To explore the application of intelligent performance evaluation system in traditional Chinese medicine hospi-tals and design an intelligent performance evaluation system solution suitable for traditional Chinese medicine hospitals,this paper takes the construction practice of intelligent performance evaluation system in a third-level public traditional Chinese medicine hospital in Guangzhou as an example.It analyzes the implementation steps,potential risks,solutions,and application effects of intelligent performance evaluation system construction from the perspectives of system data integration,evaluation index system design,pilot implementation plan and effect verification,and formulates a performance evaluation system application guide to pro-vide practical experience from the theoretical perspective for traditional Chinese medicine hospitals to build intelligent performance evaluation systems.

To explore the application of intelligent performance evaluation system in traditional Chinese medicine hospi-tals and design an intelligent performance evaluation system solution suitable for traditional Chinese medicine hospitals,this paper takes the construction practice of intelligent performance evaluation system in a third-level public traditional Chinese medicine hospital in Guangzhou as an example.It analyzes the implementation steps,potential risks,solutions,and application effects of intelligent performance evaluation system construction from the perspectives of system data integration,evaluation index system design,pilot implementation plan and effect verification,and formulates a performance evaluation system application guide to pro-vide practical experience from the theoretical perspective for traditional Chinese medicine hospitals to build intelligent performance evaluation systems.

Purpose To investigate the clinical value of artificial intelligence(AI)quantitative parameters in predicting the invasion degree of lung adenocarcinoma with diameter≤2 cm of ground-glass density.Materials and Methods A total of 80 patients with lung adenocarcinoma with diameter≤2 cm ground-glass density confirmed by pathology from March 2019 to April 2022 were retrospectively analyzed.A total of 90 nodules were rerolled,including 8 adenocarcinomas in situ(AIS),34 minimally invasive adenocarcinomas(MIA)and 48 invasive adenocarcinomas(IAC).They were divided into the experimental group(IAC)and the control group(AIS and MIA).The differences of the AI quantitative parameters such as volume,three-dimensional length diameter,maximum area,maximum CT value,minimum CT value and average CT value were compared between two groups,and the predictive values of AI quantitative parameters for the invasion degree of lung adenocarcinoma was evaluated.Results There were statistically significant differences with age,volume,three-dimensional length diameter,maximum area,maximum CT value and average CT value between the two groups(all P<0.05),but no statistically significant differences in gender and minimum CT value(both P>0.05).Binary Logistic regression analysis showed that the three-dimensional length diameter(odd ratio=2.020,P=0.034)and the maximum CT value(odd ratio=1.008,P=0.013)were independent predictors for lung adenocarcinoma with diameter≤2 cm of ground-glass density.The regression model based on the three-dimensional length diameter and the maximum CT value had the best predictive performance,and its AUC was 0.901.When the critical value was 2.432,its sensitivity and specificity were 93.75%and 71.43%,respectively.Conclusion AI quantitative parameters have a high value in predicting the degree of invasion of lung adenocarcinoma with diameter≤2 cm of ground-glass density,and the combined model with three dimensional long diameter and maximum CT value has the highest diagnostic efficiency.

Objective To investigate the value of spectral CT imaging in diagnosis of axillary lymphatic metastasis of breast carcinoma. Methods 27 cases of breast carcinoma who met the criteria underwent dual-phase enhanced spectra CT scan.The axillary lymph nodes were matched one-to-one between CT images and postoperative pathology.The four parameters,including NIC-A,NIC-V, λHU-A,and λHU-V were analyzed among primary tumors,metastasis and non-metastasis lymph nodes.The area under receiver operating characteristic (ROC)curves of the four parameters were used to evaluate the diagnostic accuracy in axillary lymphatic metastasis.Results The four parameters showed significant differences among the primary tumors,metastasis lymph nodes and non-metastasis lymph nodes. The four parameters were also significantly different between the primary tumors and non-metastasis lymph nodes,between metastasis lymph nodes and non-metastasis lymph nodes.Only NIC-V was significantly different between the primary tumors and metastasis lymph nodes.When NIC-A value of 0.148 was used as the threshold for diagnosing lymphatic metastasis,the sensitivity,specificity and the area under the curve were 80.00%,84.62% and 0.888,respectively.Conclusion The parameters of spectral CT imaging can significantly improve the diagnostic accuracy of axillary lymphatic metastasis of breast carcinoma,which can be used as a reference for clinical diagnosis.

