Analysis of the current situation of radiological health management in 66 medical institutions in Nanyang, China / 中国辐射卫生

Objective To determine the current situation of radiological health management in medical institutions in Nanyang, China, to analyze existing problems and propose improvement measures, and to improve the management level of radiological diagnosis and treatment practice in medical institutions. Methods According to the work plan of the Occupational Disease Prevention and Control Project in Henan Province, China, 66 medical institutions engaged in radiological diagnosis and treatment at different levels were selected for a questionnaire survey, in combination with on-site inspections, inquiries, and access to relevant materials. Results Of 66 medical institutions, 65 institutions held radiological diagnosis and treatment licenses, with a license holding rate of 98.5%. There were 17 “new construction, reconstruction, and expansion” projects, with an evaluation rate of 94.1%. In this survey, a total of 391 radiological diagnosis and treatment equipment were involved, and 387 units of equipment were tested for status, with a detection rate of 99.0% and a qualification rate of 94.8% (367/387); 55 units of equipment were tested for stability, with a detection rate of 14.1%; the workplace protection detection rate was 99.0%, and the qualification rate was 100%; 66 medical institutions had 1809 radiation workers, with an occupational health examination rate of 97.8%; 1262 people were trained, with a training rate of 95.7%; 1773 people were monitored for individual dose, with a monitoring rate of 98.0%. Conclusion Medical institutions should further strengthen management in licensing change, construction project evaluation, and equipment stability monitoring to improve the level of radiological health management.

Safety and feasibility of no chest tube after thoracoscopic pneumonectomy: A systematic review and meta-analysis / 中国胸心血管外科临床杂志

@#Objective    To discuss the safety and feasibility of no chest tube (NCT) after thoracoscopic pneumonectomy. Methods    The online databases including PubMed, EMbase, The Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), WanFang Database, VIP, China Biology Medicine disc (CBMdisc) were searched by computer from inception to October 2020 to collect the research on NCT after thoracoscopic pneumonectomy. Two reviewers independently screened the literature, extracted the data, and evaluated the quality of the included studies. The RevMan 5.3 software was used for meta-analysis. Results    A total of 17 studies were included. There were 12 cohort studies and 5 randomized controlled trials including 1 572 patients with 779 patients in the NCT group and 793 patients in the chest tube placement (CTP) group. Meta–analysis results showed that the length of postoperative hospital stay in the NCT group was shorter than that in the CTP group (SMD=–1.23, 95%CI –1.59 to –0.87, P<0.000 01). Patients in the NCT group experienced slighter pain than those in the CTP group at postoperative day (POD)1 (SMD=–0.97, 95%CI –1.42 to –0.53, P<0.000 1), and POD2 (SMD=–1.10, 95%CI –2.00 to –0.20, P=0.02), while no statistical difference was found between the two groups in the visual analogue scale of POD3 (SMD=–0.92, 95%CI –1.91 to 0.07, P=0.07). There was no statistical difference in the 30-day complication rate (RR=0.93, 95%CI 0.61 to 1.44, P=0.76), the rate of postoperative chest drainage (RR=1.51, 95%CI 0.68 to 3.37, P=0.31) or the rate of thoracocentesis (RR=2.81, 95%CI 0.91 to 8.64, P=0.07) between the two groups. No death occurred in the perioperative period in both groups. Conclusion    It is feasible and safe to omit the chest tube after thoracoscopic pneumonectomy for patients who meet the criteria.

Chemokines CCL21 and its receptor CCR7 expression in thyroid of thyroiditis in NOD mice induced by iodine excess and thyroglobulin immunization / 中华地方病学杂志

