Objective To evaluate the effectiveness of thermal tomography in breast cancer (BC) screening. Methods We conducted a general population-based BC screening in three regions of Hubei Province (Xiantao, Hongan, and Yangxin Districts). Participants underwent a questionnaire-based interview for baseline data collection. They then received a physical examination, thermal tomography, and ultrasound from doctors and technicians. We compared the efficacies, including sensitivity, specificity, and false-positive rates, of ultrasound and thermal tomography in BC screening. Results A total of 59 712 eligible women were included in this screening program. The BI-RADS 1, 2, 3, 4, and 5 accordance rates between the two screening methods were 0.9549, 0.8047, 0.9037, 0.3352, and 0, respectively. The overall accordance rate was 0.933 1. The kappa consistency results showed that the Cicchetti-Allison and Fleiss-Cohen kappa values were 0.7970 and 0.8583, respectively. Although the two methods had equal sensitivities, specificity was higher in thermal tomography than in ultrasound. The false-positive rate was lower in thermal tomography than in ultrasound. The area under the receiver operating characteristic (ROC) curve of thermal tomography was significantly larger than that of ultrasound. Conclusion The general consistency between thermal tomography and ultrasound in BC screening was high. Thermal tomography outperformed ultrasound in terms of specificity and diagnostic efficiency. Therefore, thermal tomography has a high application value for general population-based BC screening.

Objective Based on magnetic resonance imaging(MRI)indexes and clinical characteristics to analyze the factors affecting the curative effect of percutaneous transforaminal endoscopic discectomy(PTED)in patients with lumbar disc herniation(LDH).Methods 302 patients with LDH from December 2019 to May 2022 were included in the study,all of whom received PTED with 1-year follow-up data.Among of them,272 cases had excellent curative effect and were included in the good prognosis group,while 30 cases had reasonable curative effect and were included in the poor prognosis group.General data,MRI indexes and clinical features of the subjects were collected retrospectively.Univariate analysis and multivariate Logistic regression analysis were used to analyze the influencing factors of curative effect in patients with LDH after PTED.Results In 302 cases of LDH,the excellent in 205 cases,good in 67 cases,fair in 30 cases and poor in 0 case,the prognosis rate was 9.93％.Compared with the good prognosis group,the poor prognosis group had higher proportions of smoking,disc degeneration,longer operation time,higher absolute difference in cross-sectional area(CSA)of psoas major and multifidi,and lower intervertebral foramen area,with statistical significance(P＜0.05).There was no significant difference in age,body mass index(BMI),gender,alcohol consumption,diabetes mellitus,hypertension,hyperlipidemia,annulus fibrosus rupture,lesion segment,Lee zone,Modic change,intraoperative blood loss,incision length,surgical approach,and arthroscopic model between the two groups(P＞0.05).The multivariate Logistic analysis showed that:Smoking(OR=4.179,95％CI:1.035～16.865),gradeⅣ disc degeneration(OR=6.863,95％CI:2.049～22.983),the difference of CSA of psoas major＞1.63 cm2(OR=19.084,95％CI:3.566～102.130)and the difference of CSA of multifidi＞1.02 cm2(OR=482.525,95％CI:19.538～12 137.347)were risk factors for poor prognosis of patients with LDH after PTED,the differences were statistically significant(P＜0.05).The intervertebral foramen area＞118.31 mm2(OR=0.750,95％CI:0.721～0.862)was protective factor for poor prognosis of patients with LDH after PTED,and the difference was statistically significant(P＜0.05).Conclusion Smoking,grade Ⅳ intervertebral disc degeneration,greater than 1.63 cm2 absolute difference in psoas major CSA,and greater than 1.02 cm2 absolute difference in multifidi CSA are risk factors for poor prognosis of PTED in LDH patients.Intervertebral foramen area＞118.31 mm2 is a protective factor for poor prognosis of PTED in LDH patients.Clinically,high-risk patients with poor prognosis can be screened and corresponding intervention strategies can be taken.

