Objective:To design an assisted management system for medical consumables that integrated management logic of diagnosis related groups(DRG)for disease,so as to standardize the use for medical consumables and to strengthen regulatory efficiency.Methods:The system was designed by a microservices architecture,and the data fusion of business data,data of diagnosis and treatment,and DRG data was realized through constructed data lake.A knowledge graph of associated rule for medical consumables was established,and the intelligent analysis function included prediction for demand,usage optimization,and anomaly detection was provided to assist management decision-making on the basis of inference for historical data and knowledge,and multi-dimensional data queries.A rule engine was deployed at key clinical nodes for real-time compliance review and intelligent alerts.A DRG-based business management process was constructed to cover full lifecycle of consumables,including admission,procurement,warehousing,storage,requisition,usage billing,and traceability,so as to realize real-time monitoring and early warning for consumable costs at the DRG level.Six clinical doctors with 2-3 years of experience in using medical consumable were selected as test users from Tangdu Hospital of the Air Force Medical University,and they were randomly assigned into a system group and a control group,with 3 subjects in each group.The system group utilized the auxiliary management system for medical consumable to perform prediction for the demand of monthly procurement,and rationality verification of consumable.The control group relied on individual experience of doctors.The predicted monthly procurement demand for medical consumables,the accuracy of verifying rationality of using medical consumables between two groups were compared,and the efficiencies of two kinds of management modes also were compared.Results:The accuracy rate of system group was 89.17%in predicting the monthly procurement demand for medical consumables,and the rate of checking accuracy and the rate of checking comprehensiveness of system group were respectively 87.50%and 91.67%in verifying rationality of using medical consumables,which were significantly higher than those of control group,and the differences were significant(x2=6.62,1.96,16.73,P<0.05).The durations of predicting the demand for procurement,and verifying and testing the rationality of consumables in system group were significantly shorter than these in control group[(3.54±0.45)s,(2.23±0.15)s],and the differences were statistically significant(t=1.97,1.65,P<0.05).Conclusion:The medical consumables auxiliary management system integrated with DRG management logic can significantly enhance the accuracy of monthly demand prediction for consumables and the recall rate and precision rate of rationality verification for consumables usage,while greatly improving work efficiency.It is conducive to enhancing the standardized and refined supervision level of consumables usage.

BackgroundAttention deficit hyperactivity disorder （ADHD） is a neurodevelopmental disorder characterized by age-inappropriate inattention， excessive activities incongruous with setting， and emotional impulsivity. Subthreshold ADHD （sADHD） is clinically defined as the presence of ADHD symptoms that do not meet the full diagnostic criteria for ADHD. Children with sADHD exhibit deficits in executive function， demonstrate more conduct， learning， and anxiety-related problems compared to typically developing children， and show even poorer working memory performance than children diagnosed with ADHD. Currently， there is limited epidemiological research on sADHD in China， with few studies simultaneously investigating the prevalence of both ADHD and sADHD in children. ObjectiveTo investigate the prevalence of ADHD and sADHD among children aged 6–13 years in Chongqing， analyzing their distribution characteristics within this population， with the aim of providing references for developing preventive measures against both ADHD and sADHD. MethodsFrom October to November 2023， a total of 3 398 students in grades 1–6 from six primary schools in Jiangbei District， Chongqing were selected using a stratified cluster random sampling method. The occurrence of ADHD and sADHD was evaluated by using the short version （18-item version） of the Swanson， Nolan， and Pelham IV rating scales （SNAP-IV） and the Chinese vision of Schedule for Affective Disorder and Schizophrenia for School-aged Children-Present and Lifetime Version （K-SADS-PL）. ResultsThe ADHD detection rate among children in Chongqing was 1.90% （95% CI： 0.014–0.024）. Boys showed a significantly higher ADHD detection rate than girls （χ²=7.733， P=0.005）. No statistically significant differences were found in ADHD detection rates across different grades or age groups （χ²=7.347， 12.362， P>0.05）. The sADHD detection rate was 6.32% （95% CI： 0.054–0.072）. Similarly， boys exhibited significantly higher sADHD detection rates than girls （χ²=21.005， P<0.01）. Significant differences emerged across different grades （χ²=20.559， P=0.001）， while no statistically significant difference was observed in age groups （χ²=12.070， P=0.060）. ConclusionThe ADHD detection rates were comparable across all grade levels and age groups from 6–13 years old. Second-grade children demonstrated notably higher sADHD rates compared to other grades， while boys demonstrated higher prevalence rates than girls for both ADHD and sADHD. ［Funded by Science and Health Joint Medical Research Project in Jiangbei District， Chongqing City in the Second Half of 2023 （number， 2023JBKWLH022）］

