Objective:To establish an automatic classification approach for bone marrow cells based on microscopic hyperspectral imaging and three-dimensional spectral convolutional neural network (Spec-CNN).Methods:The research type is establishment of methodology. The study included 306 newly diagnosed patients' bone marrow smears under Wright's staining from the Department of Hematology of the First Medical Center of the PLA General Hospital from November 1st, 2013 to April 30th, 2024. The high-spectrum data and 4k image data of bone marrow cells were simultaneously collected using a microscopic hyperspectral-4k optical path integrated imaging system (with a spectral resolution of 400—1 000 nm). The high-spectrum data was used for model training, while the 4k image data recognized by morphologists was only used as a reference for labeling the high-spectrum data. The high-spectrum data set was divided into training set, validation set and test set in a ratio of 14∶6∶5. The training set and validation set were used to train and fine-tune the Spec-CNN model, and the test set was used to evaluate the model performance. The sensitivity, specificity ,accuracy ,and Kappa coefficient were calculated for comparing the manual annotation results as gold standard with the intelligent identification results of the Spec-CNN model. Five non-data set samples were used for external validation.Results:The acquired hyperspectral data and 4k imaging dataset comprised of 32 categories and 64 800 bone marrow cells. In the test set, the Spec-CNN model demonstrated weighted-average indicators on classification metrics across 32 cell types: sensitivity 87.79%, specificity 99.31%, and accuracy 98.78%, and Kappa coefficient 0.869. For external validation, the mean correct identification rate of bone marrow cells reached 83.28%.Conclusion:We successfully established an automatic classification method of bone marrow cells based on microscopic hyperspectral imaging and three-dimensional Spec-CNN. This method has a good automatic classification ability for 32 types of bone marrow nucleated cells, which has a certain auxiliary effect on improving the diagnosis efficiency of blood diseases for bone marrow morphologists.

Objective:To establish an automatic classification approach for bone marrow cells based on microscopic hyperspectral imaging and three-dimensional spectral convolutional neural network (Spec-CNN).Methods:The research type is establishment of methodology. The study included 306 newly diagnosed patients' bone marrow smears under Wright's staining from the Department of Hematology of the First Medical Center of the PLA General Hospital from November 1st, 2013 to April 30th, 2024. The high-spectrum data and 4k image data of bone marrow cells were simultaneously collected using a microscopic hyperspectral-4k optical path integrated imaging system (with a spectral resolution of 400—1 000 nm). The high-spectrum data was used for model training, while the 4k image data recognized by morphologists was only used as a reference for labeling the high-spectrum data. The high-spectrum data set was divided into training set, validation set and test set in a ratio of 14∶6∶5. The training set and validation set were used to train and fine-tune the Spec-CNN model, and the test set was used to evaluate the model performance. The sensitivity, specificity ,accuracy ,and Kappa coefficient were calculated for comparing the manual annotation results as gold standard with the intelligent identification results of the Spec-CNN model. Five non-data set samples were used for external validation.Results:The acquired hyperspectral data and 4k imaging dataset comprised of 32 categories and 64 800 bone marrow cells. In the test set, the Spec-CNN model demonstrated weighted-average indicators on classification metrics across 32 cell types: sensitivity 87.79%, specificity 99.31%, and accuracy 98.78%, and Kappa coefficient 0.869. For external validation, the mean correct identification rate of bone marrow cells reached 83.28%.Conclusion:We successfully established an automatic classification method of bone marrow cells based on microscopic hyperspectral imaging and three-dimensional Spec-CNN. This method has a good automatic classification ability for 32 types of bone marrow nucleated cells, which has a certain auxiliary effect on improving the diagnosis efficiency of blood diseases for bone marrow morphologists.

