Study on identification of Hedyotis diffusa Willd. and its two local varieties based on traditional and modern analysis methods / 国际中医中药杂志

Objective:To distinguish Hedyotis diffusa Willd. and its common countrerfeit, Hedyotis corymbosa. and Hedyotis tenelliflora. by analyzing and comparing their macroscopical identification, microscopic character and HPLC fingerprints. Methods:The features of macroscopical identification, microscopic character including cross-sections of stem, leaf, fruit and seed, and herbal powders were observed in the three samples by traditional methods. The difference of chromatographic peaks among the three samples were also analyzed by HPLC methods.Results:The stems of Hedyotis diffusa Willd. were cylindrical, and the capsules were solitary or double born in the leaf axils, oblate, 2-3 mm in diameter, with a long petiole; the Hedyotis corymbosa. and Hedyotis tenelliflora. were tetragonal, and the Hedyotis corymbosa. was 2-5 capsules born in leaf axils in corymbose inflorescences, globular, 1-1.5 mm in diameter, with a slender petiole; the Hedyotis tenelliflora. were 1-3 capsules clustered in the leaf axils, ovoid with longitudinal ribs around the margin, about 1.5 mm in diameter, without the long petiole, about 1.5 mm in diameter, sessile, the edge of the leaf drying revolute long needle-like. Under the identification, the cross section of the Hedyotis diffusa Willd. stem was almost round, the middle vein of the leaves was protrusion below, the inner pericarp fiber layer consisted of two layers of fiber cells, the surface of the seed coat cells was polygon, and the wall was densely covered with small reddish brown or yellow-brown warty spots. The cross section of the Hedyotis corymbosa. stem was quadrilateral, the surface of the seed coat cell was polygon, the wall was wavy and curved, and there was no warty point on the wall. The middle veins of the Hedyotis tenelliflora. were slightly sunken in the upper part, but not protruding in the lower part; the endocarp fiber layer consisted of 8 to 13 layers of fiber cells. Moreover, the HPLC fingerprint analysis demonstrated substantial dissimilarities in the characteristic peaks of these herbs. Conclusion:The traditional and modern analysis technology show that there are some differences in the characteristics, microscopical cross section, the powder characteristics, which can effectively distinguish the Hedyotis diffusa Willd. and its two local varieties.

Multimodal ultrasound and ultrasound-guided fine-needle aspiration biopsy for distinguishing benign and malignant thyroid nodules of C-TIRADS grade 4 / 中国医学影像技术

Objective To compare the value of multimodal ultrasound and ultrasound-guided fine-needle aspiration biopsy(US-FNAB)for distinguishing benign and malignant thyroid nodules of Chinese thyroid imaging reporting and data system(C-TIRADS)grade 4.Methods Data of 247 thyroid nodules in 201 patients were retrospectively analyzed,including 193 malignant and 54 benign noes.Taken postoperative pathology as the gold standards,the value of multimodal ultrasound,i.e.the combination of conventional ultrasound,shear wave elastography(SWE)and contrast-enhanced ultrasound(CEUS)and US-FNAB for distinguishing benign and malignant thyroid nodules were compared.Results The sensitivity,specificity,accuracy,misdiagnosis rate and rate of missed diagnosis of conventional ultrasound for diagnosing malignant thyroid nodules was 86.53％,59.26％,80.57％,40.74％and 13.47％,respectively,of SWE was 78.76％,74.07％,77.73％,25.93％and 21.24％,respectively,of CEUS was 90.16％,77.78％,87.45％,22.22％and 9.84％,respectively,while of multimodal ultrasound was 97.93％,88.89％,95.95％,11.11％and 2.07％,respectively,and of US-FNAB was 89.64％,96.30％,91.09％,3.70％and 10.36％,respectively.The sensitivity,specificity and accuracy of multimodal ultrasound for distinguishing benign and malignant thyroid nodules were higher,while the misdiagnosis rate and missed diagnosis rate were lower than those of conventional ultrasound,SWE and CEUS alone.The sensitivity,accuracy and misdiagnosis rate of multimodal ultrasound were higher,while its specificity and missed diagnosis rate were both lower than those of US-FNAB(all P＜0.05).Conclusion For distinguishing benign and malignant thyroid nodules of C-TIRADS grade 4,multimodal ultrasound had higher sensitivity and accuracy but higher misdiagnosis rate,while US-FNAB had higher specificity but also higher missed diagnosis rate.