Objectives:To investigate the clinical value of contrast echocardiography in the detection of right heart space-occupying lesions. Methods:The imaging and clinical data of 39 patients with right heart space-occupying lesions confirmed by surgery,pathology and clinical treatment in Yanbian University Hospital from January 2019 to January 2023 were retrospectively analyzed.All patients underwent contrast echocardiography and cardiac magnetic resonance(CMR)examinations.The contrast echocardiography features of right heart neoplastic from non-neoplastic occupying lesions were summarized.The diagnostic efficacy of contrast echocardiography and CMR in right heart space-occupying lesions was compared. Results:Among the 39 patients,12 patients(30.8%)were confirmed as thrombus and vegetation,6 patients(15.4%)as benign tumors and 21 patients(53.8%)as malignant tumors.There were 8,4,4 and 17 patients of thrombus,vegetation,benign tumor and malignant tumors located in right atrium,respectively.Contrast echocardiography was used to diagnose thrombus and vegetation in 12 patients(30.8%),benign tumors in 5 patients(12.8%),malignant tumors in 22 patients(56.4%).CMR was used to diagnose thrombus and vegetation in 18 patients(46.2%),benign tumors in 5 patients(12.8%),malignant tumors in 16 patients(41.0%).The Kappa coefficient between contrast echocardiography and clinical diagnosis was 0.956(P<0.001).The Kappa coefficient between CMR and clinical diagnosis was 0.754(P<0.001). Conclusions:Contrast echocardiography can dynamically observe the degree of vascularization in the lesion tissue in real-time,accurately distinguishing the nature of the right heart space-occupying lesions.

Objective:To investigate the correlation between hearing loss and microvascular complications in diabetes.Methods:This cross-sectional study conducted the data from 572 patients with diabetes hospitalized in the Endocrinology Department of the General Hospital of Southern Theater Command from September 2022 to July 2023. All participants underwent electrical audiometry and acoustic immittance in the ENY department. Based on the audiometric results, participants were categorized into normal hearing group and hearing loss group. Additionally, 572 non-diabetic patients from the outpatient department were enrolled as the non-diabetic group. The general information and laboratory results were collected and compared using t test, rank sum test or χ2 test. Binary logistic regression analysis was used to evaluate the association of diabetic hearing loss with diabetic kidney disease(DKD), diabetic retinopathy (DR), and diabetic peripheral neuropathy (DPN). Results:Among 572 patients with diabetes, 429 suffered from hearing loss and 143 were normal. χ2 test showed significant differences in combined DKD and DPN between two groups, but not in DR. Multivariate binary logistic regression analysis identified DKD and DPN as risk factors for hearing loss, but no correlation was found with DR. Conclusion:Diabetic patients with DKD or DPN should be monitored for potential hearing loss. Early screening and treatment are crucial to prevent severe hearing impairment.

