Objective To evaluate spectral CT imaging in characterizing the pathological type and the differentiation of gastric cancer.Methods Ninety-one patients diagnosed of gastric cancer were retrospectively analyzed.Patients were all underwent triple-phase enhanced scan using single source dualenergy CT on gemstone spectral imaging(GSI) mode.Three types of images were reconstructed for analysis:the water concentration (WC),iodine concentration (IC),and normalized iodine concentration (NIC).The patients were divided into groups of mucinous carcinoma (MUC),including mucinous adenocarcinoma and signet ring cell carcinoma,and non-mucinous gastric carcinoma (non-MUC).Independent-samples t test was used for statistical analysis.Results There were 24 patients of MUC and 67 patients of non-MUC.The IC and NIC of the non-MUC were significantly higher than the MUC in vein phase (VP) and in parenchymal phase (PP) [(21.33 ±6.31) × 100 vs (16.94 ±6.13) × 100 μg/ml,0.55 ±0.17 vs 0.42 ±0.14 in VP,and(20.65 ±5.49) × 100 vs (18.07 ±4.51) × 100 μg/ml,0.72 ±0.20 vs 0.57 ±0.12 in PP,respectively t =-2.948,-3.362,-2.261,-4.326,P ＜0.05].The IC and NIC of the signet ring cell carcinoma were statistically higher than those of the mucinous adenocarcinoma [(19.36 ± 4.75) × 100 vs (12.10 ±5.92) ×100μg/ml,0.49 ± 0.09 vs0.28±0.11 in VP,and (19.88±3.28) ×100 vs (14.45±4.62) ×100 μg/ml,0.63 ±0.08 vs 0.47 ±0.11 in PP,respectively t =3.253,5.180,3.339,3.850,P ＜0.01].For the poorly differentiated and well /moderately differentiated adenocarcinoma,the IC and NIC of the former were higher than those of the latter in VP and PP [(23.48 ±6.49) × 100 vs (18.98 ±5.26) × 100 μg/ml,0.61±0.16vs0.48±0.15 in VP,and (22.95±5.51) ×100 vs (18.28±4.47) ×100 μg/ml,0.81 ± 0.21 vs 0.63 ± 0.15 in PP,respectively t =3.098,3.249,3.766,4.117,P ＜ 0.01].The between-group differences of WC,IC and NIC in artery phase were no significant (P ＞ 0.05).Conclusions Different pathological types could determine different IC.The spectral CT imaging may be helpful for characterizing the pathological type of gastric cancer.

Objective To explore the medication regularity of prescriptions in Universal Relief:Cough Medicine in that to provide worthy reference for clinical treatment of cough.Methods The prescriptions in Universal Relief:Cough Medicine was collected and then established the database using Excel 2016 softwore,and carried out medication frequency analysis.SPSS Modeler 18.0 and Lantern 5.0 were used to perform association rules analysis and latent structure model analysis to explore medication rules of prescriptions in Universal Relief:Cough Medicine.Results 607 prescriptions were collected,involving 335 traditional Chinese medicines.A total of medication frequency is 3941,The most frequently used TCMs were ganca(glycyrrhizae radixet rhizoma)and shengjiang(zinglberis rhizoma recens)and kuxingren(armeniaeae semen amarum).The main efficacy of the medicine is to dissipate phlegm,relieve cough,relieve asthma,and replenish deficiency,and warm in nature,spicy,bitter,and sweet in taste and lung and spleen in meridian.14 strongly correlated material rules were sorted out by association rule analysis such as banxia(pinelliae rhizoma)+gancao(glycyrrhizae radixet rhizoma)→shengjiang(zinglberis rhizoma recens)、banxia(pinelliae rhizoma)→shengjiang(zinglberis rhizoma recens)and mahuang(ephedrae herba)+gancao(glycyrrhizae radixet rhizoma)→kuxingren(armeniaeae semen amarum).12 variables were obtained by latent structure model analysis,and according to professional knowledge inference,3 integrated cluster models and 1 single cluster and 4 core prescriptions were obtained.It was inferred that the common syndromes of Universal Relief:Cough Medicine were cold drink stoping in the lung,qi deficiency external phlegm dampness inside,phlegm heat blocking lung,and lung deficiency prolonged cough.Conclusion The medication rules of prescriptions in Universal Relief:Cough Medicine is mainly benefiting qi and resolving phlegm,cure both the symptoms and the disease,and in different situations combine with different treatment methods,such as warming the lung and resolving phlegm,clearing heat and resolving phlegm,tonifying qi and resolving external symptoms,and astringent lung qi.

