Study of extracting key plane of 11-13 + 6 weeks normal fetal palate by three-dimensional ultrasound based on artificial intelligence / 中华超声影像学杂志

Objective:To explore the feasibility of extracting the key plane of the normal fetal palate on the 11-13 + 6 week from tomography ultrasonography imaging based on artificial intelligence. Methods:The fetal volume datas of 235 cases of 11-13 + 6 week normal fetal were collected from the Department of Ultrasound in the Luohu District People′s Hospital of Shenzhen and Huazhong University of Science and Technology Union Shenzhen Hospital from May 2020 to April 2021. The data acquisition was completed by sonographers A and B by using the GE Voluson E10 color Doppler ultrasound diagnostic instrument. All datas were marked offline by sonographer C. Tomographic imaging was performed on all included data by sonographer D, the tomographic images were saved and the time-consuming was recorded, and the datas of the sonographer group were obtained. The labeled data were randomly divided into the training set and test set for model transfer learning and testing.The 4-fold cross-validation was adopted to record the test set image output by the model and the time consumption to obtain the intelligent group data. A senior sonographer performed image analysis on the two groups of data images. The feasibility of the intelligent model was verified by comparing the score of the plane of retronasal triangle(RTP), the acquisition rate of RTP, the acquisition rate of the fault, and the time-consuming difference between the sonographer group and the intelligent group. Results:①There was no significant difference in the overall distribution of RTP scores between the sonographer group and intelligent group [5 (5, 6) points vs 5 (5, 6) points, Z=0.355, P=0.722]. The RTP acquisition rate of the sonographer group and intelligent group was not statistically significant (78.72% vs 76.60%, χ 2=0.55, P=0.458). The consistency and correlation of RTP obtained by the two groups were high (Kappa=0.645, φ=0.646, both P<0.001). ②The effective layers of the sonographer group were 9 (8, 9) and the intelligent group was 8 (7, 9). The fault acquisition rate of the doctor group was higher than that of the intelligent group (78.72% vs 68.51%, χ 2=12.52, P=0.001). The consistency and correlation of the two groups in obtaining faults were media (Kappa=0.503, φ=0.521, both P<0.001). ③The time-consuming of the intelligent group was significantly lower than that of the sonographer group [1.50 (1.23, 1.75)s vs 26.94 (22.28, 30.48)s, Z=11.440, P<0.001]. Conclusions:This research model can quickly and accurately realize the extraction and tomography of the key plane of the normal fetal palate on the 11-13 + 6 week.

Epidemic characteristics of malaria cases before and after malaria elimination in Hubei Province / 中国热带医学

@#Abstract: Objective　To collect and organize malaria case data in Hubei Province from 2017 to 2021, compare and analyze the malaria epidemic characteristics on the before and after malaria elimination, and provide scientific support for Hubei Province to further optimize the comprehensive strategies to prevent re-transmission after the elimination of malaria. Methods The study was conducted by collecting the data of reported malaria cases of Hubei during 2017-2021 from the Infectious Disease Surveillance Reporting and Management System, and conducting the epidemiological characteristics of malaria on pre-elimination (2017-2019) and post-elimination (2020-2021). Results A total of 429 cases of imported malaria were reported in Hubei Province from 2017 to 2021, and the malaria epidemic showed an obvious trend of rising first and then falling. On the pre-malaria elimination, 374 malaria cases were reported, including 262 cases of P.falciparum (70.05%); on the post-malaria elimination, 55 malaria cases were reported, including 25 cases of P.falciparum (45.45%). There was a statistically significant difference in the proportion of infections caused by the four types of malaria parasites before and after the elimination of malaria (χ2=14.248, P<0.05). On the pre-malaria elimination, the peak of disease onset mainly occurred in January, July, and November; on the post-malaria elimination, the peak of disease onset mainly occurred in January to February, and December. Both before and after malaria elimination, the reported cases were mainly concentrated in Wuhan, Yichang, Huangshi, Xiangyang, Shiyan and Huanggang, but the range of cases showed a clear trend of narrowing. Before and after malaria elimination, malaria cases in Hubei Province were mainly among young and middle-aged males aged 30-49. The proportions of workers and migrant workers increased from 37.70% and 9.09% before the elimination to 50.91% and 18.18% after the elimination, respectively, with a statistically significant difference (χ2=17.839, P<0.05). The percentage of interval from onset of illness to initial diagnosis ≥ 5d decreased from 21.66% before the elimination to 10.91% after the elimination (χ2=6.448, P<0.05). The percentage of definitive diagnosis of malaria at initial diagnosis in town clinic increased from 18.18% before the elimination to 50.00% after the elimination. The proportion of malaria cases diagnosed by county-level medical institutions increased from 22.73% before the elimination to 34.55% after elimination. There was no statistically significant difference in the proportion of malaria cases diagnosed by medical institutions at all levels before and after the elimination of malaria (χ2=5.630, P>0.05). The proportion of cases with the interval between initial diagnosis and diagnosis within 24h increased from 43.85% before the elimination to 70.91% after the elimination. There was a statistically significant difference in the proportion of cases with the interval between initial diagnosis and diagnosis before and after the elimination of malaria (χ2=14.006, P<0.05). Before and after malaria elimination, all reported cases were mainly imported from African countries. Conclusions There are imported malaria cases reported every year in Hubei Province before and after the elimination of malaria, which poses a great challenge to the prevention of re-transmission. Therefore, it is necessary to strengthen the surveillance system, detect and standardize the treatment of imported malaria cases in a timely manner, conduct targeted retransmission risk surveys and assessments, and consolidate the achievements of malaria elimination.

