LOX-1 Regulation in Anti-atherosclerosis of Active Compounds of Herbal Medicine: Current Knowledge and the New Insight / 中国结合医学杂志

Lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1) have recently been identified to be closely related to the occurrence and development of atherosclerosis (AS). A growing body of evidence has suggested Chinese medicine takes unique advantages in preventing and treating AS. In this review, the related research progress of AS and LOX-1 has been summarized. And the anti-AS effects of 10 active components of herbal medicine through LOX-1 regulation have been further reviewed. As a potential biomarker and target for intervention in AS, LOX-1 targeted therapy might provide a promising and novel approach to atherosclerotic prevention and treatment.

Analysis of CT doses to paediatric patients in four children′s hospitals in Shanghai / 中华放射医学与防护杂志

Objective:To study the distribution of CT doses to paediatric patients in Shanghai by investigating the CT dose parameters availiable in Shanghai′s children′s hospticals, and to provide the basis for establishing the diagnostic reference level for the paediatic patients subjected to CT scanning in Shanghai.Methods:In 2021, a general survey was carried out of the CT doses to the head, chest and abdomen of the scanned paediatric patients in four children′s hospitals in the municipality. The scanned paediatic patients were divided into four age groups of 0-, 1-, 5- and 10-15 years old, each with 30 subjects. The basic information were collected on the subjects, CT scanning parameters, volume CT dose index (CTDI vol) and dose length product (DLP). SPSS 16.0 was used to carry out statistical analysis of the differences in CTDI vol and DLP between different age groups at the same site and between different hospitals for the same age group at the same site. Results:The 75 th percentile values of CTDI vol and DLP for 0-, 1-, 5- and 10-15 age groups were 25, 25, 28, 43 mGy and 402, 477, 504, 752 mGy·cm, respectively, for head scanning; 2.7, 2.2, 2.8, 5.4 mGy and 40, 48, 75 and 176 mGy·cm for chest; and 4.9, 4.4, 8.2, 12 mGy and 106, 131, 273, 471 mGy·cm for abdomen. There were significant differences in CTDI vol and DLP between different age groups at the same site and between different hospitals for the same age group at the same site (head, chest and abdomen CTDI vol:χ2=221.68, 167.27, 127.07, DLP: χ2=220.63, 261.46, 216.61; for four age groups, CTDI vol: head χ2=30.46, 38.39, 25.21, 73.04, chest χ2=30.46, 35.69, 58.92, and 48.03, abdomen χ2=66.58, 41.62, 48.93, and 67.38; DLP: head χ2=28.82, 72.49, 47.72, 52.34, chest χ2=28.82, 35.95, 50.66, 41.64, abdomen χ2=45.53, 26.02 39.34, 44.24, P <0.05 ). Conclusions:The 75 th percentile values of CTDI vol and DLP for head, chest and abdomen in 4 children′s hospitals in Shanghai are lower or close to the values given in the relevant national standards and the diagnostic reference levels in some European countries, with higher DLP values on some scanning sites. The CT scanning procedures for paediatric patients needs to be further optimized.

Diagnostic method and value of echocardiography for screening right patent ductus arteriosus in infants / 中华超声影像学杂志

