Objective To investigate the value of apparent diffusion coefficient (ADC) of diffusion-weighted magnetic resonance imaging (DW-MRI) in distinguishing benign from malignant breast lesions. Methods ADC in 26 normal breasts, 24 malignant breast lesions, and 30 benign breast lesions confirmed by operation and pathology were calculated, respectively, and their differentiations in statistics were compared. The differentiations of different ADCs (b=1000-0, 500-0, 1000-500 s/mm2) were also compared. EPI (TR 2900 ms, TE 84 ms, thickness 5 mm) was used in order to acquire the imaging. Results There were significant differences among the ADC values of normal breast tissue, benign, and malignant lesions. The ADC of malignant lesions was lower than those of normal breast tissue and benign lesions, and the ADC of benign lesions was lower than that of normal breast tissue. There were significant differences among the ADC value of b=1000-0, 1000-500, and 500-0 s/mm2. The lower the b value, the higher the ADC. The sensitivity and specificity of ADC for the diagnosis of malignant lesion were 64% and 96.7% if the upper bound of 95% confidence interval was set as a differential level. Conclusion The differentiation of benign from malignant breast lesions by ADC is applicable, although the sensitivity is low, the specificity is high.

Objective To investigate the diagnostic value of 1H magnetic resonance spectroscopy (1H-MRS) in mammary tumors and to discuss the technique factors which influence the detection rate.Methods The 1H-MRS features of 47 mammary tumors, of which 24 malignant tumors and 23 benign tumors confirmed by pathology were analyzed. All of the tumors were detected before Gd-DTPA enhancement. Results Eleven of 24 malignant tumors showed increased choline resonance peak at 3.24 ppm while 4 of 23 benign ones at 3.24 ppm .The positive value were 45.8% and 17.4% respectively. The sensitivity and specificity were 45.8% and 82.6% respectively by using 1H-MRS to discriminate benign from malignant tumors. The main factors influencing the detection rate were low suppressed lipid, low suppressed water and low single-noise rate.Conclusion Choline is not special features of malignant tumors. Choline can be obtained despite the nature of tumor if they grow rapidly. The low sensitivity of choline to be detected mainly dues to technique factors.

Objective To investigate the CT and MRI features of the hemangiopericytoma (HPC) in central nervous system(CNS) and improve its diagnostic accuracy. Methods The CT and MRI features of the HPC in CNS proved by operation and pathology were retrospectively analyzed and the criteria of diagnosis and differential diagnosis were summarized.Results 7 of 9 cases were intracranial and 2 were intraspinal. The lesions appeared homogeneous high density in 4 cases on plain CT scans and 3 cases appeared inhomogeneous density, 4 cases appeared isointense with cortical gray matter on both T_1-weighted and T_2-weighted images, 3 cases were heterogeneous. All contrast-enhanced scans showed marked enhancement.Conclusion The accuracy diagnosis of HPC in CNS can be made by CT and MRI.

Objective To discuss CT,MR and~1H-MRS features of central neurocytoma(CNC).Methods Imaging findings ofneurocytomas in 7 cases confirmed by pathology were retrospectively analyzed with literature review.2 cases were examined by CT、MR and~1 H-MRS,2 cases only by MR,and 3 cases only by CT.Results All the tumors were located in the lateral ventricles.There were different degree hydrocephalus in all cases.The masses were heterogeneous appearance on CT with necrotic area and fine to course calcifications.Heterogeneous enhancement was seen in the solid portion.The tumors were isointense and hypointense on T_1WI and heterogeneous on T_2WI.Heterogeneous enhancement was also seen on MRI.The in vivo~1H-MRS showed prominent choline(Cho) and low N-acetyl aspartate(NAA) compared to the normal.Conclusion Central neurocytoma should be considered when a tumor was located at the lateral ventricles especially septum pellucidum in young patients.CT,MR and~1H-MRS are helpful in making a preoperative diagnosis.

