High fidelity human patient simulator has become more and more important in clinical medical practice education.Medical circle has more and more realized that non-technical skill (NTS) is closely associated with the improvement of medical quality.This paper attempted to carry out a preliminary discussion on theory and practice of applying NTS in simulation training of critical care medicine based on their own teaching experiences.

Objective To explore the curative effect and safety of CTLA-4Ig transgene for experimental autoimmune encephalomyelitis (EAE). Methods The adenovirus loaded CTLA-4Ig was injected into Wistar rat EAE models through the lateral cerebral ventricle. The clinical symptomatic and electrophysiological changes were observed to judge the efficiency of CTLA-4Ig. Results After injection of AdCTLA-4Ig into the lateral cerebral ventricle of Wistar rat EAE models, the time of EAE onset was delayed and the incidence rate was significantly reduced. And the transductive function tested by brain-stem auditory evoked potential (BAEP) and somatosensory evoked potential (SEP) was obviously improved. Conclusion CTLA-4Ig is effective in managing EAE.

Objective To investigate the mid-term effect of SolitaireAB stent-assisted interventional embolization with spring coils for the treatment of intracranial wide-necked aneurysms. Methods During the period from May 2009 to April 2013, a total of 49 patients with intracranial wide-necked aneurysm (49 aneurysms in total) received SolitaireAB stent-assisted interventional embolization treatment at authors’ hospital. In 41 patients, a total of 41 aneurysms were detected, of which ruptured aneurysm with bleeding was confirmed in 26 and un-ruptured aneurysm in 15. These 41 patients were followed up for 12-48 months. Based on modified Rankin scoring and DSA, CTA or MRA manifestations, the clinical results were evaluated. Results After the embolization treatment, re-bleeding of the aneurysm occurred in 2 cases, cerebral infarction in 3 cases, occlusion of the parent artery in one case and death in one case; the occurrence rate of complications was 14.2%. DSA, MRA or CTA performed at 12 months after the embolization treatment, showed that 32 aneurysms (78.0%) were completely obstructed, which was obviously higher than that observed on DSA performed immediately after the embolization procedure (21 aneurysms, 42.9%), the difference was statistically significant (P=0.02);residue of aneurismal neck was seen in 7 cases (17.1%) and partial occlusion in 2 cases (4.9%), which were much better than those observed on DSA that was performed immediately after the embolization procedure. Twenty-four aneurysms (58.5%) remained stable, showing no any change, and recurrence of aneurysm was observed in 4 cases (9.7%). At the last follow-up exam, the modified Rankin scoring showed that 0 point was seen in 18 cases (43.9%), one point in 10 cases (24.4%), 2 points in 5 cases (12.2%), 3 points in 4 cases (9.8%), 4 points in 2 cases (4.85%) and 5 points in 2 cases (4.85%). The self-care rate for daily activities was 80.5%, the prognosis was good. Conclusion For the treatment of intracranial wide-necked aneurysms, SolitaireAB stent-assisted interventional embolization with spring coils is safe and effective. This technique can improve the embolization rate and reduce the procedure-related complications.

Objective To investigate the feasibility of immediate breast reconstruction by implanting silicone prosthesis wrapped by ectopectoralis after nipple-sparing mastectomy in early stage breast cancer.Methods From Jan.2006 to Nov.2009,28 breast cancer patients underwent immediate breast reconstruction by implanting silicone prosthesis wrapped by ectopectoralis after nipple-sparing mastectomy.Results Among the 28 patients,27 were satisfied with the apperance of their breast after operation.Conclusions Immediate breast reconstruction by implanting silicone prosthesis wrapped by ectopectoralis after nipple-sparing mastectomy not only ensures the curative effects but also beautifies the apperance of the breast.The operation has the advantages of simplity,less trauma and quick recovery.There is no difference compared with mastectomy in terms of complication,recurrence rate and mortality etc.

Presented in the paper are the necessity,general ideas and principles of building a teaching center for virtual simulation experiment on disaster medicine,covering the teaching modules, capability objectives and education resources deployment among other basics of such a center.The authors propose to build a comprehensive platform for teaching by experimentation,integrating basic clinical skills training to trainings targeted to disaster rescue in view of actual needs in experiments and teaching.This way resources can be shared between the experiment center website and virtual simulation teaching software,promoting a regular,standardized and scientific development of disaster medicine in China.

