Objective To investigate the effect of etimicin combined with thymopeptide α1 on intestinal flora,circulatory function and renal function in patients with sepsis.Methods A total of 80 patients with sepsis treated in Wenzhou Central Hospital from March 2021 to June 2022 were selected and divided into control group and study group according to treatment methods,with 40 cases in each group.The control group was treated with thymopeptide α1 on the basis of conventional treatment,and the study group was treated with etimicin on the basis of control group treatment,and both groups were treated for 2 weeks.The intestinal flora,circulatory function,renal function,mechanical ventilation duration,hospital stay,acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)scores and clinical efficacy of two groups were compared.Results After treatment,Bifidobacterium,central venous pressure(CVP),mean arterial pressure(MAP)and urine volume of patients in both groups were significantly higher than before treatment,Enterobacter,Enterococcus,Staphylococcus,Bacterioid,Obligate anaerobe,Pseudomonas,heart rate,serum creatinine and blood urea nitrogen were significantly lower than before treatment(P<0.05).Bifidobacterium,CVP and MAP of study group were significantly higher than those of control group,and Enterobacter,Enterococcus,Staphylococcus,Bacterioid,Obligate anaerobe,Pseudomonas,heart rate,and scores of APACHE Ⅱ were significantly lower than those of control group(P<0.05).The mechanical ventilation time and hospital stay in study group were significantly shorter than those in control group(P<0.05).The total effective rate of study group was significantly higher than that of control group(χ2=6.275,P=0.012).Conclusion Etimicin combined with thymopeptide α1 in the treatment of sepsis can effectively regulate the intestinal flora and circulatory function of patients,and has little effect on renal function,which is worthy of clinical promotion and application.

Objective:To study the variational trend in disease characteristics of patients with hepatitis B-related primary liver cancer (HBV-HCC) in the past five years.Method:A single-center retrospective cross-sectional analysis was performed to compare patients diagnosed with HBV-HCC from January 2012 to December 2016 (control group) and from January 2017 to December 2021 (observation group). The data of the study variables were extracted from the electronic medical record system of the hospital information system of the Second Hospital of Lanzhou University. The 1:2 propensity score matching was used to adjust potential confounding factors such as gender and age. Multivariate logistic regression analysis was used to study the factors affecting changes in disease characteristics of the HBV-HCC population in the observation group. GraphPad Prism 8.0 software was used to draw forest plots to intuitively display the effect size of the study variables in the logistic regression analysis.The t-test was used to compare normally distributed data between groups. The χ2 test was used for inter-group comparison. Results:A total of 1 717 eligible cases were collected, including 510 in the control group and 1 207 in the observation group. Compared with the control group, the number of newly diagnosed cases in the observation group increased by 2.36 times, and males were still the main onset population (83.3% vs. 82.7%). The median age of onset increased (51.9 vs. 53.5 years, P<0.001). 79.4% of HBV-HCC patients had not received antiviral therapy, and the proportion of HBeAg-negative patients increased (56.4%). The factors affecting HBV-HCC patients included family history of HBV ( OR=1.626, 95% CI: 1.181-2.238), family history of hepatocellular carcinoma ( OR=1.388, 95% CI: 1.013-1.901), hypoviremia ( OR=1.322, 95% CI: 1.046-1.671), abnormal alanine aminotransferase ( OR=1.545, 95% CI: 1.231-1.940), liver fibrosis ( OR=1.478, 95% CI: 1.153-1.894), liver cirrhosis ( OR=1.431, 95% CI: 1.128-1.815), and metabolic-related fatty liver disease ( OR=1.438, 95% CI: 1.116-1.815) after propensity score matching adjustment. The factors affecting HBeAg-positive patients were decreased ( OR=0.390, 95% CI: 0.389-0.617); however, the number of early HBV-HCC diagnoses was increased (12.7% vs. 19.3%, P=0.001). Conclusion:The characteristics of patient disease and occurrence of HBV-HCC are changing over the past five years. The risk of developing hepatocellular carcinoma in middle- to older male patients with chronic hepatitis B is increasing with familial history of HBV and hepatocellular carcinoma, HBeAg negativity, hypoviremia, abnormal alanine aminotransferase, liver fibrosis, cirrhosis, and metabolic-related fatty liver disease.

