Objective To study the financial inputs into community health School of Medicine and Health Management, TONGJI Medical College of HUAZHONG[service (CHS) institutions by entities of different ownerships, by comparison of their investment, housing and human resources for policy recommendations.Methods Choose 6 cities in the East, Central and West of China through stratified random sampling. Collect data by literature review, in-depth interview, focus group discussion and questionnaire survey. Analyze quantitative data through EPI data 3.02 and SPSS 13.0.Results The institutions owned by the government and hospitals were advantageous in financial investment and housing; institutions under social organizations or individuals were inferior with development supports (P=0.00). Conclusion The community health service principle of government dominance and social involvement should be advocated, with equal opportunities for community service providers of various ownership. Emphasis should be placed on betterment of policies and measures, specific budget subsidy, as well as performance appraisal and service supervision. These measures aim at encouraging non-government providers to play greater role in community health service.

The effects of liraglutide on glucose and lipid metabolism, fibroblast growth factor-21 ( FGF-21 )and its receptors (FGFR) in APoE-/-mice with hypoadiponectinemia were investigated.Hypoadiponectinemia facilitated disturbance in glucose and lipid metabolism and insulin resistance. Compared with the control mice, FGF21 mRNA and protein expressions of liver and adipose tissues as well as plasma FGF-21 level were significantly increased in ApoE-/-mice with hypoadiponectinemia, along with lowered expressions of FGFR1 and β-klotho mRNA in adipose tissues, and expressions of FGFR1-3 and β-klotho mRNA in liver. Liraglutide administration improved glucose and lipid metabolism and insulin resistance, and partially reversed the changes of FGF-21 and its receptors induced by hypoadiponectinemia.

Objective To investigate the preoperative predictive value of clinical-radiomics nomogram on N1-N2 lymph node metastasis in patients with stage Ⅰ to Ⅲ A primary lung adenocarcinoma(PL A).Methods A total of 164 PLA patients were divided into a training set(n=114)and an validation set(n=50).Three logistic regression models were created separately and the predictive efficacy of the model was evaluated using the receiver operating characteristic(ROC)curve and area under the curve(AUC)respectively.The AUC difference between models was tested by the DeLong test.The calibration degree was evaluated by the calibration curve.Decision curve analysis was performed to evaluate the benefits of clinical application.Results The radiomics model consisted of 8 imaging features[Radiomics score(Radscore)].The clinical model was composed of tumor type(central or peripheral)and tumor size.The tumor type,tumor size and Radscore formed the nomogram model.In the training set,the prediction of the nomogram model was more effective(AUC=0.909)than the clinical model(AUC=0.748)and the radiomics model(AUC=0.814),while the differences in AUC were statistically significant(P＜0.05).In the validation set,the prediction of the nomogram model was more effective(AUC=0.875)than the clinical model(AUC=0.682),and the difference in AUC was statistically significant(P＜0.05).The prediction of the nomogram model was also more effective than the radiomics model(AUC=0.799),but the difference in AUC was not statistically significant(P＞0.05).The calibration curve showed that the clinical-radiomics nomogram had a high level of calibration and the decision curve analysis showed good benefits from clinical application.Conclusion The clinical-radiomics nomogram is proven to be more effective than radiomics or clinical factors alone in the preoperative prediction of stage Ⅰ to Ⅲ A PLA N1-N2 lymph node metastasis.

