Objective: To ensure the integrity、non-repudiation、authenticity of pictures and relevent messages by making a digital signature for a DICOM file. Methods: By using OpenSSL toolkits and dcmsign of DCMTK toolkits, make a digital sig nature for the relevent messages of DICOM medical image and then save it behind of the DICOM file. Results: We can evaluate integrity、non-repudiation、authenticity of pictures and relevent messages in the DICOM file which has been made a digital signature. Conclusion: To make a digital signature in a DICOM file by using the OpenSSL toolkits and dcmsign of DCMTK toolkits can realize the security when DICOM file transported in remote medical treatment and PACS.

OBJECTIVE: To study the pulmonary function and nasal resistance characteristics of patients with chronic nose-sinusitis and nasal polyps (CRSwNP), to explore the evaluation role of nasal resistance in nasal ventilation function and the effect of endoscopic sinus surgery on pulmonary function in patients with CRSwNP. METHOD: Fifty CRSwNP patients that met the study criteria were selected . The patients were performed endoscopic surgeries according to Messerklinger surgical procedures under general anesthesia. Extent of surgery was based on preoperative CT showing the range of the lesion of disease and endoscopic findings. Perioperative treatments contained intranasal corticosteroids, cephalosporin or penicillin antibiotics, nasal irrigation and other treatments. Main outcome measures included visual analog scale (VAS), endoscopic Lind-Kennedy scores, nasal resistence, pulmonary function in patientsone week before and after surgery, three months and six months after surgery. Pulmonary function includes forced expiratory volume in one second (FEV1), forced vital capacity FEV1/FVC and peak expiratory flow (PEF). RESULT: The study found that there were significantly positive correlations among VAS score, Lund-Kennedy score and nasal resistance (P < 0.05) in CRSwNP patients, but there is a significantly negative correlation between VAS score, Lund-Kennedy score, nasal resistance and pulmonary function indexes of FEV1, FVC and PEF (P < 0.05). The VAS score, Lund-Kennedy score and nasal resistance values of CRSwNP patients were decreased significantly after comprehensive treatments with nasal endoscopic operation as the major one, the difference was statistically different (P < 0.05). And the pulmonary function indexs (FEV1, FVC, PEF) were significantly increased after surgery in CRSwNP patients. CONCLUSION The nasal resistance can objectively and reliably reflect the degree of nasal congestion and the recovery of nasal function in CRSwNP patients after endoscopic sinus surgery. The detection method of nasal resistance is simple. Functional endoscopic sinus surgery can effectively improve the pulmonary ventilation function in CRSwNP patients, providing some clinical references about the prevention and treatment of CRS related lower respiratory disease.
Administration, Intranasal ; Adrenal Cortex Hormones ; therapeutic use ; Anti-Bacterial Agents ; therapeutic use ; Chronic Disease ; Endoscopy ; Humans ; Nasal Lavage ; Nasal Polyps ; diagnosis ; Nose ; physiopathology ; surgery ; Pulmonary Ventilation ; Respiratory Function Tests ; Rhinitis ; Sinusitis ; diagnosis ; surgery

The teaching reform of education methods and course contents was carried out for seven-year program medical students in clinical neurology courses.Case-based instruction method,evidencebased medicine and standardized patient were flexibly applied,case discussion mode and multimedia teaching were added,and humanistic education was merged into teaching process.The enthusiasm and creativity of students were fully activated through the comprehensive application of various teaching meth ods,and the teaching quality of neurology course was improved,and the purpose of comprehensive quality education for the culture of long-year program medical students was better achieved.

Objective To explore the short to long term surgical outcomes and treatment experiences of esophageal atresia（EA）.Methods The clinical data of EA inpatients in our hospital from 2006 to 2009 were reviewed retrospectively.The birth weight,main associated anomalies,details of management,complications and outcomes were discussed.Main risk factors were evaluated with major prognostic classification systems.Results Totally 48 consecutive infants with EA were identified from 2006 to 2009,male 33（69%）,female 15（31%）.Mean birth weight was 2 668 g（range 1 700 g to 3 800 g）.All received primary operation.Complications included pneumonia,anastomotic leakage（16%）,tracheoesophageal fistula,incision sepsis（11%）,delayed tracheoesophageal fistula（7%）,stricture（10%）,and gastroesophageal reflux（GER）（67%）.Mortality was 12.5%,mainly due to severe pneumonia and complex cardiac anomalies.Conclusion Most patients with esophageal atresia could be cured after primary operation with excellent outcomes.The main factors for mortality were complex cardiac anomalies,aspiration and pneumonia.The main mid-term complications were GER and stricture.

