Objective To resolve the problem of sharing and storing medical images and diagnostic reports among different hospitals and to help primary health care institutions to obtain the technical supports from a major hospital in a large city for the improvement of medical imaging diagnosis.Methods The paper utilizes the existing parallel and distributed technology of cloud computing and the cloud storage virtualization to design a regional image service platform,which provides computing,storage and software services to users.In addition,the design of medical image flie accessing system (MIFAS) further raise the performance of storage and access for medical image.Results The trial results showed that the medical image file accessing system had run in the actual hospital environmental for a few months with stable and good application effect.Conclusion The proposed system can improve the stability and reliability of medical imaging storage,transmission and further improve the level of medical imaging diagnosis in primary health care institutions.

Objective To introduce a method of automatically identifying critical values from medical image examination reports and prompt the physician to report it,to prevent the omission of the critical value reporting and improve the medical quality.Methods According to the requirement of critical value reporting system,regular expressions were made for each emergency situation of medical image examination,in order to form a critical value feature library.And an algorithm was designed to find critical value and prompt doctors automatically.Results According to this method,the critical value auto recognize software was developed and had been tested in Nanfang Hospital for 6 months.The software ran well.Conclusion Using regular expressions to define a criteria value feature library and design an algorithm of identifying criteria values,can recognize critical values and prompt physician automatically.

Objective:To investigate the epidemiological characteristics, genotypes and genetic evolution of respiratory syncytial virus (RSV) isolated in Shanghai from April 2020 to December 2021, which was a period from the COVID-19 outbreak to the phase of regular epidemic prevention and control.Methods:This retrospective study collected the nasopharyngeal secretions or nasopharyngeal aspirates of children with acute respiratory tract infection (ARTI) admitted to the Shanghai Children′s Hospital from April 2020 to December 2021. PCR-capillary electrophoresis and RT-PCR were used for virus identification and the amplification of the gene fragment of the second hypervariable region of RSV G protein. Homology analysis and phylogenetic analysis were conducted using bioinformatics software. Chi-square test was used to compare the detection rates of RSV. Results:A total of 6 211 samples were collected and 13.62% (846/6 211) of them were positive for RSV. The positive rates of RSV in male and female patients were 14.07% (503/3 574) and 13.01% (343/2 637), respectively, with no significant gender difference (χ 2=1.467, P=0.226). The highest detection rate of RSV was found in children ≤6 months of age, and the rate of RSV infection decreased gradually with age (χ 2=352.942, P<0.001). No RSV-positive specimens were detected from April 2020 to August 2020, after which the detection rate of RSV gradually increased with two epidemic peaks occurring from December 2020 to February 2021 and from August to October 2021. The predominant epidemic subtype was RSV subtype B in 2020 and the first 9 months of 2021, which was gradually replaced by RSV subtype A in the last 3 months of 2021. The 176 strains of RSV subtype A obtained in this study were all ON1 genotype, and the nucleotide homology of the Shanghai epidemic strains was 90.20%-99.50%. All of the 250 strains of RSV subtype B were BA9 genotype, and the nucleotide homology of the Shanghai epidemic strains was 90.10%-100.00%. Conclusions:From April 2020 to December 2021, with the regular prevention and control of COVID-19, there is a change in the epidemic season of RSV. The prevalent genotypes of RSV subtypes A and B are ON1 and BA9, respectively, and the subtype A gradually replaces subtype B as the most prevalent subtype.

Objective:To observe any effect of fast walking on walking speed, 6-minute walking test (6MWT) time, and on serum levels of growth differentiation factor-8 (GDF-8) and insulin-like growth factor-1 (IGF-1) in patients with sarcopenia.Methods:A total of 61 sarcopenia patients were randomly divided into an observation group ( n=31) and a control group ( n=30). Both groups were given conventional drug therapy. In addition, the observation group underwent 30-minutes of walking at 100-120 steps/min (about 60% of maximum heart rate) three times a week for 12 weeks. The control group also walked, but at 70-90 steps/min (less than 50% of maximum heart rate). Grip strength, walking speed, 6MWT time, skeletal muscle index (ASMI) and serum GDF-8 and IGF-1 were compared before and after the intervention. Results:There were no significant differences in grip strength or ASMI between observation group and control group (comparing males with males and females with females) before the experiment. Afterward, grip strength and ASMI in the observation group had increased significantly on average. Both were then significantly higher than the control groups′ averages, which had not changed significantly. Average walking speed, 6MWT time and serum IGF-1 levels had improved significantly in both groups, but the observation group′s average improvement was significantly greater. A significant decrease the average serum GDF-8 level was observed in the observation group, but not in the control group.Conclusion:Fast walking can improve the walking of persons with sarcopenia, raise serum IGF-1 levels, and significantly reduce serum GDF-8.

Objective : To explore the "clinical normal reference range" of pulpal blood flow (PBF) in the physiological state in an effort to provide a reference for clinical diagnosis and treatment. Methods: According to the working principle and operational considerations of laser Doppler flowmetry (LDF), the PBF blood flow value of the first molars of the upper and lower mandibles of normal adults was detected by LDF, and the clinical reference value range under physiological conditions was analyzed and calculated. The differences in PBF values by sex, dental position and location (left and right side, upper and lower jaw) were analyzed. Results : A total of 200 normal adult participants with an average age of (22.76 ± 3.26) years were included. The cohort included 95 males and 105 females, with a total of 800 first molars. Neither the PBF values of the left and right first molars nor the PBF values of the upper and lower first molars in males or females significantly differed (P>0.05). The PBF value for females was higher than that of males. Specifically, the clinical reference PBF values for males and females were (8.56 ± 3.25) PU and (9.51 ± 3.47) PU, respectively. Conclusion The PBF values of normal adult first molars in healthy subjects were higher in females than in males, and in the PBF values of first molars of the same sex did not significantly differ between the left side and right side or upper and lower jaw; these values could be used as a reference for the selection of control teeth.

