Objective To evaluate efficiencies of 4 kinds of γ‐interferon release assay(IGRA) detection kits in diagnosis of pul‐monary tuberculosis .Methods 4 kinds of IGRA reagents produced by Oxford Immunotec Ltd (Oxford) in British ,Shanghai Fuxing Changzheng Medical Science Co .,Ltd(Fuxing) ,Cellectis in Australia(Cellectis) and Haikou VTI Biological Institute(VTI) ,respec‐tively ,were used to determine release levels of peripheral bloodγ‐interferon which had antigenicity of Mycobacterium tuberculosis in 86 cases of patients with tuberculosis and 80 cases of healthy individuals ,and diagnostic efficiencies were evaluated .Results Among the 4 kinds of IGRA reagents ,including Oxford ,Fuxing ,Cellectis and VTI ,the sensitivity was 93 .02% ,88 .37% ,90 .70% and 91 .86% ,respectively ;the specificity was 92 .50% ,75 .00% ,82 .50% and 87 .50% ,respectively ;the positive predictive value was 93 .02% ,79 .17% ,84 .78% and 88 .76% ,respectively ;the negative predictive value was 92 .50% ,85 .71% ,89 .19% and 90 .91% ;the diagnostic accordance rate was 92 .77% ,81 .93% ,86 .75% and 89 .76% ,respectively ;the area under receiver operating charac‐teristic(ROC) curve was 0 .975 ,0 .892 ,0 .958 and 0 .963 .Conclusion There are no significant differences among Oxford ,Fuxing , Cellectis and VTI reagents ,and reagents could be selected according to clinical requirements .

[Objective] To investigate the effects of the bioactive constituents of green tea polyphenols epigallocatechin gallate (EGCG) on low density lipoprotein receptor (LDLR) function of HepG2 cells.[Methods] The optimal concentration and cell proliferation of HepG2 cells were determined by CCK8 assay,and Western blotting was used to determine LDLR and PCSK9 protein levels,respectively,and LDL uptake in HepG2 cells was detected by fluorescence microscope.[Results] EGCG elevated LDLR protein expression,reduced PCSK9 protein expression and promoted LDL uptake in HepG2 cells.[Conclusion] EGCG may increase LDLR abundance by down-regulating PCSK9 protein and attenuating LDLR protein degradation,which providing a new approach for lipid lowering therapy.

Objective To explore the scanning technology of head-neck-coronaryone-stop-shopCT angiography using 256-slice iCT and complete image quality analysis.Methods 106 consecutive patients underwent 256-slice iCT head-neck-coronaryone-stop-shop CT angiography.According to the average heart rate,patients were divided into three groups,the 1ow heart rate group with the average heart rate ranged from 40 to 60,medium heart rate group with heart rate from 60 to 80 beats per minute and high heart rate group with heart rate more than 80 beats per minute.The volume rendering (VR),maximum intensity projection (MIP), multi-planar reformation (MPR)and curved planar reconstruction (CPR)were employed for three-dimensional reconstruction after the original image reached to the iCT post-processing workstation.The image quality of head-neck artery and coronary artery were assessed by two senior radiologists individually .Results The image quality scores in the three groups show statistic significance (F=14.886 , P =0.000).The difference between low heart rate group and medium heart rate group show statistic significance (P =0.031).The difference between low heart rate group and high heart rate group was statistical significant (P = 0.026 ).There was no statistic difference between medium heart rate group and high heart group.The excellent rates of coronary artery image quality reached to 100%,96.6%,92.6% in low,medium and high heart rate group respectively.The rates of excellent about head-neck vascular im-age quality in the three groups reached to 100%.Conclusion 256-slice iCT head-neck-coronaryone-stop-shopCT angiography can obtain satisfactory image.The image quality does not decrease in patients with high heat rate.

Objective To investigate the status and influencing factors of cooperation of doctors and nurses in the nutritional support of critically ill patients, and provide the basis for future improve the physician-nurse collaboration in the nutritional support. Methods Doctors and nurses who from ICU in Soochow were investigated by the Nurse-Physician Collaboration Scale (NPCS). Results The doctors′score of physician-nurse collaboration in the nutritional support of critically ill patients was 87.42 ±15.73, which was significantly higher than 80.97 ± 13.80 the nurses′(t=3.279, P= 0.001).In addition, under the item 1, 3, 5 in the dimension one as well as the total items in the dimensions two and three, the doctors′score was similarly higher than the nurses, and the differences are also statistically significant (Z=-3.894--1.964, all P<0.01 or 0.05). Technical titles, educational level and age was significantly related to the cooperative level between doctors and nurses respectively (χ2=11.037, P=0.012;F=3.488, P=0.037; F=3.499, P=0.016). Conclusions Doctors have higher levels of perceived collaboration than nurses in the nutritional support of critically ill patients, while both require further improvement. We should highlight the physician-nurse collaboration in feeding critically ill patients, and should improve the nutrition quality through standardized process management and active team cooperation.