Objective:To investigate the value of logistic regression model based on the features of cone-beam breast CT (CBBCT) for the identification of benign and malignant masses in dense breast.Methods:The data of 106 patients (130 masses) with dense breast who underwent contrast-enhanced CBBCT examination and obtained pathological results from May 2011 to August 2020 were retrospectively analyzed as the training set. From August 2020, the data of 49 patients (54 masses) who met the same criteria were prospectively and consecutively collected and used as the validation set. Taking pathological results as the gold standard, the training set was divided into benign and malignant groups. The t-test, χ 2 test and Fisher′s exact test were used to compare the differences in CBBCT image characteristics between the two groups in the training set. A binary logistic regression model was established by multivariate analysis. ROC curves were used to assess the diagnostic efficacy of the model as a whole in the training and validation sets and the diagnostic efficacy of each feature in the model, and the cut-off value of the intensity (ΔCT) value was determined. The H-L method was used to test the goodness of fit of the model. Decision curve analysis (DCA) was drawn to validate the clinical power of the model. Results:Univariate analysis showed that the breast parenchymal background enhancement (BPE), shape, margin, lobulation, spiculation, density, calcifications, ΔCT value, enhancement pattern, non-mass enhancement, ipsilateral increased vascularity (IIV), and peripheral vascular signs had statistical difference between benign group and malignant group ( P<0.05). BPE, margin, ΔCT value and IIV were included in the multivariate analysis, the equation was logit( P′)=-8.510+0.830×BPE+0.822×margin+1.919× ΔCT+1.896 × IIV. The are a under curve of the model in the training set was 0.879 ( P<0.001) and in the validation set was 0.851 ( P=0.001). The are a under curve of BPE, margin, ΔCT value, and IIV in the diagnosis of malignant mass were 0.645, 0.711, 0.712, 0.775 (all P<0.05); the best cut-off value of ΔCT was 50.38 HU. The fit of this model was good ( P = 0.776). The DCA curve showed that when the risk threshold was 0.05-0.97, the net benefit rate was>0, and this model had some clinical value. Conclusion:The logistic regression model based on the features of CBBCT is helpful to distinguish benign and malignant masses in dense breasts.

