Objective:To analyze the changes in the retinal and choroidal microvascular structures in the macular region of patients with acute central serous chorioretinopathy (CSC), as well as the influencing factors of subretinal fluid (SRF) volume.Methods:A prospective selection of 37 patients with monocular acute CSC diagnosed by ophthalmology examination at the Xi ′an First Hospital from January to October 2023 was conducted. The affected eye group was Group A, and the contralateral eye was Group B. The right eye of 30 age and gender matched normal individuals during the same period was selected as the normal eye group (group C). The scanning frequency source optical coherence tomography (SS-OCTA) was used to scan the macular area of the tested eye within a range of 6 mm×6 mm. We analyzed and recorded the vascular density (VD), perfusion area (PA), retinal thickness (RT), choroidal thickness (CT), as well as choroidal vascular volume (CVV) and choroidal vascular index (CVI) of the superficial and deep retinal capillary plexus (SCP) and deep retinal capillary plexus (DCP) in the macular area of 0-1 mm, 0-3 mm, and 0-6 mm using our own software. At the same time, we recorded the volume of SRF in the affected eye group. We compared the changes in VD, PA, RT, CT, CVV, and CVI among three groups. The Spearman rank correlation test was used to analyze the correlation between SRF volume and microvascular structural parameters.Results:(1) There was no statistically significant difference in VD and PA of SCP between the affected eye group and the contralateral eye group within the range of 0-6 mm in the macular area (all P>0.05); The VD and PA of SCP in the affected eye group and the contralateral eye group were lower than those in the normal eye group, and the differences were statistically significant (all P<0.05); The VD and PA of DCP in the affected eye group were lower than those in the contralateral eye group, and the difference was statistically significant (all P<0.05). Within the range of 0-3 mm in the macular area, the VD and PA of DCP in the affected eye group and the contralateral eye group were lower than those in the normal eye group, and the differences were statistically significant (all P<0.05). The RT of the affected eye group was higher than that of the contralateral eye group, and the RT of the contralateral eye group was higher than that of the normal eye group, with statistical significance (all P<0.05). (2) Within the range of 0-6 mm in the macular area, the CT of the affected eye group was higher than that of the contralateral eye group, and the CT of the contralateral eye group was higher than that of the normal eye group, with statistical significance (all P<0.05). There was no statistically significant difference in the CVV and CVI of the choroidal vessels between the affected eye group and the contralateral eye group (all P>0.05); The CVV and CVI of the choroidal vessels in the affected eye group and the contralateral eye group were higher than those in the normal eye group, and the differences were statistically significant (all P<0.05). (3) The volume of SRF is negatively correlated with the VD of DCP within the range of 0-3 mm in the macular area ( P<0.05), and positively correlated with CT within the range of 0-6 mm ( P<0.05). Conclusions:Acute CSC is a binocular choroidal disease, and choroidal thickening is mainly due to the thickening of the large and medium vascular layers; Acute CSC can cause a decrease in superficial and deep retinal blood flow density in the macular region; The volume of SRF is negatively correlated with the VD of DCP and positively correlated with CT.

Epigallocatechin gallate (EGCG) is a major polyphenol component in green tea. EGCG has high free radical scavenging activity, radiation protection efficiency, and metal-chelating capacity due to its unique structure with hydroxyl groups. EGCG and its derivatives have been reported in various fields. This paper reviews the effects of EGCG, including radiation protection, heavy metal ion adsorption, and promotion of heavy metal ion excretion. EGCG has the potential to be used as an ideal radiation protection agent, heavy metal adsorbent, and even excretion promoting agent.

