Objective:To explore the clinical manifestations of IgG4-related diseases（IgG4-RD） complicated with moderately differentiated adenosquamous carcinoma of the parotid gland, the diagnostic criteria for IgG4-related diseases and parotid malignant tumors, treatment regimens, and the application of fine-needle aspiration in disease diagnosis, so as to reduce clinical misdiagnosis and missed diagnosis. Methods:A retrospective analysis was conducted on the case data of a patient with IgG4-related diseases（IgG4-RD） complicated with moderately differentiated adenosquamous carcinoma of the parotid gland admitted to our department in March 2024. The clinical characteristics, imaging findings, preoperative puncture results, and postoperative pathological features were analyzed, and relevant literatures on both diseases were reviewed and summarized. Results:The elderly male patient was admitted due to "a mass in the parotid area in front of the right ear for more than 3 months". Through clinical examination, imaging examination, laboratory examination, and preoperative needle biopsy, the diagnosis of "right parotid moderately differentiated adenosquamous carcinoma complicated with IgG4-related disease" was considered. It was also considered that IgG4-related disease did not involve other organs before surgery, so no systemic hormone therapy was given before or after surgery. After surgery combined with postoperative radiotherapy, follow-up showed that neither the parotid tumor nor IgG4-related disease recurred. Conclusion:"IgG4-related disease complicated with moderately differentiated adenosquamous carcinoma"is a rare clinical disease. Both lack typical clinical manifestations and specific imaging features, and the diagnosis is mostly unclear before surgery. Pathological examination is of great significance in the diagnosis of the disease, while fine-needle aspiration has limited value in the diagnosis, which should attract the attention of clinicians. In addition, for patients with both diseases, individualized treatment plans should be formulated.
Humans ; Parotid Neoplasms/pathology* ; Male ; Carcinoma, Adenosquamous/pathology* ; Immunoglobulin G4-Related Disease/complications* ; Parotid Gland/pathology* ; Retrospective Studies ; Aged ; Biopsy, Fine-Needle ; Immunoglobulin G

Breast cancer is the worldwide most common malignant tumor in women,and early diagnosis and treatment is the key to improve prognosis.Conventional screening imaging techniques,such as mammography and ultrasonography,have only limited diagnostic efficacy for micro breast cancer.Combining diffuse optical tomography(DOT)and ultrasonography for assessing blood vessel distribution and metabolic level inside the breast lesions,optical tomography image ultrasonography system(OPTIMUS)has unique advantages for diagnosing micro breast cancer with diameter≤1.0 cm.The research progresses of OPTIMUS for diagnosing micro breast cancer were reviewed in this article.

High intensity focused ultrasound(HIFU)can non-invasively and safely focus sound waves on target region to ablate tumors.Using acoustic sensitizer combined with ultrasound to ablate tumors,Sonodynamic therapy(SDT)can ablate tumors at deep region with high precision.The progresses of HIFU combined with SDT for treating tumors were reviewed in this article.

Objective: To explore the associations of family structure with adolescent mental health and health associated behaviors, to support interventions to decrease the occurrence of psychological problems and adverse health associated behaviors among adolescents in families without two parents. Methods: The multi stage stratified random cluster sampling method was used to select 18 700 adolescents of the 13 districts and cities from Jiangsu Province for a questionnaire survey on mental health and health associated behaviors, to compare differences in mental health and health associated behaviors among adolescents with different family structures. Results: Among the adolescents, 82.1% had two parent families, 8.6% had single mother families, 4.0% had single father families, and 5.3 % had families with both parents absent. After controlling for age, urban/rural areas, gender, academic period and region, Logistic multivariate regression analysis showed that compared with adolescents from two parent families, the incidence of depression, social anxiety and bullying on campus of adolescents with single mother families increased significantly( OR=1.31, 1.15, 1.36，P ＜0.05). Compared with adolescents in two parent families, adolescents in families without two parents had significantly more types of health risk behaviors, and those in single mother families had significantly less frequent intake of a healthful diet( OR =0.81), significantly more smoking( OR =1.20), drinking behaviors( OR =1.22), and significantly less moderate intensity physical activity ( OR =0.84) and shorter duration of sleep( OR =0.87)( P <0.05). Conclusion Psychological and health associated problems were significantly higher among adolescents in families without two parents than in those with two parent families. Psychological problems and adverse health associated behaviors were particularly prominent among adolescents in single mother families.

