Medical imaging technology plays a crucial role in clinical diagnosis and treatment. Image compression technology provides robust technical support for the storage and transmission of massive medical imaging data, serving as an effective safeguard for hospital data backup and telemedicine. The technology holds broad application prospects in the medical field, enabling the processing of various imaging modalities, multidimensional imaging, and medical video imaging. This study elaborates on general image and video compression algorithms, the application of compression algorithms in the medical field, and the performance metrics of medical image compression, thereby providing critical technical support for enhancing clinical diagnostic efficiency and data management security.

Objective:To explore the impact of different autonomous breathing exercises on regional pulmonary ventila-tion using electrical impedance tomography(EIT),in order to provide effective rehabilitation guidance for pa-tients with chronic obstructive pulmonary disease(COPD)in selecting exercise standards and methods. Method:A total of 28 healthy volunteers were recruited in the study,who performed the following breathing exercises in a comfortable standing position:①quiet breathing;②diaphragmatic breathing;③pursed-lip breath-ing;④pursed-lip combining diaphragmatic breathing.The four breathing modes were randomly determined for each subject.Chest EIT was continuously performed during the whole process.The tidal volume(TV),end-ex-piratory lung impedance(EELI),center of ventilation(CoV),global inhomogeneity index(GI)and regional ventilation delay(RVD)were compared during the four breathing modes. Result:Compared with quiet breathing,diaphragmatic breathing,pursed-lip breathing,and diaphragmatic pursed-lip breathing significantly increased TV(P＜0.05),reduced EELI(P＜0.05)and decreased CoV(P＜0.05,with in-creased ventral ventilation).GI of diaphragmatic breathing and pursed lip combining diaphragmatic breathing was significantly reduced(P＜0.05,more uniform ventilation),while RVD of pursed lip breathing and pursed lip combining diaphragmatic breathing was significantly increased(P＜0.05). Conclusion:Diaphragmatic breathing,pursed-lip breathing,and pursed-lip combining diaphragmatic breathing can effectively increase pulmonary ventilation and reduce pulmonary functional residual volume.However,the three breathing exercises have different impacts on pulmonary ventilation:pursed-lip breathing shifts ventilation more significantly towards the ventral side(smaller COV),and has a more significant regional ventilation de-layed(larger RVD),while diaphragmatic breathing improves ventilation homogeneity(smaller GI).Therefore,from the perspective of regional pulmonary ventilation,it is recommended that COPD patients should alternate between diaphragmatic breathing and pursed-lip breathing independently during breathing exercises to achieve better breathing exercise effects.

Objective:To systematically evaluate and Meta-synthesize qualitative studies on the home management needs of patients with spinal cord injury (SCI) to understand their actual self-management needs and improve the quality of home management for patients with SCI in China.Methods:A comprehensive search was conducted in databases including CNKI, Wanfang, CBM, PubMed, Embase, Web of Science, CINAHL, and Cochrane Library for qualitative research on the home management needs of patients with SCI, with a search timeframe up to November 30, 2023. The methodological quality of the included studies was evaluated using the Joanna Briggs Institute (JBI) Qualitative Assessment and Review Instrument (2016). Results were integrated and analyzed using Meta-synthesize methods.Results:A total of 15 studies were included, from which 58 distinct research findings were extracted. These were categorized into 10 new categories, which were further integrated into four main results: the need for positive emotional support, daily living-related needs, healthcare service needs, and social support needs.Conclusions:Healthcare providers should deeply understand the home management needs of patients with SCI. Utilizing artificial intelligence technology, an integrated support model encompassing hospital, home, and society can be constructed. Establishing a comprehensive home rehabilitation platform for patients with SCI can focus on psychological issues and enhance social support levels, thereby improving patients' quality of life.

