The anisotropic diffusion equations-Perona &Malik(P&M)equations are resorted to to decrease the Rician noise introduced into the diffusion weighted(DW)images.To evaluate the efficiency of the P&M equations(with different functions)in accounting for the Rician noise,many experiments are designed.The results acquired from both Monte Carlo simulation experiments and real data based experiments proves the better performance of the reciprocal function based P&M equation in denoising the DTI images.

AIM: To explore the effects of CD40-CD40 ligand (CD40L) interaction on endothelial cells (ECs) procoagulant activity. METHODS: A co-incubation system of macrophage membrane with ECs was established. The changes in ECs procoagulant activity and tissue factor (TF) expression were studied by anti-CD40L antibody blocking analysis. RESULTS: Coincubation with macrophage membrane (cell ratio 1∶1) for 6 hours resulted in a 10.9-fold increase ( P

Objective:To investigate the training needs of nursing students during their practice in the emergency department, and to provide evidence for further improvement and development of the training.Methods:A total of 279 nursing students from 24 hospitals in Guangdong Province and 4 undergraduate universities running nursing specialty were investigated by convenience sampling. The contents of the questionnaire included general information and emergency training needs, including teaching contents and teaching methods.Results:Among the surveyed nursing students, 97.13% (271 students) believed it was very necessary to learn first aid knowledge and skills, and 85.66% (239 students) were very interested in learning first aid knowledge and skills. The score of "acute and critical skills" in the emergency training needs was the highest (88.91 points), and the score of "department rules and regulations" was the lowest (76.08 points). Univariate analysis showed that there were significant differences in gender, willingness to engage in nursing work in the future, interest in learning first aid knowledge and willingness to learn first aid knowledge independently by network ( P < 0.05). The three teaching methods ranked the highest in the survey of emergency teaching methods were situational teaching, problem-based learning and action teaching method. Conclusion:Nursing students have a strong demand for training during the emergency internship. Clinical nursing administrators and educators should combine the internship demand of nursing students and the teaching outline of medical colleges to carry out the training arrangement during the emergency practice, so as to meet the learning needs of nursing students during the emergency practice.

OBJECTIVE:To establish the quality standard for Siwei jiangmei tablets. METHODS:TLC method was used for the qualitative identification of Salvia miltiorrhiza,Artemisiae Scopariae Herba and Taraxaci Herba. HPLC method was adopted for the content determination of chlorogenic acid. The determination was performed on Agilents TC-C18column with mobile phase consisted of acetonitrile-3% acetic acid(10:90,V/V)at the flow rate of 1.0 mL/min. The detection wavelength was set at 327 nm,and column temperature was 25 ℃. The sample size was 10 μL. RESULTS:TLC spots of S. miltiorrhiza, Artemisiae Scopariae Herba and Taraxaci Herba were clear and well-separated without interference from negative control. The linear range of chlorogenic acid was 0.26-0.79 μg for(r=0.999 9). The limits of quantitation and detection were 0.26,0.12 μg, respectively. RSDs of precision,stability and reproducibility tests were lower than 1.0%. The recoveries were 96.11%-101.96%(RSD=1.98%,n=9). CONCLUSIONS:Established standard can be used for quality control of Siwei jiangmei tablets.

Objective To study the epidemic situation and characteristic of subtypes of HIV-1 strains prevalent in Hebei Province. Methods Viral RNA was extracted from plasma samples, HIV-1 genes (env and gag ) were amplified by RT and nested-PCR using specific primer pairs and sequenced directly.The acquired sequences were compared with international subtypes references and their phylogenetic-trees were analyzed to determine the subtype. Results Among 154 HIV-1 antibody positive cases , 148 HIV-1 gene fragments were amplified and analyzed. There were 6 kinds of HIV-1 subtypes and recombinants, moreover unidentified 2 cases in 148 samples, of which 61 (41.2%) cases of B', 59(39.9% ) cases of CRF01_AE, 16( 10.8% ) cases of CRF07_BC, 6(4.1% ) cases of CRF08_BC, and 2( 1.4% ) cases of C and B01 each. HIV-1 B01 was detected firstly in Hebei Province. Conclusion Six HIV-1 subtypes were identified in Hebei Province. B' and CRF01_AE are the primary subtypes and recombinants of HIV-1 existed in Hebei Province. The surveillance of HIV-1 gene variation should be paid more attention to.

Objective To investigate the clinical efficacy and safety of repetitive transcranial magnetic stimulation combined with duloxetine in treatment of depression. Methods Sixty-nine cases of depression were randomly divided in?to study group (n=35 patients) and control group (n=34 patients). The study group received duloxetine combined with 1Hz rTMS treatment on the right dorsolateral prefrontal cortex area for 6 weeks whereas the control group received duloxetine combined with pseudo-rTMS treatment for 6 weeks. The Hamilton Depression Rating Scale (HAMD-24) and Treatment Emergent Symptom Scale (TESS) were used to assess the clinical efficacy and the adverse reactions before, 2, 4 and 6 weeks after the treatment, respectively. Results Four patients (two from each group) dropped out of the study. The main effects of time (P<0.001) and groups (P=0.029) were significant and so was the interactive effect of time and group (P<0.001). The clinical curative effect of the study group were significantly better compared with the control group at the 2, 4, 6 weeks following treatment (P<0.001). The adverse reactions were mild in these two groups. Conclusions The combi?nation of 1 Hz rTMS with duloxetine is superior to either medication alone for the treatment depression.

