The Medical Healthcare Service Center,located at the Youxian District,Mianyang City of Sichuan Province,successfully rescued the people affected by the Wenchuan earthquake and the Tangjiashan barrier lake with great help from the senior hospitals.We suggest that the community healthcare service center could play an important role in emergency response system.

ObjectiveTo investigate clinical features and outcomes in acute ischemic stroke patients with remote symptomatic intracranial hemorrhage (sICHr) after intravenous thrombolysis.MethodsThe acute ischemic stroke patients with sICHr after intravenous thrombolysis therapy were enrolled retrospectively.The clinical data were collected and the related literature was analyzed and summarized.ResultsA total of 6 acute ischemic stroke patients with sICHr were enrolled, including 4 males.Three patients had a history of using antiplatelet agents, 2 with atrial fibrillation, 4 with hypertension, 3 with previous stroke history, 4 with smoking history, and 4 had sICHr at 2 h after intravenous thrombolysis.Of the 14 hemorrhagic foci (except in the infarct areas), 10 were in the cerebral cortex.Three patients died within 1 week, and 1 was in a persistent vegetative state.Conclusions SICHr after intravenous thrombolysis in patients with acute ischemic stroke is mainly located in the cerebral cortex.The outcomes in acute ischemic stroke patients with SICHr after intravenous thrombolysis are poor, and the mortality is high.

Purpose To explore the application value of artificial intelligence(AI)assistant diagnosis system based on Chinese thyroid imaging reporting and data system(C-TIRADS)in the diagnosis of suspected thyroid nodules.Materials and Methods A total of 441 patients(445 nodules)with suspected thyroid nodules examined in Huadong Sanatorium from January 2018 to December 2021 were retrospectively analyzed.The low seniority group,the senior seniority group and the AI group were composed of the junior doctors,the senior doctors and the AI assistant diagnosis system,respectively.The suspicious thyroid nodules were classified according to the C-TIRADS guideline,and then the suspicious thyroid nodules were classified again by the low seniority group and the senior group combined with the AI assistant diagnosis system.Taking the pathological results as the gold standard,the diagnostic efficacy of each group was compared,and the sensitivity,specificity,accuracy,positive predictive value,negative predictive value,Jordan index and area under the curve(AUC)were further compared.Results Of the 445 thyroid nodules,there were 277 malignant nodules and 168 benign nodules.The AUCs of thyroid nodules in low seniority group,high seniority group and AI group were 0.760,0.858 and 0.849,respectively.The AUCs in high seniority group and AI group were significantly higher than that in low seniority group(both P<0.001),and the AUC in high seniority group was similar to that in AI group(P>0.05).The AUCs of thyroid nodules in low seniority group and high seniority group combined with AI assistant diagnosis system was higher than those in low seniority group and high seniority group,especially in low seniority group(0.830 vs.0.760,P<0.001).The accuracy,Jordan index and AUC were the highest when TR4C was used as the cut-off point of suspected thyroid nodules.Conclusion The AI assistant diagnosis system based on C-TIRADS has high value in the differential diagnosis of thyroid suspicious nodules,and the combined model can improve the diagnostic efficiency of different seniority doctors.The best cut-off point of different seniority doctors and combined model of AI assistant diagnosis system for differential diagnosis of thyroid suspicious nodules may be TR4C.

OBJECTIVE To investigate the effects and mechanism of Glycyrrhiza inflata polysaccharides （GiP） and GiP-B1 on the maturation and anti-tumor effect of dendritic cell （DC）. METHODS The immature DC （imDC） of hepatocellular carcinoma cell H22 tumor-bearing mice cultured in vitro were divided into control group， tumor necrosis factor-α （TNF-α） group， GiP group， and GiP-B1 group. The viability， positive expressions of surface markers （CD11c， CD80， CD86， MHC-Ⅱ）， the levels of interleukin-12p70 （IL-12p70） and IL-4 in mature DC （mDC） of tumor-bearing mice were detected. mDC and CD4+T lymphocytes were co-cultured to generate CD4-cytotoxic T cell （CD4-CTL）； stimulation index， the levels of IL-12p70， interferon-γ （IFN-γ）， IL-4 and IL-10， the killing activity of CD4-CTL to H22 cell were detected. mRNA expressions of IL-12， IL-12 receptor （IL-12R）， signal transducer and activator of transcription-4 （STAT-4）， as well as the protein expression of IL-12 receptor β2 （IL-12Rβ2）， phosphorylation levels of nuclear factor-kappa B （NF- κB） p65 and STAT-4 proteins in mDC were detected after co-culture. RESULTS Compared with the control group， the viability of mDC， the positive expressions of MHC-Ⅱ， and the levels of IL-12p70 and IL-4 were increased significantly in GiP group and GiP-B1 group （P＜0.05）. The positive expressions of CD11c， CD80 and CD86 showed an increasing trend， but the differences were not statistically significant （P＞0.05）. After co-culturing， the stimulation index， the levels of IL-12p70 and IFN-γ were significantly increased （P＜0.05）， while the levels of IL-4 and IL-10 （except for the GiP group） were significantly decreased （P＜0.05）； the cytotoxicity against H22 cells was significantly enhanced （P＜0.05）. mRNA expressions of IL-12 and IL-12R （except for GiP group） and STAT-4， protein expression of IL-12Rβ2 as well as phosphorylation levels of NF-κB p65 and STAT-4 protein were increased significantly in mDC （P＜0.05）. CONCLUSIONS GiP and GiP-B1 have a good promoting effect on the maturation of DC in tumor-bearing mice， effectively stimulate CD4+T cell proliferation， enhance the anti-tumor activity of CD4-CTL，and its mechanism may be related to activating IL-12/NF-κB/ STAT-4 signaling pathway.