Final evaluation of the prevention and control plan of key parasitic diseases in Hubei Province, 2016-2019 / 中国热带医学

@#Abstract: Objective　To evaluate the completion and final effect of key parasitic disease prevention and control planning tasks in Hubei Province from 2016 to 2019, summarize the experience, find out the problems, and provide the basis for the next stage of prevention and control. Methods　According to the requirements of the Final Evaluation Plan of the National Plan for the Prevention and Control of Hydatid Disease and Other Major Parasitic Diseases (2016-2020), a retrospective survey method was adopted to collect relevant data on the implementation and safeguard measures of the prevention and control of major parasitic diseases, and population infection status in Hubei Province in 2016-2019. Results From 2016 to 2019, We carried out 2 920 992 person times of publicity and education, 209 times of prevention and control technology training, 7 680 person times of business training, with an average of 52 sessions and 1 920 person times per year. We have allocated 3.445 2 million yuan for the prevention and control of parasitic diseases, including 1.722 2 million Yuan froom provincial government, to achieved full coverage of safe drinking water in rural areas under the current national standards, and 7.687 9 million harmless toilets have been built in rural areas. From 2016 to 2019, we carried out 39 658 person times of monitoring and disease investigation, the infection rate of human liver fluke was 0, and the infection rate of soil transmitted nematode was 0.42%. While the annual infection rates varied, there was no statistically significant difference in infection rate between years (χ2＝2.276, P>0.05), but there were statistically significant differences in the infection rates between various soil nematodes (χ2=112.807, P<0.01). From 2016 to 2019, a total of 5 393 people were detected at 17 monitoring points, with the serum positive rate of 3.93% for paragonimiasis, there was a statistically significant difference in serological positive rate between years (χ2=146.011, P<0.01); a total of 738 stream crabs were collected, and the infection rate of intermediate host was 16.26%, wtih a statistically significant difference in the infection rate of stream crabs between years (χ2=49.731, P<0.01). Conclusions　From 2016 to 2019, we adhered to the prevention and control strategy of "prevention first, prevention and control combined", implemented comprehensively various prevention and control measures, and achieved remarkable results in Hubei Province. The key parasitic diseases have been in a low epidemic situation, meeting the requirements of the prevention and control objectives. But the transmission risk still exists, the next step is to continue to strengthen security and monitoring and consolidate the achievements of prevention and control.

Primary renal mesenchymal chondrosarcoma: a case report / 中华泌尿外科杂志

Renal mesenchymal chondrosarcoma is a rare malignant soft tissue tumor. This paper reports a patient who was admitted to hospital because of left renal tumor, and underwent robot-assisted laparoscopic partial nephrectomy. The patient was diagnosed as left renal mesenchymal chondrosarcoma by pathological and genetic examination after operation. There was no local recurrence and metastasis six months after operation.

