Objective To explore the feasibility to diagnose ureterolithiasis by 16-multidetector spiral computed tomography (16-MDCT) at different low doses based on body mass index (BMI).Methods A total of one hundred patients from 2009 Sep to 2010 Feb suspected of ureterolithiasis were randomly divided into 2 equal groups undergoing 16-MDCT at standard-dose (120 kV, 240 mA) or lowdose (120, 80, and 50 mA, respectively) based on the body mass index (BMI).Taking the clinical diagnosis as the standard, the sensitivity level, specificity level, and positive predictive value of these groups were compared.Results The dose length product ( DLP ) of the low-dose CT group and the average CT dose index (CTDIvol ) were 18.95 and 6.65 mGy, respectively.There was significant difference between the two groups ( t = 31.78, P ＜ 0.01 ).The sensitivity level, specificity level, and positive predictive value of the low-dose group were 97.1% , 94.0% , and 94.3% , respectively, all not significantly different from those of the standard-dose groups (97.3% , 96.0% , and 97.3% , respectively,P ＞0.05).Conclusions It is feasible to diagnose ureterolithiasis by low-dose 16-MDCT based on BMI with the obtained image quality meeting the clinical diagnostic requirements.

With the rapide development of medical imaging facilities, Traditional educational technology of experiment teaching in medical imaging have not adapted to modern imaging, In order to resolve the problem, we set up a multimedia experiment teaching system for medical imaging in 2006, The system teaching process was composed of experiment teaching,experiment question answering and experiment examination.

Objective To evaluate the systolic function in patients with preeclampsia using three-dimensional speckle tracking imaging (3D-STI) technology.Methods Totally 73 patients with mild preeclampsia (mild group),64 patients with severe preeclampsia (severe group) and 60 healthy pregnant women with matched age and gestational weeks (control group) were enrolled in this study.All the biochemical indicators and conventional echocardiogram parameters were detected.The left ventricular global longitudinal systolic peak strain (GLS),global radial systolic peak strain (GRS),global circulation systolic peak strain (GCS) and global area systolic peak strain (GAS) were measured using 3D-STI,and the dyssynchronization index of area strain (ASDI) was calculated in all three groups.The correlation between sensitive three dimensional strain and biochemical indexes and echocardiogram parameters were analyzed.Results Compared with control group,the left atrial diameter (LAD) increased,E/A decreased in severe group,Tei index increased in turn at control group,mild group and severe group (all P＜0.05).Compared with control group,the |GLS| and |GAS| reduced and ASDI was increased in mild group,the changes were more significant in severe group.The GRS and GCS were also appeared lower in severe group (all P＜0.05).The correlation analysis showed a negative correlation between |GLS| and Tei index (r=-0.471,P=0.036),a positive correlation between | GAS| and LVEF (r=0.051,P=0.028),a negative correlation between | GAS| and Tei index (r=-0.612,P =0.017),a negative correlation between ASDI and H-FABP (r=-0.525,P=0.046),a positive correlation between ASDI and Tei index (r=0.489,P=0.037).Conclusion The myocardial strain capacity of left ventricular decrease and systolic function are significantly impaired in patients with preeclampsia.The 3D-STI technology can early noninvasively assess the change of left ventricular systolic function in patients with preeclampsia.

Objective:To explore the influence of flipped classroom combined with case-based learning (CBL) teaching mode on teaching effect of X-ray cephalometric analysis in orthodontic experimental class.Methods:In the study, 70 undergraduates majoring in stomatology were selected as research objects and randomized into teaching reform group and traditional group in average. Flipped classroom combined with CBL teaching mode was adopted in teaching reform group, while traditional group adopted traditional teaching mode. Questionnaire was used to investigate the students' evaluation on the two teaching modes, and the accuracy of the measurement of X-ray cephalometrics of the two groups was compared and analyzed respectively. GraphPad Prism 7.03 software was used to perform t test and chi-square test. Results:Teaching reform group believed that this kind of teaching mode could improve the ability of self-study, communication coordination ability, independent problem solving ability, and logic and language expression ability, deepen the understanding of the project connotation, and apply the X-ray cephalometrics to the actual clinical case analysis and diagnosis. Compared with the traditional group, there were significant differences ( P<0.05). In the accuracy evaluation of measurement values, the absolute values of 70% measurement items in teaching reform group were higher than those in the traditional group, but the difference was not statistically significant ( P>0.05). Only in bone type Ⅲ malocclusion, the absolute values of Y-axis angle and FMA were lower than those of the traditional group, and the difference was statistically significant ( P<0.05). Conclusion:Flipped classroom combined with CBL teaching mode can help students improve self-study ability, communication cooperation ability and the ability of solving problem independently and clinical application. However, the accuracy evaluation of measurement values in teaching reform group were lower than that of the traditional group, indicating that this teaching method in the experimental teaching of X-ray cephalometric analysis needs to be further improved.

