Objective To evaluate the expressions of Cyr61 and β‐catenin protein in gallbladder carcinoma tissues and investigate their association with the clinicopathologic features of gallbladder carcinoma patients . Methods The expressions of Cyr61 and β‐catenin protein in 50 cases of gallbladder carcinoma and 19 cases of normal tissue were detected by immunohistochemical S‐P method .Results ① The positive expression rate of Cyr61 in gallbladder carcinoma tissues was 66 .0% (33/50) ,which was significantly higher than that in the normal tissues group (26 .3% ) .The expression of Cyr61 was related to tumor differentiation ,TNM stage and lymph node metastasis of gallbladder carcinoma (P=0 .010 ,P=0 .014 ,P=0 .007;P<0 .05) .② The positive expression rate ofβ‐catenin in gallbladder carcinoma tissues was 84 .0% (42/50) ,which was significantly higher than that in the normal tissues group 15 .7% (3/19);the expression of β‐catenin was related to tumor differentiation ,TNM stage and lymph node metastasis of gallbladder carcinoma (P=0 .018 ,P=0 .002 ,P=0 .024;P<0 .05) .③ Correlation test showed that Cyr61 andβ‐catenin were positively correlated in gallbladder carcinoma and adjacent normal tissues (r=0 .378 , P< 0 .05) .Conclusion Cyr61 and β‐catenin are highly expressed in gallbladder carcinoma tissues . Cyr61 andβ‐catenin expressions are closely related to the clinicopathologic features (tumor differentiation ,TNM staging and lymph node metastasis) in gallbladder carcinoma .Cyr61 and β‐catenin may have a synergistic effect in promoting progression and development of gallbladder carcinoma .Combined detection of Cyr61 and β‐catenin in gallbladder carcinoma tissues will contribute to the clinical diagnosis and prognosis .

Objective To assess the risk of secondary transmission induced by imported malaria in Jiangxi Province，so as to provide the evidence for adjustment of malaria surveillance strategies in the key groups and areas. Methods The Delphi method was used to establish the secondary transmission risk indicator system and the weight of each index was obtained. The data of malaria prevalence，vector distribution and intervention capacity were collected in 100 counties of Jiangxi Province from 2012 to 2015. The transmission potential index（TPI），intervention capacity index（ICI），and malaria risk index（MRI）were calculated for each county. The risk map was drawn with GIS software. Results The top ten counties with highly potential risk indicators were Linchuan District（2.131），Xinzhou District（1.609），Jiujiang County（1.404），Zhanggong District（1.365）， Fengcheng City（1.225），Qingshanhu District（1.184），Yudu County（1.171），Dingnan County（1.018），Xunyang District（1.015）and Zhushan District（1.006）. The high risk areas were mainly distributed in the regions of the capitals of their prefectures and in counties with more floating population. Conclusions There are the risk of the secondary transmission induced by imported malaria in Jiangxi Province. The high risk of the secondary transmission is shown in the areas with more floating population and weaker intervention capacity.

Geodesic active contour is a useful image segmentation method, but it may fail to segment the objects disturbed by complex noises. Prior knowledge on certain object is a powerful guidance in image segmentation. In this respect, we represent the prior knowledge of region and shape of certain object in a form of speed field and incorporate it into Geodesic Active Contours. The prior region constrains the zero level set evolving in certain region and the prior shape pulls the curve to the ideal contour. Applications in a large quantity of cardiac valve echocardiographic sequences have shown that the algorithm is a more accurate and efficient image segmentation method.
Algorithms ; Computer Simulation ; Humans ; Image Enhancement ; methods ; Image Processing, Computer-Assisted ; methods ; Imaging, Three-Dimensional ; methods ; Mitral Valve ; diagnostic imaging ; Models, Statistical ; Models, Theoretical ; Ultrasonography

