Objective To observe the value of breast imaging reporting and data system(BI-RADS)classification combined with mammography(MG)radiomics for differentiating breast benign and malignant amorphous calcification lesions.Methods A total of 217 breast amorphous calcification lesions in 206 female patients,including 43 malignant and 174 benign ones were retrospectively enrolled and randomly divided into training set(n=151)and validation set(n=66)at the ratio of 7∶3.Then radiomics features were screened based on breast MG images.BI-RADS model,radiomics model and combined model were established,and the value of each model for distinguishing benign and malignant lesions was observed.Results Eight optimal radiomics features were selected.The area under the curve(AUC)of BI-RADS model,radiomics model and combined model for differentiating breast benign and malignant amorphous calcification lesions was 0.821,0.763 and 0.897 in training set,0.800,0.746 and 0.893 in validation set,respectively,AUC of combined model was significantly higher than that of the other two(both P＜0.05).Conclusion BI-RADS classification combined with MG radiomics was helpful for differential diagnosis of breast benign and malignant amorphous calcification lesions,with efficacy higher than that of each alone.

Hip fracture in the elderly is characterized by high incidence, high disability rate, and high mortality and has been recognized as a public health issue threatening their health. Surgery is the preferred choice for the treatment of elderly patients with hip fracture. However, lower extremity deep venous thrombosis (DVT) has an extremely high incidence rate during the perioperative period, and may significantly increase the risk of patients′ death once it progresses to pulmonary embolism. In response to this issue, the clinical guidelines and expert consensuses all emphasize active application of comprehensive preventive measures, including basic prevention, physical prevention, and pharmacological prevention. In this prevention system, basic prevention is the basis of physical and pharmacological prevention. However,there is a lack of unified and definite recommendations for basic preventive measures in clinical practice. To this end, the Orthopedic Nursing Professional Committee of the Chinese Nursing Association and Nursing Department of the Orthopedic Branch of the China International Exchange and Promotive Association for Medical and Health Care organized relevant nursing experts to formulate Expert consensus on perioperative basic prevention for lower extremity deep venous thrombosis in elderly patients with hip fracture ( version 2024) . A total of 10 recommendations were proposed, aiming to standardize the basic preventive measures for lower extremity DVT in elderly patients with hip fractures during the perioperative period and promote their subsequent rehabilitation.

Objective　To provide a data foundation not only for food safety supervision and pollution source tracing, but also for the clinical treatment of drug-resistant bacteria in barreled drinking water, the drug resistance and type Ⅲ secretion system (T3SS) virulence genes carriage of Pseudomonas aeruginosa detected in barreled drinking water in Hainan Province were investigated, and the correlative relationship between strain ribosomal subtypes and virulence genes were then discussed. Methods The drug resistance of the isolated 55 strains of Pseudomonas aeruginosa was confirmed by using VITEK 2 Compact automatic microbial drug sensitivity system, and the T3SS virulence genes ExoU, ExoS, ExoT and ExoY were amplified by PCR, bacterial strain subtypes and homology were analyzed by the RiboPrinter automatic microbial gene fingerprint identification system. Results The drug sensitivity results showed that Pseudomonas aeruginosa isolated from barreled water had relatively low drug resistance, though one strain of multidrug-resistant Pseudomonas aeruginosa was discovered, resistant to imipenem, ciprofloxacin and cefepime. The distribution of T3SS virulence genes showed four genotypic combinations: ExoT+/ExoY+/ExoS+/ExoU- (45.45%, 25/55), ExoT+/ExoY+/ExoS-/ExoU+ (34.55%, 19/55), ExoT+/ExoY-/ExoS-/ExoU+(18.18%, 10/55), ExoT+/ExoY+/ExoS+/ExoU+ (1.82%, 1/55). Ribosomal typing results showed that the Pseudomonas aeruginosa strains were divided into six subtypes, the numbers of each subtype accounted for 24 (43.64%), 1 (1.82%), 25 (45.45%), 1 (1.82%), 3 (5.45%) and 1 (1.82%) respectively, with subtype Ⅰ and subtype Ⅲ being dominant. The main T3SS genotypes of the top two subtype I and subtype III were ExoT+/ExoY+/ExoS-/ExoU+ (16/24, 66.67%) and ExoT+/ExoY+/ExoS+/ExoU- (22/25, 88%). Conclusions The T3SS secretion system exhibits the characteristics of multiple virulence genes' coordinated expression, and there is a certain correlation between subtypes of bacterial strains and virulence genotypesThe exploration of the relationship between them provides guidance for tracing the source of Pseudomonas aeruginosa contamination, production control, clinical treatment in barrelled drinking water, and preliminarily establishes the initial data of local Pseudomonas aeruginosa strains in barrelled drinking water as well the related drug sensitivity data in Hainan.

