AIM:To examine the relationship between the gene defect,change of protein hydrophobicity,spacial structure change and clinical phenotypes of Duchenne muscular dystrophy(DMD),and to explore the molecular pathogenesis of DMD.METHODS:The gene sequences of 59 cases of DMD/BMD patients with deletion from mutation were analyzed.The relationship between the protein hydrophobicity,3D-spacial structure and clinical phenotypes was examined by biological informatic technology.RESULTS:50 cases of frameshift mutation were all DMD.In other 5 cases with codon mutation that involved the 3rd hydrophobic region,4 cases were diagnosed as DMD and the rest one was BMD.The exon 3 deletion leaded to the intortion of dystrophin N-terminal,which in turn affected the combination of dystrophin and troponin resulting in the DMD pathopoiesis.CONCLUSION:The severity of clinical phenotypes of muscular dystrophy diseases is related to whether the deletion destroys the reading frame,involves the 3rd hydrophobic region or changes the protein special structure.The biological informatic technology provides a new potential research methodology for studying the pathogenesis of DMD.

Objective To investigate the relationship between carotid arteriostenosis and atheromatous plaques with cerebral in-farction.Methods Cervical spiral CT angiography of 56 cases with cerebral infarction and 49 cases without cerebral infarction were retrospectively analysed .The difference between the two groups was compared with regard to the distribution ,nature of plaques and the degree of carotid artery stenosis.Results Of 56 patients with cerebral infarction,126 atheromatous plaques were detected in 42 patients,of which 39 were soft,34 were calcified,53 exhibited a combined nature of both calcified and soft plaque and 7 cases were plaque ulcerations (soft plaque and mixed plaque accounted for about 73%).Plaque location for carotid artery was in the bifurcation. 102 carotid arteries stenosis were found in 38 patients,which included mild stenosis in 29,moderate in 40,severe in 27 and occlusion in 6(moderate and severe stenosis accounted for about 65.7%).In the control group,28 plaques were detected in 1 1 cases,of which 6 were soft,13 were calcified and 9 exhibited a combined nature of both calcified and soft plaque.1 1 carotid arteries stenosis were found in 7 patients,included mild stenosis in 10,moderate in 1.A significant difference (P <0.05)in carotid arteriostenosis and ath-eromatous plaques between the two groups was found.Conclusion Carotid plaques and stenosis are important risk factors of cerebral infarction.Multi-slice spiral CT angiography(MSCTA)has important value in analysis of carotid artery stenosis and atheroderotic plaques.

Objective To analyze the plaque distribution of abdominal aorta and its branches by multislice spiral CT angiography (MSCTA).Methods 145 patients recommended to abdominal enhanced CT were randomly selected in this investigation,and divided into three groups according to their age,i.e.,young,middle and old-aged group.CTA was performed with the use of multiple planar reconstruction(MPR),volume rendering (VR)and vessel probe(VP)technology.Results 124 patients with atherosclerotic plaques of abdominal aorta and all its branch-vessels,the incidences of the three groups were 9.7%(14 cases),30.3%(44 cases)and 45.5%(66 cases)respectively(P <0.005).It showed that calcified plaques were detected in a total of 1 50 in 302 plaques of all the branch-vessels.230 plaques(76.2%)were detected in abdominal branch-vessels of grade 1,of which,the incidences of superior mesenteric artery plaques was the highest(32.4%).Of the 54 plaques(1 7.9%)detected in abdominal branch-vessels of grade 2,the incidence of splenic artery plaques was the highest(13.8%).In abdominal branch-vessels of grade 3,the plaques were mainly distributed in splen-ic lobial artery.The splenic artery plaques mainly spreaded in the middle segment,while other plaques were mostly in peristome and proximal segment of vessels.The incidences of plaques in the three branches were 47.6%(69 cases),1 5.2%(22 cases),and 9.0%(13 cases)respectively(P <0.005).Conclusion The incidences of atherosclerotic plaques are higher in the middle and aged people. The plaques of the three abdominal branch-vessels mainly distribute in the peristome and proximal segment,and are much likely to be detected in abdominal branch-vessels of grade 1.

OBJECTIVEAccurate segmentation of lung fields in chest radiographs (CXR) is very useful for automatic analysis of CXR. In this work, we propose to use dense matching of local features and label fusion to automatically segment the lung fields in CXR.

METHODSFor an input CXR, the dense Scale Invariant Feature Transform (SIFT) descriptors and raw image patches were extracted as the local features for each pixel. The nearest neighbors of the local features were then quickly searched by dense matching directly from the whole feature dataset of the reference images. The dense matching included three steps: limited random initialization, propagation of nearest neighbor field, and limited random search, with iteration of the last two steps for several times. The label image patches for each pixel were extracted according to the nearest neighbor field and weighted by the matching similarity. Finally, the weighted label patches were rearranged as the label class probability image of the input CXR, from which thresholds were obtained for segmentation of the lung fields.

RESULTSThe Jaccard index of the proposed method reached 95.5% on the public JSRT dataset.

CONCLUSIONA high accuracy and robustness can be obtained by adopting dense matching of local features and label fusion to segment the lung fields in CXR, and the result is better than that of current segmentation method.

Algorithms ; Cluster Analysis ; Humans ; Lung ; Radiographic Image Interpretation, Computer-Assisted ; Radiography, Thoracic

Objective To evaluate the effects of Traditional Chinese Medicine (TCM) nursing training based on Kirkpatrick's model relying on TCM hospitals.Methods Totally 77 clinical nurses from 50 medical institutions in Hangzhou were enrolled for TCM training.The four levels of Kirkpatrick's model including reaction,learning,behavior and results were applied for the evaluation together with questionnaires,paper-based exams,scene simulation method and semi-structured interviews.Results Nurses' attendance was over 85％,and average score of training satisfaction was 96.32±5.91 which lied between highly satisfied and very satisfied.TCM knowledge and skills were higher after training(P＜0.05).The scores of self-evaluation and peer evaluation were higher after training(P＜0.05).The numbers of projectsand personnel to practice TCM in the department or outpatient clinic were higher after training (P＜0.05).The patient satisfaction was over 82％.The themes of training benefits among nurses were reaching the expected values,growth and harvest,and expectation of continuous learning.Conclusion Using Kirkpatrick's model as the evaluation tool can evaluate the effects of TCM nursing training relying on TCM hospitals in a comprehensive and long-term manner,and improve the quality of training.