In traditional clinical teaching of impacted tooth extraction, there are problems including limited observation fields for students, insufficient doctor-patient communication training, inadequate clinical thinking development, and low levels of clinical participation. Based on the core elements of visualizing jaw structure with perspective, formulating clinical strategy, immersing in clinical participation, and cultivating the spirit of caregiving, we developed a virtual reality simulation teaching platform for the clinical decision analysis of impacted tooth extraction. The virtual simulation-based platform can create three different impacted tooth scenarios in 3D, which demonstrates the process of clinical decision analysis of impacted tooth extraction through virtuality-reality interaction, allowing students to immerse in the discovery, analysis, and resolution of the medical and humanistic problems in the process of impacted tooth extraction. The questionnaire survey showed that 81.36% (48/59) of the students believed that the software could improve their clinical thinking ability; 76.27% (45/59) of the students believed that it could help them master the basic process of impacted tooth extraction; and 62.71% (37/59) of the students believed that it could improve their skills of impacted tooth extraction. By providing immersive learning experience, constructive teaching design, and multi-dimensional teaching evaluation, the software achieved the goals of cultivating students' clinical thinking ability and professional literacy in oral and maxillofacial surgery.

Objective:To analyze the diagnostic value of sex hormone combined with carcinoembryonic antigen on lymph node metastasis in breast cancer patients.Methods:52 cases of breast cancer patients who underwent surgical resection were collected and divided into non-metastasis group and metastases group after axillary lymph node ultrasonography. The blood samples was collected from patients and the levels of serum estradiol, testosterone, progesterone and carcinoembryonic antigen were detected; The diagnostic value of the above indexes in patients with lymph node metastasis was analyzed; Logistic risk regression model was used to analyze the independent risk factors for lymph node metastasis after surgical resection.Results:There were significant differences between the non-metastatic group and the metastatic group in the largest tumor diameter and menopause (all P<0.05), but there were no significant differences among other general data (all P>0.05). The serum estradiol level in the non-metastatic group was (153.97±35.55) pg/ml, the progesterone level was (0.33±0.05) ng/ml, and the carcinoembryonic antigen level was (11.44±3.77) ng/ml, while the estradiol level in the metastatic group was (207.19±52.11) pg/ml ( t=4.13, P<0.001), progesterone level (0.38±0.04) ng/ml ( t=4.01, P<0.001), carcinoembryonic antigen level (15.41±3.46) ng/ml ( t=3.94, P<0.001). The above three indicators were significantly increased in patients in the transfer group. The area under the curve of estradiol was 0.83, the area under the curve of progesterone was 0.80, the area under the curve of carcinoembryonic antigen was 0.77, the area under the curve of the combination of the three was 0.85, and the area under the curve of the combination of the three was the largest. Logistic risk regression model showed that estradiol, progesterone, and carcinoembryonic antigen levels were independent risk factors affecting lymph node metastasis in breast cancer patients (all P<0.05) . Conclusion:The sex hormone estradiol, progesterone combined with carcinoembryonic antigen has a high diagnostic value for lymph node metastasis in patients with breast cancer, and can independently predict the occurrence of lymph node metastasis in breast cancer patients.

Objective:To explore the effect of different post-processing parameters of digital radiography (DR) on the quality of chest X-ray for pneumoconiosis diagnosis, and to provide suggestions on parameter setting suitable for this kind of DR machine.Methods:From January 1, 2022 to June 30, 2022, the chest films of 35 workers in the department of radiology of Hangzhou occupational disease prevention and treatment hospital were randomly selected and printed after setting different image post-processing parameters. The quality of chest film was evaluated by the measurement of optical densitometer and the combination of subjective and objective by professional physicians.Results:When the density is set to 2 and the contrast/detail contrast is 4.5, the optical density of each area of DR chest film meets the requirements of chest X-ray quality, and the qualified rate of physician quality evaluation is the highest.Conclusion:Reasonable setting of image post-processing parameters can improve the quality of chest radiograph.

