Objective To investigate the correlations of the expression levels of serum silencing in-formation regulatory factor 2-related enzyme 1(SIRT1),endothelial cell-specific molecule-1(ESM-1),and fibroblast growth factor-21(FGF21)with therapeutic outcome in patients with sepsis-related acute respiratory distress syndrome(ARDS).Methods A total of 140 patients with sepsis-related ARDS were selected and divided into good outcome group(n=96)and poor outcome group(n=44)accord-ing to the therapeutic outcome.The levels of serum SIRT1,ESM-1 and FGF21 were compared between the two groups,and the correlations of serum SIRT1,ESM-1 and FGF21 with the severity of the dis-ease and therapeutic outcome were analyzed.The predictive values of serum SIRT1,ESM-1 and FGF21 for therapeutic outcome were evaluated.Results The serum SIRT1 level in the poor outcome group was significantly lower,while the levels of ESM-1 and FGF21 were significantly higher than those in the good outcome group(P＜0.05).The serum SIRT1 level showed a significant gradual downward trend in mild,moderate,and severe patients,while the ESM-1 and FGF21 levels showed a significant gradual upward trend in mild,moderate,and severe patients(P＜0.05).Spearman corre-lation analysis showed that serum SIRT1 was significantly negatively correlated with disease severity,while ESM-1 and FGF21 were significantly positively correlated with disease severity(P＜0.05).Partial correlation analysis showed that serum SIRT1,ESM-1 and FGF21 were significantly correla-ted with the therapeutic outcome of ARDS patients with sepsis(P＜0.05).The receiver operating characteristic(ROC)curve showed that the area under the curve(AUC)of serum SIRT1,ESM-1 and FGF21 for predicting the treatment outcome of sepsis-related ARDS patients was 0.742,0.838 and 0.796 respectively,with sensitivities of 77.27％,77.27％and 70.45％,and specificities of 64.58％,81.25％and 87.50％.The AUC of the combination of three indexes for predicting the therapeutic outcome of sepsis-related ARDS patients was 0.939,with a sensitivity of 88.64％and a specificity of 83.33％,which was significantly higher than the predictive value of the three indexes alone(P＜0.05).Conclusion The levels of SIRT1,ESM-1 and FGF21 in the serum of sepsis-re-lated ARDS patients are significantly correlated with the severity of the disease and the therapeutic outcome,and have the abilitis to independently predict the therapeutic outcome.The combined pre-dictive value is even higher.

Objective To explore the influencing factors of bone mineral density (BMD) in obese children in Qianjiang area and analyze the correlation between BMD and insulin resistance. Methods The data on pediatric cases from the outpatient department of Jianghan Oilfield General Hospital in Qianjiang from January 2018 to December 2022 were collected. A total of 183 obese children who met the inclusion and exclusion criteria were included in the study and selected in the observation group. A total of 352 children undergoing physical examination during the same period were selected as the control group. Results The body mass, waist circumference, waist to hip ratio, and BMI of obese children were significantly higher than those of the control group (P<0.001). Biochemical indexes including FBG, FINS, Home-IR, ALP, and LDL-C in obese children were significantly higher than those in the control group (P<0.05), while bone mineral density, Ca, P, sOC and HDL-C were significantly lower than those in the control group (P<0.001). The bone mineral density of obese children was significantly correlated with their exercise intensity, sunshine exposure duration, sitting time, intake of milk and dairy products, intake of sweets, supplementation of trace elements, BMI, Home-IR, and sex (all P<0.05). BMI, Home-IR, sex, exercise intensity, and sunshine exposure length were independent risk factors affecting bone mineral density of obese children (all P<0.05). Bone mineral density was negatively correlated with BMI and Home-IR (P=0.028 and0.017, respectively), and positive correlation with exercise intensity and sunlight exposure (P=0.033). Conclusion BMD of obese children in Qianjiang area is affected by gender, body mass index, diet, vitamin intake, and physical activity, and is negatively correlated with insulin resistance. Home-IR can be used as a reference for screening BMD of obese children.

