Clinical efficacy evaluation of accelerated epithelium-off corneal collagen cross-linking on corneal ectasia after keratorefractive surgery / 中华实验眼科杂志

Objective:To investigate the efficacy and safety of accelerated epithelium-off corneal collagen cross-linking (CXL) in the treatment of corneal ectasia after keratorefractive surgery.Methods:An observational case series study was performed.Twelve patients (22 eyes) diagnosed with corneal ectasia after keratorefractive surgery in the First Affiliated Hospital of Army Medical University were enrolled from January 2016 to December 2018.All the patients received accelerated epithelium-off CXL and were followed up for 12 months.Before and 1 week, 1, 3, 6, and 12 months after the operation, the uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA) converted to the logarithm of the minimum angle of resolution (LogMAR) unit were measured.The sphericity, cylindricity, and spherical equivalent were examined by Topcon auto refractor.The maximum keratometry (Kmax) of the front surface, mean keratometry (Km) of the front surface, Km of the back surface, symmetry index of front surface (SIf), symmetry index of back surface (SIb), thinnest corneal thickness (TCT), total aberrations, total high-order aberrations, coma aberration, trefoil aberration and spherical aberration were detected by the Sirius analyzer.The depth of corneal demarcation lines was determined by optical coherence tomography.The intraocular pressure was measured by the non-contact tonometry.The corneal endothelial cell density was assayed by the endothelial cell densitometry.The inflammatory reaction and haze were observed with a slit lamp at different time points after surgery.This study adhered to the Declaration of Helsinki.The study protocol was approved by the First Affiliated Hospital of Army Medical University (No.KY2020063). Written informed consent was obtained from each patient before entering the cohort.Results:Among the 22 eyes of 12 cases, 3 eyes of 2 cases (13.64%) underwent small incision lenticule extraction, and 19 eyes of 10 cases (86.36%) underwent excimer laser in situ keratomileusis.The UCVA (LogMAR), BCVA (LogMAR), cylindricity and spherical equivalent before the operation were 0.61±0.42, 0.24±0.23, (-2.83±2.39)D, (-3.60±2.66)D, which were significantly worse than 0.45±0.31, 0.12±0.15, (-2.11±1.67)D, (-3.12±2.31)D at 12 months after the operation ( t=4.054, 4.956, -3.728, -2.742; all at P<0.05). The front surface Kmax, front surface Km and SIf at 12 months after the operation were (48.37±5.80), (41.49±3.04), (5.36±4.07)D, which were significantly lower than (49.61±5.97), (41.66±2.97), (5.85±4.18)D before the operation ( t=5.949, 2.278, 2.719; all at P<0.05). There was no significant difference in sphericity, Km of the back surface, SIb, TCT, total aberrations, total high-order aberrations, coma aberration, trefoil aberration, spherical aberration, intraocular pressure and endothelial cell density between before and 12 months after the operation (all at P>0.05). Grade 0.5-2 haze occurred in 8 eyes of 4 patients one month postoperatively.After administration of prednisolone acetate eye drops, haze decreased or disappeared 3 months postoperatively, with UCVA and BCVA unchanged.A corneal demarcation line with a depth of (285.40±51.61)μm was found in 11 eyes of 6 cases at 1 month after operation. Conclusions:Accelerated epithelium-off CXL can significantly improve visual acuity, reduce corneal astigmatism and corneal curvature, as well as effectively prevent the progress of corneal ectasia.

Architecture design and application practice of clinical intelligent application platform / 中华医院管理杂志

The application of big data and artificial intelligence technology in the medical field is key to hospital informatization. In October 2018, a tertiary hospital launched a clinical intelligent application platform. The platform took AI assistant as the carrier of intelligent application, supported the role expansion, function expansion and connotation expansion of intelligent application, and layed the foundation for the construction of clinical intelligence. As of July 2022, the platform had been embedded into the outpatient, emergency and inpatient business systems with the help of AI assistant, realizing such intelligent applications as auxiliary diagnosis, auxiliary treatment, risk warning, AI medical record quality control, research entry group and infectious disease management, as well as enriching the connotation of such specialty applications as orthopedics and ear, nose and throat. The platform satisfied the integration and integration of hospital information construction and provided convenient and effective intelligent auxiliary tools for clinical use.

