Objective To evaluate the clinical characteristics of human immunodeficiency virus (HIV) infected patients with peripheral lung masses (PLMs), and to assess the diagnostic utility of contrast-enhanced ultrasound (CEUS) in differentiating benign and malignant PLMs. Methods A retrospective analysis was performed on the clinical data of 69 patients with PLM treated in Shanghai Public Health Clinical Center from January 2020 to December 2023. All patients underwent percutaneous biopsy, and were categorized into benign group (n＝36) and malignant group (n＝33). 25 patients were HIV-positive and 44 patients were HIV-negative. The clinical features and CEUS parameters in patients were compared across these groups. Results Patients with malignant masses were significantly older than those with benign masses (P＜0.05). In the malignant group, HIV-negative patients exhibited significantly larger tumor diameters compared to HIV-positive patients (P＜0.05); in the HIV-positive patients, no significant difference in tumor size was observed between benign and malignant masses. 19 patients underwent CEUS. 10 malignant masses, irrespective of HIV status (10 positive and 9 negative), commonly presented with indistinct margins, delayed enhancement, heterogeneous perfusion, and delayed peak enhancement on CEUS. 9 benign masses showed earlier peak enhancement compared to 10 malignant masses (P＜0.05); no significant differences were observed in the initiation and washout time of enhancement between benign and malignant masses. In HIV-positive patients, 5 benign masses frequently demonstrated discrepancies between CEUS findings and pathological results. Conclusions The clinical and CEUS characteristics were different between benign and malignant PLMs. However, CEUS shows limited accuracy in distinguishing benign and malignant PLMs, underscoring the need for pathological confirmation.

China prospective multicenter birth cohort (Prospective Omics Health Atlas birth cohort, POHA birth cohort) study was officially launched in 2022. This study, in collaboration with 12 participating units, aims to establish a high-quality, multidimensional cohort comprising 20 000 naturally conceived families and assisted reproductive families. The study involves long-term follow-up of parents and offspring, with corresponding biological samples collected at key time points. Through multi-omics testing and analysis, the study aims to conduct multi-omics big data research across the entire maternal and infant life cycle. The goal is to identify new biomarkers for maternal and infant diseases and provide scientific evidence for risk prediction related to maternal diseases and neonatal health.

Objective:To discuss the correlation of serum 25-hydroxyvitamin D3[25(OH)D3] with chronic inflammation and insulin resistance (IR) in polycystic ovarian syndrome (PCOS) patients.Methods:One hundred and twenty-four PCOS patients registered from January 2018 to January 2020 in the Second Affiliated Hospital of Hebei North University were selected retrospectively. According to the difference of body mass index (BMI), the patients were divided into PCOS 1 group (BMI<25 kg/m 2, 64 cases) and PCOS 2 group (BMI≥25 kg/m 2, 60 cases). At the same time, 60 patients with simple obesity were selected as the obesity group and 58 healthy subjects were selected as the control group. The somatology indicators, gonadal hormone, serum 25(OH)D3, insulin resistance (IR) related index and chronic inflammation factors were measured, the correlations of serum 25(OH)D3 with relevant indicators were analyzed by Pearson correlation analysis. Results:The BMI, waist hip ratio, testosterone(T), luteinizing hormone (LH) / follicle-stimulating hormone (FSH), free androgen index(FAI), fasting insulin (FINS), fasting plasma glucose (FPG), insulin resistance index (HOMA-IR), insulin sensitivity index (ISI) in the four groups had significant differences ( P<0.05); the level of 25(OH)D3 in the PCOS 1 group was lower than that in the PCOS 2 group: (1.14 ± 0.36) nmol/L vs. (1.83 ± 0.25) nmol/L, P<0.05; the levels of FINS, HOMA-IR in the PCOS 2 group were higher than those in the PCOS 1 group, obesity group and control group: (13.26 ± 2.61) mg/L vs. (5.58 ± 1.03), (6.63 ± 1.42), (4.66 ± 0.85) mg/L, 1.49 ± 0.37 vs. 1.15 ± 0.20, 1.12 ± 0.22, 0.96 ± 0.11, P<0.05; the level of ISI in the PCOS 2 group was lower than that in the PCOS1 group, obesity group and control group: - 4.19 ± 0.78 vs. - 3.52 ± 0.74, - 3.23 ± 0.53, - 3.06 ± 0.54, P<0.05. The levels of interleukin-6(IL-6), transforming growth factor-β(TGF-β), tumor necrosis factor-α(TNF-α) in the four groups had significant differences ( P<0.05); the level of IL-6 in the PCOS 2 group was higher than that in the PCOS 1 group: (18.15 ± 4.93) ng/L vs. (14.77 ± 4.58) ng/L, P<0.05. The results of Pearson correlation analysis showed that the serum of 25(OH)D3 had negative correlation with IL-6, BMI, waist hip ratio, T, FINS, ISI, TGF-β and TNF-α( r = - 0.582, - 0.242, - 0.371, - 0.203, - 0.208, - 0.267, - 0.723, - 0.617, P<0.05). Conclusions:Serum 25(OH)D3 is correlated with chronic inflammation and IR, and involved into the genesis and progression of PCOS.

