Objective:To investigate the value of CT imaging radiomics in predicting the therapeutic effect of extracorporeal shock wave lithotripsy (ESWL) for pancreatic duct stones.Methods:The clinical data of 167 patients with pancreatic duct stones treated with ESWL in the Department of Gastroenterology, the First People's Hospital of Hangzhou, Westlake University from July 2016 to January 2023 were retrospectively analyzed. Patients were divided into complete lithotripsy group (stone diameter ≤3 mm, n=94) and incomplete lithotripsy group (stone diameter>3 mm, n=73), according to the size of the largest residual stone after the first ESWL treatment. ITK SNAP software was used to delineate the images of pancreatic duct stones, and the artificial intelligence tool kit developed by United Shadow Company was used to extract the image radiomics characteristics. The pancreatic duct stone data set was randomly assigned into the training set ( n=118) and the test set ( n=29) in the ratio of 8∶2, and the absolute maximum normalization treatment was used, followed by peacekeeping selection through the minimum absolute contraction and selection operator (Lasso) to calculate the CT image radiomics score, and the logistic regression classifier was used to construct the ESWL treatment effect prediction model of pancreatic duct stones. Receiver operating characteristic curves (ROC) were plotted, and the area under the curve (AUC) and sensitivity, specificity, and accuracy were calculated to assess the performance of the prediction model. Decision curve analysis was used to evaluate the clinical value of CT radiomics score in the diagnosis of ESWL for pancreatic duct stones. Results:A total of 2 287 imaging radiomics characteristics were extracted, and 11 optimal imaging radiomics characteristics were finally screened by Lasso regression dimensionality reduction to establish a prediction model for ESWL treatment effect of pancreatic duct stones. The AUC values of the training set and the test set were 0.89 and 0.87, respectively, and the sensitivity, specificity, and accuracy were 82% and 79%, 82% and 82%, 82% and 80%, respectively. The AUC value in the independent validation set was 0.90, and the sensitivity, specificity, and accuracy were 78%, 90%, and 85%, respectively. The results of decision curve analysis showed that when the probability of ESWL efficacy in the diagnosis of pancreatic duct stones with CT image radiomics score was >0.05, the use of CT image radiomics score in the diagnosis of ESWL efficacy in pancreatic duct stones was more beneficial to patients in clinical practice than not.Conclusions:The treatment effect of ESWL for pancreatic duct stones can be predicted by CT imaging radiomics model.

ObjectiveTo observe the effect of comprehensive intervention on the incidence of lactation galactostasis in communities from the perspective of preventive medicine， so as to prevent the occurrence of the mammary ducts obstruction disease. MethodsA total of 400 women in the early stage of pregnancy were selected from four communities. Those in two communities were set up as the intervention group. Comprehensive intervention for the prevention and treatment of mammary ducts obstruction disease during pregnancy and "Six-step recanalization manual therapy" practical guidance were conducted on the intervention group. The pregnant women from the other two communities were the control group， who received no intervention or guidance training. The two groups were followed up at 1 month， 3 months and 5 months postpartum， and the occurrence of mammary ducts obstruction disease was investigated and interventions were carried out. ResultsThe incidence of galactostasis in the intervention group was 26.0%， 10.6% and 5.1%， respectively at 1， 3 and 5 months after delivery， and the incidence of galactostasis in the control group was 38.0%， 22.2% and 8.3%， respectively. The incidence of galactostasis at 1 month and3 months after delivery was statistically different （P<0.05）， while the incidence of galactostasis 5 months after delivery was not statistically different （P>0.05）. The protection rates of comprehensive intervention on galactostasis were 31.58%， 52.25% and 38.55%， respectively. ConclusionPublicity and education work of prevention and control of the mammary ducts obstruction disease and "Six-step recanalization manual therapy" practical guidance can effectively reduce the occurrence of plugged mammary ducts， and therefore should be promoted.

ObjectiveTo compare the effect of proprioceptive neuromuscular training methods on pain and motor ability of knee in patients with early knee osteoarthritis (KOA) . MethodsFrom November, 2022 to May, 2023, 60 early KOA patients from Beijing Bo'ai Hospital and community were randomly divided into groups A, B and C, with 20 patients in each group. Group A received proprioceptive neuromuscular facilitation (PNF), group B received neuromuscular exercise (NEMEX), and group C received PNF and NEMEX, for six weeks. They were assessed with Visual Analogue Scale for pain (VAS), angle reappearance test, difference of pre-motor reaction time (VM-VL), active range of motion (AROM) of knee flexion, 10-meter walk test (10MWT), and Knee Injury and Osteoarthritis Outcome Score (KOOS) before and after treatment. ResultsAll the indexes improved in all the groups after treatment (|t| > 2.532, P < 0.05). Among the groups, the VAS score was the least in group A, and then groups C and B; the angle reappearance error was the least in group C, and similar in groups A and B; the VM-VL was the least in groups A and C, followed by group B. ConclusionPNF, NEMEX and PNF+NEMEX can relieve the pain and improve the motor function of knee in patients with early KOA, however, PNF is the most effective on relieving pain, and PNF+NEMEX is the most effective on improving knee function.