Clinical characteristics and short-term prognosis of acute asthmatic attack in asthma patients with comorbid bronchiectasis / 中华健康管理学杂志

Objective:To analyze the clinical characteristics and short-term prognosis of patients with acute asthmatic attack and comorbid bronchiectasis.Methods:The data of patients hospitalized for acute asthmatic attack in the Department of Respiratory and Critical Care Medicine of Peking University Third Hospital from January 1, 2012 to December 31, 2021 were retrospectively collected and analyzed. According to whether or not co-existing with bronchiectasis, all the patients were divided into asthmatic with bronchiectasis group and asthmatic without bronchiectasis group. Then the general conditions, comorbidities, pulmonary function test, grades of asthma severity, laboratory examination and in-hospital short-term prognosis of two groups were analyzed.Results:A total of 580 hospitalized patients with acute asthma attack were included, of which 132 cases (22.76%) were classified into asthmatic with bronchiectasis group and 448 cases (77.24%) were classified into asthmatic without bronchiectasis group. Co-existing with obsolete pulmonary tuberculosis and anxiety/depression in asthmatic with bronchiectasis group were more common than that in asthmatic without bronchiectasis group (13.64% vs 5.36%; 7.58% vs 2.68%) (both P<0.05). The pre-bronchodilator forced vital capacity (FVC) and its percentage to the predicted value (FVC%pred), forced expiratory volume in 1 second (FEV 1) and its percentage to the predicted value (FEV 1%pred), FEV 1/FVC and post-bronchodilator FEV 1 in asthmatic with bronchiectasis group were lower than those in the asthmatic without bronchiectasis group [2.44 (1.90, 3.01) vs 2.69 (2.10, 3.68) L, 1.55 (1.13, 2.00) vs 1.78 (1.25, 2.52) L, 70.14% (67.39%, 85.92%) vs 79.63% (70.00%, 89.52%), 70.00% (54.38%, 78.11%) vs 70.00% (61.47%, 85.00%), 61.57% (56.29%, 73.03%) vs 66.67% (60.00%, 75.00%), 1.72 (1.21, 2.18) vs 1.89 (1.37, 2.55) L] (all P<0.05). In previous year, the proportion of patients receiving hospitalization due to acute asthmatic attack in asthmatic with bronchiectasis group was higher than that in asthmatic without bronchiectasis group (15.15% vs 8.93%) ( P<0.05). The peak months of hospitalization due to acute asthmatic attack in asthmatic with bronchiectasis group were April, July and October, and the peak months in asthmatic without bronchiectasis group were April and September. The length of hospital stay was longer and the proportion of patients receiving invasive ventilation was higher in asthmatic with bronchiectasis group than those in asthmatic without bronchiectasis group [10.06 (7.62, 13.94) vs 9.95 (7.15, 13.76) d; 5.30% vs 2.01%] (both P<0.05). The risk factors for invasive mechanical ventilation in asthmatic patients with acute attack during hospitalization were co-existing with bronchiectasis, smoking, high level of partial pressure of carbon dioxide in arterial blood, serum creatinine and creatine kinase. Conclusion:Asthma patients with comorbid bronchiectasis have more frequent acute attack, a longer hospitalization due to acute asthmatic attack and a higher probability of invasive ventilation during hospitalization.

Integrated metabolism and epigenetic modifications in the macrophages of mice in responses to cold stress / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

The negative effects of low temperature can readily induce a variety of diseases. We sought to understand the reasons why cold stress induces disease by studying the mechanisms of fine-tuning in macrophages following cold exposure. We found that cold stress triggers increased macrophage activation accompanied by metabolic reprogramming of aerobic glycolysis. The discovery, by genome-wide RNA sequencing, of defective mitochondria in mice macrophages following cold exposure indicated that mitochondrial defects may contribute to this process. In addition, changes in metabolism drive the differentiation of macrophages by affecting histone modifications. Finally, we showed that histone acetylation and lactylation are modulators of macrophage differentiation following cold exposure. Collectively, metabolism-related epigenetic modifications are essential for the differentiation of macrophages in cold-stressed mice, and the regulation of metabolism may be crucial for alleviating the harm induced by cold stress.

