Objective To analyse the CT radiation dose statistically using the standardized radiation-dose-structured report (RDSR) of digital imaging and communications in medicine (DICOM). Methods Using the self-designed software, 1230 RDSR files about CT examination were obtained searching on the picture archiving and communication system ( PACS ) . The patient dose database was established by combination of the extracted relevant information with the scanned sites. The patients were divided into adult group (over 10 years) and child groups (0-1 year, 1-5 years, 5-10 years) according to the age. The average volume CT dose index ( CTDIvol ) and dose length product ( DLP) of all scans were recorded respectively, and then the effective dose ( E) was estimated. The DLP value at 75% quantile was calculated and compared with the diagnostic reference level ( DRL) . Results In adult group, CTDIvol and DLP values were moderately and positively correlated ( r=0?41 ) , the highest E was observed in upper abdominal enhanced scan, and the DLP value at 75% quantile was 60% higher than DRL. In child group, their CTDIvol in group of 5-10 years was greater than that in groups of 0-1 and 1-5 years ( t=2?42, 2?04, P<0?05);the DLP value was slightly and positively correlated with the age (r=0?16), while E was moderately and negatively correlated with the age ( r = -0?48 ) . Conclusions It is a simple and efficient method to use RDSR to obtain the radiation doses of patients. With the popularization of the new equipment and the application of regionalized medical platform, RDSR would become the main tool for the dosimetric level surveying and individual dose recording.

Objective To study the dosimetry parameters of 125I seed source (type Sinko BT-125-1) with thermoluminescent dosimeter (TLD) in the phantom.Methods The new type of phantom was modified to suit to measurement of a common type of 125I seed source.The AAPM TG43 protocol recommended measurements of dose-rate constant (Λ),radial dose function (gL (r)),and anisotropy function (F (r,θ)) have been performed in the phantom with TLD.Results The Λ was 0.928 cGyh-1 U-1.The gL(r) was determined at different radial distances r ranging from 1.0 to 10.0 cm with an interval of 1.0 cm ; and F (r,θ) at angles from 0° to 90° in 10° increments.The gL (r) of 125I seed source showed a difference of 9.6％ at the most in comparison to the corresponding values of 125I seed source (type Amersham 6711).The difference in F(2 cm,θ) of 125I seed source and Amersham 6711 was up to 10.2％ near the source end.With the phantom the combined standard uncertainty in the whole measurement was less than 6.0％.Conclusions The experimental results exhibit fairly small measurement uncertainties and good self-consistency.It's feasible to measure the dosimetry characters of permanent implant seeds in the modified phantom.

Objective: To investigate the expressions of histone lysine-specific demethylase 1 (LSD1), O⁶-methylguanine DNA methyltransferase (MGMT) and cell proliferation-associated antigen Ki-67 in high-grade glioma and their influences on prognosis. Methods: Sixty-five cases of grade Ⅲ and Ⅳ glioma confirmed by pathology from January 2011 to June 2017 in the First Affiliated Hospital of Xinjiang Medical University were selected. Immunohistochemistry (SP method) was used to detect the expressions of LSD1, MGMT and Ki-67 in pathological specimens. The therapeutic effect was evaluated by long-term follow-up. The relationships between the three markers and pathological grade, progression-free survival (PFS) and overall survival (OS) were analyzed. Results: The overall positive rates of LSD1, MGMT and Ki-67 in the 65 high-grade glioma specimens were 70.8% (46/65), 60.0% (39/65) and 100.0% (65/65), respectively. There were no significant differences in the expressions of LSD1 and MGMT in grade Ⅲ and Ⅳ glioma (χ²=1.588, P=0.208, χ²=0.013, P=0.908). Ki-67 expression (+ ), (+ + ), (+ + + ) in grade Ⅳ glioma were observed in 18, 19 and 11 cases, respectively. Ki-67 expression (+ ), (+ + ) in grade Ⅲ glioma were observed in 11, 5 cases, and 1 case was (+ + + ), and the difference in expression intensity between the two groups was statistically significant (Z=-2.083, P=0.037). Log-rank test showed that the positive expressions of LSD1, MGMT and Ki-67 were negatively correlated with the PFS of patients with high-grade glioma (χ²=12.217, P=0.007; χ²=4.446, P=0.035; χ²=12.536, P=0.002), also were negatively correlated with OS (χ²=11.708, P=0.008; χ²=6.637, P=0.010; χ²=11.807, P=0.003). Grade Ⅳ patients were more likely to have relapse progression than grade Ⅲ patients (χ²=6.573, P=0.010), and OS was shorter (χ²=3.974, P=0.046). Cox proportional hazards model analysis showed that the expressions of LSD1 (HR=1.361, 95%CI: 1.094-1.694, P=0.006; HR=1.406, 95%CI: 1.117-1.771, P=0.004) and Ki-67 (HR=1.703, 95%CI: 1.175-2.468, P=0.005; HR=1.778, 95%CI: 1.209-2.616, P=0.003) were the independent prognostic risk factors for PFS and OS of patients with high-grade glioma. Correlation analysis results showed that the expression of MGMT was positively correlated with the expression of LSD1 (r=0.406, P=0.001). Conclusion LSD1, MGMT and Ki-67 have higher positive expression rates in high-grade glioma. MGMT is a prognostic factor for high-grade glioma, and LSD1 and Ki-67 can be used as independent predictors of prognosis for high-grade gliomas.

