Objective To investigate the value of artificial intelligence iterative reconstruction(AIIR)in preoperative low-dose CT of ovarian tumor.Methods Seventy patients with ovarian tumor were prospectively enrolled.Routine-dose(120 kVp,200 mAs)and low-dose(120 kVp,40 mAs)contrast-enhanced abdominopelvic CT scanning at portal venous phase were sequentially performed.The routine-dose images were reconstructed with hybrid iterative reconstruction(HIR)(group A),while low-dose images were reconstructed with HIR(group B)and AIIR(group C),respectively.Subjective and objective evaluation of image quality were compared among groups,and the diagnostic accuracy of peripheral organ invasion and peritoneal metastasis based on group A,B and C,as well as radiation dose of routine-and low-dose scanning were recorded.Results In group B,A and C,the subjective scoring of definition of tumor margin and septation,boundary between tumor and surrounding organ,as well as the signal-to-noise ratio and contrast-to-noise ratio of ovarian tumor and psoas muscles,increased successively(all P＜0.017).No significant difference of subjective scoring of tumor feeding vessel clarity was found between group A and C(P=0.435),which were both higher than that in group B(P＜0.017).The accuracy for diagnosing peripheral organ invasion based on group A,B and C was 83.87％ (52/62),72.58％ (45/62)and 83.87％ (52/62),for diagnosing peritoneal metastasis was 85.71％ (60/70),78.57％ (55/70)and 84.29％ (59/70),respectively.Compared to routine-dose CT,the effective dose of low-dose CT was reduced by 79.70％ (2.60 mSv vs.12.81 mSv,P＜0.001).Conclusion AIIR could improve image quality and metastasis diagnostic efficacy in low-dose CT of ovarian tumors.

Objective To investigate the value of artificial intelligence iterative reconstruction(AIIR)in preoperative low-dose CT of ovarian tumor.Methods Seventy patients with ovarian tumor were prospectively enrolled.Routine-dose(120 kVp,200 mAs)and low-dose(120 kVp,40 mAs)contrast-enhanced abdominopelvic CT scanning at portal venous phase were sequentially performed.The routine-dose images were reconstructed with hybrid iterative reconstruction(HIR)(group A),while low-dose images were reconstructed with HIR(group B)and AIIR(group C),respectively.Subjective and objective evaluation of image quality were compared among groups,and the diagnostic accuracy of peripheral organ invasion and peritoneal metastasis based on group A,B and C,as well as radiation dose of routine-and low-dose scanning were recorded.Results In group B,A and C,the subjective scoring of definition of tumor margin and septation,boundary between tumor and surrounding organ,as well as the signal-to-noise ratio and contrast-to-noise ratio of ovarian tumor and psoas muscles,increased successively(all P＜0.017).No significant difference of subjective scoring of tumor feeding vessel clarity was found between group A and C(P=0.435),which were both higher than that in group B(P＜0.017).The accuracy for diagnosing peripheral organ invasion based on group A,B and C was 83.87％ (52/62),72.58％ (45/62)and 83.87％ (52/62),for diagnosing peritoneal metastasis was 85.71％ (60/70),78.57％ (55/70)and 84.29％ (59/70),respectively.Compared to routine-dose CT,the effective dose of low-dose CT was reduced by 79.70％ (2.60 mSv vs.12.81 mSv,P＜0.001).Conclusion AIIR could improve image quality and metastasis diagnostic efficacy in low-dose CT of ovarian tumors.

Objective To establish a standard operating procedure(SOP)for perioperative nursing cooperation in the corneal collagen cross-linking surgery and explore the effect of clinical application in order to improve the quality and efficiency of the management in clinical practice.Methods A research team was established in October 2022 to construct a patient-orientated standard operating procedure for perioperation nursing cooperation in corneal collagen cross-linking surgery.With the before-after control method,170 patients who underwent single eye rapid epithelial-off corneal collagen cross-linking surgery between April 2022 and July 2023 were selected.Totally 85 case form April to October 2022 were assigned into a control group and 85 cases form November 2022 to July 2023 were assigned into a trial group.The control group received a routine perioperative nursing,while the trial group received the standard operating procedure(SOP)for perioperative nursing on the basis of the control group.The two groups were compared in terms of surgical duration,surgical connection duration,perioperative time,surgeon's satisfaction,nurse's job satisfaction and patient's satisfaction.Results The trial group had significantly shorter surgical duration,connection duration and perioperative duration than those of the control group(all P<0.001).The trial group showed significantly higher scores in satisfactions of doctor,nurse and patient in comparison with the control group(all P<0.001).Conclusion The SOP for perioperative nursing cooperation in the corneal collagen cross-linking surgery not only improve the efficiency among the medical team,work quality and services level,but also improve the satisfaction of doctors and patients towards the nursing care and enhance nurse's sense of identity with nursing work.

