Improving health of Chinese people has become national strategy according to the . Patient experience evaluation examines health care service from perspective of patients; it is important for improving health care quality. Applying artificial intelligence (AI) in patient experience is an innovative approach to assist continuous improvement of care quality of patient service. A nursing quality platform based on patient experience data which is empowered by AI technologies has been established in China for the purpose of surveillance and analysis of the quality of patient care. It contains data from nearly 1300 healthcare facilities, based on which portraits of nursing service qualities can be drawn. The patient experience big data platform has shown potentials for healthcare facilities to improve patient care quality. More efforts are needed to achieve the goal of enhancing people's sense of health gain.

A 32-year-old man who complained of recurrent nauseat and vomiting was admitted to our hospital. The contrast-enhanced computed tomography revealed a cystic mass located behind the duodenum which was suggestive of lymphangioma. Laparoscopic resection of the retroperitoneal mass was successfully performed. The postoperatively pathological examination confirmed the diagnosis of cavernous lymphangioma. Ultrasound and enhanced CT can be used for making a preoperative diagnosis. Once symptoms of the disease develop, complete surgical resection should be performed.

Pathogenic mutations in 3-keto-dihydrosphingosine reductase (KDSR) gene are associated with keratinization disorders and impaired platelet function. However, no case with both homozygotic mutation of and hepatic hemangioendothelioma has ever been reported due to its low prevalence. Here we report a seven months old Chinese boy with a homozygotic missense mutation in and both of his parents carry a same heterozygous mutation. He was born with thick plate-like scales overlying erythrodermic skin, but the skin symptoms were resolved spontaneously over the first month of his birth. He was also diagnosed with hepatic hemangioendothelioma at birth and accepted a resection surgery at 2 months old. At birth, his platelet count was severely low (10-20×10/L) with recurrent skin and gingival bleeding. Meanwhile, he suffered a mild normocytic, normochromic anemia with normal iron and hematinic levels. The anemia spontaneously recovered over the first 6 months, while the platelet count keeped at a low level (4-20×10/L). Treatment with corticosteroids, immunoglobulin or thrombopoietin was all suboptimal.

The inferior alveolar nerve and facial nerve are the two most important nerves in the dental and maxillofacial region. The injury to them is one of the major postoperative complications after alveolar surgery and orthognathic surgery. However, recovering the nerve function after injury takes a long time and the recovery effect tends to be unsatisfactory. In recent years, an intensively investigated technique, low level laser which has been applying in assisting the recovery of nerve function, has been gradually proved to be effective in clinically treating postoperative nerve injury. In this article we review in terms of the mechanisms involved in low level laser-assisted functional restoration of nerve injury and its clinical application in the recovery of nerve function in the dental and maxillofacial area as well.

Objective Accumulated evidence has suggested that there is a close association between preoperative neutrophil-to-lymphocyte ratio (NLR) and prognosis of various malignant tumors. However, the relationship between NLR and surgically resectable urinary cancers remains contradictory. Therefore, we performed this systematic review and meta-analysis to explore whether preoperative NLR could predict the prognosis of surgically resectable urinary cancers. Methods After searching the Embase, PubMed/MEDLINE and Cochrane databases and screening the articles, we finally included 25 studies involving 15950 patients. Hazard ratios (s) and their 95% confidence intervals (s) were extracted to assess the association between preoperative NLR and the overall survival (OS) and cancer-specific survival (CSS) of surgically resectable urinary cancers. Results The pooled results revealed that an elevated preoperative NLR could predict a worse OS (=1.40, 95%: 1.26-1.54, <0.001) and CSS (=1.43, 95%: 1.27-1.59, <0.001) in urinary cancers. In addition, our analyses also suggested that high preoperative NLR was associated with worse prognosis in renal cell carcinoma (OS: =2.06, 95%: 1.54-2.76, =0.131; CSS: =2.46, 95%: 1.46-4.16, =0.178), upper tract urothelial carcinoma (OS: =1.91, 95%: 1.50-2.42, =0.616; CSS: =1.84, 95%: 1.41-2.39, =0.001), bladder cancer (OS: =1.09, 95%: 1.02-1.17, <0.001; CSS: =1.05, 95%: 1.01-1.09, =0.163) and prostate cancer (OS: =1.69, 95%: 1.19-2.41, =0.714). Regardless of the participants' race or the cutoff value of the preoperative NLR, the results remained valid. Conclusion Elevated preoperative NLR could predict a worse prognosis in surgically resectable urinary cancers, namely, renal cell carcinoma, bladder cancer, prostate cancer and upper tract urothelial carcinoma.