Design and application of a new type of fascia stretching cup / 中国针灸

In order to comprehensively stretch human fascia, adjust the biomechanical balance of fascia system and promote the recovery of physiological function of fascia, a new type of fascia stretching cup is designed. This design is composed of two or more silica gel cups and elastic stretching belts between cups. The bottom surface of the silica gel cup has an annular exhaust groove, which can increase the adsorption capacity of the cup to the skin. In the meanwhile, a removable magnet is placed in the groove at the top of each silica gel cup to assist analgesia. This design is suitable for the prevention and treatment of acute and chronic tendon and bone diseases with imbalance of meridians and tendons.

Analysis of curative effect of radical surgery for T 4 stage prostate cancer invading bladder neck / 中华泌尿外科杂志

Objective:To investigate the curative efficacy of radical prostatectomy (RP) for T 4 stage prostate cancer invading bladder neck. Methods:The clinical data of 22 patients with T 4 stage prostate cancer invading bladder neck treated with RP from April 2013 to March 2021 were analyzed retrospectively. The mean age of the patients was (64.09±6.33) years, and the preoperative blood PSA was 57.70(39.40, 68.56) ng/ml. Preoperative MRI or PSMA-PET examination revealed bladder neck invasion, including 16 cases (72.73%) of urinary retention. Clinical stage of T 4N 0M 0 accounted for 40.91% (9/22), T 4N 1M 0 accounted for 45.45% (10/22), and T 4N 1M 1 accounted for 13.64% (3/22). Preoperative patients were not treated with neoadjuvant endocrine or chemotherapy. Laparoscopic or robotic assisted laparoscopic radical prostatectomy and pelvic lymph node dissection were performed. Results:The 22 operations were successfully completed without conversion. The operation time was(184.27±34.82) min, the amount of intraoperative bleeding was (210.91±83.03) ml, the retention time of drainage tube was (4.73 ± 1.03) days, the recovery of gastrointestinal function took 3 (2, 3) days, and the postoperative hospital stay was (6.68 ± 1.39) days. Postoperative pathology showed that the Gleason score of 7 points accounted for 4.54% (1/22), 8 points accounted for 13.64% (3/22), and 9 points accounted for 81.82% (18/22). The positive rate of margin was 81.82% (18/22). Pathological stage of T 4N 0M 0 accounted for 22.73% (5/22), T 4N 1M 0 accounted for 63.64% (14/22), and T 4N 1M 1 accounted for 13.64% (3/22), of which extracapsular or seminal vesicle invasion accounted for 90.91% (20/22). The incidence of postoperative complications above grade 3 was 9.09% (2/22), and the rate of urinary control recovery after 3 months of surgery was 90.91% (20/22). 16 patients with preoperative urinary retention were able to urinate normally after operation. All patients were treated with adjuvant androgen deprivation therapy (ADT) with or without antiandrogens, and 13 cases (59.09%) were treated with adjuvant radiotherapy. The postoperative PSA value before adjuvant treatment was 2.53 (0.51, 5.44) ng/ml. The median survival time was not reached. Two patients died of prostate cancer at 71 and 84 months and one patient died of heart disease at 28 months. Conclusions:RP surgery could effectively relieve the condition of urinary retention with low incidence of operative complications. Although the positive rate of surgical margin is high, RP could be used as one of the treatment options for T 4 stage prostate cancer invading bladder neck, while the long-term effect is still needed to be further analyzed.

Inpatient Care Expenditure of Terminally Ill Patients in the Geriatric Ward of Peking Union Medical College Hospital / 中国医学科学院学报

Objective To describe the inpatient care expenditure of the terminally ill patients in the geriatric ward of Peking Union Medical College Hospital and facilitate future research on the economic outcomes of hospice and palliative care.Methods The histories of patients admitted to the Department of Geriatrics of Peking Union Medical College Hospital during 2018 were reviewed by trained doctors.According to the diagnosis and overall health state,terminally ill patients were selected and enrolled in the study.Demographics,health and disease information,prescriptions,and expenditure details were retrieved from the HIS system.Results In 2018,35 patients were terminally ill and eligible for hospice care,including 20 males and 15 females,with the average age of(78±8)years(59-91 years),the average age-adjusted Charlson Comorbidity Index of 10±3,and the median Barthel index of 40(10,70).These patients had malignant tumor(23 cases),heart failure(4 cases),end-stage renal disease(1 case),end-stage liver disease(2 cases),dementia(4 cases)and other severe diseases(3 cases).The patients received standard care within the scope of internal medicine and geriatrics.Finally,8 patients died during hospitalization,and 27 were discharged alive.The 35 patients had the median length of stay of 15(12,23)days,the median inpatient expenditure of CNY 21 500(13 800,37 600),and the median daily expenditure of CNY 1425(970,2503).The percentage of expenditure was(28.5±12.3)% for medication,(33.2±18.0)% for tests and examinations,and 11.5%(6.4%,15.8%)for accommodation and medical services.The medications for symptom control costed CNY(77±58)per day on average,accounting for(5.2±3.5)% of the total expenditure.Conclusions The inpatient expenditure for terminally ill patients in the tertiary grade A hospital was higher than that reported in community hospitals providing hospice care.In terms of expenditure constitution,the money spent on medications and tests/examinations were similar,and the percentage of expenditure on medications for symptom control was low.There is a need for further research on the economic impact of hospice and palliative care among terminally ill patients in China.

