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Objective To investigate the clinical characteristics of pulmonary hypertension(PH) in patients with chronic obstructive pulmonary disease (COPD) and study the related risk factors.Methods Patients with stable COPD enrolled in this study,undergoing examinations including full pulmonary function tests (PFT),6-minute walk distance (6MWD),Exercise Oxyhemoglobin,Saint.George's respiratory questionnaire (SGRQ) and transthoracic echocardiography.Pulmonary artery systolic pressure (sPAP) ≥ 36 mmHg(1 mmHg =0.133 kPa) was defined as PH.Results A total of 251 patients were finally evaluable in this study.The frequency of PH was 55.4％ (139/251) in patients with stable COPD.Significant differences were seen between patients with PH and without PH respectively in the following factors (mean P ＜0.05):proportion of age ≥ 60 years (69.8％ vs 57.1％),forced expiratory volume in one second (FEV1)(％ predicted) [(47.5±8.2)％ vs(61.2±10.2)％ and(49.8±7.9)％ vs(66.4±11.3)％],sPAP [(41.9 ± 9.1) mmHg vs (28.2 ± 3.2) mmHg],exercise oxyhemoglobin desaturation [(-5.5 ± 3.2) ％ vs(-2.2 ± 1.2) ％],6MWD [(316.0 ± 55.2) m vs(390.0 ±75.2) m].The following variables were negatively correlated with sPAP:6MWD (r =-0.330,P =0.003),FEV1 (％ predicted) (r =-0.210,P =0.024 and r =-0.130,P =0.012,respectively).The following variables were positively correlated with sPAP:age(r =0.560,P =0.031),exercise oxyhemoglobin desaturation ＞ 3％ (r =0.540,P =0.001).Logistic regression test has showed that age≥ 60 years,exercise oxygen desaturation ＞ 3％,FEV1 (％ predicted) ＜ 50％,6MWD ＜ 350 m were risk factors for PH in COPD.Conclusion The incidence of PH in COPD increases with age,yet the performance of lung function and the activity of endurance decrease in elder patients.Sixty years or older,exercise oxygen desaturation ＞ 3％,FEV1 (％ predicted) ＜ 50％,6MWD ＜ 350 m are risk factors of PH in COPD.Echocardiography or right heart catheterization when needed should be considered to confirm the diagnosis.

Objective:To carry out investigation and analysis of an extensive skin radiation injury to the back accidentally caused by interventional procedure and to explore the problems faced in the event with emphasis on avoiding the reoccurance of similar events in the future.Methods:The data were collected by consulting the patient′s detailed medical history, collecting and analyzing clinical diagnosis and treatment data, tracking and observing their clinical manifestations and signs. The patient′s peripheral blood samples were also collected, together with the biological dose estimated and the equipment data collected on the site of the interventional treatment hospital.Results:The whole body dose to the patient was estimated to be 0.95 Gy. The typical values of kerma rate of radiation incident on the body surface due to fluoroscopic procedures were 373.5 mGy/min in subtraction modality and 47.8 mGy/min in fluoroscopy modality, respectively. The annual effective dose to the interventional radiologist was 20.51 mSv due to his operation in long-time radiation exposure conditions, higher than 3.09 mSv for other interventional radiologists with similar workload in the same department. The whole body and local clinical manifestations of the patients were in line with radiation injury. No clear diagnosis has been obtained in several hospitals, nor can obvious treatment outcomes be obsevered.Conclusion:Combined with the biological dose estimation result and clinical manifestations, the case was diagnosed as degree Ⅳ skin radiation injury. Radiation injury is closely related to whether the operation is conducted according to the standard and the output dose of X-ray machine. Non-specialized hospitals should strengthen clinical diagnosis and treatment of radiation injury.

Objective:To explore the clinical value of urine semi-quantitative colorimetry by sodium dithionite reduction method in the diagnosis and treatment of diquat poisoning.Methods:The data of 49 patients with acute diquat poisoning treated in the First Affiliated Hospital of Nanjing Medical University from December 3, 2020 to November 23, 2022 were retrospectively analyzed, the correlation between urine colorimetric results and plasma diquat concentration was observed, and the predictive value of urine colorimetric results for target organ damage and prognosis were evaluated.Results:There was a significant correlation between urine colorimetric results and plasma diquat concentration, the correlation coefficient was r=0.89, P <0.01. The cut-off value of urine colorimetry for the predicting the damage of gastrointestinal tract, liver, kidney, and central nervous system injury were 2.5, 3.5, 3.5, 5.5, respectively; in which the urine colorimetric results showed the highest sensitivity in predicting digestive tract injury [ AUC 0.93 (95% CI:0.89-1.00)]. The cut-off value of urine colorimetry for the prognosis of death was 4.5, the positive predictive value was 64.2%, and the negative predictive value was 95.2%. Conclusions:The urine semi-quantitative method can be used for rapid prediction of the plasma diquat concentration range on admission. The urine colorimetry results can also effectively predict the occurrence of organ injury and clinical outcome related to diquat poisoning, which provides evidence for the clinical diagnosis and therapy.

