Objective:To investigate the differences in multi-b-value apparent diffusion coefficient (ADC) and exponential apparent diffusion coefficient (eADC) between hepatocellular carcinoma (HCC) and paracancerous liver tissue, distant cancerous liver tissue, and background liver tissues by ultra-high field 3.0T diffusion-weighted (DWI) MRI imaging.Methods:Sixty-eight consecutive HCC cases confirmed by surgical pathology from January 2018 to October 2021 were enrolled and divided into a cirrhosis ( n=39) and a non-cirrhosis group ( n=29) according to the presence or absence of cirrhosis.The average ADC and eADC of liver tissues of paracancerous (including proximal and distal), distant cancerous, and background were measured by DWI images with diffusion sensitivity factors (b) of 50, 100, 400, 600 s/mm 2, and 1 000 s/mm 2, respectively. The Kruskal-Wallis H test and Bonferroni method were used to test the differences between the measured values of the five tissues. The statistical differences were used to evaluate the diagnostic efficacy of the five tissues by parametric receiver operating characteristic (ROC) curve and area under the curve (AUC). Results:The comparison of average ADC and eADC among five types of tissues in the liver cirrhosis group showed that the average ADC and eADC measured at b values of 50, 100, 400, and 600 s/mm 2 had statistically significant differences (adjusted P<0.005) between cancerous and proximal paracancerous, distal paracancerous, distant cancerous, and background liver tissue, as well as the average ADC measured at b=1 000 s/mm 2 between cancerous and proximal paracancerous tissue. The average ADC and eADC in the non-cirrhosis group had statistically significant differences (adjusted P<0.005) between cancerous and proximal paracancerous, distant paracancerous, distant cancerous, and background liver tissue measured at b values of 50, 100, and 400 s/mm 2, respectively. The average ADC and eADC measured at b=600 s/mm 2 showed statistically significant differences (adjusted P<0.005) between cancerous and proximal paracancerous, distal paracancerous, and distant cancerous liver tissue, as well as the average ADC measured at b=1 000 s/mm 2 between cancerous and distal paracancerous, and distant cancerous liver tissue. The average ADC and eADC in the cirrhosis group had no statistically significant difference between the proximal paracancerous and the distant cancerous, as well as the background liver tissue measured at b-values of 50, 100, 400, 600, and 1 000 s/mm 2, respectively (adjusted P>0.005), while there were statistically significant differences (adjusted P<0.005) in the average ADC values in the non-cirrhosis group between the proximal paracancerous and the distant paracancerous and background liver tissues at b=50 s/mm 2, as well as the average ADC and eADC values between the proximal paracancerous and the distant liver tissues at b=100 s/mm 2. The average ADC and eADC values measured in the cirrhosis group and non-cirrhosis group had no statistically significant difference between the distant paracancerous, distant cancerous, and background liver tissue (adjusted P>0.005). The efficacy of average ADC and eADC in distinguishing five types of tissues (cancerous and proximal paracancerous, distant paracancerous, distant cancerous, and background liver tissue) showed that in the cirrhosis group, the diagnostic efficacy was best at b=50 s/mm 2. The area under the ROC curve (AUC) of average ADC was 0.815, 0.828, 0.855, and 0.855, respectively, and the AUC of average eADC was 0.815, 0.830, 0.856, and 0.855, respectively. The diagnostic efficacy was best in the non cirrhosis group at b=100 s/mm 2, with average ADC AUCs of 0.787, 0.823, 0.841, and 0.821, and average eADC AUCs of 0.836, 0.874, 0.893, and 0.873, respectively. The AUC of the average ADC in the non-cirrhosis group for distinguishing between proximal paracancerous and distant cancerous liver tissues, as well as proximal paracancerous and background liver tissues, with b=50 s/mm 2, were 0.605 and 0.604, respectively. The average AUC of ADC and eADC for distinguishing between proximal paracancerous and distant liver tissues with b=100 s/mm 2 were 0.619 and 0.620, respectively. Conclusion:The average ADC and eADC measured by multiple b-values are helpful in distinguishing HCC from proximal paracancerous, distal paracancerous, distant-cancerous, and background liver tissues in patients with cirrhosis and non-cirrhosis, while the average ADC and eADC at b=50 s/mm 2 and 100 s/mm 2 exhibit differences between the proximal paracancerous from the distant cancerous liver tissue and background liver tissue in patients with non-cirrhosis.