Re-examination of malaria diagnosis in Hubei Provincial Malaria Diagnostic Reference Laboratory from 2017 to 2019 / 中国血吸虫病防治杂志

ObjectiveTo analyze the re-examination results of malaria cases captured from the National Notifiable Communicable Disease Reporting System in Hubei Provincial Malaria Diagnostic Reference Laboratory from 2017 to 2019, so as to pro- vide the scientific evidence for improving the malaria control capability in the province. MethodsMicroscopy and nested PCR assay were performed to re-examine the diagnosis of malaria cases registered in the National Notifiable Communicable Disease Reporting System in Hubei Provincial Malaria Diagnostic Reference Laboratory from 2017 to 2019, and the coincidences of ma- laria diagnosis and malaria parasite species were evaluated. Results A total of 410 malaria cases were reported in Hubei Province from 2017 to 2019 according to the data retrieved from the National Notifiable Communicable Disease Reporting System. Among the 407 samples re-examined by Hubei Provincial Malaria Diagnostic Reference Laboratory from 2017 to 2019, the diag- nosis 374 malaria cases were confirmed, with an overall coincidence of 91.89% (374/407) for malaria diagnosis and 89.04% (333/374) for parasite species identification. The coincidence rates of malaria diagnosis and parasite species identification were 50.00% to 100.00% and 66.67% to 100.00% in 16 cities (prefectures) of Hubei Province during the re-examinations, which both varied in regions (χ2 = 40.46 and 42.30, both P values < 0.01). The coincidence rates of Plasmodium falciparum, P. vivax, P. malariae and P. ovale identification were 95.80%, 100.00%, 58.33% and 51.92% during the re-examinations, respectively (χ2 = 76.66, P < 0.01). The consistency rate between microscopic and nested PCR results was 89.83% (362/403). Conclusions The overall diagnostic quality of malaria is high in medical institutions at all levels in Hubei Province; however, the diagnostic capability of malaria remains to be improved in some regions.

Study on the practicality of the semi‐automatic measurement for the urogenital hiatus / 中华超声影像学杂志

Objective To determine the consistency of urogenital hiatus ( U H ) data between the semi‐automatic measurement and manual measurement using transperineal pelvic floor ultrasonography . Methods Total of 286 three‐dimensional images of minimal U H dimension were obtained . And they were divided into study group ( 100 images) and test group ( 186 images) randomly . T hree experts traced and created the w hole profile of the U H of those images in the study group by M AT LAB . T hen the semi‐automatic software was obtained through machine learning algorithms . In the test group , 6 parameters of U H ( including anterioposterior diameter , transverse diameter ,circumference , area ,left and right levator urethral gap distance) were measured by two experts ( D 1 and D2 ) both manually and semi‐automatically . T he time experts spent on measuring was also recorded and compared . Results T he time used for semi‐automatic measurement was significantly shorter than that for manual measurement [ ( 7 .49 ± 1 .51 ) s vs ( 42 .42 ± 11 .08) s ,( 7 .52 ± 1 .37) s vs ( 43 .45 ± 9 .09) s for D1 and D2 , t ＝ －12 .09 ,－13 .64 ,all P＝0 .00] . T he Pearson correlation coefficients between semi‐automatic and manual measurements of 6 parameters were 0 .857 －0 .985 ( P ＜ 0 .01) ,0 .853 －0 .979 ( P ＜ 0 .01 ) in D1 and D2 ,respectively . T he interclass correlation coefficients ( ICC) of six parameters were ranged from 0 .846 －0 .985 for D1 and 0 .843～0 .979 for D2 ( all P ＜ 0 .01 ) . T he Bland Altman plot also showed good agreement between two methods . Conclusions Intellectual recognition and semi‐automatic measurement has simplified the process for U H measurement ,and it is proved to be a reliable and timesaving method that is practical for clinical use .

