Objective To investigate the reduction of ultrasound ( US) guided combined with Seldinger technique ( MST) for PICC catheter through upper arm basilica vein complications. Methods To select 400 patients received PICC from July 2012 to December 2013, they were divided into control group (n=196, using common methods in fossa cubitalis place to insert catheter to basilic vein) and observation group ( n =204, using ultrasound combined with MST for catheterization). We compared the pain level during catheterization, the success rate of catheterization at first time, relevant infections and complications. Results The success rate of catheterization af first time was 99. 50% in the observation group and 81. 63% in the control group (χ2 =38. 06,P <0. 01), and 1. 16% of mechanical phlebitis, 1. 16% of venous thrombus and 0. 58% catheter rapture in the observation group lower than these of the control group (χ2 =18. 31, 7. 76, 7. 89;P<0. 01). The maintenance and medical expenses of control group was (1 706. 21 ± 210. 20) Yuan while (1 368. 44 ± 190. 33) Yuan in the control group (t=15. 47,P<0. 01). Conclusions Ultrasound guided upper basilic vein PICC catheter can effectively improve the success rate of catheterization, reduce the complication of catheter, and save catheter maintenance and the cost of treatment, which is worth the clinical promotion.

Objective:To investigate the types of cervical epithelial cells and the Human Papillomavirus (HPV) infection subtypes of 7 646 women specimens in Anhui province, and provide evidence for cervical cancer prevention.Methods:Thinprep cytologic test (TCT) and flow fluorescence hybridization technique were used to detect cervical epithelial lesions and HPV subtypes.Results:The total positive rate for TCT was 20.25%, and the positive rate was the highest in ≥ 60 age group (28.41%), followed by 10 to ≤ 19 age group (26.32%). The atypical squamous cells-undetermined significance (ASC-US), cannot exclude high-grade squamous intraepithelial lesion (ASC-H) and HSIL positive rates were the highest in the ≥60 age group, and the low-grade squamous intraepithelial lesions (LSIL) positive rate was highest in the 10-19 age group. The proportion of patients with 40-49 age group was the highest, and that of ≥60 age group was the highest. The single infection rate of different cervical epithelial cell lesions was higher than that of multiple infection rates. As the deepening degree of the lesion, the high-risk single infection rate of HPV showed a increasing trend from ASCUS, LSIL, ASC-H to high-grade squamous intraepithelial lesions (HSIL); The common subtypes of HPV infection in negative for intraepithelial lesion or malignancy (NILM) are 52, 16, 58, 53 and 6. The common subtypes of ASCUS are 52, 16, 53, 58 and 51. The common subtypes of ASC-H are 18, 58 and16. LSIL common subtypes are 16, 52, 56, 58, 53 and 66, HSIL common subtypes are16, 58, 33, 52 and 59 type.Conclusions:The high risk and single genotypes of infection were dominant in different cervical epithelial cell lesions in Anhui. Women who aged ≥60 should pay attention and regularly undergo HPV testing and cervical cancer screening. The HPV infection subtypes of different cervical epithelial cell lesions are different, and the common subtypes are HPV52, 16, 58, 53, among which types 16, 58 and 33 are common infection subtypes detected in different lesions.

Objective:To explore the feasibility of deep learning-based restoration of obscured thyroid ultrasound images.Methods:A total of 358 images of thyroid nodules were retropectively collected from January 2020 to October 2021 at Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, and the images were randomly masked and restored using DeepFillv2. The difference in grey values between the images before and after restoration was compared, and 6 sonographers (2 chief physicians, 2 attending physicians, 2 residents) were invited to compare the rate of correctness of judgement and detection of image discrepancies. The ultrasound features of thyroid nodules (solid composition, microcalcifications, markedly hypoechoic, ill-defined or irregular margins, or extrathyroidal extensions, vertical orientation and comet-tail artifact) were extracted according to the Chinese Thyroid Imaging Reporting and Data System (C-TIRADS). The consistency of ultrasound features of thyroid nodules before and after restoration were compared.Results:The mean squared error of the images before and after restoration ranged from 0.274 to 0.522, and there were significant differences in the rate of correctness of judgement and detection of image discrepancies between physicians of different groups(all P<0.001). The overall accuracy rate was 51.95%, the overall detection rate was 1.79%, there were significant differences also within the chief physicians and resident groups (all P<0.001). The agreement rate of all ultrasound features of the nodules before and after image restoration was higher than 70%, over 90% agreement rate for features such as solid composition and comet-tail artifact. Conclusions:The algorithm can effectively repair obscured thyroid ultrasound images while preserving image features, which is expected to expand the deep learning image database, and promote the development of deep learning in the field of ultrasound images.

