Objective:To compare the consistency of artificial analysis and artificial intelligence analysis in the identification of fundus lesions in diabetic patients.Methods:A retrospective study. From May 2018 to May 2019, 1 053 consecutive diabetic patients (2 106 eyes) of the endocrinology department of the First Affiliated Hospital of Zhengzhou University were included in the study. Among them, 888 patients were males and 165 were females. They were 20-70 years old, with an average age of 53 years old. All patients were performed fundus imaging on diabetic Inspection by useing Japanese Kowa non-mydriatic fundus cameras. The artificial intelligence analysis of Shanggong's ophthalmology cloud network screening platform automatically detected diabetic retinopathy (DR) such as exudation, bleeding, and microaneurysms, and automatically classifies the image detection results according to the DR international staging standard. Manual analysis was performed by two attending physicians and reviewed by the chief physician to ensure the accuracy of manual analysis. When differences appeared between the analysis results of the two analysis methods, the manual analysis results shall be used as the standard. Consistency rate were calculated and compared. Consistency rate = (number of eyes with the same diagnosis result/total number of effective eyes collected) × 100%. Kappa consistency test was performed on the results of manual analysis and artificial intelligence analysis, 0.0≤ κ<0.2 was a very poor degree of consistency, 0.2≤ κ<0.4 meant poor consistency, 0.4≤ κ<0.6 meant medium consistency, and 0.6≤ κ<1.0 meant good consistency. Results:Among the 2 106 eyes, 64 eyes were excluded that cannot be identified by artificial intelligence due to serious illness, 2042 eyes were finally included in the analysis. The results of artificial analysis and artificial intelligence analysis were completely consistent with 1835 eyes, accounting for 89.86%. There were differences in analysis of 207 eyes, accounting for 10.14%. The main differences between the two are as follows: (1) Artificial intelligence analysis points Bleeding, oozing, and manual analysis of 96 eyes (96/2042, 4.70%); (2) Artificial intelligence analysis of drusen, and manual analysis of 71 eyes (71/2042, 3.48%); (3) Artificial intelligence analyzes normal or vitreous degeneration, while manual analysis of punctate exudation or hemorrhage or microaneurysms in 40 eyes (40/2042, 1.95%). The diagnostic rates for non-DR were 23.2% and 20.2%, respectively. The diagnostic rates for non-DR were 76.8% and 79.8%, respectively. The accuracy of artificial intelligence interpretation is 87.8%. The results of the Kappa consistency test showed that the diagnostic results of manual analysis and artificial intelligence analysis were moderately consistent ( κ=0.576, P<0.01). Conclusions:Manual analysis and artificial intelligence analysis showed moderate consistency in the diagnosis of fundus lesions in diabetic patients. The accuracy of artificial intelligence interpretation is 87.8%.

Objective: To investigate the utilization of adjuvant drugs in the secondary hospitals from Xi'an, and to provide reference for rational use of adjuvant drugs.Methods: The utilization of adjuvant drugs of the top 20-ranked drugs in 32 secondary hospitals from Xi'an during 2013 and 2015 was analyzed statistically in respects of total consumption sum of adjuvant drugs, the proportion of adjuvant drugs sum, the consumption sum, DDDs and DDC of each adjuvant drug, and adverse drug reaction.Results: The total consumption sum and the proportion of adjuvant drugs sum increased year by year from 2013 to 2015.13 kinds of adjuvant drugs were included in top 20 in the list of total consumption sum from more than 3 hospitals in three years.Danhong injection, shuxuening injection, xueshuantong injection, xueshuantong injection, xuesaitong injection, deproteinized calf blood serum injection took up the front in the list of consumption sum and DDDs in 3 years.The cases of adjuvant drugs-induced ADR increased year by year.Conclusion: At present, adjuvant drugs become the important part of clinical drug use in this area.The consumption sum and amount is increasing rapidly.Great importance should be attached to the rational administration and safety use of the adjuvant drugs to control the unreasonable increase of drug expenses.

0.05). The pulmonary function in M3 after radiotherapy were lower than that in M1 after radiotherapy of control group (P

Objective To observe the effect of Yiqi Huoxue Recipe on the expression of TGF-?1 and ?-IFN in rats with radiation-induced lung injury in different radiation time, and discuss the prevention and curative effect of Yiqi Huoxue Recipe and its possible action mechanism. Methods One hundred and twenty Wistar rats were randomly allocated into irradiation group (n =30), irradiation with Yiqi Huoxue Recipe-treated group (n =30), irradiation with ambroxol-treated group (n =30) and normal control group (n =6). The former three groups were irradiated at right hemithorax with a dose of 30 Gy (5 Gy per week). Animals were followed for 26 weeks after the first irradiation. The levels of serum TGF-?1 and ?-IFN of 6 rats in each group were assayed by ELISA at the end of 4th, 6th, 8th, 12th and 26th week after the first irradiation. Results In Yiqi Huoxue Recipe-treated group, the levels of serum TGF-?1 were significantly lower from the 4th week than that of the irradiation group (P0.05). Conclusion Yiqi Huoxue Recipe can inhibit the excretion of TGF-?1 and promote the excretion of ?-IFN. It suggested that Yiqi Huoxue Recipe might play an important role in the prevention and curation of radiation-induced lung injury.

