Objective To compare the morphology differences in small shadows of occupational pneumoconiosis (hereinafter referred to as "pneumoconiosis") between computed tomography (CT) and digital radiography (DR) imaging. Methods A total of 1 010 pneumoconiosis patients were selected as the research subjects using a judgment sampling method. Chest DR imaging and CT imaging were performed on patients, and the differences in small shadow morphology between the two images were compared. Results In both DR and CT images of patients, circular small shadows identified as p, q, and r shapes accounted for 76.2%, 11.5%, and 1.3%, respectively, while irregular small shadows were identified in 1.8% of cases. There was medium high consistency between DR and CT in detecting these four types of small shadow morphology (Kappa=0.72, P<0.01). The detection rate of irregular small shadows (including interlobular septal thickening, ground-glass opacity, and/or centrilobular emphysema) by CT images was 54.0% (545/1 010), with 88.6% (483/545) of these cases also showing small circular shadows. Irregular small shadows in CT images were mostly identified as p small circular shadows in DR images, accounting for 88.8% (484/545). The results of DR and CT images for p/p, p/q, q/p, q/q, q/r, r/q and r/r in small circular shadows showed medium high consistency (Kappa =0.52, P<0.01). Conclusion The results of CT and DR imaging for pneumoconiosis with small shadow were of medium high consistency, with CT demonstrating advantages in detecting irregular small shadow morphology of pneumoconiosis. CT images can be used to describe the shape of circular small shadow as DR images, and irregular small shadow can be described as interlobular septal thickening, ground-glass opacity, and/or centrilobular emphysema.

Objective To introduce the robotic-assisted left hemicolectomy and Soave procedure and its clinical outcome for Hirschsprung's allied disease.Methods From June 2015 to November 2022,19 cases diagnosed with Hirschsprung's allied disease underwent left colectomy and Soave pull-through by using the da Vinci surgical system,and the clinical data of 19 children were summarized and analyzed.A four trocar technique was used.The left colon was firstly mobilized by laparoscopy from splenic flexure of colon to the level of peritoneal reflection,then the rectum was mobilized by Robotic system to the level of dentate line.A circumferential incision was made in the mucosa at 0.5 cm proximal to the dentate line.The upward submucosal dissection was carried out for approximately 1-2 cm.The left colon was pulled through the anal canal and resected.The coloanal anastomosis was fashioned manually 0.5 cm above the dentate line.21 cases underwent conventional laparoscopic-assisted Soave surgery were used as control group.Results All patients were successfully operated.Compared with conventional laparoscopic-assisted Soave surgery,the operation time was significantly prolonged(P＜0.01),the intraoperative blood loss was significantly reduced(P＜0.01),and the overall postoperative complication rate was significantly reduced(11％VS.43％,P＜0.05).There were no serious complications such as major bleeding and death.Conclusion Robotic-assisted left hemicolectomy and Soave procedure are safe and feasible in the treatment of Hirschsprung's allied disease,with few postoperative complications and satisfactory clinical outcome.

Objective:In order to accurately evaluate the postoperative rehabilitation of gynecological robotic surgery, a prediction model for evaluating postanesthesia care unit (PACU) extubation time and hospital stay in gynecological robotic surgery was established.Methods:The clinical data of gynecological patients who underwent robotic surgery in Xiangya Third Hospital of Central South University from October 2015 to May 2017 were retrospectively analyzed, and the data were screened to evaluate the postoperative recovery of patients from two aspects: PACU extubation time and postoperative hospital stay. Binary logistic regression was used to screen out the factors affecting PACU extubation time and postoperative hospital stay, and the prediction model was preliminarily established and verified.Results:Finally, there were 456 patients and 30 variables analyzed in the binary logistics regression. According to these variables, the prediction model of the postoperative recovery evaluation after gynecological robotic surgical procedures was established. Among them, age, intraoperative amount of atracurium and midazolam were independent risk factors affecting PACU extubation time (all P<0.05). American Society of Anesthesiologists (ASA) grade, intraoperative amount of midazolam, intraoperative bleeding and operation time were independent risk factors affecting postoperative hospital stay (all P<0.05). All models passed Hosmer lemeshow test (all P>0.05); The areas under the receiver operating characteristic curve (ROC) were 0.647 and 0.806, respectively. Conclusions:The prediction model of PACU extubation time and the postoperative hospitalization time has been established.