Objective:To explore the effect of different post-processing parameters of digital radiography (DR) on the quality of chest X-ray for pneumoconiosis diagnosis, and to provide suggestions on parameter setting suitable for this kind of DR machine.Methods:From January 1, 2022 to June 30, 2022, the chest films of 35 workers in the department of radiology of Hangzhou occupational disease prevention and treatment hospital were randomly selected and printed after setting different image post-processing parameters. The quality of chest film was evaluated by the measurement of optical densitometer and the combination of subjective and objective by professional physicians.Results:When the density is set to 2 and the contrast/detail contrast is 4.5, the optical density of each area of DR chest film meets the requirements of chest X-ray quality, and the qualified rate of physician quality evaluation is the highest.Conclusion:Reasonable setting of image post-processing parameters can improve the quality of chest radiograph.

Objective: To investigate the expression of survivin, fibronectin-1, vascular endothelial growth factor (VEGF) and ezrin in thyroid tumors and their relationship with the pathological characteristics of thyroid tumors. Methods: Ninety patients with thyroid tumors admitted to the third affiliated hospital of Zunyi Medical University and the first hospital during Oct. 2016 and Oct. 2018 were selected as the observation group. Seventy-five patients with normal thyroid confirmed by pathology in the same period were selected as the control group. The protein levels of survivin, fibronectin-1, VEGF and ezrin were detected by immunohistochemical method. Results: The positive rates of survivin, fibronectin-1, VEGF and Ezrin in the control group were 2.67%, l4.00%, 1.33% and 1.33%, which were lower than 97.78%, 96.67%, 93.33% and 95.56% in the observation group, respectively (all P<0.05 or P<0.01). The expressions of survivin, fibronectin-1, VEGF and ezrin were significantly correlated with TNM staging, tumor diameter, extrathyroid invasion and lymphatic metastasis (all P<0.05). Conclusion: Survivin, fibronectin-1, VEGF and ezrin proteins are all involved in the occurrence and development of thyroid tumors. The combined detection of these four indicators is of great significance in the diagnosis, treatment and prognosis of thyroid tumors.

Based on the pharmacogenomics theory, this study developed a software system for interpretation of drug gene loci and guidance on clinical safe medication with the purpose of providing clinical guidance on the safety and effectiveness of drug use through accurate and efficient detection and interpretation of drug gene loci. The system infrastructure was built on a service-oriented architecture (SOA) design and Docker container virtualization approach to achieve a rapid and automatic interpretation of genetic results and best available drugs. The front end was established on HTML5 and JavaScript to realize visualization of analysis results and user interaction. The system was tested and validated to show robust performance which is reliable in clinical use. It will show high impact on the development of pharmacogenomics and clinical practice of patients with personalized medicine.
Humans ; Pharmacogenetics ; Precision Medicine ; Software

Objective To explore the value of ultrsound tyorid imaige reporing and systerm (TI-RADS ), ultrasonic elastic strain rate (SR) and virtual touch tissue quantification (VTQ) three methods diagnosis of benign and malignant thyroid nodule. Methods 128 patients with thyroid nodule which need surgical treatment were selected as research objective. Before surgical treatment, all thyroid nodules detection with two-dimensional and color doppler ultrasoundand and classification by TI-RADS; All thyroid nodules measuring the SR of thyroid nodule as referenced of sternocleidomastoid; All thyroid nodules conducted with VTQ detection and recorded by shear wave velocity. Receiver operator characteristic curve (ROC) was used to evaluate TI-RADS, SR and VTQ in identifying benign and malignant thyroid nodule which by surgery pathology as the gold standard. Results TI-RADS, SR and VTQ had statistically significant (P < 0. 05 ) in benign and malignant thyroid nodules, the area under the ROC curve of TI-RADS, SR and VTQ were respectively 0. 83, 0. 87, 0. 92. Conclusion VTQ could improve the accuracy of ultrasonography in identifying benign and malignant thyroid nodule.