Objective To screen the disease-causing genes in an autosomal dominant (AD)Weill-Marchesani syndrome (WMS) family from Henan province in China,and to analyze the relationship between genotypes and phenotypes of the AD WMS.Methods A family with suspected WMS was collected and studied in Henan Eye Hospital from September 2016 to July 2017.Clinical data and genomic DNA of the families were analyzed and genetic variations were screened by whole-exome sequencing (WES) The candidate genes related to ectopia lentis (FBN1,ADAMTSL2,ADAMTSL4,TGFBR2,CBS,ADAMTS10,ADAMTS17) were analyzed,and multiplex ligation dependent probe amplification (MLPA) was applied.Novel variants were further evaluated by sequencing 96 normal individuals.The previous reports with similar genetic characteristics were reviewed and the mutation types and clinical features were summarized.Written informed consent was obtained from the participants or their guardians before the collection of their venous blood and clinical data.Ethical approval was obtained from the Institutional Review Board of Henan Eye Institute.Results The suspicious mutation of the c.5260G＞A was detected in exon 42 of the FBN1 by WES in this family,which was predicted to be pathogenic and cosegregated with the disease;the clinical futures of the patients in the family included proportionate short stature,brachydactyly,joint stiffness,and the ocular problems included microspherophakia,moderate myopia,secondary glaucoma.Four mutations of FBN1 that related to WMS were reported in previous literature,and three of them were located in 41-42 exons and the others were the deletion of exons 9-11.All patients had typical clinical features of microspherophakia,short stature,brachydactyly,joint stiffness.In addition,thick skin was common,heart defects were occasional,protuberant abdomen and umbilical hernia were rarely reported.Conclusions The affected members in this family are in according with the clinical and genetic diagnosis of WMS.A novel mutation (c.5260G＞A) in FBN1 is discovered,which increases the spectrum of WMS mutation.The 41-42 exons of the FBN1 are hotspot of mutation in WMS.

OBJECTIVE： To systematically evaluate the efficacy and safety of risperidone versus haloperidol in the treatment of behavioral and psychological symptoms of dementia （BPSD）， and to provide evidence-based reference for clinical drug use. METHODS： Cochrane library， PubMed， EMbase， CNKI， CBM， Wanfang and VIP database were searched for the randomized controlled trials （RCT） on risperidone （trial group） versus haloperidol （control group） in the treatment of BPSD. After literature screening， data extraction and quality evaluation with Cochrane system evaluator manual 5.1.0， Meta-analysis was performed by using Rev Man 5.3 software. RESULTS： A total of 26 studies were included， involving 2 219 patients. The results of Meta-analysis showed that the total response rate [RR＝1.11， 95％CI（1.05， 1.18）， P＝0.000 3] and CMAI score [SMD＝0.19， 95％CI（0.04， 0.34）， P＝0.01] in trial group were significantly higher than control group. MMSE score [SMD＝－0.32， 95％CI（－0.63， －0.01）， P＝0.04]， and the incidence of extrapyramidal reaction [RR＝0.39， 95％CI（0.31， 0.49）， P＜0.000 1]， gastrointestinal reaction [RR＝0.51， 95％CI（0.38， 0.68）， P＜0.000 1]， somnolence [RR＝0.47， 95％CI （0.25， 0.88）， P＝0.02]， thirst [RR＝0.50， 95％CI（0.33， 0.74）， P＝0.000 5] and constipation [RR＝0.33， 95％CI（0.20， 0.54）， P＜0.000 1] in trial group were significantly lower than control group. There were no statistical significance in BEHAVE-AD score [SMD＝0.03， 95％CI（－0.09，0.16）， P＝0.62] and the incidence of insomnia [RR＝1.26， 95％CI（0.76， 2.11）， P＝0.37]， headache/dizziness [RR＝0.65， 95％CI（0.38， 1.12）， P＝0.12] and tachycardia[RR＝0.40， 95％CI（0.12， 1.31）， P＝0.13] between two groups. CONCLUSIONS： The efficacy and safety of risperidone in the treatment of BPSD are signi- ficantly better than haloperidol， and risperidone can improve agitation behavior and general cognitive state of patients.

Objective To establish an HPLC method for the simultaneous determination of harpagide and harpagoside content in Scrophularia ningpoensis (SN). Methods An Eclipse C₁₈ column was used for determination of methanol extract of S. ningpoensis with a HPLC-PDA method and mobile phase of acetonitrile-0.03% phosphate solution in a gradient elution manner. The flow rate of mobile phase was 1.0 ml/min, and the detection wavelengths were 210 nm and 280 nm. Results Harpagide and harpagoside contents in SN showed good linear relationships within 0.1020-0.5100 mg/ml (r=0.9999) and 0.0340-0.1700 mg/ml (r=0.9999). Their average recovery rates were 97.44% and 97.08%.The RSDs were 0.93% and 1.24%.. There were significant differences in the contents of harpagide and harpagoside in SN from 15 origins (P<0.01). The content of harpagoside in Sichuan Long-dong, Zhejiang Lin-an, Zhejiang Pan-an and Henan Nan-feng is higher. Conclusion This method is stable, accurate and reproducible and can be used for the quality control of SN.