Objective To explore the value of ultrasound artificial intelligence(AI)in assisting naval grassroots doctors for the diagnosis of thyroid nodule in naval.Methods A total of 177 patients with thyroid nodules(200 thyroid nodules)who visited The First Affiliated Hospital of Naval Medical University from November 2020 to November 2023 were selected as research objects.The thyroid nodules were diagnosed by naval grassroots doctors,naval grassroots doctors assisted by AI,and senior doctors,respectively.Results The pathological results showed that there were 110 malignant nodules and 90 benign nodules.The diagnostic accuracy rate of AI-assisted group(85.0%)was similar to that of senior doctor group(87.0%),which were higher than that of naval grassroots doctor group(71.5%).Pathological results were taken as the gold standard,Kappa consistency test was carried out,and the area under the receiver operating characteristic(ROC)curve(AUC)was compared among groups.The diagnostic results of naval grassroots doctor group had a moderate consistency with pathological results(Kappa value was 0.424,P<0.001).The diagnostic results of AI group and senior doctor group had strong consistencies with pathological results(Kappa values were 0.693 and 0.735,respectively,both P<0.001).There was no significant difference in the AUC between AI group and senior doctor group(0.842 vs.0.864,P>0.05).However,there was a significant difference in the AUC between naval grassroots doctor group and AI group(0.712 vs.0.842,P<0.001).Conclusion AI can assist naval grassroots doctors in improving the diagnostic level of thyroid nodules.It has certain application prospects in naval forces.

Objective To study the application value of musculoskeletal ultrasonic examination and treatment in the overseas medical service task of"Mission Harmony-2023".Methods The data of 202 overseas patients and officers and soldiers on hospital ship who had indications and underwent musculoskeletal ultrasonic examination and ultrasound guided interventional treatment were analyzed.The measures to better carry out this work in the future was explored.Results There were 202 individuals who underwent musculoskeletal ultrasonic examination,and positive results were obtained in 131 individuals.Among overseas patients,the incidence of knee diseases was the highest(50.96%);among hospital ship officers and soldiers,the incidence of knee diseases was the highest(51.85%).Four patients underwent ultrasound guided musculoskeletal injection therapy,with an average treatment time of(18.60±5.19)min,preoperative visual analogue scale(VAS)pain score of(7.45±1.02),postoperative VAS pain score of(2.70±0.68),and postoperative observation time of 30 min.Conclusion Musculoskeletal ultrasound examination has strong practicality,not only can it effectively diagnose musculoskeletal system diseases,but also guide precise treatment,making it worthy of promotion and use in future"Mission Harmony".

Objective To establish and verify the fluctuation of reference intervals for biochestry parameters in routine physical exami-nation. Methods The results of biochemistry parameters,i.e., total protein (TP), albumin (Alb), total bilirubin (T-Bil), alanine aminotransferase (ALT), glucose (Glu), urea (Urea), creatinine (Cr), uric acid (UA), triacylglycerol (TG) and total cholesterol ( TC) from 2 089 healthy subjects in routine physical examination during consecutive 2014, 2015 and 2016 were randomly collected, in which all the results were within the reference range. The ratio (λ1) of the results of 2015 to those of 2014, and ratio (λ2) of the re-sults of 2016 to those of 2015 were calculated. λ1was analyzed statistically to establish the fluctuation of reference interval (CIλ). CIλ was verified by λ2.The personalized reference interval (CIp) was established by multiplying each result of 2015 and the upper and low-er limits of CIλ. The CIpwas verified by the results of 2016. The ratios of CIpto the upper and lower limits of conventional reference in-terval were calculated. Results The values of CIλwere as follows: TP: 0.91 to 1.08, Alb: 0.91 to 1.08, T-Bil: 0.58 to 1.74, ALT:0.49 to 1.99, Glu: 0.84 to 1.20, Urea: 0.67 to 1.50, Cr: 0.82 to 1.22, UA: 0.77 to 1.32, TG: 0.51 to 1.98 and TC: 0.80 to 1.26. Compared with conventional reference interval, the ratio of the upper and lower limits of CIp was lessened. Conclusion The personal-ized reference interval (CIp) which may increase the sensitivity of conventional reference intervals was established and verified.

