Objective To investigate the level and influencing factors of self-efficacy for peritoneal dialysis patients. Methods A total of 110 peritoneal dialysis patients were recruited and investigated with a self-designed scale, Self-efficacy for managing Chronic Disease 6-Item Scale, Social Support Assessment Scale, Family APGAR Index and Hospital Anxiety and Depression Scale. Results The score of the self-efficacy was (6.87±2.06) points. Multiple regression analysis showed that anxiety and depression, social support and family function were influencing factors of the self-efficacy, which could explain 44.9% of the variance. Conclusions Improving the self-efficacy of peritoneal dialysis patients can enhance self-care agency and rehabilitation efficacy.

BACKGROUND:MRI characterized as non-invasion, high resolution, high sensitivity and specificity to injury has become another important means for diagnosis of knee joint disease folowing the arthroscopy. OBJECTIVE: To explore the effective evaluation on the knee meniscus injury diagnosis, by comparing the results of MRI and arthroscopy of the knee meniscus. METHODS: Clinical data of 206 patients with meniscus injury were retrospectively analyzed. Every case was subjected to MRI and the arthroscopy. The findings of arthroscopy were considered as the golden standard. Then, the sensitivity, specificity and coincidence rate of MRI in the diagnosis of meniscus injury were calculated. The chi-square analysis was used to evaluate the MRI and arthroscopy in the diagnosis of meniscus injury. The Kappa values were used to test the consistency of MRI with arthroscopy in the diagnosis of meniscus injury. RESULTS AND CONCLUSION:For levels 0 and I meniscus injury, the coincidence rate of MRI was 97%; for level II meniscus injury, the coincidence rate of MRI was 91.1%, and there was no significant difference (P > 0.05). For level III meniscus injury, the sensitivity, specificity, concordance rate and Youden index of MRI were 92.9%, 94.4%, 93.7% and 87.3%, respectively. By the consistency checking, the value of Kappa was 0.874 and χ2 so there was a high consistency checking between the data of MRI and arthroscopy (P=0.000). MRI is a noninvasive diagnostic method for meniscus injury. For patients with levels I and II meniscus injury on MRI, arthroscopy should be cautiously adopted; however, for patients with level III meniscus injury on MRI, arthroscopy should be done as early as possible. Arthroscopic observation is more intuitive that enables to make accurate judgments of meniscus injury to reduce the rate of misdiagnosis.

Objective To detect the disinfectant-resistant geneqacA/B in the strains ofStaphylococcous aureus isolated from January 2014 to December 2014.Methods Fifty-one isolates were collected. PCR assay was used to detectmecA gene andqacA/B gene in the isolates followed byStaphylococcus protein A (spa) typing. Antimicrobial-resistant phenotypic typing was conducted to analyze the homology of theseqacA/B positive strains. The clinical information of the patients from whom the strains were isolated was collected to further understand the clinical background ofqacA/B-carryingS. aureus.Results The prevalence ofmecA and qacA/B genes was 21.6% (11/51) and 13.7% (7/51), respectively in the strains. The prevalence ofqacA/B gene in the methicillin-resistantS. aureus strains (54.5%, 6/11) was signiifcantly higher than that in the methicillin-sensitiveS. aureus strains (2.50%, 1/40). The prevalence ofmecA gene inqacA/B gene positive strains (6/7) was signiifcantly higher than that inqacA/B gene negative strains (1/7). TheseqacA/B positive strains were classiifed into 4 spa types (t037, t091, t932 and t895). The main type was t037 (4/7), which was from the pediatric ward.Conclusions The prevalence ofqacA/B gene is low in theS. aureus strains. However, the prevalence of this gene in methicillin-resistantS. aureus strains is far higher than that in methicillin-sensitiveS. aureus. spa type t037 may be a prevalent clone in pediatric ward.

