Objective:To explore the comparison of imaging characteristics and diagnostic value between ultrasound and CT in patients with pulmonary tuberculosis in Tibetan population in plateau region.Methods:From May 2022 to November 2023,a total of 100 patients with pulmonary tuberculosis of Tibetan population in plateau region,who admitted to Qinghai Provincial Hospital of Traditional Chinese Medicine,were selected as the study objects.All of them were examined by ultrasound and CT.The ultrasonic imaging characteristics of the lesions of patients with pulmonary tuberculosis in plateau region were dynamically observed.And then,the diagnostic effects of ultrasound and CT on pulmonary tuberculosis in the Tibetan population in the plateau region were compared.Results:There was no significant difference in the positive rate of pulmonary tuberculosis in Tibetan population of plateau region between ultrasound and CT examinations(x2=0.421,P＞0.05).The diagnostic sensitivity,diagnostic specificity and Yoden index of ultrasound diagnosis were respectively 97.80%,44.44%and 42.24%,and these of CT diagnosis were respectively 96.77%,42.86%and 39.63%,and the differences were not significant(x2=0.184,0.004,0.272,P＞0.05),respectively.There was no significant difference in detection rate of the distribution of pulmonary tuberculosis lesions in Tibetan population in plateau region between ultrasound and CT examinations(x2=2.011,P＞0.05).There were no significant differences in the detection rates of atelectasis,cavity,calcification and accompany of pleural effusion between ultrasound and CT examinations in patients with pulmonary tuberculosis in Tibetan population in plateau region(x2=0.190,0.197,0.190,0.046,P＞0.05).Conclusion:There are no significant differences in positive detection rate,the detection rate of the distribution of diseased lung lobes,the detection rates of the complication of pulmonary tuberculosis or associated signs such as atelectasis,cavity,calcification and accompany of pleural effusion between ultrasound and CT examinations.The medical resource of plateau region is lack,which is shorter of large examination equipment.Therefore,using ultrasound examination to conduct general survey and preliminary diagnosis for pulmonary tuberculosis is more suitable to the plateau region that lacks CT equipment or is affected by electricity

Objective:To evaluate the feasibility and safety of total aortic arch surgery under mild hypothermicvia single upper hemisternotomy approach.Methods:From January 2019 to July 2019, 35 patients(31 male and 4 female) with Stanford A type aortic dissection were diagnosed, who were(43.7±5.7)years old. Aortic arch surgeries were carried out under mild hypothermic via single upper hemisternotomy approach and the perioperative mortality, time of cardiopulmonary bypass(CPB), aortic cross clamp(ACC), circulation arrest(CA) and morbidity of neurological dysfunction were respectively were recorded.Results:All patients were finished aortic arch surgery under mild hypothermic single upper hemisternotomy approach, with 8.6% of mortality(3 patients died perioperation). The time of CPB, ACC and CA were respectively(202±53)min, (128±28)min and(8±3)min. There were 6 cases of transient neurological dysfunction(17.1%) and 1 case of permanent neurological dysfunction(2.9%).Conclusion:Aortic arch surgery under mild hypothermic for Standford A dissectionvia single upper hemisternotomy approach is safe and feasible.

Objective: To investigate the diagnostic value of superb microvascular imaging(SMI), advanced dynamic flow(ADF) and color Doppler flow imaging(CDFI) in breast microcarcinoma, and to compare the correlation coefficients between these three indicators and postoperative pathological tumor microvascular density(MVD). Methods: A total of 85 patients(87 lesions) with BI-RADS 4 and the maximum diameter≤1 cm were selected, of which, 46 lesions were benign(benign group) and 41 lesions were malignant(malignant group). All the patients and the corresponding lesions were examined by SMI, ADF and CDFI. Blood flow grading was performed on the images using Adler grade of blood flow, and the difference of blood flow among the 3 methods was compared. The expression level of MVD in pathological tumor tissues was detected and analyzed for its correlation with Adler classification by three detection techniques. Results: The areas under the ROC curve(AUR) of CDFI, ADF and SMI were 0.694, 0.705 and 0.776 respectively based on the gold standard with pathological diagnosis. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CDFI were 78.0%, 54.3%, 60.4%, 73.5%, and 65.5%, respectively; those of ADF were 75.6%, 60.9%, 63.3%, 73.7% and 67.8%, respectively; and those of SMI were 78.0%, 69.6%, 69.6%, 78.0% and 73.6%, respectively. The Adler grades of CDFI, ADF and SMI were positively correlated with MVD(P<0.05), which the highest correlation coefficient between SMI and MVD (r=0.430, P<0.001). Conclusions SMI is superior to ADF and CDFI in detecting the abundance of breast microcarcinoma, and has the highest correlation coefficient among those 3 detection techniques with tumor pathological MVD, which indicates that SMI may be used for differential diagnosis of breast microcarcinoma and indirectly evaluate the prognosis of patients.

