Objective To determine the radiation dose of sensitive organs under different protective methods in lung CT scanning environment, and to explore the best protective scheme of corresponding organs. Methods Annealed thermoluminescence dose elements were placed in the stomach, liver, colon, and thyroid gland of a simulated human body model. The dose effect experiment of protective methods included non-protective group, half lead apron group, and full lead apron group. The dose effect experiment of protective thickness included 0.50 mmpb full lead apron group and 0.35 mmpb full lead apron group. The same exposure conditions of lung CT scan were used in the above experiments. Results Compared with the non-protective group, the exposure dose of the stomach, liver, colon, and thyroid gland increased significantly in the half lead apron group (P < 0.05), and the exposure dose of the thyroid gland and colon decreased significantly in the full lead apron group (P < 0.05). There were no significant differences in the exposure dose of the liver, stomach, and colon in the simulated human body model between the 0.35 mmpb full lead apron group and the 0.50 mmpb full lead apron group. Conclusion For lung CT scan, the protective measure of lead apron may not reduce the exposure dose of subjects. The protective thickness of lead apron does not necessarily have a substantial influence on the exposure dose of human body.

In the brains of patients with Alzheimer's disease (AD) or AD animal models, β-amyloid (Aβ), tau protein, presenilin (PS)1, PS2 and apolipoprotein E4 (ApoE4) would affect the calcium channels on neuronal cell membrane, endoplasmic reticulum membrane and mitochondrial membrane, and eventually lead to the imbalance of calcium homeostasis in neurons. Aβ can also act on the endoplasmic reticulum of astrocytes and cause abnormal calcium signal. Abnormal calcium signals in the brain in turn act on neurons and promote Aβ and tau protein phosphorylation, which aggravates the disease. This study focuses on the changes of calcium signals in neurons and astrocytes in AD, in order to clarify the relationship between the calcium dyshomeostasis in neurons and astrocytes and the pathogenesis of AD, thus provides new idea for the prevention and treatment of AD.

Objective:To compare the efficacy of open surgery and arthroscopic assisted surgery in treatment of knee dislocations.Methods:A retrospective case-control study was conducted to analyze the clinical data of 80 patients with knee dislocations admitted to Second Hospital of Lanzhou University from May 2013 to September 2019, including 59 males and 21 females, aged 18-66 years [(42.5±11.6)years]. Open multiple ligament reconstruction was performed in 49 patients (open group) and arthroscopic assisted multiple ligament reconstruction was performed in 31 patients (arthroscopic group). The postoperative hospitalization days, incidence of complications, time needed for recovery of knee range of motion (>0°, >90°, >120°), and time to complete weight-bearing were compared between the two groups. The Lysholm score, international knee documentation committee (IKDC) subjective knee form, Tegner activity level, score of the MOS item short-form health survey (SF-36), patient satisfaction and knee range of motion were compared between the two groups at the last follow-up.Results:All the patients were followed up for 1.2-7.4 years [(3.8±1.5)years]. There was no significant difference in postoperative hospitalization days or incidence of complications between the two groups ( P>0.05). No significant difference was found in time needed for recovery of knee range of motion (>0°, >120°) or time to complete weight-bearing ( P>0.05). The time needed for recovery of knee range of motion (>90°) was 90(60, 90)days in open group and 60(30, 90)days in arthroscopic group ( P<0.05). At the last follow-up, there was no significant difference in Lysholm score, IKDC subjective score, Tegner activity level, SF-36 score, or patient satisfaction between the two groups ( P>0.05). At the last follow-up, the knee range of motion was 120°(90°, 130°) in open group and 135°(120°, 140°) in arthroscopic group ( P<0.05). Conclusion:For treatment of knee dislocations, open surgery and arthroscopic assisted surgery have similar results in the long-term effect, while arthroscopic assisted surgery has benefits in early rehabilitation and ultimately better knee range of motion.

