Objective To explore the diagnostic value of digital breast tomosynthesis technique (DBT) in breast suspicious calcified lesions.Methods Clinical data of 135 patients using DBT and FFDM (Full field digital mammography) was respectively analyzed.Results Of the 135 cases,43 cases were malignant,and 92 cases were benign.The diagnostic sensitivity DBT and FFDM were 93.0％ (40/43)and 88.4％ (38/43),specificity were 88.0％ (81/92) and 75.0％ (69/92),accuracy were 89.6％ (121/135) and 79.3％ (107/135),the differences were statistically significant (P ＜0.05).The ROC curve area (AUC) of DBT and FFDM were 0.905 ± 0.026 and 0.817 ± 0.034 (P =0.000 2).In premenopausal,postmenopausal and breast density ACR3-4 cases,DBT accuracy is higher than FFDM (P ＜ 0.05).The BI-RADS classification difference of the benign calcified lesions was statistically significant (x2 =11.740,P =0.038 5).Conclusions Compared with the traditional FFDM,DBT has a higher value in the diagnosis of breast suspicious calcified lesions,especially for benign calcified lesions.

Objective:To explore the value of the concentration of adenosine triphosphate (ATP) in CD4 +T lymphocytes in predicting repeated respiratory tract infections (RRTI) in silicosis patients. Methods:In April 2020, 614 silicosis patients admitted from March 2016 to March 2018 were included in the study, and they were divided into the RRTI group ( n=105) and the non RRTI group ( n=509) according to whether the occurrence of RRTI, another 30 healthy cases taken from body check were served as control group, and the concentrations of ATP produced by CD4 +T lymphocytes was measured by ImmuKnow assay, and were compared between the three groups. And drawed the receiver operating characteristic (ROC) curve, and the Logistic regression analysis was used to explore the risk factors of RRTI. Results:The incidence of RRTI in silicosis patients was 17.10% (105/614) . The concentration of ATP produced by CD4 +T lymphocytes in the RRTI group [ (260.42±90.36) mg/L] was significantly lower than that in the non RRTI group [ (413.66±138.74) mg/L] ( t=-10.849, P<0.01) . The area under the ROC curve was 0.834, the cutoff value was 284 mg/L, the sensitivity was 0.88, and the specificity was 0.83. Logistic regression analysis showed that the concentration of ATP produced by CD4 +T lymphocytes≤284 mg/L, impaired pulmonary ventilation function, serum albumin<40 g/L and diabetes were the risk factors of RRTI in silicosis patients ( OR=2.126, 1.217, 1.164, 1.125, P<0.05) . Conclusion:Low CD4 +T lymphocyte ATP value was a risk factor of RRTI in silicosis patients, and can predict the risk of RRTI in patients with silicosis.

Objective:To explore the value of the concentration of adenosine triphosphate (ATP) in CD4 +T lymphocytes in predicting repeated respiratory tract infections (RRTI) in silicosis patients. Methods:In April 2020, 614 silicosis patients admitted from March 2016 to March 2018 were included in the study, and they were divided into the RRTI group ( n=105) and the non RRTI group ( n=509) according to whether the occurrence of RRTI, another 30 healthy cases taken from body check were served as control group, and the concentrations of ATP produced by CD4 +T lymphocytes was measured by ImmuKnow assay, and were compared between the three groups. And drawed the receiver operating characteristic (ROC) curve, and the Logistic regression analysis was used to explore the risk factors of RRTI. Results:The incidence of RRTI in silicosis patients was 17.10% (105/614) . The concentration of ATP produced by CD4 +T lymphocytes in the RRTI group [ (260.42±90.36) mg/L] was significantly lower than that in the non RRTI group [ (413.66±138.74) mg/L] ( t=-10.849, P<0.01) . The area under the ROC curve was 0.834, the cutoff value was 284 mg/L, the sensitivity was 0.88, and the specificity was 0.83. Logistic regression analysis showed that the concentration of ATP produced by CD4 +T lymphocytes≤284 mg/L, impaired pulmonary ventilation function, serum albumin<40 g/L and diabetes were the risk factors of RRTI in silicosis patients ( OR=2.126, 1.217, 1.164, 1.125, P<0.05) . Conclusion:Low CD4 +T lymphocyte ATP value was a risk factor of RRTI in silicosis patients, and can predict the risk of RRTI in patients with silicosis.

Objective:To evaluate the effect of flipped classroom combined with problem-based learning (PBL) on the standardized training for perioperative beside echocardiography.Methods:A total of 64 second-year standardized training students from the Department of Anesthesiology at Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, were selected between January 2021 and June 2022 and assigned to control group ( n=32) and test group ( n=32) using a random number table method. Control group employed the traditional teaching model, and test group utilized the flipped classroom combined with PBL. After a 3-month period of teaching standard views and hemodynamic evaluation of bedside echocardiography, the comprehensive theoretical and clinical practice scores (a score of≥80 was considered excellent or good) were compared between the two groups. Additionally, a questionnaire was distributed to assess students′ self-directed learning ability and initiative, interest in learning, efficiency in mastering professional knowledge, satisfaction with teaching, communication and collaboration skills, and clinical thinking ability. Results:Compared with control group, the students in test group showed significant improvements in both comprehensive theoretical ([87 ± 8] vs [80 ± 8]) and clinical practical ([86 ± 8] vs [78 ± 8]) echocardiography scores( P<0.05 or 0.01).The excellent or good rate for comprehensive theoretical scores (88% vs 47%) and clinical practice scores (84% vs 50%) was significantly higher in test group than in control group( P<0.05 or 0.01).A total of 64 questionnaires were distributed, and all of them were returned, yielding a response rate of 100%. The students in test group demonstrated enhanced self-directed learning ability and initiative (94% vs 69%), increased interest in learning (91% vs 66%), improved efficiency in mastering professional knowledge (97% vs 75%), greater satisfaction with teaching (94% vs 62%), enhanced communication and collaboration skills (84% vs 62%), and improved clinical thinking ability (88% vs 59%) compared to control group ( P<0.05). Conclusions:The combination of a flipped classroom and PBL produces better effect than traditional teaching methods when used for standardized training for perioperative bedside echocardiography.