Objective To explore the value of DWI ADC in the diagnosis of hepatic ischemia reperfusion injury (IRI) at 3.0 T and investigate the mechanism by comparison with liver enzyme and pathological findings. MethodsForty-two New Zealand white rabbits were divided randomly into ( n ＝ 6,each) six IRI groups by rank sum test. The IRI animals underwent left lobar ischemia for 60 min and were reperfused 0. 5 h, 2. 0 h, 6. 0 h, 12. 0 h, 24. 0 h and 48. 0 h later. One Sham operative group underwent laparotomy without liver ischemia. T2 WI, T1 WI, DWI and contrast-enhanced T, WI were performed with 3.0 T magnetic resonance imaging scanner in each group respectively. For DWI, b-values of 20, 50, 100,200,300,400,500 and 600 s/mm2 were used respectively. Blood samples were taken to detect the levels of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) at different time points. Liver samples were examined histologically after MRI scanning. One-way analysis of variance (ANOVA) was used to determine differences, followed by LSD-t test for multiple comparisons. ResultsOverall, ADC decreased markedly at the early IRI phase ( 0. 5 h), drastically increased in the 2.0 h group, and then ascended slightly from 6. 0 h to 48.0 h after reperfusion, except for a transient decrease at the time point of 24. 0 h. When b values were 20, 50, 100,200 and 300 s/mm2, the ADC values in the Sham group were (3.47 ±0.53) × 10-3, (3.11 ±0.39) ×10-3, (2.87 ±0.19) ×10-3, (2.56 ±0.37) × 10-3 and (1.95 ±0.33) ×10-3mm2/s, (2.63±0.31)±10-3, (2.47±0.32) ×10-3, (2.12±0.38) ×10-3, (2.01±0.51) ×10-3and (1.61 ±0.17) ×10-3mm2/s in the 0.5 h group, (2.72 ±0.09) ×10-3, (2.51±0. 11) ×10-3, (2.28 ±0.30) ± 10-3, (1.96 ±0. 14) × 10-3 and (1.58 ±0. 17) × 10-3mm2/s in the 24.0 h group, respectively. ADC of 0. 5 h and 24. 0 h groups were significantly lower than that of Sham group (P＜0.05) when b value was under 300 mm2/s.In the Sham, 0.5 h, 2.0 h, 6.0 h, 12.0 h,24.0 h and 48. 0 h IRI groups, they were (80±8), (181 ±34), (413 ±62), (474 ±83), (424 ±41 ),(332 ±41 )and(302 ±39) U/L for the levels of ALT,and (79 ± 10), (454 ±55), (547 ±72), (607±31 ), (649 ±79), (785 ±49) and ( 1526 ± 167) U/L for the AST respectively. The levels of AST and ALT in IRI groups were significantly higher than those in the Sham group ( P ＜ 0. 01 ).Histological findings showed diffuse hepatocytes swelling and erythrocytes depositing in the hepatic sinusoids, portal area, central venous and arterials at the initial phase.With the injury aggravated, inflammatory cell infiltration,hepatocyte nuclear condensation of apoptosis, sinusoidal dissociation and coagulation necrosis developed eventually. Conclusion 3.0 T DWI can monitor the pathological process of rabbit liver ischemia reperfusion injury dynamically, and provides a feasible imaging modality for clinical diagnosis and treatment.