Objective: To investigate the feasibility and effectiveness of endoscopicretrograde cholangio-pancreatography(ERCP)in the management of long-term complications after pancreaticoduodenectomy. Methods: From January 2009 to July 2018, the clinical data of 62 patients with biliary or pancreatic long-term complications after pancreatoduodenectomy were reviewed at Department of General Surgery, and the corresponding ERCP were carried out in the multi-disciplinary cooperation.There were 39 males and 24 females.The age was 56.5 years(aging from 13 to 76 years). The time of treatment was 3 months to 20 years after pancreatoduodenectomy.The long-term biliopancreatic complications after pancreatoduodenectomy included 51 cases of biliary calculi, 42 cases of bilioenteric anastomotic stenosis with proximal bile duct dilatation, and 11 cases of pancreaticointestinal anastomosis stenosis with distal pancreatic duct dilatation.All patients received conventional duodenoscopy or single-balloon enteroscopy assisted ERCP under general anesthesia. Results: A total of 95 ERCP were performed in 62 patients, averaging 1.5 times per case.The long-term complications of cholangiopancreatic after pancreatoduodenectomy(ERCP indications) included 56 times of bile duct stones(58.9%), 45 times of bilioenteric anastomatic stricture(47.4%), 11 times of recurrent pancreatitis(11.6%), 6 cases(6.3%) of bilioenteric anastomatic foreign body, 3 times of intrahepatic bile duct stenosis(3.2%). Among the 95 times, 82 times(86.3%) achieved endoscopic endoscopy, 76 times(80.0%) were diagnosed successfully, and 72 times(75.8%) were successfully treated with ERCP.Small intestinal perforation occurred in 1 patient undergoing duodenoscopy, and then healed by surgical repair. Conclusion Multi-disciplinary collaboration of ERCP is safe and effective in the treatment of long-term complications after pancreaticoduodenectomy, but the long-term effect still needs further clinical follow-up.

Objective To study the positive significance of hemodialysis in the treatment of epidemic hemorrhagic fever complicating acute renal failure. Methods A total of 10 cases of patients with epidemic hemorrhagic fever complicating acute renal failure from January 2008 to August 2013 in our hospital were selected with hemodialysis treatment, at the same time they were given the basis of the corresponding treatment and the clinical effect was observed. Results Six cases were cured, 3 cases were improved obviously, and 1 case of automatic discharge, the clinical symptoms of 10 cases were eased, blood urea nitrogen and serum creatinine were decreased significantly before and after hemodialy-sis treatment, the difference was statistially significant (P<0.05); A significant rise was happened in platelets, the dif-ference was statistially significant (P<0.05). Conclusion Hemodialysis in the treatment of epidemic hemorrhagic fever complicating acute renal failure has exact efficacy and should be promoted and applied.

Objective To investigate the effects of cognitive function and neuron morphous in hippocampus of the chronic stress depressed rats with gamma-aminobutyric acid and sertraline.Methods Using the chronic mild unpredictable stress to make the model of the chronic stress depressed rats.Sample group,sertraline group,GABA group and research group were gave by saline,sertraline,GABA,GABA and sertraline i.p.respectively for 21 days.Control group reeepted no any stress and drugs.Using open-field test and electric maze test to detect the behavior and memory function of the rats.Using Nissl staining to observe the pyramidal neuron morphous in CA1 and CA3 region of the hippocampus.Results After stress,the squares crossing,rears,grooming movement of the four groups accecepted stress were decreased compared with the control (P ＜ 0.05).After treatment,the squares crossing(respective for 57.25±18.79,39.00±13.69),rears(respective for 23.25±7.01,16.75±4.71),grooming movement(respective for 2.25±0.46,2.25±1.04),number of correct reaction (respective for 17.00±1.93,16.88±2.64) and latency time (respective for 172.88±26.91,206.00±33.54) of the research group and sertraline group were better than sample group(P ＜ 0.05 or 0.01).GABA group showed no significant improvemerit except for the reduced latency time compared with the sample group(P＜ 0.05).Compared with the control,the morphous,numbers and alignment of pyramidal neuron in CA1 and CA3 in hippocampus of the sertraline group,GABA group and research group were improve with different level,all the better in research group.Conclusion GABA with sertraline can improve the cognitive function of the chronic stress depressed rats by protect the neuron in hippocampus.