Research on risk assessment and operation safety management of magnetic resonance imaging equipment based on work chain and extension matter-element model / 中国医学装备

Objective:To construct a safe operation management path based on work chain and extension matter-element model,and to explore its application effect in clinical management of magnetic resonance imaging(MRI)equipment.Methods:The safety risk evaluation indicators was developed from the perspective of MRI equipment work chain at the levels of personnel,equipment,environment and system.The rating of safety characteristic indicators of equipment was carried out and risk control management strategy was formulated by adopting extensible matter element model.The MRI equipment in clinical use in the Imaging Department of Shucheng People's Hospital from January 2019 to December 2021 was selected,and the standard process management mode(referred to as standard process mode)and risk assessment control mode(referred to as risk control mode)were adopted respectively for equipment operation management.The safety risk event control rate,safety operation management standardization and professional capability of staff of MRI equipment under two different management modes were compared.Results:Among 62 safety risk events of MRI equipment managed by risk control mode,the control rates of extremely dangerous,highly dangerous and significant dangerous events were 1.61%(1/62),4.84%(3/62)and 8.06%(5/62),respectively,which were lower than those of the standard process mode,the difference was statistically significant(x2=5.613,4.567,9.241,P<0.05).Among 480 cases of safety operation inspection carried out by risk control mode management,the standardization of patient reception,equipment use,operating environment and management system were 96.25%(462/480),98.96%(475/480),99.17%(476/480)and 97.50%(468/480),respectively,which were higher than those of the standard process mode,the difference was statistically significant(x2=18.631,17.563,7.353,8.789,P<0.05).The annual assessment scores of MRI technicians,nurses and medical engineering engineers of the imaging department adopting risk control mode were(91.87±4.56)points,(94.54±3.27)points and(91.45±4.95)points,respectively,which were higher than those of the standard process mode,the difference was statistically significant(t=3.291,4.277,4.292,P<0.05).Conclusion:The risk control management mode based on work chain and extension matter-element model can comprehensively explore the factors affecting the safe operation of MRI equipment,effectively control the incidence of high-risk events,improve the quality of clinical operation and operation management of MRI equipment.

Analysis of urinary calculi composition in Longnan, Gansu province / 现代泌尿外科杂志

【Objective】 To analyze the composition of urinary calculi in Longnan, Gansu province, and the relationship between the composition and clinical characteristics of patients, so as to provide reference for the prevention and treatment of this disease. 【Methods】 The composition of 500 cases of urinary calculi hospitalized in our department during Apr. 2021 and Feb.2023 were analyzed using the infrared spectrum stone composition analyzer. The clinical characteristics of the patients were evaluated and analyzed. 【Results】 The male-to-female ration of patients was 2.70∶1. Most patients aged 21 to 60 years (437, 87.4%). Most cases were ureteral calculi (72.8%), followed by renal calculi (22.2%), and bladder calculi (5.0%). There were 166 cases of calcium oxalate calculi, 293 cases of calcium oxalate + carbonated apatite calculi, 24 cases of calcium oxalate + carbonated apatite + hydroxyl apatite calculi, 4 cases of calcium oxalate + calcium bicarbonate calculi, 7 cases of urate calculi, 6 cases of carbonated apatite + struvite calculi. Oxalate calculi were the most common in all age groups, and urate calculi were the most common in the 21 to 40 age group. Calcium oxalate calculi were most common in the ureter (127, 76.5%), significantly higher than in other sites (χ2=3.222, P=0.020). Calcium oxalate + calcium hydrogen phosphate calculi was the least common in the bladder, significantly different from the other parts (χ2=2.092, P=0.037). Magnesium ammonium phosphate hexahydrate and/or calcium carbonate or calcium oxalate calculi were the most common in the kidney (50.0%), significantly different from the other parts (χ2=9.448, P=0.007). 【Conclusion】 In Longnan area, the incidence of urinary calculi is significantly higher in male than in female. Ureteral calculi are mainly composed of calcium oxalate + carbonated apatite and calcium oxalate. According to different risk factors, individual prevention programs should be developed.