Objective:To analyze the correlation between indocyanine green retention rate at 15 minutes (ICG-R15) and modified Scheuer score in liver tissues of patients with hepatitis B e antigen-positive/negative chronic hepatitis B (CHB), and further explore the indocyanine green clearance test (ICGCT) applied value in judging the progress of CHB-related liver disease.Methods:407 HBeAg (+) / HBeAg (-) CHB inpatients with normal or slightly elevated serum alanine aminotransferase (ALT) [< 2 times the upper limit of normal (ULN)] and modified Scheuer score were collected, and divided into mild liver disease group (M group, 131 cases, modified Scheuer score < G2S2) and progressive liver disease group (A group, 276 cases, modified Scheuer score≥G2 and / or S2). Furthermore, the groups were sub-divided into HBeAg (+) - M group, HBeAg (-) - M group, HBeAg (+) - A group and HBeAg (-) - A group. The correlation between ICG-R15 and modified Scheuer score was analyzed retrospectively. The data were analyzed by SPSS 24.0 software.Results:Basic clinical characteristics: Among the 407 CHB cases with normal or mildly elevated serum ALT, 171 were HBeAg(+) CHB and 236 were HBeAg(-) CHB. The baseline mean serum HBV DNA was higher in HBeAg(+) CHB patients [(6.06 ± 1.95) log10IU/ml] than HBeAg(-) CHB patients [(3.60±1.37)log10IU/ml ( P = 0.000)]. Included patients ICG-R15 detection characteristics: (1) The baseline mean value of ICG-R15 was not statistically significant between the two groups of HBeAg(+) CHB and HBeAg(-) CHB, and was basically within the normal range (< 10%); (2) Comparison of ICG-R15 baseline mean value among the subgroups showed that the patients in the HBeAg(+)-A group/HBeAg(-)-A group were higher than the HBeAg(+)-M group/HBeAg(-)-M group patients, and the difference was statistically significant ( P = 0.013/ P = 0.000). Included patients’ correlation analysis between ICG-R15 and modified Scheuer score: (1) ICG-R15 and modified Scheuer score had shown weak positive correlation with inflammatory activity grade (g) in HBeAg (+) / HBeAg (-) CHB ( r = 0.237, P = 0.002); r = 0.244, P = 0.000); (2) There was a weak positive correlation between ICG-R15 and fibrosis stage (s) in HBeAg (+) / HBeAg (-) CHB ( r = 0. 254, P = 0; r = 0.225, P = 0.001). Included patients ICG-R15 predictive value for the severity of liver histological progression: when the cut-off value of ICG-R15 was 5.1%, the area under the receiver operating characteristic curve from M group to A group was 0.601 ( P = 0.001) for predicting HBeAg (+) / HBeAg (-) CHB patients. Conclusion:ICG-R15 is positively correlated with the modified Scheuer score of liver tissue in HBeAg (+)/HBeAg (-) CHB patients with normal or slightly elevated ALT. In addition, when the cut-off value of ICG-R15 was 10%, it could not accurately reflect the effective hepatocyte reserve function of HBeAg (+) / HBeAg (-) CHB patients with normal or slightly elevated ALT. Importantly, when the cut-off value of ICG-R15 is 4.0% ~ 5.0%, it may have predictive value for liver disease progression to modified Scheuer score ≥ G2 and / or ≥S2 in HBeAg (+) / HBeAg (-) CHB patients with normal or slightly elevated ALT.

Objective:To summarize the etiology, laboratory examinations and clinical features of rhabdomyolysis(RM)in children.Methods:The clinical data of children with RM admitted to the pediatric general ward at Third Hospital of Peking University from January 1st, 2010 to March 31st, 2021 were collected.The clinical characteristics, etiology distribution, laboratory examinations, treatments and prognosis of the children were analyzed.Results:A total of 24 children were included with 16 males and 8 females.The age ranged from 4 to 15 years old, with median age was 13years old.The etiology was exertional diseases in 14 cases(58.3%), non-exertional diseases in ten cases (41.7%, 7 cases of infection and 3 cases of other causes). The average age of exertional RM was(13.50±1.83)years, and that of non-exertional RM was(8.60±3.72)years.There was significant difference( t=3.848, P=0.002). The main clinical symptoms were muscle soreness, abnormal urine color and muscle weakness.Serum creatine kinase(CK)and serum myoglobin were significantly increased.The proportion of CK value moderate to severe increased of exercise RM children was significantly higher than that of non-exertional RM children( P=0.009). All children were treated with hydration and alkalization.Except for one case who died of critical primary disease, the other 23 children had good treatment response, and no rhabdomyolysis was found during the follow-up. Conclusion:The main causes of rhabdomyolysis in children are exercise and infection.Exertional RM is common in elder children.The increasing of CK level caused by exertional RM is more obvious.Active hydration and alkalization measures could avoid the occurrence of acute kidney injury.Most children with RM have good prognosis.

