To ensure the quality of direct digital radiography images, the management and control of image quality, basic adjustment of facilities post-processing, and raising technicians' professional quality mut be performed. To protect patients from radiation should be emphasized in medical staffs. Radiation should be reduced when ensuring the images' quality, and green examination concepts should be advised.

Objective To investigate the clinical characteristic of 1 000 Hz probe tone tympanometry obtained from neonates who didn’t pass the TEOAE screening . .Methods TEOAE screening were performed to screen the hearing with GSI -70 Automated OAE(Grason-Stadler ,USA) .Then neonates were detected the 1 000 Hz probe tone tympanograms by GSI Tympstar Version Ⅱ Middle Ear Analyzer(Grason-Stadler ,USA) .The relative infor-mation ,including tympanometric peak pressure (Tpp) ,peak admittance(Yp) ,peak compensated static acoustic ad-mittance (Ypc)、tympanometric width(TW) were collatea .The of 1 000 Hz probe tone tympanometry of 47 ears that didn’t pass the first TEOAE and 1 300 ears that passed the first TEOAE were asnpared .Results We found in the single-peak type ,the ratio of the experimental group(59 .57% ) was less than that of the control group(74 .00% ) , and in the flat type the ratio of the the experimental group (23 .40% ) was more than that of the control group (8 . 54% ) ,there was a statistical significance between the two groups in each different type proportion (P<0 .05) .But there is not a statistical significance in the relative values of single -peak type admittance between the two groups , such as tympanometric peak pressure (Tpp)、peak admittance(Yp) etc .Conclusion The majority of 1000Hz tympa-nograms of the neonates who passed TEOAE is the single -peak type ,but the neonates who didn’t pass the first TEOAE mostly shored the flat type The .

Objective To investigate the preparation of a biodegradable intravascular stent (BIS) with poly-l-lactic acid (PLLA), and to evaluate its physical and mechanical properties, as well as its biocompatibility. Methods The study of this BIS was first prepared by PLLA with molecular weight of 100 000 unit as the strut, and then the micro-porous structure was fabricated and the film was coated at the struts. Following the solidified shaping of BIS, the primary physical and mechanical properties of the BIS were tested, and 22 zigzag type BISs were implanted into the aorta and iliac arteries of 11 canines, then they were euthanized according to a fixed timetable for histopathological assessment. Results Two types of BIS (spiral and zigzag) were prepared, and the strut diameter of the BIS was 0.1-0.6 mm, stent diameter of BIS was 6-15 mm, and stent length was 30-80 mm. Of this BIS, the radial strength was 1.6-2.0 kPa (1 kPa=7.5 mm Hg), the dilatable rate was 6.0-6.5, the shortening rate was smaller than 8%-10%, and the proportion of stent surface area to open surface area was 0.16-0.18 (

Objective To define the effect of drug eluting BIS with antiproliferation agent-paclitaxel in preventing vascular restenosis.Methods Bare BIS and drug BIS with 60 ?g paclitaxel were prepared. Both types of the BIS were implanted into the infrarenal restenosis aortas in canine models, and the animals were euthanized 6 weeks after implantation for histopathological, morphometric and immunohistochemical assessment.Results The mean lumen area of bare BIS group was (77 586.5?66.0) ?m2, and lumen of paclitaxel eluting BIS group was (113 435.9?71.0) ?m2. The mean neointima area of bare BIS group was (24 803?56) ?m2, and paclitaxel eluting BIS group was (12 931?63) ?m2. The PCNA-positive ratio was (38?15)% in bare BIS group and (11?0.31)% in paclitaxel eluting BIS group. The statistically significant difference between the two groups were noted ( P