Study on health promotion lifestyle and influencing factors in middle-aged and elderly patients with knee osteoarthritis / 中国实用护理杂志

Objective:To understand the status of health-promoting lifestyle of middle-aged and elderly patients with knee osteoarthritis, and to comprehensively analyze the influencing factors based on the biological-psychological-social medicine model, to explore controllable factors.Methods:Using convenient sampling method, 177 middle-aged and elderly patients with knee osteoarthritis who were hospitalized in First Affiliated Hospital of Shandong First Medical University (Shandong Provincial Qianfoshan Hospital) from July 2020 to November 2020 were selected for questionnaire survey. The Health Promotion Lifestyle Profile Ⅱ (HPLP-Ⅱ) was used to evaluate their health promotion lifestyle status, the influencing factors were measured by general data sheet, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), disease recognition questionnaire for knee osteoarthritis patients, Social Support Rating Scale (SSRS), Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD) and Self-efficacy for Managing Chronic Disease (CDSES), respectively.Results:The total score of HPLP-Ⅱ, the total score of WOMAC, the score of disease recognition questionnaire, the total score of SSRS, the score of HAMA, HAMD, CDSES were (117.52 ± 15.58), (105.63 ± 31.64), (14.21 ± 3.23), (38.60 ± 5.18), (7.76 ± 4.41), (6.01 ± 4.54), (33.77 ± 6.04) points for middle-aged and elderly patients with knee osteoarthritis. The results of multiple linear regression analysis showed that the influencing factors were disease cognition, per capita monthly income, imaging grade, self-efficacy, support utilization, objective support, a total of 71.9% variation of regression equation could be explained.Conclusions:Middle-aged and elderly knee osteoarthritis patients health promotion lifestyle score at a low level, to improve, affected by disease cognition, imaging grading, self-efficacy, social support, medical staff should combine the degree of disease and individualized factors for disease health education, improve patients′ self-efficacy and social support level, prompting patients to adopt a healthy lifestyle.

Sedentary Time and Fast-Food Consumption Associated With Weight Gain During COVID-19 Lockdown in Children and Adolescents With Overweight or Obesity

Background@#The coronavirus disease pandemic is predicted to have adverse health effects on children and adolescents who are overweight or obese due to restricted school activity and stay-at-home orders. The purpose of this observational study was to determine the factors associated with weight gain in children and adolescents with overweight and obesity during coronavirus disease 2019 (COVID-19) lockdown. @*Methods@#Ninety-seven participants (sex- and age-specific body mass index (BMI) ≥ 85th percentile) were included. A baseline examination was conducted pre-COVID-19 (August 2019 to January 2020), and re-examination was performed post-lockdown (June to September 2020) and the results were compared. Correlation and regression analyses were conducted to investigate the association among changes in cardiometabolic markers and lifestyle behaviors with changes in BMI z-score. @*Results@#During the COVID-19 pandemic, an increase in BMI z-score (2.56 [2.01–2.94] to 2.62 [2.03–3.18]) was noticed in children and adolescents with obesity. Changes in cardiometabolic markers including liver enzymes, triglycerides (r = 0.398), leptin (r = 0.578), and adiponectin (r = −0.326), as well as muscular strength (r = −0.212), were correlated with the increase in BMI z-score. According to a multivariate regression analysis, changes in sedentary time (B = 0.016; 95% confidence interval [CI], 0.001–0.032) and fast-food consumption (B = 0.067; 95% CI, 0.013–0.122) were the lifestyle variables associated with BMI z-score increase. @*Conclusion@#Changes in lifestyle behaviors including fast-food consumption and sedentary time during the COVID-19 pandemic may be associated with weight gain. In order to prevent health-related risks in children and adolescents with obesity during the pandemic, it is important to maintain the level of physical activity and healthy dietary habits.