Objective:To explore the application value of real-time shear wave elastography(SWE)and ultrafast pulse wave velocity(UFPWV)techniques in assessing carotid artery stiffness of patients with gouty arthritis(GA).Methods:A total of 80 GA patients admitted to the First People's Hospital of Yibin from August 2022 to July 2023 were selected as GA group.Among of them,24 cases combined with bone erosion who were confirmed by imaging examination,and 56 cases did not combine with bone erosion.In addition,a total of 40 healthy individuals,who underwent physical examinations in our hospital during the same period,were selected as the healthy control group.SWE and UFPWV were used to detect the maximum,minimum and mean values of Young's modulus values of the vessel wall of common carotid artery,and the pulse wave velocity at the beginning of systole(PWVBS)and pulse wave velocity at the end of systole(PWVES)of the vessel wall of common carotid artery of all subjects,and to assess the hardness of circumferential and longitudinal vessel wall of common carotid artery of them.The differences in Young's modulus values,PWVBS and PWVES between two groups were compared.And then,the correlations between bone erosion and Young's modulus values,PWVBS,PWVES of GA patients were further analyzed.Results:The maximum,minimum,mean values,PWVBS and PWVES in the GA group were respectively(78.80±12.38)kPa,(57.83±7.42)kPa,(67.67±8.38)kPa,(7.06±0.59)m/s and(9.50±0.63)m/s,which were significantly higher than those in the healthy control group(t=11.066,8.216,11.751,14.159,19.118,P＜0.05).The maximum,minimum,mean values,PWVBS and PWVES of GA patients with bone erosion were respectively(82.95±6.37)kPa,(59.59±5.29)kPa,(72.18±7.62)kPa,(7.37±0.43)m/s,(10.43±0.47)m/s,which were significantly higher than those[(77.01±5.32)kPa,(57.08±4.73)kPa,(65.73±4.54)kPa,(6.92±0.39)m/s and(9.10±0.41)m/s]of GA patients without bone erosion,the differences were significant(t=4.309,2.099,4.699,4.586,12.720,P＜0.05).Spearman correlation analysis showed that there was significant correlations between maximum,minimum,mean values,PWVBS,PWVES and the combined bone erosion in GA patients(r=0.602,0.421,0.682,0.647,0.732,P＜0.05).Conclusion:SWE and UFPEV techniques can evaluate the hardness of vascular wall of GA patients,and the hardness of circumferential and longitudinal vessel wall of common carotid artery of GA patient is higher than that of healthy person,and the hardness of circumferential and longitudinal vessel wall of common carotid artery of GA patient with bone erosion is higher.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective:To retrieve, evaluate and integrate the best evidence of blood glucose management in hemodialysis patients with end-stage diabetic kidney disease, so as to provide a basis for clinical evidence-based nursing practice.Methods:BMJ Best Clinical Practice, Cochrane, OVID, Scopus, UpToDate, CNKI, Wanfang Database, Medical Pulse database, and other guideline networks and professional association websites and databases were searched for blood glucose management in hemodialysis patients with end-stage diabetic kidney disease. The search time limit was from the establishment of the database to May 10, 2023.Results:A total of 14 articles were included, including 1 clinical decision, 5 guidelines, 6 systematic reviews, 1 randomized controlled trial, and 1 expert consensus. The best evidences for blood glucose management in hemodialysis patients were summarized, including 8 aspects of pre-dialysis assessment, pre-dialysis blood glucose management, blood glucose management during dialysis, blood glucose management during dialysis interval, diet and nutrition, exercise management, lifestyle intervention and health education, with 25 pieces of evidence.Conclusions:This study summarizes the best evidence of blood glucose management in hemodialysis patients with end-stage diabetic kidney disease, and provides evidence-based basis for clinical practice for medical staff.

BACKGROUND:Red light irradiation and silver ion dressing are mostly used to treat chronic difficult healing wounds clinically,but the optimal irradiation time of red light irradiation and silver ion dressing for chronic non-healing wounds,and the combination of different silver ion dressings have not been determined. OBJECTIVE:To investigate the optimal irradiation time and dressing combination of red light and silver ion dressing in the therapy of chronic non-healing wounds. METHODS:The chronic non-healing wound model was made by applying Staphylococcus aureus on the whole skin defect and subcutaneous hydrocortisone injection in SD rats.72 rat models were randomly divided into 4 groups with 18 rats in each group by random number table method.The rats were treated on the basis of standard dressing change and the following therapy:A1B1 group(red irradiation 20 minutes + lipid hydrocolloidal silver sulfate dressing),A1B2 group(red light irradiation 20 minutes + calcium alginate fiber dressing),A2B1 group(red light irradiation 30 minutes + lipid hydrocolloidal silver sulfate dressing),and A2B2 group(red light irradiation 30 minutes + calcium alginate fiber dressing);change dressing,irradiate once,and change dressing every 24 hours.After 14 days of continuous treatment,wound healing rate,bacterial colony number,inflammatory response,histomorphology and angiogenesis were detected in each group. RESULTS AND CONCLUSION:(1)With the extension of treatment time,the wound healing rate of rats in the four groups was increased,and the wound healing rate of rats in the A2B2 group at 3,7,and 14 days after treatment was higher than that in the other three groups(P<0.05).(2)The wound bacterial culture results on day 7 after treatment demonstrated that the number of bacterial colonies in the A2B2 group was lower than that in the other three groups(P<0.05).Western blot assay exhibited that with the extension of treatment time,the protein expressions of tumor necrosis factor α and interleukin-6 in wound tissue of rats in the four groups were decreased,while the protein expressions of interleukin-10 were increased.The protein expressions of tumor necrosis factor α and interleukin-6 in the A2B2 group were lower than those in the other three groups(P<0.05).The protein expression of interleukin-10 in the A2B2 group was higher than that of the other three groups(P<0.05).(3)The wound hematoxylin-eosin staining on day 14 after treatment demonstrated that a large number of collagen fibers in the A2B2 group were parallel distributed and the most closely connected,which was significantly better than the other three groups.(4)The results of immunofluorescence staining indicated that the fluorescence intensity expression of CD31 in the A2B2 group was higher than that in the A1B1,A1B2 and A2B1 groups(P<0.05).q-PCR detection at 3,7,and 14 days after treatment exhibited that the mRNA expressions of vascular endothelial growth factor a and vascular endothelial growth factor receptor 2 in the A2B2 group were higher than those in the other three groups(P<0.05).Western blot assay at 3,7 and 14 days after treatment revealed that the protein expressions of vascular endothelial growth factor a and vascular endothelial growth factor receptor 2 in the A2B2 group were higher than those in the other three groups(P<0.05).(5)These findings confirm that 30 minutes of red light irradiation combined with silver alginate fiber dressing has better results in treatment of chronic non-healing wounds.