This research analyzes and explores the elements of the industry education integration in the process of pharmacy talent training from two aspects: collaborative education (professional construction, curriculum co-construction, skill deepening and talent transfer) and collaborative innovation (base expansion, technological research and completion innovation). Besides, this research also explores the outstanding performance of School of Pharmacy of Xiamen Medical College in talent training of the industry education integration. The results show that through the construction of collaborative education and collaborative innovation, the elements of the industry education integration in the cultivation of pharmacy talents in the school have become increasingly prominent, and the forms have been gradually diversified, which have promotion and guiding significance for other majors in our school to develop the industry education integration.

Objective To explore the clinical value of spiral CT airway measurements on awake patients under OSAHS discussed. Methods The upper airway of 104 patients with OSAHS diagnosed with polysomnography (PSG) and 25 nor-mal controls were examined and compared. The cross-sectional areas, diameters, and the thickness of the pharyngeal wall of retropalate, lingua regions planes were scanned by MSCT scan in the waking state. Results The cross-section areas of upper airway of OSAHS were significantly smaller than those of the control group, the difference was significant (P<0.05). The cross-section areas decreased and the thickness of pharyngeal walls increased with the increase of severity of OSAHS. Conclusion Patients with OSAHS has upper airway anatomic strictures. MSCT scan can effectively localize the obstructed site and degree of upper airway accurately.

Objective:To retrieve, evaluate and integrate the best evidence of the operation related to the measurement of intra-abdominal pressure by bladder pressure sensor in adult emergency and critically ill patients.Methods:The "6S" pyramid model was used to retrieve the evidence of internal abdominal pressure measurement at home and abroad, including guidelines, best practices, evidence summary, systematic evaluation, expert consensus and so on. The retrieval time limit was from the establishment of the database to February 12, 2022. Two researchers independently evaluated the quality of the article, extracted data from the included article and graded the evidence according to Joanna Briggs Institute (JBI) evidence pre-grading system (2014 version) .Results:A total of 9 articles were included, including 1 clinical decision, 4 guidelines, 1 expert consensus and 3 quasi-experimental studies. A total of 23 pieces of best evidence were summarized from 10 aspects, including starting time, precautions, patient position, elimination of interference factors, infection control, zero calibration and measurement, data reading, monitoring frequency, equipment management, personnel education and training.Conclusions:This study integrates the best evidence of the operation related to the measurement of intra-abdominal pressure by bladder pressure sensor in adult emergency and critically ill patients, and provides evidence-based basis for standardizing clinical practice and accurately measuring intra-abdominal pressure in adult emergency and critically ill patients.

Objective To describe and compare the attitude and actual participation of decision-making regarding nursing care of patients with breast cancer, and to identify the related factors. Methods To investigate 480 cases of inpatients with breast cancer in 3 Grade ⅢA hospitals in Wuhan through questionnaire and self-designed general information questionnaire. Results There were significant differences (χ2=28.3, P<0.01) between the attitude and actual participation of decision making regarding of nursing care. The results of Logistic regression analysis showed that patients with higher education level (B=1.574, P=0.002), less children (B=-2.716, P<0.01) and higher income (B=0.323, P<0.01) , had a more active attitude to participate decision making; patients who were younger (B=-6.001, P=0.015), with higher education level (B=1.643, P=0.000), shorter duration of disease (B=-2.413, P=0.022), and lower degree of TNM stage (B=0.618, P=0.012), actually participated more often in decision making. Conclusions The actual participation was inconsistent with the attitude of decision-making regarding nursing care among patients with breast cancer. And patients′ demographic characters were related to their participation of decision making, which suggested that nurses should make a comprehensive assessment of willingness and capacity of patients′decision-making participation, identify the facilitators and barriers, and take measures to support patients to take an active part in the decision making to improve the quality of nursing care.

