AIM: To understand the influence of national constitution monitoring on sports behavior, attitude and physique of the investigators. METHODS: The study was performed at the Constitution Monitoring Center of Chenzhou Sports Bureau from March to December 2005. 285 public servants of Chenzhou were enrolled as investigators for the first study in 2005 and the second after 10 mouths with questionnaire. Age was accorded with the first measurement. 283 valid data were included (168 males and 115 females), because 2 could not participate in the constitution measurement. Questionnaire in 2006 involved individual physical awareness, behavior, attitude, participating rate, and whether doing the questionnaire according to the physical exercise prescription in the first monitoring. RESULTS: Significant differences in cardiovascular function, strength and sensitivity were detected between testees and national average value, especially in males and middle-age persons and youth. Nine months later, significant difference was found after paired test, step test and in vital capacity improvement. Improvement in other indexes had differences in age and sex. CONCLUSION: The measurement on national constitution is good for realizing their own state of health, improving their sports consciousness, increasing their frequency of doing sports greatly, and improving the physical state, especially for middle-aged and elder persons.

Objective:To explore the MRI features of fetal coronal cleft vertebrae, and to compare the efficacy of MRI and ultrasound in the diagnosis of fetal coronal cleft vertebrae, and to analyze the outcome of fetal coronal cleft vertebrae.Methods:From September 2019 to June 2021, 40 fetuses suspected of fetal vertebral deformities by ultrasound were retrospectively collected in Shandong Provincial Hospital Affiliated to Shandong University, who were diagnosed as coronal cleft vertebrae after MRI examination. Five cases of induced labor and 14 cases lost to follow-up were excluded, and 21 fetuses who underwent MRI after delivery were finally included. The gestational weeks were 25-34 (29.1±2.6) weeks, and there were 19 males and 2 females. Fetal spine MRI includes susceptibility weighted imaging (SWI) and T 2-true fast imaging with steady-state (True-FISP). The MRI features and outcome of fetal coronal cleft vertebrae were explored. The image quality scores of SWI, T 2-True-FISP and ultrasound were compared with Friedman test and Wilcoxon signed-rank test. The diagnostic accuracy of fetal coronal cleft vertebrae of SWI, T 2-True-FISP and ultrasound was calculated. Cochran test was used to compare the efficiency of 3 kinds of images, and the modified McNemar test was used for pairwise comparison between groups. Results:There were 10 cases of single and 11 cases of multiple fetal coronal cleft vertebrae, 16 cases of simple lumbar vertebrae, 2 cases of simple thoracic vertebrae, and 3 cases of thoracolumbar vertebrae. The common SWI features of 21 cases show longitudinal strip or dot high signal on the sagittal plane, and transverse fissure like high signal on axial plane. Anterior part of vertebral body was larger than posterior part in 19 cases of them. The image quality scores of SWI, T 2-True-FISP and ultrasound were 4 (3, 4), 2 (2, 2), 2 (2, 2), and the difference was statistically significant in general (χ2=34.24, P<0.001). Pairwise comparison showed that the image quality of SWI was better than those of T 2-True-FISP and ultrasound ( Z=-4.04, P<0.001; Z=-4.11, P<0.001), and there was no statistically significant difference between T 2-True-FISP and ultrasound ( Z=-0.58, P=0.388). The diagnostic accuracy of SWI, T 2-True-FISP and ultrasound was 100% (21/21), 66.7% (14/21), 47.6% (10/21). The diagnostic accuracy of SWI was better than those of T 2-True-FISP and ultrasound (χ2=5.14, P=0.008; χ2=9.09, P<0.001), and there was no statistically significant difference between T 2-True-FISP and ultrasound (χ2=0.75, P=0.194). MRI showed that coronal cleft vertebrae disappeared in all 21 fetuses after birth, including 1 case of syringomyelia and 1 case of fatty filum terminal. Conclusions:MRI, especially SWI, plays an important role in the diagnosis of fetal coronal cleft vertebrae. Fetal coronal cleft vertebrae disappeared in the follow-up after birth, which proved to be a normal physiological variation from the radiographic perspective.

Objective To investigate the value of the volume percentage of solid component in differential diagnosis of stage Ⅰ lung adenocarcinoma subtypes,and to predict the optimal critical CT value of solid component.Methods A total of 962 nodules with sur-gical pathological findings confirmed as adenocarcinoma in situ(AIS)or pulmonary adenocarcinoma and manifested as subsolid nod-ules on thin-section CT were analyzed retrospectively,and divided the lesions into:(1)AIS(n=350)or pulmonary adenocarcinoma(n=612)groups;and(2)minimally invasive adenocarcinoma(MIA)(n=213)or invasive adenocarcinoma(IAC)(n=399)groups based on pathological findings.The volume percentage of solid components within pulmonary nodules was measured via CT density histogram analysis at different thresholds,the diagnostic efficacy of different thresholds was analyzed and the optimal critical CT val-ues of solid component was found.Results In the AIS versus pulmonary adenocarcinoma groups,age,mass,and volume percentage of solid component were statistically significant(P＜0.001);the CT threshold of-350 HU had the highest diagnostic efficacy[area under the curve(AUC)0.859,accuracy 81.69％,sensitivity 85.60％,and specificity 74.86％,respetively],and the critical value of volume percentage of solid component determined under this threshold was 8.3％.In the MIA versus IAC groups,age(P=0.017),mass(P＜0.001),and volume percentage of solid component(P＜0.001)were statistically significant;the CT threshold of-350 HU had the highest diagnostic efficacy(AUC 0.857,accuracy 78.27％,sensitivity 82.91％,and specificity 69.48％,respectively),and the critical value of volume percentage of solid component determined under this threshold was 16.9％.Conclusion The volume percentage of solid component measured based on CT density histogram analysis may be helpful in the differential diagnosis of early stage lung ade-nocarcinoma subtypes.