Objective: To observe the root and root canal morphology of mandibular second molars in Western Guangxi by CBCT, to provide a reference for clinical diagnosis and treatment. Methods: In total, 564 patients′ 1 128 mandibular second molars that satisfy the inclusion criteria were analyzed with a planmecaromexis CBCT machine and its own image analysis software. The patients′ gender, age and ethnic differences in the root and canal morphology and the symmetry of the bilateral root and canal were statistically analyzed. Results: Among the 1 128 mandibular second molars, 662 were the Zhuang ethnic group and 384 were the Han ethnic group, and 82 were other ethnic groups; the double root type and C-shaped root type accounted for a relatively high proportion: 73.94% and 24.47%, respectively. The detection rates of the double root type were higher in males than in females (P < 0.05); the detection rates of the C-shaped root type were higher in females than in males (P <0.05); the root type of the teeth was mainly double-rooted in the Zhuang ethnic group (P<0.01). The incidence of type IV in the mesial root of the double root type mandibular second molar was the highest (P < 0.01), and the incidence of type I in the distal root was the highest (P < 0.01). The C-shaped root canal is more continuous at the mouth of the root canal, more downward corresponds to a worse continuity: in three different levels of root canal orifice, root middle and root apex, the root canal orifice is dominated by the C1 type, and both root middle and root apex are mainly C3-type (P < 0.01). The difference in symmetry of bilateral roots and root canals was statistically significant among different gender groups, age groups, and ethnic groups (P < 0.05): there were more males than females, the results in the 18-35-year-old group and the Zhuang ethnic group were higher. Conclusion The root and root canal morphology of mandibular second molars in western Guangxi people are complex and changeable. The roots are mainly double root type in the Han ethnic group and the Zhuang ethnic group. C-shaped roots are also common. The detection rate of C-shaped roots in the Zhuang ethnic group was higher, and the symmetry rate of bilateral roots and that of bilateral root canals was higher in the Zhuang ethnic group than in the Han ethnic group.

Objective To investigate whether a 3D printed model of the contrlateral healthy distal radius, especially its articular accuracy, helps anatomical reduction and precise reconstruction of the fractured distal radius. Methods The CT data of bilateral radii were collected from 15 normal volunteers ( 11 males and 4 females with an average age of 22. 8 years ) between November and December 2016. After 3D reconstruction of the bilateral distal 1/3 radii, solid 3D models of left radius were mirrored and generated by 3D printing. The data of right radii ( reference group ) were compared with the data of the solid 3D models of left radius acquired through a 3D scanner ( test group ) using deviation analysis. Results The maximum volume difference between the 3D printed model and the contralateral radius was 6. 86％. The average volume of the reference group was 19, 165. 82 ± 3, 250. 50 mm3 and that of the test group 19, 310. 65 ± 3, 305. 15 mm3, showing no statistically significant difference between the 2 groups ( t= -0. 941, P=0. 363 ) . The maximum surface area difference was 3. 84％ between the 2 groups. The average surface area of the reference group was 5, 075. 80 ± 549. 34 mm2 and that of the test group 5, 139. 43 ± 572. 48 mm2, showing a signifi-cant difference ( t= -2. 451, P=0. 028 ) . The 3D deviation analysis showed a mean positive deviation of 0. 37 ± 0. 10 mm and a mean negative deviation of 0. 30 ± 0. 07 mm. The maximum mean square root was 0. 65. The 3D deviation was distributed mainly within 1 mm interval, with a distribution frequency of 96. 27％. Conclusions A 3D printed model prepared by high precision equipment is accurate enough to guide reconstruction of distal radius fractures in adults. In the treatment of complex fractures of the distal radius, a 3D printed model of the contralateral healthy distal radius can be used as a reference to achieve anatomical reduction and precise reconstruction of the fractured distal radius.

Objective To observe the effect of Fufei Gushen Decoction on the BODE index, an index for body mass index(BMI), airflow obstruction, dyspnea, and exercise capacity, in severe and extremely severe chronic obstructive pulmonary disease (COPD) patients with lung-kidney deficiency interweaved with phlegm and blood stasis at stable stage. Methods Eighty qualified COPD patients were randomly divided into treatment group and control group, 40 cases in each group. Both groups were given inhalation of Seretide (Salmeterol Xinafoate and Fluticasone Propionate Powder for inhalation) , and the treatment group was given oral use of Fufei Gushen Decoction additionally. The treatment for the two groups lasted for 3 months. Before and after treatment, BMI, the percentage of forced expiratory volume in one second of the predicted value (FEV1%) , dyspnea index of modified British Medical Research Council (MMRC), and exercise performance index of 6-min walking test (6MWT) in the two groups were observed. Results (1) After treatment, FEV1%, MMRC dyspnea index, 6MWT scores and BODE index overall scores of severe and extremely severe patients in the treatment group were much improved(P < 0.05 compared with those before treatment ), but BMI was not much improved(P > 0.05). MMRC dyspnea index, 6MWT scores and BODE index overall scores of severe and extremely severe patients inthe control group were much improved (P<0.05 compared with those before treatment) , b ut the improvement of FEV1% and BMI was not obvious(P > 0.05).(2) Except for BMI, the parameters of FEV1%, MMRC dyspnea index, 6MWT scores and BODE index overall scores of the treatment group were much improved as compared with those of the control group after treatment(P < 0.05). Conclusion Fufei Gushen Decoction combined with inhalation of Seretide exerts certain effects on decreasing the BODE index scores, relieving symptoms, and improving pulmonary function, exercise performance and the quality of life of COPD patients with lung-kidney deficiency interweaved with phlegm and blood stasis at stable stage.