Objective To investigate the diagnostic value of superb microvascular imaging ( SM I ) , advanced dynamic flow ( ADF ) and color Doppler flow imaging ( CDFI) in breast microcarcinoma ,and to compare the correlation coefficients between these three indicators and postoperative pathological tumor microvascular density ( M VD ) . Methods A total of 85 patients ( 87 lesions ) with BI‐RADS 4 and the maximum diameter≤1 cm were selected ,of which ,46 lesions were benign ( benign group) and 41 lesions were malignant( malignant group) . All the patients and the corresponding lesions were examined by SM I , ADF and CDFI . Blood flow grading was performed on the images using Adler grade of blood flow ,and the difference of blood flow among the 3 methods was compared . T he expression level of M VD in pathological tumor tissues was detected and analyzed for its correlation with Adler classification by three detection techniques . Results T he areas under the ROC curve( AUR) of CDFI ,ADF and SM I were 0 .694 ,0 .705 and 0 .776 respectively based on the gold standard with pathological diagnosis . T he sensitivity ,specificity , positive predictive value ,negative predictive value ,and accuracy of CDFI were 78 .0% ,54 .3% ,60 .4% , 73 .5% ,and 65 .5% , respectively ; those of ADF were 75 .6% , 60 .9% , 63 .3% , 73 .7% and 67 .8% , respectively ; and those of SM I were 78 .0% ,69 .6% ,69 .6% ,78 .0% and 73 .6% ,respectively . T he Adler grades of CDFI , ADF and SM I were positively correlated with M VD ( P ＜ 0 .05 ) , w hich the highest correlation coefficient between SM I and M VD ( r ＝0 .430 , P ＜0 .001 ) . Conclusions SM I is superior to ADF and CDFI in detecting the abundance of breast microcarcinoma , and has the highest correlation coefficient among those 3 detection techniques with tumor pathological M VD ,which indicates that SM I may be used for differential diagnosis of breast microcarcinoma and indirectly evaluate the prognosis of patients .

Adenosine 5'-monophosphate-activated protein activated protein kinase (AMPK), a heterotrimeric complex, is an important kinase to regulate glycolipid metabolism and energy balance involved in a variety physiological processes in human body. Many research indicated that the function and activity of AMPK were closely related to inflammation, diabetes and cancers. Recent reports show that inhibition of metformin (a first-line drug) on hepatic glucose in patients with hyperglycemia is associated with AMPK pathway, suggesting that targeting AMPK may be one of the effective strategies for the prevention and treatment of a variety of chronic diseases. Here, we review research progress on the structure, activation and regulation of AMPK in glycolipid metabolism to provide an insight into the basic and clinical research of diabetes therapy.
AMP-Activated Protein Kinases ; Adenosine ; Adenosine Monophosphate ; Energy Metabolism ; Enzyme Activation ; Glycolipids ; Humans

Objective To develop a simple method identifying and illustrating clustered repeats in bacterial ge-nomes, and to observe the patterns of clustered repeats in Salmonella genomes.Methods Bacterial genomes were cut to be overlapped pieces of identical size with a sliding window strategy .Each piece of genome fragment was aligned against itself with BLAT integrated in PipMaker , which was further used to build collinearity figures . Collinearity figures were analyzed to identify the clustered repeats.Results With the new pipeline CRpred ( Clustered Repeat Predicter) , Salmonella typhimurium LT2 genome was screened, and in 151 clustered repeats were disclosed.Pattern analysis on these repeats indicated that there were five categories, including low-copy simple tandem repeats, high-copy simple tandem repeats, interspaced tandem repeats, reverse-complementary re-peats, and interspaced reverse-complementary repeats.Nine repeat regions in LT2 genome were discovered which could not be simply classified into the 5 categories defined above.Conclusions A new, simple and intuitive strategy is proposed to identify and show clustered repeats in genomes , providing clues for CRISPR , VNTR and oth-er repeat-related studies .