Effect of lathyrol derivatives on non-small cell lung cancer and the possible mechanism / 中南大学学报(医学版)

OBJECTIVES@#Non-small cell lung cancer (NSCLC) accounts for 85% of all lung cancer, with highmorbidity and mortality rate. Nove drug development for NSCLC is urgently needed.This study aims to investigate the activity of lathyrol derivatives and the mechanism for its inhibitory effect on the growth of NSCLC cells.@*METHODS@#Three lathyrol derivatives were synthesized from lathyrol and their structures were verified by nuclear magnetic resonance. MTT assay was used to detect the effects of the lathyrol derivatives on the proliferation activity of NSCLC cells (A549 and H1299 cells), and the compound with the best activity was selected for subsequent experiments. Colony forming assay, wound-healing assay, and transwell assay were applied to detect in vitro cell proliferation, migration and invasion ability in A549 and H1299 cells, respectively. Quantitative real-time RT-PCR and Western blotting were performed to detect mRNA and protein levels of E-cadherin, N-cadherin, β-catenin, and MMP2 in A549 cells, respectively.@*RESULTS@#Three lathyrol derivatives inhibited the growth of A549 and H1299 cells in a dose-dependent manner, and they showed a weak inhibitory effect on normal cells Beas-2B and 16HBE, indicating that they possessed certain selective toxic effects. Therefore, C-5 benzoylated lathyrol with the best activity was selected as the ideal drug for the subsequent experiments. Compared with the control group, the number and size of cell clusters in the treatment group of A549 and H1299 cells were significantly decreased, the relative mobility were significantly decreased, and the number of invaded cells were significantly decreased (all P<0.05), indicating that the in vitro cell proliferation, migration and invasion ability were decreased. The mRNA levels of integrin α2, integrin β1, MMP2, MMP9, β-catenin, and N-cadherin were decreased, while the expression of E-cadherin was increased (all P<0.05). The protein levels of N-cadherin, β-catenin, MMP2, and integrin αV were decreased, while the expression of E-cadherin was increased (all P<0.05).@*CONCLUSIONS@#The lathyrol derivatives synthesized in this study possess good inhibitory activity against NSCLC. Among them, C-5 benzoylated lathyrol significantly inhibits the proliferation, migration, and invasion ability of NSCLC cells in vitro through regulating the process of epithelial-mesenchymal transition.

Development of a practical innovation course for biological engineering major under the background of Engineering Education Certification / 生物工程学报

According to the teaching philosophy of the outcome-based education, this study elaborates the development of a practical innovation course for biological engineering major after five runs of teaching practice and continuous improvement. It mainly includes the methods for selection of teaching subjects, implementation of teaching process, process assessment, evaluation and improvement. Based on the performance and achievements of three grades of students majored in bioengineering, we found that the logic and methods of the practical innovation course could greatly stimulate the motivation of students for learning, as well as their scores. Therefore, the logic and methods described in this study may serve as a reference for the reforms of practical training courses of engineering major under the background of Engineering Education Certification.

Construction of the curriculum for developing the ability to solving complex engineering problems in the field of biotechnology industry / 生物工程学报

Accurately understanding the features and connotations of complex engineering problems is an important prerequisite for setting graduation requirements, constructing curriculum and designing teaching contents. By discussing the characteristics of complex engineering problems in the biological industry, this paper explored the demands for undergraduates in Yangtze river delta region, summarized the typical jobs and their requirements, and expounded the connotation of complex engineering problems contained in various typical tasks. On this basis, a gradual curriculum system was constructed, which included multiple stages of conceiving, formation and application, to cultivate the ability to solve complex engineering problems in the major of bioengineering. The curriculum coordinated the implementation of deep integration of industry and education, research feed back course construction, course team and advanced courses building up, professional associations covered all crews and students, supporting the ability training of solving complex engineering problems.

Effects of different types of exercise on type 2 diabetes risk in patients with pre-diabetes: One 2-year prospective randomized controlled study / 中华内分泌代谢杂志