Objective:Using three dimensional magnetic resonance imaging to investigate the differences in velopharyngeal structures and motion between normal resonance adults with repaired cleft palate and without cleft palate, to guide the surgical method of cleft palate repair surgery.Methods:Twelve male adults, including 6 adults with repaired cleft palate (cleft group: age 18-26 years old, average 21.8 years old) and 6 adults without cleft palate (noncleft group: age 19-28 years old, average 23.3 years old) were examined with dynamic and static 3D MRI in midsagittal. 32 velopharyngeal measures including soft palate length, effective soft palate length, pharynx ratio, palate height, levator veli palatini muscle length and thickness were obtained on midsagittal, coronal, and levator veli palatine image plane(oblique coronal image plane)and compared between groups. The correlation test of two times data were carried out by Pearson product-moment correlation coefficient to determine the error size of the measurement result. Two separate sample t-tests was used to compare the two sets of data. Results:All the subjects had no speech abnormalities, and velopharyngeal competence. Two measurements of the r value is 0.789 to 0.925 ( P<0.05), which is twice the measurement error is within the acceptable range. The noncleft group of levator veli palatini muscle form is more fluid, while the cleft group is irregular, the middle line can be observed discontinuous phenomenon, and the levator veli palatini muscle insertion soft palate angle is obviously different. Compared to those without cleft palate, participants with repaired cleft palate had a significantly bigger pharynx wide(23.83±3.48) mm, pharynx deep(29.94±3.52) mm, bone pharynx deep(39.68±3.63) mm, palate length ratio(1.18±0.16), pharynx ratio(0.87±0.91), PVU angle (movement)(105.68±20.54)°, the intravelar segment of the levator veli palatini muscle(13.13±1.00) mm, insertion spacing(13.13±1.00) mm. and the starting angle of the levator muscle(58.0±3.3)°. In contrast, the width of the hard palate(37.5±1.43) mm, soft thicknes(9.48±1.03) mm, soft palate relative extension length (/ts/)(1.09±0.05) mm, the thickness of the levator veli palatini muscle(4.07±0.25) mm, APV angle (movement)(180.51±8.55)° and the starting distance of the levator muscle(52.27±7.08) mm are larger in the normal group, The differences are statistically significant( P<0.05). Conclusions:Measuring the pharyngeal structure with three-dimensional magnetic resonance is feasible, and there are significant differences in the pharynx structure, soft palate and levator veli palatini muscle morphological structure of the adults with repaired cleft palate and without cleft palate. Attention to the anatomical reset of the levator muscle, especially the protection and extension of the the extravelar segment of the levator veli palatini muscle, and the extension of the effective soft palate when the soft flap is separated, should be noted in the early repair of the cleft palate.

Objective:Using three dimensional magnetic resonance imaging to investigate the differences in velopharyngeal structures and motion between normal resonance adults with repaired cleft palate and without cleft palate, to guide the surgical method of cleft palate repair surgery.Methods:Twelve male adults, including 6 adults with repaired cleft palate (cleft group: age 18-26 years old, average 21.8 years old) and 6 adults without cleft palate (noncleft group: age 19-28 years old, average 23.3 years old) were examined with dynamic and static 3D MRI in midsagittal. 32 velopharyngeal measures including soft palate length, effective soft palate length, pharynx ratio, palate height, levator veli palatini muscle length and thickness were obtained on midsagittal, coronal, and levator veli palatine image plane(oblique coronal image plane)and compared between groups. The correlation test of two times data were carried out by Pearson product-moment correlation coefficient to determine the error size of the measurement result. Two separate sample t-tests was used to compare the two sets of data. Results:All the subjects had no speech abnormalities, and velopharyngeal competence. Two measurements of the r value is 0.789 to 0.925 ( P<0.05), which is twice the measurement error is within the acceptable range. The noncleft group of levator veli palatini muscle form is more fluid, while the cleft group is irregular, the middle line can be observed discontinuous phenomenon, and the levator veli palatini muscle insertion soft palate angle is obviously different. Compared to those without cleft palate, participants with repaired cleft palate had a significantly bigger pharynx wide(23.83±3.48) mm, pharynx deep(29.94±3.52) mm, bone pharynx deep(39.68±3.63) mm, palate length ratio(1.18±0.16), pharynx ratio(0.87±0.91), PVU angle (movement)(105.68±20.54)°, the intravelar segment of the levator veli palatini muscle(13.13±1.00) mm, insertion spacing(13.13±1.00) mm. and the starting angle of the levator muscle(58.0±3.3)°. In contrast, the width of the hard palate(37.5±1.43) mm, soft thicknes(9.48±1.03) mm, soft palate relative extension length (/ts/)(1.09±0.05) mm, the thickness of the levator veli palatini muscle(4.07±0.25) mm, APV angle (movement)(180.51±8.55)° and the starting distance of the levator muscle(52.27±7.08) mm are larger in the normal group, The differences are statistically significant( P<0.05). Conclusions:Measuring the pharyngeal structure with three-dimensional magnetic resonance is feasible, and there are significant differences in the pharynx structure, soft palate and levator veli palatini muscle morphological structure of the adults with repaired cleft palate and without cleft palate. Attention to the anatomical reset of the levator muscle, especially the protection and extension of the the extravelar segment of the levator veli palatini muscle, and the extension of the effective soft palate when the soft flap is separated, should be noted in the early repair of the cleft palate.