Objective:To investigate the diagnostic method and value of echocardiography in screening right patent ductus arteriosus(PDA) of infants.Methods:This was a prospective study.Thirty-one infants with right PDA diagnosed by ultrasound and confirmed by prenatal ultrasonography, electronic computed tomography angiography, angiocardiography and/or surgery in Hebei Children′s Hospital from April 2014 to May 2022 were collected as research subjects, and the association of right ductus arteriosus with aortic arch anomalies and complex cardiac malformations were summarized. The diagnostic method and value of ultrasonic screening were summed up.Results:Of the 31 cases, 30 cases were correctly diagnosed by ultrasound and 1 case was misdiagnosed, who was a left aortic arch descending to the right, a crossover variation of the right and left pulmonary arteries, and a rightward displacement of the ductus arteriosus. Among these cases diagnosed correctly, 27 cases (including 24 cases with right aortic arch and 3 cases with left aortic arch) presented that ductus arteriosus was open and its ostium of pulmonary artery end was located in the proximal right pulmonary artery in views of parasternal short-axis view of great vessels at cardiac base with the combination of two dimensions and color Doppler flow imaging. Other 3 cases of right aortic arch were all single ventricle with transposition of the great artery. Due to the parallel relationship of the two great arteries, the standard parasternal short-axis view of great vessels could not be obtained, and the right ductus arteriosus was found in the high parasternal views.In all of the 27 cases with right aortic arch and right ductus arteriosus, high parasternal views showed that one end of the ductus arteriosus was connected to the right aortic arch isthmus and the other end was connected to the right pulmonary artery. In all of the 3 cases with left aortic arch and right ductus arteriosus, the high parasternal views showed that one end of the ductus arteriosus was connected to the right subclavian artery and the other end was connected to the right pulmonary artery. Among the 27 cases with right aortic arch, 16 cases were accompanied with mirror image branches, 9 cases of which had complex cardiac malformations; 10 cases were associated with aberrant left subclavian artery, 1 case of which had complex cardiac malformations; 1 case was with isolated left subclavian artery, and without complex cardiac malformations. All 3 cases of left aortic arch were accompanied with isolated right subclavian artery and none of them were associated with complex cardiac malformations. Clinical outcomes of 30 cases with right PDA: 14 cases underwent ductus arteriosus ligation due to thick ductus or other heart malformations. In other 16 cases, 4 cases were closed spontaneously, 9 cases had persistent small ductus arteriosus, and 3 cases were lost to follow-up.Conclusions:Right ductus arteriosus is mostly related to the right aortic arch, and those with mirror image branches are prone to complex cardiac malformations; cases of left aortic arch with right ductus arteriosus are tend to accompany isolated right subclavian artery. Ultrasound has an important application in the screening and diagnosis of right PDA.

Relationship between nursing student's learning engagement and teacher's support in a medical school in Shaanxi Province: mediating role of professional identity / 中华医学教育探索杂志

Objective:To analyze the mediating effect of professional identity between teacher's support and student's learning engagement in nursing students.Methods:A total of 409 nursing students were enrolled in this cross-sectional study. Their professional identity, teacher's support, learning engagement were evaluated by Professional Identification Scale (PIS), Nursing Students' Perceptions of Instructor Caring (NSPIC), and Utrecht Work Engagement Scale-Student (UWES-S). A mediating model was proposed and the impacts of professional identity on teacher's support and learning engagement were observed.Results:The average score of NSPIC was (4.60±0.67) points, that of PIS was (3.58±0.63) points, and that of UWES-S was (4.79±0.97) points. The scores of NSPIC and PIS were a highly positive correlation ( r=0.504, P<0.001). The scores of NSPIC was positively correlated with the scores of UWES-S ( r=0.362, P<0.001). The scores of PIS was positively correlated with the scores of UWES-S ( r=0.315, P<0.001). Multiple linear regression analysis showed that learning engagement of nursing students was associated with the total score of PIS and supportive learning atmosphere, which accounted for 16.6% of the total variability. Professional identity had a mediating effect between teacher's support and learning engagement, with statistic significance among all coefficients of each path ( P<0.05), and all the fitting indexes were good. Teachers support had direct effect (0.31) on learning engagement and indirect effect (0.11) on learning engagement through professional identity. Conclusion:Teacher's support can directly predict student's learning engagement and professional identity plays an mediating role between them.

The role and value of surgeon-engineer interaction during preoperative planning of patient-specific instrumentation assisted total knee arthroplasty / 中华骨科杂志