【Objective】 To compare the ability of body mass index （BMI）， body fat percentage （BFP）， waist circumference （WC）， waist-to-height ratio （WHtR）， visceral fat index （VFI） and the combinations of two kinds of obesity indices to predict the risk of hypertension. 【Methods】 Data collected in the baseline survey of “Gansu Province’s Urban and Rural Natural Population Cohort Establishment and Tumor Follow-up Study” were analyzed. Area under the curve （AUC） of ROC curve with covariates was used to analyze and compare the effects of individual obesity evaluation index and the combination of two kinds of obesity indices in predicting the risk of hypertension. 【Results】 Analyses of data of 20，079 adults showed that the AUC of BMI， WC， WHtR， BFP and VFI was 0.636， 0.604， 0.615， 0.614 and 0.619， respectively. AUC of the combination of BMI and WC （0.643） was higher than that of BMI （0.636）； however， the change rate of AUC was only 1.09%. AUC of the combinations of WC， WHtR and VFI， the three central obesity evaluation indices， and BFP， a general obesity evaluation index， were lower than that of BMI. The optimal cutoff value for BMI was 24.2 kg/m². 【Conclusion】 The effect of BMI in predicting the risk of hypertension is better than that of BFP， WC， WHtR and VFI. The effects of the combinations of the two kinds of obesity evaluation indices are not better than that of BMI. To prevent and control hypertension， adults should keep their BMI under overweight.

Objective: To investigate the incidence of juvenile myopia and associated factors in Nantong, to analyze the relationship between food intake and juvenile myopia, so as to provide a reference for preventing and controlling myopia of adolescents. Methods: Stratified cluster random sampling was used to select 13 schools in Nantong. A total of 3 437 students were selected for health monitoring and questionnaire survey, and the students sociodemographic characteristics and diet related information were collected. Results: The prevalence of myopia was 73.4%( n =2 522). The myopia rate of urban teenagers(74.1%) was higher than that in suburbs(72.4%), and the myopia rate of urban girls (78.2%)was higher than that of suburban girls(73.6%). Multivariate Logistic regression analysis showed that there was a significant positive correlation between the frequency of high energy food intake and myopia among urban adolescents ( OR =1.50, P <0.01). After adjusting for covariates, e.g. age, parental myopia, participation in extracurricular classes, outdoor inter class activities, the frequency of high energy food intake was significantly positively associated with myopia ( OR =1.29, P =0.03). Frequency of high energy food intake was significantly positively correlated with myopia of suburban adolescents ( OR =1.35, P =0.02). The association disappeared after adjusting for above ment ioned covariates ( P = 0.60 ). Conclusion There are differences in the main risk factors affecting the incidence of myopia between urban and suburban adolescents in Nantong. Parents, schools and the society should pay attention to adolescent myopia and high energy diet mode, pay attention to guide their reasonable eating habits, and prevent and control adolescent myopia from multiple angles.

Objective:To evaluate the value of radiomics analysis based on enhanced MRI in predicting the recurrence of acute pancreatitis (AP).Methods:From January 2017 to December 2020, 201 patients diagnosed with AP were collected retrospectively in the Affiliated Hospital of North Sichuan Medical College. These patients underwent plain and enhanced MRI within 7 days after onset. After clinical follow-up, 102 cases were classified as non-recurrence AP group and 99 cases were classified as recurrent acute pancreatitis (RAP) group. They were divided into training set (140 cases, 71 cases in non-recurrence AP group, 69 cases in RAP group) and validation set (61 cases, 31 cases in non-recurrence AP group, 30 cases in RAP group) using a random number table method. The independent sample t-test, Mann-Whitney U test or χ 2 test were used to compare the clinical characteristics between the two groups, and the clinical characteristics with statistical differences were included in logistic regression to construct the clinical model. The quantitative features of radiomics were extracted based on the late arterial-phase images of contrast-enhanced MRI. The best radiomics features retained after dimensionality reduction were used to construct the radiomics model through logistic regression analysis, and a combined model was constructed by combining the clinical features. The prediction ability of the models was evaluated by the receiver operating characteristic curve, and the area under the curve (AUC) was compared by DeLong test. Results:There were statistical differences in gender, severity, local complications, hyperlipidemia and smoking between non-recurrence AP group and RAP group (all P<0.05). Hyperlipidemia was an independent risk factor for AP recurrence (OR=5.236, 95%CI 2.710-10.101). The 9 best radiomics features by dimensionality reduction were selected to construct a radiomics model. The AUCs of clinical model, radiomics model and combined model in the training set were 0.803, 0.944 and 0.978 respectively, and those in the validation set were 0.678, 0.940 and 0.955 respectively. In the training set and the validation set, the prediction ability of the radiomics model and combined model were higher than those of the clinical model (training set: Z=3.28, 4.83, P=0.001,<0.001; validation set: Z=3.48, 4.05, both P<0.001). Conclusions:The radiomics model based on late arterial-phase enhanced MRI has good quantitative prediction ability for the recurrence of AP, which can provide a reference for the prevention and treatment of RAP.