Objective To evaluate the accuracy of cone?beam breast CT (CBBCT) on tumor sizing in patients with invasive breast carcinoma and analyze the influence factors. Methods The preoperative CBBCT images of 82 female patients (85 breast lesions) with invasive breast carcinoma confirmed by pathology from November, 2011 to December, 2017 in Tianjin Medical University Cancer Hospital were included in this retrospective study. All the patients underwent the pathology and immunohistochemical test after operation. Tumor size estimation were performed on preoperative CBBCT images. Referring to tumor size measurement on pathology, all the lesions were divided into two groups. Concordance was defined as the discrepancy in diameter less than 0.5 cm, and the discordance was more than 0.5 cm. Pathology examination was performed after resection, and estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2(HER?2) and Ki?67 result were recorded. All the lesions were classified into molecular subtype, including 14 Luminal A, 50 Luminal B, 11 HER?2?enriched and 10 triple?negative. Intraclass correlation coefficient (ICC) and Pearson correlation coefficient were used to analyze the reliability of CBBCT on tumor sizing. CBBCT?pathology discordance was analyzed based on the clinical, histopathology and CBBCT features by using t test, Chi?square and Fisher exact test. ROC curve was used to analyze the cut?off value between tumor size and CBBCT?pathology discordance. Results The agreement between CBBCT (2.155 ± 0.799) cm and pathology (1.986 ± 0.933) cm measurement was on moderate degree based on the ICC value (ICC=0.781, P<0.01) and had positive correlation (r=0.803, P<0.01). CBBCT?pathology concordance was found in 71 lesions, and discordance in 14 lesions. The factors of family history, symptom, pathology type, molecular subtypes, histological grade, surrounding fat invasion, lymphatic invasion, axillary lymph node metastasis, HER?2 positive and Ki?67 high expression had no significant difference between two groups. ER or PR positive had significant difference, suggesting that the accuracy of evaluation on ER or PR negative lesions could be reduced. The cut?off value of ROC curve between tumor size and CBBCT?pathology discordance was 2.08 cm, and the area under curve was 0.70. In 85 lesions. 66 of 75 mass lesions and 5 of 10 non?mass lesions were consistent. The lesion type had significant difference between two groups (χ2=6.705, P=0.010), which suggested the CBBCT evaluation on non?mass could have discrepancy with pathology. Conclusion CBBCT has high accuracy on tumor size evaluation on invasive carcinoma. ER or PR negative, large lesions or non?tumor lesions should be alert to the impact of CBBCT?pathology discordance before surgery which may cause the alteration of surgical protocols.

Objective: To explore the mediating, direct and indirect roles of self-efficacy, social support and medical coping modes with resilience in patients with chronic hepatitis B. Methods: Totally 384 inpatients and outpatients with chronic hepatitis B, without physical ailments or mental problems were selected.The Connor-Davidson resilience scale (CD-RISC), general self-efficacy scale (GSES), medical coping modes questionnaire (MCMQ) and social support rating scale (SSRS) were adopted in this research.The relationship among all variables was explored by path analysis. Results: (1)The total scores of resilience, self-efficacy, social support, confrontation, avoidance and acceptance-resignation in chronic hepatitis B patients were (61.64±15.36), (25.40±5.70), (39.82±7.39), (19.02±3.72), (16.63±2.69) and (8.45±2.94), respectively.(2)Pearson analysis showed that the scores of self-efficacy, medical coping and social support were significantly correlated with resilience(r=-0.26-0.82, P<0.05). (3)Importantly, path analysis showed that self-efficacy(β=0.53), confrontation(β=0.10), avoidance(β=0.17) and acceptance-resignation(β=-0.13) had direct prediction effects on resilience.Additionally, self-efficacy was indirectly related to resilience(β=0.05), and social support also indirectly related to resilience through self-efficacy, confrontation and acceptance-resignation(β=0.18). Conclusion Self-efficacy, social support and medical coping are the important factors which play a direct or indirect role in resilience.