Objective To analyze the application effect and economic benefit of total parathyroidectomy(TPTX)+subcutaneous implantation of forearm(AT)+thymectomy in patients with secondary hyperparathyroidism(SHPT).Methods The clinical data of 110 patients with SHPT who were treated in our hospital from March 2018 to January 2021 were retrospectively analyzed.They were divided into medication group(50 cases,receiving cinacalcet combined with low-dose calcitriol)and operation group(60 cases,receiving TPTX+AT+thymectomy)according to different treatment regimens.The biochemical indexes,cardiac structure and function,clinical symptoms and quality of life of the two groups were compared before and after treatment for 24 months,and the complications,cost-effectiveness and recurrence rate of the two groups after operation were counted.Results After treatment,the levels of serum iPTH[(206.45±152.59)pg/ml],calcium[(2.05±0.26)mmol/L],phosphorus[(1.48±0.21)mmol/L],calcium-phosphorus product(3.02±0.69)and ALP[(102.03±30.25)U/L]in operation group were all lower Drug group[(721.32±325.36)pg/ml,(2.22±0.18)mmol/L,(1.91±0.22)mmol/L,(4.22±0.74),(140.62±27.15)U/L](P＜0.05);LVEF[(60.85±4.02)％]in operation group was higher than that in drug group[(55.58±3.84)％].LVED[(48.03±2.58)mm]and LVST[(9.85±0.76)mm]were lower than those in drug group[(51.02±3.65)mm,(11.12±0.86)mm](P＜0.05).The scores of bone pain,skin pruritus and restless legs syndrome in the operation group were lower than those of the medication group,and the KDTA score was higher than that of the medication group(P＜0.05).The total cost of treatment in the operation group[(4.06±1.42)million yuan]was not significantly different from that in the drug group[(3.46±1.85)million yuan](P＞0.05).The effective rate of iPTH reduction in operation group was 90.00％(54/60),which was higher than that in drug group(48.00％,24/50)(P＜0.05).The cost-effectiveness analysis showed that the CER of the drug group and the operation group were 7.21 and 4.51 respectively,and the operation treatment had more cost-effectiveness advantages.The incremental cost-effectiveness analysis shows that compared with the drug group,the operation group needs to increase the cost by 14,800 yuan for each additional patient effectively treated for SHPT(P＞0.05).There was no significant difference in the incidence of complications(13.33％VS 12.00％)and the recurrence rate(8.33％VS 4.00％)at 2 4 months after treatment between the operation group and the drug group(P＞0.0 5).Conclusion TPTX+AT+thymectomy can relieve the bone pain,reduce the iPTH level,correct the disorder of calcium and phosphorus metabolism,improve the heart function and structure,and improve the quality of life,and the cost-effectiveness is higher than SHPT of drug treatment,without increasing short-term recurrence rate.

Objective: To discuss the use of butterfly costal cartilage as columella strut graft. Methods: On the costal cartilage that being cut, butterfly graft was designed length of 2.8 cm, upper and lower end thickness of 5 mm, middle part thickness of 1.5 mm. The lower end was designed with a groove about 1 cm in length, the width of the lower end of the butterfly graft was determined according to the degree of retraction at the caudal end of the septum, then insert to the nasal crest. The posterior end of two lamella grafts was sutured and fixed with the middle part of the nasal columnar strut graft. Results: From November 2016 to March 2018, about 150 patients underwent rhinoplasty with this method, follow-up was 3 to 12 months. Two cases had mild nasal tip deviation one month after surgery and were adjusted with auricular cartilage three months later. Three patients had mild postoperative hyporotation and adjustment three months postoperatively, residual had good shape. Conclusions The stability and controllability of the sphenoid columella strut graft are good, out of shape not easily, It is a worthy clinical method.

Objective: To determine the spatiotemporal distribution of Schistosoma (S.) japonicum infections in humans, livestock, and Oncomelania (O.) hupensis across the endemic foci of China. Methods: Based on multi-stage continuous downscaling of sentinel monitoring, county-based schistosomiasis surveillance data were captured from the national schistosomiasis surveillance sites of China from 2005 to 2019. The data included S. japonicum infections in humans, livestock, and O. hupensis. The spatiotemporal trends for schistosomiasis were detected using a Joinpoint regression model, with a standard deviational ellipse (SDE) tool, which determined the central tendency and dispersion in the spatial distribution of schistosomiasis. Further, more spatiotemporal clusters of S. japonicum infections in humans, livestock, and O. hupensis were evaluated by the Poisson model. Results: The prevalence of S. japonicum human infections decreased from 2.06% to zero based on data of the national schistosomiasis surveillance sites of China from 2005 to 2019, with a reduction from 9.42% to zero for the prevalence of S. japonicum infections in livestock, and from 0.26% to zero for the prevalence of S. japonicum infections in O. hupensis. Analysis using an SDE tool showed that schistosomiasis-affected regions were reduced yearly from 2005 to 2014 in the endemic provinces of Hunan, Hubei, Jiangxi, and Anhui, as well as in the Poyang and Dongting Lake regions. Poisson model revealed 11 clusters of S. japonicum human infections, six clusters of S. japonicum infections in livestock, and nine clusters of S. japonicum infections in O. hupensis. The clusters of human infection were highly consistent with clusters of S. japonicum infections in livestock and O. hupensis. They were in the 5 provinces of Hunan, Hubei, Jiangxi, Anhui, and Jiangsu, as well as along the middle and lower reaches of the Yangtze River. Humans, livestock, and O. hupensis infections with S. japonicum were mainly concentrated in the north of the Hunan Province, south of the Hubei Province, north of the Jiangxi Province, and southwestern portion of Anhui Province. In the 2 mountainous provinces of Sichuan and Yunnan, human, livestock, and O. hupensis infections with S. japonicum were mainly concentrated in the northwestern portion of the Yunnan Province, the Daliangshan area in the south of Sichuan Province, and the hilly regions in the middle of Sichuan Province. Conclusions: A remarkable decline in the disease prevalence of S. japonicum infection was observed in endemic schistosomiasis in China between 2005 and 2019. However, there remains a long-term risk of transmission in local areas, with the highest-risk areas primarily in Poyang Lake and Dongting Lake regions, requiring to focus on vigilance against the rebound of the epidemic. Development of high-sensitivity detection methods and integrating the transmission links such as human and livestock infection, wild animal infection, and O. hupensis into the surveillance-response system will ensure the elimination of schistosomiasis in China by 2030.