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 discuss the effect of prostaglandin E2(PGE2),a pyrogenic mediator,on the discharge activity of warm-sensitive neurons(WSNs)in median preoptic nucleus(MnPO)of hypothalamus in the female mice,and to clarify its mechanism.Methods:Coronal brain slices of MnPO were prepared from the female mice.The slices were then perfused with artificial cerebrospinal fluid(ACSF)containing synaptic transmission blockers(STBs).The discharge frequency was monitored using the patch clamp technique while changing the temperature of the perfusate to identify the WSNs.A total of 32 MnPO WSNs were divided into base line group(n=32)and PEG2(n=32).The patch clamp technique was employed to monitor the discharge frequencies of MnPO WSNs following the perfusion of ACSF and 1 μmol·L-1 PGE2,respectively.The MnPO WSNs with good activity and significant change in discharge frequency after PGE2 perfusion were divided into PGE2 receptor E-series prostaglandin receptrol(EP)1 antagonist(EP1 ant)+PGE2 group(n=7),EP3 ant+PGE2 group(n=7),and EP4 ant+PGE2 group(n=7).The patch clamp technique was used to monitor the discharge frequencies of MnPO WSNs following the perfusion of 3 μmol·L-1 EP1 ant and 1 μmol·L-1 PGE2 mixture,10 μmol·L-1 EP3 ant and 1 μmol·L-1 PGE2mixture,and 10 μmol·L-1 EP4 ant and 1 μmol·L-1 PGE2 mixture,respectively.Resluts:After perfuson of the ACSF containing STBs,a total of 188 MnPO neurons from the female mice with an intrinsic temperature sensitivity coefficient(m value)were identified;out of these,32 neurons had an m value of ≥0.8 and were identified as MnPO WSNs,accounting for approximately 17％of all recorded neurons.Compared with baseline discharge frequency,the discharge frequency of MnPO WSNs after addition of PGE2 was decreased(P＜0.05).Compared with PGE2 group,the percentage change in discharge frequency of MnPO WSNs in EP3 ant+PGE2 group was significantly decreased(P＜0.05).Compared with PGE2 group,the percentage change in discharge frequency of MnPO WSNs in EP1 ant+PGE2 group had no significant difference(P＞0.05).Compared with PGE2 group,the percentage change in discharge frequency of MnPO WSNs in EP4 ant+PGE2 group had no significant difference(P＞0.05).Conclusion:In the female mice,WSNs make up approximately 17％of the total neurons in MnPO.PGE2 can directly inhibit the discharge activity of MnPO WSNs in the female mice through postsynaptic mechanism involving EP3 receptors.

Objective Through in vitro experiments,biomechanical data of the transtibial pullout suture(TPS),tendon reconstruction(TR),and tendon reconstruction with suture augmentation(TRS)were collected,so as to evaluate the biomechanical effectiveness of tendon reconstruction for repairing medial meniscus posterior root tear(MMPRT).Methods Eighteen porcine knee joint models were divided into TPS,TR,and TRS groups.Sutures were used to fix the meniscal root in TPS group.Tendons were passed through an incision at the meniscal root in TR group.Tendons were passed through an incision at the meniscal root and secured at tendon-meniscus contact area with additional sutures in TRS group.The sutures and tendons were pulled out through tibial tunnels and fixed at the anteromedial tibia.All groups underwent failure load tests,and ultimate failure load,displacement at failure load,load at clinical failure,stiffness,and failure modes of the samples were recorded.Results The maximum failure load in TPS group was significantly higher than that in TR group(P＜0.05),but there was no significant difference between TPS group and TRS group(P＞0.05).The maximum failure load in TRS group was significantly higher than that in TR group(P＜0.05).The displacement under failure load in TR group and TRS group was significantly lower than that in TPS group(P＜0.05),but there was no significant difference between TR group and TRS group(P＞0.05).There were no significant differences in the load under clinical failure among the 3 groups(P＞0.05).The stiffness of TRS group was significantly greater than that of TPS group(P＜0.05),but no significant difference was observed between TR group and TPS group,as well as between TR group and TRS group(P＞0.05).All failures were caused by suture or tendon cutting through the meniscus.Conclusions The tendon reconstruction techniques is superior to the TPS in terms of failure displacement and stiffness,while the TRS further enhances the stability of the repair.

