Objective To discuss the effect of comprehensive mental intervention on mental health and sleep quality among the crew members during the Escort Mission in the Gulf of Aden.Methods The same batch of two escort ships was divided into study group and control group.The study group was intervened by comprehensive psychological intervention methods involving diversified forms of psychological training, counseling, behavioral intervention and cooperation between various departments.A psychological survey was conducted with Symptom Checklist 90( SCL-90) , Self-rating Anxiety Scale (SAS), Self-rating Depression Scale(SDS) and Pittsburgh Sleep Scale(PSQI) before and 3 months after intervention. Results There was no significant difference between the two groups before intervention (P>0.05).After intervention,the score of SCL-90 of study group was significantly better than that of the control group in somatization,obsessive compulsive disorder,interpersonal relationship,depression, anxiety,bigotry and hostility (P<0.05), while the score of SAS and SDS was lower(P <0.05).Sleep quality, the time taken to fall asleep, sleep time, dyssomnia,sleep efficiency,daytime dysfunction factor and the total score of PSQI were significantly more desirable than in control group (P<0.01).Conclu-sion Comprehensive intervention can effectively improve mental health and sleep quality of the crew members in the escort mission in the Gulf of Aden.It is worthy of popularization and application.

Purpose To compare radiation dose and image quality of different scan modes for CT pulmonary angiography (CTPA) including high-pitch flash mode, dual energy CT (DECT) mode, 128-slice mode of dual source CT and 64-slice CT mode. Materials and Methods One hundred and sixty-seven patients with suspected pulmonary embolism were retrospectively studied. All the patients underwent CTPA. Twenty patients were selected randomly from the patients scanned by high-pitch flash mode. Patients who were scanned by the other three modes were selected with body mass index and age matched those in high-pitch flash mode, with 20 patients in each group. Two radiologists assessed signal-to-noise ratio (SNR) and image quality with 5-piont scale. Dose parameters of volume CT dose index (CTDIvol), dose length product (DLP), and effective dose (ED) were compared among the four groups. Results Mean CTDIvol, DLP and ED were (3.72±0.74) mGy, (137.5±28.7) mGy · cm, and (2.34±0.41) mSv for Flash mode;(5.31±1.21) mGy, (181.6±34.5) mGy· cm and (3.24±0.57) mSv for DECT mode;(5.66±1.47) mGy, (198.7±42.1) mGy·cm and (3.58±0.63) mSv for 128-CT mode;and (6.75±1.68) mGy, (231.5±54.2) mGy·cm and (4.21±0.89) mSv for 64-CT mode. There was no significant difference of SNR and image quality among the four modes (P>0.05). Conclusion There are no significant difference of image quality among the four groups. Flash mode allows for minimum radiation dose compared to other modes. DECT mode and 128-CT mode get higher radiation dose with no difference between them. 64-CT mode gets the highest radiation dose.

Objective To explore the computed tomography (CT)manifestations of adrenocortical oncocytoma (ACO)for better understanding the disease and improving its diagnosis accuracy.Methods The CT manifestations of 9 cases with adrenocortical onco-cytomas confirmed by surgery were retrospectively reviewed and compared with pathological results.Results Five of cases were lo-cated in left side while 4 cases were in right side.Well defined and round or oval border could be found in all the cases.Of all the ca-ses,3 cases were solid lesions with equal density,< 3 cm in diameter,and mild consistent intensification after enhancement.Cystic lesion was detectd in 6 cases with > 3 cm in diameter.The mixed cystic and solid components with polycystic changes could be found on CT image,and remarkable intensification on solid lesion while no intensification on cystic lesion after the enhancement. Moreover,patchy or cotton-like shape could be found on solid lesion in 4 cases and 1 case with island like intensification;reticular pattern could be found in the central of lesion in 3 cases and 1 case with stellate shape.Pathological observation showed that the on-cotytomas were comprised of cells with abundant eosinophilic cytoplasm and necrotic and fibrous capsule without pathological mitosis could be found in some of lesion.Conclusion The characteristic CT features of adrenocortical oncotytoma has a worse specificity,its diagnosis was dependent on pathologic examination.

Objective:To evaluate the value of CT in preoperative assessment of tricuspid valve replacement with LuX-Valve.Methods:145 consecutive patients with severe tricuspid regurgitation from October 2020 to April 2021 were selected. The multi-slice spiral CT (256 slice and above) scans were used to measure related indicators. Then analyses were made to determine whether the patients were suitable for valves replacement and to select the appropriate valve model.Results:49 cases were excluded after CT measurements, including 8 cases because of the values of the valve annulus and the remaining 41 due to comprehensive indicators includes: valve annulus size and shape, fixation method and operational safety. A total of 96 TTVR operations were performed, of which 6 were treated with thoracic surgery, 1 had moderate valve regurgitation, and the rest had no or mild regurgitation or paravalvular leaks. The operations showed a high success rate of 92.7%. After comprehensive analysis, it was found that among the 89 successful tricuspid valve replacements with LuX-Valve, 26 cases had annulus models consistent with the measurements of the diameter from tricuspid annular circumferences, while the remaining 63 had valve models larger than the diameter measurements. The results indicate that the size of right atrium was statistically significant to the enlargement of the valve size.Conclusion:CT has important application value in the preoperative screening of TTVR. For non-radial force LuX-Valve, the annulus size is not the only decisive factor, and the valve model should be comprehensively judged considering all the measurement indicators.

