Necrotizing enterocolitis (NEC) is one of the severe gastrointestinal emergencies with high mortality in neo-natal period. Studies suggested that sepsis from NEC were associated with higher mortality in NEC. Therefore, it is important to explore the related factors and prevention measures of NEC and improve the prognosis of children with NEC. In recent years, studies have shown that the risk factors of sepsis in NEC included prematurity, low birth weight, long time of total parenteral nutrition supports and long duration of antibiotic exposure. The main pathogen of sepsis was gram-negative bacilli. Probiotics, glutamine and lactoferrin supplementation may reduce the incidence and severity of NEC, and may help further reduce the risk of gut-derived sepsis.

ObjectiveTo investigate the application of the ratio of early diastolic peak velocity of mitral valve(E) and early diastolic peak velocity of mitral annular(Ea) on evaluating left ventricuiar diastolic function in patients with chronic heart failure.MethodsLeft atrial diameter(LAD),left ventricular end-diastolic diameter (LVEDd),interventricular septal thickness (IVST),left ventricular ejection fraction (LVEF),E and late diastolic peak speed of mitral valve (A) of 30 patients with diastolic heart failure(DHF,DHF group),30 patients with systolic heart failure(SHF,SHF group) and 30 healthy persons (control group) were detected by conventional echocardiography.E/A ratio and E-wave deceleration time (DT) were calculated.Early diastolic peak velocity of longitudinal septal and left ventricular lateral part of mitral annulus (Esep,Elat) were measured by tissue Doppler imaging (TDI).Ea and E/Ea ratio were calculated as well as the relevant analysis was made.Results ( 1 ) LAD and IVST in DHF group were significantly higher than those in control group [(44.90±8.31) mm vs.(30.87±3.48) mm,(9.43±2.18) nn vs.(8.17 ± 1.12)mm,P＜0.05].LVEDd in SHF group was obviously higher than that in control group and DHF group [(66.30 ± 10.21) mm vs.(44.77 ± 4.17) mm,(48.60 ± 8.85) mm,P＜0.05],and LVEF and DT were significantly lower than those in control group and DHF group(P ＜ 0.05 ).(2) Esep,Elat and Ea in DHF and SHF group were significantly lower than those in control group( P ＜ 0.01 ),and E/Esep,E/Elat and E/Ea ratios were obviously higher than those in control group (P ＜ 0.01 ).( 3 ) The level of B type natriuretic peptide (BNP) in DHF and SHF group was significantly higher than that in control group [(477.73 ± 722.76),(978.60 ± 825.04) ng/L vs.(29.23 ± 17.84) ng/L,P ＜ 0.05 ].The level of BNP in SHF group was significantly higher than that in DHF group (P＜0.05 ).(4) Multivariate linear regression analysis showed that NYHA classification and BNP were correlated with E/Ea ratio (P ＜ 0.05).(5) The area under curve (AUC) of E/Ea in diagnosing chronic heart failure was 0.984 (95％ CI:0.000-1.000).AUC of E/Ea in identifying DHF and SHF was 0.857(95％ CI:0.773-0.940).The sensitivity and specificity of E/Ea were much higher than those of E/A.Conclusions Chronic left ventricular systolic insufficiency is commonly combined with different-degree diastolic dysfunction.The evaluation of left ventricular diastolic function can be more simple and accurate combined with pulse wave Doppler and TDI.

Exosomes are vesicle-like structures generated and secreted actively by all kinds of cells.They contain proteins, nucleic acids and also lipids from the original cells, functioning in interactions between cells by shuttling cellular cargoes, and regulation of immune response in the microenvironment.Besides, they play important roles in the oncogenesis and progression of lung neoplasms.Considerable studies have demonstrated great potentials of exosomal proteins and microRNAs as biomarkers for diagnosis, prognosis prediction and treatment of lung cancers, including immunotherapy and targeted delivering of anti-tumor drugs based on exosomes.

Amphiregulin is the ligand of epidermal growth factor receptor.It's widely expressed in many tissues and is involved in the oncogenesis,progression and metastasis of tumors.In the clinical study of lung caner,amphiregulin is a prognostic marker for NSCLC patients.Furthermore,amphiregulin is closely associated with the sensitivity and resistance of EGFRTKI treatment.Medicine target on amphiregulin can inhibit the activity of tumors.

Artificial intelligence(AI)is a strategic technology leading a new round of technological revolution and industrial transformation.It is forward-looking,important and necessary to apply AI technology to the medical field.At present,the research and development of intelligent data monitoring equipment,intelligent medical instruments,disease auxiliary diagnosis and treatment platforms,auxiliary diagnosis and treatment integrated systems and other technologies have been widely carried out,and related products are gradually used in auxiliary medical prevention,diagnosis,treatment,and rehabilitation.Based on the recent development of AI technology in the medical field,the application status of intelligent auxiliary diagnosis and treatment equipment in three fields of intelligent monitoring equipment,virtual psychological diagnosis and treatment platforms,and traditional Chinese medicine auxiliary diagnosis and treatment instruments was summarized to provide reference for AI to connect disease and health,and realize the intersection of AI and medical disciplines.