The paper sorts out and analyzes papers on medical English teaching and research published in core periodicals of China. The results show that there are various problems: slow research progress, insufficient empirical studies, a shortage of research on teachers and students, a lack of young faculty members and insufficient international perspective. With the increasing requirement for medical students' higher language proficiency imposed by the development of higher medical education in China, this paper puts forward some suggestions based on the analysis of the past ten-year data on medical English teaching and research: to build stronger medical English teaching faculty and to enhance their research competence by means of improving, enlarging and cooperating; to intensify the research into the two subjects in the teaching process: medical English teachers and medical students; and to avoid depending too heavily on questionnaire survey and employ multiple research methods and collect effective data in order to fundamentally improve medical English teaching and research.

Objective:To analyze the research hotspot and frontier of severe coronavirus disease 2019 (COVID-19) in China and abroad.Methods:The CiteSpace software was used to visually analyze the relevant research of severe COVID-19 published by CNKI and Web of Science databases from January 30th to April 20th in 2020. The analysis content included the author of the literature, the publishing institutions, and high-frequency keywords.Results:There were 389 Chinese literatures and 59 English literatures included. Analysis using CiteSpace software showed that there were four large teams in China currently concerning about the research on severe COVID-19. The co-authoring of each team was relatively close, but the teams were lack of cooperation. The main issuing institutions were affiliated hospitals of colleges and universities, but colleges and enterprises had less participation. The authors of English-language publications mainly had five research teams, some of whom had co-authored relationships. The country with the most enormous volume of English-language publications was China, followed by the United States and Canada. The Chinese keyword co-occurrence, clustering and highlighted words analysis showed that the main research areas of severe COVID-19 included clinical features, traditional Chinese medicine treatment, medical imaging, integrated traditional Chinese and Western medicine treatment and so on; nucleic acid detection, clinical features and diagnosis, plague theory and etiology mechanism, traditional Chinese medicine and integrated Chinese and Western medicine treatment, severe COVID-19 combined with diabetes and prognosis research will become future research trends; keyword cluster analysis showed that severe COVID-19, combined chronic underlying diseases, CT imaging characteristics will also become new trends in the field of research. Co-occurrence analysis of keywords in English literatures showed that the main research areas of severe COVID-19 included the names of novel coronavirus, pandemic diseases, infectious diseases, medical supplies distribution, and indicators related to myocardial damage.Conclusions:Researchers in China and abroad have different concerns about severe COVID-19. Domestic research focuses on the diagnosis and treatment of severe cases, while foreign countries attach importance to epidemic response and prevention.

