As the most common phenotype of type 1 neurofibromatosis(NF1),plexiform neurofibromas(pNF)exhibit early asymptomatic presentation but multisite involvement,with a risk of progression.Imaging serves as vital tool for evaluation and management of NF1-associated pNF.The progresses of imaging for evaluating NF1-related pNF were reviewed in this article.

As the most common phenotype of type 1 neurofibromatosis(NF1),plexiform neurofibromas(pNF)exhibit early asymptomatic presentation but multisite involvement,with a risk of progression.Imaging serves as vital tool for evaluation and management of NF1-associated pNF.The progresses of imaging for evaluating NF1-related pNF were reviewed in this article.

Objective:This study aims to summarize the theoretical basis and practical effect of interdisciplinary team building in the National Clinical Medical Research Center for Aging and Medicine, Huashan Hospital.Methods:Interactive memory was employed as the theoretical basis for building cross-disciplinary teams, and the work was carried out in three dimensions of specialization, credibility, and coordination.Results:The center had shaped a coordinative team atmosphere and strengthened its integrity in five dimensions, including discipline construction, open platform, innovation curation, science popularization, and technology transfer. The center also promoted the implementation of research tasks in the three core areas.Conclusions:As the aging healthcare issues are highly diversified, complex, and systematic, the center needs to continuously improve its ability to build interdisciplinary teams and provide a platform for integrating various types of resources into the solution of healthcare problems of the elderly.

Objective:To explore the value of the amyloid-tau-neurodegeneration (ATN) framework in neuroimaging based on PET for diagnosing mild cognitive impairment (MCI) and Alzheimer′s disease (AD), and analyze its relationship with clinical cognition.Methods:From May 2022 to March 2024, a total of 98 cases (23 males and 75 females, age (67.8±8.6) years) with a diagnosis of AD, MCI, or non-AD (control patients, CP) who underwent 18F-FDG, 18F-AV45, and 18F-AV1451 PET/CT imaging in the Second Affiliated Hospital of Guangzhou Medical University were included retrospectively. The clinical data, Mini-Mental State Examination (MMSE), and Montreal Cognitive Assessment (MoCA) scores were recorded. Cases were divided into MCI group, mild AD group, moderate AD group, moderate-severe AD group, and CP group. PET images were visually and semi-quantitatively evaluated. SUV mean and SUV ratio (SUVR) were obtained from independent brain regions of 18F-FDG ( n=8), 18F-AV45 ( n=14) and 18F-AV1451 ( n=14). ROC curve analysis was performed with clinical diagnosis as a criterion. The consistency between visual assessment and the clinical diagnosis was analyzed by Cohen′s Kappa coefficient. Semi-quantitative comparisons between groups were performed using the independent-sample t test, one-way analysis of variance, Mann-Whitney U test, or Kruskal-Wallis rank sum test. Age was used as a covariate to calculate the partial correlation coefficient between SUVR and cognitive scores. Results:The sensitivity and specificity of comprehensive visual assessment in diagnosing AD+ MCI were 87.65%(71/81) and 14/17 respectively, showing a moderate consistency with clinical diagnosis ( Kappa=0.60, P<0.001). Semi-quantitative analysis showed that 18F-FDG uptakes in all independent brain regions of MCI patients were higher than those of AD patients, whereas the uptakes of 18F-AV45 and 18F-AV1451 were lower ( t values: 2.66-3.95, z values: 4.98-15.04, all P<0.05). The difference in 18F-AV45 uptake among the three subgroups of AD was relatively small ( H values: 0.46-4.06, F values: 0.03-0.08, all P>0.05). Except for the medial temporal and occipital lobes, the 18F-AV1451 uptake in the moderate-severe AD group tended to be higher than that in the moderate and mild AD groups, though not statistically significant ( H values: 0.20-5.17, all P>0.05). 18F-FDG PET semi-quantitatively distinguished MCI from CP with a high sensitivity (13/14), 18F-AV45 demonstrated a high sensitivity for diagnosing AD+ MCI (92.59%, 75/81), and 18F-AV1451 had a high specificity for distinguishing AD from MCI (14/14) (AUCs: 0.87, 0.90 and 0.92). The uptakes of 18F-FDG in gray matter of AD and MCI patients were positively correlated with MMSE and MoCA scores ( r values: 0.30-0.43, 0.29-0.45, all P<0.05), while the uptakes of 18F-AV45 and 18F-AV1451 were negatively correlated with MMSE and MoCA scores ( 18F-AV45, r values: from -0.39 to -0.30, from -0.38 to -0.30, all P<0.05; 18F-AV1451, r values: from -0.50 to -0.28, from -0.53 to -0.28, except for medial temporal lobe P>0.05, all others P<0.05). Conclusion:The PET-based neuroimaging ATN framework is helpful for early diagnosis of MCI and AD, as well as for AD staging, and may reflect the disease progression and clinical cognitive status of AD to a certain extent.