Objective Through detecting the expression of chemokine CCL21 and its receptor CCR7 in thyroiditis of NOD mice induced by excessive iodine and thyroglobulin (Tg) immunization,to explore the mechanism of lymphocytic infiltration.Methods Seven to eight weeks old female NOD (non-obese diabetic) mice were used,the mice were divided into four groups by random number table,7 mice for each group.Control group:intoke distilled water;,Tg group:intoke'distilled water,use pig Tg emulsified in Freund's complete adjuvant subcutaneous injection to immunization,0.10 mg Tg for each mouse at 8 weeks old,strengthened immunity at 11 and 15 weeks old (0.05 mg Tg for each mouse,and emulsified by Freund's incomplete adjuvant); iodine excess (HI) group:intoke 0.05％ NaI water; iodine excess combined with Tg (HI + Tg) group:intoke 0.05％ NaI water,Tg immunization method was same to Tg group; all mice were raised in specific pathogen free (SPF) environment.All mice were executed at 16 weeks old,and removed the thyroid tissue.Morphologic change in thyroid was observed by HE staining.Immunofluorescence (IF) staining was used to observe CD3,CD22,CCL21 and CCR7 expression in thyroid.Real-time PCR was used to detect CCL21 mRNA expression in thyroid.Results The morphologic change of thyroid was observed under the light microscope,in HI group,thyroid follicle distended,colloid accumulation,lymphocytes accumulate together and disorganization was seen; Tg group thyroid had scatted lymphocytes; HI + Tg group enhanced inflammation response and disorganization.IF staining showed that lymphocytes infiltrated in thyroid were almost CD3+ T cells,only few scatted CD22+ B cells; CCL21 and CCR7 were negative in control group,CCR7 positive cells were scatted in Tg group but no CCL21 expression,in HI and HI + Tg groups,we could see CCL21 strong positive expression in inflammation area and also had CCR7 positive cells there.CCL21 mRNA relative expression in thyroid:Tg group (3.20 ± 0.18),HI group (1.72 ± 0.31),and HI ± Tg group (9.94 ± 0.32) increased compared to control group (1.00 ± 0.17,all P ＜ 0.01).Conclusion CCL21 and its receptor CCR7 have improved lymphocytic infiltration in autoimmune thyroiditis

Clinical analysis of 21 cases with primary bronchial carcinoid tumors / 中国综合临床

Objective To investigate the clinical pathologic features and treatment scheme of primary bronchial carcinoid tumor.Methods Twenty-one cases with primary bronchial carcinoid tumors were selected as our subjects.Clinical information was recorded.Of 21 patients,17 cases were undergone surgery including 12 cases for lobectomy,2 cases for pneumonectomyin,1 case for pulmonary wedge resection and 1 case for egmental resection;Three cases were received adjuvant chemotherapy,1 case for adjuvant and radiation therapy and chemotherapy and 1 case for chemotherapy only.Results Histological classification showed that 7 cases were typical carcinoid,and other 14 cases were atypical carcinoid.Nine cases were TNM stage I,8 cases at stage Ⅱ,1 case at stage Ⅲ,3 cases at stage Ⅳ.All cases were performed follow-up for 5 years.Nineteen cases survived at 1st year and 10 cases survived at 3rd years survival.5 years survival rate was 23.8％ (5/21).Conclusion Surgical operation is proved to be the main method for treating bronchopulmonary carcinoid tumors,and surgical radical operation was recommended.

Resection of the fourth ventricle tumors through lateral wall type of the cerebellomedullary fissure approach under endoscope / 中华显微外科杂志

Objective To investigate the therapeutic effect of the fourth ventricle tumors through lateral wall type of the transcerebellomedullary fissure approach under endoscope.Methods Clinical data of 14 cases with the fourth ventricle lesions were analyzed retrospectively.All the patients were treated by lateral wall type of the transcerebellomedullary fissure approach surgery.The endoscope was used if the lesions develop to the aqueduct and hard to be exposed.Both neurophysiological monitoring and intraoperative ultrasound were used regularly.Results Tumors were totally removed in 12 cases,subtotally in 1,and partially in 1.All the patients were diagnosed in postoperative histopathology,including 4 medulloblastoma,three epidermoid cyst,two ependymoma,two hemangioblastoma,one meningioma,one cavernous hemangioma and 1 astrocytoma.Hypopnea occurred immediate after operation in 1 patient.Ventilatory support was performed by Ventilator,and the respiration was restored 1 day later.Normal cerebrospinal fluid circulation was return in all cases.Neither aggravation of preoperative symptoms nor nuclei injury related complication had been found.The follow-up interval between 3 months to 28 months,one patient was dead with unexplained,and 1 medulloblastoma patient was relapse.Conclusion Lateral wall type of the transeerebellomedullary fissure approach,under endoscope,combined with the usage of neurophysiological monitoring and intraoperative ultrasound,can degrade the surgical related complications such as facial palsy and amblyacousia.

