The accuracy of ultrasound examination and measurement is of great significance to diagnosing ocular disea-ses.The commonly used ocular ultrasonography includes amplitude(A)-mode ultrasound,brightness(B)-mode ultra-sound,ultrasound biomicroscopy(UBM),and color Doppler flow imaging(CDFI).A-mode ultrasound is mainly used to measure the distance between tissues with different echo intensities.B-mode ultrasound can visualize the two-dimensional structure of the eye and make quantitative measurements of the target point.UBM is an ultra-high-frequency two-dimen-sional imaging method,which can clearly display the structural characteristics of the anterior segment and measure the rele-vant parameters.It can also help quantitatively analyze the morphological changes of the angle and the anterior segment be-fore and after implantable collamer lens surgery.CDFI can quantitatively measure the parameters of blood vessels by apply-ing the Doppler effect on the basis of two-dimensional ultrasound,reflecting the changes of blood flow in the eye.To standardize the operations of different ultrasound examination methods,this guideline is formulated.This guideline mainly focuses on the standardized operation of ocular ultrasound instruments and their clinical application in ocular diseases,so as to provide guidance for the diagnosis and treatment of related ocular diseases.

Objective To investigate the underlying mechanism of microglia ferroptosis in smoke inhalation-induced(SII)brain injury.Methods Twenty SPF-grade male C57BL/6 mice were randomly divided into the control group,the SII group,the ferrostatin-1 group(Fer-1,2.5 mmol/kg)and the deferoxamine group(DFO,200 mg/kg),with 5 mice in each group.Mice in the Fer-1 group and the DFO group were intraperitoneally injected with Fer-1 and DFO 1,3 and 5 day after smoke exposure,respectively.The pathological changes of brain tissue were examined by HE staining and Prussian blue staining on the 6th day after smoke exposure.RT-qPCR was used to detect levels of inflammatory factors,brain tissue damage markers and ferroptosis markers.The contents of iron in mouse brain tissue were determined by double pyridine colorimetric assay.The contents of malondialdehyde(MDA)and lipid peroxide(LPO)in mouse brain tissue were determined by thiobarbituric acid(TBA)colorimetric assay.Superoxide dismutase(SOD)activity in mouse brain tissue was measured by xanthine oxidase assay kit.The contents of glutathione(GSH)in mouse brain tissue were determined by direct method of dithiodinitrobenzoic acid(DTNB)assay.BV2 cells were cultured in complete DMEM medium and divided into the control group,the erastin group(10 μmol/L),the Fer-1 group(erastinc stimulation combined with 5 mmol/L Fer-1 treatment)and the DFO group(erastinc stimulation combined with 50 mmol/L DFO treatment).After 24 h,cell viability was detected by CCK-8 assay,cell apoptosis was detected by Annexin V-FITC/PI flow cytometry,intracellular reactive oxygen species(ROS)production was detected by DCFDA staining,and mitochondrial membrane potential was detected by MitoTracker Red CMXRos staining.Results Compared with the control group,enhanced iron deposition and inflammation in brain tissue,elevated mRNA expression of inflammatory markers and damage markers in brain tissue,up-regulated ACSL4 and NCOA4 mRNA levels,down-regulated GPX4 and SLC7A11 mRNA levels,decreased GSH and SOD contents,and increased LPO and MDA contents were observed in brain tissue of the SII group(P＜0.05).The mRNA expression level of 7 member of solute carrier family 11(SLC7A11)was decreased in mice of the SII group.The contents of GSH and SOD were decreased,and the contents of LPO and MDA were increased(P＜0.05).Compared with the SII group,all the above parameters were reversed in the Fer-1 group and the DFO group,and the damage of mouse brain tissue was alleviated(P＜0.05).In BV2 cell experiments,compared with the control group,decreased survival rate of BV2 cells and increased apoptosis rate were found in the erastin group(P＜0.05),and increased intracellular ROS level and decreased mitochondrial membrane potential were also observed in the erastin-stimulated BV2 cells.The above parameters were opposite to those of the erastin group in the Fer-1 group and the DFO group(P＜0.05),and the oxidative damage of BV2 cells was alleviated.Conclusion The ferroptosis inhibitors Fer-1 and DFO can inhibit microglia ferroptosis and alleviate smoke inhalation-induced brain injury.