In December 2019, the corona virus disease 2019 (COVID-19) broke out in Wuhan, Hubei Province. Although the number of newly confirmed COVID-19 cases in provinces outside of Hubei Province has declined continuously since February 4, the epidemic of COVID-19 remains serious. As companies resume work, it is still inevitable that some high-energy orthopedic trauma patients and elderly patients with low-energy fractures will need surgical treatment. The operating room, as a place for close contact between doctors, patients and nurses, increases the risk of infection and transmission. Based on the current needs of orthopedic trauma patients and the situation of the country's resistance to the epidemic of COVID-19, the authors expound the operating room management, preparation of medical materials, transfer of patients needing surgery, intraoperative protection and post-operative end disinfection in Third Hospital of Hebei Medical University so as to provide reference for prevention and control management of the operating room during the epidemic period.

Although the epidemic outbreak of Corona Virus Disease 2019 (COVID-19) restricted freecoming and going of people, it was inevitable that fracture patients, elderly ones with low-energy fracture in part ICU lar, sought medical attention. In this special situation, itwas crucial for trauma orthopaedists to do well in prevention and control of COVID-19 infection and in perioperative management of their patients as well while they went on with routine diagnosis and treatment. It was also of great significance for prognosis of the patients and prevention and control of the epidemic that orthopaedic surgeons chose proper surgical and anesthesia methods. In the process of diagnosis, treatment, nursing and rehabilitation, medical staff too was challenged by how to prevent themselves from infection and how to eliminate cluster COVID-19 transmission. This paper, from the perspectives of orthopedic surgeons, nurses and patients, expounds briefly on the management of patients with orthopedic trauma during the epidemic period of COVID-19 in a mode of multidisciplinary comprehensive interventions.