Objective To study the diagnostic value of 1.5T diffusion-weighted magnetic resonance imaging for small metastatic cervical lymph nodes of nasopharyngeal carcinoma(NPC),and to explore the optimal diagnostic threshold value of apparent diffusion coefficient(ADC)in small metastatic cervical lymph nodes of NPC.Methods 40 patients with histopathologically confirmed NPC were underwent conventional,enhanced and DWI MR.The mean ADC value of large metastatic cervical lymph nodes group,small metastatic cervical lymph nodes group and benign lymph nodes group were measured respectively.Statistical analysis was done by using the SPSS 1 6.0 program software.The receiver operating characteristic (ROC)curve was performed to obtain the ADC thresh-old value of small metastatic cervical lymph nodes and the diagnostic efficacy.Results The mean ADC value of large metastatic cer-vical lymph nodes group was (0.74±0.1 1)×10 -3 mm2/s,which was not significantly different from that in small metastatic cervical lymph nodes group(0.75±0.13)×10 -3 mm2/s,P >0.05.The mean ADC value in benign lymph nodes group was (1.05± 0.18)× 10 -3 mm2/s,which was significantly higher than that in large metastatic cervical lymph nodes group and small metastatic cervical lymph nodes group(P <0.05 ).Using a threshold ADC value of 0.908 × 10 -3 mm2/s for differentiating small metastatic cervical lymph nodes from benign lymph nodes,a sensitivity of 83.2% and specificity of 90.9% were obtained,the area under the ROC curve was 0.92.Conclusion DWI is helpful in the diagnosis of small metastatic cervical lymph nodes of NPC.

Objective To investigate the diagnostic value of DWI on nasopharyngeal neoplasm recurrence and fibrotic lesions after radiotherapy.Methods A retrospective analysis of pathologically confirmed nasopharyngeal neoplasm was performed in 39 patients with recurrent patients ( recurrence group ) confirmed by biopsy or MRI follow-up and 51 patients with confirmed localized fibrosis (fibrosis group) after radiotherapy.All patients underwent DWI , non-enhanced and enhanced MR scan.DWI findings and ADC values of the lesions in two groups of patients were observed and measured , then compared by using independent samples t test.Diagnostic performance of routine MRI and DWI in the diagnosis of nasopharyngeal neoplasm recurrence after radiotherapy was calculated by using ROC analysis and the differences of both of them were analyzed by using Z test.Results DWI of 39 recurrent patients showed hyper-intensity signal and ADC map showed hypo-intensity signal appearance.Overall signal of DWI in 51 recurrent patients is lower than that in recurrent group , in which ADC maps of 36 cases showed iso-intensity or moderately hypo-intensity signal appearance and the remaining 15 cases showed moderate hyper-intensity signal appearance.The ADC values of recurrent group and fibrotic group were (0.753 ±0.127) × 10 -3 mm2/s, and ( 1.233 ± 0.310 ) ×10 -3 mm2/s, respectively.The difference was statistically significant ( t=-9.118, P<0.05).On the ROC curve, the sensitivity of ADC for the diagnosis of tumor recurrence was 87.18%(34/39), specificity 94.12%(48/51) and area under the ROC curve 0.968 with the ADC cutoff value of 0.887 ×10 -3 mm2/s.The sensitivity of routine MRI was 71.79% ( 28/39 ) , the specificity 74.51% ( 38/51 ) and the area under the ROC curve was 0.732 for the diagnosis of tumor recurrence.The difference of area under the curve between them was statistically significant ( Z=4.583, P<0.01).Conclusion DWI can help tumor detection and diagnosis of recurrent nasopharyngeal neoplasm and has a higher diagnostic performance compared with routine MRI.

Objective To explore the post training needs,training content,training mode and the advantages and disadvantages of the existing training from the general practitioner perspective,in order to provide reasonable suggestions for the management institutions to improve the quality and effect of the post training for all general practitioners.Methods In October,2013 a questionnaire survey was conducted to 197 family physicians for their post training needs,training content and training mode.According to the interview outline,an in-depth individual interview was conducted to 20 leaders and general practitioners from the community health service center in Beijing Xicheng District on the advantages and disadvantages of general medical training.All survey information databases were established using FoxPro 6.0 software and double entry.Package was statistically analyzed with SPSS 19.0 statistical software,qualitative data using rate to represent; interviews with text descriptions,coding classification analysis.Results More than 70％ of general practitioners had the demand for strengthening the training of the clinical medicine,the knowledge of humanities and social sciences as well as clinical research methods,but the demand for the training of general medical theory and basic medicine was small,only accounting for 22.50％ general practitioners.More than 90.00％ of general practitioners were in favor of targeted flexible training methods.More than 85.00％ of general practitioners believed that existing training teachers' teaching abilities were very good,and they agreed to open general practitioner training project in medical colleges and universities.The surveyed physicians also made some criticism about too many training departments,low training quality,too many training programs,and training content repetition etc..Conclusion According to the general medical post training needs,human and scientific research of targeted training should be increased by using case discussion,site visit and many flexible and diverse teaching methods and various departments should also be coordinated and the training incentive and evaluation mechanism should be improved to guarantee the quality of training.

