Objective:To compare the differences in clinical characteristics among the patients at clinical high risk for bipolar disorder(CHR-BD),the patients with bipolar disorder(BD),and the healthy controls(HC)at low risk,and to provide the basis for the diognasis and treatment of CHR-BD.Methods:For the first time,the BD risk criteria and prospective structured assessment tools were jointly used in outpatients aged 16-30 years,and 43 CHR-BD patients were included to ensure the accuracy of the assessment.Meanwhile,33 BD patients and 32 HC subjects were also enrolled.The clinical symptoms,neurocognitive function,and global functional levels of the subjects in the three groups were evaluated using observer-rated and self-rated tools.The CHR-BD and BD groups were combined,and Logistic regression analysis was used to identify the independent influencing factors related to diagnostic status;Pearson or Spearman correlation analysis was used to analyze the correlations between the global functional levels and the symptoms or neurocognitive characteristics of the patients in CHR-BD and BD groups.Results:There were statistically significant differences in the scores of symptom and global functional level scales among HC,CHR-BD,and BD groups(P<0.05).Compared with HC group,the scores of mood symptoms(anxiety,depression,and mania/hypomania),psychotic symptoms,total affective temperament questionnaire scores,and some dimensions(cyclothymic,depressive,irritable,and anxious temperaments)in CHR-BD and BD groups were significantly increased(P<0.001),while the global functional levels were significantly decreased(P<0.001).Compared with BD group,the lowest global functional level score in the past year in CHR-BD group was significantly increased(P=0.022),while the current global functional level score was significantly decreased(P=0.005).No significant differences were observed in neurocognitive function scores among the three groups(P>0.05).The lowest global functional level score in the past year was an independent influencing factor for BD diagnosis[odds ratio(OR)=0.952,95%confidence interval(CI):0.917-0.988,P=0.010].In both CHR-BD and BD patients,the current global functional levels were negatively correlated with depressive(r=-0.417,P=0.005;r=-0.617,P<0.001)and anxiety symptoms(r=-0.360,P=0.018;r=-0.506,P=0.003).In BD patients,the current global functional level was negatively correlated with lifetime manic/hypomanic symptoms(r=-0.360,P=0.039),psychotic symptoms(r=-0.502,P=0.003),and affective temperament scores(r=-0.479,P=0.005),while the lowest global functional level in the past year was negatively correlated with lifetime manic/hypomanic symptoms(r=-0.391,P=0.024).Conclusion:CHR-BD patients share similar mood symptom characteristics with BD patients,and their global functional levels are negatively correlated with depressive and anxiety symptoms.BD patients exhibit worse lowest global functional levels in the past year,and their global functional levels are negatively correlated with manic/hypomanic symptoms.

CT is a commonly examination method in pediatric clinical practice.Formulating and popularizing low-dose pediatric CT scanning protocols and constructing a standard image quality evaluation system are the key directions of low-dose pediatric CT imaging.In recent years,domestic CT equipment achieved technological breakthroughs in hardware performance and image reconstruction algorithms,which could provide new paths for pediatric low-dose CT imaging in children combining with artificial intelligence technology.The current status of scanning protocols,the establishment of imaging quality evaluation system and the clinical promotion,as well as challenges of domestic CT in pediatric low-dose CT imaging were reviewed in this article.

There exist risks of ionizing radiation in radiodiagnosis examinations. Implementing shielding protection following the optimization and as low as reasonably achievable (ALARA) principles represents a measure to reduce radiation doses to patients. The implementation of shielding protection in clinical practices should meet high requirements due to variations in the modalities and items in radiodiagnosis examinations, the characteristics and irradiation method of X-ray beams, the method of automatic selection of image quality and radiation dose-related parameters by imaging equipment, the radiation sensitivity of human tissues and organs. This review introduced the shielding products, methods and effects in various radiodiagnosis examinations, as well as the current status and challenges in their applications, aiming to provide a reference for future related research and clinical practices.