Autologous ozonized blood transfusion(AOBT) is a therapy of re-transfusion of 100-200 mL of autologous blood after shaking and agitation with appropriate amount of oxygen-ozone in vitro. The oxidation of blood through the strong oxidation of ozone can enhance the non-specific immune response of the body, regulate the internal environment and promote health. This therapy has been increasingly applied in clinical practice, while no unified standard for the operation process in terms of ozone concentration, treatment frequency and treatment course had been established. This operation process of AOBT is primarily explored in order to standardize the operation process and ensure its safety and efficacy.

【Objective】 To investigate the current situation concerning volume control of red blood cells in additive solution produced by blood service in Chongqing, and to lay a foundation for promoting the homogenization of preparation process of red blood cells in additive solution. 【Methods】 A questionnaire was designed to investigate the factors related to the preparation of red blood cells in additive solution. The questionnaire was sent by Chongqing Association of Blood Transfusion via E-mail to 18 blood services in the city, and the collected data was sorted, revised and analyzed by research team. 【Results】 A total of 18 blood services(including 1 blood center + 1 sub-center, 6 central blood stations and 11 central blood banks) returned the questionnaires. The results showed that there were differences among blood services across Chongqing, regarding the centrifugal parameters during preparation, the operation mode and monitoring situation of the capacity control during preparation, and the formulation of the capacity standard of red blood cells in additive solution etc. 【Conclusion】 The preparation process of red blood cells in additive solution, produced by Chongqing blood services, should be further standardized, and the capacity control method of this product in Chongqing should be gradually unified to achieve regional homogeneity and to ensure blood safety.

Objective: To provide an automatic method for segmentation and diameter measurement of type B aortic dissection (TBAD). Materials and Methods: Aortic computed tomography angiographic images from 139 patients with TBAD were consecutively collected. We implemented a deep learning method based on a three-dimensional (3D) deep convolutional neural (CNN) network, which realizes automatic segmentation and measurement of the entire aorta (EA), true lumen (TL), and false lumen (FL). The accuracy, stability, and measurement time were compared between deep learning and manual methods. The intra- and inter-observer reproducibility of the manual method was also evaluated. Results: The mean dice coefficient scores were 0.958, 0.961, and 0.932 for EA, TL, and FL, respectively. There was a linear relationship between the reference standard and measurement by the manual and deep learning method (r = 0.964 and 0.991, respectively). The average measurement error of the deep learning method was less than that of the manual method (EA, 1.64% vs. 4.13%; TL, 2.46% vs. 11.67%; FL, 2.50% vs. 8.02%). Bland-Altman plots revealed that the deviations of the diameters between the deep learning method and the reference standard were -0.042 mm (-3.412 to 3.330 mm), -0.376 mm (-3.328 to 2.577 mm), and 0.026 mm (-3.040 to 3.092 mm) for EA, TL, and FL, respectively. For the manual method, the corresponding deviations were -0.166 mm (-1.419 to 1.086 mm), -0.050 mm (-0.970 to 1.070 mm), and -0.085 mm (-1.010 to 0.084 mm). Intra- and inter-observer differences were found in measurements with the manual method, but not with the deep learning method. The measurement time with the deep learning method was markedly shorter than with the manual method (21.7 ± 1.1 vs. 82.5 ± 16.1 minutes, p < 0.001). Conclusion The performance of efficient segmentation and diameter measurement of TBADs based on the 3D deep CNN was both accurate and stable. This method is promising for evaluating aortic morphology automatically and alleviating the workload of radiologists in the near future.

Objective To confirm the epidemiological characteristics of coronavirus disease COVID-19 reported in Qianjiang city and provide a scientific basis for establishing and implementing effective infection prevention and control. Methods The cases of COVID-19 reported in Qianjiang were retrospectively collected and the epidemiological characteristics, including time, spatial and population distribution, clinical symptoms and exposure history, were analyzed using descriptive epidemiological method. Results A total of 198 confirmed cases of COVID-19, including 102 imported cases, were reported in Qianjiang city by March 31, 2020. Of the 198 patients, 9 died, and 189 were discharged. The male-to-female ratio was 1.2:1. Among the reported patients, most of the patients were aged 30-69. In the early stage, only imported cases were reported, subsequently, imported cases and local cases were prevalent together, and the peak of confirmed cases was appeared on February 15, 2020. Among the clinical types for admitted diagnosis, the common type (67.17%) was dominant, and fever (82.83%) and cough (67.17%) were the predominant clinical manifestations for primary diagnosis. The median time from illness onset to first visit was 3 days, the median time from first visit to confirmed diagnosis was 7 days, and the median interval from illness onset to diagnosis was 11 days. Conclusions With comprehensive measures taken, the pandemic of COVID-19 in Qianjiang have been brought under control. However, it is necessary to be alert to the potential risks brought by the resumption of work, production, education, as well as the outbound imported cases. Various prevention and control measures should continue to be strictly implemented.

