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 analyze the current situation of depressive symptoms among medical staff in Beijing City and its correlation with symptoms of anxiety, occupational stress and insomnia. Methods A total of 2 687 medical staff from 28 medical institutions in eight municipal districts of Beijing City were selected as study subjects using multi-stage sampling method. The basic situation, depression symptoms, anxiety symptoms, occupational stress and insomnia symptoms were investigated using the National Occupational Health Literacy Monitoring Questionnaire for Key Groups, Patient Health Questionaire-9, 7-item Generalized Anxiety Disorder Scale, Core Occupational Stress Scale, and Self-Sleep Management Questionnaire. Results The detection rate of depressive symptoms was 28.3%, and the detection rates of moderate, moderate-severe and severe depressive symptoms were 18.9%, 6.9% and 2.5%, respectively. The detection rate of anxiety symptoms was 41.3%, and the detection rates of mild, moderate and severe anxiety symptoms were 29.7%, 7.7% and 3.9%, respectively. The detection rate of occupational stress was 26.7%. The detection rate of insomnia symptoms was 36.6%. The results of multivariate logistic regression analysis showed that the risk of depressive symptoms in male medical staff was higher than that in female (P<0.05). The risk of depressive symptoms in night shift staff was higher than that in staff without night shift (P<0.05). The more severe the anxiety symptoms, the higher the risk of depressive symptoms (all P<0.01). The risk of depressive symptoms in medical staff with occupational stress was higher than those without occupational stress (P<0.01). The risk of depressive symptoms in medical staff with insomnia symptoms was higher than those without insomnia symptoms (P<0.01). Conclusion The detection rate of depressive symptoms among medical staff in Beijing City is relatively high. Gender, night shift, anxiety symptoms, occupational stress, and insomnia symptoms were independent risk factors of depressive symptoms.

Purpose/Significance The disposal rate of wearable devices is high after use,and analyzing the influencing factors of their continuous usage is conducive to exploring the scheme to promote the continuous usage of wearable devices.Method/Process The paper conducts literature research on relevant researches at home and abroad,and analyzes the research status of continuous usage of wearable devices from four aspects:literature background,theoretical trends,research perspectives and influencing factors.Result/Con-clusion The theoretical research of wearable devices is mainly based on expectation confirmation model;there are two main perspectives based on wearable device application scenarios:health and exercise;the key influencing factors of continuous usage intention for wearable devices are perceived value,positive emotion,perceived risk,user traits and device characteristics.

Glioblastoma (GBM) therapy is severely impaired by the blood-brain barrier (BBB) and invasive tumor growth in the central nervous system. To improve GBM therapy, we herein presented a dual-targeting nanotheranostic for second near-infrared (NIR-II) fluorescence imaging-guided photo-immunotherapy. Firstly, a NIR-Ⅱ fluorophore MRP bearing donor-acceptor-donor (D-A-D) backbone was synthesized. Then, the prodrug nanotheranostics were prepared by self-assembling MRP with a prodrug of JQ1 (JPC) and T7 ligand-modified PEG_5k-DSPE. T7 can cross the BBB for tumor-targeted delivery of JPC and MRP. JQ1 could be restored from JPC at the tumor site for suppressing interferon gamma-inducible programmed death ligand 1 expression in the tumor cells. MRP could generate NIR-II fluorescence to navigate 808 nm laser, induce a photothermal effect to trigger in-situ antigen release at the tumor site, and ultimately elicit antitumor immunogenicity. Photo-immunotherapy with JPC and MRP dual-loaded nanoparticles remarkably inhibited GBM tumor growth in vivo. The dual-targeting nanotheranostic might represent a novel nanoplatform for precise photo-immunotherapy of GBM.

