Objective To evaluate multi-slice CT (MSCT) features and pathological basis of lung cancer containing thin-walled airspace. Methods Thirty?five cases of pathologically confirmed lung cancer containing thin-walled airspace were retrospectively analysed with regard to clinical data, pathological types and MSCT features between 2012 and 2015.There were 35 cases(25 adenocarcinoma, 9 squamous carcinoma, 1 spindle cell tumor) in total. MSCT features were compared between the lesions with or without solid component .Fisher exact test was used for the statistical analysis. For dynamic follow-up CT scans, the lesion dynamic change was evaluated .Correlations between the pathological section and CT images of the 11 cases were analysed. Results These features accounted for more than 60% of all MSCT signs in 35 cases, including round shape in 28 cases(80.0%),lobulation in 32 cases(91.4%),multiple cysts in 27 cases(77.1%), irregular inner wall in 33 cases(94.3%)and septum in airspace in 31 cases(88.6%). Shape, spiculation, bronchus cut-off, blood vessel and bronchus passing through the airspace, and ground-glass opacity were significantly different between the lesions with or without solid component(P<0.05).The frequency of spiculation(11 cases) and bronchus cut-off(12 cases) in mixed solid lesions was higher than that in lesions without solid component(1 case, respectively).The frequency of irregular shape(6 cases),blood vessel passing through the airspace(12 cases),ground-glass opacity(13 cases)and bronchus passing through the airspace(7 cases) in lesions without solid were higher than that in solid mixed lesions(1, 1, 5, 3 cases respectively).The pathological basis of the formation of thin-walled airspace was obvious central necrosis in solid lesions and emphysematous change due to the tumor cells diffused along the inner airspace wall and the alveolar wall destruction.Five lesions were with progressive wall thickening and increased size of the airspace,and two lesions were with decreased size of the airspace and enlarged nodules in followed CT.One case of lung cancer with thin-walled airspace evolved from ground glass nodule. Conclusions The CT manifestation of lung cancer containing thin-walled airspace was characteristic.The pathological basis of the thin-walled airspace was various.

Objective To establish a scientific and objective indicator system for nursing quality evaluation according to nursing works of neonatal surgical department. Methods To establish the indicator system based on the three- dimension quality structure. Literature retrieval, expert interview and Delphi expert enquiry were used to filter and improve indicators. Analytic hierarchy process was used to determine the index weight and check the consistency. Results The quality indicator system included three levels. There were 3 indicators in level one, 14 indicators in level two and 70 indicators in level three. Experts coefficient was 0.867, mean of importance values of two rounds were 3.83-5.00 and 4.08-5.00 , Kendall coordination coefficients were 0.292(P<0.01) and 0.301(P<0.01). Conclusions The nursing quality evaluation indicator system has high reliability and it can be used for guiding continuous improvement of nursing in neonatal surgical department.

Objective To explore the application of amide proton transfer (APT) imaging in differentiating glioma from treatment effect and to evaluate the diagnostic efficiency of the quantitative APT-related parameters.Methods A total of 23 patients (15 males, 8 females, age: 13-80 years) with 27 lesions who had underwent APT imaging in Tongji Hospital(Wuhan, China) from October 2014 to June 2015 were enrolled in this prospective study.The scan protocols were MRI normal plain scanning, diffusion WI, contrast-enhancement T1WI and APT imaging.Both the magnetization transfer ratio (MTR) and the relative MTR (rMTR) of lesions were manually measured by drawing ROI in the functional post-processing workstation.The results were compared with those of pathologic examinations and radiographic follow-up (≥3 months).Mann-Whitney u test was used to analyze the data.Results Compared with contralateral white matter, the primary gliomas (n=12) and recurrent gliomas (n=8) manifested hyper-intensity, while the treatment induced injuries (n=7) showed iso-or hypo-intensity.The difference of MTR between tumors and treatment effects was significant (102.78(101.93,103.84) vs 100.17(99.94, 100.63);z=-3.76, P<0.01), so was the difference of rMTR between tumors and treatment effects (3.92%(2.69%,4.67%) vs 0.47%(-0.79%,1.11%);z=-3.43, P<0.01).Both those two quantitative parameters exhibited excellent diagnostic performance with the AUC of 0.986 and 0.943.The sensitivity, specificity and accuracy of MTR were 100%(20/20), 6/7 and 96.3%(26/27) in the threshold of 100.68, while those of rMTR were 95.0%(19/20), 6/7 and 92.6%(25/27) in the threshold of 1.66%.Conclusions Combined with the routine MRI images, APT imaging can provide excellent qualitative and quantitative information in differentiating glioma from treatment effect.Both MTR and rMTR are helpful for the differentiation with high sensitivity and specificity and can be used as non-invasive imaging biomarkers in evaluating treatment effect of glioma.

