Abstract:Traditionally, programmed cell death (PCD) refers to apoptosis. As such, apoptosis is considered to be the most important cause of hepatocyte death in metabolic-associated fatty liver disease (MAFLD). However, with the discovery of more and more non-apoptotic PCD (including ferroptosis, necroptosis, and pyroptosis), their characteristics which are highly related to inflammation, reactive oxygen species, and immune signal activation have been increasingly valued. A large amount of evidence shows that compared with “immune silence” apoptosis, the non-apoptotic PCD seems to play more critical roles in causing hepatocyte death in MAFLD. The characteristic of pyroptosis is to induce the release of a large number of inflammatory molecules in liver tissue, the characteristic of necroptosis is to lead to complete necrosis of liver cells, and the characteristic of ferroptosis is to have more intense lipid oxidative stress. The purpose of this article is to elaborate the relationship between non-apoptotic PCD and MAFLD, and discuss their possible interaction mechanisms in MAFLD.

Abstract:Objective To establish a female mouse model of high serum folate levels during peri-pregnancy by feeding a formula feed with high folate contents combined with serum folate testing, and to study the effects of high folate levels caused by folate supplementation during peri-pregnancy on offspring heart development. Methods According to the literatures, the formula feeds with normal folate content (2.0 mg/kg) and high folate content (10.0, 20.0, and 40.0 mg/kg) were designed. Thirty 6-week-old female BALB/c mice were randomly divided into 5 groups (6 in each group), 1 of which continued to be fed with common feed, and the other 4 groups were fed with the above 4 kinds of formula feeds. After 2 weeks of feeding, 4 groups of mice fed with formula feeds were divided into normal serum folate group (serum folate level＜ 2 000 pg/mL), high serum folate group (2 000 pg/mL≤serum folate level＜3 000 pg/mL), and ultra-high serum folate group (serum folate level≥3 000 pg/mL). After grouping, the female mice continued to be fed with the corresponding formula feeds and caged with male mice feeding with common feed. The gestational age was calculated as 0.5 d of pregnancy (E0.5) on the day when the vaginal plug was found. Cardiac tissue samples from fetal mice of different gestational ages were obtained, and cardiac development indicators at 10.5, 11.5 and 13.5 d of pregnancy (E10.5, E11.5, and E13.5) were detected by hematoxylin-eosin and immunohistochemical staining. Results With the increase of folate content in feed, the average serum folate levels of the female mice presented a gradually increasing trend, but there was no significant difference in serum folate level among different groups (P＝0.163). Compared to the normal and high serum folate groups, in the ultra-high serum folate group the cardiac tissue of fetal mice showed a loss of mesenchymal tissue (E10.5), decreases in the number and proliferation of myocardial cells (E10.5), thinner atrial and ventricular walls (E11.5, all P＜0.001), a decrease in the phosphorylated histone H3 positive rate (E11.5, both P＜0.001), a loss of dorsal mesenchymal protrusion (E13.5), structural abnormalities in right atrial appendage and ventricular outflow tract (E13.5), and ostium primum defect (E13.5). Conclusion It is feasible and effective to construct a female mouse model with high serum folate level by folate supplementation during peri-pregnancy combined with serum folate testing. The dramatic increase of serum folate levels in female mice during peri-pregnancy induced by folate supplementation may lead to cardiac dysplasia in offspring.

