Objectlve To evaluate the clinical value of the detection of Myeobacterium tuberculosis (MTB)and its L-forms(MTB-L)in pefipheral blood.Methods MTB and MTB-L in blood samples of 156 patients with tuberculosis and 147 patients with lung cancer were detected by hemolysis centrifugal drop Intensified Kinyoun's acid fast staining (IK) and hemolysis centrifugal culture with 42 healthy persons as controls.MTB DNA was detected by TaqMan-PCR technique in plasma mononuclear cells and whole blood from aforementioned groups.Results Among each groups detected by IK.the MTB positive rate was 1.3%(2/156),0.7%(1/147),and 0%(0/42)respectively.The positive rate of culture was 0.6%(1/156),0%(0/147),and 0%(0/42)respectively.MTB-L positive rate detected by IK was 41.0%(64/156),32.7%(48/147)and 7.2%(3/42).MTB-L positive rate detected by culture was 25.6%(40/156)and 39.5%(58/147).0%(0/42).MTB positive rate were significantly different from the MTB-L positive rate (P＜0.01).Among the 98 strains L-forms,81 strains were from human,17 strains were from bovis,and 44 strains were back to the ancestors.The positive rate of mononuclear ceHs and whole blood obtained from the tuberculosis group detected by TaqMan-PCR were 77.6%(121/156) and 68.6%(107/156)(P＜0.05).The positive rate of mononuclear cells and whole blood from lung cancer group were 59.2%(87/147)and 48.3%(52/147)(P＜0.05),which were higher than the plasma positive rate 12.2%(18/147)(P＜0.05).The result of individual bloed constituents (except for plasma) from two groups were significantly different from the control(P＜0.01).Conclusions MTB-L was found in the peripheral blood of the tuberculosis and lung cancer patients.Hemolysis centrifugal culture is a rapid,simple and reliable method for detecting MTB-L TaqMan-PCR showed the positive rate of MTB DNA in plasma and whole blood samples were significantly higher than that in the plasma.

The present study reported the observations with light and electronic micros copy on hybrid cells crossed between rat intermediate or late erythroblasts and mouse SP2/0 plasmocytoma cells. In a short period after fusion, the cell size and the ratio of nuclear heterochromatin in hybrid cells appeared to be increased, but the number of nucleoli, as well as the number of microvilli, finger-like processes, and nuclear cytoplasmic ratio were decreased. Swelling mitochondria, pycnotic nuclei and/or process of enucleation also could be seen in some hybrid cells. The subcul tured hybrid cells were characterized with less microvilli and cellular surface membrane processes, and showing marked changes in nuclear size, as well as the appearance of cytoplasmic vesicles and dense granules in some cells. The observations mentioned above provide morphological and ultrastructural evidences for the regulation of malignant phenotype of hybrid cell model we reported previously. The possible relationship between the deeancerization and the morphological changes of hybrid cell nucleus, cytoplasm and cell surface were briefly discussed.

The gene expression of both the mouse plasmocytoma (SP2/0) and the hybrid cells crossed with rat nucleated erythroblasts were detected by in situ hybridization technique using the probes of mouse ?-globin gene and 7 oncogenes (v-Ki-ras, v-H-ras, v-sis, erb-B, v-abl, v-fos, c-myc). After plasmic amplification, DNA was isolated by alkali lysis, purified and recovered, the DNA containing gene fragments were labelled with ~(32)P to become high activity ~(32)P-cDNA probes through nick translation, and the labelled probes were used to detect the gene transcripts in cellular level. The results indicated that: (1) no mouse ?-globin gene transcripts could be detected in the cytoplasm of SP2/0 cells, as well as in hybrid cells within 72 hours after cell fusion, but transcript signals could be observed in hybrid cells from 4th to 26th passages. (2) Active expression of multioncogenes in SP2/0 cells was demonstrated, all the 7 oneogenes tested, except v-sis, were expressed more strongly. On the other hand, the expression of oncogenes in hybrid cells was found to be dramatically decreased, among them, the oncogenes of c-myc and Ki-ras been suppressed completely. After long term of passages (26th subcultures), the expression of c-myc and Ki-ras was still lower than that of SP2/o ceils although in some cases other oncogenes increased in their expression levels. These results confirmed that the multistep carcinogenesis involved multi-oncogenes expression and that the decancerization of tumor cells may be due to the suppression of multi-oncogenes activity as well as to activate the expression of differentiation genes.

At present, coronavirus disease 2019 (COVID-19) caused by 2019 novel coronavirus (2019-nCoV) infection has spread rapidly in China and more than 70 countries around the world and thus become a public health event of international concern. In addition to fever and respiratory symptoms, varying degrees of liver injury is also observed after 2019-nCoV infection. This article reviews the clinical features, pathology, pathogenic mechanism, and therapeutic strategies of liver injury associated with COVID-19, hoping to provide a reference for clinical decision-making on the prevention and treatment of COVID-19.

Background:Small intestinal bleeding is difficult to diagnose and treat because of its complex etiology and limit to examination method. Aims:To analyze the etiology,diagnosis,treatment and prognosis of small intestinal bleeding. Methods:The clinical data of 118 consecutive patients with small intestinal bleeding admitted from Oct. 2006 to Oct. 2016 at Daping Hospital,the Third Military Medical University were retrospectively analyzed. Results:Melena was the most common manifestation of small intestinal bleeding (41. 5％),followed by dark bloody stool,positive fecal occult blood test,hematochezia,and anemia with unknown cause. The major causes of bleeding were benign or malignant tumors (43. 2％),vascular lesions (28. 0％)and inflammatory lesions (15. 3％). Diagnosis was made by means of capsule endoscopy,colonoscopy,digital subtraction angiography (DSA),barium meal examination,multi-slice CT (MSCT)and CT enterography (CTE). Forty-one patients were treated by surgical operation,7 by selective arterial embolization,2 by endoscopic therapy,56 by conservative therapy,and all these patients achieved hemostasis. One patient died of massive hemorrhage and 11 were discharged with giving up of treatment. Conclusions:The leading cause of small intestinal bleeding is tumor,followed by vascular and inflammatory lesions. Capsule endoscopy is able to make definite diagnosis with high accuracy,and MSCT is the most widely used diagnostic approach. In addition to conventional treatment,surgical operation,interventional and endoscopic therapies also play important roles in treating small intestinal bleeding.

Fatigue-related traffic accidents and fatalities have been extensively studied by scholars globally.Specialized vehicles,due to their unique mission profiles,are more likely to cause driving-related fatigue and serious consequences.This paper reviews the current research of fatigue driving by using an inductive analysis method to summarize the mechanisms,risk factors,and monitoring methods.This paper also offers a vision of priorities and methodologies for research in the future.It is recommended that the mechanisms of driving fatigue be explored at the molecular biological level and that fatigue monitoring systems be made more feasible via the combined application of non-intrusive monitoring in order to reduce the toll on life and property taken by driving fatigue.

Objective To develop a pressure swing adsorption oxygen generating device that is workable at altitudes of 0 to 7000 meters.Methods The three-bed molecular sieve oxygen production process was adopted.The switching time of air circuit solenoid valve and the rotation speed of the compression pump were taken as controllable variables.The performance of the oxygen generating device was tested in a normal atmospheric environment and a low-pressure environment corresponding to altitudes of 0 to 7000 meters.The optimal values of controllable oxygen generating parameters corresponding to 10 low-pressure environments(89.9,79.7,69.7,65.0,62.0,57.7,53.8,47.6,43.0,41.0 kPa)were obtained.Results The oxygen concentration could reach 94％,oxygen flow rate was 9 L/min and oxygen outlet pressure stood at 44 kPa in a normal atmospheric environment(altitude 416 meters),compared with 94％,6.3 L/min and 30 kPa in a low-pressure environment of 41 kPa(altitude 7000 meters).Conclusion The oxygen generating device can meet the oxygen needs of two persons within the altitude range of 0 to 7000 meters.

Objective:To analyze distributions of dose range, occupational category, and causes of abnormal dose values from individual dose monitoring of radiation workers and to provide recommendations for improving the quality of individual monitoring data and occupational health management in medical institutions.Methods:The data of individual dose monitoring result exceeding 1.25 mSv in a single monitoring cycle, collected by Occupational Health System for Radiology Facilities’ on National Radiological Health Information Platform, was analyzed.Results:A total of 1 113 abnormal dose values were detected in 31 provinces in 2020, with an abnormal rate of 2.48‰, of which workers of diagnostic radiology and interventional radiology accounted for 68.01% and 18.78%, respectively. The dose distribution of abnormal dose values was mainly between 1.25 and 5 mSv. The abnormal dose values were mainly caused by improperly wearing or using personal dosimeters, accounting for 63.88%. Workers for whom the dose values was abnormal due to increased workload accounted for 12.32%, with an average annual individual dose of 5.14 mSv. There was no statistically significant difference in annual individual dose among radiation workers between different occupational groups( P>0.05). Conclusions:Education and training on radiation protection for radiation workers should be strengthened, and a specific and feasible system for radiation protection management, as well as a reward and punishment system, should be established in order to reduce the occurance of the improper wearing of personal dosimeters. Great attention should be paid to occupational exposure of workers in diagnostic radiology and interventional radiology, and a work shift system should be conducted to reduce individual dose levels. It is recommended that standard verification procedures for abnormal dose values from individual dose monitoring should be developed to improve the quality of individual monitoring data.

Objective:To construct the quality evaluation scale of specification of management for humanistic caring in outpatients and test its reliability and validity.Methods:Referring to the group standards in Specification of Management for Humanistic Caring in Outpatients released by the China Association for Life Care,as well as relevant guidelines and literature,a pool of items for the quality evaluation scale of specification of management for humanistic caring in outpatients was formed.After expert consultation and expert argumentation,a quality evaluation scale of specification of management for humanistic caring in outpatients was constructed.From January to February 2024,243 hospital managers from 5 hospitals in Zhengzhou were selected as survey subjects to conduct item analysis,and reliability and validity testing on the scale.Results:Two rounds of expert inquiry and two rounds of expert argumentation were conducted,with questionnaire response rates of 92.00%and 100.00%,respectively,and expert authority coefficients of 0.952.In the second round of the expert inquiry scale,the mean importance score of the first-level indicators was 4.80 to 5.00,the full score ratio was 88.00%to 100.00%,the coefficient of variation was 0.04 to 0.17,and Kendall's coefficient of concordance was 0.857(P＜0.001);the mean importance score of the second-level indicators was 4.60 to 5.00,the full score ratio was 80.00%to 100.00%,the coefficient of variation was 0.00 to 0.21,and Kendall's coefficient of concordance was 0.775(P＜0.001);the mean importance score of the third-level indicators was 4.60 to 5.00,the full score ratio was 76.00%to 100.00%,the coefficient of variation was 0.00 to 0.21,and Kendall's coefficient of concordance was 0.830(P＜0.001).Finally,a quality evaluation scale of specification of management for humanistic caring in outpatients was formed,including 5 first-level indicators,25 second-level indicators,and 58 third-level indicators.Exploratory factor analysis produced 5 common factors with a cumulative variance contribution rate of 74.628%.The Pearson correlation coefficients between the five-factor scores ranged from 0.648 to 0.798,and the correlation coefficients between the factor scores and the total score of the scale ranged from 0.784 to 0.938.The scale-level content validity index(S-CVI)of the scale was 0.945,the item-content validity index(I-CVI)was 0.725 to 1.000,the Cronbach's alpha coefficient of the total scale was 0.973,and the retest reliability coefficient was 0.934.Conclusion:The constructed quality evaluation scale of specification of management for humanistic caring in outpatients has good scientific validity and reliability,and can be used as an evaluation tool for specification of management for humanistic caring in outpatients.

Objective: For computer-aided Chinese medical diagnosis and aiming at the problem of insufficient segmentation, a novel multi-level method based on the multi-scale fusion residual neural network (MF2ResU-Net) model is proposed. Methods: To obtain refined features of retinal blood vessels, three cascade connected U-Net networks are employed. To deal with the problem of difference between the parts of encoder and decoder, in MF2ResU-Net, shortcut connections are used to combine the encoder and decoder layers in the blocks. To refine the feature of segmentation, atrous spatial pyramid pooling (ASPP) is embedded to achieve multi-scale features for the final segmentation networks. Results: The MF2ResU-Net was superior to the existing methods on the criteria of sensitivity (Sen), specificity (Spe), accuracy (ACC), and area under curve (AUC), the values of which are 0.8013 and 0.8102, 0.9842 and 0.9809, 0.9700 and 0.9776, and 0.9797 and 0.9837, respectively for DRIVE and CHASE DB1. The results of experiments demonstrated the effectiveness and robustness of the model in the segmentation of complex curvature and small blood vessels. Conclusion Based on residual connections and multi-feature fusion, the proposed method can obtain accurate segmentation of retinal blood vessels by refining the segmentation features, which can provide another diagnosis method for computer-aided Chinese medical diagnosis.