Objective:To evaluate the relevant factors to optimize the learning curve and the impact of the basic skills of endoscopic technology on the learning curve of gasless transaxillary posterior endoscopic thyroidectomy.Methods:A retrospective analysis was performed to evaluate the clinical outcomes of 50 patients who underwent Glandular Ultrasound-Assisted (GUA) thyroid surgery by a surgeon with a background in endoscopic thyroid surgery via the thoracic-areolar approach, and 50 patients operated on by a surgeon without such experience at the Thyroid Surgery Department of Jilin University China-Japan Union Hospital from Apr. to Dec. 2023. The patients were divided into two groups: the Endoscopic Experience Group and the Non-Endoscopic Experience Group. The Cumulative Sum Control Chart (CUSUM) was applied to construct learning curves for both groups, dividing the technical exploration period from the mastery period. The analysis compared the surgical time, postoperative first-day drainage volume, number of central lymph nodes dissected rates, and postoperative complications between the two groups and across the two phases.Results:The analysis of the learning curve revealed that the inflection point of the Endoscopic Experience Group was 15, while of the Non-Endoscopic Experience Group was 18. The learning curve was divided into the technical exploration stage and the proficient mastery stage. The operative time of technical exploration stagde was significantly longer than of proficient mastery stage of both group (183.46±36.13min vs.144.40±26.14min, P<0.001; 186.89±48.91min vs.131.59±22.90min; P<0.001) . The operative time in the proficient mastery stage of the Endoscopic Experience Group was longer than that of the Non-Endoscopic Experience Group (144.40±26.15min vs. 131.59±22.90min, P<0.05) . The postoperative drainage volume in the Endoscopic Experience Group was lower than that in Non-Endoscopic Experience Group in both stages (65.40±32.48mL vs.93.22±30.67mL, 57.40±15.35mL vs.78.50±28.30mL, P<0.05) , and the postoperative drainage volume in the proficient mastery stage of the Non-Endoscopic Experience Group was significantly lower than in the technical exploration stage (93.22±30.67mL vs.78.50±28.30mL, P<0.05) .No significant differences in central lymph node dissection numbers or postoperative complications were observed between the groups at both stages. Conclusions:There is a specific learning curve in the early stage of gasless transaxillary posterior endoscopic thyroidectomy. After crossing the learning curve, the operation time is obviously shortened with the improvement of the operator's surgical technique.Having a basic understanding of endoscopic technology in the early stage can reduce the occurrence of postoperative drainage, but has a minimal impact on the learning curve.

There exist risks of ionizing radiation in radiodiagnosis examinations. Implementing shielding protection following the optimization and as low as reasonably achievable (ALARA) principles represents a measure to reduce radiation doses to patients. The implementation of shielding protection in clinical practices should meet high requirements due to variations in the modalities and items in radiodiagnosis examinations, the characteristics and irradiation method of X-ray beams, the method of automatic selection of image quality and radiation dose-related parameters by imaging equipment, the radiation sensitivity of human tissues and organs. This review introduced the shielding products, methods and effects in various radiodiagnosis examinations, as well as the current status and challenges in their applications, aiming to provide a reference for future related research and clinical practices.