Objective:To evaluate the impacts of resistance training(RT)and aerobic training(AT)for 24 months on the risk of type 2 diabetes in patients with pre-diabetes.Methods:Two hundred forty-eight pre-diabetic patients were enrolled in this multi-center randomized controlled trial. All patients were randomly divided into 3 groups: RT( n=82), AT( n=83), and control( n=83)groups. The participants in RT and AT groups undertook moderate RT or AT 3 times a week(150 minutes/week)under supervision in 3 research centers for 24 months. Elastic bands were used in each session of RT, with intensity of 60% 1RM(maximum weight that muscle can lift at once). Patients in AT group performed aerobic dance at 60%-70% of maximum heart rate. Assessments for each subject were made at baseline and by the end of 6, 12 and 24 months. Primary outcomes were changes in the risk of type 2 diabetes. Secondary outcomes included changes in blood glucose, blood lipids, and blood pressure. Results:There were 217, 206, and 173 subjects who completed the follow-up of 6, 12, and 24 months, respectively. The mean ages of RT, AT, and control groups at baseline were(59.91±5.92), (60.93±5.71), and(60.73±5.83)years. Compared to control group, both RT and AT groups revealed a significant reduction in HbA 1C( P<0.05), and a significant increase in homeostasis model assessment for β-cell function index(HOMA2-β, P<0.01)by the end of 12 and 24 months. Adjusted for age, gender, statin use, lipid profile, blood pressure, and body mass index, COX regression analysis showed that RT and AT reduced the risk of type 2 diabetes by 55.6%( P=0.012)and 59.8%( P=0.010). Conclusions:This study demonstrates that 24-month moderate RT and AT have comparable effects on reducing insulin resistance, improving β-cell function, blood glucose and lipid, and reducing the risk of type 2 diabetes.

Effect of 2-year resistance exercises on cardiovascular disease risk in prediabetes patients / 中华内科杂志

Objective:To investigate the effect of a 2-year resistance and aerobic training on reducing the risk of cardiovascular disease in patients with prediabetes.Methods:A total of 248 patients with prediabetes were enrolled from Chinese and Western Medicine Hospital Affiliated to Nanjing University of Chinese Medicine from January to April 2014, and Danyang People′s Hospital and The First Affiliated Hospital of Guangxi Medical University from May to December 2014.Based on random number table method, the patients were divided into 3 groups: the resistance training group (RT group, 82 cases), the aerobic training group (AT group, 83 cases) and control group (83 cases). Participants in the RT group and the AT group underwent a total of 24 months of exercise training. Changes in indicators (blood glucose,blood lipid, etc.) at baseline and the end of 12 and 24 months among the groups were compared.Results:After intervention, glycosylated hemoglobin (HbA1c), low density lipoprotein cholesterol (LDL-C), blood pressure and homeostasis model 2 insulin resistance index (HOMA2-IR) in the RT and AT groups tended to decrease, and the steady state model 2 β cell function index (HOMA2-β) tended to increase. At the end of 24 months, HbA1c [5.80 (5.43, 6.20) %, 5.70 (5.50, 6.00)% vs. 6.20 (5.70, 6.60) %, all P≤ 0.01], LDL-C [3.07 (2.69, 3.58) mmol/L, 2.97 (2.62, 3.95) mmol/L vs. 3.21(2.54, 3.78) mmol/L, all P<0.05] and HOMA2-IR [0.96 (0.82, 1.47), 1.20 (0.99, 1.43) vs. 1.34 (1.09, 1.51), all P<0.05] were significantly decreased in the RT and AT groups than in the control group. In addition, HOMA2-β [84.50 (60.55, 107.33), 93.00 (78.60, 119.75) vs. 53.40 (37.70, 80.40), all P = 0.001] was significantly increased in the AT and RT groups compared with that in the control group. There were no significant differences in triglyceride (TG) and high-density lipoproteincholesterol (HDL-C) levels between the training groups and the control group (all P>0.05). After adjusting for age, sex and blood pressure, the cardiovascular risk of prediabetes was significantly reduced in RT ( P =0.017) and AT groups ( P =0.018). The Cox regression analyses showed that both the resistance training (HR=0.419, 95 %CI =0.415-0.942, P=0.037) and the aerobic training ( HR=0.310, 95 %CI=0.447-0.866, P=0.026) were protective factors for cardiovascular disease in prediabetic patients after adjustment of age, sex, statins, body mass index and waist-to-hip ratio, which reduced the risks of cardiovascular disease in prediabetic patients by 58.1% and 69.0%, respectively. Conclusions:Two years of aerobic and resistance training interventions have obvious advantages on glycemic and insulin resistance control in prediabetes patients. The resistance training can reduce the risk of cardiovascular disease, and it is, thus, recommended for prediabetic patients without obvious exercise contraindications.