Radionuclide-contaminated wounds are common in medical response to nuclear emergencies, which have different manifestations in different types of accidents. Medical treatment is the key part of the response. Based on the drill experience gained from medical response to nuclear emergencies, the authors summarize the research advances in radionuclide-contaminated wounds in recent years, mainly involving the biokinetic characteristics, medical response, surgical debridement, and prevention and treatment of internal contamination of radionuclide-contaminated wounds; the authors summarize the key points of technical operations and provide suggestions on improvements in the drills. The authors believe that medical treatment of radionuclide-contaminated wounds requires highly compatible integration of the practical skills from clinical medicine and radiological knowledge; emergency response, surgical debridement, and prevention and treatment of internal contamination all together constitute an integrated rescue and treatment strategy with internal logic correlations. However, targeted improvements are needed to achieve desired effects in the drills.

Objective:To observe the changes of macular microvascular structure and macular pigment density (MPOD) in eyes with macular edema (ME) secondary to retinal vein occlusion (RVO), and preliminarily analyze their correlation.Methods:A prospective clinical study. A total of 62 eyes of 62 patients with monocular RVO secondary ME (RVO-ME) diagnosed in the Ophthalmology Hospital of Xi'an No.1 Hospital from July 2020 to May 2021 were included in this study. There were 33 males with 33 eyes, 29 females with 29 eyes. The age was 58.30±12.15 years. The course of disease from the onset of symptoms to medical treatment was 12.29±7.65 days. All patients underwent best corrected visual acuity (BCVA), optical coherence tomography angiography (OCTA) and MPOD test. BCVA examination was performed using a standard logarithmic visual acuity chart, which was converted to logarithm of minimum angle of resolution (logMAR). The vascular density (VD), vascular skeletal density (SD), foveal avascular area (FAZ) and central macular thickness (CMT) of the superficial retinal capillary plexus (SCP) in the range of 3 mm×3 mm in the macular area of bilateral eyes were measured by OCTA. MPOD was measured by heterochromatic scintillation photometry. Bilateral eyes passed examination in 37 cases. The eyes of 25 patients failed to pass the test. The changes of macular VD, SD, FAZ area, CMT and MPOD between the affected eyes and the contralateral eyes were compared. The MPOD of the affected eye and the contralateral eye was compared by paired t test. FAZ area, CMT, VD, SD, and logMAR BCVA were tested by paired Wilcoxon signed rank sum test. Spearman rank correlation test was used to analyze the correlation between macular blood flow density (VD, SD) and foveal morphology (FAZ area, CMT) with logMAR BCVA and MPOD. Results:Compared with contralateral eyes, VD ( Z=-5.981) and SD ( Z=-6.021) were decreased, FAZ area ( Z=-2.598) and CMT ( Z=-6.206) were increased, and the differences were statistically significant ( P<0.05). In 37 patients who passed MPOD test in bilateral eyes, the MPOD value of the affected eye was lower than that of the contralateral eye, and the difference was statistically significant ( t=-2.930, P<0.05). Compared with the affected eye which failed to pass the MPOD detection, macular VD ( Z=-2.807) and SD ( Z=-2.460) were increased, FAZ area ( Z=-4.297) and CMT ( Z=-3.796) were decreased in the affected eye which passed the MPOD test, and the differences were statistically significant ( P<0.05). Correlation analysis showed that logMAR BCVA in the affected eye was negatively correlated with macular VD and SD ( r=-0.298, -0.461; P<0.05), which was positively correlated with FAZ area and CMT ( r=0.487, 0.789; P<0.05). MPOD in the affected eye was negatively correlated with logMAR BCVA ( r=-0.344, P<0.05). MPOD in the contralateral eye was positively correlated with CMT ( r=0.358, P<0.05). Conclusions:The VD and SD of macular SCP are decreased, FAZ area is enlarged, CMT is thickened, and MPOD is decreased in RVO-ME eyes. MPOD is negatively correlated with logMAR BCVA.

Nuclear energy is widely used in various fields such as military, medicine, scientific research, industry and agriculture.Nuclear accident may lead to radiation damage to the bodyofpractitioners. At present, the treatment of severe bone marrow radiation sickness is still not ideal.Exosomes are small vesicles with a size of 30-130 nm secreted by living cells and carry a variety of active substances including protein, RNA, DNA, which isimportant medium of intercellular communication.The contents of exosomes can be used not only as biomarkers of radiation damage, but also for the treatment of radiation damage. This article reviewsthe research progress of the application of exosomes in radiological medicine and underlying mechanisms.