Analysis of the disease spectrum of Beijing 120 prehospital emergency patients from 2013 to 2017 / 中华疾病控制杂志

Objective To understand the disease spectrum of prehospital emergency patients in Beijing, so as to provide basis for rational allocation of prehospital emergency care resources and for improvement of prehospital emergency care. Methods Emergency dispatch database from 120 dispatching command system of Beijing Emergency Medical Center to was used study the disease spectrum of 120 prehospital emergency patients from 2013 to 2017 in Beijing, and were analyzed the differences of disease spectrum among patients of different years, genders and ages, and the time distribution of different diseases. Results From 2013 to 2017 in Beijing, 1 643 375 patients used 120 prehospital emergency care. The top 3 diseases of the disease spectrum were: injury and poisoning (29.63%), diseases of the circulatory system (18.37%), and diseases of the nervous system (15.80%). The sorting of diseases remained unchanged during the 5 years. The disease spectrums were different among different age groups and gender groups. The calls in spring, summer, autumn and winter accounted for 25.23%, 24.97%, 25.05% and 24.75% respectively. Most calls were made from 08 ∶〗00 to 09 ∶〗59 (12.41%), 12 ∶〗00 to 13 ∶〗59 (10.05%), and 14 ∶〗00 to 15 ∶〗59 (9.91%) during a day. The peak months and hours of different diseases were different. Conclusions The demand for prehospital emergency care has been increasing in Beijing in recent years. It is important to strengthen the prevention of injuries among all ages, especially male, and to improve the prevention and response capacity for acute attack of chronic diseases among older people. Prehospital emergency care resources should be rationally allocated according to the peak months and hours of calls.

Analysis on influencing factors of the frailty of the elderly / 中华疾病控制杂志

Objective To explore influencing factors of the elderly's frailty. Methods Eight communities were randomly selected from Dalang Town, Dongguan City, and all the eligible elderly people were investigated using the self-developed frailty index. Univariate analysis was performed using the 2 test, and multivariate analysis was performed by ordinal multi-class Logistic regression. Results Univariate analysis showed that there were significant differences in the distribution of frailty conditions among different demographic characteristics, family relationships, economic situation and lifestyle (all P<0.05). Multivariate analysis showed that younger age (OR=0.13, P<0.001), male (OR=0.65, P=0.012), and daily exercise (OR=0.76, P=0.049) were protective factors for frailty of the elderly. Illiterate (OR=2.42, P<0.001), fewer times to see children per month (OR=1.82, P=0.035), pension funds as the main economic source (OR=1.59, P<0.001), low level of physical activity (OR=2.18, P<0.001) and none social participation (OR=1.41, P=0.004) were risk factors of frailty. Conclusion Age, gender, education level, times to see children per month, economic source, exercise frequency, physical activity level and social participation are the influencing factors of frailty of the elderly.

Study on Protective Effect of Huayu Qutan Decoction on Vascular Dementia / 中国实验方剂学杂志

Objective: To study the protective effect of Huayu Qutan decoction on vascular dementia (VD) gerbils and to explore whether its mechanism is related to Calcium ion-calmodulin-dependent protein kinase Ⅱ (CaMKⅡ)/cyclic adenosine effect element binding protein (CREB)/brain-derived neurotrophic factor (BDNF) signaling pathway. Method: Forty healthy gerbils were randomly divided into sham operation group, model group, low, medium and high dose groups (5.35, 10.7, 21.4 g·kg-1) of removing blood stasis and expelling phlegm. Eight gerbils in each group were divided into model group and removing blood stasis and expelling phlegm group. Gerbils were given corresponding drugs twice a day after operation. Water maze experiment was conducted 21 days later to investigate the spatial learning and memory ability of gerbils. The expression of p-CaMKⅡ/CaMKⅡ, p-CREB/CREB and BDNF in the hippocampus of gerbils were detected by Western blot and immunohistochemistry. Result: Compared with sham operation group, the incubation period and the number of platform trips of gerbil in the model group were significantly reduced, p-CaMKⅡ/CaMKⅡ, p-CREB/CREB, and BDNF protein expression were significantly reduced (PPPConclusion: Huayu Qutan decoction improves the learning and memory abilities of gerbils with vascular dementia, and its mechanism may be related to the activation of CaMKⅡ/CREB/BDNF signaling pathway.