Objective:To integrate qualitative research on the real experience of patients with spinal cord injury (SCI) returning to society after discharge, so as to provide a basis for developing transitional care intervention program, and promote patients' reintegration into society.Methods:Qualitative research on the real experience of patients with SCI returning to society after discharge was electronically retrieved on China National Knowledge Infrastructure, WanFang Data, VIP, China Biomedical Literature Service System, Cochrane Library, PubMed, Embase, Web of Science, CINAHL, and so on .The search period was from database establishment to August 30, 2023. The quality evaluation criteria for qualitative research of the JBI Evidence-Based Health Care Center (2016) was used to assess the quality of literature, and Meta-synthesis was used to integrate the results.Results:A total of 16 articles were included, and 51 research results were extracted. Similar research results were summarized and combined to form 12 new categories, which were then synthesized into four integrated results, including experiencing physical and mental discomfort following discharge, facing challenges in reintegrating into society, seeking social support, and adapting to social life through self-adjustment role changes.Conclusions:Patients with SCI have multiple psychological experiences in the process of reintegration into society. Medical and nursing staff should attach importance to their inner needs, help them overcome stress and challenges, provide them with personalized continuous care, and promote their role adaptation and reintegration into society.

Objective:To investigate how reactive oxygen species(ROS)regulates the signal transduction of platelet activation and apoptosis,and to explore the relationship between platelet activation and apoptosis.Methods:Platelets were directly stimulated with thrombin or pretreated with ROS inhibitor N-acetylcysteine(NAC)before being stimulated with thrombin,and then flow cytometry was used to detect the effects of thrombin and NAC on P-selectin expression,αⅡbβ3 activation,mitochondrial membrane potential depolarization,phosphatidylserine(PS)externalization,ROS expression and platelet aggregation.Results:Thrombin could induce the production of ROS in platelets in a concentration-and time-dependent manner.0.01 U thrombin induced ROS-dependent high degree of integrin αⅡbβ3 activation,P-selectin expression,and platelet aggregation.The platelets induced by different concentration gradients of thrombin exhibited ROS-dependent mitochondrial membrane potential depolarization and PS externalization in platelets.After induction with thrombin for 30 min,the activation of integrin αⅡbβ3 in platelets reached its maximum level,and after 60 minutes,the depolarization of mitochondrial membrane potential in platelets reached its maximum level.However,the expression of P-selectin,depolarization of mitochondrial membrane potential,and platelet aggregation function were all inhibited to a certain extent when the platelets were pretreated with ROS inhibitor NAC and then induced with thrombin.Conclusion:When platelets are induced by thrombin,ROS first regulates the activation of platelets,and then regulates the apoptosis of platelets.Both platelet activation and apoptosis depend on the production of ROS in platelets,and the signals of activation and apoptosis occur orderly.Inhibiting the ROS signal in platelets can effectively inhibit the activation and apoptosis of platelets.

