Objective To establish a predictive model for survival outcomes of glioma patients based on both brain radiomics features from preoperative MRI multi-sequence images and clinical features.Methods We retrospectively analyzed the MRI images and clinical data of 388 glioma patients and extracted the radiomics features from the peritumoral edema zone,tumor core,and whole tumor on T1,T2,and T1-weighted contrast-enhanced(T1CE)and fluid attenuated inversion recovery(FLAIR)sequences.The cases were divided into a training set(271 cases)and a test set(117 cases).Random survival forest algorithms were used to select the radiomics features associated with overall survival(OS)in the training set to construct a radiomic score(Rad-score),based on which the patients were classified into high-and low-risk groups for Kaplan-Meier survival analysis.Cox proportional hazard regression models for the 3 different tumor zones were constructed,and their performance for predicting 1-and 3-year survival rates was evaluated using 5-fold cross-validation and AUC analysis followed by external validation using data from another 10 glioma patients.The best-performing model was used for constructing a nomogram for survival predictions.Results Five radiomics features from the tumor core,7 from the peritumoral edema zone,and 5 from the whole tumor were selected.In both the training and test sets,the high-and low-risk groups had significantly different OS(P<0.05),and age,IDH status and Rad-score were independent factors affecting OS.The combined model showed better performance than the Rad-score model with AUCs for 1-year and 3-year survival prediction of 0.750 and 0.778 in the training set,0.764 and 0.800 in the test set,and 0.938 and 0.917 in external validation,respectively.Conclusion The predictive model combining preoperative multi-modal MRI radiomics features and clinical features can effectively predict survival outcomes of glioma patients.

Objective To establish a predictive model for survival outcomes of glioma patients based on both brain radiomics features from preoperative MRI multi-sequence images and clinical features.Methods We retrospectively analyzed the MRI images and clinical data of 388 glioma patients and extracted the radiomics features from the peritumoral edema zone,tumor core,and whole tumor on T1,T2,and T1-weighted contrast-enhanced(T1CE)and fluid attenuated inversion recovery(FLAIR)sequences.The cases were divided into a training set(271 cases)and a test set(117 cases).Random survival forest algorithms were used to select the radiomics features associated with overall survival(OS)in the training set to construct a radiomic score(Rad-score),based on which the patients were classified into high-and low-risk groups for Kaplan-Meier survival analysis.Cox proportional hazard regression models for the 3 different tumor zones were constructed,and their performance for predicting 1-and 3-year survival rates was evaluated using 5-fold cross-validation and AUC analysis followed by external validation using data from another 10 glioma patients.The best-performing model was used for constructing a nomogram for survival predictions.Results Five radiomics features from the tumor core,7 from the peritumoral edema zone,and 5 from the whole tumor were selected.In both the training and test sets,the high-and low-risk groups had significantly different OS(P<0.05),and age,IDH status and Rad-score were independent factors affecting OS.The combined model showed better performance than the Rad-score model with AUCs for 1-year and 3-year survival prediction of 0.750 and 0.778 in the training set,0.764 and 0.800 in the test set,and 0.938 and 0.917 in external validation,respectively.Conclusion The predictive model combining preoperative multi-modal MRI radiomics features and clinical features can effectively predict survival outcomes of glioma patients.

Objective:To evaluate the application effect of medical visual resources assisted nursing rounds in pediatric clinical nursing teaching.Methods:A total of 63 nursing students who entered the First Affiliated Hospital of Xinxiang Medical University for internship in 2019 and 2020 were selected as research objects from May 2021 to May 2022 by the convenient sampling method. 33 nursing students who participated in the internship in 2019 were set as the control group, while 30 nursing students who participated in the internship in 2020 were set as the intervention group. The control group adopted traditional nursing rounds to organize teaching while the intervention group used medical visual resources to organize theoretical learning and nursing rounds. Before leaving the department, the case analysis ability, critical thinking ability and teaching effectiveness of nursing students were compared between two groups.Results:The score of case analysis ability of nursing students in the intervention group was (83.06±7.58), which was higher than (74.85±9.29) of the control group, and the difference was statistically significant ( t=3.750, P<0.001). At the time of enrollment, there was no statistically significant difference in the total score and scores of each dimension of critical thinking ability of nursing students between the two groups ( P>0.05). Before leaving the department, scores of analysis ability, systematic thinking ability and the total scores of nursing students in the intervention group were higher than those in the control group, and the differences were statistically significant ( P<0.05). Except for the dimension of teaching burden, the score of each dimension and the total score of teaching effectiveness for nursing students in the intervention group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Medical visual resources assisted nursing rounds can help nursing students deeply understand and master clinical knowledge, cultivate their critical thinking ability and improve the effectiveness of clinical teaching.