The Au-PDA-Fe3O4 decorated graphene oxide electrode was modified with Prussion blue-secondary antibodies for determination of cancer biomarker α-fetoprotein (AFP) with great sensitivity.Scanning electron microscopy (SEM), X-ray diffraction (XRD) and ultraviolet-visible absorption spectrometry were used to characterize the structure of the material.Greatly enhanced sensitivity for the cancer biomarker is based on a dual signal amplification strategy.First, Fe3O4-PDA-Au used for the biosensor platform increased the surface area to capture a large amount of primary antibodies (Ab1), which resulted in amplification of the detection response.Second, graphene oxide allowed several binding events of PB-Ab2.Enhanced sensitivity was also achieved by introducing the multibioconjugates of Ab2-PB-GO onto the electrode surface through sandwich immunoreactions.The test result shows that there are linear relationships between current and AFP concentrations ranging from 0.005 ng/mL to 1 ng/mL and 1 ng/mL to 20 ng/mL, with the low detection limit (LOD) of 1.0 pg/mL.This immunosensor is simple, low-cost and sensitive and shows a great potential in biomedicine, clinical diagnosis and health examination.

Objective To retrospectively evaluate different methods (laboratory tests,liver / gallbladder ultrasound and magnetic resonance cholangiopancreatography)in differentiating biliary atresia from infant hepatitis syndrome.Methods Seventy infants with cholestatic jaundice,50 cases of biliary atresia and 20 cases of infant hepatitis syndrome were studied prospectively from January 2010 to December 2012.All cases underwent abdominal ultrasound and magnetic resonance cholangiopancreatography.The accuracy,sensitivity,specificity and predictive values of these various methods were compared.Also the laboratory parameters were statistically analyzed and compared between groups.Results Patients with BA had significantly higher GGT values at presentation [(743.5 ± 564) IU/L] compared with infants with IHS [(198.8 ± 197.8) IU/L],showing statistically significant difference (P ＜ 0.05).The sensitivity,specificity,and accuracy of the ultrasound in diagnosis of BA were 84.0％ 、100.0％ 、88.6％ respectively(P ＜ 0.05).The values for magnetic resonance cholangiopancreatography were 82.0％ 、80.0％ 、81.4％ (P ＜ 0.05).Conclusion Currently,the method of ultrasound is more reliable than MRCP for differentiating biliary atresia from infant hepatitis syndrome.

Objectives In order to discuss the effect ofShujin-Huoxue decoction combined with gradually functional exercise for the ankle fracture postoperative function recovery.MethodsA total of 60 patients with ankle joint fracture were treated by random number table method, and were divided into the observation and control groups, 30 patients in each group. The observation group was treated with the Shujin-Huoxue decoction orally and topical application and gradually functional exercise therapy; while the control group was treated with compound sodium aescinate gel for topital application combined with gradual functional exercise therapy. Two months were a course, so both groups were treated a course. The stretching and flexion angles were measured by protractor. The ankle joint function was measued by the Baird-Jackson rating scale. The clinical curative effect was evaluated.Results The total effect rate in the observation group was 90.0% (27/30) and control group was 73.3% (22/30). There was significant difference between two groups (χ2=2.004,P=0.039). After treatment, the feet stretching Angle (15.69° ± 3.02°vs. 13.50° ± 2.36°,t=6.314) and plantar flexion Angle (32.07° ± 0.34°vs. 27.95° ± 5.40°,t=10.205) in the observation group were significantly higher than those in the control group (P<0.05).Conclusions TheShujin-Huoxue decoction combined with gradually functional exercise could improve the ankle activity and the clinical curative effect.

Objective To investigate the harmless biochemical indicators for early screening of populations at high risk of suicide .Methods Seven hundred and twenty-seven new recruits were investigated according to self-rating idea of suicide scale (SIOSS) in the first month of recruitment in 2014.Twenty-five recruits (originally 27 recruits, but 2 recruits were absent from biochemical tests ) whose SIOSS scores were less than 12 were recognized as the suicidal ideation group. Another 25 recruits whose SIOSS scores were more than 12 were randomly selected as the control group .Saliva samples of the 50 recruits were collected for biochemical analysis after one month and three months of training , respectively .After three months of training , the SIOSS was also used for evaluation of suicidal ideation .Results After one-month training , the concentrations of Ca , Mg, amylase ( Amy ) and salivary acid ( SA ) in saliva were demonstrated to be statistically different between the suicidal ideation group and the control group ( P <0.05 ), but there was no significant linear correlation between these indicators and the SIOSS (P>0.05).After three-month training, the concentrations of Ca, Mg, Amy and SA in saliva between the two groups showed no significant difference (P>0.05).Conclusion After the first month training , changes in the biochemical compositions were found in the saliva of the screened recruits with suicidal ideation, which may be associated with the stress response of the body .The biochemical indicators in saliva lack specificity for suicidal ideation .