Objective To evaluate preoperative apparent diffusion coefficient (ADC) and exponential apparent diffusion coefficient (eADC) in diffusion weighted imaging (DWI) on microvascular invasion (MVI) of hepatocellular carcinoma (HCC).Methods We retrospectively reviewed 43 HCC patients with DWI data confirmed by surgery and pathology.ADC and eADC values were measured both in neoplasm and hepatic tissue,the ratio of tumor to liver (T/L) on ADC and eADC was calculated.The correlation between MVI and ADC value,T/L of ADC value,eADC value and T/L of eADC value was analysed,the best cut-off value of variables was analysed by ROC curve,multi factor analysis was carried out by Logistic regression model.Results The ADC value,T/L of ADC,eADC value and T/L of eADC were (1.458 ± 0.444) × 10-3 mm2/s,0.787 ± 0.186,0.289 ± 0.144 and 1.383 (1.179,1.655),respectively.Among them,the positive MVI group were (1.232 ± 0.480) × 10-3 mm2/s,0.683 ± 0.229,0.323 ±0.123 and 1.630(1.387,2.066),respectively.The negative MVI group were(1.545 ±0.404) × 10-3mm2/s,0.844 ±0.149,0.277 ±0.152 and 1.303(1.176,1.545),respectively.There was significant difference in ADC value,T/L of ADC value and T/L of eADC value (t =2.164,2.654,z =-2.058,all P ＜0.05),the area under the ROC curve were (1.085 × 10-3) mm2/s,0.685 and 1.475 using MVI as a diagnostic standard.Multivariate analysis showed that T/L of ADC value was an independent factor affecting MVI of HCC (OR=0.002,95％CI:1.380E-5-0.311,P＜0.05).Conclusions The ADC value in HCC patients with positive MVI is lower than in HCC patients with negative MVI,T/L of eADC value is higher than in HCC patients with negative MVI,and T/L of ADC value is an independent factor predicticing MVI of HCC.