Purpose To investigate the expression of Beclin1, LC3 and mTOR in colorectal cancer ( CRC) and their significance. Methods Immunohistochemistry, Western blot and real-time PCR were employed to detect the expression of Beclin1, LC3 and mTOR in CRC. Results The positive expression rate of Beclin1, LC3 and mTOR in 242 cases of CRC was 90. 50%, 87. 19% and 46. 28%, respectively, which were higher than that in adjacent tissues ( P<0. 05 ) . Moreover, the expression of LC3 in moderately and poorly differentiated CRC was higher than that in well differentiated CRC, and the positive rate of LC3 in CRC with lymph node metastasis was higher than that in CRC without lymph node metastasis. The overexpression of mTOR was related to lymph node metasta-sis (P<0. 05), but both differentiation degree and lymph node metastasis were not associated with Beclin1 (P>0. 05). The expres-sion of LC3 was positively correlated with Beclin1 and negatively correlated with mTOR in colorectal cancer (rs =0. 593, P<0. 01, rs= -0. 165, P<0. 01), and the expression of Beclin1 was not associated with mTOR (P>0. 05). Kaplan-Meier survival analysis re-vealed that the five-year survival rate of patients without nodal metastasis, positive expression of Beclin1, LC3 and negative expression of mTOR was higher than those with nodal metastasis, negative expression of Beclin1 and LC3, and positive expression of mTOR. Cox survival analysis results revealed that LC3, mTOR and lymphnode metastasis were independent prognostic factors. The results of IHC, real-time PCR and Western blot in fresh CRC tissues indicated that the expression of Beclin1, LC3 and mTOR in colorectal cancer was significantly higher than that in adjacent tissues (P<0. 05). Conclusions The aberrant expression of Beclin1, LC3 and mTOR may be associated with the development and progression of colorectal cancer. The simultaneous detection of Beclin1, LC3 and mTOR genes in colorectal cancer may be helpful for the evaluation of the progressive degree and the judgment of prognosis.

Objective To investigate the imaging manifestation of immature teratoma.Methods Imaging features of 9 cases of immature teratoma.confirmed pathologically were retrospective analysed.Results All 9 cases were male,age ranging from 1 to 38 years,mean age 1 9.5 years,AFP increased varying degrees in six cases .(1)3 cases (mean age 25.5 years)located in the anterior mediastinum which CT characteristics included the following features:lesions were projecting to one side,with irregular shape,obvi-ous necrosis,mild enhancement,wrap or oppression the blood vessels,one case with superior vena cava and head arm vein tumor em-boli and mediastinal lymph node metastasis.(2)6 cases (mean age 9.5 years)located in the pineal region and tricorn region,which MR finding were as following :cystic or solid placeholders,tow cases with small calcification or fat,solid part and the capsule wall enhancement significantly,4 cases with nodular enhancement.Conclusion Immature teratoma tends to occur in the middle struc-ture,and appears in children and young adults frequently,necrosis and cystic changes are seen commonly.CT and MR are of high val-ue in diagnosing immature teratoma.

Objective:To understand the surveillance status of iodine deficiency disorders (IDD) among children aged 8 - 10 years and pregnant women in Yantai City, Shandong Province.Methods:In 2019, Yantai City was divided into four areas: east, west, south and north according to administrative regions. In each area, 125 children aged 8 - 10 years (age balanced, half males and half females) and 75 pregnant women were selected as the survey subjects. The household edible salt samples and morning urine samples of the survey subjects were collected, and the contents of salt iodine and urinary iodine were detected by direct titration and arsenic-cerium catalytic spectrophotometry, respectively. At the same time, a color Doppler ultrasound diagnostic apparatus was used to examine the thyroid volume of children and the goiter rate was calculated.Results:A total of 800 salt samples were tested, and the median salt iodine was 20.9 mg/kg. Among them, 779 were iodized salts, the coverage rate of iodized salt was 97.38% (779/800); 756 were qualified iodized salts, the qualified rate of iodized salt was 97.05% (756/779), and the consumption rate of qualified iodized salt was 94.50% (756/800). A total of 491 urine samples from children aged 8 - 10 years were tested, the median urinary iodine was 169.23 μg/L, which was an appropriate level of iodine. The medians urinary iodine of children aged 8, 9, and 10 years ( n = 150, 209, 132) were 168.28, 164.39, and 171.23 μg/L, respectively, and the difference was not significant ( H = 1.123, P > 0.05). A total of 491 children's thyroid glands were examined, of which 11 were enlarged, with a goiter rate of 2.24%. The goiter rates of children aged 8, 9, and 10 years were 2.00% (3/150), 2.39% (5/209), 2.27% (3/132), respectively, and the difference was not significant (χ 2 = 0.112, P > 0.05). A total of 300 urine samples from pregnant women were tested, and the median urinary iodine was 208.98 μg/L, which was an appropriate level of iodine. Conclusions:In 2019, children aged 8 - 10 years and pregnant women in Yantai City are at an appropriate level of iodine. The consumption rate of qualified iodized salt ( > 90%) and the goiter rate of children ( < 5%) meet the national standards for eliminating IDD.