Objective To study the effects of ginkgo biloba extract(GBE)on c-reactive protein(CRP) and tumor necrosis factor-α(TNF-α)in serum and alveolar lavage fluid(BALF)from rats with chronic obstructive pulmonary disease(COPD). Methods 90 rats were randomly divided into groups A,B,C,D,E and F. There were 15 rats in each group. The rat model of COPD were established in groups B,C,D,E and F. Groups C and D were given intraperitoneal injections with GBE from day l to day l4 and day 29 to day 42. Groups E and F weregiven intraperitoneal injections with erythromycin from day l to day l4 and day 29 to day 42. After the end of experi-ment ,the contents of CRP and TNF-α in serum and BALF were detected in all groups. Results The contents of CRP and TNF-α in the serum and the BALF were markedly lower in groups C,D,E and F than in group B (P<0.05);and the contents of CRP in the serum and the BALF and TNF-αin the BALF were lower in groups C, E and F than in group D(P<0.05). Conclusions GBE can inhibit the airway and systemic inflammatory response in COPD rats. Early intervention is more effective.

Objective: To investigate the aeroallergen spectrum in allergic rhinitis in Xinjiang area and analyze its relating factors. Methods: Skin prick test was carried out in 480 cases with allergic rhinitis using 20 inhaled allergens. The major change in recent years with allergic rhinitis and allergen distribution was compared.SPSS 17.0 software was used to analyze the data. Results: Among 480 cases, 406 showed positive reaction. The most common allergens found in patients were chenopodium (61.6%) and mugwort (44.1%), followed by willow(37.7%), maple(37.7%), poplar(30.3%), house dust mite(30.3%), plantain(29.8%), acacia(25.9%), dust mite maple(25.4%), and so on. The rate of positive reaction to only one allergen was 9.6%, of which 21 were mite allergens. The positiverate to allergensin male and female were 84.2% and 85.1%, the distribution of allergens in both sexes did not differ(χ²=0.001, P=0.978). The positiverate to allergens in patients aged 21 to 35 years old was 88.6%, in patients aged 36 to 54 years old was 78.4%, the difference was statistically significant(χ²=0.258, P<0.01). The positive rate to allergens in Kazakhs was slightly higher than that in other ethnic groups (91.7%). The positive rates to allergens in the Han, Uygur and other ethnic groups were 84.8%, 86.4% and 63.3% respectively, the difference was statistically significant(χ²=9.779, P=0.044). Seventy-five point four percent of all allergen-positive patients(306 cases) combined with asthma. Conclusions The major allergen with allergic rhinitis is chenopodium. Among them, Kazakh allergic positive rate is higher than other ethnic groups.

Objective: To evaluate the efficacy and safety of pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) in prophylaxis neutropenia after chemotherapy in patients with lymphoma. Methods: This was a multicenter, single arm, open, phase Ⅳ clinical trial. Included 410 patients with lymphoma received multiple cycles of chemotherapy and PEG-rhG-CSF was administrated as prophylactic. The primary endpoint was the incidence of Ⅲ/Ⅳ grade neutropenia and febrile neutropenia (FN) after each chemotherapy cycle. Meanwhile the rate of antibiotics application during the whole period of chemotherapy was observed. Results: ①Among the 410 patients, 8 cases (1.95%) were contrary to the selected criteria, 35 cases (8.54%) lost, 19 cases (4.63%) experienced adverse events, 12 cases (2.93%) were eligible for the termination criteria, 15 cases (3.66%) develpoed disease progression or recurrence, thus the rest 321 cases (78.29%) were into the Per Protocol Set. ②During the first to fourth treatment cycles, the incidences of grade Ⅳ neutropenia after prophylactic use of PEG-rhG-CSF were 19.14% (49/256) , 12.5% (32/256) , 12.18% (24/197) , 13.61% (20/147) , respectively. The incidences of FN were 3.52% (9/256) , 0.39% (1/256) , 2.54% (5/197) , 2.04% (3/147) , respectively. After secondary prophylactic use of PEG-rhG-CSF, the incidences of Ⅳ grade neutropenia decreased from 61.54% (40/65) in the screening cycle to 16.92% (11/65) , 18.46% (12/65) and 20.75% (11/53) in 1-3 cycles, respectively. The incidences of FN decreased from 16.92% (11/65) in the screening cycle to 1.54% (1/65) , 4.62% (3/65) , 3.77% (2/53) in 1-3 cycles, respectively. ③The proportion of patients who received antibiotic therapy during the whole period of chemotherapy was 34.39% (141/410) . ④The incidence of adverse events associated with PEG-rhG-CSF was 4.63% (19/410) . The most common adverse events were bone pain[3.90% (16/410) ], fatigue (0.49%) and fever (0.24%) . Conclusion During the chemotherapy in patients with lymphoma, the prophylactic use of PEG-rhG-CSF could effectively reduce the incidences of grade Ⅲ/Ⅳ neutropenia and FN, which ensures that patients with lymphoma receive standard-dose chemotherapy to improve its cure rate.