Objective:To evaluate the relevant factors to optimize the learning curve and the impact of the basic skills of endoscopic technology on the learning curve of gasless transaxillary posterior endoscopic thyroidectomy.Methods:A retrospective analysis was performed to evaluate the clinical outcomes of 50 patients who underwent Glandular Ultrasound-Assisted (GUA) thyroid surgery by a surgeon with a background in endoscopic thyroid surgery via the thoracic-areolar approach, and 50 patients operated on by a surgeon without such experience at the Thyroid Surgery Department of Jilin University China-Japan Union Hospital from Apr. to Dec. 2023. The patients were divided into two groups: the Endoscopic Experience Group and the Non-Endoscopic Experience Group. The Cumulative Sum Control Chart (CUSUM) was applied to construct learning curves for both groups, dividing the technical exploration period from the mastery period. The analysis compared the surgical time, postoperative first-day drainage volume, number of central lymph nodes dissected rates, and postoperative complications between the two groups and across the two phases.Results:The analysis of the learning curve revealed that the inflection point of the Endoscopic Experience Group was 15, while of the Non-Endoscopic Experience Group was 18. The learning curve was divided into the technical exploration stage and the proficient mastery stage. The operative time of technical exploration stagde was significantly longer than of proficient mastery stage of both group (183.46±36.13min vs.144.40±26.14min, P<0.001; 186.89±48.91min vs.131.59±22.90min; P<0.001) . The operative time in the proficient mastery stage of the Endoscopic Experience Group was longer than that of the Non-Endoscopic Experience Group (144.40±26.15min vs. 131.59±22.90min, P<0.05) . The postoperative drainage volume in the Endoscopic Experience Group was lower than that in Non-Endoscopic Experience Group in both stages (65.40±32.48mL vs.93.22±30.67mL, 57.40±15.35mL vs.78.50±28.30mL, P<0.05) , and the postoperative drainage volume in the proficient mastery stage of the Non-Endoscopic Experience Group was significantly lower than in the technical exploration stage (93.22±30.67mL vs.78.50±28.30mL, P<0.05) .No significant differences in central lymph node dissection numbers or postoperative complications were observed between the groups at both stages. Conclusions:There is a specific learning curve in the early stage of gasless transaxillary posterior endoscopic thyroidectomy. After crossing the learning curve, the operation time is obviously shortened with the improvement of the operator's surgical technique.Having a basic understanding of endoscopic technology in the early stage can reduce the occurrence of postoperative drainage, but has a minimal impact on the learning curve.

CT is a commonly examination method in pediatric clinical practice.Formulating and popularizing low-dose pediatric CT scanning protocols and constructing a standard image quality evaluation system are the key directions of low-dose pediatric CT imaging.In recent years,domestic CT equipment achieved technological breakthroughs in hardware performance and image reconstruction algorithms,which could provide new paths for pediatric low-dose CT imaging in children combining with artificial intelligence technology.The current status of scanning protocols,the establishment of imaging quality evaluation system and the clinical promotion,as well as challenges of domestic CT in pediatric low-dose CT imaging were reviewed in this article.

The increasing frequency of radiographic diagnostic imaging and the cumulative dose to the public from radiation has raised widespread concerns. However, accurate measurement of the radiation dose received by the human body is difficult to achieve. Monte Carlo simulation, as a numerical computational method guided by probability statistics theory, has been applied to various dose assessments, imaging optimizations, and radiation protection in radiographic diagnostic imaging. We provide a comprehensive review of the principles of the Monte Carlo method, the modelling process of Monte Carlo simulation and the progress of its application to diagnostic radiological dose estimation.

Objective To determine and analyze the content of 45 inorganic elements in Fufang Xiling Jiedu preparation and to provide a reference for the safety detection of Fufang Xiling Jiedu preparation.Methods Inductively coupled plasma mass spectrometry(ICP-MS)was used to ascertain the concentrations of 45 inorganic elements,including Li,B,Al,K,Zn and As from 16 batches of Fufang Xiling Jiedu preparation which were gathered.The content determination findings were plotted as heatmaps,Pearson correlation analysis plot,PCA scatter plots,fingerprints,and control maps.The Pearson correlation analysis and PCA analysis were performed on the content determination results of 16 batches using SPSS 21.0,to evaluate the safety and quality uniformity of Fufang Xiling Jiedu preparation.Results The inorganic elements in Fufang Xiling Jiedu preparation were dominated by K and Ca.The content of different elements in the sample could be categorised into 5 levels.The content of various elements in different batches of Fufang Xiling Jiedu preparation was similar.Pb,Cd,As,Hg and Cu were all within the safety limit as those specified in the Chinese Pharmacopoeia.Co,Y,Sm,Gd,Dy,Th,Al,Si,Fe,Sb and Tl were the characteristic inorganic elements of Fufang Xiling Jiedu preparation.Conclusion This method is easy to operate and suitable for the determination of inorganic elements in Fufang Xiling Jiedu preparation,providing references for the clinical medication safety.