Pollution， human exposure and harmful effects of neonicotinoid pesticides / 上海预防医学

Neonicotinoid is a kind of neuroactive pesticide， and it has become the most widely used pesticide in the world. In recent years， neonicotinoid has been detected in the environment and food， suggesting that human can be exposed to this kind of pesticide through drinking water， ingestion and respiration， which poses potential health hazards to human. However， there is no comprehensive report on the pollution level of neonicotinoid pesticides in the environment and food and the impact on human health. In this paper， the pollution status， population exposure level and potential health risks of neonicotinoid pesticides in water， air and food were reviewed. We found that neonicotinoid residues are widespread in fruits and vegetables， of which imidacloprid has the highest detection rate. Except for a few samples with excessive neonicotinoid detection， the detection level in most samples did not exceed national food safety standards. A variety of neonicotinoid pesticides have been detected in the air， surface water， tap water and drinking water. External exposure studies in the population have shown that ingestion is the main route of exposure to neonicotinoid， and the external exposure level is much lower than its chronic reference dose. The internal exposure study mainly detected the concentration of neonicotinoid pesticides and their metabolites in urine. A variety of neonicotinoid pesticides and their metabolites are detected in urine， and the concentration range is ng/ml level. Internal exposure studies found that the detection rate of thiamethoxam and dinotefuran in urine is higher， and the detection rate of neonicotinoid in Asian countries is higher than that in European and American countries. Occupational exposure studies found that neonicotinoid exposure levels increased after pesticide spraying， and the exposure levels in rural areas where pesticides were commonly used were higher than those in neighboring urban areas. Animal experiments have found that neonicotinoid pesticides have reproductive toxicity， genetic toxicity， neurotoxicity， immunotoxicity， liver toxicity and nephrotoxicity to non-target organisms. Cell experiments suggest that neonicotinoid is an endocrine disruptor. The symptoms of acute exposure in humans are related to the exposure dose， route and physical condition of the exposed person， which ranges from mild symptoms （nausea， vomiting， headache and diarrhea） to death. Population epidemiological studies have shown that chronic exposure to neonicotinoid pesticides is associated with adverse health effects in humans such as neonatal tetralogy of Fallot， anencephaly， and adverse mental symptoms.

Emodin Inhibits Lipopolysaccharide-Induced Inflammation by Activating Autophagy in RAW 264.7 Cells / 中国结合医学杂志

OBJECTIVE@#To investigate the effects of emodin on inflammation and autophagy in lipopolysaccharide (LPS)-induced RAW 264.7 macrophages and reveal its underlying mechanism.@*METHODS@#3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium (MTS) assay was conducted to find the appropriate dose for emodin. RAW264.7 cells pretreated with different concentrations (0-50 μmol/L) of emodin or vehicle for 2 h prior to exposure to LPS for 16 h. Cell morphology was examined and propidium iodide staining was used to examine cell cycle. Expressions of inflammation-related proteins [nuclear factor-kappaB (NF-κ B) and I-kappaB (I κ B)α] and autophagy-related proteins [light chain (LC)3, P62/sequestosome 1, mammalian target of rapamycin (mTOR), and p-mTOR] were examined using Western blot analysis. Expression of inflammation-related cytokines including tumor necrosis factor (TNF)-α, interleukin (IL)-1β and IL-6 were detected by enzyme-linked immunosorbent assay. Autophagy was examined with LC3B fluorescence intensity and aggregation. The effect of emodin on autophagy was conducted with an autophagy inhibitor, 3-methyladenine (3-MA).@*RESULTS@#The expression of NF-κ B in LPS-induced cells was significantly increased (P<0.01) and simultaneously I κ B α decreased compared with the normal cell (P<0.05). The expressions of TNF-α, IL-β, and IL-6 proteins in the LPS-induced RAW264.7 cells were significantly higher than in the normal cell (P<0.05 or P<0.01). LPS increased the percentage of cells in the G@*CONCLUSION@#Emodin could inhibit inflammation of mice RAW264.7 macrophages induced by LPS, possibly through activating autophagy.