Objective:To investigate the significance and importance of the interaction between surgeons and engineers during the preoperative planning phase of total knee arthroplasty (TKA) when utilizing patient-specific instrumentation (PSI).Methods:A retrospective review was conducted on 202 knees of PSI-assisted TKA performed on 178 patients between June 2018 and August 2022. The patients' mean age was 68.4±6.2 years, ranging from 53 to 86 years. Among the participants, there were 149 females and 29 males, 93 left knees and 109 right knees. The study involved 171 patients of osteoarthritis (193 knees) and 7 patients of rheumatoid arthritis (9 knees), with 194 knees presenting varus knees and 8 knees with valgus knees. The preoperative plan documents, from the initial engineer-designed plan to the final plan approved by the surgeon, were analyzed to assess the frequency, parameters, and reasons for adjustments made during the planning process.Results:The planning of the 202 PSI-assisted TKA was subjected to at least one round of surgeon-engineer interaction. Among the 202 TKA planning, 117 knees (57.9%) underwent modifications after discussion, with most plans (100 knees, 49.5%) being confirmed after one round of modification. Two rounds of modifications were performed on 10 knees (5.0%), and three rounds on 5 knees (2.5%). A maximum of four rounds of modifications were made on two knees (0.9%). Furthermore, in the case of the remaining 85 knees (42.1%), the surgeons promptly consented to the engineers' initial planning following the discussions. Specific adjustments were made in 106 knees (52.5%) regarding femoral parameters, 57 knees (28.2%) concerning tibial parameters, and 46 knees (22.8%) requiring adjustments to both femoral and tibial parameters. Notably, the most frequently adjusted parameter was the osteotomy thickness of the posterior femoral condyles, which was modified in 94 knees (80.3%). The reasons for adjusting femoral or tibial parameters were summarized, revealing the main factors as follows: 1) Discrepancy between the mediolateral and anteroposterior diameters of the femoral condyle; 2) Twisted deformity of the proximal tibia; 3) Severe flexion contracture deformity of the knee; 4) Collapse of the medial or lateral tibial plateau; 5) Evident anterior arch deformity of the femur.Conclusion:The interaction between surgeons and engineers plays a pivotal role in the preoperative phase of PSI-assisted TKA. Effective collaboration allows surgeons to accurately analyze the unique anatomical characteristics and pathological changes of each patient in a three-dimensional perspective, facilitating the formulation of individualized surgical plans.

Biological Mechanism of Drought Improving Quality of Rhizoma Atractylodis Chinensis / 中国实验方剂学杂志

ObjectiveTo explore the biological mechanism of drought improving the quality of Rhizoma Atractylodis Chinensis and establish a new method for the production of high-quality medicinal materials. MethodThe fresh roots of Atractylodes chinensis were soaked in 0 （control）， 5%， 10%， and 20% PEG-6000 solutions. The changes in reactive oxygen species （ROS） level， antioxidant enzyme activity， activities of key enzymes in primary metabolism and secondary metabolism， and content of secondary metabolites were compared. ResultCompared with the control group， the treatment with 20% PEG for 2 days elevated the levels of superoxide anion radicals （O2-·）， hydrogen peroxide （H2O2）， and malondialdehyde （MDA） by 172.5%， 56.9%， and 14.7%， respectively. The treatment did not change the activity of superoxide dismutase （SOD）， reduced the peroxidase （POD） activity， and increased the catalase （CAT） activity by 10.8%. It increased the activities of 3-hydroxy-3-methylglutaryl-CoA reductase （HMGR）， phosphoenolpyruvate carboxylase （PEPC）， and acetyl-CoA carboxylase （ACC） by 49.9%， 12.1%， and 19.0%， respectively. Furthermore， the content of atractylodin， β-eudesmol， atractylone， and atractylenolide Ⅱ was increased by 51.0%， 36.9%， 47.1%， and 91.5%， respectively. The simulated drought stress can cause the burst of ROS in the fresh roots of A. chinensis， induce the physiological state of plants under drought， change the antioxidant system， and promote the massive synthesis of secondary metabolites in a short time. ConclusionPEG-6000-simulated drought stress can greatly improve the quality of A. chinensis in cultivation.