Extracellular vesicle-carried GTF2I from mesenchymal stem cells promotes the expression of tumor-suppressive FAT1 and inhibits stemness maintenance in thyroid carcinoma / 医学前沿

Through bioinformatics predictions, we identified that GTF2I and FAT1 were downregulated in thyroid carcinoma (TC). Further, Pearson's correlation coefficient revealed a positive correlation between GTF2I expression and FAT1 expression. Therefore, we selected them for this present study, where the effects of bone marrow mesenchymal stem cell-derived EVs (BMSDs-EVs) enriched with GTF2I were evaluated on the epithelial-to-mesenchymal transition (EMT) and stemness maintenance in TC. The under-expression of GTF2I and FAT1 was validated in TC cell lines. Ectopically expressed GTF2I and FAT1 were found to augment malignant phenotypes of TC cells, EMT, and stemness maintenance. Mechanistic studies revealed that GTF2I bound to the promoter region of FAT1 and consequently upregulated its expression. MSC-EVs could shuttle GTF2I into TPC-1 cells, where GTF2I inhibited TC malignant phenotypes, EMT, and stemness maintenance by increasing the expression of FAT1 and facilitating the FAT1-mediated CDK4/FOXM1 downregulation. In vivo experiments confirmed that silencing of GTF2I accelerated tumor growth in nude mice. Taken together, our work suggests that GTF2I transferred by MSC-EVs confer antioncogenic effects through the FAT1/CDK4/FOXM1 axis and may be used as a promising biomarker for TC treatment.

Related factors of viral nucleic acid change in critically ill patients with SARS-CoV-2 infection after treatment with Nirmatrelvir/Ritonavir: a single center retrospective cohort study / 中华危重病急救医学

OBJECTIVE@#To describe negative conversion and rebound of patients with severe and critical acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection after treatment with Nirmatrelvir/Ritonavir, and to analyze related factors associating with failure of SARS-CoV-2 negative conversion and relapse and prognosis.@*METHODS@#A single center retrospective cohort study was conducted. Patients aged ≥ 16 years old who were diagnosed with severe or critical SARS-CoV-2 infection and took Nirmatrelvir/Ritonavir for 5 days in Peking University First Hospital from December 7, 2022 to January 27, 2023, were included. General characteristics and clinical data were collected from electronic medical record system. The Kaplan-Meier curve of SARS-CoV-2 negative conversion was drawn. Factors with P < 0.10 were incorporated into multivariate Logistic regression model to analyze the relationship between the factors and persistent nucleic acid positive and rebound.@*RESULTS@#A total of 31 severe and 37 critical SARS-CoV-2 infection patients were included. The median duration from initiation of Nirmatrelvir/Ritonavir to negative conversion of SARS-CoV-2 for both was 6.0 days, and the negative conversion rate on day 15 was 93.5% and 86.5%, respectively. SARS-CoV-2 rebound was observed in 7 patients (11.3%), among whom were 1 severe patient and 6 critical patients. The above 7 patients with SARS-CoV-2 rebound and 6 patients with failure of SARS-CoV-2 negative conversion were compared with 55 patients with persistent negative conversion. Factors with P < 0.10, including the lowest lymphocyte count (LYM), the highest D-dimer, the highest procalcitonin (PCT), the lowest Ct value, cardiovascular diseases other than hypertension and coronary heart disease, were incorporated into multivariate Logistic regression analysis. The decreased LYM [odds ratio (OR) = 0.146, 95% confidence interval (95%CI) was 0.031-0.689, P = 0.015] and the increased PCT (OR = 2.008, 95%CI was 1.042-3.868, P = 0.037) were revealed to be independent risk factors of the failure of SARS-CoV-2 negative conversion or rebound. The proportion of mechanical ventilation and invasive ventilation were significantly higher in patients with persistent SARS-CoV-2 infection or rebound than those in patients with SARS-CoV-2 negative conversion (84.6% vs. 38.2%, 69.2% vs. 25.5%, both P < 0.01), but no significant difference in mechanical ventilation and invasive ventilation duration was observed. Compared with the patients with SARS-CoV-2 negative conversion, more patients with persistent SARS-CoV-2 infection or rebound were admitted to intensive care unit (ICU, 76.9% vs. 50.9%), and length of ICU stay in patients with persistent SARS-CoV-2 infection or rebound tended to be longer [days: 13.0 (10.3, 24.3) vs. 11.0 (5.3, 23.0), P > 0.05].@*CONCLUSIONS@#The decreased LYM and increased PCT are independent risk factors for the failure of SARS-CoV-2 negative conversion or rebound in patients with severe and critical SARS-CoV-2 infection. Attention should be paid to these patients for their poor prognosis.

Advances in identification of biomarkers for aspiration: from laboratory research to clinical practice / 中华老年医学杂志

Aspiration is the entry of oropharyngeal or gastric contents into the lower respiratory tract through the glottis, a common and important cause of death in elderly patients due to lung infections.However, a lack of accurate and rapid clinical methods for the diagnosis of aspiration leads to misdiagnosis, missed diagnosis or delayed diagnosis of aspiration, especially aspiration pneumonia.In recent years, with further research into the mechanisms of aspiration syndromes, multiple aspiration biomarkers with potential and clinical translational value have been found, and may help early detection of aspiration and have important and practical significance for elderly health.Therefore, this article reviews aspiration biomarkers such as pepsin, α-amylase, bile acid and other potential biomarkers as well as current relevant research, detection methods, their clinical value and prospects concerning challenges and directions of innovation in future research.