Objective:To investigate the epidemiology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with maintenance hemodialysis (MHD) in Jiangsu province during SARS-CoV-2 pandemic in China from December 7, 2022 to January 27, 2023, and to analyze the influencing factors of all-cause death.Methods:It was a multi-center cross-sectional investigation. Structured questionnaire was used to collect patient information by medical staff of each hemodialysis center (room) as investigators. Part of the demography data and laboratory examination data came from the Jiangsu Province Hemodialysis Data Information System. MHD patients from hemodialysis centers (rooms) at all levels of medical institutions and independent hemodialysis institutions in Jiangsu province during the outbreak of SARS-CoV-2 infection were included, and the clinical characteristics and all-cause mortality of confirmed and suspected cases of SARS-CoV-2 infection were analyzed.Results:Questionnaire surveys and data analysis on 57 278 patients in 407 hemodialysis centers (rooms) were completed, accounting for 90.41% of the total number of MHD patients (63 357 cases) in Jiangsu province during the same period. There were 24 038 cases (41.97%) of SARS-CoV-2 infection and 14 805 cases (25.85%) of suspected infection, which were widely distributed in all dialysis centers in Jiangsu province. After clinical classification of 38 843 confirmed and suspected SARS-CoV-2 infection cases, 3 662 cases were severe and critical cases, accounting for 9.43% of the infected and suspected cases. Among the patients who had completed the questionnaires, there were 1 812 all-cause deaths, with an all-cause mortality rate of 3.16%. Multivariate logistic regression analysis showed that elderly (taking ≤50 years as a reference, 51-59 years: OR=1.583, 95% CI 1.279-1.933, P=0.001; 60-69 years: OR=3.972, 95% CI 3.271-4.858, P<0.001; 70-79 years: OR=7.236, 95% CI 5.917-8.698, P<0.001; &ge;80 years: OR=11.738, 95% CI 9.459-14.663, P<0.001), male ( OR=1.371, 95% CI 1.229-1.529, P<0.001), and co-infection with hepatitis B virus (HBV) (positive serum HBV surface antigen, OR=0.629, 95% CI 0.484-0.817, P<0.001) were independent influencing factors for all cause mortality. Receiver-operating characteristic curve analysis showed that the area under the curve for male, age and current HBV infection prediction of all-cause death was 0.529 ( P<0.001), 0.724 ( P<0.001) and 0.514 ( P=0.042), respectively, and the cut-off value for age prediction of all-cause death was 65.5 years old. Compared with patients without HBV infection, MHD patients with HBV infection significantly reduced the proportion of severe and critically ill patients, all-cause hospitalizations and all cause deaths when infected with SARS-CoV-2 (4.99% vs. 6.41%, χ2=6.136, P=0.013; 8.90% vs. 11.44%, χ2=11.662, P<0.001; 2.01% vs. 3.37%, χ2=10.713, P=0.001, respectively). Conclusion:The MHD patients in Jiangsu province are susceptible to SARS-CoV-2. Elderly age and male gender are independent risk factors for death in MHD patients during the epidemic, while the HBV infection may be a protective factor for death of MHD patients infected with SARS-CoV-2.

Objective: To investigate the feasibility of contrast-enhanced computer tomography (CT) texture analysis in predicting early recurrence after transarterial chemoembolization (TACE) in patients with liver cancer. Methods: A retrospective analysis was performed for 47 patients with liver cancer confirmed by liver biopsy and digital subtraction angiography who underwent upper abdominal contrast-enhanced CT scan before TACE, and according to the presence or absence of focal recurrence within half a year, these patients were divided into early recurrence (ER) group and non-early recurrence (NER) group. The texture analysis was used to delineate tumor boundary layer by layer on the axial contrast-enhanced CT image before liver cancer surgery, and related parameters of tumor heterogeneity, including entropy, mean, non-uniformity, skewness, and kurtosis, were obtained. The independent samples t-test was used for comparison of texture parameters between the two groups. The receiver operating characteristic (ROC) curve was used for the analysis of entropy, mean, and non-uniformity, and the area under the ROC curve (ROC), optical cut-off value, sensitivity, and specificity were calculated to evaluate the efficiency of texture analysis in predicting early focal recurrence after TACE. Results: There were 20 patients in the ER group and 27 in the NER group. The ER group had a maximum major axis length of 88.2±36.3 mm and a maximum minor axis length of 41.4±21.4 mm, and the NER group had a maximum major axis length of 66.9±30.2 mm and a maximum minor axis length of 29.3±19.8 mm; the ER group had significantly higher maximum major and minor axis lengths than the NER group (t = 4.89 and 4.62, P < 0.001). The ER group had significantly higher entropy and non-uniformity values than the NER group, and there were no significant differences in skewness and kurtosis between the two groups. Entropy, non-uniformity, and mean had high efficiency in predicting early recurrence after TACE, and the optimal cut-off value of entropy was 4.135. Conclusion Volumetric texture analysis of contrast-enhanced CT images before liver cancer surgery has a high value in predicting early recurrence after TACE.