Purpose To evaluate the application value of using a-cyanoacrylate rapid medical glue in preoperative localization of ground-glass nodules under CT guidance.Materials and Methods 48 cases were retrospectively analyzed,in which the pulmonary ground-glass nodules took preoperative localization under CT guidance.The rapid medical glue was injected in pulmonary ground-glass nodules,which was used for preoperative localization.Results After preoperative localization of rapid medical glue in 48 cases,pulmonary ground-glass nodules of all patients were resected successfully by video-assisted thoracoscope surgery (VATS).The complications of pneumothorax did not occur in all cases,with little pulmonary hemorrhagein in 10 cases.Conclusion When the fast medical glue has been used in the CT-guided preoperative localization of ground-glass nodules,there are advantages of high accuracy of localization and surgery.Moreover,this method is simple,safe and effective.

Objective To explore the value of a radiomics model based on contrast-enhanced CT at the arterial and venous phases in predicting the regional lymph node metastasis in rectal cancer.Methods The data of 303 patients with pathologically proven rectal cancer were analyzed retrospectively,and 1 648 CT radiomics features of the primary tumors were extracted from the arterial and venous phases,respectively.Four machine learning models were used including radiomics score(Rad-score),K-nearest neighbor(KNN),multi-layer perceptron(MLP)and support vector machine(SVM),and the model with the best diagnostic performance was selected.Taking the predicted probability of the best machine model in the arterial and venous phases as the input value,logistic regression algorithm was used to further construct a combined nomogram.Results The SVM model had been proved to be the most efficient among the four machine learning models,whether in arterial or venous phases.The combined nomogram based on ASVM and VSVM prediction probability further improved the ability to predict regional lymph node metastasis.The area under the curve(AUC)of the train group was 0.860,and that of the validation group was 0.801,which were higher than those of ASVM model(train group,AUC=0.822;validation group,AUC=0.777)and VSVM model(train group,AUC=0.832;validation group,AUC=0.786).Conclusion The arterial-venous phases radiomics combined nomogram model based on enhanced CT images performs well in predicting rectal cancer patients'pre-treatment lymph node metastasis.

The great founding spirit of the Party is not only the source of the spirit of the Communist Party of China,but also the origin of the red doctor's spirit.As the enrichment and development of the great founding spirit of the Party,the red doctor's spirit in medical and health work embodies the unique advantages and distinctive characteristics of adhering to the truth and ideals,fully demonstrating the value position and goal of practicing the original intention and undertaking the mission,specifically demonstrating the heroic nature and strong will of fearless sacrifice and brave struggle,and clearly outlining the political character and public servant feelings of being loyal to the Party and not betraying the people.In the new era,to promote the great founding spirit of the Party in medical and health work,medical colleges,public hospitals,and medical staff should shoulder the heavy responsibility of inheritance,adhere to putting people's health at the center,and jointly promote the leapfrog development of medical and health services.

Objective:To investigate basic public health service personnel allocation in five regions of Guizhou province, providing reference and strategies for the construction of grass-roots disease prevention and control system in Guizhou province and the training of grass-roots public health service talents in colleges and universities.Methods:According to the topographical features of Guizhou province, stratified random sampling was completed in five regions including Guiyang, Zunyi, Liupanshui, Qianxinan Buyei and Miao Autonomous Prefecture, Qiannan Buyei and Miao Autonomous Prefecture. Questionnaires and on-the-spot symposiums were conducted among basic public health service personnel from 20 township health centers and 20 community health service centers.Results:Women (82.7%), 25-35 years of age (41.7%), working years < 5 years (65.7%), and junior professional titles (59.7%) accounted for a higher proportion of the staff in the five regions. Basic public health service personnel in Guiyang had the highest percentage of undergraduate education (47.5%) and those in other regions had the highest percentage of a junior college education. 40.3% and 26.4% of basic public health service personnel were devoted to nursing and clinical specialties, and only 3.2% of basic public health service personnel were devoted to general practice and preventive medicine. The number of public health practitioners (assistants) per 10,000 residents was 0.05, and 43.5% of public health practitioners had multiple duties.Conclusion:The professional structure of public health personnel is not reasonable at the grass-roots level in Guizhou province. There is an extreme shortage of public health practitioners (assistants), the professional title is low, staffing is inadequate, and staff loss is serious.