Evaluate the feasibleness of forecast the prognostic of sick person acute ischemic stroke Intravenous thrombolysis based on multi-phase CT angiography（mCTA）united with medical message. MethodsThe sufferer acute ischemic stroke accomplished mCTA scan were choose. The multi-phase ASPECTS collateral circulation，blood glucose results red blood cell distribution width（RDW）and neutrophil to lymphocyte ratio（NLR）were record. Pursuant to the modified Rankin Scale（mRS）as the criterion，90 daytime after therapy，sufferer mRS score≤2 were specified as set A（n=18），and sufferer mRS score≥3 were specified as set B（n=33）. The information with statistics discrepancies in univariate analysis were contained in binary Logistics regression analysis. The standalone risk elements for forecast the prognostic of sick person acute ischemic stroke were sifted out and the prognostic modeling was effected. The ROC curvature of all the variable with statistics meaning and the binary Logistics regression analysis was used to assess the diagnosis effectivity，Delong test was used to evaluate the discrepancies in between the ROC curvature. ResultsThe blood glucose results，RDW and NLR of set A were higher than those of set B，and the multi-phase score of set A was lower Compare of set B（P<0.05）. Binary Logistics regression analysis showed multi-phase score and NLR were standalone risk factor for 90 daytime prognostic of sick person acute ischemic stroke. The prediction model was logit（P）=-4.877+aspects score×-0.624+NLR×When the threshhold was 0.5288，the sensitivities and specificity were 77.8% and 93.9%，respectively. ConclusionAspects score and NLR are independent risk factors for predicting 90 daytime prognosis of patients with AIS. multi-phase CTA combined with laboratory examination can forecast the prognostic of sick person acute ischemic stroke and bestow precise forecast information for clinical sick person acute ischemic stroke.

Objective:To observe the clinical characteristics of esophageal reflux after total gastrectomy (ERATG), and to explore the mechanism of occurrence.Methods:Fourteen gastric cancer patients who underwent total gastrectomy were prospectively enrolled in this study. The postoperative symptoms were observed and recorded and 24 h MII-pH with pH monitoring was performed to investigate the characteristics of postoperative reflux.Results:After total gastrectomy patients were with different degrees of ERATG as heartburn, appetite loss, chest tightness and belching. The overall nature of ERATG is mainly weak acid, with a pH between 4 and 7. ERATG involved esophageal-jejunal anastomosis and a length of esophagus 7 cm above the anastomosis. Patients with typical reflux symptoms had a lower pH minimum in the upright position than those without typical symptoms[(4.76±0.71) vs.(5.68±0.37), t=2.866, P<0.05]. Patients with typical reflux symptoms had a higher frequency of reflux of mixed liquid and liquid-air reflux than those without typical symptoms[liquid(31.25±29.76) vs.(4.50±9.14), t=0.011, P<0.05; liquid-air(19.50±12.99) vs.(2.00±2.61), t=0.004, P<0.05]. Conclusion:ERATG is mainly a upward reflux of weakly acidic gas, with typical symptoms of heartburn, appetite loss, chest tightness and belching. Patients with typical symptoms usually have lower pH in the upright position.