Objective To investigate the clinical significance of Wilm tumor gene (WT1) expression in breast cancer. Methods Real-time quantitative reverse transcriptase polymerase chain reaction (RQ-RT-PCR) method was established for detecting WT1 and GAPDH mRNA expression levels in 110 cases of various breast tumor and the corresponding adjacent normal breast tissue. Normalized WT1 expression level (WT1_N)was determined as a ratio between WT1 and GAPDH for each case. The tumor tissue WT1_N over the normaltissue WT1_N of the same case was calculated as T/N_(WT1) ratio, and T/N_(WT1) value was analyzed with the clinicalpathological parameters. Results The WT1_N expression levels of the 102 breast cancer tissues were significantly higher than those of the adjacent normal breast tissues, with the median WT1_N of 2.38 (ranged from 0.12 to 112.3) and 0.81 (ranged from 0.03 to 11.65) for each (P <0.01), but there were no statistical differences between the WT1_N of 8 benign breast tumors and the nearing normal tissues, with the median WT1_N of 0.46 (ranged from 0.16 to 5.04) and 0.53 (ranged from 0.14 to 4.94) for each. Furthermore the WT1_Nas well as the T/N_(WT1) ratio of the malignant breast cancer tissues were significantly higher than those of the benign tumor tissues, with the median T/N_(WT1) value of 2.54 (ranged from 0.28 to 172.88) and 1.17 (ranged from 0.09 to 2.63) for each. Non-parameter correlation analysis showed that the T/N_(WT1) in breast cancers were of no relevance to lymph node metastasis, clinical-pathological types, estrogen receptor and progestone receptor status, but positively correlated with the expression level of IL-8 gene which calculated with T/N IL-8(r =0.723, P <0.01). Conclusion The WT1 gene is highly expressed in breast cancer which suggests that WT1 level assessed by RQ-RT-PCR could be a novel marker of disease progression and poor prognosis.

Objective To understand the consulting relationship among students of some teaching class of epidemiology.Methods Data were collected through questionnaire and the network characteristics were analyzed with social network analysis software-NetDraw.Results The consulting network relation of this class was loosening,but there were a few people who have more degree and betweenness than others;some cliques were associated with major and sex.Conclusions Social network analysis can help teacher understand the consulting relationship among students,which may provide the base for making the management strategy on teaching class.

Objective　To study efficacy of 2,4-dibromo-5, 5-d imethylhydantoin in killing vegetative forms of bacteria and spores of B. subtil is var.niger, and efficacy of 2,4-dibromo-5,5-dimethylhydantoin in dest roying antigenicity of HBsAg. Methods　Neutralizer test and efficacy of so lution of 2,4-dibromo-5,5-dimethylhydantoin in killing vegetative forms of ba cteria and spores. Neutralizer test and efficacy of solution of 2,4-dibromo-5, 5-dimethylhydantoin in destroying HBsAg antigenicity in suspension. Resul ts　The killing rate of Staphylococcus aureus and E. coli. was 100 % a fter exposure to its solution containing 4 mg*L-1 and 2 mg*L-1 av ailable bromo after 10 min and 20 min. The killing rate of spores of Bacil lus subtilis var. Niger also was 100% after exposure to its solution co ntainin g 2 000 mg*L-1 available bromo after 30 min. Its solution containing 1 0 00 mg*L-1 available bromo with could destroy HBsAg in su spension for 5 min. Conclusions　2,4-dibromo-5,5-dimethylhydantoi n can effe ctively kill vegetative forms of bacteria and spores of B. subtilis var.ni ger, and can completely destroy the antigenicity of HBsAg in the water.

Objective　To study killing effect of plasmas ozo ne water on microorganisms by plasmas ozone disinfection solution through plasma s ozone resulting from discharge along surface disinfection solution produced by machine and its effect factors. Methods　Quantitative solut ion test was used to study killing action of plasmas ozone disinfection water to E. coli and staphyrococcus aureus, and to study its eff ect factors. Results　Plasmas ozone water could kill 99.9% E. coli and staphyrococcus aureus after 15 min. The kill ing effect was affected by organism. With the increasing of organism concertrat ion, the killing efficacy increased. Conclusions　Plasmas ozone can effectively kill microorgnisms in water and the efficacy was affected by org anism.