Effectiveness of personal dose monitoring intercomparison results in a laboratory in Shanghai / 环境与职业医学

Background Individual monitoring of occupational external exposure is an essential part of the occupational health management of radiation workers, and is an important basis for the evaluation of individual absorbed dose and the diagnosis of occupational radiation diseases. Continuous participation of monitoring service providers in intercomparison is a fundamental quality assurance for routine monitoring, which can identify problems and improve them in time. Objective Taking the Laboratory of Radiation Protection in Shanghai Institute of Preventive Medicine as an example, to evaluate the performance of an individual occupational external dose monitoring system in the laboratory, identify influencing factors of the monitoring results, and provide a basis for improving the quality of daily monitoring by analyzing the process and results of a national intercomparison of individual dose monitoring. Methods According to the Testing criteria of personnel dosimetry performance for external exposure (GBZ 207-2016), and the relevant requirements of Class II (photon) inspection, a total of 20 groups of blind sample dosimeters were measured for four consecutive years from 2018 to 2021. The radiation energy source of each group was identified, and related personal dose equivalent Hp(10), the uncertainty of measurement results, and the deviation between the reported value and the reference value were calculated. The national intercomparison process and results of individual dose monitoring were also analyzed. Results The energy sources of the blind samples in the tested laboratory for four years were N100 or Cs-137. The reported dose values of the blind samples were 0.57-4.61 mSv, the combined uncertainties were 0.043-0.365 mSv, the expanded uncertainties (k=2) were 0.09-0.73 mSv, and the relative expanded uncertainties (k=2) were 13.8%-16.4%. The single-group performance ∣Pi∣ of 20 sets of blind samples in the four years was ≤0.10, the yearly comprehensive performance of 5 sets of blind samples was ≤0.10, and the yearly Q score of the test report was >15 points. The laboratory achieved excellent results in the national intercomparison of individual dose monitoring in four consecutive years, except the Q value not reaching full score. Conclusion The laboratory exhibits standardized data processing of individual dose monitoring, generates accurate and reliable results, and meets the requirements of relevant national standards; but it should continue to participate in the national intercomparison of individual dose monitoring, strengthen the angular response research of energy identified dosimeter, improve the monitoring ability of low-dose X-rays, analyze the key points of reducing the uncertainty of measurement results, and continuously improve the monitoring ability.

Short-Term Changes of Graft Viscosity after Anterior Cruciate Ligament Reconstruction / 医用生物力学

Objective To study the short-term variation patterns of graft viscosity after anterior cruciate ligament reconstruction (ACLR) surgery. Methods Six male New Zealand rabbits were selected. The ACLR animal model of unilateral knee was made with Achilles tendon as the graft. The experimental rabbits were euthanized 15 days after ACLR surgery, with removal of the graft, healthy anterior cruciate ligament (ACL) and Achilles tendon. The cross-sectional area and viscosity coefficient of the graft were measured, and the creep experiments were carried out under equilibrium conditions of 0.1 MPa and 1 MPa, respectively. The viscosity coefficent was calculated. Variation patterns of graft viscosity were summarize. The grafts were compared with healthy ACL. Results The cross-sectional area of the graft increased slowly within 15 days after ACLR surgery. The viscosity of ACL and graft changed nonlinearly. The viscosity coefficient was quite different under different stresses. The viscosity coefficient of the graft decreased with the time after ACLR surgery, which was more obviously under the condition of low stress. Conclusions The results are helpful to guide the implementation of early postoperative rehabilitation plan after ACLR surgery .

Effects of Cyclic Strain on Neural Differentiation of Rat Bone Marrow-Derived Mesenchymal Stem Cells / 医用生物力学

Objective To study the mechanical effects of cyclic strain on neural differentiation of rat bone marrow mesenchymal stem cells (rBMSCs). Methods The rBMSCs were subjected to cyclic strain for 24 hours andthen cultured for 5 days. The expression of neural markers and the phosphorylation of relative signaling pathway proteins were evaluated. The stress distribution on cell surface was analyzed by finite element method. The differentially expressed genes induced by strain were identified by RNA sequencing analysis. Results The 0. 5 Hz strain with 5% magnitude could significantly induce higher expression of neural markers and elevated phosphorylation level of extracellular-signal-regulated kinase (ERK), protein kinase B (AKT) and mammalian target of rapamycin ( mTOR). KEGG pathway analysis showed that the focal adhesion and ECM-receptor interaction were significantly enriched under cyclic strain. Conclusions Cyclic strain could change the interaction of cells with the extracellular matrix ( ECM) and enhance the AKT/ mTOR and ERK pathway, finally promote rBMSC neural differentiation. Knowledge about the impact of mechanical stimulation on BMSC neural differentiation is expected to improve the efficiency of stem cell differentiation, shed light on device design for tissue engineering, and promote clinical application of mesenchymal stem cells in neural issue repair and regeneration.

