Objective:To study the role of cadherin 1 (CDH1) gene DNA methylation in autoimmune thyroiditis (AIT) in population from different water-iodine regions.Methods:From May to June 2019, the information of AIT cases and healthy individuals in Shandong Province were collected in three types of water-iodine regions: iodine-fortification (IF) region, iodine-adequate (IA) region and iodine-excess (IE) region. A case-control study design was applied to match 176 AIT cases (case group) with age, gender, body mass index, and place of residence in a 1 ∶ 1 ratio to 176 healthy individuals (control group). Fasting urine and whole blood samples were collected to test the contents of urinary iodine, thyroid function indicators [serum free triiodothyronine (FT 3), free thyroxine (FT 4), thyroid stimulating hormone (TSH)], and serum iodine. The DNA methylation levels of the target region of the CDH1 gene and its four CpG sites in whole blood were determined using methylation sequencing technology for target regions (MethylTarget TM). Results:The DNA methylation level of the target region of CDH1 gene in the case group was 0.832 ± 0.044, and that in the control group was 0.828 ± 0.049, there was no statistically significant difference between the two groups ( t = 0.76, P = 0.448). There was no statistically significant difference in DNA methylation levels of the four CpG sites in the target region of CDH1 gene between the case group and the control group ( P > 0.05). There was no statistically significant difference in the DNA methylation level of the CDH1 gene target region between the case group and the control group in IF, IA and IE regions ( P > 0.05). The detection results of DNA methylation levels at CpG sites in the target region of CDH1 gene in different water iodine regions showed that the DNA methylation level at site 83 in case group in IF region was higher than that in the control group ( t = 2.30, P = 0.023). However, there was no statistically significant difference in the DNA methylation levels of the four CpG sites between the case group and the control group in IA and IE regions ( P > 0.05). The DNA methylation level of CDH1 gene target region in AIT patients was not significantly correlated with urinary iodine, serum iodine, and serum FT 3, FT 4, and TSH contents ( P > 0.05), but was significantly negatively correlated with age ( r =-0.19, P = 0.014). Conclusions:The DNA methylation level at CpG site 83 of CDH1 gene in AIT patients in IF region is significantly higher than that in control population, indicating that DNA methylation at this locus may be involved in the occurrence and development of AIT after iodine fortification. The DNA methylation level of CDH1 gene is negatively correlated with age.

Objective:To study the role of cadherin 1 (CDH1) gene DNA methylation in autoimmune thyroiditis (AIT) in population from different water-iodine regions.Methods:From May to June 2019, the information of AIT cases and healthy individuals in Shandong Province were collected in three types of water-iodine regions: iodine-fortification (IF) region, iodine-adequate (IA) region and iodine-excess (IE) region. A case-control study design was applied to match 176 AIT cases (case group) with age, gender, body mass index, and place of residence in a 1 ∶ 1 ratio to 176 healthy individuals (control group). Fasting urine and whole blood samples were collected to test the contents of urinary iodine, thyroid function indicators [serum free triiodothyronine (FT 3), free thyroxine (FT 4), thyroid stimulating hormone (TSH)], and serum iodine. The DNA methylation levels of the target region of the CDH1 gene and its four CpG sites in whole blood were determined using methylation sequencing technology for target regions (MethylTarget TM). Results:The DNA methylation level of the target region of CDH1 gene in the case group was 0.832 ± 0.044, and that in the control group was 0.828 ± 0.049, there was no statistically significant difference between the two groups ( t = 0.76, P = 0.448). There was no statistically significant difference in DNA methylation levels of the four CpG sites in the target region of CDH1 gene between the case group and the control group ( P > 0.05). There was no statistically significant difference in the DNA methylation level of the CDH1 gene target region between the case group and the control group in IF, IA and IE regions ( P > 0.05). The detection results of DNA methylation levels at CpG sites in the target region of CDH1 gene in different water iodine regions showed that the DNA methylation level at site 83 in case group in IF region was higher than that in the control group ( t = 2.30, P = 0.023). However, there was no statistically significant difference in the DNA methylation levels of the four CpG sites between the case group and the control group in IA and IE regions ( P > 0.05). The DNA methylation level of CDH1 gene target region in AIT patients was not significantly correlated with urinary iodine, serum iodine, and serum FT 3, FT 4, and TSH contents ( P > 0.05), but was significantly negatively correlated with age ( r =-0.19, P = 0.014). Conclusions:The DNA methylation level at CpG site 83 of CDH1 gene in AIT patients in IF region is significantly higher than that in control population, indicating that DNA methylation at this locus may be involved in the occurrence and development of AIT after iodine fortification. The DNA methylation level of CDH1 gene is negatively correlated with age.