Objective: To investigate the application value of magnetic resonance imaging (MRI) in the classification diagnosis of rectal mucinous adenocarcinoma. Methods: The retrospective and descriptive study was conducted. The clinical data of 74 patients with rectal mucinous adenocarcinoma who were admitted to Chongqing Traditional Chinese Medicine Hospital from July 2009 and February 2019 were collected. There were 40 males and 34 females, aged (46±8)years, with a range from 32 to 82 years. Among the 74 patients, 41 were simple mucinous adenocarcinoma, 26 were partial mucinous adenocarcinoma, and 7 were focal or small foci mucinous adenocarcinoma. All patients underwent MRI plain scan and dynamic enhanced scan. Observation indicators: (1) morphology of rectal mucinous adenocarcinoma; (2) the lesion margin of rectal mucinous adenocarcinoma; (3) the value of apparent diffusion coefficient (ADC) of rectal mucinous adenocarcinoma; (4) internal enhancement features of rectal mucinous adenocarcinoma; (5) timesignal intensity curve of rectal mucinous adenocarcinoma. Measurement data with normal distribution were represented as Mean±SD, and count data were described as absolute numbers. Results: (1) Morphology of rectal mucinous adenocarcinoma: 74 patients had different morphological changes. Among the 41 cases of simple mucinous adenocarcinoma, 22 were oval, 8 were round, and 11 were irregular. Among the 26 patients with partial mucinous adenocarcinoma, 15 were oval, 8 were round and 3 were irregular. Among the 7 patients with focal or small foci mucinous adenocarcinoma, 2 were oval, 1 was round and 4 were irregular. (2) The lesion margin of rectal mucinous adenocarcinoma: the lesion margin of 74 patients was mainly unclear and irregular. Among the 41 cases of simple mucinous adenocarcinoma, 32 had unclear and irregular margin, 7 had clear margin, and 2 had unclear margin combined with fissure. Among the 26 cases of partial mucinous adenocarcinoma, 20 had unclear margin combined with fissure, 5 had unclear margin and irregular margin, and 1 had clear margin. Among the 7 patients with focal or small foci mucinous adenocarcinoma, 5 had unclear or irregular margin, 1 had unclear or irregular margin, and 1 had clear margin. (3) The value of ADC of rectal mucinous adenocarcinoma: diffusion weighted imaging of 74 patients showed diffused limited changes. The average ADC value was (1.24±0.23)×10^-3 mm²/s of 41 patients with simple mucinous adenocarcinoma, (0.91±0.42)×10^-3 mm²/s of 26 patients with partial mucinous adenocarcinoma, and (1.07±0.24)×10^-3 mm²/s of 7 patients with focal or small mucinous adenocarcinoma. (4) Internal enhancement features of rectal mucinous adenocarcinoma: 74 patients showed delayed heterogeneous enhancement and marginal enhancement. Among 41 cases of simple mucinous adenocarcinoma, 24 showed delayed heterogeneous enhancement, 17 showed marginal enhancement, and none showed homogeneous enhancement. Among 26 patients with partial mucinous adenocarcinoma, 20 showed marginal enhancement, 6 showed homogeneous enhancement, and none showed heterogeneous enhancement. All the 7 cases of focal or small foci mucinous adenocarcinoma showed heterogeneous enhancement. (5) Timesignal intensity curve of rectal mucinous adenocarcinoma: 74 patients showed mainly outflow type in the timesignal intensity curve. Among the 41 cases of simple mucinous adenocarcinoma, 22 presented progressive curve, 12 presented platform type, and 7 presented outflow type. Among the 26 patients with partial mucinous adenocarcinoma, 17 presented outflow type, 8 presented platform type, and 1 presented progressive type. Among the 7 patients with focal and small forci mucinous adenocarcinoma, 4 presented outflow type, 2 presented platform type, and 1 presented progressive type. Conclusions MRI findings show different results for different types of rectal mucinous adenocarcinoma. A correct understanding of the MRI features of different types of rectal mucinous adenocarcinoma is helpful for the classification diagnosis of rectal mucinous adenocarcinoma.

Objective? To explore the current status of frailty in elderly patients with chronic heart failure (CHF), and the influencing factors. Methods? From January 2016 to December 2017, a total of 190 elderly inpatients with CHF in Cardiology Department in China-Japan Union Hospital of Jilin University were selected as participants by convenient sampling method, and the CP-FI-CGA questionnaire was used in the study. Results? The 190 elderly patients with CHF scored (0.05-0.87) points in the CP-FI-CGA questionnaire with an overall average score of (0.32±0.10) points, indicating a moderate level of frailty. Multiple linear regression analysis showed that age, NYHA cardiac function classification and sleeping condition were the influence factors for frailty in elderly patients with CHF (P＜0.01). Conclusions? The elderly patients with CHF are mostly at moderate levels of frailty, the older the patients are, the worse their cardiac function and the sleep condition become, and the more serious the frailty get.