Objective:To investigate the clinical efficacy of continuous veno-venous hemodia-filtration (CVVHDF) combined with hemoperfusion (HP) HA380 in the treatment of heat stroke patients with multiple organ dysfunction syndrome (MODS).Methods:A retrospective and observational study was conducted. A total of 15 patients with heat stroke combined with MODS who were admitted to the department of intensive care unit (ICU)of Suizhou Central Hospital/Hubei University of Medicine from July to September 2022 were selected as the study objects. All 15 patients were treated with CVVHDF combined with HA380 based on the comprehensive management strategy for severe illness. Organ function indicators [including total bilirubin (TBil), aspartate aminotransferase (AST), creatine kinase (CK), lactate dehydrogenase (LDH), creatinine (Cr), cardiac troponin T (cTnT), myoglobin (Myo), MB isoenzyme of creatine kinase (CK-MB), sequential organ failure assessment (SOFA)] and inflammatory indicators [including white blood cell count (WBC), neutrophil count (NEU), C-reactive protein (CRP), procalcitonin (PCT), and interleukin-6 (IL-6)] were collected. The improvements of the above indexes at admission, after the first HP, after the second HP, after the third HP, and on the 5th day of treatment were compared. Combined with the clinical outcome of patients, the comprehensive efficacy of CVVHDF combined with HA380 in the treatment of severe heat radiation disease was evaluated.Results:There were 10 males and 5 females among the 15 patients. The average age was (64.5±11.5) years old. There were 6 cases of classical heat stroke and 9 cases of exertional heat stroke. Glasgow coma scale (GCS) was 3-8 at admission; SOFA score was 9-17 within 12 hours after admission; acute physiology and chronic health evaluation Ⅱ(APACHEⅡ) was 25-45 within 24 hours after admission. After treatment, the IL-6 level and SOFA score gradually decreased, and there were significant differences in the decrease after the second HP compared to admission [IL-6 (ng/L): 48.37 (15.36, 113.03) vs. 221.90 (85.87, 425.90), SOFA: 8.3±3.3 vs. 11.1±2.4, both P < 0.05]. The PCT level reached its peak after the first HP [12.51 (6.07, 41.65) μg/L], and then gradually decreased, and the difference was statistically significant after the third HP [1.26 (0.82, 5.40) μg/L, P < 0.05]. Compared those at admission, Cr level significantly improved after the first HP (μmol/L: 66.94±25.57 vs. 110.80±31.13, P < 0.01), Myo significantly decreased after the second HP [μg/L: 490.90 (164.98, 768.05) vs. 3?000.00 (293.00, 3?000.00), P < 0.05], After the third HP, the CK level also showed significant improvement [U/L: 476.0 (413.0, 922.0) vs. 2?107.0 (729.0, 2?449.0), P < 0.05]. After CVVHDF combined with 3 times HP treatment, the patient's inflammatory response was gradually controlled and organ function gradually recovered. On the 5th day of the disease course, WBC, PCT and IL-6 levels were significantly improved compared to admission, and AST, CK, LDH, Cr, Myo, CK-MB, and SOFA score were significantly corrected compared with those on admission. The 24-hour survival rate of 15 patients was 86.67%, and the 24-hour, 7-day and 28-day survival rates were both as high as 73.33%. The average mechanical ventilation time of 11 surviving patients was (101.8±22.0) hours, the average continuous renal replacement therapy (CRRT) time was (58.8±11.0) hours, the average length of ICU stay was (6.3±1.0) days, and the average total hospitalization was (14.6±5.2) days. Conclusion:CVVHDF combined with HP HA380 in the treatment of heat stroke patients with MODS can effectively improve organ function and alleviate the inflammatory storm, which is an effective means to improve the rescue rate and reduce the mortality of severe heat stroke patients.

Objectives:To investigate the value of metagenomic next-generation sequencing (mNGS) in the diagnosis of Pneumocystis jirovecii pneumonia (PJP) in patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT) .Methods:The data of 98 patients with suspected pulmonary infection after allo-HSCT who underwent pathogen detection from bronchoalveolar lavage fluid between June 2016 and August 2023 at Nanfang Hospital were analyzed. The diagnostic performance of mNGS, conventional methods, and real-time quantitative polymerase chain reaction (qPCR) for PJP were compared.Results:A total of 12 patients were diagnosed with PJP, including 11 with a proven diagnosis and 1 with a probable diagnosis. Among the patients with a proven diagnosis, 1 was positive by both conventional methods and qPCR, and 10 were positive by qPCR only. Pneumocystis jirovecii was detected by mNGS in all 12 patients. The diagnostic sensitivity of mNGS for PJP was 100%, which was greater than that of conventional methods (8.3%, P=0.001) and similar to that of qPCR (91.6%, P=1.000) . A total of 75% of the patients developed mixed pulmonary infections, and cytomegalovirus and Epstein-Barr virus were the most common pathogens. Mixed infection was detected in eight patients by mNGS and in five patients by qPCR, but not by conventional methods ( P=0.008) . Conclusions:mNGS had good sensitivity for diagnosing PJP after allo-HSCT and was advantageous for detecting mixed infectious pathogens; therefore, mNGS might be an effective supplement to regular detection methods and qPCR.