Surveillance of Anopheles populations in different periods in Suizhou City / 中国血吸虫病防治杂志

Objective To evaluate the effect of malaria vector control measures so as to provide the evidence for consolidating the control effectiveness of malaria and carrying out the vector surveillance in Suizhou City. Methods The distributions of Anopheles sinensis and An. anthropophagus were investigated by the combination of retrospective review and field survey. The changes of density and population of mosquito vectors were investigated and compared among various years. Results From 1985 to 1996, both An. sinensis and An. anthropophagus were found in 18 towns, and An. anthropophagus mosquitoes accounted for 52.3% of the total Anopheles mosquitoes. Only An. sinensis mosquitoes were found in other 26 towns. In 2003 and 2004, An. anthropophagus mosquitoes were found in the original 18 towns, and they accounted for 47.0% and 38.1% respectively, but in 2005, An. anthropophagus mosquitoes were not found in this city. However, the density of An. sinensis presented an upward trend. Conclusions An. anthropophagus population has gradually disappeared in Suizhou City, and currently, An. sinensis is the main Anopheles population, which might be the malaria vector in suitable conditions. Therefore, the surveillance and control of Anophe les vector should be strengthened in order to consolidate the achievements of malaria elimination.

Surveillance of Anopheles populations in different periods in Suizhou City / 中国血吸虫病防治杂志

Objective To evaluate the effect of malaria vector control measures so as to provide the evidence for consolidating the control effectiveness of malaria and carrying out the vector surveillance in Suizhou City. Methods The distributions of Anopheles sinensis and An. anthropophagus were investigated by the combination of retrospective review and field survey. The changes of density and population of mosquito vectors were investigated and compared among various years. Results From 1985 to 1996, both An. sinensis and An. anthropophagus were found in 18 towns, and An. anthropophagus mosquitoes accounted for 52.3% of the total Anopheles mosquitoes. Only An. sinensis mosquitoes were found in other 26 towns. In 2003 and 2004, An. anthropophagus mosquitoes were found in the original 18 towns, and they accounted for 47.0% and 38.1% respectively, but in 2005, An. anthropophagus mosquitoes were not found in this city. However, the density of An. sinensis presented an upward trend. Conclusions An. anthropophagus population has gradually disappeared in Suizhou City, and currently, An. sinensis is the main Anopheles population, which might be the malaria vector in suitable conditions. Therefore, the surveillance and control of Anophe les vector should be strengthened in order to consolidate the achievements of malaria elimination.

Cognition and response of haze in pregnant women in Shunyi District, Beijing / 预防医学

Objective The present study was conducted to investigate the perception of haze among pregnant women and to provide basis for developing interventions.Methods A pregnant woman who has been living in Shunyi district for at least six months has been selected as the subject of investigation. A self-designed questionnaire was used to conduct field investigation. Results A total of 320 questionnaires were collected, including 308 valid questionnaires and 96.25% effective questionnaires. In terms of the cognitive aspects of haze, pregnant women think that there is a serious harm to the respiratory system, and 52.27%(161/308)of pregnant women think that the haze is harmful to the cardiovascular system. In the area of haze protection, 79.22%(244/308)of pregnant women wear masks when they go out. Pregnant women who are in the haze of 100.00% (308/308)will reduce window ventilation time. Access to information about haze information and protection knowledge is mainly including mobile phones(83.12%), network(44.16%)and TV(23.38%). The multi-factor logistic regression analysis showed that the haze was harmful to the health of the fetus (OR=0.12, 95%CI: 0.031-0.446), which was the influencing factor of the pregnant women's haze protection measures. Conclusion Pregnant women in Shunyi District have higher awareness of haze knowledge, and the influencing fact of the measures on the haze weather is the cognition that the haze is harmful to the health of the fetus.