Construction and practice of paperless management in medical records automatic archiving / 中华医院管理杂志

As medical record management is key to hospital management, a hospital introduced paperless practice of automatic archiving in the following practices. Clarification and identification of the scope of business system transformation, establishment of an architecture integrating various business systems, integration platform, hospital data center, archiving system and certification authority, creation of three automatic archiving processes: initial archiving, late return archiving and modification archiving, for refined management of the review and tracking of archived medical records. Thanks to this paperless management, the automatic archiving rate was as high as 95.95%for medical records, 96.47%for laboratory reports and 99.58%for medical orders respectively. A full-process and whole-cycle informationized closed loop management was achieved for the collection, archiving, review and utilization of medical records, substantially upgrading hospital informationization and medical record management.

Design and practice of fine management of single-disease data based on data center / 中华医院管理杂志

Single-disease management is an important means of medical quality management, and data is the basis of single-disease management. Aiming at the problem of difficult data collection of single disease in hospital, the authors designed a solution to realize the fine management of single-disease data based on data center. The hospital optimized the data quality through overall management, unified the data collection source based on the data center, built a single-disease intelligent collection platform to complete the data collection, and calibrated the data to ensure its accuracy, so as to form a single-disease index management process and realize high-quality data collection. The average actual backfill rate was as high as 95.7%. On this basis, the hospital optimized the single-disease reporting and quality control management mode to further promote the fine management of medical quality.

The cellular immunotherapy of integrated photothermal anti-oxidation Pd-Se nanoparticles in inhibition of the macrophage inflammatory response in rheumatoid arthritis

Reducing the inflammatory response is a major goal in the therapy of rheumatoid arthritis (RA). Herein, we integrated palladium nanoparticles (Pd NPs) with selenium nanoparticles (Se NPs) and obtained a multiple nanosystem (Pd@Se-HA NPs) that could simultaneously scavenge hydroxyl radicals (⋅OH) and provide a photothermal effect. The Pd@Se-HA NPs were constructed by a simple self-assembly method in which Se NPs were electrostatically bonded to Pd NPs; hyaluronic acid (HA) was linked to the NPs by ester bonding to provide macrophage targeting ability. The experiments show that the combined therapy of eliminating ⋅OH with Se NPs and utilizing PTT with Pd NPs could effectively reduce the inflammatory response in macrophages more effectively than either individual NP treatment. In addition, the outer layer of HA could specifically target the CD44 receptor to enhance the accumulation of Pd@Se NPs at the lesion, further enhancing the therapeutic effect. After treatment for 15 days, the Pd@Se-HA NPs nearly eliminated the inflammatory response in the joints of mice in an induced RA model, and prevented joint damage and degradation.

Automatic segmentation of kidney tumor based on cascaded multiscale convolutional neural networks / 生物医学工程学杂志

The background of abdominal computed tomography (CT) images is complex, and kidney tumors have different shapes, sizes and unclear edges. Consequently, the segmentation methods applying to the whole CT images are often unable to effectively segment the kidney tumors. To solve these problems, this paper proposes a multi-scale network based on cascaded 3D U-Net and DeepLabV3+ for kidney tumor segmentation, which uses atrous convolution feature pyramid to adaptively control receptive field. Through the fusion of high-level and low-level features, the segmented edges of large tumors and the segmentation accuracies of small tumors are effectively improved. A total of 210 CT data published by Kits2019 were used for five-fold cross validation, and 30 CT volume data collected from Suzhou Science and Technology Town Hospital were independently tested by trained segmentation models. The results of five-fold cross validation experiments showed that the Dice coefficient, sensitivity and precision were 0.796 2 ± 0.274 1, 0.824 5 ± 0.276 3, and 0.805 1 ± 0.284 0, respectively. On the external test set, the Dice coefficient, sensitivity and precision were 0.817 2 ± 0.110 0, 0.829 6 ± 0.150 7, and 0.831 8 ± 0.116 8, respectively. The results show a great improvement in the segmentation accuracy compared with other semantic segmentation methods.