【Objective】 To explore the application of machine learning in scientific and rational blood preparation and predictive analysis for surgical blood usage before liver transplantation surgery. 【Methods】 Clinical basic information including gender, age, clinical diagnosis and surgical methods of 356 liver transplantation patients were collected. The duration (Time) and preoperative laboratory test results of hemoglobin (Hb), hematocrit (Hct), platelet count (Plt), prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fib), total bilirubin (TBIL), albumin (ALB), creatinine (Crea) and total protein (TP), as well as the amount of intraoperative blood transfusion were collected. A machine learning model capable of predicting the risk of massive blood transfusion during liver transplantation surgery was established by Python, and was evaluated to select the optimal predictive model. 【Results】 Among the 7 machine learning models constructed, the logistic regression model performed the best (AUROC: 0.90, F1 score: 0.82), with an accuracy of 79.44% and precision of 79.69%, followed by the random forest classifier (AUROC: 0.87, F1 score: 0.83), with an accuracy of 79.44% and precision of 77.94%. 【Conclusion】 Establishing a machine learning prediction model by Python is of significant clinical importance for scientific blood preparation, predicting the risk of massive blood transfusion and ensuring the safety of blood use in liver transplantation surgery.

Purpose To investigate the cell components in different tumor lineages of multiple synchronous pituitary neuro-endocrine tumors(PitNETs)/neuroendocrine tumors(MSPs)and to carry out accurate histological typing,which provides an important basis for determining the follow-up plan and adjuvant therapy after surgery.Methods The clinical data of 855 pa-tients with PitNETs were collected and reclassified according to the new WHO standard.The clinicopathological features of 13 patients diagnosed as MSPs were analyzed retrospectively.The immunohistochemical EnVision two-step method was used to de-tect the expression of PIT-1,SF-1,T-PIT,GH,PRL,TSH,LH,FSH,ACTH,etc.,and related literatures were reviewed.Methods A total of 855 cases of pituitary neuroendocrine tumor from the second hospital of the Chinese Hebei Medical U-niversity were collected and reclassified according to the new WHO standard,and review the literature.Results(1)The age of patients were 39-68 years with median age of 55 years.7 cases were female and 6 were male;(2)Imaging findings:There was 1.2～3.8 cm(mean 2.5 cm)in maximum tumor di-ameter.13 patients were large adenomas,neither MSPs nor sin-gle lineage PitNETs could not assessed on imaging;(3)Clinical manifestations:3 cases had hyperprolactinemia which all contai-ning PitNETs components of PRL,one case was immature PIT-1 polyhormone cell tumor,one was dense granular prolactinoma,and one case was eosinophilic stem tumor.One patient had Cushing's disease and contained a Crook cell tumor component;two had elevated ACTH,and one had an adrenocorticotropic ad-enomatous component.In the two patients with no evidence of hormone excess,all contained gonadotropin cell tumor compo-nents;(4)Combination form:11 cases of the combination of the two cell lineages(5 cases of combination of SF-1 lineage and PIT-1 lineage;4 cases of combination of T-PIT lineage and PIT-1 lineage;1 case of null cell tumor and PIT-1 lineage;1 case of plurihormonal PitNETs and SF-1 lineage);Two cases of three cell combinations(null cell tumor,PIT-1 lineage,and T-PIT lineage);Among them,13 cases were PIT-1 lineage tumors,46.2％(6/13)were gonadotropin cell tumor,38.5％(5/13)were prolactinoma;(5)The presence of high-risk lineage tumors in the 10 patient combinations:3 immature PIT-1-lineage tumor,1 Crooke cell PitNETs,1 acidophil stem cells tumor,3 zero-cell PitNETs,and 4 silent-type sparse granular adrenocorti-cotropic hormone PitNETs;Two of them were combinations of two high-risk subtypes.Conclusion MSPs in our center are large adenomas,although their incidence is only 1.5％of Pit-NETs,2/3 cases have high-risk lineage tumor components,and the use of pituitary cell lineage transcription factors and adeno-hypophyseal hormones plays an important role in distinguishing and clarifying the different components of MSPs.