Objective:To determine the inhibitory effect of Rupixiao ( RPX) granule on mammary gland hyperplasia ( HMG) in rabbits and explore the possible mechanism to provide reference for clinical medication. Methods:Rabbit model of mammary hyperpla-sia was established by estradiol benzoate and progesterone. Xiaoyao pills and tamoxifen were used as the positive control, and the RPX granule group was respectively at low, medium and high dose (0. 525,1. 05,2. 1 g·kg-1). Each group was with intragastric adminis-tration for 30 days. The levels of E2 , PROG, FSH, LH and PRL in serum and the expression of VEGF in the homogenate tissue were determined by an Elisa method. The breast tissue of rabbits in each group was withdrawn to observe the structure changes after Hema-toxylin-eosin staining ( HE) . Results:Ovarian preservation-benzoic acid, estradiol combined with progesterone could be used to estab-lish mammary gland hyperplasia in rabbits. RPX granule could significantly decrease the serum levels of E2 and PRL (P<0. 01)and increase that of PROG (P<0. 01 or P<0. 001). The results of pathological section showed that the breast structure in RPX granule high dose group could be restored to the level of the blank control group, which showed its therapeutic effect on HMG was better than that of tamoxifen and Xiaoyao pills. The expression of VEGF in each treatment group significantly decreased compared with that in the model group by the Elisa reagent (P<0. 001). Conclusion:RPX granule has good efficacy in HMG rabbits. The inhibitory effects of RPX granule on HMG in rabbits maybe related to the inhibition of VEGF in rabbit breast tissues, and the inhibition of RPX granule was similar to that of tamoxifen and Xiaoyao pills.

Objective To obtain a clear and qualified compound glycyrrhiza oral solution by using NaSO3 and EDTA as stabi-lizers and Tween80 as solubilizer so as to solve the problem of morphine content instability. Methods NaSO34g and EDTA 0.6 g as stabilizers,and Tween803 g as solubilizer were added in the traditional method. The pH of the solution was adjusted to 8.0. Then the solution was obtained and filled in the brown polyester bottle. Results The preparation was clear,qualified and the content of mor-phine was steady. Conclusion The improved method is feasible,simple,stabilized and suitable for manufacturing.

OBJECTIVETo investigate the expression and clinical significance of G protein-coupled receptor 31 (GPR31) in colorectal cancer tissue.

METHODSCancer tissues and adjacent normal tissues of 321 cases with colorectal cancer confirmed by pathology and undergoing resection in the First Affiliated Hospital of Sun Yat-sen University from January 1996 to December 2008 were collected. The expression of GPR31 was examined by immunohistochemical staining. According to the expression level of GPR31 (A value=0.051), all the patients were divided into low GPR31 expression group and high GPR31 expression group. Clinicopathology and prognosis between the two groups were compared. Risk factors affecting prognosis were investigated.

RESULTSGPR31 expression was significantly higher in colorectal cancer tissues compared to adjacent normal tissues (mean A, 0.063±0.014 vs. 0.045±0.020, P<0.001). A total of 197 cancer tissue samples were defined as low expression and 124 as high expression. Significant difference was observed in the number of patient in pM classification between the two groups (P=0.007). High expression group had obviously higher distant metastasis rate than low expression group [12.1% (15/124) vs. 4.1% (8/197), P=0.007]. The 5-year survival rate and tumor-free survival rate were 84.3% and 82.2% in the low expression group, and both 59.7% in high expression group (all P<0.05). Multivariate analysis revealed elderly, abnormal CEA, lymphatic metastasis, distant metastasis and up-regulated GPR31 expression were independent risk factors of overall survival and disease-free survival in colorectal cancer patients (all P<0.05).

CONCLUSIONSGPR31 expression is significantly up-regulated in colorectal cancer tissues. High GPR31expression indicates poor prognosis of colorectal cancer, and may be used as a predictive marker.

Aged ; Biomarkers, Tumor ; metabolism ; Colorectal Neoplasms ; diagnosis ; metabolism ; Disease-Free Survival ; Humans ; Lymphatic Metastasis ; Prognosis ; Receptors, G-Protein-Coupled ; metabolism ; Risk Factors ; Survival Rate ; Up-Regulation