Objective To compare imaging quality and radiation dose on DR and dual-sided reading of CR system.Methods The TRG of ALVIM statistics phantom was exposed by DR and dual-sided reading of CR with the same radiation dose,then the exposure factor and the entrance surface dose (ESD) were recorded.After that,the phantom was exposed by dual-sided reading of CR with various mAs ( 3.2,4.0,4.3,4.8 and 5.2 mAs) and the same kV,and the ESD was recorded,too.The acquired images were read by three radiologists on the monitor of diagnosis work station with the same window width and window level,then the total points of the images were given with the method of a five-level confidence scale.ROC curves were drawn and probability Pdet was calculated.Then the data was analyzed statistically by analysis of variance (ANOVA).Results The ROC analysis of bone substitute with diameter from 0.5 to 1.0 mm and muscle substitute with diameter from 0.9 to 2.0 mm showed A (z) values of 0.742 to 0.923 and 0.635 to 0.900 for DR system when the radiation dose was 137.5 μGy.The ROC analysis of bone substitute and muscle substitute showed A(z) values of 0.526 to 0.586 and 0.473 to 0.560 for dual-sided reading of CR at the same radiation dose.The probability Pdet discrepancy of bone substitute in two systems was from 0.216 to 0.337,with the highest of 0.337 in the diameter of 1.0 mm.The probability Pdet discrepancy by muscle substitute in two systems was from 0.075 to 0.342,with the highest of 0.342 in the diameter of 2.0 mm.There was significant statistical difference between the two groups ( F =35.30,P ＜ 0.01 ).When the exposure factor of dual-sided reading of CR system was 75 kV,4.8 mAs,the ESD was 180.4 μ Gy,the ROC analysis in the bone substitute with diameter from 0.5 to 1.0 mm and muscle substitute with diameter from 0.9 to 2.0 mm showed A(z) values was the same.The probability Pdet discrepancy of bone substitute in two systems was from - 0.003 to 0.009.The probability Pdet discrepancy of muscle substitute in two systems was from -0.005 to 0.008,and there was no statistical difference between the two groups ( F =5.23,P ＞0.05).When the probability Pdet of two systems was the same,the ESD was 180.4 μGy by dual-sided reading of CR system,and the ESD was 137.5 μGy by DR system.Conclusion Detection with DR system was proved to be superior to dual-sided reading of CR system at the same radiation dose.When the image quality was similar,the radiation dose of DR system was less than the dual-sided reading of CR system.

Objective To explore the optimum voltage for digital chest radiography in adult. Methods PMMAs of Different thickness (7.2, 9.0, 10. 8 and 12. 6 cm) were used to simulate chest of different depth ( 17. 5, 22. 5, 27.0 and 32. 5 cm). The combinants of contrast-detail Cdrad 2.0 phantom and above PMMAs were exposed with automatic exposure control (AEC) and different tube voltages. The images of these combinants were obtained and the entrance surface dose (ESD) was recorded. The imaging quality factor (IQF) was calculated and the curves were drawn between the ESD,IQF and kV. The PMMAs of different thickness, on which a contrast object ( PMAA of 5 cm diameter and 1.8 cm thickness ) was placed, were exposed with the same condition used for above test. Their images were obtained and SNRs were calculated. Results The ESD, SNR and IQFinv of different chest depth decreased with increase of kV.When tube voltages of 70, 100 and 140 kV were used, for 17. 5 cm chest depth, the ESD was 0. 22, 0. 09 and 0. 06 mGy, the IQF was 43.3, 58. 8 and 72. 0, the SNR was 7.5, 6. 2 and 5.0; for 22. 5 cm chest depth, the ESD was 0.37, 0.12 and 0.06 mGy, the IQF was 56. 0, 61.4 and 65.3, the SNR was 6. 4, 5.2 and 3. 8; for 27. 0 cm chest depth, the ESD was 0. 52, 0. 20 and 0. 09 mGy, the IQF was 54. 2, 64. 3 and 91. 0, the SNR was 6. 0, 4. 8 and 3. 5; for 31.5 cm chest depth, the ESD was 0.53, 0.24 and 0. 10 mGy,the IQF was 53.2, 66. 8 and 95.3, the SNR was 5. 7, 4. 5 and 3. 0. Conclusion To balance ESD, SNR and IQF, proper tube voltage should be chosen for chest radiography according to thickness and constitution of patients.

Objective To research the efficacy of using low dose dexmedetomidine in short time to prevent restless after laparoscopic surgery. Methods Forty patients ASA grade ⅠorII,age 20~70 yeas old,scheduled for selective laparo-scopic cholecystectomy or ectopic pregnancy or oophorocystectomy etc,operation time about 30min,were randomly as-signed to low groupsgroup D and N. Group DIntravenous dexmedetomidine(0.5~0.8)μg/(kg·h) when we inducing,for 10~15 min,no more than 50 μg; Group Nno dexmedetomidine. Observed extubation tiwe after surgery,riker sedation and restless score(SAS),restless incidence rate. Results There was no obvious difference in the time of extract the tra-cheal tube (P>0.05). The SAS in group D was significantly lower than group N (P<0.05),incidence of restlessness of group D was significantly lower than N. Conclusion Intravenous low dose dexmedetomidine while inducing for short time can effectively prevent restlessness after Laparoscopic Surgery.