Objective:To investigate the application value of advance care planning among patients with chronic heart failure, so as to provide reference for the clinical practice of advance care planning.Methods:A total of 62 chronic heart failure patients from October 2017 to November 2019 in Fuwai Central China Cardiovascular Hospital were assigned to control group and experimental group according to the enrolled time, with 31 cases in each group. The patients in the control group from October 2017 to October 2018 recieved routine nursing, the experimental group from November 2018 to November 2019 carried out advance care planning based on the routine care. Before and after 3 weeks of intervention, the fatigue symptom and psychological condition were assessed by the Multidimensional Fatigue Inventory (MFI-20) and Symptom Checklist 90 (SCL-90), respectively.Results:There was no significant difference in the score of MFI-20 and SCL-90 before intervention between the two groups( P>0.05). After 3 weeks of intervention, the mental fatigue scores and total scores in MFI-20 were (8.23 ± 2.77), (51.00 ± 5.03) points in the experimental group, significantly lower than those in the control group (10.23 ± 2.58), (54.06 ± 5.50) points, the differences were statistically significant ( t=2.94, 2.29, all P<0.05). After 3 weeks of intervention, the somatization, obsessive symptoms, depression, anxiety, hostility scores and total score of SCL-90 were (1.28 ± 0.14), (1.43 ± 0.09), (1.19 ± 0.12), (1.13 ± 0.08), (1.33 ± 0.07), (121.00 ± 3.68) points in the experimental group, significantly lower than those in the control group (1.82 ± 0.44), (1.73 ± 0.58), (1.69 ± 0.12), (1.78 ± 0.13), (1.39 ± 0.10), (144.69 ± 9.09) points, the differences were statistically significant ( t values were 2.76-23.06, all P<0.05). Conclusions:Advance care planning can effectively alleviate fatigue symptom and improve psychological condition of patients with chronic heart failure.

Objective:To explore the application value of artificial intelligence-assisted diagnosis system for TBS report in cervical cancer screening.Methods:A total of 16 317 clinical samples and related data of cervical liquid-based thin-layer cell smears, which were obtained from July 2020 to September 2020, were collected from Southern Hospital, Guangzhou Huayin Medical Inspection Center, Shenzhen Bao′an People′s Hospital(Group) and Changsha Yuan′an Biotechnology Co., Ltd. The TBS report artificial intelligence-assisted diagnosis system of cervical liquid-based thin-layer cytology jointly developed by Southern Medical University and Guangzhou F. Q. PATHOTECH Co., Ltd. based on deep learning convolution neural network was used to diagnose all clinical samples. The sensitivity,specificity and accuracy of both artificial intelligence-assisted diagnosis system and cytologists using artificial intelligence-assisted diagnosis system were analyzed based on the evaluation standard(2014 TBS). The time spent by the two methods was also compared.Results:The sensitivity of artificial intelligence-assisted diagnosis system in predicting cervical intraepithelial lesions and other lesions (including endometrial cells detected in women over 45 years old and infectious lesions) under different production methods, different cytoplasmic staining and different scanning instruments was 92.90% and 83.55% respectively, and the specificity of negative samples was 87.02%, while that of cytologists using artificial intelligence-assisted diagnosis system was 99.34%, 97.79% and 99.10%, respectively. Moreover, cytologists using artificial intelligence-assisted diagnosis system could save about 6 times of reading time than manual.Conclusions:Artificial intelligence-assisted diagnosis system for TBS report of cervical liquid-based thin-layer cytology has the advantages of high sensitivity, high specificity and strong generalization. Cytologists can significantly improve the accuracy and work efficiency of reading smears by using artificial intelligence-assisted diagnosis system.

