Objective:To investigate the value of 18F-FDG PET/CT combined with conventional imaging modalities in the evaluation of the depth of tumor invasion, regional lymph node metastasis, distant organ and lymph node metastasis (TNM staging), and the adjacent structure invasion of rectal cancer. Methods:Fifty-four patients (28 males, 26 females, age (65.8±11.0) years) with pathologically confirmed rectal cancer admitted to the Affiliated Qingdao Central Hospital of Qingdao University between September 2019 and June 2021 were retrospectively analyzed. 18F-FDG PET/CT examination, conventional imaging modalities including high-resolution MRI (HR-MRI), chest CT plain scan, upper abdominal MRI or CT plain scan+ enhanced examination were performed within 2 weeks before or after the rectal cancer being confirmed. The TNM staging and adjacent structural invasions including circumferential resection margin (CRM), extramural vascular invasion (EMVI), anal sphincter complex involvement were evaluated by 18F-FDG PET/CT and conventional imaging modalities separately or in combination, and those results based on imaging were compared with the pathological results or clinical follow-up results. χ2 test was used to compare the differences of diagnostic sensitivity, specificity and accuracy between the 18F-FDG PET/CT or conventional imaging modalities and combined examination. Results:The accuracy for T staging and the sensitivity and accuracy for N staging of the combined examination were 96.30%(52/54), 98.65%(73/74) and 93.91%(185/197), respectively, which were significantly higher than those of 18F-FDG PET/CT (85.19%(46/54), 66.22%(49/74), 81.73%(161/197); χ2 values: 3.97, 26.88, 13.66, all P<0.05). The specificity (91.06%, 112/123) and accuracy of the combined examination for N staging were higher than those of the conventional imaging modalities (77.24%(95/123), 83.76%(165/197); χ2 values: 8.81, 10.23, both P<0.05). The sensitivity and accuracy of the combined examination for M staging were higher than those of the conventional imaging modalities (97.01%(65/67) vs 73.13%(49/67), 95.95%(71/74) vs 68.92%(51/74); χ2 values: 15.05, 18.66, both P<0.001). The sensitivities of the combined examination in evaluating CRM and EMVI were 100%(22/22) and 95.00%(19/20), and the accuracies were 98.15%(53/54) and 96.30%(52/54), all of which were higher than those of 18F-FDG PET/CT (CRM: 54.55%(12/22), 74.07%(40/54); EVMI: 30.00%(6/20), 74.07%(40/54); χ2 values: 12.94, 13.08, 18.03, 10.56, all P<0.01). The accuracy of the combined examination in evaluating EMVI was higher than that of the conventional imaging modalities (85.19%(46/54); χ2=3.97, P=0.046). Conclusion:18F-FDG PET/CT combined with conventional imaging modalities can improve the diagnostic efficacy for TNM staging and assessment of adjacent structural invasion in rectal cancer.

Objective To explore the effect of Internet+cardiac rehabilitation on hypertension patients with coronary heart disease.Methods 80 patients with hypertension and coronary heart disease admitted to our hospital from January 2022 to April 2023 were randomly divided into the combined group(n=40)and the conventional group(n=40).Both groups were given routine cardiac rehabilitation interventions.The combined group combined adoptionof the Internet for continuous interventionson the basis of routine cardiac rehabilitation interventions.Compare the oxygen uptake,blood pressure,compliance,and self-management scores between two groups before intervention and three months after discharge.Results The AT Mets,AT VO2,peak VO2,and expected value compliance ratio in the combined group were all higher than those in the conventional group(P<0.05);The systolic and diastolic blood pressure in the combination group were lower than those in the control group,and the proportion of complete compliance was significantly higher than that in the control group(P<0.05);The self-management scores of the joint group were higher than those of the conventional group(P<0.05).Conclusion The continuous interventions of Internet plus cardiac rehabilitation can control the blood pressure of patients with hypertension and coronary heart disease,and patients'compliance behavior is significantly im-proved,andthus improving patients'self-management ability,which can be used for reference and promotion in clinical practice.