Objective:To explore the formulation of the evaluation system of nuclear emergency medical rescue drills.Methods:By using the analytic hierarchy process, theoretical analysis and expert consultation, the evaluation system was established, and online questionnaires were used to investigate student satisfaction. Excel software was used for data entry, Matlab 6.5 software was used for weight calculation, and questionnaire data were authorized to SPSSAU online platform to analyze the correlation coefficient between trainees' attitude towards drills and satisfaction of the evaluation system.Results:An evaluation system of nuclear emergency medical rescue drills composed of multiple indicators was constructed, and the weights of each indicator of the system were obtained. The corresponding weights for group comprehensive proficiency, topic theoretical oral examination, personal practice and virtual system were 0.108, 0.557, 0.280 and 0.054, respectively. Simultaneously, the evaluation of the system by the trainees was investigated, and it was found that there was a significant correlation between the trainee's attitude towards the drills and satisfaction with the system.Conclusion:The nuclear emergency medical rescue evaluation system formed in this research is expected to provide theoretical methods for comprehensive evaluation of students' knowledge and capabilities, and at the same time it's helpful to improve the nuclear emergency rescue capabilities of students.

Objective:To verify the predictive value of fully-automated 3D volume segmentation of CT images for the overall survival prognosis of resectable pancreatic ductal adenocarcinoma (PDAC).Methods:From July 2018 to March 2019, the clinical data of 198 cases of resectable PDAC were continuously collected in the First Affiliated Hospital of Naval Medical University. According to the level of carbohydrate antigen(CA)19-9 and carcinoembryonic antigen(CEA), the patient were divided into low CA19-9 group(≤210 U/ml ), high CA19-9 group (>210 U/ml ), normal CEA group (<5 ng/ml ) and high CEA group (≥5 ng/ml). Using our fully-automated segmentation tool developed in the early stage, images at the plain phase and portal phase were matched to those at the late artery phase by taking the artery phase as the matching target to establish UNet model; and the PDAC tumor and pancreatic glands were three-dimensionally segmented to estimate the tumor 3D volume. Univariate and multivariate logistic regression analysis were performed to compare the tumor 3D volume with the common preoperative risk factors (tumor 2D long diameter, CA19-9 level, CEA level, etc.) in predicting the patients′ survival. C-index was used to estimate the accuracy for predicting the survival. Receiver operating characteristics curve (ROC) was drawn and AUC was calculated to evaluate the accuracy for predicting the 1-year and 2-year overall survival and the influence of CA19-9 and CEA level on the patients′ overall survival.Results:Univariate logistic analysis showed that age, tumor 3D volume, tumor location, CA19-9 and CEA level were correlated with the patients′ overall survival. Multivariate logistic analysis showed that tumor 3D volume, CA199 and CEA were correlated with the overall survival. Among them, tumor 3D volume was most strongly correlated with the overall survival ( HR=2.25, 95% CI1.49-3.39, P<0.0001). The prognostic C-index of automatic 3D tumor volume, tumor long diameter, serum CEA and CA19-9 was 0.667(95% CI0.617-0.717), 0.637(0.583-0.691), 0.593(0.527-0.659) and 0.585(0.526-0.644), respectively. The AUCs of 3D tumor volume, tumor location, tumor long diameter, serum CEA and CA19-9 for predicting 1-year and 2-year survival were 0.726 and 0.698, 0.562 and 0.562, 0.703 and 0.660, 0.583 and 0.624, 0.602 and 0.609 respectively. C-index and AUC of tumor 3D volume was significantly better than those of the other common preoperative risk factors, and the difference was statistically significant (all P value <0.05). The survival of patients with large tumor 3D volume was greatly poorer than that of patients with small tumor 3D volume in low CA19-9 group, high CA19-9 group, normal CEA group and high CEA group, and the differences were all statistically significant ( HR=2.27, 95% CI 1.39-3.72; HR=2.42, 95% CI1.23-4.74; HR=2.08, 95% CI1.07-4.06; HR=2.67, 95% CI1.63-4.38, all P value <0.01). And the automatic 3D volume was the strongest predictor for the survival in high CA19-9 group. Conclusions:The tumor 3D volume obtained by automatic CT segmentation was an objective and reliable prognostic biomarker, which can supplement the established preoperativel risk factors and was expected to guide the personalized choice of neoadjuvant therapy.