Characteristics of sexual partner network and high-risk sex behaviors among men who have sex with men / 上海预防医学

[Objective]To ascertain characteristics of sexual partner network and high-risk sex behaviors among men who have sex with men (MSM) , providing references for intervention of high risk behavior in MSM. [Methods] Face-to-face questionnaire interview was conducted among MSM recruited by voluntary counseling and testing clinics, peer mobilization, internet mobilization, outreach intervention, and so on.Descriptive statistics, χ2test, logistic regression analysis were applied for statistical analysis. [Results]A total of 334 MSM was investigated. Over the past 6 months, proportion of female partners, fixed male partners, multiple male partners, occasional and business male partners was 37.13％, 43.11％, 52.69％, 56.29％, and 4.19％ respectively. Logistic regression analysis showed that respondents who were married, less educated, non-Shanghai domicile, and non-homosexual had more female partners in proportion, those with high income and homosexuality had more fixed male partners in proportion, and those who were married, non-Shanghai domicile had more multiple or occasional male partners in proportion. In the past 6 months, MSM who had unprotected sexual behaviors with female partners, fixed male partners, multiple or occasional male partners accounted for 75.21％, 65.97％, 59.66％, and 48.40％respectively. And analysis showed that respondents had more high-risk sexual behaviors with multiple male partners with their age increasing. [Conclusion] Sexual partner network of MSM is complex. MSM has a variety of sexual partners. Multiple sexual partners and unprotected sexual behaviors exist extensively among MSM. Related factor of sexual behaviors with multiple sexual partners is age.

Evaluation value of echocardiography for right ventricular function in patients with pulmonary embol-ism and analysis of influencing factors of risk stratification / 心血管康复医学杂志

Objective :To study evaluation value of echocardiography for right ventricular function in patients with pulmonary embolism (PE) and analyze the influencing factors of risk stratification .Methods :A total of 130 PE ca-ses treated in our hospital from Feb 2016 to Aug 2017 were selected .All patients received risk stratification ,inclu-ding 48 high risk cases (high risk group) and 82 low-medium risk cases (low-medium risk group).Another 60 healthy subjects undergoing physical examination were regarded as healthy control group during the same period .All subjects received two-dimensional echocardiography and tissue Doppler imaging .PAD ,PASP ,right ventricular Tei index , RVEDV ,RVSV ,RVEF and RVESV were measured and compared among all groups .Multi-factor Logistic regres-sion analysis was used to analyze independent risk factors of PE risk stratification .Results : Compared with normal control group and low-medium risk group ,there were significant rise in PAD [ (22.02 ± 1.33) mm vs .(24.42 ± 2.02) mm vs.(36.31 ± 2.12) mm] ,PASP [(22.28 ± 2.71) mmHg vs.(32.42 ± 4.83) mmHg vs.(84.57 ± 21.01) mmHg] ,right ventricular Tei index [(0.30 ± 0.04) vs.(0.40 ± 0.06) vs.(0.66 ± 0.05)] ,RVEDV [(68.08 ± 4.71) ml vs.(75.55 ± 7.88) ml vs.(123.29 ± 7.14) ml] and RVESV [ (29.33 ± 3.46) ml vs.(43.12 ± 6.11) ml vs. (87.01 ± 9.94) ml] ,and significant reductions in RVSV [ (37.79 ± 3.82) ml vs .(35.34 ± 1.89) ml vs .(33.12 ± 3.28) ml] and RVEF [(56.93 ± 3.00)% vs.(45.37 ± 4.88)% vs.(25.48 ± 4.92)% ] in high risk group ;and PAD , PASP ,right ventricular Tei index ,RVEDV and RVESV of low-medium risk group were significantly higher than those of normal control group ,and RVSV and RVEF of low-medium risk group were significantly lower than those of normal control group , P＝0. 001 all.Multi-factor Logistic regression indicated that PASP ,right ventricular Tei index and RVESV were independent risk factors for PE risk stratification (OR＝ 1.789～5.602 , P＜ 0.05 or ＜0.01).Conclusion :Echocardiography is of high clinical value in the evaluation of right ventricular function in PE , PASP ,right ventricular Tei index and RVESV can be used for risk stratification .