Analysis of quality control and protection level test results of medical electron linear accelerators in Shanghai, China / 中国辐射卫生

@#<b>Objective</b> To investigate the quality control and protection level of medical electron linear accelerators in Shanghai, China. <b>Methods</b> The startified random sampling method was used to cover tertiary, secondary and ungraded hospitals, and a total of 30 medical electron linear accelerators in 15 hospitals were tested for quality control and protection level according to relevant standards. <b>Results</b> Five medical electron linear accelerators failed the quality control test, with an overall inspection pass rate of 83.3% and a re-inspection pass rate of 100%. The pass rate of flatness of square X-ray irradiation field (5 cm × 5 cm)-(30 cm × 30 cm) was 83.3%, the pass rate of symmetry of square X-ray irradiation field was 96.7%, and other indices were qualified. All medical electron linear accelerator rooms passed the protection test. <b>Conclusion</b> The protection of medical electron linear accelerator rooms in Shanghai meets the requirements of national standards, and some indices do not meet the requirements of national standards in the preliminary inspection. The quality control of medical electron linear accelerators should be further strengthened to ensure the treatment effect of patients.

Effect of H2O2 on Secondary Metabolism in Atractylodes chinensis and Its Mechanism / 中国实验方剂学杂志

ObjectiveTo investigate the effect of exogenous H2O2 on secondary metabolism in Atractylodes chinensis and its mechanism. MethodFresh rhizomes of A. chinensis were treated with 5.0， 1.0， 0.2， 0.04 mmol·L-1 H2O2 solution and clean water， and the relationships between the contents of reactive oxygen species， activities of antioxidant enzymes， activities of key enzymes of secondary metabolites， and contents of secondary metabolites in A. chinensis were compared. ResultUnder treatment with exogenous H2O2， the content of reactive oxygen species and malondialdehyde （MDA） in the fresh rhizomes of A. chinensis were significantly elevated on the 4th day， and returned to normal level on the 6th-8th day. The activities of superoxide dismutase （SOD）， catalase （CAT） and peroxidase （POD） were all increased first and then decreased， and reached the peak on the 4th， 4th-6th and 2th-4th day， respectively. The activities of 3-hydroxy-3-methyl glutaryl coenzyme A reductase （HMGR） and acetyl CoA carboxylase （ACC）， key enzymes of the secondary metabolites， were remarkably enhanced， and under treatments with different concentrations of H2O2， the activities of key synthetic enzymes of the secondary metabolites in 0.2 mmol·L-1 H2O2 group were increased most， with the highest biosynthesis of secondary metabolites. The contents of atractylodin， β-eudesmol， atractylone， atractylenolide Ⅱ， and atractylenolide Ⅲ on the 6th day of 0.2 mmol·L-1 H2O2 treatment were 89.5%， 108.7%， 308.8%， 64.7% and 9.3%， respectively higher than those in the control. ConclusionThe antioxidant enzymes and secondary metabolites in A. chinensis synergistically maintain the balance of reactive oxygen species， and exogenous H2O2 can improve the medicinal quality of A. chinensis remarkably.

Clinical application of serum Golgi protein 73 in patients with chronic liver diseases / 中华肝脏病杂志

Golgi protein 73 (GP73) is a transmembrane protein on the Golgi apparatus and can be cut and released into the blood. In recent years, an increasing number of clinical studies have shown that the elevated serum GP73 level is closely related to liver diseases. And thus GP73 is expected to be used as a new serum marker for assessing progress of chronic liver diseases. Herein, the clinical application of serum GP73 in chronic hepatitis, liver fibrosis, liver cirrhosis and hepatocellular carcinoma with different etiologies was reviewed based on available literatures; and a research outlook in this field is made.