Objective To investigate the distribution of gross α and gross β levels of centralized drinking-water of township in Beijing from 2018 to 2019, so as to carry out better monitoring and evaluating the radioactivity in water. Methods A total of 215 underground drinking water samples were collected from 12 districts of Beijing, then monitored and evaluated according to the Determination of gross alpha activity in water-thick source method EJ/T 1075—1998 and Determination of gross beta activity in water-evaporation method EJ/T 900—1994. Results The gross α level of centralized drinking water of township in Beijing was 0.050 (0.052) Bq/L, ranging from 0.001 to 0.210 Bq/L, and the gross β level was 0.048 (0.038) Bq/L, ranging from 0.002 to 0.261 Bq/L from 2018 to 2019. Gross α and gross β levels of all samples did not exceed the guidance value recommended by standards for drinking water quality. There was no significant difference in the distribution of gross α and gross β levels of samples of all districts from 2018 to 2019(P > 0.05), there were significant differences in the distribution of gross α and gross β levels of samples from different district in the same period (P < 0.05). And the levels of Miyun, Huairou and Shunyi in Chaobai River system were higher than other districts. Conclusion The distribution of radioactive background of centralized drinking-water of township in Beijing was mastered, which was in the normal range.

Objective    To investigate whether metformin has protective effect on myocardial injury in patients with coronavirus disease 2019 (COVID-19) combined with coronary heart diseases and diabetes. Methods    COVID-19 patients with coronary heart disease and diabetes who were admitted to Tongji Hospital from January 18 to April 25 in 2020 were enrolled. They were divided into a metformin group and a none-metformin group according to whether the metformin was used. The demographic characteristics, clinical symptoms, laboratory parameters, treatment and clinical outcomes of the two groups were analyzed retrospectively. Results    There were 29 patients in the metformin group, 3 patients (12.0%, 3/25) suffered myocardial injury and 1 (3.4%) died of acute respiratory failure complicated by septic shock; 67 patients were in the non-metformin group and 24 (37.5%, 24/64) had myocardial injury but 15 died in hospital among whom 1 died of septic shock complicated by disseminated intravascular coagulation, 1 acute respiratory failure complicated by possible cerebral hemorrhage, 2 acute respiratory failure, 1 fulminant myocarditis, 3 acute myocardial infarction and 7 cardiac arrest. The incidence of myocardial injury (12.0% vs. 37.5%, P=0.019), hospital mortality (3.4% vs. 22.4%, P=0.034) and mortality of cardiovascular events (0.0% vs. 16.4%, P=0.049) in the metformin group were significantly lower than those in the non-metformin group. Multivariate analysis showed that the use of insulins (OR=11.235, P=0.003) was an influencing factor for in-hospital mortality of patients. The use of metformin (OR=0.154, P=0.013) was positively correlated with the myocardial injury. Conclusion    When patients with coronary heart disease and diabetes are infected with COVID-19, metformin can effectively reduce myocardial damage and has a certain effect on reducing hospital mortality. Combined with clinical considerations, it is worthy of popularization.

Objective:To understand the current situation and trend of nursing cost research in China so as to provide a reference for researchers in the field of nursing cost research.Methods:We retrieved literature on nursing cost from January 1, 1990 to December 13, 2019 in China National Knowledge Infrastructure (CNKI) . CiteSpace software was used for visual analysis.Results:A total of 463 related literature were obtained, and the number of publications was on the rise as a whole, and research institutions had little cooperation. Nursing economics, nursing human resources, nursing management, cost analysis were the main research directions at present. Long-term care insurance with the highest emergent word intensity was the research frontier in the field.Conclusions:We should strengthen the cooperation in scientific research institutions, and rely on big data, computers and other means to establish a nursing cost accounting model, and extend the scope of research to communities and homes so as to provide a quantitative basis for Chinese long-term care insurance compensation standards.