Objective To explore the effectiveness of ADDIE instruction model(Analyse,Design,Develop,Implement,Evaluate)in the on-the-job training for neonatal transfer nurses to improve the comprehensive ability in life-saving as well as to ensure the safety of neonates during the transfer.Methods The pre-and post-control study in self-trained comparison was conducted with 35 neonatal nurses in our hospital.Thirty-five neonatal nurses in our hospital were included in a special training group for neonatal transport.According to the ADDIE instruction model,the training needs of nurses were analysed,special training protocols were designed and developed,training rules were implemented and the effects of training on the nurses were evaluated.Scores in professional theoretical knowledge,practical and various skills and teamwork and communication abilities in neonatal transfer were compared before and after the implementation of the ADDIE instruction model.Results All of the 35 nurses had completed the training and responded to the survey.The scores in professional theoretical knowledge,practical skills and teamwork and communication abilities in the neonatal transfer nurses were all significantly increased after the training with ADDIE instruction model(P＜0.001).Conclusions On-the-job training of ADDIE instruction model among the neonatal transfer nurses can effectively enhance the professional knowledge and practice skills,enable the nurses to play a leading role in the process of treatment and improve abilities in teamwork and communication of the neonatal transfer nurses.The ADDIE instruction model provides valuable insights in the training of neonatal transfer nurses.

The aim of this study was to investigate the functional characteristics and in vitro specific killing effect of EGFRvIII CAR-T cells co-expressing interleukin-15 and chemokine CCL19, in order to optimize the multiple functions of CAR-T cells and improve the therapeutic effect of CAR-T cells targeting EGFRvIII on glioblastoma (GBM). The recombinant lentivirus plasmid was obtained by genetic engineering, transfected into 293T cells to obtain lentivirus and infected T cells to obtain the fourth generation CAR-T cells targeting EGFRvIII (EGFRvIII-IL-15-CCL19 CAR-T). The expression rate of CAR molecules, proliferation, chemotactic ability, in vitro specific killing ability and anti-apoptotic ability of the fourth and second generation CAR-T cells (EGFRvIII CAR-T) were detected by flow cytometry, cell counter, chemotaxis chamber and apoptosis kit. The results showed that compared with EGFRvIII CAR-T cells, EGFRvIII-IL-15-CCL19 CAR-T cells successfully secreted IL-15 and CCL19, and had stronger proliferation, chemotactic ability and anti-apoptosis ability in vitro (all P < 0.05), while there was no significant difference in killing ability in vitro. Therefore, CAR-T cells targeting EGFRvIII and secreting IL-15 and CCL19 are expected to improve the therapeutic effect of glioblastoma and provide an experimental basis for clinical trials.
Humans ; Receptors, Chimeric Antigen/metabolism* ; Glioblastoma/metabolism* ; Interleukin-15/metabolism* ; Chemokine CCL19/metabolism* ; Cell Line, Tumor ; T-Lymphocytes/metabolism*

Objective:To summarize the etiological mechanism, echocardiographic and clinical features of fetal cardiomyopathies (FCMs).Methods:According to the data of echocardiography in Maternal-Fetal Medicine Center in Fetal Heart Disease of Beijing Anzhen Hospital during 2015 January to 2020 December, 70 cases with FCMs were retrospectively reviewed, and the clinical, ultrasonic, pathological and clinical outcome data were collected. Whole exome sequencing and whole genome sequencing were used to identify the genetic changes.Results:Primary FCMs were diagnosed in 55 cases (78.6%, 55/70), including 39 fetuses with non-compaction of the ventricular myocardium (NVM), 10 with dilated cardiomyopathy (DCM), 5 with hypertrophic cardiomyopathy (HCM), and 1 with restricted cardiomyopathy (RCM). Secondary FCMs were diagnosed in 15 cases (21.4%, 15/70), including 7 fetuses with maternal anti-Ro/La antibodies (presenting with DCM), 4 with twin-twin transfusion syndrome (2 with DCM and 2 with HCM), 2 with fetal anemia (presenting with DCM), 1 with maternal diabetes (presenting with HCM) and 1 with chorioangioma of the placenta (presenting with DCM). In all cases, 9 cases were born, 3 cases died in perinatal period, and 58 pregnancies were terminated due to ineffective treatment or the decisions of pregnant women. Thirty cases with primary FCMs were performed with genetic tests, and 13 of them were identified with positive genetic changes related to FCMs, including 12 cases with NVM and 1 with HCM.Conclusions:Primary FCMs are more common than secondary FCMs in fetal period. The genetic disorders have a high proportion in fetal NVM. Fetal DCM and HCM have a large spectrum of intrinsic and extrinsic causes.