As a physical treatment technique, modified electro-convulsive therapy (MECT) is used to treat mental and certain neurological disorders by causing seizures with short, suitable electrical currents applied to the brain while the patient is under general anesthesia and muscle relaxants. MECT is recognized for its therapeutic efficacy and clinical safety, rendering it one of the most prevalent interventions in psychiatric care. To enhance clinical outcomes and minimize adverse effects, this consensus document delineates the indications, therapeutic parameters, therapeutic procedures, potential adverse effects, and associated management strategies for MECT. These guidelines are informed by the latest clinical research and expert consensus, integrating evidence-based medicine methodologies. The objective is to furnish clinicians with precise operational guidelines and to advance the standardization of MECT practices in clinical settings.

Objective:To design an assisted management system for medical consumables that integrated management logic of diagnosis related groups(DRG)for disease,so as to standardize the use for medical consumables and to strengthen regulatory efficiency.Methods:The system was designed by a microservices architecture,and the data fusion of business data,data of diagnosis and treatment,and DRG data was realized through constructed data lake.A knowledge graph of associated rule for medical consumables was established,and the intelligent analysis function included prediction for demand,usage optimization,and anomaly detection was provided to assist management decision-making on the basis of inference for historical data and knowledge,and multi-dimensional data queries.A rule engine was deployed at key clinical nodes for real-time compliance review and intelligent alerts.A DRG-based business management process was constructed to cover full lifecycle of consumables,including admission,procurement,warehousing,storage,requisition,usage billing,and traceability,so as to realize real-time monitoring and early warning for consumable costs at the DRG level.Six clinical doctors with 2-3 years of experience in using medical consumable were selected as test users from Tangdu Hospital of the Air Force Medical University,and they were randomly assigned into a system group and a control group,with 3 subjects in each group.The system group utilized the auxiliary management system for medical consumable to perform prediction for the demand of monthly procurement,and rationality verification of consumable.The control group relied on individual experience of doctors.The predicted monthly procurement demand for medical consumables,the accuracy of verifying rationality of using medical consumables between two groups were compared,and the efficiencies of two kinds of management modes also were compared.Results:The accuracy rate of system group was 89.17%in predicting the monthly procurement demand for medical consumables,and the rate of checking accuracy and the rate of checking comprehensiveness of system group were respectively 87.50%and 91.67%in verifying rationality of using medical consumables,which were significantly higher than those of control group,and the differences were significant(x2=6.62,1.96,16.73,P<0.05).The durations of predicting the demand for procurement,and verifying and testing the rationality of consumables in system group were significantly shorter than these in control group[(3.54±0.45)s,(2.23±0.15)s],and the differences were statistically significant(t=1.97,1.65,P<0.05).Conclusion:The medical consumables auxiliary management system integrated with DRG management logic can significantly enhance the accuracy of monthly demand prediction for consumables and the recall rate and precision rate of rationality verification for consumables usage,while greatly improving work efficiency.It is conducive to enhancing the standardized and refined supervision level of consumables usage.

As a physical treatment technique, modified electro-convulsive therapy (MECT) is used to treat mental and certain neurological disorders by causing seizures with short, suitable electrical currents applied to the brain while the patient is under general anesthesia and muscle relaxants. MECT is recognized for its therapeutic efficacy and clinical safety, rendering it one of the most prevalent interventions in psychiatric care. To enhance clinical outcomes and minimize adverse effects, this consensus document delineates the indications, therapeutic parameters, therapeutic procedures, potential adverse effects, and associated management strategies for MECT. These guidelines are informed by the latest clinical research and expert consensus, integrating evidence-based medicine methodologies. The objective is to furnish clinicians with precise operational guidelines and to advance the standardization of MECT practices in clinical settings.