Relationship between the chemical properties of drinking water and the prevalence of dental fluorosis based on the principal component regression model in Bijie City, Guizhou Province / 中华地方病学杂志

Objective:To study the relationship between the relevant chemical elements in the original surface drinking water sources and the prevalence of dental fluorosis in Bijie City, Guizhou Province, and to provide a scientific basis for further studying the distribution of dental fluorosis patients, clarifying the mechanism of endemic fluorosis, and scientifically adjusting relevant prevention and treatment policies.Methods:From August 2021 to March 2022, based on the local census data of endemic fluorosis in Guizhou Province, 385 samples of original surface drinking water sources were collected in 214 townships (towns) of Bijie City. The pH value, and contents of fluorine (F), calcium (Ca), magnesium (Mg), aluminum (Al), titanium (Ti), manganese (Mn), copper (Cu), zinc (Zn), nickel (Ni), arsenic (As), molybdenum (Mo), cadmium (Cd), barium (Ba), lead (Pb), chromium (Cr), iron (Fe), and selenium (Se) in the drinking water were determined. Taking the dental fluorosis index representing the prevalence of dental fluorosis as the dependent variable, a principal component multiple regression model was constructed based on the above chemical elements of drinking water to study the related factors affecting the prevalence of dental fluorosis, and its contribution rate was calculated.Results:The median of dental fluorosis index in 214 townships (towns) of Bijie City was 1.460. The average of pH values and contents of F, Ca, Mg, Al, Ti, Cr, Mn, Fe, Ni, Cu, Zn, As, Se, Mo, Cd, Ba and Pb of 385 drinking water samples were 6.369, and 0.209, 179.706, 16.198, 0.163, 0.987, 0.015, 0.073, 0.176, 0.027, 0.014, 0.191, 0.007, 0.005, 0.003, 0.001, 0.155, 0.005 mg/L, respectively. Six principal components ( F1 - F6) were extracted by principal component regression analysis, and the cumulative contribution rate was 72.05%. After multiple linear regression analysis, the chemical elements in drinking water were positively correlated with the prevalence of dental fluorosis in the order of Se, Fe, Cr, Mn, Ni, Cd and Cu, and negatively correlated with the prevalence of dental fluorosis in the order of Ba, F, Ti, Mo, Zn, Al, Pb, Ca, As and Mg. Conclusions:The chemical properties in drinking water of endemic fluorosis areas in Bijie City have obvious synergistic or antagonistic effects on the occurrence and prevalence of dental fluorosis in this area. The F in the drinking water may not play a decisive role in the occurrence and prevalence of local dental fluorosis.

Development of rehabilitation medical resources in Jiangsu during Thirteenth Five-year Plan / 中国康复理论与实践

@#Objective To investigate the development of rehabilitation medical resources in Jiangsu during Thirteenth Five-year Plan.Methods The electronic questionnaire was issued uniformly to the medical and health institutions in 13 prefecture-level cities in Jiangsu Province through the Health Commission system, to survey the rehabilitation medical resources data from 2015 to 2019.Results Compared with those in 2015, the secondary and above general hospitals with rehabilitation medicine departments increased 3.42 percentage points and community-level medical and healthcare institutions providing rehabilitation medical services increased 5.67 percentage points at the end of 2019; while, the authorized beds increased 127 and actual beds increased 142 in the rehabilitation department per million population; the early rehabilitation intervention increased 4 326 person-times per million population; there were 91 more rehabilitation professionals per million population, including 25 rehabilitation physicians, 31 rehabilitation therapists, 29 rehabilitation nurses and six other rehabilitation practitioners; the practitioners with associate senior titles and above increased 1.65 percentage points, and those with master-degree or above increased 1.27 percentage points.Conclusion The allocation of various rehabilitation resources has been improved in Jiangsu province during Thirteenth Five-year Plan.