Objective:To analyze the superficial retinal blood flow around the optic disc of optical coherence tomography angiography (OCTA) in non-arteritic anterior ischemic optic neuropathy (NA-AION) patients with affected eyes and contralateral healthy eyes, compared with healthy people.Methods:From May 2018 to may 2019, 30 patients with NA-AION in Xi′an No. 1 Hospital were selected. The changes of superficial retinal blood flow density and perfusion around the optic disc on OCTA of 30 patients with NA-AION, whose contralateral healthy eyes were compared. The pattern visual evoked potential (PVEP) of both eyes was also compared. 30 healthy people with no history of eye disease and history of eye surgery were selected as healthy control group, and differences between healthy control group and contralateral healthy eye group in NA-AION patients of the superficial retinal blood flow density and perfusion around the optic disc were compared.Results:The average values of serum homocysteine, apolipoprotein E and low density lipoprotein in 30 patients with NA-AION were higher than the normal reference range. Compared with the contralateral healthy eyes, the effected eyes of NA-AION patients had lower retinal blood flow density and perfusion in the center, inner layer and complete area of the optic disc, with significantly difference ( P<0.05); there was no significant difference in the latency and amplitude of PVEP-P100 between the two groups ( P>0.05). There was no significant difference in the density and perfusion of superficial retinal blood flow in the center, inner layer and complete area of the optic disc between the contralateral healthy eyes of NA-AION patients and healthy control ( P>0.05). Conclusions:OCTA is a safe, rapid and non-invasive test, and it can detect blood perfusion defects promptly, which can be used as the most commonly test method for patients with NA-AION in order to make auxiliary diagnosis and gain time for clinical treatment.

With the rapid development of nuclear technology in the fields of industry and medicine, the possibility of people suffering from radiation damage has also increased. Radiation injury prevention and treatment drugs are the most effective and direct means for the treatment and protection of radiation injury, but the current radiation injury prevention and treatment drugs have limited effects. Due to the unique valence structure of cerium nanomaterials, it has a variety of enzymatic simulation activities and reproducibility. It shows superior oxidation resistance, powerful free radical scavenging function, and can protect cells from radiation damage. It can be used as an ideal it is a radioprotective agent, and is used in a variety of biological fields. A review of relevant literature shows that the antioxidant properties, high SOD mimicking activity, free radical scavenging ability and radiation resistance of ceria nanoparticles are derived from the mutual conversion of Ce³⁺/Ce⁴⁺ and the formation of oxygen vacancies. This article mainly introduces the basis of anti-radiation activity of ceria nanoparticles, radiation protection effects and the research progress of radiotherapy sensitization, and provides theoretical basis and reference for ceria nanoparticles in the field of radiation direction.

In order to improve our military's medical support capabilities, the Army Military Medical University regularly organizes comprehensive military medical drills, of which nuclear emergency medical rescue is an important subject. Therefore, it is urgent to form a standardized teaching process of nuclear emergency medical rescue drills. Firstly, based on the two major tasks of nuclear emergency medical rescue, and "emergency treatment of nuclear wounded in killing area" and "early treatment of nuclear wounded in developing area," a nuclear emergency medical rescue drill teaching process has been formed, including "reconnaissance, detection, classification, decontamination and treatment". Then, it's applied to actual teaching, and the problems in teaching are found by analyzing the changes in the rescue ability of the students before and after learning. Finally, the corresponding improvement measures are put forward to open up new ideas for drill teaching.