ObjectiveTo observe the influence of lipopolysaccharide (LPS) on collagen metabolism of normal human skin fibroblasts and its biological role in the formation of hypertrophic scar.Methods Fibroblasts were isolated and cultured in vitro,and then exposed to different doses of LPS (0.005,0.01,0.05,0.1,0.5,1.0 μg/ml) from E.coli.055:B5 respectively.The expression of proccllagen type Ⅰ,Ⅲand collagenase mRNAs was tested by RT -PCR.Fibroblasts from hypertrophic scar tissue obtained from the same patients in the same culture passage were used as control.ResultsCompared with control group,the expression of procollagen typeⅠ,Ⅲ mRNAs in normal skin fibroblasts increased (0.323 ± 0.041,0.303 ± 0.063,0.391 ± 0.071,0.344 ± 0.086,0.488 ± 0.059,0.401 ± 0.087,0.616 ± 0.107,0.434 ±0.084,0.823 ±0.092,0.542 ± 0.082),while the expression of collagenase mRNAs of normal skin fibroblasts depressed(0.598 ± 0.068,0.556 ± 0.049,0.441 ± 0.043,0.372 ± 0.083,0.260 ± 0.027 ).When LPS was set to the concentration of 0.005 μg/ml,it showed a concentration dependent manner.However,when the concentration of LPS was set to 0.5 μg/ml,the expression of procollagen type Ⅰ,Ⅲ and collagenase mRNAs of normal skin fibroblasts began to decrease (0.451 ± 0.063,0.374 ± 0.072,0.360 ± 0.062).When the concentration of LPS was set to 1.0 μg/ml,the expression of procollagen type Ⅰ,Ⅲ mRNAs (0.162 ± 0.025,0.171 ± 0.061 )were inhibited and the expression of collagenase mRNAs began to increase (0.444 ±0.114).When the concentration of LPS was set to 0.1 μg/ml,the expression of procollagen type Ⅰ,Ⅲ and collagenase mRNAs of normal skin fibroblasts(0.823 ±0.092,0.542 ±0.082,0.260 ±0.027)was similar to that of hypertrophic scar tissue fibroblasts(0.829 ±0.049,0.569 ±0.038,0.277 ±0.059).ConclusionsThis result supported that LPS may be an important factor in collagen metabolism of normal skin fibroblasts and it plays an important role in hypertrophic scar formation.

Objective To evaluate the value of 16-slice spiral computed tomography angiography(16SCTA) and reconstruction technique in the diagnosis of vascular diseases. Methods Using 0.75 mm collimation,1mm slice thickness and 0.5mm repitition,16SCTA was performed in 100 patients with suspected vascular diseases.Reconstruction methods were multiple planar reconstruction(MPR),maximum intensity projection(MIP) and volume rendering technique(VRT). Results 65 patients were proved by pathology or DSA in 100 vascular diseases,which included cerebral aneurysm(n=8),brain arteriovenous malformation(AVM,n=2),pulmonary AVM(n=6),pulmonary artery embolism with thrombus of the lower limb vein(n=9),pulmonary sequestration(n=4),coronary artery soft plaque and / or calcification(n=20),aortic aneurysm(n=12),renal artery stenosis(n=3),superior mesenteric artery thrombus(n=2),femoral artery stenosis(n=1),soft tissue hemangioma(n=33).Three reconstruction techniques showed the size,shape and extent of the lesion and displayed the lesion in any directions.VRT could display three-dimensionally the lesion.MPR and MIP could show the thrombus of lesion,MIP and VRT could display the calcification of lesion. Conclusion Application of every 16 SCTA reconstruction technique can display clearly lesion and replace DSA in diagnosis of vascular diseases,and provides another reliable diagnostic method for patients and has clinical importance for treatment.

Objective To observe the influence of lipopolysaccharide (LPS) on the cell cycle and the mRNAs expression of procollagen type Ⅰ , Ⅲ of normal human skin fibroblasts. Methods Purified dermal fibroblasts were exposed to different doses of LPS(0. 005 ～ 1.0 μg/ml) from E. coli. Then the cell cycle of fibroblasts at logarithmic stage at day 7 after LPS administration was assayed with flow cytometry.The expression of procollagen type Ⅰ , Ⅲ and collagenase mRNAs was tested by RT-PCR. Results The percentage of S phase cells in cell cycle of normal human skin fibroblasts increased when LPS concentrations were changed from 0. 005 to 0. 1 μg/ml, and the increase showed a concentration dependent manner. However, when the concentration of LPS was 0. 5 μg/ml, the percentage of S phase cells began to decrease, but still higher than normal control. When LPS concentration reached 1.0 μg/ml, the percentage of S phase cells were lower than normal control. The expression of procollagen type Ⅰ , Ⅲ mRNAs of normal skin fibroblasts increased when LPS was challenged to the concentration of 0. 005 μg/ml, and the influence showed a concentration dependent manner. However, when the concentration of LPS was 0. 5 μg/ml, the influence of LPS on the expression of procollagen type Ⅰ , Ⅲ of normal skin fibroblasts began to decrease.When the concentration of LPS reached 1.0 μg/ml, the expression of procollagen type Ⅰ , Ⅲ mRNAs were inhibited. Conclusions LPS promoted the proliferation and collagen synthesis of normal human skin fibroblasts within a certain range of low doses, while high doses of LPS might inhibit the proliferation and collagen synthesis of normal human skin fibroblasts.