Abstract:Objective To investigate the effects of tirofiban on neuron injury in acute cerebral infarction (ACI) rats through silent information regulator factor 2-related enzyme 1 (SIRT1)/vascular endothelial growth factor (VEGF) signaling pathway. Methods Seventy-five SD rats were randomly divided into sham group, model group, tirofiban (60 μg/kg) group, SIRT1 inhibitor (5 mg/kg SIRT1 specific inhibitor EX-527) group, and tirofiban＋SIRT1 inhibitor group, with 15 rats in each group. Except for the sham group, ACI models were constructed in the other 4 groups. The rats in each group were scored for neurological function. Triphenyl tetrazolium chloride staining was used to analyze the cerebral infarction volume percentage of rats. The serum malondialdehyde level was measured by thiobarbituric acid method, glutathione peroxidase (GSH-Px) level was detected by colorimetry, and superoxide dismutase (SOD) level was detected by microplate test. Hematoxylin-eosin staining was used to detect the pathological changes of rat brain tissue. Terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling assay was used to detect the apoptosis of rat neurons. Western blotting was used to detect the expression of SIRT1 and VEGF proteins in the hippocampal tissue of rats. Results Compared with the sham group, the pathological damage of the hippocampus was more serious in the model group, the neurological function score, cerebral infarction volume percentage, serum malondialdehyde level and neuronal cell apoptosis rate were significantly increased (all P＜0.05), and the levels of serum GSH-Px and SOD and the expression levels of SIRT1 and VEGF proteins in the hippocampal tissue were significantly decreased (all P＜0.05). Compared with the model group, the pathological damage of the hippocampus was decreased in the tirofiban group and tirofiban＋SIRT1 inhibitor group, the neurological function scores, cerebral infarction volume percentage, serum malondialdehyde levels and neuronal cell apoptosis rates were significantly decreased (all P＜0.05), and the levels of serum GSH-Px and SOD and the expression levels of SIRT1 and VEGF proteins in the hippocampal tissue were significantly increased (all P＜0.05); however, the corresponding indexes of the rats in the SIRT1 inhibitor group showed an opposite trend (all P＜0.05). Conclusion Tirofiban may inhibit oxidative stress and neuron apoptosis by activating SIRT1/VEGF signaling pathway, thus alleviating neuron injury in ACI rats.

Abstract:Objective To analyze the changes of high-resolution magnetic resonance imaging (HR-MRI) characteristics in patients with spontaneous unruptured cervicocranial arterial dissection (CCAD) before and after drug treatment. Methods The data of 30 CCAD patients who were diagnosed in The First Affiliated Hospital of Naval Medical University (Second Military Medical University) from Aug. 2015 to Dec. 2022 and underwent HR-MRI before and after drug treatment were retrospectively and continuously collected. According to the improvement of the stenosis of dissecting vessels on magnetic resonance angiography (MRA) at follow-up, the patients were divided into improvement group (the patients who had a reduction of 1 grade or more in the lumen stenosis at follow-up compared with baseline) and unimprovement group (the patients who had an increase of 1 grade or more or no change in the lumen stenosis at follow-up compared with baseline). The differences in clinical data of patients in the improvement group and unimprovement group, as well as the lumen and wall characteristics of HR-MRI before and after treatment, were analyzed. Results A total of 30 dissections were found in the 30 CCAD patients, including 14 in the improvement group (11 completely returned to normal and 3 improved in the lumen stenosis) and 16 in the unimprovement group. The age of patients in the improvement group was significantly younger than that in the unimprovement group (［37.86±9.83］ years old vs ［56.94±9.86］ years old, P＝0.001), and there were no significant differences in other clinical characteristics (all P＞0.05). At baseline, in the improvement group the proportion of intramural hematoma was higher and the lumen stenosis was relatively mild, while in the unimprovement group the lumen stenosis was severe, and the intimal flap, double lumen sign and pseudolumen thrombosis were more common (all P＜0.05). At follow-up, intramural hematoma and the degree of lumen stenosis in the improvement group were significantly improved, while there were still many residual intramural hematoma, intimal flap, double lumen sign, and pseudolumen thrombus in the unimprovement group (all P＜0.05). At baseline, there was no significant difference in the enhancement of the dissection vessel wall between the 2 groups (P＞0.05). At follow-up, the enhancement of the dissection vessel wall in the improvement group was significantly decreased compared with the unimprovement group (P＜0.001). Conclusion HR-MRI can be used to evaluate the morphological changes of the lumen and wall of CCAD before and after drug treatment. Patients with younger age and relatively mild lumen stenosis at baseline can achieve better outcomes after drug treatment.