Abstract In order to achieve the goal of reducing the smoking rate among Chinese adults at ages of 15 years and above to below 20% by 2030, smoking cessation services require to be reinforced. The current Chinese smoking cessation service system includes short-term smoking cessation interventions and smoking cessation hotlines at the population level, and smoking cessation clinics at the individual level; however, these smoking cessation services suffer from problems of low awareness, low accessibility and low utilization rate. Based on the publications pertaining to smoking cessation services and released policy documents in China until June 2022, this review analyzes the current status, problems and causes of smoking cessation services, and proposes suggestions for improving the smoking cessation service system construction in China.

Objective:To explore the value of Astograph challenge test and small airway functional parameters to diagnose asthma.Methods:86 asthmatics were enrolled along with 40 non-asthmatic patients as a control group from January 2018 to March 2019 in People′s Hospital of Nanhai Economic Development Zone, Foshan Chancheng District Central Hospital and Affiliated Hospital of Guangdong Medical University. All subjects were required to complete data acquisition, impulse oscillometry (IOS), pulmonary function test, and Astograph challenge test. The routine pulmonary function indexes, pulse oscillation indexes and reaction threshold (Dmin) were compared between asthma group and non asthma group, and the correlation between each index was analyzed.Results:The Dmin, max expiratory at 50% forced vital capacity (MEF 50%), max expiratory at 75% forced vital capacity (MEF 25%), maximal mid expiratory flow (MMEF) of asthma group were significantly lower than those of non-asthmatic group ( P<0.05). The IOS parameters such as respiratory impedance (Zrs), resistance at 5 Hz (R 5), resistance at 20 Hz (R 20), peripheral resistance (R 5-R 20), reactance at 5 Hz (X 5), the resonance frequency (Fres) showed no statistical significance between the asthmatics and the non-asthmatics ( P>0.05). Response threshold (Dmin) was positively correlated to MEF 50, MEF 25 and MMEF respectively (0.295, 0.306, 0.381, all P<0.05). A receiver operating characteristic (ROC) analysis indicated the area under ROC curve (AUC) of Dmin in diagnosis of asthma was 0.978 (95% CI: 0.950-1.000), the best cutoff point of Dmin was 13.609 Units, with sensitivity in diagnosing asthma 94.6%, specifity 96.8%. The AUC for MEF 50, MEF 25, MMEF were 0.674, 0.738, 0.683, with the best cutoffs 3.990 L, 1.685 L, 3.445 L, respectively. Conclusions:Astograph challenge test, which is fast, safe and precise, can assist in the diagnosis of asthma. MEF 50 and MEF 25 may be associated with the diagnosis of asthma and can predict airway hyper-responsiveness while IOS parameters could not, which make MMEF, MEF 50 and MEF 25 superior to IOS parameters in the diagnosis of asthma.