Objective:To investigate the clinicopathological characteristics of acidophil stem cell pituitary neuroendocrine tumors (PitNET)/adenoma.Methods:Five cases of acidophil stem cell PitNET/adenoma were diagnosed between May 2022 and July 2023 at the Second Hospital of Hebei Medical University, Shijiazhuang, China. The clinicopathological features of the tumor were analyzed by using histology, immunohistochemistry, and electron microscopy. The relevant literature was reviewed.Results:There were 1 male and 4 females, aged from 23 to 69 years. Patient 3 was 55 years old at the time of diagnosis and first surgery, and relapsed 5 years later. The patients′ median age was 32 years. Patients 1 and 5 showed elevated blood prolactin, with various degrees of hormonal symptoms except Patient 3, who showed only tumor compression symptoms. Imaging studies showed that all cases involved the sellar floor. The tumors of Patients 1, 2 and 5 were closely related to the cavernous sinus segment of the internal carotid artery. The tumors exhibited a diffuse growth pattern with chromophobic to slightly acidophilic cytoplasm. A few of tumor cells showed chromophobic cytoplasm. The nucleoli were conspicuous. Intranuclear inclusion bodies and variably-sized clear vacuoles were observed occasionally. Under electron microscope, marked mitochondrial abnormalities were observed, including increased mitochondria number, expanded hypertrophy, and absence of mitochondrial ridge fracture. Some mitochondrial matrices were dense, while some were vacuolated.Conclusions:Acidophil stem cell PitNET/adenoma is a rare type of pituitary adenomas/PitNETs. It often has a more clinically aggressive manner with immature cells, diffuse expression of PIT1, prolactin, and varying degrees of growth hormone expression. Because of the obvious diversity of their clinical hormone status and hormone immune expression, the diagnosis of this type tumor is still a challenge.

Objective:The epidemiological characteristics of occupational pneumoconiosis in Gansu Province from 2010 to 2018 were analyzed to provide a theoretical basis for the development of prevention and control strategies for pneumoconiosis in Gansu Province.Methods:In March 2019, the data of newly diagnosed occupational pneumoconiosis in 2010 -2018 and the data of occupational pneumoconiosis as of December 31, 2018 in Gansu Province were collected by the Occupational Disease and Occupational Health Information Monitoring System. The stage, type of disease, time, enterprise information of newly diagnosed pneumoconiosis and the region, type of disease, enterprise information of existed pneumoconiosis were analyzed. Results:From 2010 to 2018, a total of 1269 new cases of occupational pneumoconiosis were reported in Gansu Province, including 818 cases (64.46%) of stage I pneumoconiosis, 284 cases (22.38%) of stage II pneumoconiosis, 167 cases (13.16%) of stage III pneumoconiosis. Silicosis, coal worker's pneumoconiosis and cement pneumoconiosis ranks the top 3, accounting for 55.71% (707/1269) , 37.67% (478/1269) and 3.78% (48/1269) of the total number, respectively. The new cases of stage III pneumoconiosis were mainly distributed in private economy (58.09%, 79/136) and small -sized (59.88%, 97/162) enterprises. As of December 31, 2018, Gansu Province had reported a total of 12211 cases of occupational pneumoconiosis, of which 58.16% (7102/12211) were coal worker's pneumoconiosis and 28.15% (3438/12211) were silicosis. Mainly distributed in Baiyin city (21.63%, 2641/12211) , Lanzhou city (17.79%, 2172/12211) and Wuwei city (13.73%, 1676/12211) . The existed cases of pneumoconiosis are mainly distributed in state -owned economy (76.95%, 9396/12211) and large -sized (54.23%, 6622/12211) enterprises. Conclusion:Silicosis and coal worker's pneumoconiosis are the main type of pneumoconiosis in Gansu Province. And the number of silicosis reported is on the rise, which should be taken seriously. Pneumoconiosis in Gansu Province is mainly distributed in state -owned economy and large -sized enterprises. However, pneumoconiosis patients in private economy and small -sized enterprise is generally serious, so it should be the focus of supervision.