Patients with severe or critical coronavirus disease 2019 (COVID-19) are at high risk of death primarily due to respiratory failure caused by the cytokine storm in pulmonary tissues. The treatment response of these patients remains limited. Recently, low-dose radiation therapy (LDRT) has been clinically adopted to treat severe or critical COVID-19 patients in multiple medical centers abroad, indicating high feasibility and effectiveness. However, the mechanism and optimal radiation dose are still incompletely clear. This paper reviews the radiobiological mechanism, effectiveness, adverse reactions, and radiotherapy dose of LDRT in the treatment of severe or critical COVID-19 patients, aiming to better understand the clinical benefits and adverse reactions of LDRT.

Objective:To explore the effects of interpregnancy interval (IPI) on pregnancy outcomes of subsequent pregnancy.Methods:A multicenter retrospective study was conducted in 21 hospitals in China. Information of age, height, pre-pregnancy weight, IPI, history of diseases, complications of pregnancy, gestational age of delivery, delivery mode, and pregnancy outcomes of the participants were collected by consulting medical records of pregnant women who had two consecutive deliveries in the same hospital during 2011 to 2018. The participants were divided into 4 groups according to IPI:<18 months, 18-23 months, 24-59 months and ≥60 months. According to the WHO′s recommendation, with the IPI of 24-59 months group as a reference, to the effects of IPI on pregnancy outcomes of subsequent pregnancy were analyzed. Stratified analysis was further carried out based on age, history of gestational diabetes mellitus (GDM), macrosomia, and premature delivery, to explore the differences in the effects of IPI on pregnancy outcomes among women with different characteristics.Results:A total of 8 026 women were included in this study. There were 423, 623, 5 512 and 1 468 participants in <18 months group, 18-23 months group, 24-59 months group and ≥60 months group, respectively. (1) The age, pre-pregnancy body mass index (BMI), history of cesarean section, GDM, gestational hypertension and cesarean section delivery rate of <18 months group, 18-23 months group, 24-59 months group and ≥60 months group were gradually increased, and the differences were statistically significant ( P<0.05). (2) After adjusting for potential confounding factors, compared with women in the IPI of 24-59 months group, the risk of premature delivery, premature rupture of membranes, and oligohydramnios were increased by 42% ( OR=1.42, 95% CI: 1.07-1.88, P=0.015), 46% ( OR=1.46, 95% CI: 1.13-1.88, P=0.004), and 64% ( OR=1.64, 95% CI: 1.13-2.38, P=0.009) respectively for women in the IPI≥60 months group. No effects of IPI on other pregnancy outcomes were found in this study ( P>0.05). (3) After stratified by age and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would significantly increase the risk of oligohydramnios for women with advanced age ( OR=2.87, 95% CI: 1.41-5.83, P=0.004); and <18 months could increase the risk of premature rupture of membranes for women under the age of 35 ( OR=1.59, 95% CI: 1.04-2.43, P=0.032). Both the risk of premature rupture of membranes ( OR=1.58, 95% CI: 1.18-2.13, P=0.002) and premature delivery ( OR=1.52, 95% CI: 1.07-2.17, P=0.020) were significantly increased in the IPI≥60 months group. After stratified by history of GDM and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would lead to an increased risk of postpartum hemorrhage for women with a history of GDM ( OR=5.34, 95% CI: 1.45-19.70, P=0.012) and an increased risk of premature rupture of membranes for women without a history of GDM ( OR=1.44, 95% CI: 1.10-1.90, P=0.009). After stratified by history of macrosomia and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months could increase the proportion of cesarean section for women with a history of macrosomia ( OR=4.11, 95% CI: 1.18-14.27, P=0.026) and the risk of premature rupture of membranes for women without a history of macrosomia ( OR=1.46, 95% CI: 1.12-1.89, P=0.005). After stratified by history of premature delivery and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would significantly increase the risk of premature rupture of membranes for women without a history of premature delivery ( OR=1.47, 95% CI: 1.13-1.92, P=0.004). Conclusions:Both IPI≥60 months and <18 months would increase the risk of adverse pregnancy outcomes in the subsequent pregnancy. Healthcare education and consultation should be conducted for women of reproductive age to maintain an appropriate IPI when they plan to pregnant again, to reduce the risk of adverse pregnancy outcomes in the subsequent pregnancy.