This paper introduces the setting and configuration of our hospital's fPACS workstation, which is developed by the First Military Medical University. The fPAX video workstations are used as the terminals, including fPAX sampling workstation for video, picture and number, fPAX diagnosis workstation, fPAX clinician workstation and fPAX consultation center workstation. The workstation is equipped with an IBM4 2G host computer, an 80G fixed disc, an EMS memory more than 512M and a SONY 21″ pure flat display. Our experience of building PACS workstation proves that the reasonable setting and configuration is helpful to save the money and increase the efficiency.

Objective To investigate the tracing value of drug-loaded nano-active carbon for lymphatic visualization and its potential application in the lymphadenectomy of gastric cancer. Methods Sixty-three patients with advanced gastric carcinoma were randomized into 2 groups:control group and tracing group. For the tracing group, 5-Fu-loaded nano-active carbon (NP-5-FU) suspension was intratumorally administered by preoperative gastroscope-guided or intra-operative injection. No tracing reagents was given in the control group. The numbers of removed lymph nodes and metastasis-involved lymph nodes as well as the lymph node staining were recorded and compared between the two groups. The adverse effects was monitored. Results The resected lymph nodes in the tracing group were much more than that of control group (43.73 ± 9. 25 vs. 25. 36 ± 4. 73, t = 3.82,P ＜ 0. 05). For the N1, N2 and N3 lymph nodes, 27. 17 ± 5. 82,13.73 ± 4. 61 and 2. 83 ± 0. 15 per case of the tracing group were desected, while they were 14. 45 ± 2. 75,8. 27 ± 1.89, and 2. 64 ± 0. 11 per case in the control group,respectively (P ＜ 0. 05 ). 26. 2% (211/842) of the lymph nodes in the tracing group showed black intensity,higher than that of unstain lymph nodes (4. 5% ,21/470,χ2 =95. 108,P ＜0. 05) and that in control group (16.9%, 142/837)( χ2 =7.485 ,P ＜ 0.05, ). No local and systemic adverse reactions were observed for the local injection of nano-active carbon. No extension of operating time and increased complications occurred. Conclusion Local injection of nano-active carbon which was loaded with 5-FU around the tumor is a very useful measure to trace the lymph nodes and facilitate the lymphedetectomy and chemotherapy.

Objective To establish a monitoring database of historical Oncomelania hupensis environments at grass?root lev?el for schistosomiasis prevention based on Google Earth(GE),so as to improve the management efficiency of historical O. hu?pensis environments. Methods GE was labeled with the information about the historical O. hupensis environments through add?ing landmark,path and polygon. Meanwhile,POCO web album was used to storage the practice situation pictures of the environ?ments,which could be imported into GE so that the environments could be monitored dynamically. Results There were 553 historical O. hupensis snail environments in Yangjian Town,Xishan District,Wuxi City and the accumulative area was 506 000 m2. Among these environments,224(40.5%)were Class IV environments,accounting for 40.5%of accumulative area. Conclu?sions The monitoring database of historical O. hupensis environments based on GE at country level is established successfully and it can be used to manage the historical snail environments visually and monitor the changes dynamically.

Current occupational health and occupational medicine teaching content focused on the detection of harmful factors,and more belonged to validation experiments.Closed-end management of experimental teaching,experimental report-based performance evaluation methods and single model of teaching methods reduced the students' study interesting,lack of problem-solving abilities.Therefore,it is necessary to optimize the experimental curriculum,adopt an open experimental teaching,build a reasonable experimental evaluation system and promote the diversification of teaching model.

Objective:To explore the characteristics of type 3 secretion system and biofilm of Pseudomonas aeruginosa in diabetic foot wound, and to analyze the relationship between these factors, as well as to the antibiotic sensitivity.Methods:Thirty-three strains of Pseudomonas aeruginosa were collected from the foot wounds of diabetic foot inpatients in Tianjin Medical University Chu Hsien-I Memorial Hospital from February 1, 2018 to December 31, 2018. Thirteen strains of Pseudomonas aeruginosa were collected from non-diabetic wounds. All strains were tested for antibiotic sensitivity. The virulence genes exoS or exoU of Pseudomonas aeruginosa and the ability of biofilm formation were tested. The characteristics of exoS or exoU and biofilm of Pseudomonas aeruginosa were analyzed. Patients′ clinical outcomes were also analyzed.Results:Pseudomonas aeruginosa with exoS gene was the major pathogen, 90.9% found in diabetic foot group and 84.6% in control group, with no significant difference( χ2=0.54, P=0.46). The drug-resistant strains of Pseudomonas aeruginosa with exoS accounted for 16.7% in diabetic foot group and 18.2% in control group, also with no significant difference( χ2=0.18, P=0.83). There were 5 strains of Pseudomonas aeruginosa carrying exoU, 3 strains in diabetic foot group, of which 1 was resistant, 2 in control group, no resistant strain. Pseudomonas aeruginosa increased the ability of biofilm formation in diabetic foot group, accounting for 57.6%, and for resistant strains, 83.3% of them increased the biofilm formation ability. Two kinds of Pseudomonas aeruginosa produced different biofilms, but they were effectiveless for carbapenem antibiotics. The times of debridement ( P<0.01), time of antibiotic use ( P<0.01) were more in biofilm wound, but the healing rate reached 75%-90%. Conclusion:Pseudomonas aeruginosa secreting ExoS is the main one in the diabetic foot wound. The ability of Pseudomonas aeruginosa to produce biofilm in DF wound is increased. Biofilm is one reason for its antibiotic resistance. Multiple debridement combined with sensitive antibiotics is an effective method to remove biofilm.