OBJECTIVE:To reduce drug repercussion of outpatient pharmacy,and to promote safe drug use.METHODS:By quality control circle (QCC),the data of drug repercussion were selected from outpatient pharmacy of our hospital in Sept.2016.The drug repercussion reason check list was designed to master the situation of drug repercussion in outpatient department,formulate improvement measures and confirm effect through field inspection.The case number of drug repercussion and the improvement of circle members' ability were compared one month before and after QCC (Mar.2017).Finally,the effects of QCC were evaluated.RESULTS:Referring to the reasons for the repercussion of adjunct drugs for inspection and the repercussion of unsuitable drug use in our hospital,those problems were improved by formulating manual for drug use examination project,optimizing and examining drug delivery process in the department,etc.The case number of drug repercussion in outpatient pharmacy decreased from 31 cases per month to 12 cases per month;the rate of goal achievement was 119％;the rate of improvement was 61％.The ability of QCC members to solve problems and the ability to use QCC skills were increased positively.CONCLUSIONS:The development of QCC activity in our hospital reduces case number of drug repercussion and optimizes drug delivery process in outpatient pharmacy,and promotes safe drug use.

Objective To investigate the value of the shear wave elastography ( SWE) in the diagnosis of biliary atresia ( BA ) in infants by ultrasonography . Methods SWE was used to measure the liver stiffness measurement( LSM ) of 138 infants . Following surgical or pathological diagnosis ,the infants were subclassified into BA and non-biliary atresia ( non-BA ) groups . ROC analysis was used to determine the sensitivity and specificity of LSM ,the ultrasonic findings in the differential diagnosis of suspected BA ,and the cut-off value to diagnose BA . Results Of the 138 infants with cholestatic hepatitis ,51 were diagnosed as BA group and 87 cases were assigned to the non-BA group . The ROC analysis showed the cut-off value of LSM for diagnosis of biliary atresia in children with jaundice was 12 .35 kPa ,the AUC was 0 .936 ,and the sensitivity and specificity were 84 .3% and 89 .7% ,respectively .In the parallel test ,the triangular cord ( TC) sign combined with abnormal gallbladder ( AbGB) had the best diagnostic performance in all patients . However ,in patients older than 30 days ,the LSM combined with TC had the best AUC ( 0 .987 ) and diagnostic performance( 98 .6% ) like with TC combined with AbGB . Conclusions Both SWE and gray scale ultrasound have higher diagnostic performance for BA . LSM can be used as a valuable index for diagnosing BA by ultrasound .

Objective To investigate the role of Trx-1 and Trx-2 in the progression of hepatitis B associated acute-on-chronic liver failure (ACHBLF).Methods We determined the mRNA levels of Trx1,Trx-2 in peripheral blood mononuclear cells (PBMC) from a cohort of 60 patients with ACHBLF,38 patients with chronic hepatitis B (CHB) and 26 healthy controls by fluorescence real-time quantiative PCR.Results We demonstrated that there were significantly higher expressions of Trx-1 and Trx-2 mRNA in patients with ACHBLF than those patients with CHB and healthy controls (P ＜ 0.05,respectively).Furthermore,the levels of Trx-1 and Trx-2 mRNA significantly correlated with total bilirubin (TBIL) levels in patients with ACHBLF (P ＜ 0.05,respectively).The relative expression of Trx-1 mRNA significantly correlated with model for end-stage liver disease (MELD) scores in patients with ACHBLF (P ＜ 0.05).Besides,Trx-1 and Trx-2 levels were higher in non-survivors with ACHBLF than survivors with ACHBLF (P ＜0.05,respectively).The relative expression of Trx-1 mRNA was predictive of 90-day mortality using Kaplan-Meier analysis (P ＜ 0.05),with a sensitivity of 75％ and a specificity of 64.29％.Conclusion Trx and associated oxidative stress may play an important role in the pathogenesis and progression of ACHBLF,the mRNA level of Trx-1 and Trx-2 may be associated with disease severity and poor prognosis of ACHBLF.

OBJECTIVE To analyze the si tuation and hot spots of gabapentinoid drugs in the treatment of pain. METHODS Related researches about gabapentinoid drugs in the treatment of pain were retrieved from Web of Science core collection database during Jan. 1st，2011-Dec. 31st，2020. VOSviewer 1.6.17，CiteSpace 5.8.R1 and Excel 2018 software were used to statistically analyze the key characteristics of relevant literature ，such as the annual publications ，countries/regions，institutions，authors， journals and research hot spots. RESULTS & CONCLUSIONS A total of 3 519 literatures were retrieved ，and the annual publication outputs showed an upward trend generally. Totally 86 countries/regions had conducted relevant studies ，of which the United States ranked first （up to 1 219），and had close cooperation with the United Kingdom ，Canada，China，Germany，Japan， etc；a total of 3 996 institutions had published relevant literatures ，and the Pfizer Inc. issued the most publications ；the most studies were devoted by Professor Parsons from the University of California San Diego ，and the highest co-citations author was Professor Gilron from the Queen ’s University. Among 1 185 journals，Pain ranked first not only in the high-productive journal ，but also in the co-cited journal. The main hot topics include abuse and misuse of gabapentinoid ，off-label use of gabapentinoid ，clinical application of gabapentinoid as a component of multimodal analgesia ，and the update of guidelines for pain based on systematic evaluation and meta-analysis.