Role of extracellular vesicles in the diagnosis and therapy of kidney disease: opportunities and challenges / 中华检验医学杂志

Extracellular vesicles (Evs) are important vectors for cell-cell communication and their potential value in the diagnosis and treatment of kidney diseases has been explored. Recent studies have revealed that changes in the level and characteristics of urinary extracellular vesicles from resident kidney cells are related to severity of various kidney diseases. Yet, circulating extracellular vesicles may also be altered in kidney disease. Circulating EVs and urinary EVs secreted by renal cells have been shown as potential early biomarkers of renal injury. EVs derived from repair cells such as mesenchymal stem cells also represent promising therapeutic agents for treatment of kidney diseases. Furthermore, engineered extracellular vesicles are being developed for specific therapy of certain kidney diseases. In conclusion, EVs may represent promising biomarkers for the detecting and monitoring of renal diseases, which has also the potential to be used as diagnostic and therapeutic tools. This review focuses on the utility of extracellular vesicles as therapeutic and diagnostic tools in kidney diseases and future prospective of EVs research.

Epidemic characteristics and influencing factors of influenza outbreaks in Xinwu District of Wuxi in 2017-2019 / 公共卫生与预防医学

Objective To analyze the epidemic characteristics and influencing factors of influenza outbreaks in Xinwu District of Wuxi City from 2017 to 2019, and to provide a basis for the prevention and control of influenza outbreaks in schools. Methods The 2017-2019 influenza data was retrieved from the China Influenza Surveillance Information System and the Public Health Emergency Management System. A descriptive epidemiology method was used to analyze the characteristics of the influenza outbreaks. The related factors on the epidemic intensity and duration were analyzed. Results From 2017 to 2019, a total of 26 influenza outbreaks occurred in Xinwu District, with a cumulative total of 927 cases and an average prevalence rate of 1.74%. The outbreaks mainly occurred between November and April of the following year, accounting for 100%. The outbreaks all occurred in schools, with primary schools accounting for 88.46% (23/26) and kindergartens accounting for 11.54% (3/26) of the total. The main influenza viruses that caused influenza outbreaks were B/Victoria and B/Yamagata, which accounted for 65.60% (164/250) and 16.40% (41/250), respectively, followed by influenza A/H3N2, which accounted for 16% (40/250). The epidemic intensity was related to the number of students (P < 0.05), and the duration of the epidemic was related to the type of schools and the reporting time of the epidemic (P < 0.05). Conclusion The outbreaks of influenza had obvious seasonality, and occurred mainly in schools. Improving the timeliness of epidemic reporting and taking timely control measures are the key to controlling influenza outbreaks in schools.

Eating behaviors related to brucellosis infection in Mongolian middle school students in Abaga Banner, Inner Mongolia / 中国学校卫生

Objective@#To understand current situation and associated factors of brucellosis infection among students in Mongolian middle school in Abaga Banner, and to provide basis for further development of prevention and treatment strategies.@*Methods@#Serological examinations were performed on pupils and middle school students in a Mongolian middle school in Abaga Banner. Questionnaire surveys were used to investigate students knowledge of eating behaviors related to brucellosis infection.@*Results@#A total of 500 primary and middle school students were investigated, and 6 cases of brucellosis were confirmed, and the infection rate was 1.20%. There were 4 cases of male infection and 2 cases of female infection. The infection rate in boys (1.61%) was higher than that of girls (0.79%). Higher proportion was found in 14-year-old group (n=3), accounting for 17.40%. The residence period of 10-15 years includes 6 cases of all infected persons. The number of infections in Narenbaolige Town was 4, accounting for 23.40%. Univariate logistic regression analysis shows that frequent consumption of unsterilized dairy products, milking, processing lambs or slugs and infected cloth The disease was positively correlated (OR=11.80, 139.14, 8.02, P<0.05). Multivariate Logistic regression analysis showed that milking was positively correlated with brucellosis infection(OR=20.19, 95%CI=2.01-202.74, P=0.01).@*Conclusion@#The brucellosis infection of Mongolian primary and middle school students in Abaga Banner is related to a variety of related dietary factors, and its prevention and treatment should be strengthened.