Objective:To observe the efficacy of pars plana vitrectomy (PPV) in the treatment of different types of chorioretinal coloboma with retinal detachment (RD).Methods:A single-center, retrospective clinical study. From April 2021 to March 2023, 24 eyes of 23 patients who were diagnosed as chorioretinal coloboma with RD in Henan Provincial Eye Hospital were included in this study. There were 11 males with 12 eyes and 12 females with 12 eyes. The mean age was (33.3±13.7) years old. Best corrected visual acuity (BCVA), spectral domain optical coherence tomography were performed. The BCVA examination was performed using a international standard logarithmic visual acuity chart, which was converted into logarithm of the minimum angle of resolution (logMAR) visual acuity during statistics. According to the types of chorioretinal coloboma, the affected eyes were divided into the coloboma involved the optic disc group and the coloboma not involved the optic disc group, with 15 eyes and 9 eyes. According to whether the RD containing the coloboma area, the affected eyes were divided into RD containing the coloboma area group and the RD not containing the coloboma area group, with 15 eyes and 9 eyes. All eyes underwent standard pars plana three-channel 25G PPV, retinal laser photocoagulation combined with silicone oil tamponade. The follow-up time after surgery was (19.5±16.3) months. The last follow-up was the time point for efficacy determination. The retinal reattachment, BCVA recovery and postoperative complications were observed. Paired t-test or t test was performed for comparison of quantitative data. Fisher's exact test was performed for comparison of qualitative data. Results:At the last follow-up, retinal reattachment was achieved in 20 eyes (83.3%, 20/24). The logMAR BCVA of the coloboma involved the optic disc group before and after surgery were 1.85±0.62 and 1.71±0.71, the difference was no significant ( t=0.845 , P=0.412). The logMAR BCVA of the coloboma not involved the optic disc group before and after surgery were 1.75±0.45 and 0.84±0.26, the difference was statistically significant ( t=6.153 , P<0.001). The improvement of BCVA in the coloboma not involved the optic disc group was significantly higher than that in the coloboma involved the optic disc group after surgery, with statistically significant differences ( t=3.024 , P=0.006). There was no significant difference in the retinal reattachment rate between the two groups ( P=0.615). There was no significant difference in the retinal reattachment rate between the RD containing the coloboma area group and the RD not containing the coloboma area group ( P=0.259). Postoperative complications included elevated intraocular pressure in five eyes, cataract progression in ten eyes, recurrent RD in two eyes, bullous keratopathy in one eye and band-shaped keratopathy in one eye. Conclusion:PPV combined with silicone oil tamponade is safe and effective in the treatment of chorioretinal coloboma with RD, the improvement of visual acuity in the coloboma not involved the optic disc group is better than that in the coloboma involved the optic disc group after surgery.