Objective:To investigate the diagnostic value of multi-slice spiral CT (MSCT) combined with CT angiography (CTA) in the recurrence of hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE).Methods:97 HCC patients who received TACE therapy in the 942 Hospital from January 2017 to January 2019 were enrolled in the study. MSCT, CTA and MSCT combined with CTA were performed in all subjects to compare the efficacy of different examination methods in diagnosing postoperative recurrence.Results:MSCT results showed that 45 new lesions were detected in 30 of the 97 patients, with a diameter of 0.4-1.8 cm, with an average of (0.92±0.31)cm. In arterial phase, 32 lesions were significantly enhanced, 10 were mildly enhanced and 3 were not significantly enhanced. In the venous phase, there were 20 high-density shadows, 18 isodensity shadows and 7 low-density shadows. In the delay period, there were 24 shadows with high density or slightly high density, 10 with clear edge of low density, and 11 with unclear edge of low density. The results of CTA showed that there were 47 vessels in 32 cases of 97 patients, including 18 cases of hepatic artery variation and 29 cases of blood supply artery of lateral hepatic branch. Taking pathological diagnosis as the gold standard, the sensitivity, specificity and accuracy of MSCT combined with CTA in the diagnosis of HCC recurrence after TACE were 97.50% (39/40), 96.49%(55/57), 96.91% (94/97), which were higher than 75.00% (30/40), 77.19% (44/57), 76.29% (74/97) of MSCT and 80.00% (32/40), 80.70% (46/57) and 80.41%(78/97) of CTA respectively (all P<0.05) . Conclusions:MSCT combined with CTA has a better efficacy in the diagnosis of TACE recurrence in HCC patients, which is worthy of clinical application.

Objective:To evaluate the clinical value of color Doppler ultrasound(CDUS) combined with vascular enhancement technology(VET) in diagnosis of iliac vein compression syndrome(IVCS).Methods:From Jan 2016 to Oct 2018, 252 patients with the lower extremities chronic venous diseases(CVD) were selected in the Second Hospital of Hebei Medical University. The ipsilateral iliac veins of the affected limbs were examined by CDUS, VET and the combined diagnosis of IVCS before X-Ray venography(XRV). Iliac vein diameter stenosis ratio(DSR)>50% in transverse section was the criterion of ultrasound diagnosis of IVCS. The stenosis site of iliac vein and indirect signs of IVCS, such as presence of collateral circulation and the retrograde flow of internal iliac vein were recorded. The cases, which had the same results in CDUS, VET and both and XRV, were divided into IVCS group and non-IVCS group. The results of XRV were taken as the gold standard, the diagnostic efficiency of the above 3 methods in diagnosis of IVCS was calculated. The cases identically diagnosed by the most effective ultrasonic method and XRV were divided into DVT group and non-DVT group according to the deep vein thrombosis in lower limbs. In the non-DVT group, there were five groups of C2-C6 on the basis of the CEAP clinical grades of CVD in lower extremity. The relationship between IVCS and different CEAP clinical grades were analyzed. The locations of common iliac vein stenosis and collateral circulation formation and internal iliac vein reverse flow were evaluated for the diagnosis of the IVCS.Results:①XRV diagnosis of IVCS was used as the gold standard. Compared with CDUS and VET alone, the sensitivity and specificity of CDUS combined with VET was the highest(all P<0.05). ②The distribution of DVT and non-DVT was significantly different in IVCS group and non-IVCS group diagnosed by the CDUS combined with VET(χ 2=145.0, P<0.001). ③In the non-DVT group, statistically significant differences of grades C3 and C5 were found between IVCS group and non-IVCS group(all P<0.05), while the differences of grades C2, C4 and C6 were non-significant(all P>0.05). ④For the proportion of the iliac vein stenosis sites, the prevalence of the primary section of left common iliac vein was much higher than those of the primary section of right common iliac vein and the middle-distal sections of bilateral common iliac veins(all P<0.05). There was no statistical difference between the middle-distal section of bilateral common iliac veins, and nor was bilateral junction area between external iliac vein and common femoral vein(all P>0.05). ⑤In IVCS group, which had the same results of CDUS combined with VET and XRV, there were statistical differences in the positive rate of collateral circulation and the retrograde flow of internal iliac vein(χ 2=6.717, P=0.010), and the former is higher than the latter. Conclusions:CDUS combined with VET has a higher diagnostic efficiency for IVCS than VET or CDUS alone. The presence of IVCS is closely related to DVT of lower extremities, but not related to clinical class of CEAP. The most common site of IVCS is the initial segment of the left common iliac vein. The presence of collateral circulation can be used as indirect indicators for the diagnosis of IVCS.