Objective To provide a comprehensive reference index for different mouse models of herpes simplex virus 1 (HSV-1) infection by investigating the related clinical manifestations, pathological features and characteristics of viral distribution in tissues and organs of BALB/c mice infected with different HSV-1 strains by using different strategies.Methods Acute infection models were established by challenging BALB/c mice at age three or six weeks with HSV-1 17+ and McKrae strains via intranasal and corneal administrations.Correspondingly, chronic infection models were established with BALB/c mice through subcutaneous and foot pad injections.Results Although all experimental mice showed trichiasis and roachback, there were differences in weight and fatality rate among different groups.Results of the quantitative PCR detection indicated that the proliferation of HSV-1 in the nervous tissues (brain, spinal cord, trigeminal ganglion) varied among different groups.The pathological examination indicated that in the acute infection groups, significant pathological changes only occurred in the brain tissues, while in the chronic infection groups, pathological injuries only occurred in the trigeminal ganglia.Although a key index latency-associated transcript (LAT) was not detected in the trigeminal nerve tissues of mice in the chronic infection groups, co-culturing the tissues with Vero cells resulted in infectious lesions in the cells.Conclusion This study indicates that there are significant differences in weight and fatality rate among different BALB/c mouse models of HSV-1 infection.Varied replication dynamics of HSV-1 were observed in different tissues or organs of the BALB/c mice in different groups.Therefore, different indexes should be adopted to evaluate different HSV-1 infection models.

OBJECTIVE: To observe the changes of chest imaging and prognosis in pneumoconiosis patients in tin smelting workers. METHODS: Ten pneumoconiosis patients working with tin smelting were examined by chest X-ray,computed tomography( CT) photography and dynamic observation on pulmonary imaging to analyze their characteristics and prognosis. RESULTS: There were mild clinical manifestations and no tuberculosis in these 10 cases of tin smelting pneumoconiosis patients. There was no obvious change on the pulmonary ventilation function change. The high k V X-ray chest observation results showed that the circular shadow was the primary small shadow of the two lungs,that were mostly distributed in the medium and upper lung zones of both lungs. In most cases,we found lung texture distortion,deformation or increase,blurred,hilar shadow increased thickening,lymph node calcification,individualized eggshell. There was no pleural changes and emphysema changes. There was no significant change found in 5-10 years of dynamic observation except for 1 case of increased small shadow. The chest CT examination in 2011 showed 2-5 mm nodular shadows. Among them,we found 7 cases of small nodules from the upper lobe evenly distributed to the middle of the lobe,the lower back lobe of the lungs,lower basal ganglia lesions decreased,lesions were diffuse distribution of the whole lung,and the small nodules in 3 cases. Interval lobular thickening at varying degrees were found in 5 cases,lobular central or apoptotic pulmonary emphysema were found in 4 cases,and 1 case of pulmonary bullae formation was found. The results of chest CT examination in 2016 showed 2 cases of diffuse pulmonary nodules,3 cases of thickening of lobular septum and 2 cases of pulmonary emphysema compared with the CT result in 2011. CONCLUSION: There was no obvious lung small shadow absorption found in tin smelting pneumoconiosis patients after 5 to 10 years of X-ray dynamic observation,and progress of lesions could be seen. CT examination is helpful for follow-up observation in tin smelting pneumoconiosis.

Objective Based on the medical records and follow-up records of hospitalized patients who received anti-tuberculosis therapy in the Third People' s Hospital of Zhenjiang in Jiangsu province from 2006 to 2012,we investigated the incidence and outcome of anti-tuberculosis drug induced hepatotoxicity (ATDH) and provided evidence for the prevention of ATDH.Methods According to tuberculosis patients' medical information and liver function test records,ATDH patients were diagnosed according to the criteria of International Consensus Meeting and American Thoracic Society respectively,then the related factors and outcomes were analyzed.Results A total of 1 967 hospitalized tuberculosis patients were reviewed retrospectively,in which 1 403 (71.3％) were men,1 790 (91.0％) were pulmonary tuberculosis patients,1 528 (77.8％) were patients receiving initiative treatment,979 (49.8％) were sputum smear-positive patients,and 1 297 (65.9％) had other complicated diseases.According to the criterion of International Consensus Meeting,the incidence of ATDH was 16.5％,the median time of onset was 25 days.According to the criterion of American Thoracic Society,the incidence of ATDH was 8.3％,the median time of onset was 23 days.The incidence of ATDH was significantly higher in males and HRZE therapy group (P＜0.05).Under the two liver criteria,69.5％ and 70.1％ of the patients changed primary therapy respectively after ATDH occurred.89.8％ and 88.4％ patients' liver function returned to normal range after changing or stopping therapy.Conclusion According to two liver injury criteria,the incidences of ATDH were 16.5％ and 8.3％ in hospitalized tuberculosis patients respectively,and ATDH mainly occurred in the furst month of anti-tuberculosis treatment.The monitoring of liver function should be strengthened in males and HRZE therapy group to reduce the incidence of ATDH.