Objective To investigate the relationship between Notch1 and autophagy under high glucose conditions and to explore the effects of Notch1 inhibitor DAPT and autophagy inhibitor 3-MA on human retinal pigment epithelial cells cultured in high glucose conditions.Methods Via preliminary experiment,25 mmol·L-1 glucose was used as the high glucose culture medium of adult retinal pigment epithelial(ARPE)-19 cells,and 5 mmol·L-1 3-MA was adopted as the au-tophagy inhibitor.ARPE-19 cells cultured in vitro were randomly divided into four groups:control group(treated with 5 mmol·L-1 glucose for 48 h),high glucose group(treated with 25 mmol·L-1 glucose for 48 h),high glucose+DAPT group(treated with 40 μmol·L-1 DAPT for 2 h and then 25 mmol·L-1 glucose for 48 h),and high glucose+3-MA group(treated with 5 mmol·L-1 3-MA for 2 h and then 25 mmol·L-1 glucose for 48 h).A transmission electron microscope was used to observe the ultrastructure of cells in each group.Cell proliferation and migration were observed using Cell Counting Kit-8 and scratch assays.Western blot was used to detect the protein expression levels of Notch1 and autophagy-related proteins LC3 and Beclin1.Reverse transcription-polymerase chain reaction was used to measure the relative messenger ri-bonucleic acid(mRNA)expression levels of Notch1,LC3 and Beclin1 of cells in each group.Results Transmission elec-tron microscope showed that cells in the control group had normal structures,with round or oval nuclei and a few autopha-gosomes.In the high glucose group,cells exhibited slightly obvious injury,with uneven cytoplasm and numerous autolyso-somes.Compared to the control group,ARPE-19 cells in the high glucose group had increased proliferation and migration abilities,and higher mRNA and protein expression levels of Notch1,LC3 and Beclin1(all P＜0.05).Compared to the high glucose group,ARPE-19 cells in the high glucose+DAPT group showed decreased proliferation and migration abilities,and lower mRNA and protein expression levels of Notch1,LC3 and Beclin1(all P＜0.05).The high glucose+3-MA group showed reduced proliferation and migration abilities,as well as decreased mRNA and protein expression levels of LC3 and Beclin1(all P＜0.05)compared to the high glucose group.Conclusion High glucose can activate Notch1 and the auto-phagy process,promoting the proliferation of ARPE-19 cells.In the high glucose+DAPT group and high glucose+3-MA group,the autophagy process is inhibited to a certain extent,thereby restraining cell proliferation.

Objective To investigate if Lycium barbarum polysaccharide(LBP)could inhibit the high glucose-in-duced human retinal microvascular endothelial cell(HRMEC)injury by regulating the NOD-like receptor family pyrin do-main containing protein 3(NLRP3)/Caspase-1 pyroptosis pathway.Methods HRMECs cultured in vitro were randomly divided into the control group(5.5 mmol·L-1 glucose),the high glucose group(55.5 mmol·L-1 glucose),the low LBP group(55.5 mmol·L-1 glucose+100 mg·L-1 LBP),the medium LBP group(55.5 mmol·L-1 glucose+500 mg·L-1 LBP),the high LBP group(55.5 mmol·L-1 glucose+1 000 mg·L-1 LBP),the si-NC group(55.5 mmol·L-1glucose after transfection with 20 pmol·L-1 si-NC)and the si-NLRP3 group(55.5 mmol·L-1 glucose after transfection with 20μmol·L-1si-NLRP3).The Cell Counting Kit-8 was used to detect the proliferation of HRMECs in each group and flow cy-tometry was adopted to measure the pyroptosis of HRMECs in each group.The reverse transcription-polymerase chain reac-tion was used to detect the relative messenger ribonucleic acid(mRNA)expression levels of NLRP3,Caspase-1,nuclear factor(NF)-κB,Gasdermin-D(GSDMD)and vascular endothelial growth factor(VEGF)in the HRMECs of each group,Western blot was adopted to detect the relative protein expression levels of HRMEC pyroptosis-related NLRP3,Caspase-1,NF-κB,GSDMD and VEGF in each group,and enzyme-linked immunosorbent assay was used to detect the interleukin(IL)-1β and IL-18 expression levels in downstream pyroptosis in the HRMEC supernatant of each group.Results Com-pared with the control group,the proliferation rate of HRMECs decreased,the pyroptosis rate increased,the relative mR-NA and protein expression levels of NLRP3,Caspase-1,NF-κB,GSDMD and VEGF increased,and the expressions of IL-1βand IL-18 increased in the high glucose group(all P＜0.05).Compared with the high glucose group,the proliferation rate of HRMECs increased,the pyroptosis rate decreased,the relative mRNA and protein expression levels of NLRP3,Caspase-1,NF-κB,GSDMD and VEGF decreased,and the expressions of IL-1β and IL-18 decreased in the si-NLRP3 group(all P＜0.05).There were no significant differences in cell proliferation rate,pyroptosis rate,mRNA and protein expression levels of NLRP3,Caspase-1,NF-κB,GSDMD and VEGF,as well as levels of IL-1β and IL-18,in the si-NC group compared with the high glucose group(all P＞0.05).Compared with the high glucose group,the medium LBP group and high LBP group had increased proliferation rates,lower pyroptosis rates,and declined mRNA and protein expression levels of NLRP3,Caspase-1,NF-κB,GSDMD and VEGF as well as expressions of IL-1β and IL-18(all P＜0.05).Compared with the high glucose group,there was no significant difference in the proliferation rate of HRMECs and various protein expression levels in the low LBP group(all P＞0.05),and other indicators were consistent with those in the medium LBP group and high LBP group.Conclusion LBP has a protective effect on HRMEC injury induced by high glucose,can promote cell prolif-eration and inhibit pyroptosis,and its mechanism is related to inhibiting the activation of NLRP3/Caspase-1 signaling path-way and reducing the expression of related inflammatory factors.