Objective:To explore the application value of digital three-dimensional(3D) reconstruction technology in the repair of oral and maxillofacial defects with superficial inferior epigastric artery (SIEA) flap.Methods:Twelve cases of oral cancer patients, including 8 males and 4 females; aged (57.4±12.6) years, were selected from the Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Bengbu Medical College from January 2018 to October 2019 and were proposed to repair with SIEA flap. There were 10 cases of squamous cell carcinoma, one case of adenoid cystic carcinoma and 1 case of mucinous epidermal carcinoma. The data were imported into AW4.7 software for post-processing. The left or right dominant donor area was selected to clarify the origin, diameter, alignment, and location of penetration point of the flap blood supply, and digital 3D reconstruction technology was used to guide the flap preoperative design.Results:Eleven cases were repaired by SIEA flap in 12 patients, one case was repaired by superficial iliac artery flap because the source artery was undiscovered, one case had venous vascular crisis after surgery, and the rest of the flap survived. In 11 patients repaired with SIEA flap, there was no significant difference between the preoperative SIEA diameter measured by CTA [(1.0±0.3) mm] and the actual measured value [(1.1±0.3) mm] ( P>0.05). The follow-up was 6 to 12 months, with an average of 10 months, and the donor-receiver areas were all healed in phase Ⅰ. No obvious complications occurred, and the abdominal scar was hidden. Conclusions:In the SIEA flap repair oral and maxillofacial defect reconstruction surgery, the use of digital 3D reconstruction technology can objectively reflect the diameter and the location of the superficial artery of the abdominal wall before surgery, effectively reduce the difficulty and risk of flap surgery.

Objective:To explore the imaging changes of lung lesions in patients with imported COVID-19 when reaching the discharge standard.Methods:The clinical and CT imaging data of 60 cured patients with imported COVID-19 and discharged from January to February 2020 in Anhui Province were retrospectively collected. At the initial diagnosis, 5 cases were mild, 53 were ordinary, and 2 were severe. The clinical characteristics of the patients and the characteristics of chest CT images at discharge were analyzed.Results:Fever (57 cases) and cough (55 cases) were the main symptoms in 60 patients. In 5 mild patients, 3 cases were negative in the whole course of CT examination, 2 cases were negative in the first time and abnormal in the second time. The first CT imaging features of 55 patients (53 common type and 2 severe type) were mainly bilateral lung involvement (51 cases), multiple lesions (33 cases), more common under the pleura (40 cases), and ground glass opacities were the most common (55 cases). The features of chest CT in clinical outcomes were that the ground glass shadow in the lung gradually faded and was completely absorbed (19 cases); the scope of ground glass shadow in the lung expanded and progressed to crazy-paving, consolidation shadow, and the lesion gradually absorbed again followed by fibrous cord shadows (27 cases); ground-glass opacities in the lungs quickly progressed to a consolidation and then slowly absorbed. Most of the lesions were accompanied by more residual fibrous cord shadows (4 cases). In 2 severe patients, the lesions in the lungs were larger ground glass, and a large amount of fibrous foci remained after slow absorption.Conclusions:Chest CT plays an important role in the diagnosis and treatment of imported COVID-19, and the degree of lung involvement seen on CT images is in good agreement with clinical outcome.

FcγRIIB, the only inhibitory IgG Fc receptor, functions to suppress the hyper-activation of immune cells. Numerous studies have illustrated its inhibitory function through the ITIM motif in the cytoplasmic tail of FcγRIIB. However, later studies revealed that in addition to the ITIM, the transmembrane (TM) domain of FcγRIIB is also indispensable for its inhibitory function. Indeed, recent epidemiological studies revealed that a non-synonymous single nucleotide polymorphism (rs1050501) within the TM domain of FcγRIIB, responsible for the I232T substitution, is associated with the susceptibility to systemic lupus erythematosus (SLE). In this review, we will summarize these epidemiological and functional studies of FcγRIIB-I232T in the past few years, and will further discuss the mechanisms accounting for the functional loss of FcγRIIB-I232T. Our review will help the reader gain a deeper understanding of the importance of the TM domain in mediating the inhibitory function of FcγRIIB and may provide insights to a new therapeutic target for the associated diseases.
Autoimmune Diseases ; drug therapy ; genetics ; immunology ; Humans ; Protein Domains ; Receptors, IgG ; chemistry ; immunology