Objective To discuss the clinical effect of perioperative bundle of care for patients with advanced hepatocellular carcinoma (HCC) who are receiving CT-guided percutaneous minimally-invasive argon-helium knife cryoablation.Methods A total of 30 HCC patients,who underwent percutaneous argonhelium knife cryoablation,were enrolled in this study.Perioperative measures based on the concept of bundle of care were implemented,which included training of nursing team members,perfect preoperative psychological nursing,dietary guidance,preoperative routine preparations,effective intraoperative guidance and close observation of the patient's condition,postoperative activity guidance,prevention and observation of complications,etc.Results All 30 advanced HCC patients could actively cooperate with physicians for the performance of percutaneous argon helium cryoablation.After the treatment,two patients developed nausea and vomiting and one patient developed chills and fever,which were improved after symptomatic treatment.All the 30 patients recovered well during the perioperative period and were discharged from hospital smoothly.Conclusion Perioperative bundle of care can help patients restore the surgical damage as soon as possible,reduce the pain and improve the quality of life.

Mirror therapy has been widely used in practice as an effective rehabilitaiton method. Mirror integrated therapy combined mirror therapy with some other technologies, such as virtual reality, functional electrical stimulation, augmented reality, etc., to enhance the task orientation, and improve the efficiency of treatment.

Objective To explore the effect of applying syndrome differentiation and medicated diet in patients with liver cirrhosis as cites based on"Gu Ben Kai Qu"theory of TCM. Methods Seventy patients of liver cirrhosis as cites were randomly divided into observation group (35 cases) and control group(35 cases).The control group was cared with care routine of liver cirrhosis as cites,The observation group was based on care routine traditional nursing and implementation of dialectical medicalated meal which based on "Gu Ben Kai Qu" theory of TCM. The two groups of patients were used to assess the efficacy of liver cirrhosis as cites,urine volume,abdominal circumference,weight,TCM syndrome scale of liver disease. Results The urine volume on the 7th day, the 14th day, 2 weeks after discharge,the weight and the abdominal circumference on the 2 weeks after discharge from the patients in the observation group were respectively(1.90±0.52)L,(2.09±0.56)L,(2.02±0.35)L,(59.36±8.19)kg,(89.56±7.24)cm,while they were(1.63±0.36)L,(1.79±0.40)L,(1.82±0.38)L,(63.33±8.21)kg,(93.57±7.56)cm in the control group,the difference between the two groups was statistically significant (F=6.083, 6.484, 5.030, 4.108, 5.144,all P<0.05). The efficacy of liver cirrhosis as cites from the patients in the observation group were cured 40.0%(14/35),improved 42.9%(15/35),not cured 17.1%(6/35),while they were cured 22.9%(8/35),improved 40.0%(14/35),not cured 37.1%(13/35),the difference between the two groups was statistically significant (Z=2.012,P<0.05). The efficacy of TCM Syndromes on liver disease from the patients in the observation group were respectively[significant effect 37.1%(13/35),valid 45.7% (16/35),invalid 17.2%(6/35)],[significant effect 60.0%(21/35),valid 28.6%(10/35),invalid 11.4%(4/35)], while they were respectively [significant effect 20.0%(7/35), valid 42.9%(15/35), invalid 37.1%(13/35)], [significant effect 40.0%(14/35),valid 25.7%(9/35),invalid 34.3%(12/35)],the difference between the two groups was statistically significant(Z=2.065,2.104,all P<0.05). Conclusions Based on"Gu Ben Kai Qu"theory of TCM,the implementation of dialectical diet can effectively improve efficacy of liver cirrhosis as cites, reduction rate of TCM symptoms scale, urine volume,reduce the weight,shrink down the abdominal circumference,worthy of clinical application.