Abstract:Objective To investigate the clinical manifestations of premenopausal women with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI). Methods The clinical data of 74 premenopausal women and 109 postmenopausal women with CAD who underwent PCI in The First Medical Center of Chinese PLA General Hospital from Jan. 2014 to Dec. 2018 were retrospectively analyzed. The general data, coronary artery lesion characteristics and incidence of major adverse cardiovascular event (MACE) within 1 year after surgery were compared between the 2 groups. The independent risk factors of the postoperative MACE were investigated by multivariate logistic regression analysis. Results Compared with the postmenopausal group, the prevalence rates of hypertension and smoking and the levels of low density lipoprotein-cholesterol, triglyceride and total cholesterol were significantly lower in the premenopausal group (41.9% ［31/74］ vs 72.5% ［79/109］, 0 vs 13.8% ［15/109］, ［2.40±0.86］ mmol/L vs ［2.71±0.95］ mmol/L, ［1.40±0.74］ mmol/L vs ［1.69±0.97］ mmol/L, and ［3.88±1.02］ mmol/L vs ［4.39±1.05］ mmol/L, all P＜0.05), while the prevalence of autoimmune diseases and the left ventricular ejection fraction were significantly higher in the premenopausal group (14.9% ［11/74］ vs 1.8% ［2/109］ and ［62.4±4.9］% vs ［60.0±5.4］%, both P＜0.05). The incidence rates of left anterior descending artery and left main disease lesions were significantly higher in the premenopausal group than those in the postmenopausal group (83.8% ［62/74］ vs 67.9% ［74/109］ and 14.9% ［11/74］ vs 4.6% ［5/109］, both P＜0.05). The incidence of MACE within 1 year after PCI was significantly higher in the premenopausal group than that in the postmenopausal group (12.2% ［9/74］ vs 3.7% ［4/109］, P＜0.05). Multivariable logistic regression analysis showed that premenopause was an independent risk factor of MACE within 1 year after PCI in female CAD patients (odds ratio＝3.635, 95% confidence interval 1.075-12.283, P＝0.038). Conclusion Premenopausal females with CAD have higher incidence rates of left anterior descending and left main artery lesions and higher incidence of MACE within 1 year after PCI.

Abstract:Objective To investigate the efficacy and safety of potassium-competitive acid blocker vonoprazan in the treatment of Helicobacter pylori infection. Methods A total of 60 patients with Helicobacter pylori infection in our hospital from May 2020 to Dec. 2021 were selected and treated with a 4-drug combination regimen based on vonoprazan (vonoprazan treatment group). The treatment regimen was vonoprazan fumarate tablets 20 mg orally in the morning and evening, colloidal bismuth pectin capsules 150 mg orally 3 times a day, amoxicillin capsules 1.0 g orally in the morning and evening, and clarithromycin tablets 500 mg orally in the morning and evening, for 2 weeks. A retrospective paired study was conducted to select 60 patients with Helicobacter pylori infection treated with a 4-drug combination regimen based on proton pump inhibitor lansoprazole (lansoprazole treatment group) during the same period. The treatment regimen was lansoprazole enteric-coated tablets 30 mg orally in the morning and evening, colloidal bismuth pectin capsules 150 mg orally 3 times a day, amoxicillin capsules 1.0 g orally in the morning and evening, and clarithromycin tablets 500 mg orally in the morning and evening, for 2 weeks. The Helicobacter pylori eradication, medication compliance and adverse reactions (nausea, vomiting, abdominal pain, diarrhea, rash, etc.) of the 2 groups were statistically analyzed, and all patients were included for intention to treat (ITT) analysis. The patients with poor compliance and lost to follow-up were excluded for per-protocol (PP) analysis. Results Of the 120 patients, 5 were lost to follow-up, including 4 in the lansoprazole treatment group and 1 in the vonoprazan treatment group. The medication compliance of the lansoprazole treatment group and vonoprazan treatment group were 94.6% (53/56) and 96.6% (57/59), respectively, with no significant difference (P＞0.05). According to the analyses of ITT and PP, the eradication rates of Helicobacter pylori in the vonoprazan group were 93.3% (56/60) and 98.2% (56/57), respectively, which were significantly higher than those in the lansoprazole group (76.7% ［46/60］ and 86.8% ［46/53］) (both P＜0.05). There were 1 case of decreased appetite and 1 case of diarrhea during the medication process in the vonoprazan treatment group, and 2 cases of nausea and 1 case of abdominal discomfort in the lansoprazole treatment group. There was no significant difference in the incidence of adverse reactions between the 2 groups (3.33% ［2/60］ vs 5.00% ［3/60］, P＞0.05). Conclusion Four-drug combination regimen based on vonoprazan is more effective in the treatment of Helicobacter pylori infection compared with 4-drug combination regimen based on lansoprazole, and the safety and medication compliance of the 2 regimens are similar.