Objective To compare the similarities and differences of early CT manifestations of three types of viral pneumonia induced by SARS-CoV-2 (COVID-19), SARS-CoV (SARS) and MERS-CoV (MERS) using a systemic review. Methods Electronic database were searched to identify all original articles and case reports presenting chest CT features for adult patients with COVID-19, SARS and MERS pneumonia respectively. Quality of literature and completeness of presented data were evaluated by consensus reached by three radiologists. Vote-counting method was employed to include cases of each group. Data of patients' manifestations in early chest CT including lesion patterns, distribution of lesions and specific imaging signs for the three groups were extracted and recorded. Data were compared and analyzed using SPSS 22.0. Results A total of 24 studies were included, composing of 10 studies of COVID-19, 5 studies of MERS and 9 studies of SARS. The included CT exams were 147, 40, and 122 respectively. For the early CT features of the 3 pneumonias, the basic lesion pattern with respect to "mixed ground glass opacity (GGO) and consolidation, GGO mainly, or consolidation mainly" was similar among the 3 groups (=7.966, >0.05). There were no significant differences on the lesion distribution (=13.053, >0.05) and predominate involvement of the subpleural area of bilateral lower lobes (=4.809, >0.05) among the 3 groups. The lesions appeared more focal in COVID-19 pneumonia at early phase (=23.509, <0.05). The proportions of crazy-paving pattern (=23.037, <0.001), organizing pneumonia pattern (<0.05) and pleural effusions (<0.001) in COVID-19 pneumonia were significantly lower than the other two. Although rarely shown in the early CT findings of all three viral pneumonias, the fibrotic changes were more frequent in SARS than COVID-19 and MERS (=6.275, <0.05). For other imaging signs, only the MERS pneumonia demonstrated tree-in-buds, cavitation, and its incidence rate of interlobular or intralobular septal thickening presented significantly increased as compared to the other two pneumonia (=22.412, <0.05). No pneumothorax, pneumomediastinum and lymphadenopathy was present for each group. Conclusions Imaging findings on early stage of these three coronavirus pneumonias showed similar basic lesion patterns, including GGO and consolidation, bilateral distribution, and predominant involvement of the subpleural area and the lower lobes. Early signs of COVID-19 pneumonia showed less severity of inflammation. Early fibrotic changes appeared in SARS only. MERS had more severe inflammatory changes including cavitation and pleural effusion. The differences may indicate the specific pathophysiological processes for each coronavirus pneumonia.
Betacoronavirus ; Coronavirus Infections ; diagnostic imaging ; Humans ; Lung ; diagnostic imaging ; Middle East Respiratory Syndrome Coronavirus ; Pandemics ; Pneumonia, Viral ; diagnostic imaging ; SARS Virus ; Severe Acute Respiratory Syndrome ; diagnostic imaging ; Tomography, X-Ray Computed

Objective To investigate effect of MR field strength on texture features of cerebral T2 fluid attenuated inversion recovery (T2-FLAIR) images. Methods We acquired cerebral 3D T2-FLAIR images of thirty patients who were diagnosed with ischemic white matter lesion (WML) with MR-1.5T and MR-3.0T scanners. Histogram texture features which included mean signal intensity (Mean), Skewness and Kurtosis, and gray level co-occurrence matrix (GLCM) texture features which included angular second moment (ASM), Contrast, Correlation, Inverse difference moment (IDM) and Entropy, of regions of interest located in the area of WML and normal white matter (NWM) were measured by ImageJ software. The texture parameters acquired with MR-1.5T scanning were compared with MR-3.0T scanning. Results The Mean of both WML and NWM obtained with MR-1.5T scanning was significantly lower than that acquired with MR-3.0T (<0.001), while Skewness and Kurtosis between MR-1.5T and MR-3.0T scanning showed no significant difference (>0.05). ASM, Correlation and IDM of both WML and NWM acquired with MR-1.5T revealed significantly lower values than those with MR-3.0T (<0.001), while Contrast and Entropy acquired with MR-1.5T showed significantly higher values than those with MR-3.0T (<0.001). Conclusion MR field strength showed no significant effect on histogram textures, while had significant effect on GLCM texture features of cerebral T2-FLAIR images, which indicated that it should be cautious to explain the texture results acquired based on the different MR field strength.

Objective To explore novel long non-coding RNA (lncRNA) molecular markers related to bladder cancer prognosis and to construct a prognostic prediction model for bladder cancer patients. Methods LncRNA expression data of patients with bladder cancer were downloaded from TCGA database. Univariate Cox regression and likelihood-based survival analysis were used to discover prognosis related lncRNAs. Functional studies of prognosis related lncRNAs were conducted by co-expression analysis and pathway enrichment analysis. Multivariate Cox regression analysis was used to establish risk score model, and Receiver Operating Characteristic analysis was used to determine the optimal cut-off point of the model. The risk score model was validated through Kaplan Meier estimation method and log-rank test. Results Seven prognosis related lncRNAs (OCIAD1-AS1, RP11-111J6.2, AC079354.3, RP11-553A21.3, RP11-598F7.3, CYP4F35P and RP11-113K21.4) which can predict survival of bladder cancer patient were discovered. Co-expression analysis and pathway analysis of these novel lncRNA signature and their target genes further revealed that these lncRNAs play important roles in the occurrence and development of bladder cancer. Additionally, a seven-lncRNA signature based risk score model for prognostic prediction of bladder cancer patients was established and validated. Notably, we identified the potential significance of two tumor-related antisense lncRNAs (OCIAD1-AS1 and RP11-553A21.3) in the prognosis of bladder cancer. Conclusion Our results suggest that these lncRNA markers may serve as potential prognosis predictors for bladder cancer and deserve further functional verification studies.