Objective:It aims at constructing the equipment visualization management system in orthopedics on the basis of Godot engine,as well as exploring and discussing its values related to equipment visualization management system in orthopedics of hospitals.Methods:The equipment visualization management system in orthopedics on the basis of Godot engine was designed which further contained data collection,model drawing and function development,then,it further realized the equipment visualization management in orthopedics by relying on the movable terminal.180 medical equipment commonly used in orthopaedic clinic of Beijing Puren Hospital were selected in 2021-2022.Moreover,they were managed by two modes of management which were respectively the traditional equipment management mode(traditional equipment mode)and equipment visualization management system in orthopedics on the basis of Godot engine(visual system).Finally,the effectiveness of the two management modes of the medical equipment,the level of management and the satisfaction scores of doctors,nurses and patients on the two management modes were assessed accordingly.Results:The time utilization rate,quality stability rate and diagnosis and treatment effectiveness rate of the visual system equipment were respectively(95.37±4.06),(96.74±4.72)and(96.41±5.01)%,which were higher than that of the traditional equipment model and the differences were all statistically significant(t=9.608,9.438,4.909,P<0.05).the standardized placement rate,standardized recording rate and intact rate of the visual system equipment were respectively 97.22%(175/180),97.78%(176/180)and 99.44%(179/180),which were higher than that of the traditional equipment model and the differences were all statistically significant(x2=6.972,11.429,9.656,5.236,P<0.05).the failure rate of the visual system was 5.00%(9/180),which was lower than the traditional equipment mode(x2=5.236,P<0.05).the satisfaction scores of doctors,nurses and patients for the visual system equipment were respectively(95.63±3.47),(96.85±3.21)and(95.79±3.92),which were higher than that of the traditional equipment mode and the difference was statistically significant(t=14.068,17.996,14.438,P<0.05).Conclusion:The application of equipment visualization management system in orthopedics on the basis of Godot engine can visualize and manage medical equipment in orthopedics of hospitals,enhance the equipment effectiveness,intensify the equipment management level,as well as improve the users'satisfaction degree with the equipment.

Objective:To construct equipment risk management model based on particle swarm optimization(PSO)algorithm,and to discuss its application value in the management of ECG monitoring equipment in emergency department.Methods:The operation risk data of ECG monitoring equipment in the hospital were collected and normalized,and the PSO algorithm was used to optimize the neural network model to construct the risk management model of ECG monitoring equipment.30 ECG monitoring equipment in clinical use in the emergency department of Beijing Puren Hospital from November 2021 to October 2023 were selected and according to different equipment management modes,the backpropagation(BP)neural network model(referred to as the conventional BP model)and the PSO algorithm equipment risk management model(referred to as the PSO algorithm model)were used to manage the equipment respectively.The equipment risk fault identification effect,alarm risk control effect and equipment fault maintenance diagnosis time were compared between two management models.Results:The area under the curve(AUC)of the receiver operating characteristic(ROC)value,accuracy,sensitivity,and specificity of risk fault data identification in the test set using the PSO algorithm were 0.869,93.6%,92.8 and 95.1%,respectively,the AUC value,accuracy,sensitivity,and specificity of risk fault data identification in the training set were 0.839,95.6%,97.9%and 96.7%,respectively,which were higher than those of the conventional BP model,and the difference was statistically significant(x2test=3.691,4.023,3.557,3.409,x2training=6.884,5.962,5.334,3.215,P<0.05).The pass rate of ECG monitoring equipment alarm threshold and the average pass rate of equipment maintenance using PSO algorithm were(98.61±3.07)%and(98.79±3.11)%,respectively,which were higher than those of the conventional BP mode,and the alarm mute rate was(1.14±0.27)%,which was lower than that of the conventional BP mode,and the differences were statistically significant(Z=11.831,10.020,21.141,P<0.05).The internal repair time,external repair time,fault diagnosis time and total repair time of ECG monitoring equipment using PSO algorithm were(1.21±0.96)min,(3.18±1.09)min,(5.08±1.93)min and(10.95±2.81)min,respectively,which were all less than those of the conventional BP mode,the difference was statistically significant(t=15.404,19.020,16.694,25.511,P<0.05).Conclusion:The application of the risk management model of ECG monitoring equipment based on PSO algorithm can improve the sensitivity,specificity and accuracy of risk fault data identification of ECG monitoring equipment,improve the qualified rate of alarm threshold and equipment maintenance,reduce the silence rate of alarm,and shorten the time of fault diagnosis and repair.

Objective To evaluate the feasibility and the safety of endoscopic closure for acute colon perforations with novel successive endoclips in animal model. Methods Approximately 1. 5 to 2 cm colonic full-thickness resections were created with an electrotome in 3 Ba-Ma pigs that were under general anesthesia and were closed with the conventional endoclips and novel successive endoclips respectively. The procedure time and the efficacy of each endoclip were recorded. After the procedure,the general condition and physiological indicators were carefully monitored. After a follow-up of 1 week,the pigs were euthanized for an endoscopic observation of the healing condition and the residual endoclips. A postmortem examination was performed to observe the abdominal infection and incision condition. Transverse sections of the colon across the site of perforation were taken for histopathologic examination to assess the healing process. Results All the colonic perforation models in three pigs were established successfully. Endoscopic closure for acute colon perforation with two kinds of endoclips was technically successful in all 3 pigs. The mean time of the procedure with successive endoclip was less than that with the conventional endoclip(54. 0 seconds VS 91. 9 seconds,P<0. 001),but the successful release rate of the successive endoclip was lower than that of the conventional endoclip without significant difference[62. 5%(15/ 24)VS 14/ 16,P= 0. 17].All the ani-mals survived without infection and hemorrhage. Five perforations demonstrated signs of healing,whereas one closed with the novel successive endoclips failed to heal completely. Conclusion Endoscopic closure for a-cute colon perforations with novel successive endoclips is effective and safe. The novel successive endoclip has the advantage of saving time,but it needs to be further improved and perfected to satisfy the clinical need.