We detected Zika virus (ZIKV) in a febrile case returning from Suriname and entry China from Guangzhou Baiyun International Airport Port.Serum and saliva samples were collected from a suspected case returning from Suriname.We detected ZIKV RNA using real-time fluorescence RT-PCR methods by both in-house reagent and commercial detection kits.RT-PCR detection was carried out with saliva sample and sequence analysis was performed.Phylogenetic tree was constructed to analyze the source of imported cases.Real-time fluorescent RT-PCR result showed that saliva was detected ZIKV RNA positive while for serum was weakly positive.A specific 1 500 bp fragment in size was amplified with saliva sample by RT-PCR.Sequence analysis showed 99％ homologous to the corresponding sequence of Brazil ZIKV (GenBank No.KX197250).Phylogenetic tree indicated it was located on African lineage.According to the epidemiological investigation results,clinical manifestations and nucleic acid detection of case,the suspected case was confirmed to infect Zika virus,being the first case from Suriname into Guangdong Province.

Objective This study aims to investigate the gene expression of P2X7 receptor in retinal ganglion cell line (RGC-5),and to design and select the small interfering RNA (siRNA) which can specifically and effectively downregulate P2X7 receptor expression.Methods The mRNA and protein expressions of P2X7 receptor in RGC-5 cells were examined by real-time polymerase chain reaction (qRT-PCR),Western blot and Immunofluorescence,and compared with those of mouse retina and other tissues.Three P2X7 receptor-specific double stranded siRNAs (P2X7-siRNA-1-3) were designed and delivered into RGC-5 cells by riboFECTTM CP.60 hours after transfection,the expression level of P2X7 receptor was analyzed by qRT-PCR,Western blot and Immunofluorescence.Results The expression of P2X7 receptor was detected in both RGC-5 cell line and mouse retina,and the receptor was mainly expressed in the nucleus and cytoplasm of RGC-5 cells.P2X7-siRNA-3 can effectively down-regulate the mRNA and protein expression of P2X7 at the same time.Conclusions RGC-5 cell line can serve as a good model for studying the biological function of P2X7 receptor in retinal ganglion cells in vitro.We have managed to design and synthesize the siRNA pair that specifically and effectively lowering P2X7 receptor expression.The current study has laid the foundation for future investigations on treating glaucomatous retinopathy by downregulation of P2X7 receptor.

Objective:To study the effect of magnetic nursing concept on improving nurses' nursing ability of extracorporeal membrane oxygenation (ECMO).Methods:In the study, 33 nurses of emergency intensive care unit of The First Affiliated Hospital of Nanjing Medical University from January 2019 to December 2020 were selected as the research objects. From January 2019 to December 2019, the Department carried out routine nursing management, and from January 2020 to December 2020, the Department implemented the management mode of magnetic nursing concept. The mastery of nursing knowledge of ECMO was analyzed by using scale, and the critical thinking ability and self-study ability of the nurses were compared before and after intervention. SPSS 22.0 was used to perform t test on the data. Results:After the intervention, nurses' mastery of respiratory system nursing, circulatory system nursing, fluid balance nursing, skin nursing, digestive system nursing, bleeding, anticoagulant problem nursing, hospital infection prevention and control, and pipeline nursing related knowledge of ECMO patients was significantly better than that before the intervention ( P<0.05). After the intervention, nurses' truth-seeking, open thinking, systematic ability, analytic ability, thinking self-confidence, thirst for knowledge, cognitive maturity and total scale scores were significantly higher than those before the intervention ( P<0.05). After the intervention, nurses' self motivation belief, task analysis, self-monitoring and regulation, self-evaluation and total score were significantly higher than those before the intervention ( P<0.05). Conclusion:The nursing management mode of magnetic nursing concept is of value in improving nurses' autonomous learning ability and critical thinking ability.

Objective To investigate the application of continuing care in the indwelling gastric tube feeding of patients with dysphagia in order to improve the patients′ satisfaction and reduce complication as well as the readmission rate. Methods A total of 60 discharged patients undergoing indwelling gastric tube feeding were selected as the study subjects. Out-of-hospital nursing team conducted active care in the observation group consisting of 30 patients while the control group with 30 patients went back home and received passive care from the out-of-hospital nursing team. Indexes of the two groups were collected including complications after two-month indwelling gastric tube feeding, patients′ satisfaction, re-attendance rate, active consultation rate and swallowing rehabilitation and so on. Results The observation period, the observation group abdominal distension / diarrhea, nasopharyngeal mucosa injury, aspiration, lung infection were 1, 2, 2 and 1 cases, control group 6, 9, 8 and 7 cases with significant difference between two groups ( χ2 = 4. 04,5. 45,4. 32,5. 19, respectively; P < 0. 05). In the observation group, the rates of ED visits, readmission rate, active consultation rates were 0% , 6. 7% and 50% while these of the control group were 13. 3% ,26. 7% and 6. 7% . There was significant difference between two groups (χ2 = 4. 28,4. 32,13. 87, respectively; P < 0. 05); the two group continuity nursing satisfaction, the observation group than in the control group ( U = 2. 121, P < 0. 05). Conclusions The continuing nursing care outside the hospital can improve the caring quality for patients experiencing indwelling gastric tube feeding, patients′ satisfaction and active consultation rate, and reduce the re-attendance rate.