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 Through in vitro experiments,biomechanical data of the transtibial pullout suture(TPS),tendon reconstruction(TR),and tendon reconstruction with suture augmentation(TRS)were collected,so as to evaluate the biomechanical effectiveness of tendon reconstruction for repairing medial meniscus posterior root tear(MMPRT).Methods Eighteen porcine knee joint models were divided into TPS,TR,and TRS groups.Sutures were used to fix the meniscal root in TPS group.Tendons were passed through an incision at the meniscal root in TR group.Tendons were passed through an incision at the meniscal root and secured at tendon-meniscus contact area with additional sutures in TRS group.The sutures and tendons were pulled out through tibial tunnels and fixed at the anteromedial tibia.All groups underwent failure load tests,and ultimate failure load,displacement at failure load,load at clinical failure,stiffness,and failure modes of the samples were recorded.Results The maximum failure load in TPS group was significantly higher than that in TR group(P＜0.05),but there was no significant difference between TPS group and TRS group(P＞0.05).The maximum failure load in TRS group was significantly higher than that in TR group(P＜0.05).The displacement under failure load in TR group and TRS group was significantly lower than that in TPS group(P＜0.05),but there was no significant difference between TR group and TRS group(P＞0.05).There were no significant differences in the load under clinical failure among the 3 groups(P＞0.05).The stiffness of TRS group was significantly greater than that of TPS group(P＜0.05),but no significant difference was observed between TR group and TPS group,as well as between TR group and TRS group(P＞0.05).All failures were caused by suture or tendon cutting through the meniscus.Conclusions The tendon reconstruction techniques is superior to the TPS in terms of failure displacement and stiffness,while the TRS further enhances the stability of the repair.

To review the diagnosis and treatment of a case of hypercalcium crisis caused by primary hyperparathyroidism（PHPT） and prophylactic treatment of hungry bone syndrome. In a 32-year-old male with hypercalcemia, the main manifestations were loss of appetite, nausea, polyuria, polydipsia, fatigue, lethargy, etc. parathyroid hormone, serum calcium increased, thyroid function was normal, thyroid color ultrasound and MRI showed space-occupying behind the right thyroid, radionuclide examination showed abnormal imaging agent concentration in the right parathyroid area, there was a history of pathological fracture. Clinically diagnosed as hypercalcemia crisis secondary to PHPT.
Male ; Humans ; Adult ; Hypercalcemia/diagnosis* ; Hyperparathyroidism, Primary/surgery* ; Parathyroid Hormone ; Hypocalcemia/complications* ; Thyroid Gland ; Calcium

【Objective】 To evaluate and analyze the impact of COVID-19 epidemic on inventory of red blood cells (RBCs)in local and municipal blood stations in China, and to provide reference for the management of public health emergencies. 【Methods】 Relevant data from 2018 to 2021 were collected, and the differences in the volume of qualified RBCs, the usage efficiency of inventory RBCs, the average daily distribution of RBCs,the blood distribution rate of RBCs prepared by 400 mL whole blood, the difference in the average storage days of RBCs at the time of distribution, the average daily inventory of RBCs and the time of the average daily inventory of RBCs to maintain the distribution in 24 local and municipal blood stations in China during the COVID-19 epidemic and non-epidemic periods were retrospectively analyzed. 【Results】 Compared with non-epidemic periods, the volume of qualified RBCs [(117 525.979 ±52 203.175)U] and the average daily distribution of RBCs [( 156. 468 ± 70. 186) U ] increased significantly, but the usage efficiency of inventory RBCs decreased(97.24%±0.51%) significantly (P<0.05).There was no significant difference in the blood distribution rate of RBCs prepared by 400 mL whole blood(73.88%±20.30%), the average storage days of RBCs distribution(13.040 ±3.486), the average daily stock quantity of RBCs[(2 280.542 ±1 446.538) U ] and the time of the average daily inventory of RBCs to maintain the distribution[(15.062 ±7.453) d] (P>0.5). 【Conclusion】 During the COVID-19 epidemic, the inventory management of RBCs operated well, the overall inventory remained relatively stable, the stock composition and storage period showed no significant change.