Functional experiment plays an important role in understanding the mechanisms of diseases and principles of diagnosis and treatment. It requires students to master basic skills of func-tional operation, and complicated disciplines of functional alteration as well. Thus functional experi-ment needs to be an open course. The use of the virtual reality (VR) and real-time recording tech-niques provides potential for this exploration. By the way of real-time recording system, HD video of experiment operation is played, which helps guiding students to learn basic experiment skills; while based on the development status of VR technology, it is more applicable for learning by oneself, such as preview before the class and review for the test, and furthermore, the advantage of VR technique will be more apparent, if the key development focuses on experiment extensions to disclose more compli-cated functional alterations. This new technique helps to improve teaching effects of functional experi-ment.

Objective To investigate the incidence of sub-health fatigue among medical workers exposing to radioactive rays, and to observe the therapeutic effect of Bushen Jianpi recipe on sub-health fatigue. Methods An investigation was carried out among 1 056 medical workers exposing to radioactive rays which were from the medical and sanitary institutions of Guangzhou city. Sixty cases subjecting to the inclusion criteria were sampled from the investigated population by epidemiological methods for the randomized controlled trial. The subjects were evenly randomized into treatment group and control group. Both groups received health education and health-promoting lifestyle, and the treatment group was given self-prescribed Bushen Jianpi recipe additionally. The treatment lasted for 4 weeks. The scores of Multidimensional Fatigue Inventory ( MFI-20) and Sub-health Measurement Scale Version 1.0 ( SHMS V1.0) were observed before and after treatment, and the therapeutic effect was evaluated after treatment. Results ( 1) We got 976 effective questionnaires, and the effective response rate was 92.4%. Among the admitted 976 workers, the incidence of sub-health state was 66.8% (652/976) and that of sub-health fatigue is 31.4% ( 205/976). ( 2) The total effective rate was 80.0% in the treatment group and was 36.7% in the control group, the difference being significant ( P<0.01). ( 3) After treatment, the scores of MFI-20 and SHMS V1.0 were decreased in the treatmeat group, and fatigue symptom scores were decreased in the control group ( P<0.05 or P<0.01) , the decrease in the treatment group being superior to that in the control group ( P<0.05 or P<0.01). Conclusion The incidence of sub-health fatigue is popular in the medical workers exposing to radioactive rays, and Bushen Jianpi recipe has an effect on improving the sub-health fatigue.

Objective To research and develop a suitable clinical pathway chart for patients undergoing cervical vertebra anterior approach.Methods Totals of 156 cases undergoing cervical vertebra anterior approach,from April 2010 to March 2013,were selected and randomly divided into the observation group (78cases) and the control group (78 cases).The control group was using the traditional care and health education,while the observation group accepted new nursing pattern that following clinical pathway chart.The amount of bleeding,operation time,the incidence of complication and satisfactory level were compared between groups.Results The amount of bleeding and operation time in the observation group were (144.67 ± 70.64) ml and (111.67 ± 53.46) min,which were significantly lower than (189.33 ± 74.60) ml and (260.01 ± 72.11) min in the control group (t =-5.931,-2.862,respectively ; P ＜ 0.05).In the observation group,2 patients (2.56％) had postoperative hoarseness,14 patients (17.95％) had bucking,10 patients (12.82％) had pharynx pain.Those incidences in the control group were 14.10％,41.03％ and 35.90％.The differences were significant (x2 =6.797,9.989,11.272,respectively ; P ＜ 0.05).The mean score of satisfaction in the observation group was (4.59 ± 0.94),which was significantly higher (3.06 ± 1.02) in the control group (t =3.650,P ＜ 0.05).Conclusions Application of clinical pathway chart for patients undergoing cervical vertebra anterior approach can shorten the operation time and has lower incidence of postoperative complications,and it can improve satisfactory level.