Objective:To investigate the relevant data on radiation dose in interventional radiodiagnosis and radiology of adults in Beijing and to provide a basis for establishing relevant diagnostic reference levels (DRLs) in this region.Methods:A total of 30 medical institutions in Beijing were surveyed, covering interventional radiodiagnosis and radiology surgeries for coronary artery, structural heart diseases, permanent cardiac pacemaker implantation, electrophysiological study and radiofrequency ablation, nervous systems, abdominal systems, and the blood vessels of the lower limbs. The primary parameters investigated included the air kerma area product ( PKA) and incident air kerma ( Ka, r). The 75 th percentiles of radiation dose were considered DRLs, which were analyzed at both the overall and individual medical institution levels. Results:A total of 3 331 cases of the abovementioned radiodiagnosis and radiology surgeries were collected. The DRLs (i.e., PKA and Ka, r) of various diagnostic examinations were 37.87 Gy·cm 2 and 509.00 mGy for coronary artery, 9.34 Gy·cm 2 and 48.00 mGy for electrophysiological study and radiofrequency ablation, 218.50 Gy·cm 2 and 901.70 mGy for nervous systems, 81.00 Gy·cm 2 and 302.20 mGy for the abdominal system, and 83.37 Gy·cm 2 and 214.69 mGy for the blood vessels of the lower limbs. In contrast, the DRLs (i.e., PKA and Ka, r) for interventional radiodiagnosis and radiology were determined at 135.00 Gy·cm 2 and 1 897.58 mGy for coronary artery, 26.91 Gy·cm 2 and 172.30 mGy for structural heart diseases, 27.77 Gy·cm 2 and 87.75 mGy for permanent cardiac pacemaker implantation, 34.46 Gy·cm 2 and 247.00 mGy for electrophysiological study and radiofrequency ablation, 214.36 Gy·cm 2 and 1 282.80 mGy for the nervous system, 196.64 Gy·cm 2 and 875.71 mGy for abdominal system, and 108.25 Gy·cm 2 and 523.25 mGy for the blood vessels of the lower limbs. Conclusions:The DRLs of radiation dose in interventional radiodiagnosis and radiology in Beijing were determined through a survey and statistic analysis. These findings suggest that for certain interventional procedures, the optimized radiation protection should be enhanced.

Objective:To investigate the relevant data on radiation dose in interventional radiodiagnosis and radiology of adults in Beijing and to provide a basis for establishing relevant diagnostic reference levels (DRLs) in this region.Methods:A total of 30 medical institutions in Beijing were surveyed, covering interventional radiodiagnosis and radiology surgeries for coronary artery, structural heart diseases, permanent cardiac pacemaker implantation, electrophysiological study and radiofrequency ablation, nervous systems, abdominal systems, and the blood vessels of the lower limbs. The primary parameters investigated included the air kerma area product ( PKA) and incident air kerma ( Ka, r). The 75 th percentiles of radiation dose were considered DRLs, which were analyzed at both the overall and individual medical institution levels. Results:A total of 3 331 cases of the abovementioned radiodiagnosis and radiology surgeries were collected. The DRLs (i.e., PKA and Ka, r) of various diagnostic examinations were 37.87 Gy·cm 2 and 509.00 mGy for coronary artery, 9.34 Gy·cm 2 and 48.00 mGy for electrophysiological study and radiofrequency ablation, 218.50 Gy·cm 2 and 901.70 mGy for nervous systems, 81.00 Gy·cm 2 and 302.20 mGy for the abdominal system, and 83.37 Gy·cm 2 and 214.69 mGy for the blood vessels of the lower limbs. In contrast, the DRLs (i.e., PKA and Ka, r) for interventional radiodiagnosis and radiology were determined at 135.00 Gy·cm 2 and 1 897.58 mGy for coronary artery, 26.91 Gy·cm 2 and 172.30 mGy for structural heart diseases, 27.77 Gy·cm 2 and 87.75 mGy for permanent cardiac pacemaker implantation, 34.46 Gy·cm 2 and 247.00 mGy for electrophysiological study and radiofrequency ablation, 214.36 Gy·cm 2 and 1 282.80 mGy for the nervous system, 196.64 Gy·cm 2 and 875.71 mGy for abdominal system, and 108.25 Gy·cm 2 and 523.25 mGy for the blood vessels of the lower limbs. Conclusions:The DRLs of radiation dose in interventional radiodiagnosis and radiology in Beijing were determined through a survey and statistic analysis. These findings suggest that for certain interventional procedures, the optimized radiation protection should be enhanced.