Objective:To evaluate the effects of vaccine switch on the levels of neutralizing antibody (NA) of poliovirus in children aged<12 years.Methods:Subjects aged<12 years from 9 districts in Fujian province were chosen by stratified cluster and complete random sampling method. Blood samples were collected for testing NA of poliovirus by microcell neutralization.Results:A total of 2 134 subjects aged<12 years were selected. The positive rate of NA against PVⅠand Ⅲ were 98.64% and 95.83%; and geometric mean titers (GMTs) were 1∶259.35 and 1∶105.14, respectively. The GMTs presented a trend of decreasing as age increased. Compared to trivalent oral poliovirus vaccine (tOPV), bivalent oral poliovirus vaccine (bOPV) and inactivated poliovirus vaccine (IPV) induced higher GMTs of NA against poliovirusⅠand Ⅲ respectively. Among 182 children aged<5 years, the positive rate of NA against PVⅠ, Ⅱ, Ⅲ were 97.25%, 76.37% and 92.86%. There were statistical differences among the three types ( χ2=44.44, P=0.000). The rate of NA against PVⅡwas significantly lower than those ofⅠand Ⅲ (Ⅱ vs. I: χ2=34.65, P=0.000; Ⅱ vs. Ⅲ: χ2=18.99, P=0.000). And the GMTs of NA against PV Ⅰ, Ⅱ, Ⅲ were 1∶368.96、1∶23.06 and 1∶183.10, which were significantly different ( F=156.54, P=0.000). The GMT of PVⅠwas the highest, PV Ⅲ was the second, PVⅡ was lowest (pairwise comparison showed values of P all were 0.000). The analysis of general linear model showed that the interval between the date of last immunization and the date of sample collection would affect the GMTs of PVⅠand Ⅲ, different vaccine models would affect only the GMT of PV Ⅰ. The age maybe was a confounding factor. But no factors would affect the GMT of PV Ⅱ. Conclusions:After the vaccine switch, the level of NA against PVⅠand PV Ⅲ were still maintaining high level, but the level of PVⅡamong children<5 years was at relatively low level, which indicated that the surveillance should be strengthened.

Background Obstructive sleep apnea (OSA) is a sleep disorder characterized by recurrent episodes of obstruction of the upper airway during sleep. Given the substantial number of OSA patients, it is urgently in need to address the burden on society. Current available evidence linking outdoor light at night (LAN) to OSA is scarce. Objective To explore the relationships regarding outdoor LAN and OSA among residents in Southern China. Methods A total of 3925 hospitalized patients in Guangdong Provincial People's Hospital Sleep Center were recruited between January 1, 2005 and December 31, 2015. The severity of OSA was determined by apnea-hypopnea index (AHI) using polysomnography or home sleep test. The annual Suomi National Polar-orbiting Partnership Visible Infrared Imaging Radiometer Suite (NPP-VIIRS)-like LAN data with a 500 m spatial resolution were used to evaluate outdoor LAN levels of the participants 1, 3, and 5 years before undergoing sleep monitoring. Generalized linear regression models were utilized to examine the associations of outdoor LAN with OSA. Results The ORs (95%CIs) of OSA, mild OSA, and moderate OSA were 1.175 (1.021, 1.351), 1.215 (1.038, 1.421), and 1.195 (1.003, 1.425) respectively for per interquartile range (IQR) increment in three-year average outdoor LAN. The results of stratified analyses showed a higher OR of 1.933 (95%CI: 1.424, 2.637) in female than male participants (P _interaction < 0.001). Additionally, the ORs of OSA did not substantially change using one-year/ five-year instead of three-year average outdoor LAN. Conclusion Our findings demonstrate that an elevated outdoor LAN is significantly associated with higher odds of OSA (especially mild and moderate OSA) in Southern China, especially in females. An effective outdoor LAN management and policy-making framework has been suggested as potential preventive measures to reduce burden of OSA.