Surgery is an important method for the treatment of resectable esophageal cancer. With the continuous development of minimally invasive esophageal technology, video-assisted thoracoscopic esophagectomy (VATE) has demonstrated obvious advantages over conventional open surgery and has been widely accepted. However, there are still some esophageal cancer patients who cannot benefit from VATE. Inflatable video-assisted mediastinoscopic transhiatal esophagectomy(IVMTE) does not require one-lung ventilation, reduces postoperative complications, expands surgical indications, and brings surgical opportunities for patients with impaired lung function and thoracic lesions, which has become a new choice for the treatment of esophageal cancer. However, the limited field of surgical view and the tunneling surgical approach undoubtedly increase the difficulty of surgery, and how to clearly expose the anatomical structures and thoroughly dissect the lymph nodes has always been the key points and difficulties of surgery. The authors review relevant literatures to discuss the clinical progress and limitations of IVMTE.

Xiaoxuming decoction is one of the classical prescriptions in ancient times,mainly used for treating stroke syndrome,with significant therapeutic effects.Recent studies have found that it is also effective for other neurological diseases besides stroke,such as facial paralysis and vertigo,but there are few reports on related achievements,lacking systematic organization and summary.This article systematically summarizes the application practice and mechanism of Xiaoxuming decoction in the above-mentioned diseases,aiming to provide a solid foundation and scientific reference for deepening the exploration of Xiaoxuming decoction in the field of nervous system disease.

Objective:To evaluate the safety and efficacy of the domestic robotic surgical system for general surgery.Methods:A prospective single-center, single-arm exploratory study was conducted at Gansu Provincial People's Hospital from Jun 2022 to Oct 2023, enrolling 54 patients undergoing general surgery using domestically produced Toumai? Endoscopic Surgical Robotic System. The primary study endpoint was surgical success rate, and the secondary study endpoints were intraoperative bleeding, operative time, complications, system performance, hospitalization days.Results:In this study, robotic surgery was successfully completed in 52 patients, and in 2 patients undergoing thyroid operation it was converted to open surgery due to bleeding, with a success rate of 96%, no organ injury or death during surgery, and no system failure. The types of surgery included cholecystectomy, radical gastric cancer resection, radical colorectal cancer resection, inguinal hernia repair, partial hepatectomy, total thyroidectomy and choledocho-jejunal anastomosis.Conclusion:The study provides preliminary evidence of the safety and efficacy of the Toumai? Endoscopic Surgical Robotic System for the treatment of general surgical diseases.

OBJECTIVE: Segmented cardiac cine magnetic resonance imaging (MRI) is the gold standard for cardiac ventricular volumetric assessment. In patients with difficulty in breath-holding or arrhythmia, this technique may generate images with inadequate quality for diagnosis. Real-time cardiac cine MRI has been developed to address this limitation. We aimed to assess the performance of retrospective electrocardiography-gated real-time cine MRI at 3T for left ventricular (LV) volume and mass measurement. MATERIALS AND METHODS: Fifty-one patients were consecutively enrolled. A series of short-axis cine images covering the entire left ventricle using both segmented and real-time balanced steady-state free precession cardiac cine MRI were obtained. End-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), ejection fraction (EF), and LV mass were measured. The agreement and correlation of the parameters were assessed. Additionally, image quality was evaluated using European CMR Registry (Euro-CMR) score and structure visibility rating. RESULTS: In patients without difficulty in breath-holding or arrhythmia, no significant difference was found in Euro-CMR score between the two techniques (0.3 ± 0.7 vs. 0.3 ± 0.5, p > 0.05). Good agreements and correlations were found between the techniques for measuring EDV, ESV, EF, SV, and LV mass. In patients with difficulty in breath-holding or arrhythmia, segmented cine MRI had a significant higher Euro-CMR score (2.3 ± 1.2 vs. 0.4 ± 0.5, p < 0.001). CONCLUSION: Real-time cine MRI at 3T allowed the assessment of LV volume with high accuracy and showed a significantly better image quality compared to that of segmented cine MRI in patients with difficulty in breath-holding and arrhythmia.
Arrhythmias, Cardiac ; Diagnosis ; Heart Ventricles ; Humans ; Magnetic Resonance Imaging ; Magnetic Resonance Imaging, Cine* ; Retrospective Studies* ; Stroke Volume