Background: Enteritis is one of the most frequently reported symptoms in piglets infected with porcine circovirus type 2 (PCV2), but the immunopathogenesis has not been reported. Objectives: This study examined the effect of a PCV2 infection on the intestinal mucosal immune function through morphological observations and immune-related molecular detection. Methods: Morphological changes within the ileum of piglets during a PCV2 infection were observed. The expression of the related-molecules was analyzed using a gene chip. The immunocyte subsets were analyzed by flow cytometry. The secretory immunoglobulin A (SIgA) content was analyzed by enzyme-linked immunosorbent assay. Results: The PCV2 infection caused ileal villus damage, intestinal epithelial cells exfoliation, and an increase in lymphocytes in the lamina propria at 21 days post-infection.Differentially expressed genes occurred in the defense response, inflammatory response, and the complement and coagulation cascade reactions. Most of them were downregulated significantly at the induction site and upregulated at the effector site. The genes associated with SIgA production were downregulated significantly at the induction site. In contrast, the expression of the Toll-like receptor-related genes was upregulated significantly at the effector site. The frequencies of dendritic cells, B cells, and CD8 + T cells were upregulated at the 2 sites. The SIgA content decreased significantly in the ileal mucosa. Conclusions PCV2 infections can cause damage to the ileum that is associated with changes in immune-related gene expression, immune-related cell subsets, and SIgA production.These findings elucidated the molecular changes in the ileum after a PCV2 infection from the perspective of intestinal mucosal immunity, which provides insights into a further study for PCV2-induced enteritis.

Objective To evaluate the feasibility and accuracy of cardiac CT (CCT) in quantitation of extracellular volume (ECV) fraction in patients with heart failure, with 3 T Cardiac MR (CMR) as the reference. Methods Twenty?eight patients with variety reasons of heart failure were enrolled in this study. ECVs was calculated, the correlation between CCT and CMR ECV value and other cardiac function parameters (left ventricular end systolic volume LVESV, left ventricular end diastolic volume LVEDV, cardiac output CO and ejection fraction LVEF, and clinical bio?marker BNP) was determined. Interclass correlation coefficient (ICC) was used to evaluate the agreement of measurement by two radiologists. Results The average of ECV on CCT and CMR was 33% ± 8% and 31% ± 6%, respectively. A good correlation was revealed between myocardial ECV at CCT and that at CMR (r=0.854, P<0.001). Bland?Altman analysis between CCT and CMR showed a small bias (4.6%), with 95% limits of agreement of-18.2% to 27.4%. ICC for ECV at CCT was excellent (ICC=0.910). For both CCT and CMR, ECV was inversely related to LVEF. The radiation dose for CCT?ECV was (1.60±0.04) mSv. Conclusions ECV at CCT and that at CMR showed good correlation, suggesting the potential for myocardial tissue characterization using CCT. However, CCT?ECV would possibly overestimate the extent of ECV.

Objective To analyze the correlation between calcification factors and fractional flow reserve derived from CT (CT?FFR). And to evaluate the diagnostic efficacy of CT?FFR in coronary artery lesions with calcification compared with that of invasive FFR. Methods Sixty?five patients (74 coronary artery vessels) who were admitted to Beijing Anzhen Hospital from July 2014 to December 2016 were included in this study retrospectively. All patients had completed CCTA (coronary CT angiography), coronary angiography and invasive FFR measurements, and had coronary lesions contain calcifications. The evaluation of CCTA data included quantitative analyses of plaque components, coronary artery stenosis, and CT?FFR measurements. The patients′basic data were grouped and compared according to the FFR values. The measurement data was tested by independent?samples t tests, and the categorical data were analyzed by χ2 tests. Quantitative measurements of plaques were compared between groups using independent?sample t tests or rank sum tests based on FFR and CT?FFR values. The reproducibility of CT?FFR measurement software was evaluated by inter?class correlation coefficient (ICC) and the Youden index was calculated to determine the threshold for CT?FFR diagnosis of ischemia. Pearson or Spearman correlation analyses were used to assess the correlations between CT plaque quantitative indicators, CT?FFR and invasive FFR. Multivariate logistic regression analysis was used to analyze the predictors of ischemia by FFR and CT?FFR. In contrast to invasive FFR results, the sensitivity, specificity, negative predictive value, positive predictive value (PPV) of CT?FFR in the diagnosis of coronary ischemic lesions were evaluated, and the diagnostic consistency was evaluated by the Bland?Altman method. Results Compared with invasive FFR, CT?FFR had a more significant correlation with calcification volume and ratio of calcification in plaques (r=-0.519 and－0.547, respectively, both P=0.001). Multivariate logistic regression analysis showed that plaque length was a predictor of invasive FFR in the diagnosis of pathological ischemia ( OR=1.13, 95%CI : 1.05—1.23, P=0.002), and was associated with CT?FFR to determine pathological ischemia. In addition to plaque length ( OR=1.10, 95%CI : 1.02—1.18, P=0.010), the predictor also included ratio of calcification in plaque ( OR=1.09, 95%CI: 1.03—1.15, P=0.003). Compared with invasive FFR results, the diagnostic sensitivity of CT?FFR was 79.1%, the specificity was 80.6%, the PPV was 85.0%, and the area under the ROC curve was 0.78. The result for the diagnosis of ischemia lesion by using CT?FFR had significant statistical differences with the results by according coronary artery stenosis (χ2=10.05, P=0.002; χ2=34.71, P=0.001; χ2=7.65, P=0.006; Z=2.10, P=0.029). The Bland?Altman analysis showed a mean difference of －0.01 (-0.26—0.25) between the CT?FFR and the invasive FFR. Conclusions There is no significant correlation between the proportion of calcification components of coronary plaque and the presence or absence of myocardial ischemia, but the proportion of calcification in plaque will affect the result that is evaluated by CT?FFR. However, compared with CT?based stenosis evaluation, CT?FFR can still significantly improve the ability of CCTA to diagnose ischemia lesion with calcification.