Abstract:Objective To investigate the changes of resting-state functional connectivity and brain network metrics in the response inhibition-related cortices after anodal high definition transcranial direct current stimulation (HD-tDCS) on the right inferior frontal gyrus (rIFG) by resting-state functional near-infrared spectroscopy (fNIRS) imaging. Methods The experiment followed a 2 (stimulation type: rIFG stimulation vs sham stimulation)×2 (detecting time: pre-stimulation vs post-stimulation) 2-factor mixed design. A group of 48 healthy college students were enrolled and randomly divided into rIFG stimulation and sham stimulation groups (n＝24). Resting-state fNIRS was used to record the changes of oxyhemoglobin, deoxyhemoglobin (HbR) and total hemoglobin (HbT) signals for 7 min before and after a single anodic HD-tDCS (1.25 mA, 20 min) stimulation of rIFG. The functional connectivity from region of interest to region of interest (ROI2ROI), functional connectivity matrices, and brain network efficiency indicators were analyzed for the key cortices of response inhibition (rIFG and right pre-supplementary motor area ［pre-SMA］). Results The ROI2ROI functional connectivity analysis based on HbR signals showed that compared with the sham stimulation group, the functional connectivity between rIFG and right pre-SMA was significantly elevated in the rIFG stimulation group (P＜0.05); the results of the functional connectivity matrix analysis revealed that the functional connectivity between channel 2 and channel 24 was significantly improved in the rIFG stimulation group than that in the sham stimulation group (P＜0.001). The graph theory analysis based on HbT signals showed that the nodal efficiency delta values of channels 1, 5, 8, 9, 12, 19 and 26 in the rIFG stimulation group were significantly higher than those in the sham stimulation group (all corrected P＜0.05). Conclusion Anodal HD-tDCS on the rIFG significantly enhances the functional connectivity between rIFG and right pre-SMA and increases the nodal efficiency of the response inhibition cortical network.

Abstract:Objective To analyze the disability status and its influencing factors among elderly people living alone in China. Methods Based on the data obtained from the Chinese Longitudinal Healthy Longevity Survey in 2018, a total of 1 854 elderly people living alone were included in this study. The disability status of the subjects was evaluated using Kata scale, and the distribution patterns of disability status were analyzed using χ² test. Furthermore, binary logistic model was used to identify the factors influencing the disability status of elderly people living alone. Results The prevalence of disability among the elderly people living alone was 13.86% (257/1 854). The results of the univariate analysis indicated that there were significant differences in age, body mass index, smoking, drinking, regular exercise, self-rated health, and annual physical examination between disabled elderly people and non-disabled elderly people (all P＜0.05). The logistic regression analysis showed that age≥ 80 years old (odds ratio ［OR］ ＝2.554) and sleep duration＜4.0 h (OR＝2.460) were risk factors of disability in the elderly people living alone, while regular exercise (OR＝0.637), good self-rated health (OR＝0.593), and participation in annual physical examination (OR＝0.698) were protective factors. Conclusion The disability status of elderly people living alone is influenced by various factors, and the incidence of disability among this population is lower than that among the general elderly population.