Currently, the epidemic of 2019 coronavirus disease (COVID-19) is still ongoing. The characteristics including high contagiousness, herd susceptibility and clinical phenotype diversity, made a serious influence on people’s daily life and rountine therapy for other diseases. Breast dieases are clinical common diseases. In the central epidemic area of COVID-19, Hubei province, especially Wuhan, the clinical specialists of breast diseases should consider all of the following factors comprehensively: the prevention of COVID-19, the diagnosis and treatment of breast diseases and the accessibility of medical resources. Besides, we should select the appropriate therapy and optimize treatment process so as to prevent the propagation and cross infection of COVID-19 as well as manage the breast diseases without delay. Therefore, we carried out some management proposals of the patients with breast diseases in the central epidemic area during the epidemic of COVID-19 on the basis of conventional treatment guidelines and clinical experiences. The suggestions and corrections from colleagues will be welcomed.

Objective To understand the prevalence of thyroid nodules of children lived in different water iodine areas in Cangzhou City. Methods From Oct. 2015 to Jan. 2017, 15 villages were selected as monitoring sites in Cangzhou,two drinking water samples were collected from each survey site(all had centralized water supply), and the water iodine content was determined. A total of 100 children aged 8 to 10 (half male and female) were examined for thyroid nodules, and at least 50 children (half male and half female) were selected to detect urinary iodine content. In the high iodine water counties, the monitoring sites of iodine salt was according to "National Iodine Deficiency Monitoring Program"; in the monitoring sites of iodine salt supplied counties, students in the monitored village were asked to detect urinary iodine and household salt samples were collected to monitor salt iodine. In the high iodine area, the salt iodine test was carried out by semi-quantitative method. In the non-high iodine area, the salt iodine content of the iodized salt monitoring sites was determined by direct titration, the salt iodine content of Chuan salt and other intensified edible salt was tested by arbitration(GB/T 13025.7-2012). Water iodine and urinary iodine were tested by arsenic and cerium catalytic spectrophotometry. Results Water iodine content was 28.2 - 1 128.0 μg/L in 15 villages; a total of 1 066 urine samples were examined, the median of uriary iodine in each village was 102.6-1 162.0 μg/L;a total of 1 575 children aged 8 to 10 years were examined,among them,125 cases of thyroid nodules were detected; thyroid nodules detection rate was 7.9%. The prevalence of male was 7.0% (61/871), and the prevalence of female was 9.1% (64/704), there was no significant difference in the detection rate of thyroid nodules between different sex (χ2=2.07,P>0.05); The detection rate of thyroid nodules were 4.5%(23/508),7.8%(4/51), 11.6%(59/507)in children with urinary iodine at the appropriate level (100 - <200 μg/L), the appropriate level (200 - < 300 μg/L) and iodine excess level (≥300 μg/L), the difference of thyroid nodules in children with different levels of urinary iodine detection rate was statistically significant (χ2=17.30, P < 0.01). The difference of prevalence of thyroid nodules in children aged 8 to 10 years with water iodine concentrations of 10 - < 100, 100 - < 300 and ≥300 μg/L was statistically significant[2.9%(13/448),7.9%(25/317), 10.7%(87/810),χ2=23.86,P<0.05].The patients with unilateral thyroid nodule accounted for 64.8% (81/125); the patients with multiple thyroid nodules counted for 58.4% (73/125), and 34.2%(13/38),69.0%(60/87)in areas with iodine content less than 300 μg/L and no less than 300 μg/L,the difference between the two was statistically significant (χ2= 13.14, P < 0.01). A total of 1 800 salt samples were collected from the high water iodine counties,of which 1 779 were iodine-free salt, the rate of iodine-free salt was 98.8%; a total of 190 salt samples were collected in student family, in the 4 iodized salt monitoring sites, the salt iodine median of resident's edible salt was 0.0 mg/kg. Conclusion The prevalence of thyroid nodules in children aged 8 - 10 years may be related to high water iodine in Cangzhou City; children with multiple thyroid nodules is also significantly higher in water iodine content greater than 300 μg/L areas.