Poly (I:C) promotes iodine excess-induced chronic lymphocytic thyroiditis in NOD mouse / 中国病理生理杂志

AIM: To investigate the effects of poly (I:C) as virus mimics on iodine excess-induced chronic lymphocytic thyroiditis in NOD mouse. METHODS: Female, 32 NOD mice were randomly divided into 4 groups: (1) control;(2) high iodine;(3) poly (I:C);(4) high iodine+poly (I:C). Nine weeks after administration, mice were sacrificed. The following parameters were determined: body weight, thyroid weight and anatomic form. Thyroid hormone (T_4) in serum was measured by radioimmunoassay, the thyroid morphology was observed through HE staining, apoptosis was detected by TUNEL, the mRNA expression levels of TRAIL, TRAIL-sR1, ICAM-1 and CXCL10 were determined by the method of real time RT-PCR. RESULTS: Compared to control group and poly (I:C) group, the thyroid absolute weight and relative weight in high iodine group were increased (P<0.01), the level of total T_4 in serum was decreased (P<0.05), inflammation and apoptosis were obviously observed, the mRNA expressions of TRAIL, TRAIL-sR1, CXCL10 and ICAM-1 were upregulated (P<0.05). Compared to high iodine group, thyroid absolute weight and relative weight in high iodine+poly (I:C) group were further increased, the level of total T_4 in serum was further decreased (P<0.05), the ratio of inflammatory degree Ⅳ increased to 50.0%, the numbers of apoptosis cells were further enhanced, the mRNA expressions of TRAIL, TRAIL-sR1, ICAM-1 and CXCL10 were further upregulated (P<0.05). Otherwise, the tendency of all parameters in poly (I:C) group was similar to that in control group (P>0.05). CONCLUSION: Poly (I:C) aggravates chronic lymphocytic thyroiditis induced by excess of iodine associated with increase in infiltration of lymphocytes and induction of apoptosis.

DeBakey Ⅲ dissecting aneurysm treated by way of aortic isolation / 中国综合临床

Objective To study the technical skill and therapeutic effect of aortic isolation for treating DeBakey Ⅲ dissecting aneurysm.Methods Among 20 cases of DeBakey Ⅲ dissecting aneurysm,7 cases were with DeBakey Ⅲ a and 13 cases were with DeBakey Ⅲb.Imaging examinatin showed that among the 20 cases there were 5 cases with more than two tearings at difreret site.Covered stent was used to close left subclavian artery in 7 cases and distaI aortic isolation of left subclavian artery was conducted in other 13 cases.Restuls All cases were followed up for 3-40 months,finding that 19 cases survived but one case died because of pseudocoele bronchial fistula hemoptysis 18 months later.Conclusions Endovasular covered stent grafts is the simple,safe and effective way to treat dissecting aneurysm.

Poly(I:C) promotes iodine excess-induced chronic lymphocytic thyroiditis in NOD mouse / 中国病理生理杂志

AIM:To investigate the effects of poly (I:C) as virus mimics on iodine excess-induced chronic lymphocytic thyroiditis in NOD mouse. METHODS:Female,32 NOD mice were randomly divided into 4 groups:(1) control; (2) high iodine; (3) poly (I:C); (4) high iodine+poly (I:C). Nine weeks after administration,mice were sacrificed. The following parameters were determined:body weight,thyroid weight and anatomic form. Thyroid hormone (T4) in serum was measured by radioimmunoassay,the thyroid morphology was observed through HE staining,apoptosis was detected by TUNEL,the mRNA expression levels of TRAIL,TRAIL-sR1,ICAM-1 and CXCL10 were determined by the method of real time RT-PCR. RESULTS:Compared to control group and poly (I:C) group,the thyroid absolute weight and relative weight in high iodine group were increased (P0.05). CONCLUSION:Poly (I:C) aggravates chronic lymphocytic thyroiditis induced by excess of iodine associated with increase in infiltration of lymphocytes and induction of apoptosis.