Objective:To investigate the accuracy of a threshold-based segmentation method based on cone beam breast CT(CBBCT) images in breast density measurement,and its value for breast-type classification and breast cancer screening.Methods:A retrospec-tive analysis of 195 patients who had undergone CBBCT examination at Tianjin Medical University Cancer Institute and Hospital be-tween May 2012 and August 2014 was performed.A total of 64 breasts were analyzed.On the basis of the classification criteria for breast density in BI-RADS,they were classified into four types and the majority report was reported.Breast density was measured by the threshold-based segmentation method based on CBBCT images and corrected manually to obtain the corrected breast density.A month later,the procedure was repeated.Intra-class correlation coefficients(ICCs)were used to compare the intra-observer and inter-observer consistencies of threshold-based segmentation and manually corrected breast density measurement results for non-dense and dense breasts.Results:For threshold-based segmentation measurements the intra-observer and inter-observer ICC values were 0.0.9624(95% CI:0.9388~0.9770)and 0.9666(95% CI:0.9500~0.9785).For manually corrected measurements,the intra-observer and inter-observer ICC values were 0.9750 (95% CI: 0.9592~0.9847) and 0.9775 (95% CI: 0.9661~0.9855). The ICC between the threshold-based segmentation method and manual correction was 0.9962 (95% CI: 0.9983~0.9977). The ICC values of threshold-based and manually corrected measurement in non-dense and dense breasts were 0.9497(95% CI:0.7072-0.9914)and 0.9983(95% CI:0.9971-0.9990),respectively.Conclusions:The threshold-based segmentation method based on CBBCT is a reliable and accurate com-puter-aided method of measuring breast density.It is expected to be applied in large-scale screening of breast cancer and to provide more information for predicting the risk of breast cancer.

In order to solve the problems that the injury, hemorrhage, infection and edema of the brain tissue caused by brain electrodes implantation for aquatic animal robots, a light stimulation device and an optical control experiment method for carp robots are proposed in this paper. According to the shape of the carp skull, the device is a structure of Chinese character " cut by a printed circuit board which can provide three groups of A, B and C bridge platforms for the light stimulation source. The two ends of a bridge in every group are welded with a jumper board, and the light emitting diodes (LED) are inserted into the jumper boards as the light stimulation source, and all negative poles of the jumper boards are connected to the console by the wire. A LED light can be replaced by another LED light according to the need of the wavelength of the LED light, and various combinations of the light stimulation modes can be also selected. This device was mounted on the carp robot's head, the carp robot was placed in a water maze, and the optical control experiment method was observed to control the forward movement and steering movement of the carp robots ( = 10) under the dark light condition. The results showed that the success rates of the three groups of red light control experiments were 53%-87%, and the success rates of the three groups of blue light control experiments were 50%-80%. This study shows that the apparatus and the method are feasible.

To solve the problem of precise positioning of carp brain tissue coordinates, it is proposed in this paper for a method for transforming the coordinates of magnetic resonance imaging of carp brain tissue into the coordinates of electrode implantation using a brain stereotaxic apparatus. In this study, the 3.0T magnetic resonance imaging instrument was used to scan the carp brain. We independently established the three-dimensional positioning coordinate system of the brain, the three-dimensional coordinate assistance system of skull surface and the three-dimensional coordinate assistance system in brain tissue. After two coordinate transformations, the magnetic resonance image coordinates of the brain electrodes implantation sites were converted into the three-dimensional stereotactic coordinate system to guide the electrodes implantation. The experimental groups were divided into two groups, A and B. Group A was the group of magnetic resonance imaging apparatus combining with the brain stereotaxic apparatus, and group B was the group of brain atlas combining with the brain stereotaxic apparatus. Each group had 20 tails of carps ( = 20). This two methods were used to implant the electrodes into the cerebellar motor area. The underwater experiments of the carp robots were carried out to test the two methods. The results showed that the accuracy of the implanted electrodes were 90% in group A and 60% in group B. The success rate of group A was significantly higher than that of group B ( < 0.05). Therefore, the new method in this paper can accurately determine the coordinates of carp brain tissue.