Objective To process the image of endoscopic uhrasonography(EUS)by digital imaging processing(DIP)and pattem recognition,and to evaluate its efficacy in diagnosis of pancreatic adenocarcinoma.Methods Two hundreds and sixteen patients,who underwent EUS between Feb 2005 and Feb 2007,were randomly recruited to the study.The cohort jncluded 153 cases of pancreatic cancer,which were confirmed by cytological findings after fine-needle aspiration,and 63 cases of non-pancreatic cancer(normal pancreas and chronic panereatitis).The texture features of the EUS image were selected and extracted,and cases were automatically divided into cancer and non-cancer based on findings of support vector machine (SVM).Sensitivity,specificity and accuracy of the technique were calculated.Results From each region of interest(ROI),a total of69 texture features vest in 9 sets were extracted,and 25 features with most set interval were taken as initial.The images of 216 cases were divided randomly into training set(108 eases,76 cancer and 32 non cancer)and testing set(108 cases,77 cancer and 31 non cancer).After 50 times of random tests,the average accuracy,sensitivity and specificity of the diagnosis of pancreatic cancer were (97.98±1.237)%,(94.32±0.0354)%,and(99.45±0.0102)%respectively.Conclusion DIP,combined with computer aided EUS imaging,is an accurate and noninvasive technique in diagnosis of pancreatic cancer.which warrants novel and further researches.

Objective To detect the expression of beta 2 adrenergic receptor in the infantile hemangiomas (IH) tissue and to explore its role in the pathological evolution of infantile hemangiomas as well.Methods 48 cases of infantile hemangioma were divided into two groups.29 cases were in the proliferating period,while the other 19 cases were in non-proliferating period.By using immunofluorescence technology,the endothelial nuclei and beta 2 adrenergic receptor of the IH tissue were marked by fluorescent tags,respectively,in two groups.The location of fluorescent labeling was shown in photos.By using the Image-Pro Plus 6.0 software,we analyzed and compared the average fluorescence intensity of endothelial cell nucleus and beta 2 adrenergic receptors in these two groups.Results Beta 2 adrenergic receptors were widely expressed in IH tissue,especially in endothelial cell nucleus shown in fluorescent images.The average fluorescence intensity of endothelial cell core in proliferating IH group was 0.031 ±0.002,which was much higher than that of fading period IH group (0.022±0.002).There was significant statistical different (P＜0.05).The average fluorescence intensity of beta 2 adrenergic receptor in proliferating IH group was 0.035± 0.003,which was much higher than that of fading period IH group (0.028± 0.002).There was significantly statistical different between the two groups (P＜0.05).Conclusions Beta 2 receptors are widely expressed in the endothelial cells of infantile hemangioma.

Objective To develop and evaluate the digital discrimination system for pancreatic ultrasound endoscopy images. Methods EUS images of 153 pancreatic cancer and 63 non-cancer cases were selected. According to the multi-fractal feature vectors based on the M-band wavelet transform, we acquired the fractal features with lower dimension with the feature screening algorithm. With the optimal feature combination, cases were classified into pancreatic cancer group and non-pancreatic cancer group automatically.Then the sensitivity, specificity and accuracy of this method were calculated, and compared with those of traditional 9 dimension fractal feature vectors. Results Three kinds of multi-fractal dimensions were introduced to the framework of M-band wavelet transform according to the EUS images to form fractal vectors of 18 dimension. With the selection by sequence forward search (SFS) algorithm, 7 dimension of feature vectors were chosen and were combined with bi-order multi-fractal dimension to a better feature combination. The Bayes, support vector machine (SVM) and ModestAdaBoost classifiers were introduced to evaluate the classification efficiency, resulting in a classification accuracy of 97.98% and short running time of 0. 49 s with lower feature dimension. Conclusion These data suggest the feasibility, accuracy, noninvasiveness and efficacy of classification of EUS images to differentiate pancreatic cancer from normal tissue based on the Mband wavelet transform algorithm. It is a new and valuable research area in diagnosis of pancreatic cancer.