Dendrimers, a special class of synthetic polymers known for their well-defined ramified structures and unique multivalent cooperativity, hold great promise for various biomedical applications. However, preparation of defect-free dendrimers of high-generation on a large scale remains challenging because of the tedious and time-consuming synthesis as well as difficult purification. To overcome these limitations, an alternative strategy based on self-assembling approach has been developed to construct supramolecular dendrimers using small amphiphilic dendrimer-building units. By virtue of the amphiphilic nature, these small dendrimer-building units self-assemble and form large non-covalent supramolecular dendritic structures that mimic high-generation covalent dendrimers. Here, we present a brief overview of the supramolecular dendrimers developed in our group for the delivery of nucleic acid therapeutics, anticancer drug and imaging agents.

Objective:To investigate the application value of three dimensional (3D) imaging fusion navigation system (hereinafter referred as navigation system) in laparoscopic pan-creatic surgery.Methods:The retrospective and descriptive study was conducted. The clinical data of two volunteers, including volunteer 1 undergoing laparoscopic pancreaticoduodenectomy for cholangiocarcinoma and volunteer 2 undergoing laparoscopic pancreaticotomy + splenectomy for pancreatic cancer, who were admitted to the Second Hospital of Hebei Medical University from December 2020 to May 2021 were collected. The 2 volunteers were females, aged 68 years and 40 years, respectively. The self-developed navigation system was applied in laparoscopic simulator model test, including in rigid-body model and prosthesis model, and clinical test. Observation indicators: (1) results of model test; (2) results of clinical test. Measurement data with normal distribution were represented as Mean± SD. Results:(1) Results of model test. The rigid-body model or prosthesis model with occlusion can be seen in the laparoscopic visual field of the initial laparoscopic simulator. The rigid-body model or prosthesis model with occlusion and rigid-body model or prosthesis model without occlusion can be seen in the 3D visual reconstruction image of enhanced computer tomography (CT) examination. The rigid-body model or prosthesis model with occlusion can be seen in the laparoscopic visual field of the initial laparoscopic simulator after the 3D visual reconstruction image was superimposed and fused with the real-time laparoscopic image. Both of the rigid-body model and prosthesis model were in high consistency, with the distance error of marker points were (0.26±0.11)mm and (0.29±0.18)mm, respectively. (2) Results of clinical test. The abdominal organs and blood vessels with occlusion of the 2 volunteers can be seen in the initial laparoscopic visual field. The location of tumor, important organs and blood vessels can be seen in the navigation system using the 3D visual reconstruction image of enhanced CT examination. The location of tumor, important organs and important blood vessels can be seen in the laparoscopic visual field after the 3D visual reconstruction image was superimposed and fused with the real-time laparoscopic image. The distance error of marker points of the volunteer 1 was (1.36±0.57)mm and the distance error of marker points of the volunteer 2 was (1.24±0.33)mm.Conclusions:The self-developed navigation system can integrate the preoperative 3D visual reconstruction image of enhanced CT examination and the intraoperative real-time laparoscopic image with a good effect. The relationship between deep tissue and blood vessels which is not clarified in conventional laparoscopy can be shown in the navigation system assisted laparoscopic pancreatic surgery.

Objective:To compare and analyze the perioperative outcomes of jaundiced patients undergoing laparoscopic pancreaticoduodenectomy (LPD) using preoperative percutaneous transhepatic cholangial drainage (PTCD) versus endoscopic nasobiliary drainage (ENBD).Methods:The perioperative data of 173 patients who underwent LPD at the Second Hospital of Hebei Medical University from January 2016 to December 2020 and were treated preoperatively with either PTCD versus ENBD to alleviate jaundiced were retrospectively analyzed. There were 100 males and 73 females, with age of (60.4±10.8) years old. These patients were divided into the PTCD group ( n=126) and the ENBD group ( n=47). Clinical data including operation time, blood loss, transfusion volume, R 0 resection, and postoperative complications were compared. Results:There was no convension to open surgery. There were no significant differences in operation time, blood loss, transfusion volume, R 0 resection rate, pathological results and hospital stay between the two groups ( P>0.05). For the PTCD group, the pancreatic fistula rate was 10.3% (13/126) and the post-operative hemorrhage rate was 8.7% (11/126). They were both significantly lower than those of the ENBD group [25.5% (12/47) and 25.5% (12/47) respectively, P<0.05]. There were also significant differences in the postoperative complications according to the Clavien-Dindo classification system between the two groups ( P=0.008). Conclusion:Compared with ENBD, PTCD had the advantages of lower post-operative pancreatic fistula and post-operative hemorrhage rates, resulting in a better postoperative recovery.