Objective To investigate the clinical value of Fluorine-18-fluorodeoxyglucose (18 F-FDG)positron-emission temography/computed tomography (PET/CT) examination to predict microvascular invasion (MVI) of hepatocellular carcinoma (HCC).Methods The retrospective cohort study was conducted.The clinicopathological data of 51 HCC patients who were admitted to Changhai Hospital of the Second Military Medical University (32 patients) and Universal Medical Imaging Diagnostic Center (19 patients) from January 2013 to October 2017 were collected.Of 51 patients receiving postoperative pathological examination,21 diagnosed with positive MVI and 30 diagnosed with negative MVI were respectively allocated into the positive and negative MVI groups.All the patients received preoperative 1s F-FDG PET/CT examination and underwent surgery after related examinations.Two imaging doctors independently read films and made a semi-quantitative analysis.Observation indicators:(1) results of 18F-FDG PET/CT examination;(2) multivariate analysis and diagnostic value affecting MVI of HCC;(3) treatment and follow-up.Follow-up using outpatient examination and telephone interview was performed to detect the postoperative patients' survival up to November 2017.Measurement data with normal distribution were represented as (x)±s,and comparisons between groups were evaluated with the independent-sample t test.Measurement data with skewed distribution were described as M (Qn),and comparisons between groups were analyzed using the independent-sample rank sum test.Comparisons of count data were analyzed using the chisquare test.Logistic regression analysis was performed in variables with statistical significance.The inclusion criteria was 0.05 and exclusion criteria was 0.10 according to Backward (LR) method for screening variables.Receiver Operating Characeristic (ROC) curve analysis was used to evaluate the diagnostic value using MVI as a diagnostic standard.Results (1) Results of 18F-FDG PET/CT examination:of 51 HCC patients,tumors located in the right lobe,left lobe and caudate lobe of the liver were respectively detected in 37,12 and 2 patients.CT examinations of 51 HCC patients:HCCs showed the hypodense shadow or slightly hypodense shadow in liver and were round-like,and some of the larger lesions were irregularly conglomerate,with a relatively clear tumor-liver boundary;tumor necrosis area showed patchy and irregular lower density,with small lesions around the port of tumors.Of 51 patients,34 were positive on PET and 17 were negative on PET,and some necrotic areas showed no uptake and located in the center of tumors.There was no abnormal 18 F-FDG uptake in other parts of the whole body.The maximum diameter of tumor was (6± 3)cm.The maximum standardized uptake value (SUVmax),and ratio of SUVmax of tumor to SUVmax of liver (SUVmax T/L) in all the lesions were 6.38±4.91 and 2.42±1.93,respectively.The mean standardized uptake value (SUVmean),metabolism of volume (MTV),total lesion of glycolysis (TLG) of 40 patients were 4.30± 2.46,43.82 cm3 (8.97 cm3,219.13 cm3) and 165.73 (28.26,794.50),respectively,and software could not automatically delineate lesions in other 11 patients due to low metabolism.Delayed imaging was found in 21 patients,and the delayed SUVmax and retention index (RI) were 7.22±6.26,19.66％ (-7.10％,50.84％),respectively.The cases with positive and negative on PET were 18,3 in the positive MVI group and 16,14 in the negative MVI group,respectively,with a statistically significant difference between groups (x2=5.829,P＜0.05).The maximum diameter of tumor in the positive MVI group and negative MVI group was respectively (7.7±2.9)cm and (5.2±3.1)cm,with a statistically significant difference between groups (t=-2.930,P＜0.05).(2) Multivariate analysis and diagnostic value affecting MVI of HCC:the results of multivariate analysis showed that maximum diameter of tumor was an independent factor affecting MVI of HCC (OR=1.276,95％ confidence interval:1.028-1.585,P＜0.05).The area under the ROC curve of the maximum diameter of tumor was 0.723 using MVI as a diagnostic standard.The sensitivity,specificity and Youden index were respectively 90.5％,50.0％ and 0.405,with 4.55 cm as the critical value.(3) Treatment and followup:all 51 patients underwent tumor resection.Twenty-two patients were followed up for 25 months (range,12-46 months).The 1-and 2-year overall survival rates were 81.8％ (18/22) and 63.6％ (14/22),respectively.The 1-and 2-year tumor-free survival rates were 59.1％ (13/22) and 45.5％ (10/22),respectively.Conclusion The positive rate on PET of 18F-FDG PET/CT examination in HCC patients with positive MVI is higher than that in HCC patients with negative MVI,and the maximum diameter of tumor is an independent factor predicting MVI of HCC,with a certainly reference value.

Objective To explore CT,MRI and 18F-FDG PET/CT features of splenic lymphangioma.Methods A retrospective analysis of 18 pathology proved splenic lymphangioma cases was made,including their clinical,imaging characteristics and pathological findings.15 cases with plain and enhanced CT scan,6 cases with plain and enhanced MRI scan and 1 case with 18F-FDG PET/CT examination.Results (1) 13 cases were single lesion,4 cases were multiple lesions and 1 case was lymphangiomatosis.The largest diameter was 15.8 cm,minimum diameter was less than 1.0 cm.(2) On CT imaging:cystic watery density and equal density interval was showed in 12 cases,in 3 cases as solid and slightly were showed lower density.Calcification was showed in 3 cases.On enhanced CT,internal septa was slightly enhanced and progressive inhomogeneous enhancement was shown in 3 cases.(3) On MRI imaging:cystic content was manifested as low signal on T1WI and high or highlight signal on T2WI,and there was a difference between the lesion and the splenic tissue on DWI.(4) One case underwent PET/CT imaging:18F-FDG uptake was not increased.Conclusions Preoperative CT,MRI and 18F-FDG PET/CT help establish a tentative diagnosis of splenic lymphangioma while final diagnosis relies on pathological examination.