Objective To analyze the impact of dual energy monochromatic reconstructions (50-160 keV) on coronary calcified plaque stenosis quantification in a cardiac phantom with the real stenosis as standard of reference.Methods Signal-to-noise(SNR)and contrast-to-noise ratios(CNR)were calculated. In conventional 120 kV coronary CT angiography (CCTA) images as well as 12 monochromatic series(50-160 keV),luminal narrowing of calcified plaque was measured and compared to the real stenosis. Bland-Altman plots were performed to analyze the correlation of reference standard with conventional 120 kV and 12 monochromatic series (50-160 keV). The sensitivity, specificity, and accuracy of CCTA for detection of≥50% stenosis were calculated and receiver operating characteristic(ROC)curve was analyzed with the real stenosis as reference standard.Results The SNR and CNR were decreased with the increase of keV from 70 keV.The SNR and CNR of monochromatic imaging were lower compared with conventional 120 kV images(SNR:76.4±16.1;CNR:274.7±54.1)(P<0.05).The Bland-Altman plots presented a smaller measurement bias towards 90-160 keV than conventional 120 kV, and smallest measurement bias was revealed in 100-130 keV imaging(100-130 keV:bias 17.2% vs 120 kV:21.4%).Using the stenosis≥50% as cut-off value, the specificity were higher in the monochromatic series (70-160 keV) than conventional 120 kV CCTA.The specificity(75.0%)were the highest in the 120 keV and 130 keV images.The area under the ROC curve(AUC)of 90-130 keV(0.991-0.995)was higher than that in conventional 120 kV imaging (0.990). Conclusions The use of monochromatic imaging improves the overall accuracy of stenosis evaluation in coronary calcified plaques. Reconstructions at 100-130 keV for calcified lesions yielded the optimal results.

Objective To observe the value of optimized temporal parallel acquisition technique (TPAT) sequence in evaluating cardiac structure and function in arrhythmia patients.Methods Totally 33 arrhythmia patients (arrhythmia group) and 48 normal rhythm subjects (normal group) underwent cardiac MRI with conventional cine (balanced steadystate free-precession [bSSFP]) sequence and optimized TPAT sequence.Myocardial thickness,cardiac function,myocardial strain parameters of left ventricle and image quality of 2 sequences were compared in the two groups,respectively.Results In arrhythmia group,there was statistical difference of myocardial thickness in 12 myocardial segments between the 2 sequences (all P ＜ 0.05),as well as peak and average values of myocardial radial and circumferential strain (all P＜0.05).In normal group,there was no statistical difference of myocardial thickness and stain parameters between the 2 sequences (all P＞0.05).Additionally,no statistical difference of cardiac function was found between the 2 sequences in two groups (all P＞0.05).In arrhythmia group,the image quality of optimized TPAT sequence was better than that of bSSFP sequence (P＜0.05).Conclusion For arrhythmia patients,optimized TPAT cine sequence could improve image quality of cardiac MRI.