Objeetive: To evaluate the imported risk of COVID-19 cases from aboard to Zhejiang Province,so as to provide reference for control strategies. Methods: The epidemic data of COVID-19 in 9 foreign countries（US,UK,Italy,etc.）and Zhejiang Province were collected,as well as the number of entry persons. The imported risk values of COVID-19 cases to 90 counties（cities or districts）of Zhejiang Province and from the 9 countries during March 7th and 30th were calculated and normalized to the imported risk indexes. The imported risk indexes were classified into five levels from high to low according to percentiles. The imported risk of 90 counties（cities or districts）,the developing trend and the source were analyzed. Results : A total of 39 confirmed cases and 24 asymptomatic cases were imported to Zhejiang Province untill March 30th. There were 10,13,22,21 and 24 counties（cities or districts）with high,medium high,medium,medium low and low imported risk,respectively. Qingtian had the highest imported risk（0.43）,followed by Ruian（0.32）and Wencheng（0.29）. The imported risks in 80（88.89%）counties（cities or districts）showed increased trend. The highest imported risk came from Italy（0.51）,followed by US（0.14）and Spain（0.11）. The imported risk in Wenzhou and Lishui mainly came from Italy and Spain,while that in the other areas mainly came from US,Germany and UK. Conclusions The risk of imported COVID-19 cases from aboard to Zhejiang Province showed an upward trend since March. The areas at high and medium high risk lay in southeast Zhejiang and the downtown of Hangzhou. The source of imported risk were maimly from Italy,US and Spain,but varied in counties.

Objective:For severe skin defects which are deep to dermis, engineered skin with epidermis and dermis (bilayered) is required. Based on the success of engineering epidermis with GT/PCL electrospun membranes, our study was to investigate whether this membrane could be also used for engineering bilayered skin graft.Methods:From 2013 to 2019, we first prepared three GT/PCL electrospun membranes with different proportion (70∶30; 50∶50; 30∶70) in our laboratory; the biocompatibility of the membrane was evaluated in vitro by seeding fibroblasts or keratinocytes on the membranes. Then the outcome of GT/PCL membranes repairing skin defects in the nude mouse was investigated.Results:Cell attachment and proliferation were significantly improved with increase of gelatin. Histological analyses showed that bilayered skin engineered with GT/PCL (70∶30) group could form relatively better structure after 3 weeks of cultivation in vitro. Further in vivo transplantation studies revealed that scaffolds were not degraded in all three groups, indicating that these materials were not suitable for engineering bilayered skin although they had good biocompatibility.Conclusions:The higher gelatin membranes possess better biocompatibility. Further in vivo transplantation studies reveal that bilayered skin engineered with GT/PCL membranes is able to repair skin defects in the nude mouse.

Objective:To investigate the current status of professional identity among the clinical medical postgraduates and its correlation with mentoring function and professional competency, so as to provide reference for optimizing the training mode of clinical medicine postgraduates.Methods:A questionnaire survey was conducted among 217 academic and professional full-time postgraduates from Batch 2016 to 2018 majoring in clinical medicine in Peking University Health Science Center in 2019. The contents included four aspects: basic information, preliminary questionnaire of professional identity, mentoring function scale and professional competency. SPSS 26.0 was used for t test, one-way ANOVA, Kruskal-Wallis H test, and Pearson correlation analysis to analyze the status of professional identity and its correlation with professional competency and mentoring function. Results:Both professional and academic clinical medicine postgraduates had high scores of the overall level and four factors, and there was no statistical significance in the scores between the two groups ( P >0.05). There were significant differences in the overall level, behavior and appropriateness of professional identity among different grades of professional postgraduates ( P<0.05). Correlation study showed that the professional identity was significantly positively correlated with the total score of professional competency and mentoring function ( P<0.001). Further interview survey showed that the role of supervisor and employment prospects also played an important role in the elevation of professional identity. Conclusion:The overall degree of professional identity of academic and professional postgraduates is good and closely related to professional competency and mentoring function and for professional postgraduates, the overall level of professional identity of senior students is better. It is suggested that besides focusing on their professional competency, it is necessary to further optimize the employment policy of academic postgraduates and the training of tutors for professional postgraduates.