Objective:To explore the predictive value of serum levels of N-terminal pro brain natriuretic peptide(NT-proBNP),growth differentiation factor-15(GDF-15),type Ⅰ procollagen C-terminal propeptide(PⅠCP)and type Ⅲ procollagen C-terminal propeptide(PⅢCP)for acute left ventricular failure(ALVF)in patients with angina pectoris.Methods:A total of 316 patients with angina pectoris who were treated in Hospital of China Uni-versity of Geosciences(Wuhan)between July 2019 and October 2021 were selected as study group,another 200 healthy subjects undergoing physical examination in our hospital simultaneously were enrolled as control group,then serum levels of NT-proBNP,GDF-15,PⅠCP and PⅢCP were compared between two groups.Incidence of ALVF in study group during hospitalization was observed.Multivariate Logistic regression was used to analyze influencing factors of ALVF in patients with angina pectoris,and ROC curve was used to analyze predictive value of above ser-um indexes for ALVF in patients with angina pectoris.Results:Serum levels of NT-proBNP,GDF-15,PⅠCP and PⅢCP in the study group were significantly higher than those in the control group(P＜0.001 all).Serum levels of above indexes in patients with unstable angina pectoris were significantly higher than those of patients with stable angina pectoris(P＜0.001 all).Multivariate Logistic regression analysis indicated that age≥65 years,unstable angi-na pectoris,angina grade Ⅲ and serum levels of NT-proBNP,GDF-15,PⅠCP and PⅢCP were independent risk factors of ALVF in angina patients(OR=1.885～3.428,P＜0.05 or＜0.01);ROC analysis indicated that area under the curve of combined detection of serum NT-proBNP,GDF-15,PⅠ CP and PⅢCP predicting ALVF in angina patients was 0.947,which was significantly higher than single detection of above indexes(AUC=0.826,0.727,0.759,0.733,P＜0.05 or＜0.01).Conclusion:Serum levels of NT-proBNP,GDF-15,PⅠCP and PⅢCP significantly increase in angina patients,and they are all independent risk factors of ALVF in angina pectoris,and the combination of the four indexes has high predictive value for ALVF in these patients.

Objective:To investigate the relationship between three-dimensional choroidal vascularity index (3D CVI) and the severity of diabetic retinopathy (DR) using swept-source optical coherence tomography angiography (SS-OCTA).Methods:A cross-sectional study was conducted.A total of 139 eyes of 139 subjects, including 115 eyes with diabetes mellitus and 24 control eyes without diabetes, were enrolled in the Second People's Hospital of Hefei from March to December 2022.DR was graded according to the standard seven-field ETDRS color fundus photographs.Eyes with diabetes mellitus were divided into non-DR (NDR) group (34 eyes), non-proliferative DR (NPDR) group (42 eyes), NPDR with diabetic macular edema (DME) group (21 eyes) and PDR group (18 eyes).3D CVI in central fovea 1 mm (C1) and parafoveal 3 mm (C3), choroidal vascular volume (CVV), and choroidal thickness were measured by SS-OCTA in the area of 3 mm×3 mm centered on the fovea using the built-in automated quantification software.Parafoveal region was divided into superior, inferior, temporal and nasal quadrants, and 3D CVI of the different quadrants was detected.3D CVI was defined as the ratio of CVV to total choroidal volume.The monocular data were analyzed to compare 3D CVI among the five groups, and multiple linear regression analysis was used to evaluate the influencing factors.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of the Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University (No.2022064).All subjects were aware of the study purpose and agreed to participate the study.Results:There were significant differences in 3D CVI-C1 and 3D CVI-C3 among all groups ( F=3.103, 3.036, both at P<0.05).In PDR group, 3D CVI-C1 was lower than in non-DR group, and 3D CVI-C3 was lower than in control group and non-DR group, with statistically significant differences (all at P<0.05).There were significant differences in 3D CVI in the inferior and nasal quadrants among all groups ( F=2.714, 4.020, both at P<0.05).In PDR group, 3D CVI in the inferior quadrant was lower than that in non-DR group, and 3D CVI in nasal quadrant in PDR group was lower than that in control group, non-DR group, NPDR group and NPDR with DME group, with statistically significant differences (all at P<0.05).Multiple linear regression showed that after controlling for age, course of disease and glycosylated hemoglobin, the severity of DR was the influencing factor of 3D CVI in fovea and parafovea.PDR eyes had the greatest impact on 3D CVI in fovea and parafovea.Compared with non-DR eyes, there was a -0.019(95% CI: -0.031--0.007, P=0.003) decrease in central foveal 3D CVI and a -0.019(95% CI: -0.030--0.008, P=0.001) decrease in parafoveal 3D CVI in PDR eyes, followed by a 0.014(95% CI: -0.027-0.000, P=0.044) decrease in central foveal 3D CVI in NPDR with DME eyes. Conclusions:Macular foveal 3D CVI correlates with DR severity, and a decrease in 3D CVI of large vessels in the macular choroid may be a sensitive indicator of DR exacerbation.

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.