Objective:To measure the morphological parameters of the fetal vertebral centrum ossification centers (COC) in the second-third trimester using MRI susceptibility weighted imaging (SWI), and to explore the growth and development trajectory of the vertebrae.Methods:Fetus in the second-third trimester with normal vertebrae development were prospectively and continuously included in Shandong Provincial Hospital Affiliated to Shandong First Medical University from December 2015 to December 2021, and the SWI scanning of fetal spine was performed. The following morphometric parameters of the C4, T6, L3, S1 vertebrae COC were measured, including sagittal diameter, transverse diameter, height, cross-sectional area and volume. The linear and nonlinear regression analysis was used to derive the best-fit curve for each parameters and gestational age.Results:A total of 112 fetuses were recruited with gestatonal age 21-39 (29.4±3.9) weeks, including 30 cases of C4, 58 cases of T6, 92 cases of L3, 62 cases of S1. Fetal spine in utero with global curvature was kyphosis, presenting two primary curves (thoracic and sacral kyphosis). The morphological parameters sagittal diameter, transverse diameter, height, cross-sectional area and volume of C4 followed the quadratic polynomial rule during 25 to 38 weeks (R 2=0.938, 0.943, 0.952, 0.957, 0.982). During 21 to 38 weeks, the sagittal diameter, transverse diameter and height of the T6 followed the exponential growth pattern (R 2=0.915, 0.923, 0.849) and the growth of the area and volume followed the quadratic polynomial growth pattern (R 2=0.943, 0.961). The L3 followed the quadratic polynomial rule during 21 to 39 weeks (R 2=0.910, 0.916, 0.914, 0.942, 0.948) The sagittal diameter, transverse diameter and height of the S1 followed the linear growth pattern (R 2=0.905, 0.911, 0.922) and the area and volume followed the quadratic polynomial growth pattern (R 2=0.930, 0.964) during 23 to 39 weeks. Conclusions:The growth and development of C4, T6, L3 and S1 COC of fetus in the second-third trimester has a good correlation with gestational age. The growth of fetal vertebral COC in the early stage is slow, but with the growth of gestational age, the growth rate of vertebral bodies accelerates.

On January 20, 2020, WHO defined the epidemic of novel coronavirus pneumonia as a public health emergency of international concern, and the epidemic attracted worldwide attention. While effectively controlling source of infection, cutting off the route of transmission, and protecting the susceptible population, it is of great importance to reduce the delay in the diagnosis and treatment of patients with acute abdominal disease and ensure normal clinical work. Therefore, with reference to the current diagnosis and treatment protocols and guidelines and the actual situation in Baoding Second Hospital, this article summarizes the experience in outpatient triage, treatment process, operation classification, prevention and control, and ward management for patients with acute biliary tract infection. The analysis shows that the formulation of emergency plans for patients with acute biliary tract infection during the epidemic of novel coronavirus pneumonia can help to differentiate such patients from the patients with novel coronavirus pneumonia and avoid transmission and cross-infection of novel coronavirus during standardized diagnosis and treatment of acute biliary tract infection.

Traumatic rib fractures are the most common injury in thoracic trauma. Previously，the patients with traumatic rib fractures were mostly treated non-surgically，of which 50%，especially those combined with flail chest presented chronic pain or chest wall deformities and over 30% had long-term disabilities，being unable to retain a full-time job. In the past two decades，thanks to the development of internal fixation material technology，the surgical treatment of rib fractures has achieved good outcomes. However，there are still some problems in clinical treatment，including inconsistency in surgical treatment and quality control in medical services. The current consensuses on the management of regional traumatic rib fractures published at home and abroad mainly focus on the guidance of the overall treatment decisions and plans，and relevant clinical guidelines abroad lacks progress in surgical treatment of rib fractures in recent years. Therefore，the Chinese Society of Traumatology affiliated to Chinese Medical Association and Chinese College of Trauma Surgeons affiliated to Chinese Medical Doctor Association，in conjunction with national multidisciplinary experts，formulate the Chinese Consensus for Surgical Treatment of Traumatic Rib Fractures（2021）following the principle of evidence-based medicine，scientific nature and practicality. This expert consensus puts forward some clear，applicable，and graded recommendations from aspects of preoperative imaging evaluation，surgical indications，timing of surgery，surgical methods，rib fracture sites for surgical fixation，internal fixation methods and material selections，treatment of combined injuries in rib fractures，in order to provide references for surgical treatment of traumatic rib fractures.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.