Objective To predict the length of peripherally inserted central venous catheters(PICC) with electronic chest radiograph scale measurement techniques, and observe its clinical effect. Methods A total of 185 breast cancer patients from October 2012 to December 2013 who were treated by PICC combined with MST guided by ultrasonic technology were as control group. A total of 192 breast cancer patients from January to November 2014 were as observation group. Control group adopted from the puncture point to right sternoclavicular joints impreaaion nip down again to the third floor of PICC in vitro measurement method. Observation group used to right sternoclavicular joints from the puncture point plus right sternoclavicular joints to subcarinal 1 vertebral body length, right sternoclavicular joints to subcarinal 1 vertebral body length measurement by electronic chest radiograph scale technology directly measured from the electronic chest radiographs. The accuracy rates and complications between the two measurement methods were compared. Results The accuracy rate in observation group was 97.92%(188/192), which was higher than that in control group (68.11%,126/185 ),and there was significant differencek,χ2=60.15, P<0.01. The complication rate in observation group was 6.77%(13/192), which was lower than that in control group (20.54%, 38/185) ,and there was significant difference,χ2=9.58, P<0.01. Conclusions The electronic chest radiograph scale measurement techniques could effectively improve the accuracy of PICC catheter placed, improve the quality of venipuncture, decrease the complications .

Abstract College students are a vulnerable population for psychological problems, who are facing challenges from environmental adaptation, career planning, peer competition and interpersonal relationships. In recent years, the state attaches great importance to psychological health education of college students. Virtual reality technology (VR) has been widely used in clinical psychology with the development of techology. In order to enrich channels of psychological health education of college students, the paper summarizes the methods, advantages and future direction of its application in promoting mental health of college students, providing reference for expanding the intervention ways of college students psychological health education and promotion.

Objective To investigate the prevalence of DUOX2 mutations in Chinese patients with congenital hypothyroidism (CH) and to discuss the inheritance pattern of DUOX2 gene.Methods Blood samples were collected from 91 CH children and their genomic DNA was extracted from peripheral blood leukocytes.All exons and exon-intron boundaries of DUOX2 were analyzed by target next-generation sequencing and family trios was established to study the inheritance pattern of DUOX2 gene.Results Fifty-four out of 91 children with CH carried DUOX2 mutation, with a prevalence of 59.34%.Of the 54 CH children, 36 carried DUOX2 biallelic mutations.In all 12 family trios with probands carrying biallelic DUOX2 mutations, the parents carried heterozygous DUOX2 mutations while still showing normal thyroid function, suggesting that CH caused by DUOX2 mutations is inherited in an autosomal recessive manner.Conclusion DUOX2 gene is one of the most frequently mutated genes in Chinese CH patients and its inheritance pattern is an autosomal recessive one.

Objective To set up the model of deiodinase ( Dio) 3b-/- zebrafish and to observe the effect of which on embryo development. Methods The zebrafish model of Dio3b-/- was set up by CRISPR-Cas9 gene editing technology, PCR and sequencing was used to confirm the efficiency of deletion. The heart rate of embryos at 48 hours post fertilization was counted. The locomotor activity of 5-7 days post fertilization larve was detected using behavior tracking system. Results The model of Dio3b knockout zebrafish was set up successfully. The heart rate of embryos Dio3b-/- increased ( P＜0. 001) and the locomotor activity of 5-7 days post fertilization larves lacking Dio3b gene increased (P＜0.05) significantly compared with that of wild type control respectively. Conclusion The deletion of zebrafish Dio3b gene results in the phenotype of hyperthyroidism and the model of Dio3b-/- is proper for studying the effect of partial excess thyroid hormone on embryo development.

Objective To explore the value of vesical imaging reporting and data system(VI-RADS)combined with absolute tumor-wall contact length(ABTCL)and actual tumor-wall contact length(ACTCL)in diagnosing muscle invasive bladder cancer(MIBC).Methods The MRI data of 113 patients with pathologically confirmed bladder cancer(BCa)were analyzed retrospectively.All patients underwent conventional MRI,diffusion weighted imaging(DWI)and dynamic contrast enhanced(DCE)MRI before sur-gery.Two radiologists independently evaluated MRI images based on VI-RADS score,and measured quantitative parameters,inclu-ding ABTCL and ACTCL.The Chi-square test was used to compare the difference of VI-RADS scores between MIBC and non-mus-cle invasive bladder cancer(NMIBC).Quantitative parameters between MIBC and NMIBC were compared by Mann-Whitney U test.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of VI-RADS,quantitative parameters and VI-RADS combined with quantitative parameters in the diagnosis of MIBC.Results VI-RADS,ABTCL and ACTCL had significant differences between MIBC and NMIBC(P＜0.05).The area under the curve(AUC)for VI-RADS,ABTCL and ACTCL in diagno-sing MIBC were 0.89,0.76 and 0.77,respectively.There was no significant difference between the AUC for ABTCL and ACTCL(P＞0.05).The AUC for VI-RADS combined with ABTCL or ACTCL in diagnosing MIBC was 0.93,higher than that of only VI-RADS(P＜0.05).Conclusion The combination of VI-RADS with either ABTCL or ACTCL can effectively improve the diagnostic performance of MIBC.ABTCL obtainedby linear measurement is easier to implement in clinical practice than ACTCL obtained by curved measurement.