Objective: To study influencing factors for aspirin resistance in women with ischemic stroke.Methods: A total of 150 women with ischemic stroke, who visited to our hospital from Jun 2013 to Jun 2015, were selected.According to presence of aspirin resistance, they were divided into aspirin resistance group (n=61) and aspirin sensitive group (n=89).All patients received aspirin enteric-coated tablets on morning, then arachidonic acid pathway platelet aggregation inhibition rate and glycosylated hemoglobin A1c (HbA1c) level were measured in two groups on 10 h after administration.According to HbA1c level, patients were divided into normal blood glucose group (n=83) and elevated blood glucose group (n=67), then aspirin resistance rate was compared between two groups.Logistic regression analysis was used to analyze influencing factors for aspirin resistance.Results: Compared with aspirin sensitive group, there was significant rise in body weight[(63.5±7.9) kg vs.(66.9±10.2) kg]in aspirin resistance group, P=0.041.Compared with normal blood glucose group, there was very significant rise in aspirin resistance rate (14.46% vs.73.13%) in elevated blood glucose group, P=0.008.Multi-factor Logistic regression analysis indicated that body mass index (BMI) and blood glucose level were independent risk factors for aspirin resistance (OR=4.012, 3.012, P=0.016, 0.018).Conclusion: Incidence rate of aspirin resistance is high in women with ischemic stroke.Blood glucose control and body weight status may affect incidence of aspirin resistance.

OBJECTIVE:To provide reference for the informational and automatic management in Pharmacy intravenous admix-ture service (PIVAS). METHODS:The composition and practical application of PIVAS automatic management system developed in our hospital were introduced,and ratio of irrational medical order,drug dispensing efficiency and the numbers of error before and after application were compared to evaluate its effect. RESULTS & CONCLUSIONS:The work process was intelligently opti-mized,PIVAS automatic management system developed in our hospital composed by automatic prescription audit system,intelli-gent drug dispensing system,intelligent liquid preparation system,automated sorting system and automatic transportation system, which respectively achieved the automated audit of prescription,intelligent drug dispensing and labeling,responsibility traced in drug dispensing,intelligent mixed deployment of intravenous infusion,automated sorting and transportation of finished products of transfusion liquid. The ratio of irrational medical order decreased from 2.07%to 1.73%,time of drug dispensing and labeling short-ened from(3.15±0.53)h to(1.55±0.27)h,numbers of error within daily dispensing decreased from 0.26±0.78 to 0.06±0.13, numbers of error within daily sorting of finished products of transfusion liquid decreased from 6.57 ± 1.76 to 0.07 ± 0.17. The con-struction of the system achieves the information and automation of major work in PIVAS and improves the management level of PI-VAS.

OBJECTIVE:To introduce the application of intelligent sorting system for prepared infusion in PIVAS of our hospi-tal. METHODS:Intelligent sorting system established by our hospital with barcode scanning technology and relevant hardware de-vices such as automatic drug sorting devices was introduced from system operation environment,system software design and sys-tem function. The effects of the system was evaluated through comparing with manual sorting mode. RESULTS:The intelligent sort-ing system used had such functions as sorting batch selection,intelligent sorting and discharging,information tracing management. Compared to manual sorting,the number of staff under intelligent sorting mode decreased from 7 to 2,sorting errors within 3 months were reduced by 99.0%(591 times vs. 6 times),and the daily sorting errors were reduced by 98.9%(6.57 times vs. 0.07 times). CONCLUSIONS:The system runs stably and sorts accurately,the errors is reduced,the working efficiency is improved and intensity of sorting is reduced,compared to manual sorting.

Humans ; Liver Diseases ; Practice Guidelines as Topic ; Prognosis