Objective To explore the nutritional status of vitamin D among healthy adults lived in Fuling district of Chongqing .Methods A total of 718 healthy adults aged 23-90 years old undergoing the physical examination in the physical ex‐amination center of our hospital from March 2012 to December 2013 were selected and divided into the 23-44 years old group and the ≥45 years old group .The tandem mass spectrometer was adopted to detect the level of serum 25(OH) vitamin D for evaluating the nutritional status of vitamin D .Results The proportions of lack ,insufficiency ,normal and excess of vitamin D in the 23 -44 years old group were 80 .79% ,19 .21% ,0% and 0% respectively ;which in the ≥45 years old group were 77 .91% ,18 .20% ,3 . 89% and 0% respectively .The average level of serum 25(OH) vitamin D in 23-44 years old group was lower than that in the ≥45 years old group ,the difference was statistically significant (P=0 .002 ,t=1 .98) .In these two groups ,the difference in serum 25 (OH) vitamin D level between males and females had no statistical significance (P>0 .05) .Conclusion The healthy adults in Ful‐ing district are lack of vitamin D in different degrees .

A total of 100 HIN1 flu real-time-PCR positive throat swabs collected from fever patients in Zhejiang,Hubei and Guangdong between June and November 2009,were provided by local CDC laboratories.After MDCK cell culture,57 Influenza A Pandemic (H1N1) viruses were isolated and submitted for whole genome sequencing.A total of 39 HA sequences,52 NA sequences,36 PB2 sequences,31 PB1 sequences,40 PA sequences,48 NP sequences,51 MP sequences and 36 NS sequences were obtained,including 20 whole genome sequences.Sequence comparison revealed they shared a high degree of homology (96％～99％) with known epidemic strains (A/Califomia/04/2009(H1N1).Phylogenetic analysis showed that although the sequences were highly conserved,they clustered into a small number of groups with only a few distinct strains.Site analysis revealed three substitutions at loop 220 (221-228) of the HA receptor binding site in the 39 HA sequences:A/Hubei/86/2009 PKVRDQEG→PKVRDQEA,A/Zhejiang/08/2009 PKVRDQEG→PKVRDQER,A/Hubei/75/2009PKVRDQEG→PKVRDQGG,the A/Hubei/75/2009 was isolated from an acute case,while the other two were from patients with mild symptoms.Other key sites such as 119,274,292 and 294 amino acids of NA protein,627 of PB2 protein were conserved.Meanwhile,all the M2 protein sequences possessed the Ser32Asn mutation,suggesting that these viruses were resistant to adamantanes.Comparison of these sequences with other H1N1 viruses collected from the NCBI database provides insight into H1N1 transmission and circulation patterns.

Objective To describe MRI findings of acute spinal cord decompression sickness.Methods MRI findings of 5 cases with clinical definite acute spinal cord decompression sickness were retrospectively analyzed.The main clinical informations included underwater performance history against regulations,short-term complete or incomplete spinal cord injury symptoms after fast going out of water,sensory disability and urinary and fecal incontinence,etc.Results Spinal cord vacuole sign was found in all 5 cases.Iso-signal intensity(n=3),high signal intensity(n=1),and low signal intensity (n=1)was demonstrated on T1 WI,and high signal intensity(n=5)was found on T2 WI.Owl eye sign was detected in 3 cases,and lacune foci were seen in 2 cases.Conclusion MRI findings of acute spinal cord decompression sickness had some characteristics,and it was easy to diagnose by combining diving history with clinical manifestations.

Objective To investigate the gene expression of vascular endothelial growth factor(VEGF) and ultrastructural changes in cultured endothelial cells from human cerebral microvessels under hypoxic conditions.Methods Human cerebral microvessels were isolated from freshly obtained specimens of normal brain adherent to resected cerebral arteriovenous malformations.The expression of factor Ⅷ-relative antigen(FⅧ-RA) in cultured cells was observed with immunocytochemistry.The level of VEGFmRNA in cells and released VEGF protein in cell supernatant were determined by RT-PCR analysis and ELISA respectively when they were exposed to hypoxic conditions(95% N_2,5% CO_2;two hours,four hours,eight hours) or maintained in basal condition.Ultrastructural changes in cells were also observed by electron microscopy.Results In inverted microscope the cultured cells showed contact inhibition and a rounded cobblestone appearance.More than 90% of them were stained strongly with antibodies against FⅧ-RA.Significant VEGF mRNA and protein accumulated when these cells were exposed to hypoxia for 4 hours.However,their VEGF expression was down-regulated after hypoxia for 8 hours and a number of vesicles and swollen mitochondria were present in the cytoplasm.Conclusion The level of VEGF expression may havesignificant relationship with ultrastructural changes in human cerebral endothelial cells under hypoxic conditions.