ObjectiveTo determine the antibody levels of varicella-zoster virus （VZV） in healthy individuals aged 1 to 30 years in Songjiang District of Shanghai， and to provide evidence for further development of varicella immunization strategies for healthy population. MethodsSix village committees were selected in Songjiang District through multi-stage stratified random sampling method from July to September 2022. Healthy individuals aged 1 to 30 years old in these villages were recruited and 3‒5 mL of venous blood was collected. Anti-VZV IgG antibody was tested by ELISA. Positive rate of anti-VZV IgG antibody and geometric mean concentration （GMC） were determined. ResultsA total of 315 healthy individuals aged （10.97±8.38） years were included in this study， of which 165 were males aged （11.00±8.52） years and 150 were females aged （10.96±8.25） years. Blood samples were collected and tested for anti-VZV IgG antibody， with the overall positive rate of 55.24% （174/315）. The GMC was calculated to be 99.73 mIU·mL^-1， with the GMC in those tested positive for anti-VZV IgG antibody of 413.11 mIU·mL^-1. The positive rate of anti-VZV IgG antibody and GMCs across age groups ranged between 13.33%‒86.67% and 16.36‒355.14 mIU·mL^-1， respectively. The highest GMC was found in the group of 20‒30 years old （355.14 mIU·mL^-1）， followed by 132.41 mIU·mL^-1 in the group of 5‒ years old and 138.12 mIU·mL^-1 in the group of 15‒ years old. Moreover， the positive rate was 38.47% in the group with 1-dose varicella vaccine and 63.49% in the group with 2 doses， while the GMC were 53.28 mIU·mL^-1 and 130.79 mIU·mL^-1 in these two groups， respectively. Multivariable analysis revealed that occupation was a risk factor associated with anti-VZV IgG antibody （OR=2.540）. Stratified analysis by varicella immunization history showed that among 2-dose vaccination group， time interval since the last dose was a protective factor （OR=0.315）. ConclusionsThe overall positive rate of anti-VZV IgG antibody in healthy population in Songjiang District of Shanghai remains low. The 2-dose varicella vaccination should be strengthened to improve the coverage in susceptible population.

Vaccination is the most economical and effective measure to prevent infectious diseases targeted by vaccines. Despite this， the safety of vaccines has garnered increased attention due to recent vaccine incidents. The tetravalent human papillomavirus vaccine （HPV） is one of the effective means to prevent cervical cancer and in situ adenocarcinoma caused by infection with corresponding serotypes. The inactivated novel coronavirus vaccine is an emergency vaccine developed to prevent novel coronavirus infection after the COVID-19 outbreak， and is also the main measure used to control the spread of COVID-19 at present. The monitoring data show that both vaccines have good safety after inoculation， but due to individual differences and other reasons， rare reactions may occur in a very small number of recipients. This article presents two cases of urticaria vasculitis following inoculation of the tetravalent HPV and the novel corona virus inactivated vaccine.