Objective To investigate the association and interaction of heat shock proteins B1 (HSPB1) gene rs2868371 and tumor-suppressor protein p53 (TP53) gene rs1042522 polymorphisms with chromosome damage levels among coke oven workers. Methods We recruited 1 333 male workers from a state-run coke oven plant in Wuhan in September-October 2010. Among them, 949 who had worked in coke oven workplaces, including auxiliary facilities and bottom, side, and top ovens, were nominated as coke oven workers (i.e., exposed), and 384 administrative or medical staff whose workplaces were offices were used as controls. General characteristics and 5 ml of venous blood were collected from each participant. The plasma concentrations of benzo [a] pyrene-diolepoxide (BPDE)-albumin adducts and the lymphocytic micronucleus (MN) frequencies for each individual were detected by ELISA and cytokinesis-block micronucleus assay, respectively. Gene polymorphisms were genotyped using TaqMan assays via quantitative PCR (ABI Prism 7900HT), and the corresponding frequency ratios (FR) with 95%confidence intervals (CI) were computed for all assays. Results In the exposed group, the MN frequencies were higher in HSPB1 rs2868371 GC, CC, and GC+CC genotype carriers ((3.88 ± 2.88)‰, (4.00 ± 2.66)‰, and (3.91 ± 2.83)‰, respectively) than in rs2868371 GG genotype carriers ((3.52±2.67)‰;FR=1.10, 1.13, and 1.11;95%CI:1.02-1.19, 1.02-1.25, and 1.03-1.19, respectively), and the HSPB1 rs2868371C allele was associated with increased MN frequency (Ptrend=0.006). Further, in the exposed group, the MN frequencies were lower in TP53 rs1042522 CG and CG+GG genotype carriers ((3.63±2.61)‰and (3.66±2.61)‰, respectively) than in TP53 rs1042522 CC genotype carriers (3.95 ± 3.06)‰(FR=0.87 and 0.90;95%CI:0.83-0.96 and 0.84-0.97, respectively). The effect of gene-gene interaction between HSPB1, rs2868371, and TP53 rs1042522 on MN frequency was significant among coke oven workers (P=0.001). Further stratified analyses showed that the effects of the HSPB1 rs2868371C allele in increasing MN frequencies were robust in subjects aged>40 years (FR=1.07, 95% CI: 1.01-1.12), those working >20 years (FR=1.08, 95% CI: 1.02-1.14), those with BMI ≤24 kg/m2 (FR=1.07, 95% CI: 1.01-1.13), drinkers (FR=1.09, 95% CI: 1.02-1.16), and workers with higher BPDE-albumin adduct levels (FR=1.07, 95% CI: 1.01-1.13) (Ptrend=0.023, 0.013, 0.029, and 0.020, respectively). The decreasing effect of the TP53 rs1042522 G allele on MN frequencies was robust in subjects aged >40 years (FR=0.94, 95% CI: 0.89-0.99), those with BMI ≤24 kg/m2 (FR=0.94, 95% CI:0.88-0.99), and drinkers (FR=0.94, 95% CI: 0.88-1.00) (Ptrend=0.031, 0.023, and 0.038, respectively). In addition, there were interactions between HSPB1 rs2868371 and age and between HSPB1 rs2868371 and working years in terms of MN frequency (P=0.030 and 0.013, respectively). Conclusion In coke oven workers, the HSPB1 rs2868371 C and TP53 rs1042522 G alleles were associated with increased and decreased chromosome damage levels, respectively, and their interaction effect on chromosome damage levels was significant.