Objective To establish a standard operating procedure(SOP)for perioperative nursing cooperation in the corneal collagen cross-linking surgery and explore the effect of clinical application in order to improve the quality and efficiency of the management in clinical practice.Methods A research team was established in October 2022 to construct a patient-orientated standard operating procedure for perioperation nursing cooperation in corneal collagen cross-linking surgery.With the before-after control method,170 patients who underwent single eye rapid epithelial-off corneal collagen cross-linking surgery between April 2022 and July 2023 were selected.Totally 85 case form April to October 2022 were assigned into a control group and 85 cases form November 2022 to July 2023 were assigned into a trial group.The control group received a routine perioperative nursing,while the trial group received the standard operating procedure(SOP)for perioperative nursing on the basis of the control group.The two groups were compared in terms of surgical duration,surgical connection duration,perioperative time,surgeon's satisfaction,nurse's job satisfaction and patient's satisfaction.Results The trial group had significantly shorter surgical duration,connection duration and perioperative duration than those of the control group(all P<0.001).The trial group showed significantly higher scores in satisfactions of doctor,nurse and patient in comparison with the control group(all P<0.001).Conclusion The SOP for perioperative nursing cooperation in the corneal collagen cross-linking surgery not only improve the efficiency among the medical team,work quality and services level,but also improve the satisfaction of doctors and patients towards the nursing care and enhance nurse's sense of identity with nursing work.

Objective:To explore the occurrence of potentially inappropriate medication (PIM) and its influencing factors in discharge prescriptions in elderly patients with stroke.Methods:The medical record data of elderly patients (≥65 years) with stroke, who were discharged from the Department of Neurology in the First Affiliated Hospital of Shantou University Medical College between July 2016 and December 2017, were collected and retrospectively analyzed. There were 2 wards in the Department of Neurology in total, 1 of which had clinical pharmacists to participate in medication management of the discharged patients. The patients′ basic information (gender, age, length of hospital stay, ward, and etc.), discharge diagnosis, and discharge prescriptions were collected. PIM in discharge prescriptions in the patients was evaluated according to the 2019 American Geriatrics Society Beers criteria. The patients were grouped according to their gender, age (65-74, 75-84, ≥85 years), number of diseases (1-5, 6-10, ≥11), Charlson comorbidity index (1, 2, ≥3), length of hospital stay (<15, 16-20, ≥21 d), number of prescribed drugs (1-4, 5-9, ≥10), and with or without clinical pharmacists involving in medication management in the ward, and the occurrence of PIM was compared. The influencing factors of PIM were analyzed using multivariate logistic regression method.Results:A total of 435 patients were included in the analysis. Of them, 230 were males and 205 were females, with ages from 65 to 92 years; the number of drugs in discharge prescriptions ranged from 2 to 16, with a median number of 6; 200 patients were in ward with pharmacists participating in the management and 235 patients in ward without pharmacists participating in the management. One hundred and seventy-nine prescriptions were found with PIM in 435 patients and the incidence of PIM was 41.15%. A total of 280 times of PIM were found in 179 prescriptions. Multivariate logistic regression analysis showed that the number of prescribed drugs (≥5) was an independent risk factor for the occurrence of PIM [odds ratio ( OR)=2.617, 95 % confidence interval ( CI): 1.689-4.054, P<0.001], and the participation of pharmacists in discharge medication management was a protective factor for PIM ( OR=0.673, 95 %CI: 0.457-0.990, P=0.045). Conclusions:The incidence of PIM in discharge prescriptions in elderly patients with stroke was 41.15%. The occurrence of PIM was related to the number of prescribed drugs. Pharmacists′ participation in the management of discharge medications helps to reduce the occurrence of PIM.

