Conclusion There is some changes in white matter structure of the patients with early stage Parkinson''s disease, which may due to demyelination or fiber integrity damaged.