Objective To explore the therapeutic effects of trimetazidine (TMZ) on diabetic patients with coronary heart diseases.Methods We conducted a comprehensive electronic search of PubMed, EMBASE, and Cochrane databases between the inception dates of databases and May 2019 (last search conducted on 30 May 2019) to identify randomized controlled trials. The evaluation method recommended by Cochrane Collaboration for bias risk assessment was employed for quality assessment. Random or fixed models were used to investigate pooled mean differences in left ventricular function, serum glucose metabolism, serum lipid profile, myocardial ischemia episodes and exercise tolerance with effect size indicated by the 95% confidence interval ().Results Additional TMZ treatment contributed to considerable improvement of left ventricular ejection fraction (=4.39, 95%: 3.83, 4.95, <0.00001), left ventricular end diastolic diameter (=-3.17, 95%: -4.90, -1.44, =0.0003) and left ventricular end systolic diameter (=-4.69, 95%: -8.66, -0.72, =0.02). TMZ administration also significantly decreased fasting blood glucose (=-0.43, 95%: -0.70, -0.17, =0.001), glycosylated hemoglobin level (=-0.59, 95%: -0.95, -0.24, =0.001), serum level of total cholesterol (=-20.36, 95%: -39.80, -0.92, =0.04), low-density lipoprotein cholesterol (=-20.12, 95%: -32.95, -7.30, =0.002) and incidence of myocardial ischemia episodes (=-0.84, 95%: -1.50, -0.18, =0.01). However, there were no significant differences in serum triglyceride level, high-density lipoprotein cholesterol, exercise tolerance between the TMZ group and the control group. Conclusion TMZ treatment in diabetic patients with coronary heart disease is effective to improve cardiac function, serum glucose and lipid metabolism and clinical symptoms.

Objective Graves' disease is the most common autoimmune thyroid disease and its prevalence and clinical manifestations are disparate between females and males. Costimulatory molecules play an essential role in regulating autoimmune responses. The objective of this study was to determine if expression of inhibitory molecules was correlated with treatment by dihydrotestosterone (DHT) in an BALB/c mouse model of experimental autoimmune Graves' disease.Methods Female BALB/c mice were immunized three times with thyroid stimulating hormone receptor A-subunit encoded by adenovirus to establish a Graves' disease model. Three different doses of DHT or a matching placebo were administered by implantation of slow-release pellets a week before the first immunization. Four weeks after the third immunization, the mice were euthanatized, and then the spleen and thymus were removed. Total thyroxine and free thyroxine levels in serum of mice were detected using a radioimmunoassay kit. Real-time polymerase chain reaction was performed to estimate the expression of costimulatory molecules in lymphocytes from the spleen and thymus. Flow cytometry was used to analyze the percentage of CD4 T cells in splenic lymphocytes. Quantitative data were compared with unpaired -tests. Correlation between two variables was analyzed using Analysis of Variance.Results Treatment with DHT can dramatically reduce total thyroxine and free thyroxine levels. Higher expression of programmed death-1 was found in the spleen of Graves' disease mice receiving 5 mg of DHT treatment (0.635±0.296 . 0.327±0.212; =2.714, =0.014), similarly, T-cell immunoglobulin domain and mucin domain 3 (TIM-3) in both the spleen (1.004±0.338 . 0.646±0.314; =2.205, =0.022) and the thymus (0.263±0.127 . 0.120±0.076; =3.221, =0.004) also increased after 5 mg of DHT treatment compared with the parallel placebo model mice. Moreover, the percentage of CD4 T cells declined in the splenic lymphocytes of Graves' disease mice treated with 5 mg of DHT (19.90%±3.985% . 24.05%±2.587%; =2.804, =0.012). A significant negative association was observed between expression of TIM-3 in the spleen and serum levels of total thyroxine (=-0.7106, =0.014) as well as free thyroxine (=-0.6542, =0.029).Conclusion This study demonstrates that DHT can ameliorate experimental autoimmune Graves' disease, which may occur by up-regulating expression of programmed death-1 and TIM-3 and inhibiting development of CD4 T cells.