Abstract:Objective To establish a convenient, reliable and sensitive ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) method for detecting the content of 3 kinds of quorum sensing molecules (farnesol, tyrosol, and 3-indoleethanol) secreted by Candida albicans. Methods With carbamazepine as the internal standard, the samples were extracted with ethyl acetate and separated by gradient elution on Agilent Poroshell 120 EC-C₁₈ column (3.0 mm×100 mm, 2.7 μm) using Agilent 6470 triple quadrupole tandem mass spectrometry in positive ion monitoring mode. The mobile phase A was 0.1% formic acid in water, and the mobile phase B was acetonitrile. The elution gradient was 0-3 min 20%-40% B, 3-4 min 40%-80% B, and 4-8 min 80% B; flow rate was 0.5 mL/min; injection volume was 5 µL; column temperature was 25 ℃; the analysis period of each sample was 8 min; and the equilibrium time was 2 min. The mass spectrometry was performed using electrospray ionization source and positive ion multiple reaction monitoring mode. Results Farnesol, tyrosol and 3-indoleethanol had good specificity and linear relationship (all r＞0.999), and had good precisions and accuracy (intra- and inter-day precisions were ＜5% and absolute values of accuracy were ＜10%). The average recovery rate was 90%-115%. The stability under 3 conditions (4 h at room temperature, 24 h at 4 ℃ with autosampler, and 3 freeze-thaw cycles) met the requirements of the methodology. In the planktonic samples, the contents of the 3 kinds of quorum sensing molecules were increased with the growth of the strains. However, in the biofilm samples, the contents of farnesol and tyrosol were decreased at the mature stage of the biofilm. Conclusion This UHPLC-MS/MS method can be used to determine the contents of farnesol, tyrosol and 3-indoleethanol secreted by Candida albicans, and it provides a reference for rapid and accurate detection of quorum sensing molecules in fungi.

Abstract:Objective To prepare the berberine-Bletilla striata polysaccharide-carboxymethyl chitosan composite dressing (BBCCD) and evaluate its physical properties and efficacy. Methods The BBCCD was prepared by vacuum freeze-drying method. The optimum proportion was selected based on porosity, water absorption and air permeability. The microstructure of BBCCD was observed by scanning electron microscopy, the antibacterial activity was evaluated by antibacterial experiment, and the cytotoxicity was tested by cell counting kit 8 method. The blood samples of New Zealand rabbits were randomly divided into gauze group, gelatin sponge group and BBCCD group, and the coagulation effect of BBCCD was evaluated by in vitro coagulation experiment (n＝6). Seventy-two SD rats were randomly divided into gauze group, gelatin sponge group and BBCCD group, and the hemostatic time was evaluated by femoral vein, liver and tail-cut hemostasis experiments (n＝8). Fifty-four SD rats were randomly divided into control group, chitosan group and BBCCD group, and the wound repair effects of BBCCD were evaluated by wound healing rate (n＝6), detection of serum interleukin (IL)-1β, tumor necrosis factor α (TNF-α) and IL-10 (n＝4) and histopathological examination. Results The optimal volume ratio of 5% Bletilla striata polysaccharide to 5% carboxymethyl chitosan composite in BBCCD was 1∶3. BBCCD had a membranous sponge-like porous structure with no obvious toxicity. It could absorb wound exudate and had strong adhesion. The content of berberine was (52.39±0.87) mg/g. BBCCD had antibacterial effects on Staphylococcus aureus and Escherichia coli. The in vitro blood clotting index and the hemostatic time of femoral vein trauma, liver trauma and tail-cut in the BBCCD group were significantly better than those in the gelatin sponge group and gauze group (all P＜0.01). On the 3^rd, 5^th, 7^th and 14^th days, the wound healing rate of the BBCCD group was significantly higher than that of the chitosan group and control group (all P＜0.05). On the 7^th and 14^th days, the serum level of IL-10 in the BBCCD group was significantly increased and the serum levels of IL-1β and TNF-α were significantly decreased compared with the chitosan group and control group (all P＜0.05). The pathological results showed that BBCCD could promote the formation of granulation tissue and capillaries at the initial stage of wound healing, attenuate inflammatory response, and accelerate wound healing. Conclusion The prepared BBCCD has excellent antibacterial activity, hemostasis and wound healing effects with stable properties.

Abstract:Chronic low back pain (CLBP) has a high general population and lifetime prevalence, which causes a significant economic burden to patients and social health care system, and has become a research focus in recent years. With the deepening of research, the pathogenesis and influencing factors of CLBP have been found one after another, and the diagnosis and treatment guidelines have been continuously updated. However, due to the absence of definite etiology, the concept of CLBP is still not unified, and its diagnosis and treatment are also controversial. This article reviews the research progress on the concept, pathogenesis and influencing factors, and diagnosis and treatment of CLBP, so as to provide reference for the clinical diagnosis, treatment and research.