Objective To study the effect on the environmental radioactivity level and the health of the residents in Shanghai when Qinshan Nuclear Power Station(QNPS) has been in normal operational condition for 17 years. Methods The field monitoring and the sampling analytical method were used for monitoring the radioactivity level in outdoor environment, drinking water, food and soil. Results The outdoor natural radiation level and the radioactivity level in the sample of the environmental media were on the normal background level. There was no distinct change in the environmental radiation level of Jinshan Area when QNPS was in normal operational condition. The radioactivity level in the environmental media was far lower than the limit values specified by the national standard GB. The effective dose of the outdoor natural external exposure for the residents is about 0.102 mSv/a and the effective dose of the internal exposure from the artificial radionuclides 90Sr and 137Cs in food for the residents is about 0.488 μSv/a. Conclusions There is no effect of the radioactive contamination on the environmental radioactivity level and the health of the residents in Shanghai when QNPS has been in normal operational condition for 17 years.

Based on the breast ultrasound database of West China Hospital from January 1, 2002 to December 31, 2007, a study of data mining techniques for utilizing the diagnostic information of breast ultrasound and breast pathology was carried out. An innovative computerized retrieval system was invented. With the visual user interface of the system, the data of benignancy or malignancy diagnosed by ultrasound and pathologic examination, and the data on the diagnostic correlation of ultrasound and pathology were obtained, respectively. The qualities of data mining were 99. 98%-100%. By means of the retrieval system, the users can secure numerous data from the breast ultrasound database rapidly and accurately; so it contributes to the rational utilization of information from medical database for serving various medical studies. This method may also be helpful for doctors to utilize ultrasound database in other fields.
Breast Neoplasms ; diagnostic imaging ; pathology ; Data Mining ; Databases, Factual ; Female ; Humans ; Information Storage and Retrieval ; methods ; Medical Records Systems, Computerized ; Ultrasonography

The Monte Carlo N-Particle (MCNP) is often used to calculate the radiation dose during computed tomography (CT) scans. However, the physical calculation process of the model is complicated, the input file structure of the program is complex, and the three-dimensional (3D) display of the geometric model is not supported, so that the researchers cannot establish an accurate CT radiation system model, which affects the accuracy of the dose calculation results. Aiming at these two problems, this study designed a software that visualized CT modeling and automatically generated input files. In terms of model calculation, the theoretical basis was based on the integration of CT modeling improvement schemes of major researchers. For 3D model visualization, LabVIEW was used as the new development platform, constructive solid geometry (CSG) was used as the algorithm principle, and the introduction of editing of MCNP input files was used to visualize CT geometry modeling. Compared with a CT model established by a recent study, the root mean square error between the results simulated by this visual CT modeling software and the actual measurement was smaller. In conclusion, the proposed CT visualization modeling software can not only help researchers to obtain an accurate CT radiation system model, but also provide a new research idea for the geometric modeling visualization method of MCNP.
Radiation Dosage ; Software Design ; Tomography, X-Ray Computed/methods* ; Software ; Algorithms ; Phantoms, Imaging ; Monte Carlo Method

In recent years, photon-counting computed tomography (PCD-CT) based on photon-counting detectors (PCDs) has become increasingly utilized in clinical practice. Compared with conventional CT, PCD-CT has the potential to achieve micron-level spatial resolution, lower radiation dose, negligible electronic noise, multi-energy imaging, and material identification, etc. This advancement facilitates the promotion of ultra-low dose scans in clinical scenarios, potentially detecting minimal and hidden lesions, thus significantly improving image quality. However, the current state of the art is limited and issues such as charge sharing, pulse pileup, K-escape and count rate drift remain unresolved. These issues could lead to a decrease in image resolution and energy resolution, while an increasing in image noise and ring artifact and so on. This article systematically reviewed the physical principles of PCD-CT, and outlined the structural differences between PCDs and energy integration detectors (EIDs), and the current challenges in the development of PCD-CT. In addition, the advantages and disadvantages of three detector materials were analysed. Then, the clinical benefits of PCD-CT were presented through the clinical application of PCD-CT in the three diseases with the highest mortality rate in China (cardiovascular disease, tumour and respiratory disease). The overall aim of the article is to comprehensively assist medical professionals in understanding the technological innovations and current technical limitations of PCD-CT, while highlighting the urgent problems that PCD-CT needs to address in the coming years.
Tomography, X-Ray Computed/methods* ; Photons ; Noise ; China ; Phantoms, Imaging

To explore the effect and experience of quality control circle(QCC) in quality control testing for CT scanners, the quality control circle group was set up to determine the theme of quality control circle, and the causes of the failure of the quality control testing for CT scanners were analyzed, then the corresponding corrective measures were formulated and carried out. After the activity of the quality control circle, the qualified rate of CT quality control testing in the second level 2nd Class of public hospitals and private hospitals in Shanghai increased from 40.6% to 86.1%. By conducting quality control circle activities, we found the problems existed in the quality control testing of CT scanners, and put forward many corresponding corrective measures and solutions which finally improved the qualified rate of CT quality control testing.
China ; Quality Control ; Tomography Scanners, X-Ray Computed ; standards ; Tomography, X-Ray Computed