Research on gait recognition and prediction based on optimized machine learning algorithm / 生物医学工程学杂志

Aiming at the problems of individual differences in the asynchrony process of human lower limbs and random changes in stride during walking, this paper proposes a method for gait recognition and prediction using motion posture signals. The research adopts an optimized gated recurrent unit (GRU) network algorithm based on immune particle swarm optimization (IPSO) to establish a network model that takes human body posture change data as the input, and the posture change data and accuracy of the next stage as the output, to realize the prediction of human body posture changes. This paper first clearly outlines the process of IPSO's optimization of the GRU algorithm. It collects human body posture change data of multiple subjects performing flat-land walking, squatting, and sitting leg flexion and extension movements. Then, through comparative analysis of IPSO optimized recurrent neural network (RNN), long short-term memory (LSTM) network, GRU network classification and prediction, the effectiveness of the built model is verified. The test results show that the optimized algorithm can better predict the changes in human posture. Among them, the root mean square error (RMSE) of flat-land walking and squatting can reach the accuracy of 10 -3, and the RMSE of sitting leg flexion and extension can reach the accuracy of 10 -2. The R 2 value of various actions can reach above 0.966. The above research results show that the optimized algorithm can be applied to realize human gait movement evaluation and gait trend prediction in rehabilitation treatment, as well as in the design of artificial limbs and lower limb rehabilitation equipment, which provide a reference for future research to improve patients' limb function, activity level, and life independence ability.

Design and implementation of surgical medical waste management system based on B/S structure / 中华医学科研管理杂志

Objective:To explore the application effect of medical waste management system based on B/S architecture in medical waste disposal.Methods:Select a third-class hospital in Yantai for continuous quality improvement of medical waste disposal, and verify the feasibility of the medical waste management system through key indicators such as medical waste related theoretical knowledge, medical waste disposal efficiency, and medical waste disposal management process standardization rate. Through monitoring indicators and result feedback evaluation, it is judged whether the medical waste management system has positive significance for the improvement of medical waste disposal.Results:Taking the adoption of medical waste management system as the node, a five-month comparison before and after was conducted to monitor key indicators such as medical waste disposal efficiency and standardized rate of medical waste disposal management processes. The daily error rate of medical waste classification was reduced from 6.00% to 1.33%, the daily confusion rate of working procedures was reduced from 6.67% to 0.67%, the time delay rate of medical waste disposal was reduced from 7.33% to 2.00%, and the standardized rate of medical waste disposal management processes was increased from 93.33% to 100%. All the data were statistically significant ( P<0.05). Conclusions:Since the operation of the medical waste management system, through the top-down management and control of the administrator and with its unique time retrieval function, the time delay problem of the previous manual management has been greatly improved. The classification management function of medical waste solves the criticism of unclear and chaotic classification of medical waste. The department retrospective function enables the division of responsibilities for medical waste work to be clear, and improves the work efficiency. The construction of medical waste management system based on B/S architecture provided a new information approach for the scientific management of medical waste and a reference for the scientific and effective management of clinical medical waste.

Systemic factors associated with treatment response in patients with diabetic macular edema / 中华眼底病杂志

Diabetic macular edema (DME) is the main cause of vision loss and even blindness in patients with diabetic retinopathy. Intravitreal anti-vascular endothelial factor therapy has become the gold standard management of DME. However, not all eyes response optimally to common management of DME, which could be due to the differences of individual factors. Increasing age could be the predictive factors for poor outcome. The influence of glycemic control, hypertension, dyslipidemia, chronic kidney disease and relative factors on treatment response require further investigation. Identifying the systemic factors that influence the treatment response of DME can provide the evidence to predict the prognosis of DME, and improve the efficacy of clinical treatment.

Investigation on current radiological examinations in Jinshan district of Shanghai based on the health information platform / 中华放射医学与防护杂志