Objective To explore the effect of gene mutation on sudden deafness through investigation on the relationship between MTHFR C677T polymorphism and the effect on such patients, so as to provide solid evidence for the treatment of sudden deafness. Methods Samples of venous blood in 99 patients with profound sudden deafness were collected and DNA was extracted from them. Real-time PCR was used for SNP genotyping of MTHFR gene. The patients underwent HBO and drug therapy and therapeutic effects were observed, then, the relationship between different genotypes and therapeutic effects were compared. Results The mutation types and frequencies of MTHFR genotype in the study population were: C/C 17. 17％, C/T 51. 51％ and T/T 31. 32％. The effective rate in the patients with profound sudden deafness treated with HBO and drug therapy was 75. 76％, and there was no statistical significance in the distribution of C/C and C/T+T/T genotypes, when comparisons were made between the effective and non-effective groups(P>0. 05). Conclusion Study results revealed that MTHFR gene polymorphism was not associated with the efficacy of HBO combined with drug therapy in the patients with profound sudden deafness.

Objective To explore the effect of gene mutation on sudden deafness through investigation on the relationship between MTHFR C677T polymorphism and the effect on such patients, so as to provide solid evidence for the treatment of sudden deafness. Methods Samples of venous blood in 99 patients with profound sudden deafness were collected and DNA was extracted from them. Real-time PCR was used for SNP genotyping of MTHFR gene. The patients underwent HBO and drug therapy and therapeutic effects were observed, then, the relationship between different genotypes and therapeutic effects were compared. Results The mutation types and frequencies of MTHFR genotype in the study population were: C/C 17. 17％, C/T 51. 51％ and T/T 31. 32％. The effective rate in the patients with profound sudden deafness treated with HBO and drug therapy was 75. 76％, and there was no statistical significance in the distribution of C/C and C/T+T/T genotypes, when comparisons were made between the effective and non-effective groups(P>0. 05). Conclusion Study results revealed that MTHFR gene polymorphism was not associated with the efficacy of HBO combined with drug therapy in the patients with profound sudden deafness.

Objective To observe the therapeutic effects of hyperbaric oxygen ( HBO ) on skin ischemia induced by hyaluronic acid .Methods Forty-two patients with skin ischemia induced by hyaluronic acid were divided into 2 groups: The patients in group A were given routine treatment , and some patients received HBO therapy 72 hours later, while the patients in group B all received HBO therapy within 72 hours after injection of hyaluronic acid on the basis of routine therapy .Effectual time was recorded and compared between the patients of the 2 groups, and Pearson analysis was performed with respect to HBO implementation time and effectual time.Effectual rates were compared between the 2 groups, 10 days after injection of hyaluronic acid.Results The average effectual time of group A was (13.2 ±2.8)days, while that of group B was(11.0 ±3.1) days.Statistical significance could be noted when comparisons were made between them ( P<0.05).Results of Pearson analysis concerning HBO implementation time and effectual time indicated that there was a positive correlation between HBO implementation time and effectual time (P<0.05, r>0).Observation at day 10 showed that the effectual time of group A was 28.57％and that of group B was 53.57％.Conclusion Therapeutic effects of early HBO therapy on skin ischemia induced by hyaluronic acid injection was positive , and the earlier HBO intervention was made , the earlier the effectual time was .

Objective To observe the therapeutic effects of hyperbaric oxygen ( HBO ) on skin ischemia induced by hyaluronic acid .Methods Forty-two patients with skin ischemia induced by hyaluronic acid were divided into 2 groups: The patients in group A were given routine treatment , and some patients received HBO therapy 72 hours later, while the patients in group B all received HBO therapy within 72 hours after injection of hyaluronic acid on the basis of routine therapy .Effectual time was recorded and compared between the patients of the 2 groups, and Pearson analysis was performed with respect to HBO implementation time and effectual time.Effectual rates were compared between the 2 groups, 10 days after injection of hyaluronic acid.Results The average effectual time of group A was (13.2 ±2.8)days, while that of group B was(11.0 ±3.1) days.Statistical significance could be noted when comparisons were made between them ( P<0.05).Results of Pearson analysis concerning HBO implementation time and effectual time indicated that there was a positive correlation between HBO implementation time and effectual time (P<0.05, r>0).Observation at day 10 showed that the effectual time of group A was 28.57％and that of group B was 53.57％.Conclusion Therapeutic effects of early HBO therapy on skin ischemia induced by hyaluronic acid injection was positive , and the earlier HBO intervention was made , the earlier the effectual time was .