Objective To explore the preventive effect of low molecular weight heparin(LMWH)combined with integrated medical-nursing enhanced recovery after surgery(ERAS)intervention on postoperative deep vein thrombosis(DVT)in colorectal cancer(CRC)patients.Methods A retrospective collection of postoperative CRC patients at Hangzhou Hospital of Traditional Chinese Medicine from January 2021 to October 2023 was conducted.Patients were divided in the combined intervention group(LMWH combined with ERAS)and the control group(LMWH)based on the intervention methods.The primary observation indicators of this study was the incidence of lower extremity DVT.Secondary observation indicators included changes in coagulation parameters[D-dimer(D-D),thrombin time(TT),prothrombin time(PT),activated partial thromboplastin time(APTT),and fibrinogen(Fib)]before and after intervention;blood flow velocity in the bilateral popliteal,external iliac,and femoral veins;time to first postoperative anal gas passage,time to resume eating,time to get out of bed and length of hospital stay;postoperative complication rate and adverse drug reaction rate.Results A total of 110 patients were included in the study,with 55 in the combined intervention group and 55 in the control group.There were no statistically significant differences between the two groups in terms of baseline characteristics,coagulation-related indicators before intervention,and lower limb venous blood flow velocity(P＞0.05).After 7 and 14 days of intervention,TT,PT,APTT,and Fib levels in both groups were higher compared to before the intervention,while D-D levels decreased(P＜0.05).There were no significant differences in TT,PT,and APTT between the two groups(P＞0.05),but the D-D level in the combined intervention group was lower than that in the control group(P＜0.05),and the Fib level was higher than that in the control group(P＜0.05).After 14 days of intervention,the blood flow velocities in the bilateral popliteal,external iliac,and femoral veins were higher in the combined intervention group than in the control group(P＜0.05),and the incidence of DVT was lower(1.82％vs.7.27％),but the difference was not statistically significant(P=0.363).The combined intervention group had shorter postoperative time to first anal gas passage,resumption of eating,getting out of bed,and length of hospital stay compared to the control group(P＜0.05).Finally,there were no statistically significant differences between the two groups in the incidence of postoperative complications and adverse reactions to LMWH(P＞0.05).Conclusion The combined intervention of LMWH and ERAS can effectively improve the hypercoagulable state in postoperative CRC patients,increase the venous blood flow velocity in the lower limbs,reduce the incidence of DVT,promote postoperative recovery,and has good safety.

Objective:To explore a teaching rounds model tailored for the ophthalmology day ward in standardized resident training.Methods:Based on the guidelines for teaching rounds in standardized resident training, we set up a teaching round working group and designed a teaching rounds model combining disease-based learning (DBL) and slit lamp-side (SLS) teaching. This teaching rounds model was implemented in 71 ophthalmology residents undergoing standardized training. The teaching effectiveness was evaluated through a questionnaire survey, including the rationality of the process design, the practicality of round content, the smoothness of round process, trainee engagement, and knowledge on the diseases involved. The results were compared with those of residents who received traditional bedside teaching rounds during the same period in 2022.Results:In the survey of satisfaction for the teaching rounds model combining DBL and SLS, 63 (88.73%) trainees were very satisfied with the rationality of the teaching round process design, trainee engagement, and knowledge on the diseases involved, 66 (92.96%) trainees were very satisfied with the practicality of the round content, and 64 (90.14%) trainees were very satisfied with the smoothness of the ward round process. Compared with the traditional bedside teaching rounds, the above five aspects of satisfaction were significantly improved ( P=0.022, P=0.023, P=0.003, P=0.019, P=0.025). Conclusions:The novel ophthalmology teaching rounds model combining DBL and SLS can be effectively integrated into the diagnosis and treatment processes in the day ward. The resident trainees showed high satisfaction with this model. This is an innovative teaching model well-suited for the operation of ophthalmology day wards.