ObjectiveTo investigate the effect of different reference vessel groups on CT perfusion in patients with nasopharyngeal carcinoma (NPC) after radiation therapy,and explore the feasibility of substitution of reference vessel.MethodsThirty patients with NPC after radiation therapy were divide into two groups,recurrence group ( n =19) and fibrosis group ( n =11 ).All patients underwent CT perfusion scans,and the CT parameters were calculated with different arterial input and vein output in order to study their differences.The vessels were internal carotid artery-internal jugular vein( ICA-IJV group),external carotid artery-retomandibular vein (ECA-RTV group)and external carotid artery-internal jugular vein( ECAIJV group) respectively.The differences of the CT parameters between local recurrence group and fibrosis group were compared among the various vessel groups by rank sum test.With the help of receiver operating characteristic curve (ROC),the diagnostic efficiencies were compared by the area under the ROC curve (AUC).ResultsIn ICA-IJV group,ECA-RTV group and ECA-IJV group,bloood flow(BF) of local recurrence group were 201.88,439.59,252.23 ml · min-1 · 100 g-1,while BF of fibrosis group were 98.96,180.50,106.55 ml · min-1 · 100 g-1.Blood volume (BV) of local recurrence group were 6.71,12.39,6.70 ml/l00 g,while BV of fibrosis group were 2.35,4.76,2.95 ml/100 g.Mean transit time (MTT) of local recurrence group were 1.66,1.50,1.56 s,while MTT of fibrosis group were 2.13,1.96,1.79 s.Permeability surface (PS) of local recurrence group were 19.31,36.39,15.22 ml · min- 1 ·100 g-1,while they were 16.58,29.08 ,16.63 ml · min-1 · 100 g-1 in the fibrosis group.The differencesof BF and BV between the local recurrence group and fibrosis group were statistically significant in each vessel group (P ＜ 0.05 ) but MTT and PS showed no significant difference( P ＞ 0.05 ).In ICA-IJV group,the AUC of BF,BV,MTT,PS were 0.909,0.947,0.677,0.703,respectively.BF,BV,MTT,PS in ECA-RTV group were 0.938,0.967,0.648,0.679 respectively,and those in ECA-IJV group were 0.861,0.890,0.641,0.656 respectively.However,AUC of BF and BV of three groups all had significant difference ( P ＜ 0.01 ).ConclusionsBoth BF and BV values calculated by three pairs of reference vessels had enough diagnosis efficiency for local recurrence and fibrosis,so all of the three groups of vessels may substitute each other in CT perfusion.

Objective To investigate the sensitivity of tumor cells to photodynamic therapy(PDT), and to select the optimal photo-dose and photo density for PDT to the cultured cells. Methods Cells of SHEE and SHEEC cell lines were divided into 21 groups randomly,after 24 h inoculation, the cells accreted on paries of culture capsule completely, we replaced M199 complete culture solution with 30 μg/rnl Photofrin-Ⅱ solution 100 μl and then replacd with M199 complete culture solution without Photofiin-Ⅱ after 150 min of incubation in Photofrin-Ⅱ. Within 15 min,we dealed the cells with PDT using Photofrin-Diomed 630 under three different power densities:25 raW/cm~2,50 mW/cm~2 and 100 mW/cm~2 for 10 s,20 9,30 s,50 s, 100 s, 150 s and 200 s respectively,and then continue for 24 h culture. We examined the inhibiting effect on cell line SHEE and SHEEC under PDT by the method of CCK-8. Results There was no significant difference in the inhibition ratio with same power density of PDT between cell line SHEE and SHEEC under the concentration of 30 μg/ml Photofrin-Ⅱ. However, the inhibition ratio increased with the raising of photo-dose of PDT,but there was a platform stage after the 2.5～30 J/cm~ 2 photo-dose. Conclu-sion The difference for photodynamic sensitivity between human immortalization esophageal epithelial cell line SHEE and the malignant transformation cell line SHEEC is not significant. The targeting of PDT to malignant tumor cell may not be involved in the photosensitivity for tumor cell.

OBJECTIVE To investigate the characteristic of Gram-positive bacteria in general ICU then discuss the susceptible factors and the treatment.METHODS A retrospective analysis of clinical information was performed on patients with Gram-positive infection in ICU from May 2002 to May 2004.RESULTS Most of Gram-positive bacteria resulted in infection in general ICU were Staphylococcus aureus and all of them were MRSA.The infective site focused on lower respiratory tract(84.44%).The second was catheter(8.89%).CONCLUSIONS The risk factors of hospital-acquired infection are relative with patient's age,underlying diseases,stay time in ICU,ventilated time and invasive operation.