Abstract:Early metastasis is one of the important factors for poor prognosis of pancreatic cancer. Early detection of abdominal metastasis can urge patients to undergo neoadjuvant therapy and conversion therapy as soon as possible and avoid unnecessary surgical trauma. This paper reviews the diagnostic efficacy of imaging methods, laboratory methods and combined multi-mode comprehensive evaluation in patients with abdominal metastasis of pancreatic cancer, briefly describing the application of computed tomography, magnetic resonance imaging, ultrasound, tumor markers, microRNA and other methods, and summarizing the use of multi-index comprehensive evaluation to improve the ability of metastasis risk prediction, so as to provide reference for the selection and application of clinical diagnostic methods.

Abstract:Cardiovascular diseases bring a huge burden to health care, and cold is an important risk factor for cardiovascular diseases. Cold can lead to complex changes in autonomic nervous system, endocrine system and so on, thus affecting the function and structure of the heart and blood vessels, ultimately leading to an increased risk of cardiovascular diseases. Sympathetic excitation-mediated neurohumoral pathways are important physiological processes involved in cold exposure, while other specific mechanisms including immune imbalance, oxidative damage, and metabolic abnormalities are also involved in the development and progression of cardiovascular diseases. Appropriate preventive and control measures can reduce the risk of cold-induced cardiovascular diseases. Keeping warm, appropriate cold adaptation, rational dietary therapy, and Chinese herbal medicine treatment can reduce the incidence of cardiovascular diseases. After cold injury, reasonable treatment inside and outside the hospital is the key to save lives. In conclusion, clarifying the epidemiological status and pathophysiological mechanisms between cold and cardiovascular diseases and proposing prevention and treatment strategies are of great significance to alleviate the health care pressure in China, protect people’s health in cold regions, and promote polar development strategies.

Abstract:Objective To explore the effects of a domestic wearable transcutaneous acupoint electrical stimulation bracelet on preventing seasickness. Methods A total of 76 medical personnel who were on their first naval mission from Jan. 2020 to Jul. 2022 were selected. After all participants boarded the ship, they filled out the motion sickness susceptibility questionnaire-adult version (MSSQ-Adt), and the MSSQ-R3-Adt index was calculated. Participants were allocated to experimental group and control group using variable block randomization, with 38 participants in each group. The participants in the experimental group wore transcutaneous acupoint electrical stimulation bracelets 0.5 h before sailing and the bracelets were switched on to stimulate the Neiguan acupoint. The participants in the control group wore bracelets but did not receive electrical stimulation. After 72 h of sailing, all participants filled out an improved seasickness symptom questionnaire, and the severity of seasickness was rated. Results The incidence of seasickness in the experimental group was significantly lower than that in the control group (31.6% ［12/38］ vs 65.8% ［25/38］, χ²＝7.584, P＝0.006). The risk of seasickness in the control group was 2.0 times higher than that in the experimental group (relative risk＝2.0, 95% confidence interval 1.3-3.3). The incidence of seasickness in female participants was significantly higher than that in male participants (80.0% ［24/30］ vs 28.3% ［13/46］, χ²＝17.441, P＜0.05). The participants with seasickness had significantly higher MSSQ-R3-Adt index than those without seasickness (12.3 ［7.0, 28.0］ vs 4.7 ［0.0, 11.0］, U＝330.0, P＜0.05). Conclusion The domestic wearable transcutaneous acupoint electrical stimulation bracelet can effectively reduce the incidence of seasickness.