Objective:To study the relationship between IL-1β and TNFα expression and cell apoptosis in gingival tissue of the subjects with diabetes associated periodontitis(DAP).Methods:20 cases of DAP(group DAP) and 20 cases of health controls(group H)were included.The cell apoptosis and the ultrastructural changes in gingival tissue were observed by Tunnel staining and transmission electron microscope (TEM).IL-1β and TNFα expression in gingival tissue were detected by immunohistochemical staining.SBI,GI,PD and AL of the subjects were measured.The relationship between the level of IL-1β,TNFα and the cell appotosis was analyzed.Results:Apoptosis was obvious in prickle cells and basal cells of gingival tissue of DAP group.The percentage of apoptosis cells of DAP group was significantly higher than that of group H(P＜0.01).The expression of IL-1β and TNFα in group DAP was significant higher than that of group H (P＜0.01),and the mainly positive expression cells were macrophages,plasmocytes and lymphocytes.Conclusion:IL-1β and TNFα play a role in cell apoptosis in the gingival tissue of the patients with DAP.

Objective To establish and verify the personalized reference interval of blood cells.Methods The results of blood cells from 2 089 health subjects in 2014,2015 and 2016 were collected.The ratio of the later results to the previous results was defined as the fluctuation (λ).The ratio (λ1) of the results of 2015 to the results of 2014 was calculated and λ1 was analyzed statistically to establish the fluctuation reference interval (CIλ).The ratio (λ2) of the results of 2016 to the results of 2015 was calculated.λ2 was used to verify λ2.The personalized reference interval (CIp) was established by multiplying each result of 2015 and CIλ.CIp was verified by results of 2016.The ratio of the upper and lower limits of CIp was calculated.The ratio of the upper and lower limits of the reference interval (WS/T 405) was calculated.Results The values of CIλ were as follows:WBC (0.66 to 1.53),L(0.67 to 1.51),M (0.50 to 2.00),N(0.56 to 1.78),E(0.4 to 2.51),PLT(0.76 to 1.32),RBC(0.92 to 1.12),Hb(0.92 to 1.11),Hct(0.91 to 1.12),MCV(0.95 to 1.07),MCH(0.95 to 1.05)and MCHC(0.94 to 1.06).The validation tests of CIλ and CIp showed that both CIλ and CIp were suitable for this laboratory.Compared with the reference interval of professional criteria,the ratio of the upper and lower limits of the CIp was smaller than that of traditional criteria.Conclusion CIp for this laboratory was established and verified.Compared with traditional criteria,CIp should be more personalized and highly sensitive.

Objective To find frontal lobe-amygdala functional connections in different age paragraph female patients with bipolar disorder. Methods The FMRI date were acquired from 30 patients with bipolar disorder aged 13 to 25 years old and 30 age-and education level-and gender-matched health controls.FMRI was also conducted on 30 patients with bipolar disorder aged 26 to 45 years old and 30 age-and education level-and gender-matched health controls.The date was calculated by using MATLAB based DPARSF software. Results Compared with corresponding health controls, the lobe-amygdala functional connections significantly decreased in patients aged 13 to 25 years but remained unchanged in patients aged 26 to 45 years old. Conclusions The decrease in the frontal lobe-amygdala functional connections decreased in female patients aged 13 to 25 years old may be related to the underdevelopment in vulnerable immature brain.In contrast, the frontal lobe-amygdala functional connections in female patients aged 26 to 45 years old remain intact.

Objective To investigate the diagnostic value of serum LP ( a) and C-reactive protein ( CRP) in patients with ca-rotid atherosclerosis vulnerable plaque .Methods One hundred and twenty-eight patients with acute cerebral infarction coupled with carotid atherosclerosis were selected for the study , and they were divided into the vulnerable plaque group (90 cases) and the stable plaque group(38 cases) in accordance with the detection results from color Doppler ultrasonorgraphy .Then, the levels of LP(a) and CRP in the two groups were measured .Results The levels of LP(a) and CRP in the vulnerable plaque group were significantly higher than those in the stable plaque group , and statistical significance could be seen , when comparisons were made between the 2 groups ( P<0.01).Conclusion The higher levels of LP(a) and CRP might indicate that there was probably a transfer from the stable plaque to the vulnerable plaque .