Objective:To investigate the predictive value of thrombus enhancement (TE) and thrombus permeability in cardioembolic thrombus with acute middle cerebral artery occlusion based on CT.Methods:The clinical and image data of 93 patients with acute middle cerebral artery occlusion who were admitted to the First Affiliated Hospital of Soochow University within 12 hours after onset from January 2020 to July 2022 were retrospectively analyzed. According to the TOAST criteria, the patients were divided into the cardioembolism (CE) group (43 cases) and the large artery atherosclerosis (LAA) group (50 cases). All patients received noncontrast CT and CT angiography, and then thrombus permeability [thrombus attenuation increase (TAI), void fraction (ε)] and TE were assessed. Independent sample t-test, Mann-Whitney U test and χ2 test were used in univariable analysis between two groups. Multivariable logistic regression analysis was used to explore the independent influencing factors for cardioembolic stroke and establish a logistic model. The receiver operating characteristic (ROC) curve and the area under the curve (AUC) were used to evaluate the predictive value of TAI, ε, TE and the logistic model in cardioembolic thrombus with acute middle cerebral artery occlusion. Results:There were statistically significant differences in sex, atrial fibrillation, hypertension, diabetes mellitus, smoking, baseline National Institutes of health stroke scale (NIHSS), TAI, ε and TE between the CE group and the LAA group ( P<0.05). Binary logistics regression analysis showed that TAI (OR=1.300, 95%CI 1.147-1.473, P<0.001), hypertension (OR=0.116, 95%CI 0.025-0.535, P=0.006) and baseline NIHSS (OR=1.165, 95%CI 1.040-1.304, P=0.008) were independent influencing factors for cardioembolic thrombus. The ROC curve indicated that the logistic model predicted cardioembolic thrombus with the highest AUC of 0.907 (95%CI 0.848-0.966). TE predicted cardioembolic thrombus with the highest sensitivity of 90.7%. Conclusion:TE and thrombus permeability have application value for predicting cardioembolic thrombus with acute middle cerebral artery occlusion based on CT.

ObjectiveThe effects of two microbial fertilizers （Bacillus subtilis fertilizer and Trichoderma harzianum-Purpureocillium lilacinum compound fertilizer） on the growth and development， the accumulation of active ingredients， and the microbial community diversity of rhizosphere soil of Atractylodes chinensis were investigated. MethodsA field experiment was carried out with two-year-old Atractylodes chinensis as the test material. Plant samples were collected during the wilt stage （September 26， 2023） to determine the general agronomic traits of Atractylodes chinensis. High-performance liquid chromatography （HPLC） was utilized to evaluate the effects of microbial fertilizers on the synthesis and accumulation of four active ingredients （atractylodin， atractylon， β-eudesmol， and atractylenolide Ⅰ） in Atractylodes chinensi. PacBio Sequel sequencing technology was used to explore the differences in bacterial community structures and diversity in the rhizosphere soil of Atractylodes chinensis treated with different microbial fertilizers. ResultsThe two microbial fertilizers had significant growth-promoting effects on Atractylodes chinensis. Compared with those of the CK group， the stem diameter， stem and leaf dry and fresh weight， and rhizome dry and fresh weight of Atractylodes chinensis significantly increased by 0.47-1.07 times （P<0.05） after the application of the Bacillus subtilis fertilizer （16 kg/667 m²）， and those significantly increased by 0.62-0.96 times （P<0.05） after the application of the Trichoderma harzianum-Purpureocillium lilacinum compound fertilizer （1.5 kg/667 m²）. The effect on plant height was not significant. The application of two microbial fertilizers was beneficial to the accumulation of atractylodin， atractylon， β-eudesmol， and atractylenolide Ⅰ （P<0.01）， and the effect of the Bacillus subtilis fertilizer on the accumulation of active ingredients of Atractylodes chinensis was better than that of the Trichoderma harzianum-Purpureocillium lilacinum compound fertilizer. The results of high-throughput sequencing showed that compared with the CK group， the Bacillus subtilis fertilizer （8 kg/667 m²） could significantly increase the diversity of rhizosphere bacterial species by regulating the Simpson index and Shannon index （P<0.05）， and the Trichoderma harzianum-Purpureocillium lilacinum compound fertilizer significantly reduced the bacterial diversity （P<0.05）. The relative abundance of dominant bacteria was compared at the phylum and genus levels. The relative abundance of Proteobacteria （45.73%） and Burkholderia_Caballeronia_Paraburkholderia （9.98%） significantly increased after the application of the Bacillus subtilis fertilizer （P<0.01）， and the relative abundance of Acidobacteriota （20.53%） and Sphingomonas （3.63%） increased significantly （P<0.01） after the application of the Trichoderma harzianum-Purpureocillium lilacinum compound fertilizer. The relative abundance of beneficial bacteria in the Bacillus subtilis fertilizer was slightly higher than that in the Trichoderma harzianum-Purpureocillium lilacinum compound fertilizer. Pearson correlation analysis showed that Burkholderia_Caballeronia_Paraburkholderia and Sphingomonas were positively correlated with the content of atractylodin， atractylon， β-eudesmol， and atractylenolide Ⅰ （P<0.05）. ConclusionThe application of the Bacillus subtilis fertilizer and Trichoderma harzianum-Purpureocillium lilacinum compound fertilizer can increase the yield of medicinal materials and promote the synthesis and accumulation of active ingredients by regulating the rhizosphere microecological diversity of Atractylodes chinensis， and the application effect of the Bacillus subtilis fertilizer is better than that of the Trichoderma harzianum-Purpureocillium lilacinum compound fertilizer.