ObjectiveTo observe the effect of modified Tianwang Buxindan （MTBD） on the skin of sleep-deprived （SD） mice and investigate its mechanism. MethodSixty 2-month-old female Kunming mice were randomly divided into a blank group， a model group， a vitamin C （VC， 0.08 g·kg^-1）， and MTBD low-， medium-， and high-dose groups （6.5， 12.5， 25 g·kg^-1）. Except for the blank group， the other groups were subjected to SD mouse model induction （using multiple platform water environment method for 18 hours of sleep deprivation daily from 15：00 to next day 9：00）， continuously for 14 days， and caffeine （CAF， 7.5 mg·kg^-1） was injected intraperitoneally from the 2nd week onwards， continuously for 7 days. While modeling， the blank group and the model group were administered with normal saline （0.01 mL·g^-1）， and the other groups received corresponding drugs for treatment. On the day of the experiment， general observations were recorded （such as body weight， spirit， fur， and skin）. After sampling， skin tissue pathological changes were observed under an optical microscope using hematoxylin-eosin （HE） and Masson staining methods. Skin thickness and skin moisture content were measured. Biochemical assay kits were used to detect skin hydroxyproline （HYP） content， skin and serum superoxide dismutase （SOD） activity， and malondialdehyde （MDA） content. Enzyme-linked immunosorbent assay （ELISA） was used to detect serum interleukin （IL）-6， tumor necrosis factor （TNF）-α， and IL-1β levels in mice. Western blot was used to detect skin tissue type Ⅰ collagen （ColⅠ）， type Ⅲ collagen （ColⅢ）， phosphatidylinositol 3-kinase （PI3K）， phosphorylated （p）-PI3K， protein kinase B （Akt）， p-Akt， nuclear factor E₂-related factor 2 （Nrf2）， heme oxygenase （HO）-1， and nuclear factor （NF）-κB protein expression. ResultCompared with the blank group， the model group showed varying degrees of changes. In general， signs of aging such as reduced body weight （P<0.01）， listlessness， dull fur color， and formation of wrinkles on the skin appeared. Tissue specimen testing revealed skin thinning， flattening of the dermoepidermal junction （DEJ）， and reduced collagen fibers under the optical microscope. Skin thickness and moisture content decreased， skin tissue HYP content significantly decreased （P<0.01）， skin and serum SOD activity significantly decreased （P<0.01）， and MDA content significantly increased （P<0.01）. Serum IL-6， TNF-α， and IL-1β levels significantly increased （P<0.01）. Skin ColⅠ， ColⅢ， p-PI3K/PI3K， p-Akt/Akt， Nrf2， and HO-1 protein expression significantly decreased （P<0.05， P<0.01）， and NF-κB expression increased （P<0.01）. Compared with the model group， the VC group and the MTBD low-dose group showed increased skin moisture content， HYP content， SOD activity， and ColⅠ， ColⅢ， p-PI3K/PI3K protein expression （P<0.05， P<0.01）， and decreased serum MDA content （P<0.05）. In addition， a decrease in serum IL-6 and IL-1β levels was detected in the MTBD low-dose group （P<0.05）， while the above indicators in the MTBD medium- and high-dose groups improved （P<0.05， P<0.01）. ConclusionSleep deprivation accelerates the aging process of the skin in SD model mice. MTBD can improve this phenomenon， exerting anti-inflammatory and antioxidant effects， and its mechanism of action may be related to the activation of the PI3K/Akt/Nrf2 signaling pathway.