Effect of nutritional status and comfortability of early postoperative diet of patients following sedated colonoscopic polypectomy / 中国实用护理杂志

Objective:To investigate the effect of nutritional status and comfortability of early postoperative diet of patients following sedated colonoscopic polypectomy.Methods:A total of 300 patients who undergoing sedated colonoscopic polypectomy were randomly divided into normal group and experimental group 1, group 2, with 100 cases in each group. The control group received total fasting with intravenous infusion, oral clear fluids were begun up on the first postoperative day and solid foods on the fourth day. In the experimental group 1 and group 2, clear fluids were begun up to six hours or two hours after surgery, respectively, followed by semi-liquid on the first postoperative day, and solid food three days later. The clinical outcomes such as time of first defecation, hospitalization time, abdominal pain, hypoglycemial reaction, bleeding volume and nausea/vomiting was recorded between three groups. In addition, the nutritional status and comfortability was compared by using serum albumin detection and Visual Analogue Scale (VAS), respectively.Results:The time of first defecation were (22.46±2.96) hours and (21.54±2.17) hours in the experimental group 1 and group 2, significantly shorter than that in the control group (26.37±4.87) hours; meanwhile, the time of first defecation were significantly decreased in the experimental group 2 compared to the experimental group 1, the difference was statistically significant ( F value was 51.812, P<0.05). The rate of hypoglycemial reaction were 5.10% (5/98) and 2.04% (2/98) in the experimental group 1 and group 2, significantly lower than that in the control group 13.40% (13/97), the difference was statistically significant ( χ2 value was 10.582, P<0.05). After 5th day of surgery, the level of serum albumin were (36.16±6.44) g/L and (36.55±6.57) g/L in the experimental group 1 and group 2, significantly higher than those in the control group (33.97±5.91) g/L, the difference was statistically significant ( F value was 4.732, P<0.05). However, there was no significant difference in the VAS scores among the three groups ( P>0.05). Conclusion:Two hours after sedated colonoscopic polypectomy oral feeding can obviously promote the recovery of gastrointestinal function, which does not increase the occurrence of postoperative complications, and promote the postoperative recovery of the patients.

Practical on primary trauma care training mode in public cardiopulmonary resuscitation training / 中华危重病急救医学

Objective:To envaluate the effect of public cardiopulmonary resuscitation (CPR) training in Ningnan Mountain area.Methods:Using the method of convenient sampling, 775 people in Ningnan Mountain area were investigated about CPR and first aid knowledge by questionnaire from January to December 2019. The awareness rate of CPR, operation score, and operation qualification rate of the public before and after CPR training in the primary trauma treatment (PTC) mode were observed.Results:After PTC training, the public's CPR knowledge score, operation score and operation qualification rate, in terms of first aid telephone, consciousness judgment method, identification of respiratory arrest, artificial respiration implementation method, effective CPR indication and extrathoracic cardiac compression position were significantly improved [first aid telephone score: 82.68±8.54 vs. 60.25±10.38, consciousness judgment method score: 79.46±10.82 vs. 58.35±9.26, identification of respiratory arrest score: 80.85±9.64 vs. 59.26±11.45, artificial respiration implementation method score: 81.54±9.48 vs. 56.47±10.54, extrathoracic cardiac compression site score: 80.35±10.48 vs. 59.56±9.85, effective indication of CPR score: 81.02±9.45 vs. 58.21±8.69, operation assessment score: 60.25±10.45 vs. 50.38±9.68, operation assessment qualified rate: 60.39% (468/775) vs. 12.13% (94/775), all P < 0.05]. Conclusion:PTC mode is helpful to improve the effect of public CPR training, which is worthy of clinical promotion.

Cycle-Consistent Generative Adversarial Network: Effect on Radiation Dose Reduction and Image Quality Improvement in Ultralow-Dose CT for Evaluation of Pulmonary Tuberculosis