Objective:The epidemiological characteristics of occupational pneumoconiosis in Gansu Province from 2010 to 2018 were analyzed to provide a theoretical basis for the development of prevention and control strategies for pneumoconiosis in Gansu Province.Methods:In March 2019, the data of newly diagnosed occupational pneumoconiosis in 2010 -2018 and the data of occupational pneumoconiosis as of December 31, 2018 in Gansu Province were collected by the Occupational Disease and Occupational Health Information Monitoring System. The stage, type of disease, time, enterprise information of newly diagnosed pneumoconiosis and the region, type of disease, enterprise information of existed pneumoconiosis were analyzed. Results:From 2010 to 2018, a total of 1269 new cases of occupational pneumoconiosis were reported in Gansu Province, including 818 cases (64.46%) of stage I pneumoconiosis, 284 cases (22.38%) of stage II pneumoconiosis, 167 cases (13.16%) of stage III pneumoconiosis. Silicosis, coal worker's pneumoconiosis and cement pneumoconiosis ranks the top 3, accounting for 55.71% (707/1269) , 37.67% (478/1269) and 3.78% (48/1269) of the total number, respectively. The new cases of stage III pneumoconiosis were mainly distributed in private economy (58.09%, 79/136) and small -sized (59.88%, 97/162) enterprises. As of December 31, 2018, Gansu Province had reported a total of 12211 cases of occupational pneumoconiosis, of which 58.16% (7102/12211) were coal worker's pneumoconiosis and 28.15% (3438/12211) were silicosis. Mainly distributed in Baiyin city (21.63%, 2641/12211) , Lanzhou city (17.79%, 2172/12211) and Wuwei city (13.73%, 1676/12211) . The existed cases of pneumoconiosis are mainly distributed in state -owned economy (76.95%, 9396/12211) and large -sized (54.23%, 6622/12211) enterprises. Conclusion:Silicosis and coal worker's pneumoconiosis are the main type of pneumoconiosis in Gansu Province. And the number of silicosis reported is on the rise, which should be taken seriously. Pneumoconiosis in Gansu Province is mainly distributed in state -owned economy and large -sized enterprises. However, pneumoconiosis patients in private economy and small -sized enterprise is generally serious, so it should be the focus of supervision.

Objective: To analyze the epidemiological characteristics of occupational diseases in Gansu Province, China in 2010-2017, and to provide a scientific basis for the prevention and control of occupational diseases. Methods: The cluster sampling method was adopted to make statistical analysis of 1339 cases of occupational disease reported by "occupational disease and occupational health information monitoring system" in Gansu province from 2010 to 2017, to investigate the diseases, regions and industries of occupational diseases in June 2018. Results: A total of 1339 cases of occupational diseases (39 types, 8 classes) were diagnosed and reposed in 2010-2017. The three most frequent diseases were pneumoconiosis (87.53%, 1172/1339), occupational poisonings (5.83%, 78/1339), and occupational ear, nose, and throat (ENT) diseases (3.14%, 42/1339). The cases of silicosis accounted for 54.61% (640/1172) of all cases of pneumoconiosis, the second was coalworker pneumoconiosis, which accounted for 38.57% (452/1172). In the cases of occupational poisonings, 32.05% (25/78) suffered from carbon monoxide poisoning. Patients with occupational diseases were reported in 14 districts of Gansu, mostly in Lanzhou (27.52%, 347/1261), Jinchang (16.57%, 209/1261), and Baiyin (14.20%, 179/1261). The reported cases are mainly concentrated in mining (71.56%, 468/654) and manufacturing (21.87%, 143/654), the types of state-owned economy (55.63%, 692/1244) and private economy (33.68%, 419/1244), large (43.41%, 540/1244) and small enterprises (35.21%, 438/1244) in 2010-2017 in Gansu. Conclusion The pneumoconiosis caused by silicious and coal dust and the occupational poisonings caused by carbon monoxide seem to be the main occupational hazards in Gansu province. Occupational diseases occur in all districts of Guangzhou and in various industries. The state-owned economy and private sector, large and small enterprises should be the focuses of occupational health supervision.