Objective:To analyze the eye lens dose and annual effective dose to interventional radiation workers in some hospitals of Xinxiang city from 2020 to 2022, and to ascertain the dose to interventional radiation workers.Methods:By using TLDs, the eye lens dose Hp(3) and annual effective dose Hp(10) were monitored for three consecutive years in six hospitals in Xinxiang city. The lens doses and annual effective doses to intervention radiation workers in different years in different-level hospitals and departments were analyzed. Results:From 2020 to 2022, a total of 117 people were monitored. The left eye lens dose range was 0.12-164.24 mSv, and the right eye lens dose range was 0.07-51.64 mSv. The average annual dose was 8.56 mSv for left eye lens and 4.49 mSv for right eye lens The average annual dose distribution in the MDL-5 mSv range for the left and right eye lens was 60.68% and 73.50%, respectively. 9.41% (11 people) of the left eye lens doses exceeded 20 mSv. The annual effective doses range was 0.11-31.27 mSv, with average annual dose of 2.56 mSv. The proportion of average annual effective doses mainly distributed in the range of MDL to 1.25 mSv was 52.14%, with 2.56% annual effective dose exceeding 20 mSv. There was no significant difference in left and right eye lens dose and annual effective dose between the tertiary hospitals and the secondary hospitals in three years ( P>0.05). Compared with different departments, the cumulative per capita dose in three years was statistically significant (left eye H=11.42, right eye H=13.72, annual effective dose H=25.94, P<0.05). The lens dose and annual effective dose in neurology department were lower than those in cardiology department and comprehensive intervention department ( Zcardiology department=-3.33, -3.78, -4.83, P<0.05; Zcomprehensive intervention department=-2.71, -2.63, -4.39, P<0.05). Conclusions:Most of the annual equivalent dose and annual effective dose to eye lens of the interventional radiation workers in Xinxiang city meet the national limits, but some of them have higher doses and exceed the national limits. It is suggested that the routine and continuous monitoring of eye lens doses to interventional radiologists should be strengthened while routine monitoring of annual effective dose, and attention should be paid to the eye lens and annual effective dose to interventional radiologists in secondary hospitals to improve the awareness of protection.

Objective:To evaluate biological dose and retrospective biodosimetry of a case of large area back skin injury caused by suspected interventional procedure.Methods:Peripheral blood from the patient was collected at about 7 months after interventional procedure, and the chromosomal aberrations in peripheral blood cells were analyzed to evaluate the retrospective biodosimetry using the correction factor of dose estimation, Dolphin′s model and Qdr method, respectively. Results:Based on the amounts of semi-automated dic and manually detected dic plus ring, the whole-body average absorbed dose of the victim was estimated to be 0.68-0.95 Gy by four different dose response curves. Over dispersion of dic or dic plus ring was also detected, and the efficiency of dose assessment was obviously increased using dic semi-automatic detection. Based on three different retrospective biodosimetry models, the estimated average absorbed dose was further corrected to be between 1.80-2.86 Gy, which was consistent with clinical diagnosis of degree Ⅳ radiation skin injury.Conclusions:A case of suspected radiation skin injury was confirmed by chromosomal aberration analysis and it’s biodosimetry was reconstructed, suggesting that the unstable chromosomal aberration analysis may be applicable to assess the retrospective biodosimetry of non-uniform local radiation exposure.

With the optimization of surgical technologies and postoperative management regimens, the number of lung transplantation has been significantly increased, which has become an important treatment for patients with end-stage lung disease. However, due to the impact of comprehensive factors, such as bronchial ischemia and immunosuppression, the incidence of airway stenosis after lung transplantation is relatively high, which severely affects postoperative survival and quality of life of lung transplant recipients. In recent years, with the improvement of perioperative management, organ preservation and surgical technologies, the incidence of airway stenosis after lung transplantation has been declined, but it remains at a high level. Early diagnosis and timely intervention play a significant role in enhancing clinical prognosis of patients with airway stenosis. In this article, the general conditions, diagnosis, treatment and prevention of airway stenosis after lung transplantation were reviewed, aiming to provide reference for comprehensive management of airway stenosis after lung transplantation and improving clinical prognosis of lung transplant recipients.