【Objective】 To establish a paper-free system of the total whole blood donation flow in constructing intelligent blood stations, and build digitalized whole blood donation system for practice. 【Methods】 A paper-free whole blood collection system was constructed through information process reforming, system frame designing and data network transportation constructing, and was applied in various blood donation scenario. 【Results】 Fixed blood collection sites carried out 49 063 donations via paper-free information system from November 2022 to July 2023, and 24 822 donations( group blood donation) were conducted via paper-free system from April to July 2022. Compared with the traditional paper-based model, paper-free system is safer, more standardized and more convenient, effectively enhancing the experience of blood donors. 【Conclusion】 The construction of paper-free whole blood collection system effectively enhances the experience of blood donors, improves the safety, accuracy, traceability of the data, and has good social value and economic value, which is worth popularizing.

China/epidemiology* ; Humans ; Pemphigoid, Bullous/epidemiology* ; Retrospective Studies

China has made great strategic achievements in the struggle against COVID-19 epidemic, which shows the profound and rich value of the times of the red doctors’ spirit. It not only give noble occupation responsibility and historical mission to the training of medical students in the new era, but also provide value guidance and action guide. Based on the successful experience of COVID-19 prevention and control and the special background of the times, set training objectives guided by the demand of society and universities for medical talents, combined with the ideological reality of medical students at present, actively carry out patriotism education, mental health education, professional ethics education and scientific spirit education for medical students through multiple channels such as strengthen the effectiveness of ideological and political theory curriculum, promote the ideological and political construction of curriculum, give full play to the educational function of various practical activities, and using environmental infiltration method to make red culture "live", with a view to cultivating medical talents with firm politics, superb medical skills, dedication, both ability and political integrity, being able to take on great responsibilities, and helping the construction and development of a healthy China.

Objective To detect the spatial clustering and high risk areas of pulmonary tuberculosis (PTB) in Sichuan province in 2018 and,to compare the effects of application on both SaTScan 9.4.1 software and FleXScan 3.1.2 software to detect the PTB spatial clusters.Methods Geographic information database was established by using the incidence data of PTB and demographic data reported in the'China disease prevention of infectious disease reporting information management system'in Sichuan province in 2018.Spatial clustering analysis was conducted using the Poisson model in software SaTScan 9.4.1 and FleXScan 3.1.2 to detect the high risk areas of PTB by software ArcGIS 10.5.Differences of clusters locations and scopes in the two scanning methods were compared.Results The reported incidence rate of PTB was 57.34/100 000 (47 601 cases) in Sichuan province in 2018,presenting an obvious clustering distribution.SaTScan and FleXScan scanned 8 and 10 clusters showed statistically significant differences (P＜0.05),with log-likelihood ratio (LLR) as 24.62-2 416.05 and 1.48-2 618.96,respectively.Results from scanning of the two methods showed that the most likely clusters appeared in the Daliangshan and Xiaoliangshan of Liangshan Yi ethnic aggregation areas.The other clustering areas would include some minority areas in the western Sichuan plateau,detected by both two methods differences in the shape and scope of the clustering were detected by both methods.The clustering scopes detected by SaTScan covered some counties,in which the actual incidence was not high.FleXScan could distinguish the clusters and detect more irregular shaped clusters.Conclusions Obvious spatial clusters of PTB distribution were found in Sichuan in 2018.Areas of Daliangshan,Xiaoliangshan and the minority areas in Western Sichuan plateau appeared at high risk,suggesting these were the key areas for prevention and control.FleXScan seemed more conducive in accurately distinguishing the "cold spot" areas in the highly aggregated areas,and more suitable for the application of spatial clustering detection for TB,in Sichuan province.

Mosaic variants resulting from postzygotic mutations are prevalent in the human genome and play important roles in human diseases. However, except for cancer-related variants, there is no collection of postzygotic mosaic variants in noncancer disease-related and healthy individuals. Here, we present MosaicBase, a comprehensive database that includes 6698 mosaic variants related to 266 noncancer diseases and 27,991 mosaic variants identified in 422 healthy individuals. Genomic and phenotypic information of each variant was manually extracted and curated from 383 publications. MosaicBase supports the query of variants with Online Mendelian Inheritance in Man (OMIM) entries, genomic coordinates, gene symbols, or Entrez IDs. We also provide an integrated genome browser for users to easily access mosaic variants and their related annotations for any genomic region. By analyzing the variants collected in MosaicBase, we find that mosaic variants that directlycontribute to disease phenotype show features distinct from those of variants in individuals with mild or no phenotypes, in terms of their genomic distribution, mutation signatures, and fraction of mutant cells. MosaicBase will not only assist clinicians in genetic counseling and diagnosis but also provide a useful resource to understand the genomic baseline of postzygotic mutations in the general human population. MosaicBase is publicly available at http://mosaicbase.com/ or http://49.4.21.8:8000.