A feasibility study of the automatic cystocele severity grading software for quantitative evaluation of prolapse of bladder posterior wall by transperineal ultrasound / 中华超声影像学杂志

Objective To investigate the feasibility of the automatic cystocele severity grading software for quantitative evaluation of prolapse of bladder posterior wall by transperineal ultrasound . Methods One hundred and seventy transperineal ultrasound video clips were recorded when the female patients performing the Valsalva maneuver and those clips were divided into training group ( 85 cases) and test group ( 85 cases) randomly ,then the ralated structures of the images from the training group offline were marked . Through machine learning algorithm ,the computer had learned and was able to analyzed the marking information ,then the automatic cystocele severity grading software was obtained . And later the software was ran to mark the structures and get the cystocele severity grading in the images from the test group . Meanwhile , the same structures of the same images manually were marked and after an interval of more than two weeks the process were repeated by 3 doctors . Finally the grading results obtained from the software and the measurers of the 3 doctors were compared . Results The intelligent identification and automatic measurement software obtained from the machine learning algorithm was able to identify the related structures . The grading results of each measurer were of good consistency ( κ :0 .72 －0 .78 ;ICC :0 .980－0 .990) . The grading results between different measurers were of good consistency ( κ :0 .65－0 .75 ;ICC :0 .985－0 .992) . The grading results between automatic software and three different measurers were of good consistency ( κ :0 .63－0 .67 ;ICC :0 .967－0 .969 ; r ＝0 .936 ,0 .943 ,0 .936 ,all P ＜0 .01) . Conclusions The automatic cystocele severity grading software is able to identify the related structures in the images and reliable to apply the software in pelvic floor ultrasound .

A Predictive Model for Estimation Risk of Proliferative Lupus Nephritis / 中华医学杂志(英文版)

<p><b>Background</b>Lupus nephritis (LN) is classified by renal biopsy into proliferative and nonproliferative forms, with distinct prognoses, but renal biopsy is not available for every LN patient. The present study aimed to establish an alternate tool by building a predictive model to evaluate the probability of proliferative LN.</p><p><b>Methods</b>In this retrospective cohort with biopsy-proven LN, 382 patients in development cohort, 193 in internal validation cohort, and 164 newly diagnosed patients in external validation cohort were selected. Logistic regression model was established, and the concordance statistics (C-statistics), Akaike information criterion (AIC), integrated discrimination improvement, Hosmer-Lemeshow test, and net reclassification improvement were calculated to evaluate the performance and validation of models.</p><p><b>Results</b>The prevalence of proliferative LN was 77.7% in the whole cohort. A model, including age, gender, systolic blood pressure, hemoglobin, proteinuria, hematuria, and serum C3, performed well on good-of-fit and discrimination in the development chohort to predict the risk of proliferative LN (291 for AIC and 0.84 for C-statistics). In the internal and external validation cohorts, this model showed good capability for discrimination and calibration (0.84 and 0.82 for C-statistics, and 0.99 and 0.75 for P values, respectively).</p><p><b>Conclusion</b>This study developed and validated a model including demographic and clinical indices to evaluate the probability of presenting proliferative LN to guide therapeutic decisions and outcomes.</p>

The technique and effectiveness of potency preservation in robotic-assisted laparoscopic radical prostatectomy / 中华泌尿外科杂志

Objective To evaluate the key technique and effectiveness of potency preservation in robotic-assisted laparoscopic radical prostatectomy (RALP).Methods The complete clinical and follow-up data of 30 cases underwent RALP between February and May of 2016 were reviewed retrospectively.The average age of the patients was 67.3 years (48-82 years).The peak PSA level before surgery ranged from 7.6 to 53.4 ng/ml with the average level of 21.1 ng/ml.There were 7,16,6 and 1 case with the Gleason score of 6,7,8,and 9 point,respectively.Preoperative erectile score (IIEF-5) of the 30 patients were list as below:3 cases (0-10 points),4 cases(11-15 points),17 cases(16-20 points),and 6 cases(21-25 points).The key techniques of potency preservation during RALRP includes deep dorsal vein ligation techniques,neurovascular bundles preservation techniques and drain tube placement techniques.Results All 30 cases underwent operation successfully with no transfer to open surgery.Average operative time was 150.7 min (98-240 min) with an estimated blood loss of 165.7ml (50-550 ml).The average drainage removal time was 5.1 d postoperatively.The average bowel recovery time was 2.7 d and average hospitalization time was 8.2 d,respectively.There were two cases with one positive margin on the bladder neck and one on the tip of prostate,respectively.Seventeen cases gained potency preservation six months after surgery.Conclusion It was safe and beneficial for the potency preservation in RALP,which could be considered as one of the best options for the prostate cancer surgery.