Differentiated thyroid carcinoma (DTC) is the most common endocrine tumor,characterized by high incidence,low recurrence rate,and low mortality. Locally advanced thyroid cancer (LATC) is rare in clinical practice,with poor prognosis,and is one of the leading causes of death among thyroid cancer patients. In August 2024,the Thyroid Surgery Department of China-Japan Union Hospital of Jilin University admitted a 61-year-old male patient with a history of "neck mass surgery 16 years ago and progressive enlargement with ulceration of the mass over the past 3 months." Physical examination revealed an irregularly shaped mass measuring approximately 12 cm × 12 cm in the left supraclavicular fossa,with a dark red surface,ulceration,bleeding,and necrotic exudate in some areas. After admission,a multidisciplinary team (MDT) consultation was initiated,and the patient underwent his fifth surgery,which included resection of the left cervical mass,left cervical lymphadenectomy,resection of a submental mass,and free flap transplantation. The patient was discharged on postoperative day 10 in good condition. One month after surgery,a follow-up ultrasound at our hospital showed no significant abnormalities in the neck,with good healing of the local skin and survival of the transplanted flap. This article reviews the MDT treatment process of this LATC case and summarizes the characteristics of LATC based on domestic and international literature,providing experience and references for the comprehensive treatment of this disease.

Objective:A nationwide multi-center and large sample survey was conducted to compare the validity of the Mini International Neuropsychiatric Interview (Hypo-) Manic Episode with Mixed Features-DSM-5 Module (MINI-M) questionnaire and the Clinically Useful Depression Outcome Scale Supplemented with Questions for the DSM-5 Mixed Features Specifier (CUDOS-M) depression subscale in identifying mixed features in patients experiencing (hypo-) manic episodes.Methods:Using a convenience sampling method, 366 patients with bipolar disorder experiencing acute (hypo-) manic episodes who met the inclusion and exclusion criteria were recruited. The diagnosis of "with mixed features" was based on the DSM-5 criteria for mixed features. The predictive validity of the MINI-M questionnaire and the CUDOS-M depression subscale to screen mixed features was analyzed using the receiver operating characteristic (ROC) curve. Additionally, the difference in area under the ROC curve (AUC) between the two instruments was compared.Results:The AUC for the MINI-M questionnaire and the CUDOS-M depression subscale in screening mixed features were 0.79 (95 %CI=0.75-0.84) and 0.81 (95 %CI=0.77-0.86), respectively. There was no statistically significant difference in AUC between the two measurements ( Z=-1.19, P>0.05). Among patients with acute (hypo-) manic episodes, 45.9% (168/366) presented with mixed features according to the DSM-5 criteria, while the corresponding figures were 43.7% (160/366) using the MINI-M questionnaire (total score≥3) and 42.1% (154/366) using the CUDOS-M depression subscale (total score≥20). Screening results were comparable among the three measures. Conclusion:Mixed features are common among patients experiencing acute (hypo-) manic episodes. The MINI-M questionnaire and the CUDOS-M depression subscale demonstrate equivalent validity in identifying mixed features.

Differentiated thyroid carcinoma (DTC) is the most common endocrine tumor,characterized by high incidence,low recurrence rate,and low mortality. Locally advanced thyroid cancer (LATC) is rare in clinical practice,with poor prognosis,and is one of the leading causes of death among thyroid cancer patients. In August 2024,the Thyroid Surgery Department of China-Japan Union Hospital of Jilin University admitted a 61-year-old male patient with a history of "neck mass surgery 16 years ago and progressive enlargement with ulceration of the mass over the past 3 months." Physical examination revealed an irregularly shaped mass measuring approximately 12 cm × 12 cm in the left supraclavicular fossa,with a dark red surface,ulceration,bleeding,and necrotic exudate in some areas. After admission,a multidisciplinary team (MDT) consultation was initiated,and the patient underwent his fifth surgery,which included resection of the left cervical mass,left cervical lymphadenectomy,resection of a submental mass,and free flap transplantation. The patient was discharged on postoperative day 10 in good condition. One month after surgery,a follow-up ultrasound at our hospital showed no significant abnormalities in the neck,with good healing of the local skin and survival of the transplanted flap. This article reviews the MDT treatment process of this LATC case and summarizes the characteristics of LATC based on domestic and international literature,providing experience and references for the comprehensive treatment of this disease.

