OBJECTIVE To study the effect of epipolythiodioxopiperazine compound C87 on tumor cell proliferation and explore the potential mechanisms. METHODS Tumor cells were exposed to C87 0.05-1 μmol.L-1 for 24, 48 and 72 h, cell viability was determined by sulforhodamine B (SRB) assay and the half growth inhibition (Gl50 ) was calculated. After treatment with C87 0.1-2.5 μmol.L-1 for 6 h, or C87 2.5 μmol.L-1 for 0-6 h, the generation of reactive oxygen species (ROS) was measured using the compound 2′,7′-dichlorofluoresceindiacetate and flow cytometry analysis. After treatment with C87 2.5 μmol.L-1 , either alone or with antioxidant N-acetylcysteine (NAC), for 6 h, the generation of ROS was measured by flow cytometry analysis. Tumor cells were exposed to C87 0.05-1 μmol.L-1 , either alone or with NAC, for 24 and 48 h, while cell viability was determined by SRB assay. RESULTS The cell viability was significantly reduced following exposure to C87 0.05-1 μmol.L-1 for 24, 48 and 72 h in a concentration-dependent manner in A549, HCT116, HeLa and SMMC7721 cells(P<0.05). At 72 h, the value of r2 was 0.946, 0.989, 0.973 and 0.984(P<0.05), respectively. The cell viability was significantly reduced following exposure to C87 1 μmol.L-1 for 24 - 72 h in a time-dependent manner in A549, HCT116, HeLa and SMMC7721 cells(P<0.05). The value of r2 was 0.983, 0.956, 0.951 and 0.873(P<0.05), respectively. The generation of ROS was increased after exposure to C87 0.25-2.5 μmol.L-1 in a concentration-dependent manner in HCT116 and HeLa cells for 6 h (r2 = 0.760, P = 0.045: r2 = 0.987, P=0.001), and after exposure to C87 2.5 μmol.L-1 in a time-dependent manner in HCT116 and HeLa cells for 0.5-6 h (r2 = 0.886, P = 0.017: r2 = 0.994, P = 0.000).The C87-induced ROS generation could be blocked by NAC in HCT116 and HeLa cells(P<0.05). The C87 induced cell death could be blocked by NAC 5 and 10 mmol.L-1 , and the Gl50 value was 1.446 and 1.134 μmol.L-1 for 24 h (the Gl50 value of C87 group was 0.513 μmol.L-1 ), and 0.882 and 1.166 μmol.L-1 for 48 h (the Gl50 value of C87 group was 0.333 μmol.L-1 ). CONCLUSION The novel epipolythiodioxopiperazine derivative C87 exerts potent antitumor activity in vitro, possibly via triggering ROS production.

Objective:To determine the reliability and validity of the Chinese version of Fagerstrom Test for Nicotine Dependence (FrND) scale among smoking male inpatients with schizophrenia.Methods:Two hundred and twenty smoking male inpatients,who met criteria for schizophrenia of Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition (DSM-Ⅳ),were consecutively included.FTND scale and Russell's Reasons for Smoking Questionnaire (RRSQ) were used to assess subjects'severity of nicotine dependence and addiction score of the dimension of reason for smoking,respectively.According to the principle of voluntariness,37 subjects were selected and re-assessed with FTND scale after two-week interval.Reliability,correlation and factor analyses were used to examine the reliability and validity.Results:The Cronbach α (internal consistency) and two-week re-test reliability coefficients of FTND scale were 0.68 and 0.72 (P ＜0.01),respectively.The criterion related validity coefficient with addiction score of RRSQ was 0.53 (P ＜0.01).Two common factors were abstracted from the scale factor analysis,accounting for 52.4％ of the total variance.There were statistically significant differences between patients with different duration of illness,number of hospitalizations and age of smoking initiation (P ＜0.05).Conclusion:The Chinese version of FTND scale for smoking male inpatients with schizophrenia has a relatively low internal consistency and good re-test reliability,criterion related validity,construct validity and empirical validity.