Objective@#To investigate the image quality of ultralow-dose CT (ULDCT) of the chest reconstructed using a cycle-consistent generative adversarial network (CycleGAN)-based deep learning method in the evaluation of pulmonary tuberculosis. @*Materials and Methods@#Between June 2019 and November 2019, 103 patients (mean age, 40.8 ± 13.6 years; 61 men and 42 women) with pulmonary tuberculosis were prospectively enrolled to undergo standard-dose CT (120 kVp with automated exposure control), followed immediately by ULDCT (80 kVp and 10 mAs). The images of the two successive scans were used to train the CycleGAN framework for image-to-image translation. The denoising efficacy of the CycleGAN algorithm was compared with that of hybrid and model-based iterative reconstruction. Repeated-measures analysis of variance and Wilcoxon signedrank test were performed to compare the objective measurements and the subjective image quality scores, respectively. @*Results@#With the optimized CycleGAN denoising model, using the ULDCT images as input, the peak signal-to-noise ratio and structural similarity index improved by 2.0 dB and 0.21, respectively. The CycleGAN-generated denoised ULDCT images typically provided satisfactory image quality for optimal visibility of anatomic structures and pathological findings, with a lower level of image noise (mean ± standard deviation [SD], 19.5 ± 3.0 Hounsfield unit [HU]) than that of the hybrid (66.3 ± 10.5 HU, p 0.908). The CycleGAN-generated images showed the highest contrast-to-noise ratios for the pulmonary lesions, followed by the model-based and hybrid iterative reconstruction. The mean effective radiation dose of ULDCT was 0.12 mSv with a mean 93.9% reduction compared to standard-dose CT. @*Conclusion@#The optimized CycleGAN technique may allow the synthesis of diagnostically acceptable images from ULDCT of the chest for the evaluation of pulmonary tuberculosis.

Thinking and practice on establishing a high-quality university education system of laboratory medicine / 中华检验医学杂志

It is an urgent need for the development of medical and health undertakings in the new era to build a high-quality university education system and cultivate high-quality personnel for laboratory medicine. In the process of building a national first-class specialty, the medical laboratory technology specialty of Southern Medical University adheres to the concept of high-quality university education and improves the training level of laboratory medicine personnel through the teaching reform practice of constructing the whole-process moral education system, systematical training mode, internationalized teaching team, and intelligent teaching technology. In this paper, we analyzed the connotation and construction experience of a high-quality university education system of laboratory medicine, in order to increase the exchange and communication between different colleges and universities, and make contributions to the national strategic goal of building a powerful country in education before 2035.

Cycle-Consistent Generative Adversarial Network: Effect on Radiation Dose Reduction and Image Quality Improvement in Ultralow-Dose CT for Evaluation of Pulmonary Tuberculosis

Objective@#To investigate the image quality of ultralow-dose CT (ULDCT) of the chest reconstructed using a cycle-consistent generative adversarial network (CycleGAN)-based deep learning method in the evaluation of pulmonary tuberculosis. @*Materials and Methods@#Between June 2019 and November 2019, 103 patients (mean age, 40.8 ± 13.6 years; 61 men and 42 women) with pulmonary tuberculosis were prospectively enrolled to undergo standard-dose CT (120 kVp with automated exposure control), followed immediately by ULDCT (80 kVp and 10 mAs). The images of the two successive scans were used to train the CycleGAN framework for image-to-image translation. The denoising efficacy of the CycleGAN algorithm was compared with that of hybrid and model-based iterative reconstruction. Repeated-measures analysis of variance and Wilcoxon signedrank test were performed to compare the objective measurements and the subjective image quality scores, respectively. @*Results@#With the optimized CycleGAN denoising model, using the ULDCT images as input, the peak signal-to-noise ratio and structural similarity index improved by 2.0 dB and 0.21, respectively. The CycleGAN-generated denoised ULDCT images typically provided satisfactory image quality for optimal visibility of anatomic structures and pathological findings, with a lower level of image noise (mean ± standard deviation [SD], 19.5 ± 3.0 Hounsfield unit [HU]) than that of the hybrid (66.3 ± 10.5 HU, p 0.908). The CycleGAN-generated images showed the highest contrast-to-noise ratios for the pulmonary lesions, followed by the model-based and hybrid iterative reconstruction. The mean effective radiation dose of ULDCT was 0.12 mSv with a mean 93.9% reduction compared to standard-dose CT. @*Conclusion@#The optimized CycleGAN technique may allow the synthesis of diagnostically acceptable images from ULDCT of the chest for the evaluation of pulmonary tuberculosis.

The value of the Luminex magnetic bead immunoassay in detecting serum MBL in kidney transplantation patients / 中华检验医学杂志