Objective:To explore a teaching rounds model tailored for the ophthalmology day ward in standardized resident training.Methods:Based on the guidelines for teaching rounds in standardized resident training, we set up a teaching round working group and designed a teaching rounds model combining disease-based learning (DBL) and slit lamp-side (SLS) teaching. This teaching rounds model was implemented in 71 ophthalmology residents undergoing standardized training. The teaching effectiveness was evaluated through a questionnaire survey, including the rationality of the process design, the practicality of round content, the smoothness of round process, trainee engagement, and knowledge on the diseases involved. The results were compared with those of residents who received traditional bedside teaching rounds during the same period in 2022.Results:In the survey of satisfaction for the teaching rounds model combining DBL and SLS, 63 (88.73%) trainees were very satisfied with the rationality of the teaching round process design, trainee engagement, and knowledge on the diseases involved, 66 (92.96%) trainees were very satisfied with the practicality of the round content, and 64 (90.14%) trainees were very satisfied with the smoothness of the ward round process. Compared with the traditional bedside teaching rounds, the above five aspects of satisfaction were significantly improved ( P=0.022, P=0.023, P=0.003, P=0.019, P=0.025). Conclusions:The novel ophthalmology teaching rounds model combining DBL and SLS can be effectively integrated into the diagnosis and treatment processes in the day ward. The resident trainees showed high satisfaction with this model. This is an innovative teaching model well-suited for the operation of ophthalmology day wards.

Objective:A nationwide multi-center and large sample survey was conducted to compare the validity of the Mini International Neuropsychiatric Interview (Hypo-) Manic Episode with Mixed Features-DSM-5 Module (MINI-M) questionnaire and the Clinically Useful Depression Outcome Scale Supplemented with Questions for the DSM-5 Mixed Features Specifier (CUDOS-M) depression subscale in identifying mixed features in patients experiencing (hypo-) manic episodes.Methods:Using a convenience sampling method, 366 patients with bipolar disorder experiencing acute (hypo-) manic episodes who met the inclusion and exclusion criteria were recruited. The diagnosis of "with mixed features" was based on the DSM-5 criteria for mixed features. The predictive validity of the MINI-M questionnaire and the CUDOS-M depression subscale to screen mixed features was analyzed using the receiver operating characteristic (ROC) curve. Additionally, the difference in area under the ROC curve (AUC) between the two instruments was compared.Results:The AUC for the MINI-M questionnaire and the CUDOS-M depression subscale in screening mixed features were 0.79 (95 %CI=0.75-0.84) and 0.81 (95 %CI=0.77-0.86), respectively. There was no statistically significant difference in AUC between the two measurements ( Z=-1.19, P>0.05). Among patients with acute (hypo-) manic episodes, 45.9% (168/366) presented with mixed features according to the DSM-5 criteria, while the corresponding figures were 43.7% (160/366) using the MINI-M questionnaire (total score≥3) and 42.1% (154/366) using the CUDOS-M depression subscale (total score≥20). Screening results were comparable among the three measures. Conclusion:Mixed features are common among patients experiencing acute (hypo-) manic episodes. The MINI-M questionnaire and the CUDOS-M depression subscale demonstrate equivalent validity in identifying mixed features.

Objective:This study investigates the difference in the detection rate and symptomatology between ICD-10 and DSM-5 diagnostic criteria for bipolar disorder with mixed states.Methods:Based on the Phase Ⅰ (2012) and Phase Ⅱ (2021) databases of National Bipolar Mania Pathway Survey (BIPAS), patients with bipolar disorder were included. General demographic data, clinical characteristics, symptomatic phenotypes, and mixed characteristics were retrieved. The detection rates and symptomatic performances of patients with or without mixed states in Phase Ⅰ and Ⅱ were compared using the chi-square test.Results:For patients with mixed states, the detection rate during Phase Ⅱ (2021) using DSM-5 (18.79%, 199/1 059) criteria was significantly higher than that during Phase Ⅰ (2012) using ICD-10 (6.78%, 199/2 934; χ 2=125.05, P<0.001). Whether using ICD-10 or DSM-5 criteria, patients with mixed states had a significantly higher frequency of multiple symptomatic manifestations. Conclusion:The DSM-5 diagnostic criteria generate a high detection rate for bipolar disorder with mixed states. The clinical phenotypes of bipolar disorder with mixed states vary significantly using different diagnostic tools.