Objective To examine the value of bronchoscopy in the diagnosis of sputum-negative pulmonary tuberculosis in a general hospital.Methods A retrospective study was conducted for the 459 patients treated in a general hospital from June 2010 to May 2015.All the patients had symptoms and radiographic changes suggestive of pulmonary tuberculosis but smearnegative.All patients were subjected to bronchoscopy,including brushing,bronchoalveolar lavage (BAL) and transbronchial biopsy (TBB).The bronchoscopic specimens were submitted for direct smear and acid-fast stain,Mycobacterium tuberculosis culture or histopathological assay,respectively.Results The diagnosis was confirmed by bronchoscopy in 378 (82.4％) of the 459 patients.Of the 378 patients whose diagnosis was confirmed,pulmonary tuberculosis was identified in 238 patients (63.0％).Other diagnoses included bronchogenic carcinoma,non-specific inflammation,organizing pneumonia,pulmonary fungal infection,interstitial pneumonia,sarcoidosis,nontuberculous mycobacterial infection.Of the patients with confirmed diagnosis by bronchoscopy,the sensitivity for diagnosis was 57.95％ by direct smear and acid-fast stain of brushing or BALF,79.78％ by culture of BALF,and 56.93％ by histopathological assay of TBB specimens.The integrated method by combining smear and stain,culture and histopathological assay of TBB specimens could improve the sensitivity,specificity,positive predictive value,and negative predictive value to 91.01％,97.46％,97.98％ and 88.89％.Conclusions For the patients whose clinical manifestations and imaging changes are suggestive of pulmonary tuberculosis but smear-negative,bronchoscopy is a valuable method for the diagnosis,which should be adopted as a routine test in clinical practice.

Objective:To explore the multiple mediation effects of the positive and negative affect between emotional intelligence and life satisfaction in military personnel.Methods:Totally 967 male military personnel aged 17 to 34 years were investigated with the Schutte's Emotional Intelligence Scale (SSEIS),the Positive Affect and Negative Affect Scale (PANAS) and Life Satisfaction Index A (LSIA).The relationship among these variables was analyzed by using path analysis and Bootstrap test.Results:Totally 68.7％ military personnel were satisfied with their lives.Path analysis showed that emotional intelligence had indirect effects on life satisfaction through the mediation effects of positive affect and negative affect (x2/df=8.88,GFI =0.98,AGFI =0.94,NFI =0.98,IFI =0.98,TLI =0.95,CFI =0.98,RMSEA =0.09).Bootstrap test showed that the mediational path through positive affect and negative affect with the effect size were 31.5％ and 14.8％,and the total mediational effect size was 46.3％.Conclusion:It suggests that positive affect and negative affect may have mediating effects on the relationship between emotional intelligence and life satisfaction among military personnel.

Objective: In comparison with thrombus aspiration, to study the safety and effcacy of precise intracoronary retrograde thrombolysis during primary percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI).
Methods: A total of 123 consecutive patients with acute STEMI received primary PCI in our hospital from 2014-01 to 2015-12 were enrolled.The patients were randomly divided into 2 groups: RT group, the patients received precise intracoronary retrograde thrombolysis (RT),n=60 and TA group, the patients received thrombus aspiration (TA),n=63, among them, 3 patients with failed TA were excluded. Primary end points included occurrence rates of no-lfow after PCI and ST-segment resolution (STR)≥50% at (60-90) min after PCI; primary safety end points included occurrence rates of in-hospital stroke and TIMI-hemorrhage events.
Results:①Compared with TA group, RT group showed decreased no-lfow rate after PCI (1.7% vs 15.0%),P=0.008 and increased rate of STR≥50% after PCI (65.0% vs 45.0%),P=0.028, improved LVEF by echocardiography (50.7±8.6) % vs (46.7±8.3)%,P=0.011. The in-hospital MACE occurrence rate was similar between 2 groups,P>0.05.②No in-hospital stroke or TIMI-hemorrhage events occurred in neither group.
Conclusion: Intracoronary retrograde precise thrombolysis had the similar safety to thrombus aspiration during primary PCI in patients with acute STEMI, it may reduce no-relfow rate and improve left ventricular function after PCI.