Abstract:Objective To explore the value of narrow band imaging (NBI) combined with aniline blue staining in endoscopic screening and diagnosis of nasopharyngeal carcinoma. Methods From Oct. 2017 to Oct. 2021, 68 patients with suspected nasopharyngeal space-occupying lesions were selected from Gongli Hospital of Naval Medical University (Second Military Medical University) and The First People’s Hospital of Yinchuan. Electronic nasopharyngoscope with NBI was used for nasopharyngeal examination. Meanwhile, the effusion on the surface of the suspected lesions was stained with aniline blue, and the suspected lesions were examined by pathological biopsy. With the pathological results as the gold standard, the sensitivity, specificity, positive predictive value, negative predictive value, accuracy and Kappa value of white light mode, NBI, aniline blue staining and NBI combined with aniline blue staining were calculated, and χ² test was used to compare the diagnostic positive rates of the above 4 examination methods. Results The positive rate of the combined diagnosis was significantly higher than those of white light endoscopy, NBI and aniline blue staining alone (97.83% ［45/46］ vs 56.52% ［26/46］, 84.78% ［39/46］, and 80.43% ［37/46］, all P＜0.001). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of NBI combined with aniline blue staining for nasopharyngeal carcinoma were 97.83%, 86.36%, 93.75%, 95.00% and 94.12%, respectively. The diagnostic results of NBI combined with aniline blue staining for nasopharyngeal carcinoma were in good consistency with the pathological findings (Kappa value was 0.862). Conclusion Compared with white light mode, NBI or aniline blue staining alone, NBI combined with aniline blue staining has higher sensitivity and specificity for the diagnosis of nasopharyngeal carcinoma.

Abstract:Objective To summarize the imaging characteristics of hepatic epithelioid hemangioendothelioma (EHE) and analyze the misdiagnosed cases. Methods The clinical and imaging data of 11 patients with hepatic EHE confirmed by surgical or puncture pathology from Feb. 2015 to Dec. 2021 were retrospectively analyzed. Results All 11 patients underwent magnetic resonance imaging (MRI) and 2 cases underwent computed tomography (CT). Ten cases showed multiple liver lesions and 1 case showed a single solid lesion. A total of 78 lesions were detected in all 11 patients. Seven cases were misdiagnosed before surgery, of which 4 were misdiagnosed as liver metastases, 1 as intrahepatic cholangiocarcinoma, 1 as hemangioma, and 1 as benign lesion. CT plain scan showed uneven low-density lesions. The lesions presented slightly hypointensity on T1 weighted imaging and slightly hyperintensity on T2 weighted imaging. After enhancement, the lesions showed annular continuous enhancement (9 cases) or cloud flocculent gradual enhancement (2 cases). Nine cases had Halo sign on T2 weighted imaging, 5 cases showed multiple lesions fusing with each other, 7 cases had liver capsule retraction, 7 cases showed lollipop sign in portal vein phase of MRI enhanced scan, and 6 cases showed vascular penetration sign. Conclusion Hepatic EHE is more likely to be misdiagnosed; however, EHE has certain imaging characteristics. Knowing the imaging features of hepatic EHE can help improve the diagnostic accuracy.

Abstract:Objective To explore the quality of life and its influencing factors in epilepsy patients with depression. Methods A total of 87 epilepsy patients who were treated in the outpatient or ward of Suzhou Hospital Affiliated to Nanjing Medical University from Mar. 2017 to Feb. 2021 were selected. The quality of life in epilepsy-31 (QOLIE-31), Hamilton depression rating scale-17 (HAMD-17), patient health questionnaire-15 (PHQ-15), and Hamilton anxiety rating scale (HAMA) were used to evaluate the patients’ quality of life, depression, number and severity of somatic symptoms, and anxiety. According to the HAMD-17 score, the patients were divided into depression group (＞17, n＝34) and control (no depression or possible depression) group (≤17, n＝53), the general information and scale scores of the 2 groups of patients were compared. Spearman rank correlation, Pearson correlation and multiple linear regression analyses were used to explore the influencing factors of quality of life in epilepsy patients with depression. Results Compared with the control group, the depression group had a higher proportion of females, more frequent seizures, longer period of worrying episodes, lower satisfaction with treatment, higher PHQ-15 and HAMA scores, and lower total QOLIE-31 score and scores of worry about seizures, emotional health, energy/fatigue and overall quality of life (all P＜0.05). Correlation analysis showed that the quality of life of epilepsy patients with depression was negatively correlated with the severity of depression and anxiety, and the number and severity of somatic symptoms (all P＜0.01). Multiple linear regression analysis showed that the severity of depression and the number and severity of somatic symptoms had impacts on the quality of life of epilepsy patients with depression, explaining 65.4% of the total variation in quality of life (adjusted R²＝0.654, P＜0.01). Conclusion The severity of depression and the number and severity of somatic symptoms are important factors for the impairment of quality of life in epilepsy patients with depression, and effective intervention may improve the quality of life of these patients.

Abstract: