Objective To investigate the usage of Shuxuening Injection in Chuzhou Hospital of Traditional Chinese and Western Medicine (hereinafter referred to as our hospital); To promote clinical rational usage of Shuxuening Injection. Methods A retrospective study was conducted to 297 cases of using Shuxuening Injection in our hospital from January 2016 to June 2016. Results In the 297 cases, 58.9% patients were over 60 years old, and indication coincidence rate of Shuxuening Injection was 52.2%. 91.2% single dose met the instructions and 6.7%solvent use met instructions. Shuxuening Injection in the joint medication also had irrational usage phenomenon. Conclusion There is irrational usage of Shuxuening Injection in our hospital, especially in indication and solvent.

Objective To enhance the awareness of diagnose and treatment of venous thrombus in premature infants. MethodsThe clinical features, treatment and prognosis of lower limb vein thrombus in three case of premature infants were retrospectively analyzed.ResultsThree premature infants of gestational age 29-36 weeks were found thrombosis in 1-57 days after birth. One case received peripherally inserted central cathete (PICC). All of three cases had infection signs and trauma. One case received thrombolytic and anticoagulant therapy, one case received high dose thrombolytic therapy, and both of them were treated successfully without bleeding complication. However, another case was deteriorated after giving up treatment.ConclusionsCritically ill premature infants are at high risk of thrombosis. Infection, indwelling tube, thrombophilia constitution, and maternal risk factors were the high risk factors of thrombosis. Early detection, early diagnosis, and effective individualized treatment can improve the prognosis.

To explore the effects and mechanism of dexamethasone and ambroxol on expression of surfactant protein (SP)-B mRNA and thyroid transcription factor (TTF)-1 in premature rat lung. Methods Sixteen pregnant Sprague-Dawley rats were randomly divided into four equal groups: two doses of dexamethasone (0.2 mg/kg injected intramuscularly on Day 17 and 18 of pregnancy respectively);single dose of dexamethasone (0.2 mg/kg injected intramuscularly on Day 18 of pregnancy);ambroxol group (100 mg/kg injected intraperitoneally on Day 16, 17 and 18 of pregnancy respectively); and control group (normal saline injected intraperitoneally on Day 16, 17 and 18 of pregnancy respectively). There were four pregnant rats in each group. All of the fetal rats were taken out on Day 19 of pregnancy as the preterm birth model, and 20 fetal rats from each group were randomly selected. The ratio of body weight to fetal lung weight of newborn rats was calculated. Changes in lung morphology were observed under light microscopy and the ratio of alveoli surface area to alveolar septae surface area was calculated. Expression of TTF-1 protein was determined by immunohistochemistry. Expression of SP-B mRNA was detected by reverse transcriptase-polymerase chain reaction. One-way analysis of variance, Student-Newman-Keuls method and Pearson correlation analysis were applied as statistical methods. Results (1) The ratio of body weight to fetal lung weight was (6.5±0.6), (7.9±0.8), (9.5±0.8) and (9.5±0.9) mg/g in two doses of dexamethasone group, one dose of dexamethasone group, ambroxol group and control group respectively (F=67.69,P<0.01). The ratio of two doses and one dose of dexamethasone group was lower than that of control group (q=17.143 and 9.143, all P<0.01) and ambroxol group (q=17.143 and 9.143, all P<0.01). The ratio of two doses dexamethasone group was lower than that of one dose dexamethasone group (q=8.000, P<0.01). (2) The ratio of alveoli surface area to alveolar septae surface area was 2.19±0.15, 1.70±0.18, 1.67±0.13 and 1.08±0.12 in two doses of dexamethasone group, one dose of dexamethasone group, ambroxol group and control group respectively (F=190.85, P<0.01). The ratio of two doses of dexamethasone group, one dose of dexamethasone group and ambroxol group were higher than that of the control group (q=33.639, 18.788 and 17.879, all P<0.01). The ratio of two doses dexamethasone group was higher than that of one dose dexamethasone group (q=14.848, P<0.01). (3) Expression of TTF-1 protein was 0.311±0.018, 0.224±0.019, 0.196±0.013 and 0.191±0.018 in two doses of dexamethasone group, one dose of dexamethasone group, ambroxol group and control group respectively (F=211.69,P<0.01). TTF-1 protein expression of two doses and one dose of dexamethasone group were higher than that of control group (q=30.000 and 8.250, all P<0.01) and ambroxol group (q=28.750 and 7.000, all P<0.01). TTF-1 protein expression of two doses dexamethasone group was higher than that of one dose dexamethasone group (q=21.750, P<0.01). (4) Expression of SP-B mRNA was 1.25±0.13, 1.15±0.12, 1.10±0.10 and 1.01±0.12 in two doses of dexamethasone group, one dose of dexamethasone group, ambroxol group and control group respectively (F=14.48, P<0.01). SP-B mRNA expression of two doses of dexamethasone group, one dose of dexamethasone group and ambroxol group were higher than that of control group (q=9.231, 5.385 and 3.462, all P<0.01). SP-B mRNA expression of two doses of dexamethasone group was higher than that of ambroxol group (q=5.769, P<0.01) and one dose of dexamethasone group (q=3.846, P<0.01). (5)TTF-1 expression in two doses of dexamethasone group, one dose of dexamethasone group and control groups was positively correlated with SP-B mRNA expression (r=0.512, 0.597 and 0.449, respectively, all P<0.05). Conclusions Ambroxol can accelerate the maturation of fetal lung with minimal adverse effects on fetal lung weight. Ambroxol might be an alternative to dexamethasone to prevent neonatal respiratory distress syndrome.

This study was aimed to observe the body weight and behavioral changes of heart-spleen deficiency mouseandtoassesstheefficacyofLing-Qi-Jia (LQJ)oralsolutiononqi-supplementingandmind-tranquilizing. The heart-spleen deficiency syndrome mouse model was established by using loading swimming anddrugdaily.Thebodyweight,foodconsumption,intestinepropulsion,tailsuspensiontest (TST),forced swimmingtest (FST),sleepingtimeandtheamountofbrainneurotransmitterweredetected.Theresultsshowed that mouse suffered loading swimming and drug formed heart-spleen deficiency syndrome model, which were indicated by lowering body weight and food consumption, shortened time in FST, prolonged accumulative immobility time in TST, intestine propulsion hyperfunction, shortened sleeping time and lowering brain neurotransmitter amount. LQJ oral solution can obviously improve experiment indexes mentioned above. It was concluded that LQJ oral solution, which can improve insomnia due to heart-spleen deficiency, might had close relation to the efficacy of qi-supplementing and mind-tranquilizing. Meanwhile, changes of brain neurotransmitters might also be the material basis on its efficacy.

Objective To find out the association between the indicators(pulse concussion lung function test index) of bronchial hyperresponsiveness (BHR) with fractional concentration of exhaled nitric oxide (FeNO) at different control periods among preschool asthmatic children.Methods Totally 74 asthmatic children in the pediatric department of our hospital from April 2015 to February 2017 were enrolled in this study,and 25 children undergoing the lung function and FeNO examination served as the controls,aged 3-5 years old.The cases were divided into three groups according to the standard in 2016 version of the Prevention and Treament Guide of Children Bronchial Asthma:asthma control group(n =26),asthma non-control;group(n =48) and control group (n=25).All data of FeNO,resistance of the respiratory system at 5 Hz(R5),resistance of the respiratory system at 5 Hz (R20),difference of R5 and R20(R5-20),reactance area (AX),reactance of the respiratory system at 5 Hz (X5) and resonant frequency of reactance (Fres) were collected.The FeNO,pulse concussion lung function test value and their association were analyzed.Results (1) The FeNO value of asthma the non-control group was significantly higher than that of the asthma control group and the control group,which were 34.00 ± 18.17,20.23± 11.07 and 28.00± 17.30 respectively.The AX detection value of the asthma non-control group was significantly higher than that of the control group(37.29 ± 15.27 vs.30.17 ± 9.50,P＜0.05).(2)R20 had weak correlation with FeNO in the control group(P＜0.05),while R20 had no correlation with FeNO in the non-control group and control group (P＞0.05).FeNO had no obvious correlation with R5,R520,AX,X5 and Fres in the asthma non-control group,asthma control group and control group(P＞0.05).Conclusion In preschool children with asthma,FeNO can reflect the airway eosinophilic inflammation control,and does not reflect the airway hyperresponsiveness.Thereforeit ie needed to combined with FeNO and IOS indicators (airway hyperresponsiveness index AX,etc.),which can more precisely judge whether asthma being controlled.

The standardized training of resident doctors is the main form of medical education after graduation. The standardization training of ultrasound doctors was guided by post competence, and was explored from the aspects, such as training target, teaching management, teaching method, teaching mode, and examination means. In this study, we adhered to the tutor responsibility system, and horizontal multi-module and vertical step-by-step teaching modes, made study plans according to local conditions, and improved the assessment system, so as to build a standardized and practical training system for ultrasound residents.

Objective:To explore the application effect of "blended learning + flipped classroom" in public elective courses for medical students, and provide reference for the blended construction of related courses.Methods:Totally 229 medical students were selected as research participants, who were taught by "blended learning + flipped classroom". After the courses, the curriculum evaluation questionnaires and focus group interview were used to collect students' evaluation of this course. SPSS 22.0 statistical software was used to make descriptive statistics on the questionnaire data.Results:Totally 98.5% students preferred "blended learning + flipped classroom" teaching mode, and more than 93% students thought this teaching method could improve their learning interest, empathy, understanding and application of knowledge. The results of the qualitative survey extracted two themes, namely "improving learning autonomy" and "expanding comprehensive quality".Conclusion:Perfecting the "blended learning + flipped classroom" teaching mode of the medical public elective courses plays a positive role in improving the learning autonomy and comprehensive quality of medical students and optimizing the learning effect.

Objective:To investigate the value of CT features in predicting visceral pleural invasion (VPI) in clinical stage ⅠA peripheral lung adenocarcinoma under the pleura.Methods:The CT signs of 274 patients with clinical stage ⅠA peripheral lung adenocarcinoma under the pleura diagnosed in Changzheng Hospital of Naval Medical University from January 2015 to November 2021 were retrospectively analyzed. According to the ratio of 6∶4, 164 patients collected from January 2015 to August 2019 were used as the training group, and 110 patients collected from August 2019 to November 2021 were used as the validation group. The maximum diameter of the tumor (T), the maximum diameter of the consolidation part (C), and the minimum distance between the lesion and the pleura (DLP) were quantitatively measured, and the proportion of the consolidation part was calculated (C/T ratio, CTR). The CT signs of the tumor were analyzed, such as the relationship between the tumor and the pleura classification, the presence of a bridge tag sign, the location of the lesion, density type, shape, margin, boundary and so on. Variables with significant difference in the univariate analysis were entered into multivariate logistic regression analysis to explore predictors for VPI, and a binary logistic regression model was established. The predictive performance of the model was analyzed by receiver operating characteristic curve in the training and validation group.Results:There were 121 cases with VPI and 153 cases without VPI among the 274 patients with lung adenocarcinoma. There were 79 cases with VPI and 85 cases without VPI in the training group. Univariate analysis found that the maximum diameter of the consolidation part, CTR, density type, spiculation sign, vascular cluster sign, relationship of tumor and pleura and bridge tag sign between patients with VPI and those without VPI were significantly different in the training group( P<0.05). Multivariate logistic regression analysis found the relationship between tumor and pleura [taking type Ⅰ as reference, type Ⅱ (OR=6.662, 95%CI 2.364-18.571, P<0.001), type Ⅲ (OR=34.488, 95%CI 8.923-133.294, P<0.001)] and vascular cluster sign (OR=4.257, 95%CI 1.334-13.581, P=0.014) were independent risk factors for VPI in the training group. The sensitivity, specifcity, and area under curve (AUC) for the logistic model in the training group were 62.03%, 89.41% and 0.826, respectively, using the optimal cutoff value of 0.504. The validation group obtained an sensitivity, specifcity, and AUC of 92.86%, 47.06%, and 0.713, respectively, using the optimal cutoff value of 0.449. Conclusion:The relationship between the tumor and the pleura and the vascular cluster sign in the CT features can help to predict visceral pleural invasion in the clinical stage ⅠA peripheral lung adenocarcinoma under the pleura.

Objective To evaluate the effectiveness of deep learning methods to detect subsolid nodules from chest X-ray images.Methods The building,training,and testing of the deep learning model were performed using the research platform developed by Infervision,China.The training dataset consisted of 1 965 chest X-ray images, which contained 85 labeled subsolid nodules and 1 880 solid nodules. Eighty-five subsolid nodules were confirmed by corresponding CT exams. We labeled each X-ray image using the corresponding reconstructed coronal slice from the CT exam as the gold standard,and trained the deep learning model using alternate training.After the training,the model was tested on a different dataset containing 56 subsolid nodules,which were also confirmed by corresponding coronal slices from CT exams. The model results were compared with an experienced radiologist in terms of sensitivity,specificity,and test time. Results Out of the testing dataset that contained 56 subsolid nodules, the deep learning model marked 72 nodules,which consisted of 39 true positives(TP)and 33 false positives(FP).The model took 17 seconds.The human radiologist marked 39 nodules,with 31 TP and 8 FP.The radiologist took 50 minutes and 24 seconds. Conclusions Subsolid nodules are prone to mis-diagnosis by human radiologists. The proposed deep learning model was able to effectively identify subsolid nodules from X-ray images.

Objective To develop and validate the radiomics nomogram on the discrimination of lung invasive adenocarcinoma from'non-invasive'lesion manifesting as ground glass nodule(GGN)and compare it with morphological features and quantitative imaging. Methods One hundred and sixty pathologically confirmed lung adenocarcinomas from November 2011 to December 2014 were included as primary cohort. Seventy-six lung adenocarcinomas from November 2014 to December 2015 were set as an independent validation cohort. Lasso regression analysis was used for feature selection and radiomics signature building. Radiomics score was calculated by the linear fusion of selected features. Multivariable logistic regression analysis was performed to develop models. The prediction performances were evaluated with ROC analysis and AUC,and the different prediction performance between different models and mean CT value were compared with Delong test. The generalization ability was evaluated with the leave-one-out cross-validation method. The performance of the nomogram was evaluated in terms of its calibration. The Hosmer-Lemeshow test was used to evaluate the significance between the predictive and observe values.Results Four hundred and eighty-five 3D features were extracted and reduced to 2 features as the most important discriminators to build the radiomics signatures. The individualized prediction model was developed with age, radiomics signature, spiculation and pleural indentation, which had the best discrimination performance(AUC=0.934)in comparison with other models and mean CT value(P<0.05)and showed better performance compared with the clinical model(AUC=0.743,P<0.001).The radiomics-based nomogram demonstrated good calibration in the primary and validation cohort, and showed improved differential diagnosis performance with an AUC of 0.956 in the independent validation cohort. Conclusion Individualized prediction model incorporating with age, radiomics signature, spiculation and pleural indentation, presenting with radiomics nomogram, could differentiate IAC from'non-invasive'lesion manifesting as GGN with the best performance in comparison with morphological features and quantitative imaging.