Objective:To explore the occurrence of potentially inappropriate medication (PIM) and its influencing factors in discharge prescriptions in elderly patients with stroke.Methods:The medical record data of elderly patients (≥65 years) with stroke, who were discharged from the Department of Neurology in the First Affiliated Hospital of Shantou University Medical College between July 2016 and December 2017, were collected and retrospectively analyzed. There were 2 wards in the Department of Neurology in total, 1 of which had clinical pharmacists to participate in medication management of the discharged patients. The patients′ basic information (gender, age, length of hospital stay, ward, and etc.), discharge diagnosis, and discharge prescriptions were collected. PIM in discharge prescriptions in the patients was evaluated according to the 2019 American Geriatrics Society Beers criteria. The patients were grouped according to their gender, age (65-74, 75-84, ≥85 years), number of diseases (1-5, 6-10, ≥11), Charlson comorbidity index (1, 2, ≥3), length of hospital stay (<15, 16-20, ≥21 d), number of prescribed drugs (1-4, 5-9, ≥10), and with or without clinical pharmacists involving in medication management in the ward, and the occurrence of PIM was compared. The influencing factors of PIM were analyzed using multivariate logistic regression method.Results:A total of 435 patients were included in the analysis. Of them, 230 were males and 205 were females, with ages from 65 to 92 years; the number of drugs in discharge prescriptions ranged from 2 to 16, with a median number of 6; 200 patients were in ward with pharmacists participating in the management and 235 patients in ward without pharmacists participating in the management. One hundred and seventy-nine prescriptions were found with PIM in 435 patients and the incidence of PIM was 41.15%. A total of 280 times of PIM were found in 179 prescriptions. Multivariate logistic regression analysis showed that the number of prescribed drugs (≥5) was an independent risk factor for the occurrence of PIM [odds ratio ( OR)=2.617, 95 % confidence interval ( CI): 1.689-4.054, P<0.001], and the participation of pharmacists in discharge medication management was a protective factor for PIM ( OR=0.673, 95 %CI: 0.457-0.990, P=0.045). Conclusions:The incidence of PIM in discharge prescriptions in elderly patients with stroke was 41.15%. The occurrence of PIM was related to the number of prescribed drugs. Pharmacists′ participation in the management of discharge medications helps to reduce the occurrence of PIM.

Objective To evaluate the evidence and recommendations of the relevant clinical practice guidelines for the prevention and treatment of stroke published in the last five years. Methods The stroke and guideline-related key words and free words domestic computer retrieval platforms(China biomedical literature database,CNKI,and Yimaitong etc.),as well as foreign platforms(PubMed,NGC,GIN,etc.) were retrieved.The retrieval time limit ranged from January 2012 to May 2017.Appraisal of Guidelines for Research and Evaluation Ⅱ(AGREE Ⅱ)was used to assess the quality of the guidelines. Results A total of 9 490 documents were retrieved preliminarily and finally 16 articles were included. The average scoring rates of the 16 guidelines in the 6 fields of AGREE Ⅱ,including the scope and purpose,participants,rigor of the formulation,clarity of expression,applicability,and independence of the editors were 66.3%, 27.4%,23.0%,53.9%,18.8%,and 0%,respectively.The different guidelines all recommend that internal endarterectomy or carotid balloon dilatation and carotid artery stenting are used to extracranial carotid stenosis,while the treatment of vertebral artery stenting is recommended for extracranial vertebral artery stenosis.However,the intravascular interventional therapy is not recommended for intracranial arterial stenosis.The perioperative period of ischemic stroke intravascular intervention need to pay attention to the application of anti-platelet aggregation,anticoagulation,blood pressure,blood glucose,blood lipid management,and postoperative monitoring. For postoperative stent restenosis,especially after vertebral artery stenting,the guidelines recommend using drug-eluting stents,however,the dosage of heparin in intraoperative anticoagulation is still controversial.The intracranial aneurysm guidelines are more recommended for interventional therapy.The cerebral hemorrhage in different regions is recommended for different surgical procedures. Conclusions The guidelines in this field can reflect the key problems in clinical practice and keep up with the international concept.However,the quality of the methodology of the guidelines development needs to be improved. Some of them need to be updated and the recommendations should refer more evidence of the Chinese population.