ObjectiveThe aim of this study was to investigate the professional cognitive level and its influencing factors of fresh nursing students in Yunnan,in order to provide a basis for nursing education workers, improve the situation and put forward a series of interventions.MethodsA questionnaire survey was done among 623 fresh nursing students in 5 universities of Yunnan province,and the data were collected and analyzed using the descriptive analysis and chi-square test of software SPSS22.0.Results There were 313 peoples choose nursing for easy future employment in qualified 599 questionnaires. The professional cognitive level in Yunnan was not comprehensive compared with other provinces,and the ratio of the nursing mission and etc were lower than other provinces with statistical significance(P < 0.05). However,there were 50 people(40.98%)would like to choose other major of 122 people who come from other provinces,which was higher than that of Yunnan (34.98%). There were 324 students(63.11%)were proud of nursing,327 students(63.70%)think nursing have a good development prospect who received the freshmen entrance education,which were higher than 35.62% and 42.47% of who could not receive the freshmen entrance education,with a statistical significance(P < 0.05). ConclusionSchool should reinforce the new students entrance education and professional publicity to cultivate the professional emotion of nursing freshmen.

Objective To prospectively evaluate the risk factors for the decline of residual renal function (RRF) in new peritoneal dialysis (PD) patients.Methods A total of 84 new PD patients in our PD center were included in this study.Clinical comprehensive assessment were made,and regression models was established to analyze the relationship between the decline of RRF and clinical indicators,which included the rate of peritonitis,systolic pressure,diastolic pressure,urine volume,24 h urinary protein,serum albumin,C-reactive protein(CRP),history of diabetes mellitus,and the use of angiotensin converting enzyme inhibitor (ACEI) or angiotensin receptor blockers (ARB) drugs,cardiac functional grading,sodium and water retention and biochemical indicators.The primary outcome was defined as two consecutive urine volume ≤ 100 ml/24 h.Results The mean follow-up time was (11.7± 1.1) months,primary outcome occurred in 20 patients,accounting for 23.8％,and their average period progressed to the primary outcome was (10.5±2.0) months.The 20 patients had higher ultrafiltration volume [(551.6±328.2) ml vs (294.1±288.0) ml,P=0.001],higher systolic blood pressure [(145.2±16.5) mmHg vs (136.0±13.8) mmHg,P=0.016],worse cardiac functional grading [(1.7±0.8) vs (1.3±0.4),P=0.000],more serious water-sodium retention [(1.0±0.7) vs (0.6±0.5),P=0.012],higher peritonitis rates (35.0％ vs 4.7％,P=0.000),lower Kt/V [(1.7 ± 0.4) vs (2.0 ± 0.3),P=0.003],lower hemoglobin levels [(89.0± 14.9) g/L vs (99.5± 17.8) g/L,P=0.020],higher C-reactive protein levels [(19.4±34.4) mg/L vs(8.7±12.6) mg/L,P=0.017],higher Scr levels [(1 004.6±291.1) μmol/L vs (753.1±254.3) μ mol/L,P=0.000],lower serum calcium levels[(1.86±0.1) mmol/UL vs (2.02±0.2) mmol/L,P=0.000],higher serum phosphorus [(2.1±0.6) mmol/L vs (1.6±0.4) mmol/L,P=0.001] and higher calcium phosphorus product [(3.8±1.1) mmol2/L2 vs (3.1±0.8) mmol2/L2,P=0.010] as compared with those of the patients without the primary outcome.Based on the results of multivariable Cox regression analysis,ultrafiltration volume,cardiac functional grading,peritonitis,Kt/V and serum phosphorus level contributed to the decline of RRF significantly.Conclusion The higher Kt/V in PD patients plays a protective role,the higher ultrafiltration volume,the worse heart function,the more peritonitis rate and higher serum phosphorus predict more rapid declination of RRF.