Objective: To explore the imaging changes of lung lesions in patients with imported COVID-19 patients when reaching the discharge standard. Method: The clinical and CT imaging data of 60 patients with imported COVID-19 cured and discharged from January to February 2020 in Anhui Province were retrospectively collected. The clinical characteristics of the patients and the characteristics of chest CT images at discharge were analyzed. Results: Fever (57 cases) and cough (55 cases) were the main symptoms in 60 patients. At the initial diagnosis, 5 cases were mild, 53 were ordinary, and 2 were severe. In 5 light patients, 3 cases were negative in the whole course of CT examination, 2 cases were negative in the first time and abnormal in the second time. . The first CT imaging features of 55 patients (53 common type and 2 severe type)were mainly bilateral lung involvement (51 cases), multiple lesions (33 cases), more common under the pleura (40 cases), and ground glass opacities were the most common. (55 cases). The clinical features of chest CT in clinical outcomes are that the ground glass shadow in the lung gradually fades and was completely absorbed (19 cases); the scope of ground glass shadow in the lung expanded and progressed to crazy-paving, consolidation shadow, and the lesion gradually absorbs again followed by Fibrous cord shadows (27 cases); ground-glass opacities in the lungs quickly progressed to a consolidation and then slowly absorbed . Most of the lesions were accompanied by more residual fibrous cord shadows (4 cases). In 2 severe patients, the lesions in the lungs were larger ground glass, and a big amount of fibrous foci remained after slowly absorption. Conclusion Chest CT plays an important role in the diagnosis and treatment of imported COVID-19, and the degree of lung involvement seen on CT images is in good agreement with clinical outcome.

Objective:To study the diagnostic value of artificial intelligence B-ultrasound image computer-aided diagnosis system (hereinafter referred to as intelligent ultrasound system) in adult goiter.Methods:In June 2022 and March 2023, two phases of thyroid disease survey were carried out in 4 cities in Anhui Province. One village was selected in each city, and 250 adults were selected as survey subjects in each village. Adult bilateral thyroid area was scanned by both intelligent ultrasound system and conventional ultrasound scanning equipment, and the effectiveness of intelligent ultrasound system in the diagnosis of goiter was analyzed based on the results of conventional ultrasound examination. Receiver operating characteristic (ROC) curve was drawn, and Kappa test was used to analyze the consistency between intelligent ultrasound system and conventional ultrasound examination in the diagnosis of goiter. At the same time, Spearman correlation analysis and Bland-Altman method were used to evaluate the consistency of the two methods in measuring thyroid volume.Results:After screening and removing outliers and missing values, a total of 910 adults were included, including 253 males (27.80%) and 657 females (72.20%). The age was (45.92 ± 10.20) years old, ranging from 18 to 60 years old. The sensitivity, specificity, and accuracy of the intelligent ultrasound system for diagnosing adult goiter were 80.00%, 99.67%, and 99.56%, respectively. The area under the ROC curve (AUC) was 0.996, which was consistent with the results of conventional ultrasound examination for diagnosing goiter ( κ = 0.67, P < 0.001). After controlling for variables such as gender, thyroid function, and thyroid nodules, the intelligent ultrasound system showed good consistency with conventional ultrasound examination in the diagnosis of goiter in females, adults with thyroid dysfunction, and adults without thyroid nodules ( κ = 0.66, 0.80, 0.80, P < 0.001). The consistency in the diagnosis of goiter in adults with thyroid nodules was moderate ( κ = 0.56, P < 0.001). Spearman correlation analysis showed a highly positive correlation between the measurement results of adult thyroid volume by intelligent ultrasound system and conventional ultrasound examination ( r = 0.88, P < 0.001). The Bland-Altman method results showed that only 4.62% (42/910) of points in adults were outside the 95% consistency limit, indicating good consistency between intelligent ultrasound system and conventional ultrasound examination in measuring thyroid volume (< 5%). The proportion of points outside the 95% consistency limit in males, adults with thyroid dysfunction, and adults with thyroid nodules was 6.72% (17/253), 5.83% (12/206), and 6.45% (12/186), respectively. Conclusions:The intelligent ultrasound system has certain diagnostic value for adult goiter and has good consistency with conventional ultrasound examination for thyroid volume measurement. However, the accuracy of diagnosis for males and adults with thyroid nodules still needs to be improved.