Objective:To evaluate the performance of serum mannose-binding lectin(MBL) using Luminex magnetic bead immunoassay, and further clarify the value of serum MBL in the patients of renal transplantation.Methods:A retrospective study based on 110 patients who had underwent renal transplantation in Peking University First Hospital from February 2012 to May 2016 was carried out, and 50 healthy persons were selected as controls. The precision, linearity and correlation of serum MBL were evaluated using Luminex magnetic bead immunoassay, and compared with the traditional ELISA method. The frequency of infection and clinical rejection after transplantation was evaluated according to serum pre-transplant MBL level before transplantation, based on the Luminex method. Statistics analysis was implemented with SPSS 19.0 and MedCalc 12.7.0 software.Results:The repeatability precision and inter-day precision were less than 7.15% and 8.44% respectively, and linear range was 0.05-11 233.00 μg/L detected by Luminex immunoassay.The linear range of MBL detected by ELISA was 3.20-4 202.70 μg/L. The Luminex method had a wider range compared with ELISA. Correlation analysis showed that the regression equation was Y=1.248 6 X+231.81, and the correlation coefficient was r=0.978 ( P<0.01). Bland-Altman analysis showed that the average deviation percentage was 37.4% (95 %CI 33.7%-41.1%).The median (quartile) of pre-transplant serum MBL was 4 164.00 (2 124.00, 7 064.50) μg/L. Patients with a serum MBL<4 164.00 μg/L and MBL≥4 164.00 μg/L were defined as low-and high-level group, respectively. The incidence of infection among the low-level group and high-level group was 47.4% (27/57) and 28.3% (15/53)respectively, which showed a statistical difference(χ 2=4.230, P<0.05). The incidence of rejection among the low-level group and high-level group was 43.9% (25/57) and 20.8% (11/53)respectively, which also showed a statistical difference(χ 2=6.659, P<0.05). Conclusions:The Luminex magnetic bead immunoassay has a wider linearity compared with ELISA in detecting serum MBL. Additionally, serum pre-transplant MBL level has a good predictive value for the infection and rejection reaction after transplantation.

Novel small molecule retrograde transport blocker confers post-exposure protection against ricin intoxication

Ricin is a highly toxic type 2 ribosome-inactivating protein (RIP) which is extracted from the seeds of castor beans. Ricin is considered a potential bioterror agent and no effective antidote for ricin exists so far. In this study, by structural modification of a retrograde transport blocker Retro-2, a series of novel compounds were obtained. The primary screen revealed that compound has an improved anti-ricin activity compare to positive control. pre-exposure evaluation in Madin-Darby Canine Kidney (MDCK) cells demonstrated that is a powerful anti-ricin compound with an EC of 41.05 nmol/L against one LC (lethal concentration, 5.56 ng/mL) of ricin. Further studies surprisingly indicated that confers post-exposure activity against ricin intoxication. An study showed that 1 h post-exposure administration of can improve the survival rate as well as delay the death of ricin-intoxicated mice. A drug combination of with monoclonal antibody mAb4C13 rescued mice from one LD (lethal dose) ricin challenge and the survival rate of tested animals is 100%. These results represent, for the first time, indication that small molecule retrograde transport blocker confers both and post-exposure protection against ricin and therefore provides a promising candidate for the development of anti-ricin medicines.

The value of the Luminex magnetic bead immunoassay in detecting serum MBL in kidney transplantation patients / 中华检验医学杂志

Objective@#To evaluate the performance of serum mannose-binding lectin(MBL) using Luminex magnetic bead immunoassay, and further clarify the value of serum MBL in the patients of renal transplantation.@*Methods@#A retrospective study based on 110 patients who had underwent renal transplantation in Peking University First Hospital from February 2012 to May 2016 was carried out, and 50 healthy persons were selected as controls. The precision, linearity and correlation of serum MBL were evaluated using Luminex magnetic bead immunoassay, and compared with the traditional ELISA method. The frequency of infection and clinical rejection after transplantation was evaluated according to serum pre-transplant MBL level before transplantation, based on the Luminex method. Statistics analysis was implemented with SPSS 19.0 and MedCalc 12.7.0 software.@*Results@#The repeatability precision and inter-day precision were less than 7.15% and 8.44% respectively, and linear range was 0.05-11 233.00 μg/L detected by Luminex immunoassay.The linear range of MBL detected by ELISA was 3.20-4 202.70 μg/L. The Luminex method had a wider range compared with ELISA. Correlation analysis showed that the regression equation was Y=1.248 6X+231.81, and the correlation coefficient was r=0.978 (P<0.01). Bland-Altman analysis showed that the average deviation percentage was 37.4% (95%CI 33.7%-41.1%).The median (quartile) of pre-transplant serum MBL was 4 164.00 (2 124.00, 7 064.50) μg/L. Patients with a serum MBL<4 164.00 μg/L and MBL≥4 164.00 μg/L were defined as low-and high-level group, respectively. The incidence of infection among the low-level group and high-level group was 47.4% (27/57) and 28.3% (15/53)respectively, which showed a statistical difference(χ2=4.230, P<0.05). The incidence of rejection among the low-level group and high-level group was 43.9% (25/57) and 20.8% (11/53)respectively, which also showed a statistical difference(χ2=6.659, P<0.05).@*Conclusions@#The Luminex magnetic bead immunoassay has a wider linearity compared with ELISA in detecting serum MBL. Additionally, serum pre-transplant MBL level has a good predictive value for the infection and rejection reaction after transplantation.

