ObjectiveTo study the modes of case finding and diagnosis for inpatients of active pulmonary tuberculosis with primary treatment.MethodsData of 1000 inpatients with active pulmonary tuberculosis input into a computer were analyzed retrospectively.including clinical symptoms,signs and relevant laboratory examinations.to evaluate their diagnostic value.ResultsAmong 1000 active tuberculosis case8 hospitalized with symptoms and signs,95.9 percent suffered by cough,77.7 percent by expectoration and 50.8 percent (n=508) by fever,and 51.5 percent (n=777) with strong positive purified protein defivative (PPD) skin test,61.5 percent with positive serum anti-tuberculosis antibody,48.8 percent with positive acid-fast staining on sputum smear and 57.9 percent with positive sputum bacteriologle culture.And,49.4 percent of the patients were diagnosed by laboratory positive sputum,and 50.6 percent of those with negative sputum were diagnosed by comprehensively clinical considerations,ineluding 51.6 percent positive PPD skin teat, or positive serum anti-tubereulosis antibody,but 48.4 percent of them were all negative in varied laboratory examinations.ConclusionsHospital visit due to symptom is the main method for tuberculosis finding in our country.All those with Cough for two or more weeks should be screened by routine examinations for excluding tuberculosis.Case finding rate Was low by sputum examinations.so comprehensive diagnosis is still important for those tuberculosis patients with negative sputum.

Objective To investigate the factors influencing the positioning error of conical beam CT(CBCT)radiotherapy and the occurrence of acute radiation dermatitis in breast cancer fixed by cervical and thoracic integrated membrane in order to provide a basis for personalized out-target external boundary,selec-tion of fixed mode and guidance of radiodermatitis clinical practice work.Methods A total of 147 patients with breast cancer in this hospital from June 2022 to October 2023 were selected as the study subjects,inclu-ding 74 cases of breast conserving operation and 73 cases of modified radical(excision)operation.During the treatment period,CBCT scanning once a week obtained the image and conducted the grey match with the planned CT images to acquire the translational error of X(left and right),Y(head and foot)and Z(abdominal and dorsal)and the rotational posing error of X(pitch),Y(roll)and Z(yaw)axis,and at the same time,the acute radiodermatitis in nearly 3 months during radiotherapeutic period was recorded.Results Compared with the Z axis,the translation error of X axis and Y axis was greater,the rotation error was smaller,and the differ-ences were statistically significant(P＜0.05).The PTV external boundary of X,Y and Z axis calculated by the formula was 0.70,0.76,0.46 cm respectively.There was no statistically significant difference in the posi-tioning error of each direction of left and right breast between breast conservation operation and breast resec-tion operation(P＞0.05).The correlation between the age with X,Y and Z axis translation errors was-0.14,0.18 and 0.10 respectively,which of the age with X,Y and Z axis rotation errors was 0.12,＜0.01,0.02 respectively.The occurrence of grade 1 acute radiodermatitis in the patients with breast conserving oper-ation was 100.0％(74/74),which in the patients with excision operation was 13.7％(10/73),the occurrence of grade 2 was 82.2％,which of grade 3 was 4.1％(3/73),and the difference between them was statistically significant(P＜0.05).Conclusion In the every day positioning and target area external expansion,particular attention should be paid to the X and Y axis translational directions and the Z axis rotation direction.Using the integrated cervicothoracic thermoplastic membrane for fixing breast cancer is not affected by the operation mode,affected side position and age.

Ischemia-reperfusion (I / R) is a complex hemodynamic process that can cause tissue damage through oxidative stress, mitochondrial dysfunction, and inflammatory reactions. It is an important factor leading to poor prognosis in patients, and the exploration of effective prevention and treatment measures is of significant clinical significance. As an endogenous hormone with strong antioxidant and anti-inflammatory properties, Melatonin plays an important role in reducing cell death and improving tissue I / R injury. Therefore, this article reviews the relationship between Melatonin and organ I/R injury in order to provide a theoretical basis for the clinical application of melatonin to alleviate organ I/R injury.

Objective To investigate the diagnosis and prognosis of patients with coronary artery aneurysm in Kawasaki disease.Methods The data of ultrasonic diagnosis and follow-up of 338 children with Kawasaki disease complicated with coronary artery aneurysms were analyzed.Results The incidence of coronary artery aneurysm in the acute stage of Kawasaki disease was 21.2％ (338/1 594).Of all the 338 cases,small aneurysms was 66.6％ (225 cases),medium aneurysms was 25.1％ (85 cases),and giant aneurysms was 8.3％ (28 cases).There were 719 branches involved in 338 cases,32.8％ of them in left main coronary artery and 31.1％ in right coronary artery;25.3％ in left anterior descending branch,and 10.8％ in left circumflex branch.A total of 382 branches were followed up,including 218 branches of small coronary aneurysm group and 82.1％ of them were completely recovered to the normal diameter.The medium aneurysm group was 124 brunches,the proportion of no significant change,retraction,and normal were 23.4％,68.5％ and 8.1％,respectively.There were 40 brunches in the giant anuerysm group,in which the proportion of no significant change,retraction,and normal were 70.0％,27.5％ and 2.5％,respectively.A total of 30 thrombosiswere detected by echocardiography in the acute stage,20 thrombosis were regularly followed up,12 thrombosis gradually subsided,and the other remained persist.Five thrombosis were detected in the sequelae stage,and all located in the giant coronary aneurysm.Seven children were clinically diagnosed with ischemic heart disease,of them,acute myocardial infarction in 1 case,1 died of heart failure.Conclusions Kawasaki disease coronary artery disease are common in small coronary aneurysms,of which the left main artery and right coronary artery lesions are the most common,and the prognosis is better;medium and giant aneurysm need more time to recovery,and are easy to complicated with thrombosis.