Objective:To study the effects of radiotherapy and the prognostic factors in hepatocellular cancer (HCC) patients with cardiophrenic angle or superior diaphragmatic lymph nodes metastasis (LNM).Methods:We retrospectively analyzed 56 HCC patients with cardiophrenic angle or superior diaphragmatic LNM who were treated with or without external beam radiation therapy (EBRT) in Zhongshan Hospital of Fudan University from Jan 2010 to Aug 2020. Patients were divided into two groups according to whether they received radiotherapy, EBRT group and non-EBRT group, and each group had 28 patients. Radiation fields included or excluded primary tumor in EBRT group, and the cardiophrenic angle or superior diaphragmatic LNM did not receive any local treatment in non-EBRT group. The response rate, survival rate, local control rate, prognostic risk factors of the two groups were studied.Results:After EBRT, the partial response rate and complete response rate were 32.1%(9/28) and 32.1%(9/28). The median survival rate of EBRT group was 16.1 months (95% CI 9.00-23.21, RR=3.63) vs. 6.9 months (95% CI 4.63-8.77, RR=1.06) for the non-EBRT group, with statistically significant difference ( χ2=15.53, P<0.05). Cardiophrenic angle or superior diaphragmatic lymph nodes 1-year local control rate for EBRT group and non-EBRT group were 37.0% vs. 10.7%, with statistically significant difference ( χ2=5.28, P<0.05). Since diagnosis of cardiophrenic angle or superior diaphragmatic LNM, 4 patients (14.3%) in the EBRT group vs. 13 patients (46.4%) in the non-EBRT group had higher alpha-fetoprotein (AFP) level after 3 months compared with the AFP before EBRT ( χ2=6.84, P<0.05). Multivariate analysis showed that multiple intrahepatic tumors, maximal diameter of intrahepatic tumors >5 cm, AFP≥400 μg/L, no EBRT were poor prognostic factors. Conclusions:EBRT can prolong overall survival and improve the control rate of lymph node of HCC patients with cardiophrenic angle or superior diaphragmatic LNM. Patients with multiple intrahepatic tumors, maximal diameter of intrahepatic tumors >5 cm, AFP≥400 μg/L and no EBRT have poor prognosis.

Objective:To evaluate the feasibility of brain injury after cardiopulmonary resuscitation (CPR) in rats based on T2WI image texture analysis.Methods:Eighteen SD rats were randomly divided into the sham group ( n=8) and model group ( n=10). The rats in the model group underwent MRI scanning at 6 h after return of spontaneous circulation (ROSC), and the rats in the sham group received MRI scanning at 6 h after the operation. The differences in the texture features of T2WI images and the expressions of AQP4 and NSE between the two groups were analyzed. The receiver operating characteristic curve (ROC) was used to evaluate the diagnostic efficacy of statistically different texture features between the two groups for brain injury. The associations between texture features and AQP4 and NSE expressions in the sham group and model group were analyzed using Spearman correlation coefficients. Results:The minimum intensity, standard deviation, and inverse difference moment of the whole brain T2WI texture features of the model group were significantly lower than those of the sham group ( P<0.05), while the difference entropy and characteristics of high gray in homogeneity were significantly higher than those of the sham group ( P<0.05). The difference entropy was the best with an area under curve (AUC) of 0.922, a sensitivity of 100% and a specificity of 75%. The AQP4 and NSE expressions in the model group were significantly higher than those in the sham group ( P<0.05). The minimum intensity value was positively correlated with AQP4 and NSE expressions ( r=0.501, 0.568, P=0.048, 0.022). The standard deviation was positively correlated with AQP4 and NSE expressions ( r=0.620, 0.530, P=0.010, 0.035). The difference entropy was negatively correlated with AQP4 expression ( r=-0.535, P=0.033). Conclusions:Texture analysis on T2WI images can evaluate the degree of brain edema and neuronal damage. The minimum intensity, standard deviation, and difference entropy are sensitive indicators to evaluate brain injury after CPR, and difference entropy has the highest sensitivity and specificity.