Objective:To explore the application value of single source dual energy CT (DECT) scanning technique in improving the image quality of the pancreas.Methods:Imaging data of 21 patients with normal pancreas and 36 patients with pancreas related diseases in the First Affiliated Hospital of Naval Medical University from July 2021 to August 2021 were collected. All the patients first underwent multi-slice CT (MDCT) scan with no-contrast, and then dynamic enhanced MDCT scan. And the DECT scan was used in the delay period. Virtual single energy images (VMI, 40~100keV) of normal pancreas and mixed energy images of pancreatic lesions (PI, 80 and 140kVp) were obtained. The regions of interest (ROI) of fat on abdominal wall, normal pancreas and abdominal aorta were delineated, the CT values and standard deviation (SD) of each ROI were measured and recorded, and the pancreatic signal-to-noise ratio (SNR) and contrast-to-noise ratio (SNR) of each energy image were calculated. The objective index and subjective score of VMI(40-100keV) and PI (80kVp and 140kVp) with iodine (water) base map and VMI best CNR were compared between groups. The correlation between VMI(40-100keV) and PI(80, 140kVp) with iodine (water) base map and VMIbest CNR was analyzed by univariate regression.Results:In VMI(40-100keV) of normal pancreas, the highest SNR value was VMI best CNR and iodine (water) base map, and the highest CNR values were VMI 60keV and iodine (water) base map. There were significant differences on SNR and CNR values between different energy VMI and iodine (water) base map ( P<0.05). Among the four images of PI 80kVp, PI 140kVp, VMI best CNR and iodine (water) base map for pancreatic lesions, the SNR and CNR values of iodine (water) base map were the highest. The SNR and CNR values of VMI best CNR were higher than those of PI 80kVp, and the differences were statistically significant ( P<0.05). The lesion significance and edge sharpness score of iodine (water) base map was the highest, which was better than other groups; the lesion significance and edge sharpness score of VMI best CNR was better than PI 140kVp, and the differences were statistically significant ( P<0.05). The results of univariate regression analysis showed that the SNR values of PI 80kVp, PI 140kVp and VMI best CNR for pancreatic lesions were positively correlated with those of the iodine (water) base map ( P<0.05), the CNR values of PI 140kVp and VMI best CNR images were positively correlated with the iodine (water) base map ( P<0.05), and the SNR and CNR values of PI 140kVp were positively correlated with VMI best CNR ( P<0.05). Conclusions:VMI with different energy and iodine (water) base maps can be obtained by single source DECT enhanced scanning of pancreas related diseases. The VMI best CNR was the best among all VMIs, while the SNR and CNR values of iodine (water) base maps were the highest in all images. The VMI best CNR and iodine (water) base maps can improve the image quality of pancreas related diseases.

In this paper, the domestic and international demand and development trend of clinical diagnostic radionuclides are analyzed, and the medium and high-energy cyclotrons, adequate and systematic facilities, and preparation techniques required for the production of medical radionuclides based on solid targets are introduced. This paper focuses on the research and development carried out by some important medical institutions and scientific research institutes in China over the years in the aspects of medium and high-energy cyclotrons, beam transmission lines, high-power irradiation target stations and new medical isotope production processes etc. It also looks forward to some new directions for the development of medical radionuclides in China during the 14th Five-Year Plan period.

Objective: To analyze the molecular characteristics of Listeria monocytogenes strains from ready-to eat food in China. Methods: A total of 239 Listeria monocytogenes strains isolated from ready-to-eat food in 2017, all strains underwent whole-genome sequencing (WGS) , and comparisons uncovered population structure derived from lineages, clonal complex, serogroups, antimicrobial susceptibility and virulence, which were inferred in silico from the WGS data. Core genome multilocus sequence typing was used to subtype isolates. Results: All strains were categorized into three different lineages, lineage Ⅱ was the predominant types in food, and IIa was the main serogroups. CC8, CC101 and CC87 were the first three prevalent CCs among 23 detected CCs, accounting for 49.4%. Only 4.6% (11 isolates) of tested strains harbored antibiotic resistance genes, which were mostly trimethoprim genes (7 isolates, 2.9%). All strains were positive for LIPI-1, and only a part of strains harbored LIPI-3 and LIPI-4, accounting for 13.8% (33 isolates) and 14.2% (34 isolates), respectively. ST619 carried both LIPI-3 and LIPI-4. 51.5% (123 isolates) of strains carried SSI-1, and all CC121 strains harbored SSI-2. Different lineages, serogroups and CCs can be separated obviously through cgMLST analysis, and 24 sublineages were highly concordant with CCs. Conclusion Ⅱa was the main serogroups in ready-to-eat food isolates in China; CC8, CC101 and CC87 were the prevalent CCs, and CC87 isolates was hypervirulent isolates, cgMLST method can be adopted for prospective foodborne disease surveillance and outbreaks detection.