Objective:To investigate the core competence of nurses in neurology department and analyze its influencing factors.Methods:A total of 988 neurology nurses from 48 tertiary hospitals in 11 provinces and cities were selected by convenience sampling method from November to December 2019. The general information questionnaire and the self-made core competence questionnaire of Neurology nurses were applied. SPSS 24.0 was used for statistical analysis of the survey results, and single factor analysis of variance, independent sample t test, multiple linear regression analysis were used to analyze the influencing factors. Results:A total of 998 questionnaires were collected and 988 were valid. The total average score of nurses' core competence was (332.19±64.96) . The results of multiple linear regression analysis showed that working years and whether received specialized training in neurology were important variables affecting the core competence of neurology nurses ( P<0.05) . Conclusions:The core competence of nurses in the department of neurology is generally in the upper middle level. The working years and whether received specialized training in neurology are the important influencing factors of the core competence of neurology nurses. In the vocational education of nurses, we should focus on the weak links of core competence, adjust the curriculum of continuing education, strengthen the construction of comprehensive knowledge system, and cultivate comprehensive nursing talents.

Objective: This ex vivo study evaluated the effect of ultrasound and Er:YAG laser irrigation activation techniques on the penetration of sodium hypochlorite solution into infected human root canal dentin, providing a reference for clinical infection control of infected root canals. Methods : Thirty-six cases of infected root canals were collected and randomly divided into three groups according to the irrigation technique: 12 cases in the conventional syringe irrigation (CSI) group, 12 cases in the passive ultrasonic irrigation (PUI) group, 12 cases in the Er:YAG laser and photon-induced photoacoustic streaming (PIPS) group and 36 cases of clean root canals (12 cases in the CSI group, 12 cases in the PUI group, 12 cases in the PIPS group). All of the selected root canals were straight root canals of posterior teeth. After standardizing the root length, all canals were subjected to instrumentation and dynamic irrigation. 2% methylene blue solution was used to visualize the penetration of the irrigant. EXAKT cutting and grinding equipment was used to take transverse sections of 100-150 μm at the coronal, middle and apical thirds of the root canals. The data (maximum penetration depth, average penetration depth, and penetration percentage) were observed under a light microscope to evaluate the effect of dye penetration. Results : With the three irrigation techniques, the maximum penetration depth, average penetration depth and penetration percentage of the infected root canals were significantly lower than those of clean root canals in the full length of the root canal (P<0.05). The penetration percentage, average penetration depth and maximum penetration depth of the PIPS group were significantly higher than those of the CSI group in the coronal, middle and apical thirds of the infected root canal, respectively (P<0.05). There was no significant difference in the maximum penetration depth, average penetration depth or penetration percentage between the PUI and CSI groups (P>0.05). There was also no significant difference in the maximum penetration depth, average penetration depth or penetration percentage between the PIPS and PUI groups (P>0.05). Conclusion The dentine permeability of infected root canals was weaker than that of clean root canals. Er:YAG laser-assisted irrigation activation technology could significantly improve the penetration of sodium hypochlorite solution into infected dentin, but passive ultrasonic irrigation did not significantly improve the penetration.

The continuing challenges that limit effectiveness of tumor therapeutic vaccines were high heterogeneity of tumor immunogenicity, low bioactivity of antigens, as well as insufficient lymph nodes (LNs) drainage of antigens and adjuvants. Transportation of in situ neoantigens and adjuvants to LNs may be an effective approach to solve the abovementioned problems. Therefore, an FA-TSL/AuNCs/SV nanoplatform was constructed by integrating simvastatin (SV) adjuvant loaded Au nanocages (AuNCs) as cores (AuNCs/SV) and folic acid modified thermal-sensitive liposomes (FA-TSL) as shells to enhance de novo antitumor immunity. After accumulation in tumor guided by FA, AuNCs mediated photothermal therapy (PTT) induced the release of tumor-derived protein antigens (TDPAs) and the shedding of FA-TSL. Exposed AuNCs/SV soon captured TDPAs to form in situ recombinant vaccine (AuNCs/SV/TDPAs). Subsequently, AuNCs/SV/TDPAs could efficiently transport to draining LNs owing to the hyperthermia induced vasodilation effect and small particle size, achieving co-delivery of antigens and adjuvant for initiation of specific T cell response. In melanoma bearing mice, FA-TSL/AuNCs/SV and laser irradiation effectively ablated primary tumor, against metastatic tumors and induced immunological memory. This approach served a hyperthermia enhanced platform drainage to enable robust personalized cancer vaccination.