Objective : To compare the removal efficiency and the amounts of apically extruded debris using Twisted File (TF), Twisted File Adaptive (TFA), ProTaper, and ProTaper Next combined with ultrasonic irrigation and to provide an experimental basis for the selection of root canal instrumentation in the clinic. Methods: Forty mandibular premolars were randomly divided into 4 groups (n=10 teeth per group). The canals were cut using a Twisted File, Twisted File Adaptive, ProTaper, or ProTaper Next nickel-titanium instrument. The canals were irrigated with ultrasonic irrigation. The apically extruded debris were collected in preweighted Eppendorf tubes. The amount of dental tissue removed and extruded debris were assessed with an electronic balance. Results : The amount of tooth tissue removed in groups A, B, C and D was 20.5 ± 2.0 mg, 17.8 ± 4.2 mg, 20.8 ± 3.9 mg and 16.5 ± 2.2 mg, respectively. Combined with ultrasonic irrigation, the Twisted File and ProTaper had a better removal efficiency than the ProTaper Next(P < 0.05). There was no significant difference in the amount of extruded debris (χ2=4.057, P=0.255) among four groups. Conclusion The Twisted File and ProTaper had a better removal efficiency than the ProTaper Next combined with ultrasonic irrigation. There was no significant difference in the amount of extruded debris using four Nickel-titanium instruments combined with ultrasonic irrigation.

Stroke at the acute stage is a major cause of disability in adults, and is associated with dysfunction of brain networks. However, the mechanisms underlying changes in brain connectivity in stroke are far from fully elucidated. In the present study, we investigated brain metabolism and metabolic connectivity in a rat ischemic stroke model of middle cerebral artery occlusion (MCAO) at the acute stage using F-fluorodeoxyglucose positron emission tomography. Voxel-wise analysis showed decreased metabolism mainly in the ipsilesional hemisphere, and increased metabolism mainly in the contralesional cerebellum. We used further metabolic connectivity analysis to explore the brain metabolic network in MCAO. Compared to sham controls, rats with MCAO showed most significantly reduced nodal and local efficiency in the ipsilesional striatum. In addition, the MCAO group showed decreased metabolic central connection of the ipsilesional striatum with the ipsilesional cerebellum, ipsilesional hippocampus, and bilateral hypothalamus. Taken together, the present study demonstrated abnormal metabolic connectivity in rats at the acute stage of ischemic stroke, which might provide insight into clinical research.
Acute Disease ; Animals ; Brain ; diagnostic imaging ; metabolism ; Brain Mapping ; Disease Models, Animal ; Fluorodeoxyglucose F18 ; Glucose ; metabolism ; Infarction, Middle Cerebral Artery ; diagnostic imaging ; metabolism ; Male ; Neural Pathways ; diagnostic imaging ; metabolism ; Positron-Emission Tomography ; Radiopharmaceuticals ; Random Allocation ; Rats, Sprague-Dawley

Objective: To explore the clinical features, the serotype distribution and drug resistance of the isolates in patient with invasive pneumococcal disease (IPD). Methods: By retrieving the laboratory information system in 18 children′s hospitals from 2012 to 2017, the children with IPD were enrolled. Streptococcus pneumoniae (Spn) must be isolated from the sterile sites (blood, cerebrospinal fluid, hydrothorax and joint effusion etc.). The clinical characteristics, serotype, drug resistance, treatment and prognosis were reviewed and analyzed. According to the telephone follow up results, the patients were divided into death group and recovered group. The index as an independent risk factor of mortality was demonstrated by multivariate logistic regression analysis. Results: There were 1 138 children with IPD, including 684 male and 454 female. The proportion of male to female was 1.5∶1. The age ranged from one day to 16 years. The median age was 1 year 3 month. The majority was under 5 years of age (89.3%, n= 1 016), especially under 2 years of age (61.9%, n=704). In all cases, 88.2% (n=1 004) were community acquired infection. The infections included meningitis (n=446, 39.2%), pneumonia with bacteremia (n=339, 29.8%), and bacteremia without focus (n=232, 20.4%). Underlying diseases were found in 242 cases (21.3%). Co-infections were determined in 62 cases (5.4%) with mycoplasma, 27 cases (2.4%) with adenovirus and 34 cases with influenza virus (3.0%). The penicillin insensitivity (PNSP) rates in meningitis and non-meningitis isolates were 69.5% (276/397) and 35.9% (221/615), respectively. There were 81 strains serotyped, in which 93.8% (76/81) were covered by 13-valent protein-polysaccharide conjugate vaccine (PCV13). In the 965 patients who were followed up by phone call, 156 cases (16.2%) were confirmed dead. The independent risk factors for the death were under 2 years of age (OR=2.143, 95%CI 1.284-3.577, P=0.004), meningitis (OR=3.066, 95%CI 1.852-5.074, P<0.01), underlying disease (OR=4.801, 95%CI 2.953-7.804, P<0.01), septic shock(OR=3.542, 95%CI 1.829-6.859, P<0.01), disseminated intravascular coagulation (DIC) (OR=4.150, 95%CI 1.468-11.733, P=0.007), multiple organ failure (OR=12.693, 95%CI 6.623-24.325, P<0.01) and complications of central nervous system (OR=1.975, 95%CI 1.144-3.410, P=0.015). Conclusions Most children with IPD were under 5 years of age, having underlying diseases and acquired the infection in community. The independent risk factors for death were under two years old, meningitis, underlying diseases and multiple organ failure. The problem of drug resistance was severe. The universal immunization of PCV13 would be effective to prevent IPD in Chinese children.