Objective: To investigate the clinical effect and safety of long-acting pegylated interferon-α-2b (Peg-IFN-α-2b) (Y shape, 40 kD) injection (180 μg/week) in the treatment of HBeAg-positive chronic hepatitis B (CHB) patients, with standard-dose Peg-IFN-α-2a as positive control. Methods: This study was a multicenter, randomized, open-label, and positive-controlled phase III clinical trial. Eligible HBeAg-positive CHB patients were screened out and randomized to Peg-IFN-α-2b (Y shape, 40 kD) trial group and Peg-IFN-α-2a control group at a ratio of 2:1. The course of treatment was 48 weeks and the patients were followed up for 24 weeks after drug withdrawal. Plasma samples were collected at screening, baseline, and 12, 24, 36, 48, 60, and 72 weeks for centralized detection. COBAS® Ampliprep/COBAS® TaqMan® HBV Test was used to measure HBV DNA level by quantitative real-time PCR. Electrochemiluminescence immunoassay with Elecsys kit was used to measure HBV markers (HBsAg, anti-HBs, HBeAg, anti-HBe). Adverse events were recorded in detail. The primary outcome measure was HBeAg seroconversion rate after the 24-week follow-up, and non-inferiority was also tested. The difference in HBeAg seroconversion rate after treatment between the trial group and the control group and two-sided confidence interval (CI) were calculated, and non-inferiority was demonstrated if the lower limit of 95% CI was > -10%. The t-test, chi-square test, or rank sum test was used according to the types and features of data. Results: A total of 855 HBeAg-positive CHB patients were enrolled and 820 of them received treatment (538 in the trial group and 282 in the control group). The data of the full analysis set showed that HBeAg seroconversion rate at week 72 was 27.32% in the trial group and 22.70% in the control group with a rate difference of 4.63% (95% CI -1.54% to 10.80%, P = 0.1493). The data of the per-protocol set showed that HBeAg seroconversion rate at week 72 was 30.75% in the trial group and 27.14% in the control group with a rate difference of 3.61% (95% CI -3.87% to 11.09%, P = 0.3436). 95% CI met the non-inferiority criteria, and the trial group was non-inferior to the control group. The two groups had similar incidence rates of adverse events, serious adverse events, and common adverse events. Conclusion In Peg-IFN-α regimen for HBeAg-positive CHB patients, the new drug Peg-IFN-α-2b (Y shape, 40 kD) has comparable effect and safety to the control drug Peg-IFN-α-2a.

Objective: To investigate the efficacy and safety of the new investigational drug pegylated interferon α-2b (Peg-IFN-α-2b) (Y shape, 40 kD) injection (180 µg/week) combined with ribavirin in the treatment of patients with genotype 1/6 chronic hepatitis C (CHC), with standard-dose Peg-IFN-α-2a combined with ribavirin as a positive control. Methods: A multicenter, randomized, open-label, and positive-controlled phase III clinical trial was performed. Eligible patients with genotype 1/6 CHC were screened out and randomly divided into Peg-IFN-α-2b(Y shape, 40kD) group and Peg-IFN-α-2a group at a ratio of 2:1. The patients in both groups were given oral ribavirin for 48 weeks in addition and then followed up for 24 weeks after drug withdrawal. Abbott Real Time HCV Genotype II was used to determine HCV genotype, and Cobas TaqMan quantitative real-time PCR was used to measure HCV RNA level at 0, 4, 12, 24, 48, and 72 weeks. Adverse events were recorded in detail. The primary efficacy endpoint was sustained virological response (SVR), and a non-inferiority test was also performed. Results: A total of 561 patients with genotype 1/6 CHC were enrolled, among whom 529 received treatment; 90.9% of these patients had genotype 1 CHC. The data of the full analysis set showed that SVR rate was 69.80% (95% CI 65.00%-74.60%) in the trial group and 74.16% (95% CI 67.73%-80.59%) in the control group (P = 0.297 0). The data of the per protocol set (PPS) showed that SVR rate was 80.63% (95% CI 76.04%-85.23%) in the trial group and 81.33% (95% CI 75.10%-87.57%) in the control group (P = 0.849 8), and the 95% CI of rate difference conformed to the non-inferiority standard. The analysis of the PPS population showed that of all subjects, 47.9% achieved rapid virologic response, with a positive predictive value of 93.8%. The incidence rate of adverse events was 96.30% in the trial group and 94.94% in the control group, and the incidence rate of serious adverse events was 5.13% in the trail group and 5.06% in the control group. Conclusion In the regimen of Peg-IFN-α combined with ribavirin for the treatment of genotype 1/6 CHC, the new investigational drug Peg-IFN-α-2b(Y shape, 40 kD) has comparable clinical effect and safety to the control drug Peg-IFN-α-2a.