Objective To explore the similarities and differences in amplitude of low frequency fluctuation ( ALLF) between patients with first-episode drug-naive schizophrenia and offspring of schizophrenia patients.Methods ALFF values were estimated by measuring the Blood Oxygen Level-Dependent ( BOLD) signal using resting state function-al magnetic resonance imaging ( rs-fMRI) .The fMRI date were acquired from 23 patients with first-episode drug-naive schizophrenia (SZ), 25 offsprings of schizophrenia patients (OS) and 29 age -and gender -matched health controls ( HC) .The ALFF value of each subject was calculated by MATLAB-based DPARSF software.Results Compared with HC, the ALFF values of SZ and OS were significantly different in the left posterior part of the inferior temporal gyrus, left parahippocampal gyrus, left hippocampus, right postcentral gyrus and bilateral precuneus.The ALFF values were not signif-icantly different between these two groups in the aforementioned regions.Compared with OS and HC, the ALFF values of SZ were significantly different in the left anterior part of the inferior temporal gyrus, left temporal pole and bilateral calcarine cortex.But there was no significant difference between OS and HC.Conclusions The brain function is abnormal in pa-tients with early schizophrenia and offspring of schizophrenia patients.The significant difference of ALFF in the left posterior part of the inferior temporal gyrus, left parahippocampal gyrus, left hippocampus, right postcentral gyrus and bilateral pre-cuneus may suggest the heredodiathesis-related brain functional alterations.Significant difference of ALFF in the left ante-rior part of the inferior temporal gyrus and the left temporal pole bilateral calcarine cortex may suggest the disease-related brain alterations.

Objective To investigate the effect of blood-bag placement mode in the refrigerator on the expression of adherent molecules in the preservation of human erythrocytes onboard the ship.Methods On the first day of deployment to sea, 4 blood samples were collected from 4 healthy volunteers.Erythrocyte suspension was equally aliquoted into four portions, one as the control group was placed vertically in the refrigerator of the hospital and the other three as the experiment group were preserved in the same refrigerator on-board the ship in 3 different placement modes ( the layer-upon-layer mode, the upright mode and the vertical suspension mode) .After completion of the training, the preserved samples were immediately sent to the laboratory for the detection of the expressions of CD47, CD58, and CD44.Results The expression levels of CD44 and CD47 in the erythrocytes of whole blood placed on the shipboard refrig-erator were significantly higher, as compared with those of the control group in the hospital.The expression levels of CD58 in the eryth-rocytes placed in the layer-upon-layer mode decreased significantly.Conclusion From the aspect of the expression of erythrocyte, the upright placement mode was most suitable for the preservation of blood in the shipboard refrigerator.

Objective To evaluate and analyze the performance of Mindray BC-5D hematological control materials.Methods First, uniformity and stability tests were performed by using the Mindray BC5300 hematological analyzer.Then, the Mindray BC5300 hematological analyzer and the Coulter LH780 hematological analyzer were used simultaneously for the detection of Mindray BC-5D.The Coulter 5C hematological control materials and the domestic analyzer were used and replaced with new batches every month, to detect hematological control materials once for a succession of 6 months.Finally, the stability of the 3 hematological control materials from the 6 batches was compared accordingly.Results The uniformity of Mindray BC-5D hematological control materials met the na-tional requirements of the Pharmaceutical Industry Standards of the People′s Republic of China for whole blood quality control materials. Within the 90-day expiry date as specified by the manufacturer, no statistical significance could be seen in the short-term stability, mid-term stability and long-term stability, when comparisons were made between them(P>0.05).Therefore it conformed to the 14-day sta-bility requirements as declared by the manufacturer, once it was opened.The results of comparison for the stability of the 3 brands of hematological control materials were that the stability of Mindray BC-5D hematological control materials was similar to the Coulter 5C he-matological control materials, but was obviously superior to the control materials by the domestic analyzer.Conclusion The perform-ance of Mindray BC-5D hematological control materials was of better quality, more economical and had better clinical efficacy, which was worth further clinical extension.