Objective: To explore how to select osteotomy line and its significance in mandibular distraction osteogenesis in infants and young children. Methods: From May 2013 to July 2018, 208 infants and young children with mandibular deformity were admitted to the Department of Oral and Maxillofacial Surgery, Guangzhou Women and Children Medical Center, including 131 males and 77 females, with the age range of 8 days to 4 years, mean age of 6 months. Their clinical records were retrospectively analyzed. There were 162 cases of Robin sequence, 37 cases of the first and branchial arch anomalies, 2 cases of Treacher-Collins syndrome, and 7 cases of other congenital malformations. During the distraction osteogenesis, different osteotomy lines were selected according to the characteristics of the mandibular deformity: (1) For short mandibular body, the straight osteotomy line was used to extend the mandibular body. (2) For short mandibular ramus, a polygonal osteotomy line was used to extend the ramus. (3) For the increased mandibular angle, a curved osteotomy line was used to change the angulation. Results: Linear osteotomy was used in 38 patients, polygonal line osteotomy were used in 129 patients, and curved osteotomy was performed in 41 patients. Among them, 4 patients with linear osteotomy had deciduous embryo injury, 6 patients with linear osteotomy and 2 patients with polygonal osteotomy had open occlusion, and patients with curved osteotomy did not have tooth and mandible damage, or malocclusion. All patients were followed up for 3 months to 5 years. The average follow-up time was 6.2 months. All osteotomy healed well, without osteonecrosis or nonunion. Conclusions For the mandibular distraction osteogenesis, osteotomy line could be individualized, according to the characteristics of mandibular deformity of infants and young children, which can reduce complications such as dental damage and open occlusion.

Objective:To investigate the clinical features and treatment strategies of infection after lumbar transpedicular dynamic stabilization.Methods:A total of 1 623 cases with lumbar transpedicular dynamic stabilization conducted from January 2010 to June 2020 were retrospectively analyzed, including 854 males and 769 females and aged 47.56±12.76 years old. There were 1 150 cases with Dynesys fixation, 235 cases with K-Rod, 181 cases with Isobar, 52 cases with Fule and 5 cases with Waveflex. The primary diseases were as following, 984 cases (60.63%) with lumbar disc herniation, 280 cases (17.25%) with lumbar spinal stenosis, 174 cases (10.72%) with lumbar spondylolisthesis, 98 cases (6.04%) with lumbar degenerative scoliosis and 87 cases (5.36%) with discogenic low back pain. Some baseline indicators, such as the overall incidence of infection, the age, gender, smoking, drinking, diagnosis, previous operation history, concomitant disease, the number of fenestration, the number of discectomy, the number of fixed segments, operation duration, blood loss, blood transfusion, the number of the dura mater rupture, postoperative infection duration from primary operation, inflammation indicators (leukocytes, neutrophils, C-reactive protein, erythrocyte sedimentation rate and procalcitonin) of the infected patients, were recorded. According to the time when the infection occurred, the cases were divided into the early infection group (within 3 months after surgery) and the late infection group (more than 3 months after surgery). The clinical indicators and treatment strategies were compared between the two groups.Results:The overall infection rate was 1.66% (27/1 623), including 2.17% (25/1 150) in Dynesys fixation, 1.92% (1/52) in Fule fixation and 0.55% (1/181) in Isobar fixation. The follow-up duration was 51.89±32.55 months. The number of fenestrations was 1(1, 2). The number of discectomy was 1(1, 2), and that of fixed segments was 2(1, 3). The operation duration was 186.30±81.33 minutes, with the blood loss 200 (200, 500) ml and the blood transfusion volume 0(0, 345) ml. There was 1 case of cerebrospinal fluid leakage in early infection group. Thirteen cases of pathogenic bacteria were identified, included 5 cases of Staphylococcus epidermidis, 2 cases of Staphylococcus aureus and 1 case each of Salmonella, Escherichia coli, Pseudomonas aeruginosa, Enterobacter aerogenes, Acinetobacter baumannii, and Streptococcus lactis. A total of 21 patients underwent secondary surgery, including 10 cases of debridement and suturing, 2 cases of internal fixation replacement and 9 cases of internal fixation removal. The other 4 cases underwent puncture and irrigation, while 2 cases received only antibiotic treatment. There were 16 cases with early infection and 11 cases with late infection. There were no significant differences between the two groups in the number of fenestrations, discectomy, operation duration, blood loss, and blood transfusion ( P>0.05). The inflammation indexes of early infection group were higher than those of late infection group with significant difference ( P<0.05), except for procalcitonin. The detection rates of pathogenic bacteria in early and late infection group were 62.5% (10/16) and 27.3% (3/11), respectively. The main infection sites in early infection group were the incision (50.0%, 8/16) and around the internal fixation (18.8%, 3/16). However, the main infection sites in late infection group were around the internal fixation (90.9%, 10/11). In the early infection group, the main treatments including debridement and suturing were conducted in 9 cases, puncturing in 2 cases and internal fixation replacement in 2 cases. In the late infection group, internal fixation removal was performed in 8 cases and puncturing in 2 cases. Conclusion:The overall infection rate after lumbar transpedicular dynamic stabilization was 1.66%. The incidence of early infection was 0.99%, while that of late infection was 0.68%. The incidence of Dynesys fixation was 2.17%. In early infection, the internal fixation could be retained through some treatments as debridement and internal fixation replacement. In most late infection cases, removal of the internal fixation could be helpful to control the infection.