Objective To summarize the computed tomography (CT),magnetic resonance imaging (MRI) and fluorine-18 fluorodeoxy glucose (18 F-FDG) positron emission tomography (PET)/CT features of abdominal non-organi lymphangioma.Methods The retrospective cross-sectional study was conducted.The clinical data of 16 patients with abdominal non-organi lymphangioma who were admitted to the Affiliated Hospital of Ningbo University (11 patients) and the Changhai Hospital Affiliated to the Second Military Medical University (5 patients) between January 2009 and December 2015 were collected.All the patients received CT,MRI and 18F-FDG PET/CT examinations.Observation indicators:(1) imaging examinations;(2) imaging features of CT and MRI;(3) imaging features of PET/CT;(4) treatment and follow-up.Operations were applied to patients based on agreements of patients and families after finishing preoperative examinations,and postoperative pathological examinations were also performed.Follow-up using outpatient examination and telephone interview was performed once every 6-12 months postoperatively up to July 2016.Results (1) Imaging examinations:of 16 patients,12 underwent plan and contrast-enhanced CT scans,5 underwent plan and contrast-enhanced MRI scans,2 underwent plan MRI scans and 1 underwent 18 F-FDG PET/CT scan.One patient underwent simultaneously CT,MRI and 18 F-FDG PET/CT examinations and 2 patients underwent simultaneously CT and MRI examinations.(2) Imaging features of CT and MRI:① Classification of lymphangioma:unilocular cyst,plurilocular cyst and lymphangiomatosis were detected in 6,9 and 1 patients,respectively.② Lymphangioma location:9 of lymphangioma located in the single regions (6 with unilocular cyst and 3 with plurilocular cyst),7of lymphangioma involved multiple regions (6 with unilocular cyst and 1 with lymphangiomatosis).③ Lymphangioma diameter:lesion diameter was 4-25 cm,with an average of 12 cm,and diameter in 9 of lymphangioma was more than 10 cm.④ Lymphangioma shape:3 lymphangiomas were regular-shaped,showing round-like changes,and 13 lymphangiomas were irregular-shaped,showing'moulding'-like changes.⑤ Internal structure of lymphangioma:internal structures in 12 patients undergoing plain CT scans presented as liquid low density,with homogeneous density and-10-19 HU of CT value.MRI scans in 7 patients showed low signal on T1WI and high signal on T2WI,with homogeneous signals.No bleeding was found inside the abdominal non-organi lymphangiomas of 16 patients.The fluid-fluid level was detected in 1 patient with lymphangioma due to bleeding in pathological changes of liver.The septa and wall thickness was less than 2 mm in 15 patients with lymphangiomas,and was more than 3 mm in 1 plurilocular cyst lymphangioma,showing a equal density and isointensities on T1WI and T2WI.There was no nodule and calcification in 16 patients.⑥ Lymphangioma boundary:15 patients had clear boundary of lymphangioma and 1 had an unclear boundary of lymphangioma.⑦ Extrusion of adjacent organs:lymphangiomas in 10 patients were local concave,showing arc-shaped impression and hilar depression,lymphangiomas in 4 patients showed surrounding blood vessels,and fat density or signal inside lymphangioma was found in 2 patients.There were no surrounding intestine and lymph node enlargement in 16 patients.⑧ Lymphangioma reinforcement:of 14 patients with contrast-enhanced scans,septa and wall of lymphangiomas demostrated slight enhancement in 13 patients and moderate enhancement in 1 patient,and all contents showed no enhancement.(3) Imaging features of 18F-FDG PET/CT:inhomogeneous uptake of FDG was manifested in 1 plurilocular cyst lymphangioma,metabolic activity of the lesion was slightly higher than liver,SUVmax=3.71.(4) Treatment and follow-up:14 patients underwent single resection of lymphangioma (6 with unilocular cyst and 8 with plurilocular cyst);1 patient with plurilocular cyst lymphangioma underwent resection of lymphangioma,descending part of duodenum,pancreatic head and ascending colon;1 patient with lymphangioma underwent splenectomy due to smaller lesion.Sixteen patients were confirmed with lymphangioma by postoperative pathological examinations.Of 16 patients,13 were followed up for 6-31 months,with a median time of 15 months.During the follow-up,12 patients had no recurrence,with satisfactory outcomes,and 1 with recurrence of lymphangioma underwent multiple cervical and thoracic resections under right arm and sclerotherapy.Conclusion Abdominal non-organi lymphangioma has some imaging characteristics,it usually manifests as a larger mass with plurilocular cyst,moulding,liquid density/signal,thin septa and wall and clearly boundary.Plurilocular cyst lymphangioma has uptake of 18F-FDG.