Objective To explore the differences of patient comfort and nursing workload between ultrasound guidance on upper arm placement of PICC and traditional placement of PICC, and to provide a reference for correct selection of catheter way. Methods Using a nonrandomized controlled study, a total of 1 116 patients were divided into the control group and the observation group, patients with traditional placement of PICC were set as the control group, and the patients with upper arm placement of PICC were named as the observation group. The patient comfort and workload of use and maintenance of PICC by nurses were compared between two groups. Results The incidence of catheter sliding out of PICC in the observation group was 1.9%(7/365), obviously higher than that of the control group, which was 0.3%(2/751), the difference was significant (χ2=8.37,P=0.007). The patient comfort had no statistical significance between two groups (t=2.13,P=0.082). The workload of use and maintenance of PICC in the observation group were (1.87±0.31) min and (9.16±1.07) min ,which were obviously higher than that of the control group [(0.85±0.16) min and(7.22±2.13) min] in winter (t=4.39, P=0.022;t=3.44, P=0.041), but there was no statistical significance between two groups in summer (P>0.05). Conclusions The workload of use and maintenance of PICC on upper arm placement was higher than traditional placement of PICC in winter, but the obvious differences of patient comfort and nursing workload in summer between the two PICC groups were not been found.

This study was aimed to optimize dihydromyricetin liposome formulations by orthogonal design in order to study its characterization. Dihydromyricetin liposomes were prepared with thin-film ultrasonic dispersion technology. Formulations of dihydromyricetin liposomes were optimized with entrapment efficiency as the optimized index. The formulation and technology were evaluated by the single factor. Based on this, orthogonal design was made on the screening and optimization of dihydromyricetin liposome. Its morphology was observed by transmission electron micro-scope. Its in vitro drug-release behavior was studied by equilibrium dialysis. The preliminary stability was studied. The results showed that the optimized formulation and technology of dihydromyricetin liposome was when the molar ratio of lecithin and cholesterol was 1:1, the dosage of dihydromyricetin was 4.0 mg. The pH of PBS was 5.0, ultra-sonic time was 3 min. The encapsulation efficiency of dihydromyricetin liposome was 58.1%. Its morphology was small spherical or nearly spherical vesicle with observation in transmission electron microscope. It showed that the in vitro release of dihydromyricetin liposome arrived 76.29% in 48 h. The drug content was still 96.57% of dosage for 30 days at 4oC in the dark place. It was concluded that the optimized formulation and preparation technology of di-hydromyricetin liposome were simple, replicable and stable.

Objective To investigate the impact of delineator and delineating criteria on the target delineation of the peripheral lung cancer based on four-dimensional computed tomography (4D-CT).Methods The 4D simulation CT images of twelve patients with peripheral lung cancer were selected.Before and after the establishment of the target delineation criteria,six radiation oncologists were asked to delineate the targets based on 4D-CT images at the end-inhalation phase (0％),end-exhalation phase (50％),and three-dimensional computed tomography (3D-CT) images respectively.The delineated targets were denominated as GTV0,GTV50,GTV3D.IGTVIN+Ex was created by combining GTV0 and GTV50.IGTVMIP was delineated based on the maximum intensity projection (MIP) of 4D-CT.The interand intra-observer variability before and after the establishment of the delineation criteria was compared.Results The mean coefficients of variation of GTV0,GTV50,GTV3D,IGTVMIP and IGTVIN+Ex delineated by the six delineators before and after the establishment of the delineation criteria were 0.50 ± 0.25 vs 0.24 ±0.10,0.52 ±0.38 vs 0.26 ±0.12,0.45 ±0.19 vs 0.20 ±0.07,0.54 ±0.27 vs 0.23 ±0.09 and 0.44±0.23 vs 0.26 ±0.09,respectively.The differences were statistically significant(t =3.38,2.44,3.60,4.20,3.11,P ＜ 0.05).No statistically significant difference was found in the volume of the same target for GTV0,GTV50,GTV3D,IGTVMIP and IGTVIN+Ex delineated by the six oncologists before and after the establishment of the delineation criteria.For delineator 3 and 6,the differences of GTV0,GTV50,IGTVIN+EX before and after establishment of the delineation criteria were statistically significant(t =2.46,2.91,3.28,P ＜0.05 ;t =2.40,2.79,3.22,P ＜0.05).For delineator 4,the differences of GTV0,GTV50,IGTVIN+EX,IGTVMIP,GTV3D before and after establishment of the delineation criteria were statistically significant (t =2.70,3.21,3.04,3.99,3.00,P ＜ 0.05).Conclusions The unified delineation criteria can significantly reduce the inter-observer variability in delineating the GTVs based on 3D-CT or 4D-CT images,and in delineating the IGTVMIP based on 4D-CT images of peripheral lung cancer patients.However,regarding the same delineator,various influences of the unified delineation criteria on the target delineation are observed.