Objective:To explore the improvement of core symptoms in children with autism whose auditory pathway dysfunction were repaired after accepting auditory integration training(AIT).Methods:The ASD children with abnormal auditory evoked potentials were divided into AIT group (the ones whose BAEP return to normal after AIT training into test group), control group A (blank control group) and control group B (ABA training group). The ASD children were assessed by Portage Development Checklist, Child Autism Rating Scale (CARS) and Autism Therapy Assessment Scale (ATEC) at the time of admission, one month after admission, three months after admission.The curative effect with the change value of each factor fraction was evaluated.Results:At the time of enrollment, there were no significant differences among the scores of CARS((36.31±4.08), (36.33±3.76), (36.33±5.14)) as well as ATEC language ((19.08±6.43), (16.40±6.42), (18.48±5.96)), social ((15.63±7.13), (16.05±7.57), (16.19±7.19)), and perception ((16.78±5.39) (16.92±6.75), (17.12±6.73)) and self-care ((15.98±8.71), (17.93±8.22), (17.26±8.93), respectively)) in the AIT group, control group B and control group A. After one month and three months from enrollment, the scores of CARS were ((33.96±3.79), (35.09±4.38) and (34.30±3.98), respectively after one month; (32.95±3.15), (36.86±3.86) and (33.95±3.90), respectively) after three months in the AIT group, control group B and control group A. The repeated measurement analysis of variance showed that the main effect of time was significant ( F=22.308, P<0.01), the main effect of group was not significant ( F=2.647, P>0.05), and there was interaction between time and group ( F= 8.626, P<0.01). For the scores of ATEC language (one month: (16.18±7.10), (18.62±6.63), (13.40±5.44); three months: (14.13±6.13), (18.40±6.35), (10.75±5.17)), social(one month: (12.31±6.68), (17.76±6.82), (15.08±6.75); three months: (10.71±5.42), (16.31±6.30), (12.15±7.30)), perception (one month: (14.37±5.86), (17.43±7.22), (18.58±6.92); three months: (10.35±5.43), (16.44±7.05), (16.68±7.37)) in AIT group, control group B and control group A. The main effect of time was significant ( F=35.534, 40.729, 40.401, all P<0.01), the main effect of group was also significant ( F=7.600, 6.193, 7.675, all P<0.01), and there was interaction between time and group ( F=7.602, 3.355, 7.649, all P<0.05). Multiple comparisons showed that there were statistically significant differences between the AIT group and the control group B, the control group A and the control group B in the scores of ATEC language scale after intervention (I1-J1=-1.69, P1<0.05; I2-J2=-4.98, P2<0.01) between the AIT group and the control group A in the scores of ATEC social scale after intervention (I-J=-4.54, P<0.01) .There were significant differences between the AIT group and the control group A, the AIT group and the control group B in the scores of ATEC perception scale after intervention (I1-J1=-3.16, P1<0.05; I2-J2=-4.89, P2<0.01); for the scores of ATEC self-care ability subscale the main effect of time was significant ( F=22.876, P<0.01), the main effect of group was also significant ( F=3.427, P<0.05), and time and group had no interaction ( F=1.885, P>0.05). Multiple comparisons showed that the scores of ATEC self-care ability scale between the AIT group and the control group A were statistically significant (I-J=-4.46, P<0.05). Conclusion:The results of this study show that AIT training can improve the core symptoms of the ASD children whose BAEP returns to normal.