In this paper, with B/S application and architecture, an integrated solution of PACS is designed, and the function and application of each part of PACS based on the architecture is introduced. The PACS based on this mode is safe, stable, easy to manage and upgrade and convenient for use in telemedicine.
Computer Systems ; Humans ; Radiology Information Systems ; Research ; Software ; Telemedicine

Objective To investigate the effects of metoprolol succinate sustained-release tablets on acute phase ventricular pacing threshold and intracardiac electrical signal amplitude in a leadless pacemaker(Micra).Methods A total of 100 patients implanted with a leadless pacemaker were selected and divided into a study group(n=43)and a control group(n=57)according to whether oral metoprolol succinate sustained release tablets were postoperatively administered.The patients with underlying diseases including hypertension,coronary heart disease,or diabetes were treated with antihypertensive drugs,hypoglycemic drugs,or anti-platelet aggregation drugs.The study group received oral metoprolol succinate sustained release tablets within one to three days after implantation of a leadless pacemaker;while the control group received no metoprolol succinate sustained release tablets.Changes in ventricular pacing threshold and intracardiac electrical signal amplitude were observed in two groups one week,one month and three months after implantation.Results No serious complications occurred in the patients at the three time points after implantation.Ventricular pacing thresholds were stable in both groups,and there was no statistical significance between the two groups as compared with the same time period(P>0.05).In terms of amplitude of ventricular intracardiac electrical signal,theamplitude of ventricular R-wave did not differ significantly between the two groups at the three time points after implantation(P>0.05).Conclusions Oral administration of metoprolol succinate sustained release tablets had no significant effects on acute phase ventricular pacing threshold and intracardiac electrical signal amplitude in a leadless pacemaker(Micra).

Objective:To explore the correlation between rs231775 polymorphism of cytotoxic T lymphocyte-associated antigen 4 (CTLA4) gene and autoimmune thyroid disease (AITD) of Uygur in Xinjiang Uygur Autonomous Region.Methods:A total of 382 Uygur patients with AITD [including 328 Hashimoto's thyroiditis (HT) patients and 54 Graves' disease (GD) patients] diagnosed in the People's Hospital of Xinjiang Uygur Autonomous Region from January 2017 to December 2018 were selected as the case group, and 383 Uygur health physical examiners in the same period were selected as the control group. The whole blood genomic DNA of the study subjects was extracted, and the Sequenom-mass spectrometry analysis platform was used to determine the genotyping of CTLA4 gene single nucleotide polymorphism (SNP) locus rs231775 and analyze the genetic model, and the correlation between rs231775 polymorphism and AITD under different genetic models was compared. The logistic regression analysis model was used to analyze the influencing factors of AITD. And the thyroid function index of different genotype population was compared.Results:In the case group and the control group, the differences of CTLA4 gene rs231775 alleles (A: 41.88%, 49.35%; G: 58.12%, 50.65%) and genotype frequencies (AA: 17.80%, 23.24%; AG: 48.17%, 52.22%; GG: 34.03%, 24.54%) were statistically significant (χ 2=8.586, 9.260, P < 0.05). Compared with the control group, the genotype frequency of rs231775 in HT group, the alleles and genotype frequencies of rs231775 in GD group were significantly different (χ 2=5.997, 11.130, 10.210, P < 0.05). Under the additive and dominant models, the CTLA4 gene rs231775 was correlated with AITD [odds ratio ( OR)=0.67, 0.55, 0.63] and HT ( OR=0.69, 0.62, 0.67, P < 0.05); and correlated with GD under the additive, dominant and recessive genetic models ( OR=0.53, 0.23, 0.44, 0.34, P < 0.05). The logistic regression analysis showed that genotype, gender, age, thyroid stimulating hormone (TSH) and free thyroxine (FT 4) were independent influencing factors of AITD ( P < 0.05). Among all the subjects, the level of thyroglobulin antibody(TgAb) in the population with the recessive genotype (GG) at the rs231775 of the CTLA4 gene was higher than that in the dominant genotype (AA+AG) population ( P < 0.05). Conclusion:The CTLA4 gene rs231775 polymorphism is significantly related to AITD of Uygur in Xinjiang Uygur Autonomous Region, and the level of TgAb in GG genotype is higher than that in other genotypes.