This paper introduced the present situation and the existing problems of palliative care and hospice care system in Russia.The coverage of palliative is narrow,regional development is not balanced,the medical professionals in palliative care is lack,the professional skills should be improved urgently,the training system of palliative care is not perfect and the quality of training is not high,the medical professionals have high work pressure,the brain drain is serious,the social cognition is not enough,the volunteer service system is underdeveloped,and the acquisition rate of mental and narcotic drugs is low.On the basis of the above,this paper introduced the development strategy of Russian palliative care,and discussed the enlightenment to our country.For example,government departments should attach importance to the introduction of legal norms of palliative care,perfect the service system of palliative care,establish the supporting facilities,reasonably plan palliative care system,implement the integration of service management and scientific research,and bring the guarantee palliative care fund into the national budget.

Objective To analyze the spatial and temporal distribution of smear positive pulmonary tuberculosis (PTB) in Liangshan Yi autonomous prefecture in Sichuan province from 2011 to 2016. Methods The registration data of PTB in 618 townships of Liangshan from 2011 to 2016 were collected from"Tuberculosis Management Information System of National Disease Prevention and Control Information System". Software ArcGIS 10.2 was used to establish the geographic information database and realize the visualization of the analysis results. Software OpenGeoda 1.2.0 was used to conduct the analyses on global indication of spatial autocorrelation (GISA) and local indication of spatial autocorrelation (LISA). Software SaTScan 9.4.1 was used for spatio-temporal scanning analysis. Results From 2011 to 2016, the registration rate of smear positive PTB in Liangshan declined from 56.97/100000 (2666 cases) to 21.11/100000 (1038 cases). The global spatial autocorrelation coefficient Moran's I ranged from 0.25 to 0.45 and the difference was significant (all P=0.000). Local autocorrelation analysis showed that"high-high"area covered 43, 34, 37, 34, 42 and 61 townships from 2011 to 2016, respectively, mainly in Leibo county. Spatial temporal clustering analysis found one class Ⅰ clustering in the area around Bagu township of Meigu county and two class Ⅱ clustering in the areas around Liumin and Hekou township of Huili county, respectively (all P=0.000). Conclusion Obvious spatial temporal clustering of smear positive PTB distribution was found in Liangshan from 2011-2016. Hot spot areas with serious smear positive PTB epidemic and high spread risk were mainly found in northeastern Liangshan, including townships in Leibo and Meigu counties. Targeted TB prevention and control should be conducted in these areas.

Objective To investigate the condition of exercise, medicine compliance and the rehabilitation of patients with arteriosclerosis obliterans (ASO) in lower extremity after the surgery, and also to study the influence of self-efficiency and social support to their rehabilitation. Methods The questionnaire survey was performed in 102 patients who had surgical or interventional therapy of arteriosclerosis obliterans in the lower extremity in our hospital, investigated the general information of the patients, their knowledge of postoperative rehabilitation, medicine compliance, exercise condition, general self-efficiency and social support. Results The postoperative time for the patients with arteriosclerosis obliterans was 2 to 22months, the knowledge rate for postoperative rehabilitation was 7.8%-46.1%.The Morisky score for the patients of taking medicine for the treatment of vascular disease was 2.0,and there was only 6 patients(5.9%)with good medicine compliance. There were 22 patients(21.0%) had completed the ambulation training according to the guidelines, and there were 25 patients(24.5%) had completed the Buerger training. The self-efficiency score of the patients was 2.78 ± 0.76, and the gross score of social support was 32.38 ± 7.89. Spearman correlation analysis shows that the Morisky score for the patients of taking medicine for the treatment of vascular disease was in positive correlation with self-efficiency (r=0.289, P=0.003), but in negative correlation with social support (r=–0.286, P=0.006). Conclusions Most of the patients with arteriosclerosis obliterans have poor medicine compliance, and do not do exercise as required by the guidelines. Patients with high self-efficiency demonstrates medicine noncompliance, however the enhancement of social support will help patients improve their medicine compliance.