Objective To comprehend the current status of research on community pressure ulcers in China in recent years, so as to provide reference for developing community pressure ulcer care in the future. Methods Documentary analysis was adopted to construct a database of literature reading and appraisal. With three databases, China Journal Full-text Database (CNKI), Wanfang Data, and VIP chosen as sources and searched with "community" or "community health service" or "home" or "pressure sores", "bedsores","pressure ulcers" as index words, all articles from 2000 to 2015 were retrieved. Results A total of 101 articles were eligible, and 52 were selected and analyzed according to quality standard of literature reading and appraisal.Conclusions Regarding community pressure ulcers management in China, firstly, special training should be conducted to community nurses;joint and linkage between communities and superior hospitals should be strengthened; a community-family-hospital pressure ulcers prevention and treatment management network should be built;continued nursing on pressure ulcer should be done;corresponding knowledge training and skill instruction should be given to caregivers;gate of pressure ulcers management should be moved forward.

Objective To investigate the relationships between serum osteocalcin (OC) levels and glycometabolism markers in nondiabetic post-traumatic male patients.Methods Populaitons were selected at the Department of Emergency Medicine of Shanghai Jiao Tong University Affiliated Sixth People's Hospital from October 2017 to February 2019.The age,injury severity score (ISS),and characteristic indicators were recorded.The inclusion criteria were age ≥ 18 years and blood collection time ＜ 24 h after the injury.The exclusion criteria were emergency surgery,acute brain trauma,and hemoglobin A1c (HbA1c) ≥ 6.0％.The patients were divided into two groups by fasting plasma glucose (FPG):stress hyperglycemia (SH) (FPG＞7.8 mmol/L) and nonstress hyperglycemia (NO-SH) (FPG ≤ 7.8 mmol/L) groups.The fasting venous blood samples were collected and examined.The characteristics and biochemical indicators in the two groups were compared statistically by LSD-t test,rank sum test and ANOVA,and the relationships between serum OC levels and glycometabolism markers were analyzed by partial correlation analysis.Results A total of 395 traumatic patients were enrolled and divided into the SH group (n=182) and NO-SH group (n=213).There were no differences in ISS,fasting insulin (FINS),and C-peptide (C-P) levels between groups.Age,HbAlc and FPG were higher (P=0.041,P=0.037,P＜0.01),while the OC level was lower (P=0.023),in the SH group than those in the NO-SH group.The serum OC level did not correlate with HbAlc,FPG,and FINS,but negatively correlated with C-P by partial correlation analysis (r=-0.262,P=0.008).The multivariate linear regression analysis showed that C-P was an independent factor affecting serum OC levels after trauma (β=-0.655,P=0.043).Conclusion A correlation existed between the serum OC level and glycometabolism markers in nondiabetic post-traumatic male patients.

BACKGROUND: Knee osteoarthritis (KOA) is a prevalent chronic joint disease caused by various factors. Mesenchymal stem cells (MSCs) therapy is an increasingly promising therapeutic option for osteoarthritis. However, the chronic inflammation of knee joint can severely impede the therapeutic effects of transplanted cells. Gelatin microspheres (GMs) are degradable biomaterial that have various porosities for cell adhesion and cell–cell interaction. Excellent elasticity and deformability of GMs make it an excellent injectable vehicle for cell delivery. METHODS: We created Wharton’s jelly derived mesenchymal stem cells (WJMSCs)-GMs complexes and assessed the effects of GMs on cell activity, proliferation and chondrogenesis. Then, WJMSCs loaded in GMs were transplanted in the joint of osteoarthritis mice. After four weeks, joint tissue was collected for histological analysis. Overexpressing-luciferase WJMSCs were performed to explore cell retention in mice. RESULTS: In vitro experiments demonstrated that WJMSCs loaded with GMs maintained cell viability and proliferative potential. Moreover, GMs enhanced the chondrogenesis differentiation of WJMSCs while alleviated cell hypertrophy. In KOA mice model, transplantation of WJMSCs-GMs complexes promoted cartilage regeneration and cartilage matrix formation, contributing to the treatment of KOA. Compared with other groups, in WJMSCs+GMs group, there were fewer cartilage defects and with a more integrated tibia structure. Tracking results of stable-overexpressing luciferase WJMSCs demonstrated that GMs significantly extended the retention time of WJMSCs in knee joint cavity. CONCLUSION Our results indicated that GMs facilitate WJMSCs mediated knee osteoarthritis healing in mice by promoting cartilage regeneration and prolonging cell retention. It might potentially provide an optimal strategy for the biomaterial-stem cell based therapy for knee osteoarthritis.