Objective To investigate the pathogenesis characteristics and epidemic tendency of notifiable infectious diseases (NID) in Zhujing County of Shanghai from 2013 to 2017, and to provide scientific basis for effective prevention and control measures. Methods Descriptive epidemiological method was used to statistically analyze the epidemic data of NID in Zhujing County of Shanghai during 2013-2017 reported by the China Information System for Disease Control and Prevention. Results A total of 3 259 cases of 17 different NID were reported in Zhujing County of shanghai during 2013-2017.The average annual incidence rate was 509.89/10⁵, A total of 7 cases of death were reported and average annual rate of mortality was 1.10/10⁵.No type A NID was reported and a total of 1 089 cases of 13 type B NID were reported, with the average annual incidence rate of type A and B NID being 170.38/10⁵; a total of 2 170 cases of 4 type C NID were reported, with the average annual incidence rate of type C NID being 339.51/10⁵. The top 5 diseases were HFMD, influenza, syphilis, gonorrhea and tuberculosis, accounting for 32.46%, 25.65%, 17.40%, 7.24% and 5.43% of the total.The onset was mainly to occur from May to August and from December to January, mostly in 0-6 years and 18-40 years groups.Most of the cases were students, scattered children, nursery children, farmers, workers.The incidence rate was higher in men than in women, and the incidence rate of household-registered residents in this city was higher than that of floating population.Intestinal infectious diseases were the main components. Conclusion As HFMD, influenza, syphilis, gonorrhea, tuberculosis prove to be the key NID in Zhujing County of Shanghai, we should act according to the epidemic features of the infectious diseases to formulate perfect control strategy to prevent the outbreak and prevalence of infectious diseases.

Objective To compare the clinical effectiveness and safety of transperitoneal robot assisted and retroperitoneal laparoscopic Anderson-Hynes dismembered pyeloplasty for the treatment of ureteropelvic junction obstruction. Methods From September 2008 to June 2009,six patients with primary UPJO underwent transperitoneal robot assisted dismembered pyeloplasty (TRADP) (5 males and 1 female;average age 25 yrs,range from 14-40 yrs),of whom 4 with severe hydronephrosis,2 with intermediate.According to the demographic and preoperative information,each patient in the TRADP group was matched to two corresponding patients with primary UPJO accepting retroperitoneal laparoscopic Anderson-Hynes dismembered pyeloplasty (RLADP) in the same period.The operative time,the intracorporeal suturing time,intraoperative blood loss,the duration of the urethral catheter and the drainage time,the postoperative hospital stay and the postoperative result were compared between the 2 groups.The two groups were identical with regard to gender,side of UPJO,and surgical procedure.The mean age and BMI were comparable between the TRADP and RLADP. Results Between the two groups,the operative time was ( 157 ± 20) min vs ( 127 ± 18) min ( P ＞ 0.05 ),the intracorporeal suturing time was (44 ± 6) min vs (49 ± 6 ) min ( P ＞0.05).In TRADP and RLADP groups,the intraoperative blood loss was (23 ± 8) ml vs (21 ± 17) ml ( P ＞ 0.05 ),the duration of the drain was (47 ± 10) h vs ( 161 ± 41 ) h ( P ＜ 0.01 ),the duration of the urethral catheter was (92 ±46) h vs ( 175 ±26) h (P ＜0.05),the postoperative hospital stays were (6.0 ± 0.8 ) d vs (8.0 ± 0.5) d ( P ＜ 0.01 ).The operation was successful in all cases of two groups,with no conversion to open surgery.The follow-up of 6 -32 months,with average of 20 months,showed that the clinical symptoms in the two groups disappeared and the hydronephrosis relieved. Conclusion Compared with RLADP,the TRADP has the comparable operative time,but the postoperative management for TRADP is more simple and the healing is faster,the postoperative outcomes are comparable as well.

Foot ulcer prevention plays a crucial role in reducing the amputation rate among diabetic patients. With regard to the prevention of diabetic foot ulcers, the 2023 guidelines of the International Working Group of Diabetic Foot(IWGDF) were different from the 2019 counterpart. The most notable change is the addition of high-level evidence to support recommendations, primarily derived from randomized controlled studies. The 2023 guidelines also advocate for local skin temperature measurement, participation in ankle exercise training, and psychological intervention for foot ulcer prevention. This article conducts a comparative analysis of the two guidelines across six key dimensions: identification of high-risk feet, regular examination of high-risk feet, health education, ensuring appropriate daily footwear, addressing ulcer risk factors, and comprehensive foot care. Drawing from clinical insights, the application and prospective implications of the 2023 guidelines in China are also examined.