Objective:To investigate the characteristics of diagnostic radiology and the situation of repeated examinations at medical institutions of Jinshan district, and put forward strategies and suggestions for the correct guidance on and reasonable applications of various medical exposures.Methods:The cases data on radiological examinations at medical institutions in Jinshan district, obtained in 2017 from Shanghai Municipal Health Commission Information Center Platform, was used to describe the characteristics of population distribution of patients, examination types, examination areas, diagnosed diseases, number of repeated examinations and the result of radiological examinations.Results:The main types of radiological examinations in Jinshan district were the CT scans and the conventional X-ray diagnosis, accounted respectively for 53.2% and 44.7% of the total radiological examinations. The radiological examinations were mainly performed on household registration (77.3%). The number of radiological examinations on males was close to on females, with examination frequency of 49.4% for males and 50.1% for females. The greatest frequency of radiological examinations was found in the age group older than 41 years, accounting for 77.1% of CT scans and 65.2% of the conventional X-ray diagnosis. The main examination sites of the CT scans at Jinshan medical institutions were chest (32.8%), abdomen (19.4%), brain (16.1%) and spine (11.4%), and for the conventional X-ray diagnosis were chest (43.2%) and limbs (39.6%). The main departments applying for radiological examinations are surgery (39.7%) and medicine (27.1%). The numbers of radiological examinations are, respectively, diseases of the respiratory system (19.8%), the injury, poisoning and some other consequences of external causes (15.8%), and the diseases of musculoskeletal system and connective tissue (15.8%). The positive rate of the conventional X-ray diagnosis was 53.1%, and the positive rate of CT scans was 73.5%. The conventional X-ray diagnosis and CT scans contributed higher specific rates of repeated examinations, accounting for 9.3% and 7.9% of the total of such type examination, respectively.Conclusions:CT scans in Jinshan district accounted for more than half of the total frequency of radiological examinations, therefore, interventions should be imposed on certain types of phycians and patients types.

Feasibility study of predicting dose of radioiodine in hyperthyroidism patients based on neural network / 中华放射医学与防护杂志

Objective:To construct back propagation (BP) neural network model to predict the dose required for 131I therapy for hyperthyroidism and to calculate the personalized dose plan for patients. Methods:A complete set of data of patients treated for hyperthyroidism radioaiodine was collected from the nuclear medicine departments of several medical colleges in Shanghai, including history, examination result, treatment course, etc. As a result, a prediction model was established. The predicated result for BP neural network, radial basis function (RBF) neural network and Support Vector Machine (SVM) were compared by means of small sample data. The optimal model was selected to predict administrated dose and to finally test the accuracy of the model.Results:The average errors in BP neural network, RBF neural network and SVM model based on small samples were 5.53%, 7.09% and 9.64%, respectively. After comparison, BP neural network was selected to build the prediction model. 30 cases of data were selected by random sampling to verify the BP neural network. The mean error, mean square error, minimum error and maximum error of the prediction result were 7.22%, 0.053, 0.57% and 13.78%, respectively.Conclusions:In this study, a neural network prediction method was proposed to provide a more accurate dose for patients in need of radioiodine therap for hyperthyroidism, and to reduce the possibility of radiation damage or the unsatisfactory therapeutic effect caused by insufficient dose. It has clinical practical significance in providing the reference for clinicians to evaluate the administrated dose.

Exploratory and research on the course construction and teaching mode of the Digital Medicine MOOC / 中华医学教育探索杂志

There are many difficulties in digital medical teaching, including new course content, multiple key and difficult points, wide knowledge coverage, large knowledge structure span, high requirements for teachers, and few shared resources for online teaching during the epidemic. This research aims to give full play to the advantages of our team in the field of digital medicine, and promote the construction of network resources of this course and its extensive development in more universities through the exploratory and research on the course construction and teaching mode of the Digital Medicine MOOC (massive open online course). The questionnaire study found that the satisfaction score of the average satisfaction score of MOOC teaching in terms of students' pre-class preview, quick grasp of knowledge points in class and after-class review reached more than 90 points, and the score of improving students' learning initiative was (88.10±10.87) points. It can be seen that the use of MOOC teaching mode can significantly help students to preview before class, master knowledge points in class and review after class, and improve students' initiative in learning. The research suggests that the production of Digital Medicine MOOC should keep the consistency and individuality of all knowledge points under the framework of digital medical knowledge; teachers should focus on the explanation of basic knowledge points and deepen in further step integrated with frontiers of this field; it’s suggested to make a separate MOOC on frontier knowledge and application explanation, so as to cope with the outdated courseware content caused by the development and update of this subject.