Effect of Lanqin oral liquid combined with Azithromycin in treating mycoplasma pneumoniae pneumonia children with syndrome of heat-toxicity blocking lung / 国际中医中药杂志

Objective:To evaluate the efficacy of Lanqin oral liquid combined with Azithromycin in treating mycoplasma pneumoniae pneumonia children with syndrome of heat-toxicity blocking lung. Methods:A total of 82 children with mycoplasma pneumoniae from January of 2017 to January of 2019 who met the inclusion criteria were divided into two groups according to the random number table method with 41 patients in each group. The control group was given with Azithromycin sequential therapy, and the observation group was given with Lanqin oral liquid on the basis of conventional western medicine. Both groups were treated for 7 days. Scores of symptoms and signs were evaluated before and after treatment, serum levels of IL-4 and tumor necrosis TNF-α were detected by ELISA method, the disappearance time of fever, cough, dry and wet ralogue and wheezing were observed and recored, adverse reactions occurred during treatment were recorded, and the clinical efficacy was evaluated. Results:The total effective rate of the observation group and the control group was 95.1% (39/41) and 75.6% (31/41), respectively, and the difference was statistically significant ( χ2=4.783, P=0.029). The antipyretic time, cough disappearance time, dry and wet ralogue disappearance time, and wheezing disappearance time of the observation group were significantly shorter than those of the control group ( t=9.312, 8.740, 7.350, 12.467, respectively, all Ps<0.001). After treatment, the scores of cough, fever, wheezing, thirst, phlegm yellow thick and difficultly coughing in the observation group were significantly lower than those in the control group ( t=14.350, 16.779, 18.005, 17.441, 23.633, respectively, all Ps<0.001). After treatment, the scores of cough, fever, wheezing, thirst, yellow thick phlegm and difficultly in coughing in the observation group were significantly lower than those in the control group ( t=14.350, 16.779, 18.005, 17.441, 23.633, respectively, all Ps<0.001). After treatment, serum levels of IL-4 (12.56 ± 1.80 ng/L vs. 17.09 ± 2.78 ng/L, t=8.758) and TNF-α (14.08 ± 2.15 ng/L vs. 20.04 ± 2.93 ng/L, t=10.501) of the observation group were significantly lower than those of the control group ( P<0.01). The incidence of adverse reactions in the control group and the observation group was 17.07% (7/41) and 19.51% (8/41) respectively, and the difference was not statistically significant ( P>0.05). Conclusions:Lanqin oral liquid combined with Azithromycin can improve symptoms of mycoplasma pneumoniae pneumonia children and down-regulate serum levels of IL-6 and TNF-α, increase the efficacy with safety.

Survey on the inhabitants′ cardio-pulmonary resuscitation theory knowledge, skill mastery and self-efficacy in the mountainous area of southern Ningxia / 中国实用护理杂志

Objective:To analyze the knowledge, skills and self-efficacy of cardiopulmonary resuscitation among the public in mountainous areas of southern Ningxia, and provide scientific support for the popularization of cardiopulmonary resuscitation.Methods:According to inclusion and exclusion criteria, a total of 1 503 inhabitants in Ningxia district (Jan. 2018 to Jan. 2019) were chosen as research samples. The general data was analyzed; the self-made questionnaire was applied to evaluate the inhabitants ′ theory knowledge, skill mastery and self-efficacy by professional nurses. Multiple linear regression was used to analyze the influence factors of theory knowledge and skill mastery degree. Results:A total of 1 503 valid questionnaires were collected, the assessment scores of theory knowledge, skill mastery and overall self-efficacy were (53.11±12.34), (62.64±18.35) and (6.09±2.18) points; According to demographic characteristics, multiple linear regression indicated that the influence factors of theory knowledge and skill mastery assessment scores included age, occupational distribution, education backgrounds, training conditions, time of taking training to survey, "onlooker" experience and self-efficacy indicators ( t/ F values were 5.723, 4.393, 5.817, 6.435, 5.990, 6.438, 6.631, P<0.01). The positive correlations were assumed ( r values were 0.012, 0.016, P<0.05) . Conclusion:In Ningxia, the inhabitants generally have low theory knowledge, skill mastery and self-efficacy levels. Therefore, the relevant medical institutions shall enhance the inhabitants ′ cardio-pulmonary resuscitation training through multiple methods and approaches.