Objective To study the N terminal pro brain natriuretic peptide (NT-proBNP)in serum of hypertension patients. Methods 152 patients with hypertension were included in this study.According to the different degree and development of hypertension,152 patients were divided into three different grade group of hypertension:first grade of hypertension group (30 patients),second grade of hypertension group (36 patients)and third grade of hypertension group (86 patients).And the 86 patients were divided into hypertension group (40 patients)and hypertension with diabetes group (46 patients)re-spectively,comparaed with the level of NT-proBNP in serum of different hypertension grade groups.Results The levels of the NT-proBNP in serum were 68±44,122±31 and 834±309 pg/ml of first grade of hypertension group,second grade of hypertension group and third grade of hypertension group,respectively.The level of the NT-proBNP was gradually increased with grade of hypertension (t=2.455,3.561,P<0.01).The level of the NT-proBNP (1 178±864 pg/ml)of hypertension with diabetes group was significantly higher than hypertension group (599±411 pg/ml)(t=3.785,P<0.01).Conclusion The level of NT-proBNP can obj ectively reflect the grade of the disease in patients with hypertension.it is a certain signifi-cance guiding for monitoring the clinical treatment of the disease.

Objective To observe the effect of Yiqi Huexue Recipe on the expression of TGF-β1 and TNF-α on serum and lung of rots with radiation-induced lung injury in different radiation time,and discuss the preventative and curative effect and mechanisms of Yiqi Huoxue Recipe.Methods 66 Wistar rats were randomly allocated into irradiation with Yiqi Huoxue Recipe-treated group(A group)irradiation group(B group),and normal control group(C group).The first two groups were irradiated at right hemithorax with a dose of 30 Gy/6 fractions(in 6 weeks).The levels of TGF-β1,and TNF-α on rat serum and lung were measured by ELISA and immunohistochemistry at the end of the 4th,6th,8th,12th,and 26th week after the first irradiation.Results TGF-β1,and TNF-α level on rats serum and lung in irradiation group showed an increase from the 4th week after the first irradiation,peaking at the 12th week,and descending at the 26th week.In A group,the levels of TGF-β1 and TNF-α were significantly lower from the 4th week than those of B group.Conclusions Yiqi Huoxue Recipe could inhibit the excretion of TGF-β1,and TNF-α and might play an important role in the prevention and curation of radiation-induced lung injury,which might be related to inhibiting the expression of TGF-β1 and TNF-α.

Objective:To analyze the clinical characteristics and SLC25A13 gene mutation in children with neonatal intrahepatic cholestasis caused by citrin deficiency(NICCD).Methods:The data of 18 children diagnosed with NICCD in Xi′an Children′s Hospital from January 2014 to December 2018 were collected.The clinical manifestations, biochemical characteristics, SLC25A13 gene mutation and prognosis were analyzed.Results:All the 18 cases of NICCD were from North China and the age of initial diagnosis averaged(63.4±19.5)days.The clinical manifestations included jaundice(100%), light yellow or white stool(38.9%), growth retardation(27.8%)and so on.All patients had cholestasis.Of 18 cases, the levels of glutamyltranspeptidase, total bile acid and alpha fetoprotein were all increased, and serum albumin was decreased.Elevated aspartate aminotransferase(94.4%), elevated glutamic pyruvic transaminase(72.2%), prolonged prothrombin time(88.9%), hyperlactemia(83.3%), hypoglycemia(77.8%), anemia(66.7%)and other biochemical abnormalities were observed.Citrulline and other serum amino acids of all cases were elevated in blood samples by tandem mass spectrometry.The increase of 4-hydroxyphenyllactate and 4-hydroxyphenylpyruvate was found in 70%(7/10)urine samples by gas chromatography.Age was negatively correlated with total bile acid( r=-0.469, P=0.049), and positively correlated with blood ammonia, threonine, methionine, ornithine and tyrosine( r=0.472, 0.690, 0.698, 0.678 and 0.769, respectively, P<0.05). A total of 16 SLC25A13 gene mutations were detected, of them c. 851_854del(33.3%)and c. 1638_1660dup(19.4%)were the most common.c.1841+ 3_1841+ 4del, c.980_981del(p.E327Vfs*45)and c. 602A>T(p.E201V)were novel mutations.Among the 17 children who were followed up, 1 case died and 16 cases had normal biochemical parameters within 1 year. Conclusion:The characteristic biochemical changes are helpful for early recognition of NICCD.The prognosis of NICCD is good if the treatment is appropriate and timely.c.851_854del and c. 1638_1660dup are high-frequency mutations of SLC25A13 gene in north China.