The procurement, preservation and transportation of the donor organs directly affect the clinical prognosis of the recipients. The establishment of process optimization and quality control standards of organ procurement, preservation and transportation contributes to improving the quality and utilization rate of donor organs and reducing the medical risk. According to Guide to the Quality and Safety of Organs for Transplantation (6th edition) proposed by European Union, the 11th chapter of organ procurement, preservation and transportation was interpreted and summarized in this article.

OBJECTIVE: To assess the value of chromosomal microarray analysis (CMA) and fluorescence in situ hybridization (FISH) for the prenatal diagnosis of chromosomal mosaicisms. METHODS: A total of 775 pregnant women who had visited the Prenatal Diagnosis Center of Yancheng Maternal and Child Health Care Hospital from January 2018 to December 2020 were selected as study subjects. Chromosome karyotyping analysis and CMA were carried out for all women, and FISH was used to validate the suspected mosaicism cases. RESULTS: Among the 775 amniotic fluid samples, karyotyping has identified 13 mosaicism cases, which yielded a detection rate of 1.55%. Respectively, there were 4, 3, 4 and 2 cases for sex chromosome number mosaicisms, abnormal sex chromosome structure mosaicisms, abnormal autosomal number mosaicisms and abnormal autosomal structure mosaicisms. CMA has only detected only 6 of the 13 cases. Among 3 cases verified by FISH, 2 cases were consistent with the karyotyping and CMA results, and clearly showed low proportion mosaicism, and 1 case was consistent with the result of karyotyping but with a normal result by CMA. Eight pregnant women had chosen to terminate the pregnancy (5 with sex chromosome mosaicisms and 3 with autosomal mosaicisms). CONCLUSION For fetuses suspected for chromosomal mosaicisms, CMA, FISH and G-banding karyotyping should be combined to determine the type and proportion of mosaicisms more precisely in order to provide more information for genetic counseling.
Female ; Pregnancy ; Humans ; Mosaicism ; In Situ Hybridization, Fluorescence ; Chromosome Disorders/genetics* ; Prenatal Diagnosis/methods* ; Chromosome Aberrations ; Sex Chromosome Aberrations ; Microarray Analysis/methods* ; Chromosomes

Objective The Kellinghaus grading method was used to manually read and grade the thin-layer CT of sternal end of clavicle,and a variety of traditional statistical methods as well as machine learning methods were used to construct age estimation models for adolescents and adults in early adulthood,to explore the value of the application of machine learning technology in the study of age estimation of the Han Chinese population in Sichuan.Methods Thin-section CT images of the chest were retrospectively collected from 491 individuals aged 10～30 years,and the collected samples were assigned a reading grade with reference to the Kellinghaus grading method.10%of the xases were randomly selected as the test set,and the remaining data were used as the training set to construct a variety of traditional statistical regression models and machine learning models for estimating the age of adolescents and adults in early adulthood,and the performance of the models was evaluated by using the mean absolute error(MAE).Results The statistical regression model with the best efficacy was the cubic regression model,with an MAE value of 1.34 for males and 1.57 for females;of the three machine learning models,the Random Forest model had the best predictive efficacy for males,with an MAE value of 1.39,and the Support Vector model had the best predictive efficacy for females,with an MAE value of 1.51.Conclusion In the construction of age estimation models for sternal end of clavicle,the machine learning model has a certain improvement in the accuracy of age prediction,but there is no obvious advantage compared with the traditional statistical regression model,and the use of the machine learning method in age estimation based on sternal end of clavicle still needs further exploration.

Objective: To construct the BCMA-CAR using the B-cell maturation antigen (BCMA) specific ligand APRIL as antigen binding region and to validate the effect of BCMA-CAR modified T cells (BCMA-CAR-T) on myeloma cells. Methods: The BCMA-CAR was constructed using the BCMA specific ligand APRIL as antigen binding domain and 4-1BB as the costimulatory domain. The specific cytotoxicity against BCMA⁺ myeloma cell lines and primary multiple myeloma (MM) cells in vitro were evaluated. In addition, BCMA⁺ myeloma xenograft mouse model was established to assess the anti-tumor effect of BCMA-CAR-T cell therapy in vivo. Results: BCMA-CAR-T cells could specifically kill BCMA⁺ myeloma cell lines (For BCMA-CAR-T cells, BCMA⁺ cells are almost undetectable in the E∶T ratio of 1∶4) and MM patients’ bone marrow mononuclear cells (the proportion of residual cells in BCMA-CAR-T and vector-T groups was 16.0% vs 66.85%, P=0.003) with significant degranulation (CAR-T and vector-T cells cocultured with MM1.S, H929 and U266 had degranulation levels of 33.30% vs 5.62%, 16.97% vs 2.95% and 25.87% vs 2.97%, respectively, P<0.001) and cytokines release (P<0.01) in vitro. In a human BCMA⁺ myeloma xenograft mouse model, BCMA-CAR-T cells could significantly prolong the survival of mice (The median survival time of mice treated with BCMA-CAR-T and vector-T cells was 87.5 days and 67.5 days, respectively, P<0.001) . Conclusion The ligand-based BCMA-CAR-T cells could be a promising strategy for BCMA⁺ multiple myeloma treatment.