Objective To prospectively determine the feasibility of high-resolution in vivo MR imaging in the evaluation of esophageal carcinoma invasion at 3.0 T.Methods One hundred and eighteen patients with esophageal carcinoma,proven by the gastroscopic biopsy,were prospectively studied using 3.0 T MR.The esophageal specimens were sectioned transversely to keep consistent in the orientation with the MR images,the histopathological stage was made and the thickness of the tumor on the largest diameter of the slice were measured.The MR images were reviewed in the transverse plane.According to the seventh American joint committee on cancer,the MR stage was made and the tumor's thickness was measured.The MR images and the histopathological slices were matched.The staging diagnostic efficacy of the MR imaging was evaluated with the histopathological results as the standard reference,Kappa test was used to compare the stage of MR imaging with that at the histopathological analysis.Bland-Altman scatterplots were used to compare the thickness of tumor measured on the MR images with that at the histopathological measurement.Results Ninety seven cases(82.2％,97/118) of MR stage were accurately made,including 7 T1a,15 T1b,18 T2,25 T3 and 32 T4a cases,furthermore,14 cases were over staged and 7 cased were underestimated.The MR stage was highly consistent with the histopathological stage (Kappa=0.772).The sensitivity for the staging of high-resolution MR imaging at 3.0 T was 58.3％(7/12) to 100.0％(32/32),the specificity was 95.3％ (82/86) to 98.1％ (104/106),and the accuracy was 91.5％ (108/118) to 96.6％ (114/118),respectively.Bland-Altman scatterplots demonstrated that the discrepancy of the mean thickness between the value obtained by three radiologists respectively and the histopathological analysis were 2.0,2.6 and 2.1 mm,which demonstrated a good consistency.Conclusion High-resolution MR images obtained at 3.0 T can be used to evaluate the depth of carcinoma invasion and provide excellent diagnostic accuracy for preoperative staging.

Objective:To explore the clinical efficacy of double opposing rhomboid flap in repairing facial skin defects.Methods:From January 2020 to December 2020, 30 cases of facial skin lesions were removed in the Department of Plastic and Aesthetic Surgery, the Affiliated Hospital of Qingdao University, including 12 males and 18 females, aged 14-65 years, with an average age of 34.2 years. The diameter of the facial skin defect wound was 0.5-2.0 cm. The patients with facial skin defect were repaired with double opposing rhomboid flap. All patients were followed up for 3-12 months.Results:The incisions of 30 patients were healed in one stage, and double opposing rhomboid flaps survived. Following-up for 3 to 12 months showed that the operation area was flat, the incision scar was not obvious, the texture and color of the operation area and the surrounding skin matched well, the surrounding organs were not deformed, the lesions were not recurrent, and the cosmetic effect was satisfactory.Conclusions:The double opposing rhomboid flap is an effective method to repair quasi-circular facial skin defects, which is worthy of clinical application.

Based on the ideas of management systemization, system standardization, process specialisation, post accountability, duty formalization, form informatization, information digitization and digital intelligence, the smart, mobile and paperless bedside billing service was developed which incorporated both functional and financial prospects. The innovation was realized by Internet+ bedside billing and an integrated information platform, so that the inter-hospital billing system could be connected to the medical insurance system, electrical receive system and commercial insurance system. This saved manpower and equipment deployment, and improved service quality. The bedside intelligent mobile billing system of a hospital was launched in January 2021, and the average discharge billing time of inpatients in 2020 and 2021 was 44.36 min and 30.59 min, respectively, and the online billing fee time was significantly shorter than offline billing in 2021, and the differences were all significant( P<0.01).