Objective: To investigate the efficacy and adverse effects of sustained lung inflation (SLI) combined with pulmonary surfactant (PS) in the treatment of neonatal respiratory distress syndrome (NRDS). Methods: This prospective randomized controlled trial included 124 premature infants (gestational age <34 weeks and birth weight <2 000 g) diagnosed with NRDS and in need of PS treatment in Shenzhen Maternity & Child Healthcare Hospital affiliated to Southern Medical University from July 1, 2016 to October 31, 2018. They were randomly divided into experimental or control group, with 62 cases in each. Infants in the experimental group were treated with SLI using T-piece and intratracheal PS, while those in the control group were given PS only. Blood gas analysis and measurement of fraction of inspiration O₂ (FiO₂) and ratio of partial pressure of oxygen (PO₂) over FiO₂ were performed before and 1 h after PS injection. Results of the treatments and incidence of complications were compared. Paired samples t-test, two independent samples t-test, rank-sum test and Chi-square test were used for statistical analysis. Results: There were 56 participants in the experimental group and 54 in the control group who were eventually analyzed. In the experimental group, the pH value, partial pressure of carbon dioxide (PCO₂), FiO₂ and PO₂/FiO₂ at 1 h after PS injection were all improved compared with those before treatment [pH value: 7.26±0.09 vs 7.19±0.09, t=3.814; PCO₂: (51.5±12.6) vs (59.8±16.3) mmHg (1 mmHg=0.133 kPa), t=2.610; FiO₂: 26.0 (21.0-31.5)% vs 40.5 (38.5-51.5)%, U=392.000; PO₂/FiO₂: (284.6±117.9) vs (173.4±59.7) mmHg, t=6.427; all P<0.05]. The overall decrement of FiO₂ after PS injection in the experimental group was more significant than that in the control group [-10.0 (-15.0 to -5.0)% vs -5.0 (-8.0 to 0.0)%, U=706.500, P<0.001]. The experimental group had a higher rate of extubation within 24 h than the control group [80% (45/56) vs 71% (32/54), χ²=5.830, P=0.016]. However, no significant differences were shown in total mechanical ventilation time, non-invasive/high-flow nasal cannula ventilation time, the ratio of re-intubation within 72 h, or the incidence of air leak, bronchopulmonary dysplasia, periventricular-intraventricular hemorrhage, necrotizing enterocolitis or patent ductus arteriosus between the two groups (all P>0.05). Conclusions SLI combined with PS for NRDS babies can increase the rate of extubation within 24 h and promote the down-regulation of FiO₂ without causing significant complications.

Objective To investigate the preventive and adverse effects of postnatal inhalation of Budesonide in early stage on bronchopulmonary dysplasia (BPD) in very low birth weight infants.Methods A total of 105 cases of high risk premature infants with BPD,who were born in the Neonatal Intensive Care Unit (NICU) from Shenzhen Maternity and Child Healthcare Hospital from July 15,2015 to December 25,2016,and their gestational age ≥ 27 weeks and ＜ 32 weeks or birth weight ≥ 1 000 g and ＜ 1 500 g were collected for a prospective randomized controlled trial,and were randomly divided into 3 groups:early inhalation group(34 cases),late inhalation group(34 cases) and non-inhalation group(37 cases).The oxygen time,and the incidence of BPD,periventricular-intraventricular hemorrhage (IVH),retinopathy of prematurity (ROP),necrotizing enterocolitis of the newborns (NEC),patent ductus arteriosus in preterm infants (PDA),sepsis and hyperglycemia of infants in 3 groups were compared.Results The average oxygen time in early inhalation group was 9 days,while in late inhalation group and the non-inhalation group was 15 days and 18 days,respectively.The average oxygen time in early inhalation group was significantly lower than that in the late inhalation group and the non-inhalation group,with the difference being statistically significant (H =6.09,P ＜ 0.05).The noninvasive ventilation time in early inhalation group was 3 days,while both the late inhalation group and non-inhalation group were 6 days.The noninvasive ventilation time in early inhalation group was significantly lower than that in the late inhalation group and non-inhalation group,with the difference being statistically significant (H =6.17,P ＜0.05).The incidence of BPD in the early inhalation group,late inhalation group and non-inhalation group were 14.7％ (5/34 cases),20.6％ (7/34 cases) and 37.8％ (14/37 cases),respectively.The incidence of BPD in non-inhalation group was significantly higher than that in the early inhalation group and late inhalation group,with the difference being statistically significant (x2 =12.017,P ＜ 0.05).There were no significant differences in IVH,ROP,NEC,PDA,sepsis and hyperglycemia among the 3 groups (all P ＞ 0.05).Conclusions Postnatal inhalation of Budesonide in early stage in high risk very low birth weight infants can reduce the incidence of BPD and the oxygen time,and the adverse reactions are not obvious.