Clinical application of self-made minimally invasive hood-assisted transforaminal lumbar interbody fusion via modified bilateral Wiltse approach in the treatment of lumbar degenerative diseases / 中国骨伤

OBJECTIVE@#To explore the advantages of self made minimally invasive hook assisted transforaminal lumbar interbody fusion (TLIF) via modified bilateral Wiltse approach in the treatment of lumbar degenerative diseases.@*METHODS@#The clinical data of 140 patients underwent lumbar spine fusion surgery from October 2016 to October 2017 were retrospectively analyzed. Among them, 72 cases were treated by self-made minimally invasive hook-assisted TLIF via modified bilateral Wiltse approach (group A), there were 37 males and 35 females, aged (48±16) years old;68 cases were treated by TLIF via traditional posterior median approach (group B ), there were 38 males and 30 females, aged (45±15) years old. The surgical incision size, operation time, intraoperative blood loss volume, postoperative drainage volume, postoperative wound healing, and intervertebral fusion rate at the final follow-up were recorded between two groups. Visual analogue scale (VAS) and Oswestry Disability Index (ODI) were used to assess the clinical efficacy.@*RESULTS@#All the patients were followed up for 3 to 13 (8±5) months. The wound in group A healed well after operation, and 1 case in group B occurred wound necrosis after operation, and healed after debridement and suture. There were no significant differences in operation time and postoperative fusion rate between two surgical methods (@*CONCLUSION@#The self made minimally invasive hook assistedTLIF via modified bilateral Wiltse approach has the characteristics of minimally invasive, less intraoperative blood loss, less postoperative drainage, fewer complications, and more stable fusion in the treatment of lumbar degenerative desease.

Finite element analysis of different fixation methods for mandibular defects reconstructing with fibula flaps / 中国组织工程研究

BACKGROUND: Segmental defect of mandible is often caused by tumor, trauma and other reasons. Simultaneous mandibular defect by vascularized fibular flap is the most important repair method at present. It is not only useful for the reconstruction with titanium plates, but also useful for small titanium plates for fixation. Clinical retrospective studies have shown that there is no significant difference in postoperative complication rate between patients with the two fixation methods, but relevant biomechanics studies are still lacking at present. OBJECTIVE: The three-dimensional finite element analysis was used to analyze the stress distribution and stability on mandibular segmental defects simulated fibular flaps grafted with reconstruction plates and miniplates fixation. METHODS: A healthy adult male with complete dentition was selected for CT scan and data were input into the computer to reconstruct the mandible and dentition model. Three types of 3D models were built for mandibular defects dependent on Jewer’s classification, including models H (loss of lateral mandible, mandibular angle, ascending branch of mandible, and condyles), L (loss of unilateral mandible) and C (loss of bilateral mandible chin). Mechanical distribution features and stability of fixation with reconstruction plates and miniplates were comparatively studied after fibular repair of mandibular segmental defects. RESULTS AND CONCLUSION: (1) The stress graphs showed that stress was mostly higher in surrounding areas of normal mandibles such as condyle, condylar neck, mandibular angle, molar and titanium screws. In particular, the stress was highest near mandibular angles. (2) For type-H defect, the great stress was generated near the mandibular angles when mandible was reconstructed with reconstruction plate, and the stress value was 185 MPa. The stress values approximately ranged from 117 to 135 MPa on type-H and type-L defects with miniplates. The maximum stress of fibula block was less than 30.4 MPa, and the maximum stress of titanium nail was 56.2 MPa. (3) The relative displacements approximately varied between 15 µm and 18 µm on the fracture sides after repair with type-H and type-L defects with miniplates and reconstruction plates. Almost no relative displacement was generated on the fracture sides after type-C mandibular defects. (4) Both titanium reconstruction plates and titanium miniplates could meet biomechanical requirements for fibular repair of H, C, and L defects.

Research progress of the mechanism of rituximab in the treatment of focal segmental glomerulosclerosis / 上海交通大学学报（医学版）

Rituximab (RTX), as a monoclonal antibody of CD20 acting on B cell epitopes, has been applied to the field of kidney since 2005, and has become a research hotspot in the clinical treatment of glomerulonephritis. At present, in addition to its clinical safety and efficacy, some researchers are still committed to explore the mechanism of RTX in the treatment of renal diseases, trying to find out whether there is a specific target in renal tissue. In this paper, the mechanism of RTX in the treatment of focal segmental glomerulosclerosis is reviewed.