Objective Starting from the actual numbers of health personnel of tertiary public hospitals of Traditional Chinese Medicine(TCM),to quantitatively analyze the influencing factors on the allocation of human resources and obtain a prediction model.Methods The balanced panel data from 517 Tertiary Public TCM Hospitals in the period of 2011-2020 were collected,and the two-way fixed effects model was used to empirically analyze the impact of scale,demand and other factors on the actual number of health personnel in these hospitals.Result The number of beds is a key factor affecting the human resource allocation of Public TCM Hospitals,and various factors such as de-mand,policy,price,efficiency,and administrative management also have significant impacts on the allocation.The demand for outpatient services,government financial support,and efficiency of resource utilization are all promoting factors,while the increase in human resource prices,income generation efficiency,and administrative manage-ment levels have negative effects.A prediction model is proposed.Conclusion The planning principle of matching bed numbers with human resources allocation is in line with the actual environment.When predicting the total personnel allocation or authorized strength,various factors should also be fully considered,which can provide reference for the formulation of human resource policies in Public TCM Hospitals.

Objective To explore a new method for the treatment of nasal deformity in the middle part of facial cleft.Methods Eight patients with craniofacial cleft midface depression were treated with nasal reconstruction,nasal reconstruction plus pear shaped hole week osteotomy forward,pyriform aperture osteotomy advancement by using the auxiliary week preoperative design and postoperative surgical navigation system,and the preoperative design and postoperative CT data fit was compared.Results All the 8 patients were satisfied with results of the operation.There was no significant difference in CT data between preoperative simulation design and postoperative follow-up.Conclusions The expanded forehead flap in nasal reconstruction surgery has good effect on congenital craniofacial cleft nasal defect,and surgical navigation assisted pyriform hole osteotomy advancement for correction of congenital craniofacial cleft caused by midface depression to achieve a precise osteotomy,has good application value.

Objective:To measure the changes in the orbital and nasal parameters before and after Tessier box osteotomy with primary aesthetic rhinoplasty concurrently with byotogenous costochondral graft.Methods:From 2013 to 2018, 60 hypertelorism patients were treated in our craniofacial center. Correction involved a classic Tessier box osteotomy combined with aesthetic augmentation and reconstruction of the nasal dorsum using a costochondral graft. All patients underwent photographic and tomographic documentation both before and 12 months after surgery. Patients underwent morphometric analysis to document the changes in interorbital distance (IOD) and aesthetic nasal parameters, including the nasal dorsum and alar width, the nasal dorsal height, and the index of nasal apex protrusion versus nasal length.Results:All patients were satisfied with the outcome of the combined orbital and nasal repair. Morphometric analysis indicated that the IOD and aesthetic nasal parameters all improved following surgery. The resorption rate of the costochondral graft was 16-19%, and graft warpage was nearly absent. Although complications so as infection, cerebrospinal fluid leak or hyposomia, no severe or life-threatening complications occurred.Conclusions:Tessier box osteotomy with primary aesthetic rhinoplasty using costochondral grafts has showed to be efficacious in the treatment of patients with hypertelorism.

Objective To evaluate the etiology,therapeutic approaches and prognosis of orbital hypertelorism.Methods Clinical data of 23 cases were summarized with review ot the literature.Results All operations provided satisfactory cosmetic effects.All the patients were followed up for 6 months to 5 years,and no recurrence were observed.Conclusions A good cosmetic effect can be obtained by operation in orbital hypertelorism.The preschool period the best opportunity,and stable effects could be gotten and the psychological development of children has not been influenced.The intracranial and extracranial joint pathway orbit box osteotomy still has drawbacks and requires to be improved.The etiology of gene and molecular aspects need to be explored.