Objective: To study the impact of vascular injury on neointimal hyperplasia and the expressions of nuclear transcription factor-κb (NF-κb), tissue factor (TF), endothelin-1 (ET-1) and matrix metalloproteinase-3 (MMP-3) in experimental rabbit model.
Methods:A total of 32 male New Zealand big-eared white rabbits were used to establish vascular injury model by femoral artery puncture, balloon was sent to abdominal aorta via the wire followed by balloon dilatation to strain abdominal aorta. Blood sample was taken from femoral artery sheath 1 minute after operation, and the rabbits were killed at 4 weeks after operation, meanwhile blood sample was taken from the heart. Injured arteries were isolated, ifxed and embedded; slices were stained by HE, basic fuchsine and NF-κb immunohistochemical methods for light microscope observation; slices were also stained by lead and uranium for transmission electron microscope observation. Neointimal thickness was measured by computer analysis, vascular injury integral and NF-κb positive cell rate were determined, blood levels of TF, ET-1 and MMP-3 were examined by ELISA. The relationship between vascular injury integral and the contents of TF, ET-1, MMP-3 and NF-κb positive cell rate were analyzed by SPSS statistical software.
Results: The optimal iftting curve between vascular injury integral and neointimal thickness was S-shaped cubic curve. NF-κb was mainly expressed in neointima, vascular injury integral was positively related to NF-κb positive cell percentage, Pearson correlation coeffcient was 0.916,P<0.05. Vascular injury integral was positively related to the contents of 1 min post-operative TF; 1 min and 4 weeks post-operative ET-1; 1 min and 4 weeks post-operative MMP-3; Pearson correlation coeffcients were 0.925, 0.957, 0.947, 0.914 and 0.940 respectively, allP<0.05.
Conclusion: Vascular injury may activate NF-κb pathway, promote ET-1 and MMP-3 expression, therefore accelerating neointimal hyperplasia, leading negative vascular remodeling, TF was an initiating factor for neointimal hyperplasia. Internal elastic lamina was the key structure reflecting vascular injury, it is the only barrier hindering neointimal hyperplasia in experimental rabbit model.

[ABSTRACT]OBJECTIVETo study of the relationship of age and climate with the nasal mucosa lesions.METHODSAll the patients met with the inclusive criteria were registered and followed-up once a month and their nasal mucosal lesions were observed through nasal speculum and/or nasal endoscope. The recording data was analyzed by SPSS17.0 software.RESULTSA total of 259 patients, 555 person-times and 957 lesion spots were observed. The nasal mucosa was injured by airflow with the highest incidence rate from October to next year April. Patients numbers gradually increased after August, and significantly increased at November, December (P<0.05). Children aged from 2 to 12 years old and the adults aged from 40 to 80 years old were susceptible population (P<0.05), the incidence rate had a negative relation with humidity (P<0.05). The susceptible spots of the lesion were ranked as follows: Little area, inferior turbinate, mucosa of the both side of the deviated nasal septum, inferior meatus, middle meatus, middle turbinate and olfactory area. CONCLUSIONNasal mucosal injury relates to age and seasons. The nasal cavity airflow may be a factor of these lesions.