[Objective] To investigate the expression of eukaryotic translation initiation factor 5A2 (EIF5A2) and its clinical significance in esophageal squamous cell carcinoma (ESCC).[Methods] Immunohistochemistry was used to detect the expression of EIF5A2 protein in 135 cases of esophageal squamous cell carcinoma,and analyzed the correlation between the expression of EIF5A2 protein and clinicopathological parameters,and its prognosis value.[Results] Immunohistochemical analysis showed that 68 cases were overexpressed in 135 cases of ESCC.Pearson's chi-square test indicated that the expression of EIF5A2 in ESCC was significantly correlated with T stage (P =0.006),lymph node metastasis (P =0.031) and clinic stage (P =0.026).The Cox proportional hazard model analysis showed that EIF5A2 was an independent prognostic risk factor for ESCC patients.Kaplan-Meier analysis showed that the median survival time of patients with the low expression was 72.5 months,which was significantly higher than that of patients with the high expression,the median survival time of it are 51.7 months (P ＜ 0.05).[Conclusion] The overexpression of EIF5A2 may contribute to the development and progression of ESCC and EIFSA2 could be a novel potential prognostic marker for ESCC.

Objective To evaluate the capability of virtual non-contrast (VNC)of the second-generation dual-source CT (DSCT), and to display the adipose tissue of gastric serosa.Methods 48 patients with gastric cancer undergoing preoperative DSCT and sur-gery were enrolled.The true non-contrast (TNC)values and VNC values of perigastric adipose tissue were measured and compared with conventional non-contrast scanning and VNC of arterial phase and venous phase.The VNC values of perigastric adipose tissue were compared between serosal involvement group and non-serosal involvement group.Results There was statistical difference be-tween TNC values and VNC values of perigastric adipose tissue (P <0.05),the absolute differences were under 13 HU.The differ-ence of VNC values between serosal involvement group and non-serosal involvement group was significant (P <0.05).Conclusion VNC of the second-generation DSCT can clearly display the adipose tissue of gastric serosa.It has certain capability in judging sero-sal involvement.VNC has the proficiency to replace conventional non-contrast scanning.

Objective To assess the clinical value of dobutamine 201Tl stress-redistribution/nitroglycerin augmented ~(99m)Tc-metho~(99m)Tc-xyisobutylisonitrile (MIBI) gated myocardial perfusion imaging (MPI) in patients with coronary artery disease (CAD). Methods A total of 132 patients with suspected CAD underwent dobutamine 201Tl stress-redistribution/nitroglycerin augmented MIBI gated MPI and coronary arteriography (CAG) within two weeks after MPI. Percutaneous coronary interventions (PCI) were performed in 23 patients with myocardial infraction. The regional wall movement was assessed with echocardiography before and within three months after PCI. Results Taking stenosis ≥50% as standard of CAD, the sensitivity, specificity and accuracy of dual-isotopic SPECT imaging in diagnosing CAD was 93.41%, 87.80% and 91.67%, respectively. The sensitivity, specificity and accuracy in diagnosing left anterior descending artery (LAD) stenosis was 93.85%, 91.04% and 92.42%, for left circumflex artery (LCX) was 86.79%, 89.87% and 88.64%, while for right coronary artery (RCA) was 81.25%, 82.14% and 81.82%, respectively. Of all 207 myocardium segments in 23 patients with myocardial infarction, radioactivity defect was found in 113 segments on the redistributed ~(201)Tl images, and radiofilling was found in 52 (52/113) segments on the nitroglycerin augmented ~(99m)Tc-MIBI images, whereas 61 segments had no radiofilling. Taking regional wall movement improvement as the criterion of viable myocardium, the sensitivity, specificity and accuracy of identifying viable myocardium with nitroglycerin augmented ~(99m)Tc-MIBI imaging was 87.23%, 83.33% and 84.96%. Conclusion Dobutamine ~(201)Tl stress-redistribution/nitroglycerin augmented ~(99m)Tc-MIBI gated MPI is able to effectively detect CAD and viable myocardium and helpful in diagnosis and treatment of CAD.