Objective To investigate the expression and clinical significance of lipoxin A4,leukotrienc C4,lipoxygenase-5 in peripheral blood of pregnant women with different types of severe preeclampsia.Methods Forty-five singleton pregnant women who accepted antenatal care and delivered in First Affiliated Hospital of Wenzhou Medical College were enrolled in this study from December 2010 to June 2011.All objects were divided into normal pregnancy group (n=20),early onset severe preeclampsia group (n=10) and late onset severe preeclampsia group (n=15).Enzymelinked immunosorbent assay was used to detect lipoxin A4 and leukotriene C4 levels in peripheral blood.The level of lipoxygenase-5 mRNA in white blood cells was detected by real time fluorescence quantitative reverse transcription-polymerase chain reaction.The differences of lipoxin A4,leukotriene C4 and lipoxygenase-5 mRNA among groups were compared by analysis of variance and LSD-t test;and correlations among their expressions were analyzed by linear regression.Results Lipoxin A4 level in early and late onset severe preeclampsia group was (355.3±116.0) pg/ml and (389.7±117.5) pg/ml,which were both significantly lower than that in normal pregnancy group [(555.0±139.8) pg/ml] (t=-4.03 and-3.77,P＜0.05 respectively).The leukotriene C4 level in early and lateonset severe preeclampsia and normal pregnaney group was (591.3±185.5) pg/ml,(510.3±197.1) pg/ml and (496.9 ± 158.8) pg/ml,no statistical difference were found (F=0.889,P＞0.05) ; neither did the expression of lipoxygenase 5 mRNA,which was 4.2± 1.9 in normal pregnancy group,4.8 ± 2.0 in early onset severe preeclampsia group and 4.4 ± 1.2 in late onset severe preeclampsia group (F=0.311,P＞0.05).There was no correlation among the levels of lipoxin A4,leukotriene C4 and lipoxygenase-5 mRNA in each group (P ＞ 0.05).Conclusions Early and remarkable decreasing of lipoxin A4 level might contribute to the development of early onset severe preeclampsia.

AIM　To investigate the effect of frozen recombinant staphylokinase on the hemostatic and fibrinolytic systems in healthy volunteers, in order to obtain reliable evidence for the possibility of further clinical application. METHOD　r-Sak had been taken intravenously by 20 cases of healthy volunteers in different dosages (1 mg, 2.5 mg, 5 mg, 10 mg, 15 mg). The clinical hemorrhagic manifestations were observed and a set of hemostatic tests(BT, BPC, ATPP, PT, TT, Fg) and fibrinolytic tests (PL∶A,α2-PI∶A, FDP, D-D) monitored before and after injection.　RESULT　Four of 20 volunteers showed slight hemorrhagic tendency on mucocutaneous area (3/4 from gingivea and 2/4 at the sites of injection). It stopped spontaneously. None of them showed visceral bleeding. There were no significant changes in hemorrhagic and coagulative phases. Only 4 of them showed slight abnormal changes in D-D. It was supported that r-Sak was a highly selective fibrirolytic agent without significant influence in human hemostatic and coagulatic system. CONCLUSION　The specific ranges of doseges, r-Sak is a relatively safe and well tolerated agent for healthy people. Further clinical study is still needed for the suitable dosage for clinical application.