Objective:To evaluate the therapeutic effect of 177Lu-prostate specific membrane antigen (PSMA)-I&T on prostate cancer. Methods:The culture medium of 1.85, 18.50, 185.00, 555.00 and 925.00 MBq/L 177Lu-PSMA-I&T was added into LNCaP cells (200 μl/well, 5 experimental groups and 1 control group, 3 replicates in each group) for 24 h, and the cell viability in each group was detected. The culture medium of 3.7 MBq 177Lu-PSMA-I&T was added into LNCaP cells (1 experimental group, 1 control group, 3 replicates in each group) for 48 h to detect the changes of cell cycle. LNCaP cells (3 experimental groups and 1 control group, 3 replicates in each group) were added into the culture medium of 3.7, 19.5 and 37.0 MBq 177Lu-PSMA-I&T for 48 h to detect cell apoptosis. Tumor-bearing mice models were established (BALB/c-nu/nu nude mice, n=32). The changes of tumor volume and body mass of tumor-bearing mice were observed within 20 d after treatment. On the 7th day after treatment, tumor tissues of tumor-bearing mice were stained with HE staining and fluorescently stained with Ki-67 protein, and apoptosis was detected by TdT-mediated dUTP nick end labeling (TUNEL) assay. On the 20th day after treatment, pathological analysis was performed on the main viscera of the tumor-bearing mice. One-way analysis of variance, the least significant difference t test and paired t test were used to analyze the data. Results:Compared with the control group ((100.00±12.35)%), the cell survival rates were significantly decreased after 177Lu-PSMA-I&T intervention in 185.00, 555.00, 925.00 MBq/L groups ((57.56±6.35)%, (38.65±3.39)%, (27.95±4.48)%; F=78.91, t values: 8.312-14.106, all P<0.01). Cell survival rates were significantly reduced in 185.00 MBq/L group at different time points (24, 48 and 72 h; F=78.28, t values: 6.628-14.384, all P<0.01). The proportion of LNCaP cells in G2/M phase was increased from (12.36±0.28)% to (19.92±0.48)% ( t=17.180, P<0.01). The apoptosis rates of cells were significantly increased in 18.5 and 37.0 MBq groups ( F=71.86, t values: -6.138, -13.050, both P<0.05). The difference of relative tumor volume (RTV%) was statistically significant among 3.7, 14.8 and 29.6 MBq groups and control group (136.7±7.4, 59.2±23.8, 47.3±13.8 vs 240.3±3.7; F=78.20, t values: 7.549-13.345, all P<0.01). But there was no significant difference in body mass of tumor-bearing mice among groups. Compared with the control group, the positive rates of Ki-67 staining cells ((37.23±3.04)% vs (14.89±3.80)%, (5.60±1.83)%, (3.46±0.71)%) and TUNEL-fluorescein isothiocyanate (TUNEL-FITC) staining ((0.74±0.18)% vs (1.61±0.30)%, (3.19±0.44)%, (3.54±0.47)%) in tumor tissues of 3.7, 14.8 and 29.6 MBq groups were statistically significant ( F=103.91, t values: 10.429-15.762; F=38.66, t values: from -9.312 to -2.881, all P<0.01). Conclusions:177Lu-PSMA-I&T has a good therapeutic effect on prostate cancer, with no obvious therapeutic side effects. Therefore, 177Lu-PSMA-I&T is expected to be an ideal drug for treating prostate cancer.

Objective:To review the development and progress of geriatric research in China from the perspective of funding from the National Natural Science Foundation of China, and to provide supporting data for further development of the field.Methods:Based on project funding data of the National Natural Science Foundation of China for geriatric medicine from 2008 to 2017, the number and composition of projects, funding amount and funded institutions were statistically analyzed, and the overall trend of change was examined.The research hotspots in recent years were summarized by using word frequency analysis.Results:From 2008 to 2017, a total of 446 projects were approved in the field of geriatric medicine.Both the number of projects and the amount of funding showed an increasing trend.Project types were gradually expanded and the composition was constantly optimized.Since 2014, the fund types each year included 6 or more and breakthroughs in major projects were achieved.East China remained the leading region in the number of projects and amount of funding, with Beijing, Shanghai and Zhejiang receiving the highest numbers of project approvals and accounting for more than 10% of the national total in the number of project approvals and the amount of funding.During this period, 114 institutions received funding, with 74 winning 2 or more projects.In word frequency analysis, senescence(229 times), cell(161 times)and protein(120 times)were the three most frequently used keywords.Conclusions:In the field of geriatric medicine, the project approval level from the National Natural Science Foundation of China has significantly improved in quantity and quality, but it has always been under-represented in the branch of medical sciences.The regional and institutional distribution of projects is unbalanced and tends to skew in favor of institutions with prominent academic disciplines.Basic research is the main type of funded projects.Geriatric research is centered on the mechanisms of aging.