Objective:To investigate feasibility, efficiency and safety of kissing pancreatojejunostomy after pancreatoduodenectomy.Methods:From Jan 2006 to Sep 2020, the clinical data of 267 patients undergoing pancreatoduodenectomy and kissing pancreatojejunostomy were retrospectively analyzed.Results:Grade B postoperative pancreatic fistula (POPF) occurred in 6.37%, Grade C POPF in 2.25% of patients. There was no mortality within 30 days postoperatively as to pancreatic fistula, by cut-off of pancreatic duct diameter at 3mm, there was no significant difference between two subgroups (15/140 vs. 8/127, P=0.20). also, when grouped by texture of the pancreas, no there was significant difference (20/194 vs. 3/73, P=0.11). Conclusions:Kissing pancreatojejunostomy is feasible and easy to perform. It also does not increase the POPF rate when applied to the pancreatojejunostomy with thin pancreatic duct and soft texture.

Objective To discuss the clinicopathological features and prognostic factors of patients with triple negative breast cancer (TNBC) in Shanxi province. Methods The medical records of 958 female TNBC patients who were admitted to Shanxi Provincial Cancer Hospital and the First Hospital of Shanxi Medical University from January 2005 to December 2015 were retrospectively analyzed. The clinicopathological features and prognostic factors were summarized. Results The median age of TNBC patients in Shanxi province was 46 years old (21-87 years old), the median body mass index (BMI) was 24.42 kg/m2 (15.0-37.5 kg/m2), and the rural population was slightly more. The left breast cancer was more than the right breast cancer, and 492 patients (51.4％) were in stage T2. The main histological type was invasive ductal carcinoma. The main surgical method was modified radical mastectomy. Univariate Cox regression analysis showed that the patient's place of residence, fertility status, age at first birth, breastfeeding history, tumor size, American Joint Committee on Cancer Staging, lymph node metastasis, and surgical approach were associated with the risk of death in TNBC patients (all P<0.05);but the BMI, menstrual status, menarche age, and family history were not associated with the risk of death (all P>0.05). Multivariate Cox regression analysis showed that rural residents (HR= 1.46, P= 0.044), positive lymph node metastasis (HR= 2.51, P< 0.01), non-fertility (HR=1.08, P= 0.009) and no surgery (HR= 2.53, P= 0.004) were independent risk factors affecting the risk of death, a history of breastfeeding was a protective factor affecting the risk of death in TNBC patients (HR=0.44, P=0.013). Conclusions In Shanxi province, TNBC is more common in premenopausal women and the main pathological type is invasive ductal carcinoma. Rural population, lymph node positive, non-fertility, and no surgical treatment are independent risk factors for the prognosis of TNBC patients.

Objective To observe the application value and therapeutic efficacy of wide-field digital pediatric retinal imaging system (Retcam Ⅲ) fundus fluorescein angiograms (FFA) assisted photocoagulation on familial exudative vitreoretinopathy (FEVR).Methods The study included 46 eyes of 34 patients with staging 2 FEVR.All patients received color fundus photography and FFA under general anesthesia.The blood vessel reliability of color fundus photography and FFA was comparatively determined.Binocular indirect ophthalmoscope laser photocoagulation was applied to peripheral retina with abnormal leakage as indicated by FFA,the wavelength was 532nm,the duration was 0.25 s and the energy was 200-280 mW.After laser photocoagulation,fundus imaging and FFA was repeated.Further laser photocoagulation was immediately added to areas with vessel leakage but missing the photocoagulation.After treatment,the mean follow-up duration was 14.4 months.The follow up focused on neovascularization,exudative lesions,vitreous traction and merging of photocoagulation spots within 3 months,and on fibrosis membrane resulting in macular traction,tractional retinal detachment,vitreous hemorrhage or Coats disease-like retinal exudates after 3 months.Results It was hard to identify the blood vessels based on the color fundus images and some avascular zone maybe missed.Neovascularization can't be determined by shape of the blood vessels.On the other hand,those new blood vessels can be easily recognized by FFA as leakage sites at the boundary of avascular zone.The surgeon could quickly and accurately locate the FEVR area guided by the color fundus images and FFA from same angle under binocular indirect ophthalmoscope.During the treatment,there was no retinal FEVR area missed laser photocoagulation for all patients.There was no neovascularization,exudative lesions,vitreous traction within 3 months,and no fibrosis membrane,tractional retinal detachment,vitreous hemorrhage or Coats disease-like retinal exudates after 3 months.There were no ocular and systemic complications during and after the FFA and laser photocoagulation.Conclusion Wide-field Retcam Ⅲ FFA can help retinal specialists to identify abnormal neovascularization,locate the lesion area,and thus increase the success rate of laser photocoagulation,reduce the ocular and systemic complications for FEVR.