OBJECTIVETo determine whether the level of serum cardiac troponin T (cTnT) was increased in patients with congestive heart failure (CHF).

METHODSThis study consisted of 265 patients with CHF and 75 healthy people. Serum cTnT was measured by electrochemiluminescence immunoassay using an Elecsys 1010 automatic analyzer.

RESULTScTnT concentration was 0.181 +/- 0.536 ng/mL in CHF patients and 0.003 +/- 0.001 ng/mL in controls (P < 0.001). Patients were categorized according to the levels of heart function and left ventricular ejection fraction (LVEF). In the first group consisting of 105 patients with LVEF 35%, cTnT was 0.07 +/- 0.0 5 ng/mL (P < 0.01). In patients with NYHA class I, II, III and IV, cTnT values were 0.062 +/- 0.022 ng/mL, 0.113 +/- 0.121 mg/mL, 0.191 +/- 0.231 mg/ml and 0.384 +/- 0.211 mg/mL, respectively (class I vs class II P > 0.05, class II vs class III P < 0.01, class III vs class IV P < 0.01). A negative correlation was observed between serum cTnT concentration and LVEF in 265 patients with CHF (r = -0.493, P < 0.001).

CONCLUSIONSThis study shows that the level of serum cTnT is increased in patients with CHF and that the increased level indicates the severity of CHF.

Adult ; Aged ; Female ; Heart Failure ; blood ; physiopathology ; Humans ; Male ; Middle Aged ; Stroke Volume ; Troponin T ; blood ; Ventricular Function, Left

【Objective】 To investigate the recurrence of patients with renal cell carcinoma (RCC) after robot-assisted partial nephrectomy (RAPN), and to explore the related factors of recurrence. 【Methods】 Clinical data of 367 RCC patients who underwent RAPN during 2015 and 2020 in our hospital were retrospectively collected. Patients were divided into recurrence group and non-recurrence group. The related factors of recurrence and 5-year cumulative recurrence rate of RCC and clear cell renal cell carcinoma (ccRCC) in the recurrence group were analyzed. 【Results】 The median follow-up was 48 (IQR:38-60) months. Recurrence occurred in 9 patients, with a 5-year cumulative recurrence rate of 97.5%. For RCC patients, univariate analysis showed that tumor size, T-stage, R. E. N. A. L. score, R value, N value, and operation time were significantly associated with postoperative recurrence (P<0.05), while multivariate analysis showed that N value (HR=15.75, 95%CI:2.00-124.17, P=0.009) was an independent related factor. For ccRCC patients, univariate analysis showed that hypertension, tumor size, T-stage, R. E. N. A. L. score, N value, operation time and WHO/ISUP grade were significantly associated with postoperative recurrence (P<0.05), while multivariate analysis showed that WHO/ISUP grade (HR=4.99, 95%CI:1.04-24.01, P=0.045) was an independent related factor. 【Conclusion】 The 5-year cumulative recurrence rate of RCC patients after RAPN is 2.5%. N value and WHO/ISUP grade are the independent related factor of recurrence of RCC and ccRCC, respectively.

【Objective】 To explore the influencing factors of planned robot-assisted partial nephrectomy (RAPN) converted to radical nephrectomy (RN). 【Methods】 Clinical data and operation records of 488 patients planned for RAPN in our hospital during 2015 and 2020 were retrospectively collected. The patients were divided into converted and unconverted groups, and relevant clinical data of the two groups were compared. The causes and influencing factors for conversion were analyzed. 【Results】 Among the 488 patients, 14 (2.9%) converted to RN. The causes included: ①complicated tumor anatomy and surgical difficulties; ②local advanced renal tumor suspected during operation; ③severe intraoperative hemorrhage. Univariate analysis showed that R. E. N. A. L score (P<0.001), E value (P<0.001), N value (P<0.001), L value (P<0.001), renal hilum position (P<0.001) and T stage (P=0.002) were influencing factors of conversion. 【Conclusion】 Causes for the conversion of RAPN to RN include complicated tumor anatomy, suspected local advanced renal tumor and severe intraoperative hemorrhage. The R. E. N. A. L score, E value, N value, L value, renal hilum position and T stage are influencing factors.