Purpose/Significance To explore the changes,challenges,key application scenarios and future development directions of generative artificial intelligence(AI)represented by ChatGPT in the field of hospital management,and to provide references for the ap-plication of AI natural language processing(NLP)technology in the field of hospital management in China.Method/Process Through literature review and analysis,the changes and challenges brought about by the rapid development of generative AI in the field of hospital management are sorted out,its key application scenarios and future development directions in the field of hospital management are empha-sized and explored.Result/Conclusion AI has broad application prospects in the field of hospital management,and it should focus on exploring its practical application scenarios and strategic directions to provide reference and guidance for promoting the high-quality de-velopment of public hospitals.

Objective To observe the value of CT radiomics-based nomogram for predicting difference of Lauren types of gastric cancers between endoscopic biopsy and postoperative pathology.Methods Totally 126 patients with gastric cancer diagnosed by surgical pathology were retrospectively analyzed.The patients were divided into concordant group(n=77)and inconsistent group(n=49)according to the concordance between endoscopic biopsy and postoperative pathology results or not,also divided into training set and validation set at the ratio of 2∶1.Clinical predictors were screened,then a clinical prediction model was constructed.Radiomics features were extracted based on venous-phase CT images and screened using L1 regularization.Radiomics models were constructed using 3 machine learning(ML)algorithms,i.e.decision trees,random forests and logistic regression.The nomogram based on clinical and the best ML radiomics model was constructed,and the efficacy and clinical utility of the above models and nomogram for predicting inconsistency of Lauren types of gastric cancers between endoscopic biopsy and postoperative pathology were evaluated.Results Patients'age,platelet count,and arterial-phase CT values of tumors were all independent predictors of inconsistency between endoscopic biopsy and postoperative pathology of Lauren types of gastric cancer.CT radiomics model using random forests algorithm showed better predictive efficacy among 3 ML models,with the area under the curve(AUC)of 0.835 in training set and 0.724 in validation set,respectively.The AUC of clinical model,radiomics model and the nomogram in training set was 0.764,0.835 and 0.884,while was 0.760,0.724 and 0.841 in validation set,respectively.In both training set and validation set,the nomogram showed a good fit and considerable clinical utility.Conclusion CT radiomics-based nomogram had potential clinical application value for predicting inconsistency of Lauren types of gastric cancers between endoscopic biopsy and postoperative pathology.