Objective To study the distribution and evolution of yiiG, a Salmonella gene encoding a candidate type secretedsubstrate .Methods Salmonella genomes were comprehensively screened for yiiG distribution with se-quence alignment strategies .The evolutionary history of yiiG was traced .Comparative genomic analysis was per-formed to study the evolutionary mechanisms of yiiG gene acquisition , loss and duplication .RNA-seq data were combined to analyzing the correlation between yiiG and other virulence factors .A variety of bioinformatic tools were used for discovering the possible type Ⅲsecretion signals .Results yiiG distributed in S.enterica subsp.enterica but variable in other subspecies of S.enterica.No yiiG was found in S.bongori.Besides Salmonella, only a part of Shigella and E.coli strains were detected with yiiG homologs .The genomic locus of yiiG and its adjacency showed conservation among all Salmonella, E.coli and Shigella strains.In most of the serovars of S.enterica subsp.enteri-ca, there was a head-to-head tandem whole yiiG repeat sequence upstream the yiiG gene, which was renamed as yiiGRrc.RNA-seq analysis showed that yiiG gene expression level was highly correlated with T 3SS-related genes . Bioinformatic prediction also indicated the T 3SS effector signals in YiiG N-terminus.Conclusions yiiG represented an ancient genomic locus , which will be a hot spot where rearrangement events frequently happened .The function of yiiG could potentially be related with Salmonella virulence.Finally, a new protein-encoding gene (yiiGRrc) was newly identified that was closely related with yiiG, providing the target for further understanding the composition , function and function variation of yiiG gene family .

Objective To investigate the distribution and changes of microorganisms on the skin of submariners under a chronically closed environment , and provide reference for targeted medical support .Methods One hundred and twenty-two samples were collected using swab.After culture and isolation, the microbes were identified by matrix-assisted laser desorption/ionization time of flight mass spectrometry ( MALDI-TOF-MS) .Results A total of 52 types of 229 bacteria and 2 types of fungi were isolated . Major opportunistic pathogens included Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter cloacae, while major dwelling bacteria included Micrococcus luteus, Oslo Mora bacteria, Acinetobacter, Staphylococcus epidermidis, and Serratia marcescens.Compared with the early period of the task, major opportunistic pathogens and dwelling bacteria were significantly increased in the middle and late period of the task .Conclusion The skin microbes of the submariners are investigated , targeted drugs need to be prepared for daily medical support and war trauma .

Objective To analyze the causes and treatment methods of early complications after central systemic-pulmonary shunt in complex cyanotic congenital heart diseases.Methods Two hundred and twelve cases of central systemic-pulmonary shunt in complex cyanotic congenital heart diseases were retro-spectively analyzed in order to explore the early postoperative complications and related treatment measures. Results There were 61 cases(28.77%)of the early postoperative complications,including severe low car-diac output syndrome in 27 cases,acute pulmonary edema in 14 cases,24 h shunt pipe blockage in 12 cases, and supraventricular tachycardia in 8 cases.All patients got followed up,average for(2.49 ±1.21 )years.Af-ter the systemic-to-pulmonary artery shunts,pulmonary vascular had significant growth,8 patients(3.77%) of them who pulmonary hypoplasia were promoted by transcatheter aortopulmonary collateral vessels.At the end of the follow-up,77 patients(36.32%)achieved the standard of radical surgery.Conclusion The factors affecting surgical survival rate include:enhancement of patients cardiac function and strictly handle operation indication before operation a clear operational view;rational surgical methods;treatment of complication with-out delay;strict,intensive care and synthesized treatment.

Objective To explore the risk factors and nursing measures for senile patients with osteoporosis. Methods All 160 cases of senile osteoporosis patients in January 2012 to August 2014 in our hospital and 160 cases of non senile osteoporosis patients at the same period were as the research object,the osteoporosis patients were as the observation group,the non osteoporosis patients were as the control group,general information of two groups were compared,includ-ing age,height,weight and BMI,and analyzed the influence factors of osteoporosis,including risk factors Logistic re-gression in senile osteoporosis risk factors by univariate Logistic regression of senile osteoporosis and multiple factors,and to explore the nursing measures. Results①The average height of the observation group was(165.21±4.89)cm,the control group (168.44±6.23)cm, with statistical difference (t=4.2069, P<0.05); the average weight of the observation group was(64.21±10.01)kg,the control group was(68.37±10.24)kg,with statistical difference(t=3.3607,P<0.05);②Single factor Logistic regression analysis showed that the factors associated with senile osteoporosis including lie in bed,height, exercise, calcium agent and drink milk; ③Logistic multi factor regression analysis showed taller, sport and drinking milk were protective factors of senile osteoporosis,and lie in bed was the risk factor of senile osteoporosis. Conclusion The taller,sport and drinking milk are protective factors of senile osteoporosis,and lie in bed is risk factor for senile osteoporosis.