Objective To study the curative efficacy and safety of single-unit umbilical cord blood transplantation (sUCBT) for malignant hematologic diseases,which is provided by China's public cord blood bank.Methods We retrospectively analyzed 409 cases of malignant hematologic diseases who accepted myeloablative single-unit unrelated donor UCBT without ATG at our center between May 2008 and December 2016.A comparative analysis was made on the total nuclear cells (TNC) of the umbilical cord blood before freezing and after thawing,the cells of CD34+,the recovery rate of cells and the clinical effect of UCBT.Result 409 units of umbilical cord blood used in UCBT respectively came from eight China's public cord blood banks.The average TNC of 409 units of umbilical cord blood before freezing and after the tubular recovery were respectively 18.5 × 108 and 16.34 × 108 (p =0.000).The average recovery rate of the tubular recovery was 88.5％,and there was significant difference among cord blood banks (P =0.000).The average TNC of umbilical cord blood before freezing and transfusion were respectively 18.5 × 108 and 15.86 × 108 (p =0.000).The average recovery rate of umbilical cord blood transfusion was 85.9％,with the difference being significant among cord blood banks (P =0.000).The average number of CD34+ cells before freezing and after the tubular recovery was 11.18 × 106and 8.68 × 106 (p =0.000).The average recovery rate of CD34+ cells after the tubular recovery was 80.75 ％,with the difference being significant among the cord blood banks (P =0.000).At 42nd day after UCBT,the cumulative incidence of neutrophil engraftment was 95.4％,and the median time of the engraftment was 17 days (11-38 days).The cumulative incidence of platelet engraftment at 120th day was 84.6％,and the median time of the engraftment was 36 days (14-93 days).The cumulative incidence of erythrocyte engraftment at 60th day was 92％,and the median time of engraftment was 22 days (9d-60 days).After the umbilical cord blood provided by each bank was used in UCBT,it got the difference in cumulative incidence of engraftment.The P values for cumulative incidence of neutrophil,platelet and erythrocyte engraftment were respectively 0.004,0.01 and 0.000 2,with the differences being statistically significant.At 100th day after UCBT,the cumulative incidence of Ⅱ-Ⅳ and Ⅲ-Ⅳ degrees of acute graft-versus-host disease (aGVHD) was respectively 28.63％ and 15.7％.After umbilical cord blood provided by each bank was used in UCBT,it got the difference in cumulative incidence of aGVHD.There was no significant difference between Ⅱ-Ⅳ and Ⅲ-Ⅳ degrees (P =0.809 and 0.68 respectively).At 3rd year after UCBT,the cumulative incidence of relapse was 15.89％.After umbilical cord blood provided by each bank was used in UCBT,there was no significant difference in the cumulative incidence of relapse (P =0.898).At 3rd year after UCBT,the overall survival (OS) rate and disease free survival (DFS) rate were respectively 66.7％ and 59％.After umbilical cord blood provided by each bank was used in UCBT,it got the difference in OS and DFS.There was no significant difference in OS and DFS (P =0.566 and 0.703 respectively).At 3rd year after sUCBT,the rate of graft-versus-host diseases/relapse-free survival (GRFS) was 54.3％.After umbilical cord blood provided by each bank was used in UCBT,there was no significant difference in the rate of GRFS (P =0.449).Conclusion The umbilical cord blood provided by China's public cord blood bank was used in UCBT.It has a high safety and good efficacy in treating malignant hematologic diseases.But it needs to set up the standardized and normalized quality-control system of umbilical cord blood for China's public cord blood bank.

Objective:Based on the previous epidemiological investigation of hyperparathyroxinemia in Urumqi community, a follow-up study was conducted to understand the changes of serum parathyroid hormone (PTH) level and clinical characteristics of residents with PTH.Methods:In the previous study (2013), an epidemiological cross-sectional study of hyperparathyroxinemia was conducted on 1 473 residents of the resident community, and 180 people with hyperparathyroxinemia were found. The serum PTH, parathyroid related laboratory indexes and vitamin D were observed in high PTH population of different genders.Results:According to the inclusion criteria, 159 patients with high PTH were included in the study. The total follow-up rate was 88.3% (159/180), including 24 males (15.09%) and 135 females (84.91%). The serum PTH level in the follow-up population was 68.60 (47.85-98.80)pg/ml, which was significantly different from that in the first visit ( P<0.01). There was no significant difference in serum PTH levels between men and women ( P>0.05). The levels of serum 25(OH)D, calcium, phosphorus, magnesium, creatinine, albumin and alkaline phosphatase in the follow-up population had no significant changes compared with the first visit population (all P>0.05); After stratified by sex, the serum creatinine level of men with high PTH was significantly higher than that of women ( P<0.01), and there was no significant difference in other PTH related laboratory indexes ( P>0.05); Although the vitamin D level was still deficient (<20 ng/ml), the proportion of people with sufficient vitamin D was significantly higher than that at the first visit. Conclusions:25(OH) D deficiency was still common in the follow-up population, but the vitamin D level of the residents with PTH was significantly improved and the serum PTH level was significantly lower than that in the first visit.