Objective To investigate the value of CT radiomics combined with CT and preoperative pathological features for predicting postoperative early recurrence(ER)of local advanced esophageal squamous cell carcinoma(LAESCC).Methods Data of 334 patients with LAESCC were retrospectively analyzed.The patients were divided into training set(n=234)and verification set(n=100)at the ratio of 7:3 and were followed up to observe ER(recurrence within 12 months after surgery)or not.Univariate and multivariate logistic regression were used to analyze clinical,CT and preoperative pathological features of LAESCC in patients with or without ER in training set.The independent risk factors of ER were screened,and a CT-preoperative pathology model was constructed.Based on venous phase CT in training set,the radiomics features of lesions were extracted and screened to establish radiomics model,and finally a combined model was established based on radiomics model and the independent risk factors.Receiver operating characteristic(ROC)curves were drawn,and the area under the curve(AUC)was calculated to evaluate the diagnostic efficacy of each model.Results Among 334 cases,168 were found with but 166 without ER.In training set,117 cases were found with while the rest 117 without ER,while in verification set,51 were found with but 49 without ER.The length of lesions,cT stage and cN stage shown on CT and tumor differentiation degree displayed with preoperative pathology were all independent risk factors for ER of LAESCC(all P＜0.05).The AUC of CT-preoperative pathology model in training set and validation set was 0.759 and 0.783,respectively.Ten best radiomics features of LAESCC were selected,and AUC of the established radiomics model in training set and validation set was 0.770 and 0.730,respectively.The AUC of combined model in training and validation set was 0.838 and 0.826,respectively.The AUC of CT radiomics combined with CT and preoperative pathological features in training set was higher than that of CT-preoperative pathologymodel and radiomics model(both P＜0.01).Conclusion CT radiomics combined with CT and preoperative pathological features could effectively predict postoperative ER of LAESCC.

Objective To observe the value of dual-energy CT(DECT)radiomics combined with clinical and CT features for predicting differentiation degree of gastric adenocarcinoma(GAC).Methods Totally 254 patients with GAC were prospectively analyzed and divided into high-grade group(low differentiation GAC,n=88)and low-grade group(middle-high differentiation GAC,n=166)according to pathological results.The patients were also divided into training set(n=203,including 70 high-grade and 133 low-grade GAC)and verification set(n=51,including 18 high-grade and 33 low-grade GAC)at the ratio of 8∶2.Radiomics features were extracted and screened based on venous phase single-level(40,70,100 and 140 keV)DECT,and a multi-energy radiomics model was constructed to predict GAC classification.Univariate analysis and multivariate logistic regression were used to analyze clinical and CT features as well as DECT parameters in training set to construct a clinic-CT model.Then a combined model was constructed through combining clinic-CT model with radiomics model.The predictive efficacy of the models were evaluated,and the calibration degree of the combined model was assessed.Results The area under the curve(AUC)of clinic-CT model,multi-energy radiomics model and combined model was 0.74,0.75 and 0.78 in training set,and 0.73,0.77 and 0.78 in verification set,respectively.Except for AUC of combined model was higher than that of clinic-CT model in training set(P＜0.05),no significant difference of AUC was found among models in training set nor verification set(all P＞0.05).The calibration degree of combined model was good in both training set and verification set(both P＞0.05).Conclusion DECT radiomics combined with clinical and CT features could effectively predict differentiation degree of GAC.

Objective To observe the value of spectral CT parameters for evaluating T staging of advanced gastric cancer(AGC).Methods Totally 155 AGC patients were collected and divided into T2 stage(n=40)and T3/4a stage(n=115)according to postoperative pathology.CT values,water concentration(WC)and iodine concentration(IC)of AGC lesions on 40-140 keV arteriovenous phase single energy level images were measured,and the standardized IC(nIC)and spectral curve slopes k1 and k2 were calculated.Clinical variables and spectral quantitative parameters were compared between groups,and receiver operating characteristic curve was plotted,the area under the curve(AUC)was calculated to evaluate the value of each parameter and model for identifying T2 and T3/4a stage AGC.Results Tumor thickness,proportion of low differentiation degree,CT100kev,CT140kev,and WC values in T3/4a group were all significantly higher than those in T2 group(all P＜0.05).CT140keV of AGC lesions on venous phase images presented the highest discrimination efficacy among single parameters,with AUC of 0.782.AUC of clinical-arterial phase-venous phase model was 0.848,higher than that of clinical model and arterial phase model alone(both P＜0.05)but not significantly different compared with AUC of venous phase model(P＞0.05).Conclusion Spectral CT quantitative parameters,especially venous phase parameters could be used to effectively identify T stage of AGC.Multi-parameter combined models had higher diagnostic value.