Objective    To evaluate the prognosis of benign esophageal perforation by Pittsburgh scoring system (perforation severity scores, PSS) combined with co-disease index (Charlson comorbidity index, CCI). Methods    Thirty patients with benign esophageal perforation from August 2016 to August 2018 in our hospital diagnosed by imaging or endoscopy were selected, including 14 males and 16 females, aged 68.660±10.072 years. After treatment, we retrospectively analyzed whether there was any complication in the course of treatment, the healing of esophageal perforation at discharge and the follow-up after discharge. And the patients were divided into a stable group (20 patients with no complication, clear healing of esophageal perforation at discharge or death during follow-up) and an unstable condition group (10 patients with complications, esophageal perforation at discharge or death during follow-up). Complete clinical data of all the patients were obtained and were able to be calculated by the scores of PSS and CCI scoring system. The difference of PSS and CCI scores between the two groups was compared, and the clinical value of PSS combined with CCI score in the prognosis of benign esophageal perforation was analyzed. Results    In the stable group, the PSS was 2.750±1.372 (95%CI 2.110 to 3.390), CCI score was 2.080±1.055 (95%CI 1.650 to 2.500) with a statistical difference between the two systems (P=0.000). In the unstable group, PSS was 7.300 ±1.829 (95%CI 7.300 to 8.120), CCI was 4.640±1.287 (95%CI 4.220 to 5.060) with a statistical difference between the two systems (P<0.05). The area under the receiver operating characteristic  curve of PSS and CCI scores in the prognostic evaluation of benign esophageal perforation was 0.982 and 0.870 respectively, which was statistically significant (P<0.05). Conclusion    Esophageal perforation is a dangerous condition. It is of great practical value to evaluate the condition of esophageal perforation by PSS and CCI scores.

ObjectiveTo study the effect of Huangqintang on intestinal T helper cells（Th）17/regulatory T cells（Treg） and Th1/Th2 balance in experimental ulcerative colitis （UC） mice. MethodSixty male C57BL/6J mice were randomly divided into normal group， model group， sulfasalazine group （0.2 g·kg^-1）， and Huangqintang low-dose， medium-dose and high-dose groups （4.55，9.1，18.2 g·kg^-1， respectively） according to body weight. Except for the normal group， all mice were given 2.5% dextran sodium sulfate （DSS， added to free drinking water） for 5 days to induce UC. After 7 days of continuous intragastric administration， the mice were sacrificed and the mesenteric lymph nodes （MLNs） and colon tissues were collected. The Th17/Treg and Th1/Th2 cell ratios in MLNs of mice were measured by flow cytometry. Interleukin-2 （IL-2）， interleukin-17A （IL-17A）， interleukin-6 （IL-6）， tumor necrosis factor-α （TNF-α）， interferon-γ （IFN-γ）， interleukin-4 （IL-4）， interleukin-10 （IL-10） and other cytokines in colon tissues were detected by flow cytometric microsphere-based assay. The colon tissues samples were sectioned， and immunohistochemical method was used to detect the expression levels of T-box transcription factor （T-bet）， GATA binding protein 3 （GATA-3）， IL-17A and forkhead box P3 （FoxP3） in colon tissues. The content of transforming growth factor-β （TGF-β） in colon tissue of mice was determined by enzyme-linked immunosorbent assay （ELISA）. ResultCompared with the normal group， the number of Th1 and Th17 cells in the model group was significantly increased， while the number of Th2 and Treg cells was significantly decreased， and Th1/Th2 and Th17/Treg were significantly increased (P<0.05， P<0.01). The expressions of T-bet， GATA-3， IL-17A and FoxP3 in colon tissues of mice were significantly increased (P<0.05， P<0.01)， and the contents of cytokines IL-2， IL-17A， IL-6， TNF-α and IFN-γ were significantly increased. The contents of IL-4， TGF-β and IL-10 were significantly decreased (P<0.05， P<0.01). Compared with the model group， the imbalance of Th1/Th2 and Th17/Treg cells was reversed in each dose group of Huangqin decoction (P<0.01). The expressions of T-bet and GATA-3 in colon of mice were significantly decreased in low-dose， medium-dose and high-dose groups of Huangqintang (P<0.05， P<0.01)， and the expression of IL-17A was significantly decreased in high-dose and low-dose groups of Huangqintang (P<0.01). The contents of cytokines IL-2， IL-17A， IFN-γ， IL-6 and TNF-α were significantly decreased in the high-dose and medium-dose groups of Huangqintang， and the contents of TGF-β and IL-10 were significantly increased in the high-dose group of Huangqintang (P<0.05， P<0.01). ConclusionHuangqintang could reduce colonic inflammation and improve colonic tissue damage in UC mice， possibly by regulating Th17/Treg and Th1/Th2 balance and related cytokines levels， and the release level of pro-inflammatory cytokines.