Objective:To investigate the trend of radiological diagnostic examination frequency and the related influencing factors in a general hospital in recent four years.Methods:The hospital information system and the radiology information system were used to collect the information on the numbers of the outpatients, the emergency patients, and the inpatients and the radiology examination information from 2019 to 2022. The examination frequency and proportion of various imaging equipment were counted by using the perspective table of data, and the examination items and the proportion of the radiological diagnostic examinations were calculated. The positive rates of the radiological examinations were measured from 2019 to 2022. The gender and age distribution of the patients were analyzed. Spearman correlation analysis was used to analyze the relationships between the numbers of the patients undergoing radiological examinations and the numbers of the outpatients, emergency patients and the inpatients.Results:The annual frequency of radiological diagnostic examinations from 2019 to 2022 were 307 306, 245 418, 317 250 and 325 625, respectively, with a total of 1 195 599. Among them, the proportions of CT, X-rays, bedside X-rays, bone density, gastrointestinal imaging and mammography were 59.74%, 38.04%, 1.39%, 0.42%, 0.21% and 0.19%, respectively. In each year, the proportion of CT in all radiological diagnostic examinations was 49.58%, 63.40%, 60.40% and 65.20%, respectively. The frequency of emergency CT and emergency chest CT was correlated with the number of emergency patients( r =0.63, 0.61, P<0.05), and the frequency of non-emergency CT was correlated with the number of outpatients and inpatients ( r =0.61, 0.66, P<0.05). The positive rates of the CT examinations were higher than 80% except the lowest of 79.95% in 2021. Conclusions:Radiological examinations especially CT examinations have increased significantly, and played an important role in the diagnosis of diseases. However, attention should be paid to the Justification of the CT examinations. Timely statistical analysis of radiological examination information can provide data supports and references for scientific management of radiological examinations.

To evaluate the effectiveness and safety of 8-ring assisted traction in endoscopic submucosal dissection (ESD), a total of 13 patients with 15 gastric lesions who underwent 8-ring traction-assisted ESD in Nanjing Drum Tower Hospital from July 2021 to January 2022 were included in the retrospective cohort study. All patients successfully completed the operation. The median procedure time was 56 min, and the dissected area per unit time was 0.20±0.02 cm 2/min. The en bloc resection rate, the complete resection rate and the curative resection rate were 93.3% (14/15), 80.0% (12/15) and 80.0% (12/15), respectively. There were no ESD-related complications, such as delayed bleeding or intraperative and postoperative perforation. No deaths occurred. As a novel internal traction technology, 8-ring traction method is simple to operate, providing a good field of vision during ESD to improve the dissection efficiency and reduce complications, which is worthy of further clinical research and promotion.

The accurate location of root canals is essential for the treatment of various endodontic diseases,including negotiation of calcified root canals,treatment of canal abnormality,removal of fiber posts and apical surgeiy.However,traditional root canal treat-ment has numerous drawbacks,such as being time-consuming,high risk of iatrogenic complications and strong dependence on the expe-rience of operators.With the progress of technology,the application of digital RCT guides based on CBCT and intraoral scanning,3D printing technology is gradually used worldwide,providing an accurate and predictable alternative for the treatment of endodontic disea-ses.This article reviews the clinical procedures,applications,indications,advantages,limitations and the latest technical progress of this technology,in order to provide guidance for clinical work.

Objective To study the influence of ANGPTL8 in lipopolysaccharide(LPS)-induced hepatic lipid deposition.Methods Male wild-type(WT)and ANGPTL8 knockout mice at 6-8 weeks were used to induce sepsis models by intrabitoneal injection of LPS(10 mg/kg).qPCR and immunofluorescence were used to detected the mRNA and protein expression of ANGPTL8 in liver tissue and HepG2 cells respectively;The contents of alanine aminotransferase(ALT),aspartate aminotransferase(AST)in serum and the triglyceride(TG)and malondialdehyde(MDA)in liver homogenate were detected by kits;the histopathological changes of liver tissue were analyzed through HE staining.Lipids accumulation in liver were detected by oil red O staining.The apoptosis of liver was determinated by TUNEL staining.RNA-seq was used to analyzing the differentially expressed genes in the liver tissue of WT and ANGPTL8 KO mice,and the qPCR and Western Blot were used to verify the differential expressed genes.Results The expression of ANGPTL8 in the liver was significantly upregulated at 48 hours after LPS stimulation.Compared with WT mice,the hepatic lipid deposition,steatosis,and apoptosis were significantly alleviated in liver of ANGPTL8 KO mice,the ALT and AST levels in serum and the TG and MDA content in liver homogenate of ANGPTL8 KO mice were also reduced significantly.The expression of caveolin-1(CAV1)in liver of ANGPTL8 KO mice was significantly higher than that of WT mice.Conclusions LPS promoted the expression and secretion of ANGPTL8 in liver tissue,and ANGPTL8 increased hepatic lipid deposition and peroxidation by inhibiting the expression of CAV1.

Objective To develop a whole course management information system for breast cancer and verify its effect in disease management of breast cancer patients.Methods An integrated service plan and system construction of"screening-diagnosis-treatment-rehabilitation"was developed,and then an information system was developed.The method of historical control was used to conveniently sample 260 cases of breast cancer patients diagnosed in a tertiary A hospital.130 cases diagnosed from May 1 to December 31,2022 were taken as a test group,and 130 cases diagnosed from May 1 to December 31,2021 were taken as a control group.The test group was managed by the whole course management information system,and the control group was managed by conventional disease management.The relevant indicators of the screening and diagnosis period of patients,the completion rate of treatment,the incidence of treatment related side effects and the cancer care satisfaction of the 2 groups were compared.Results There was a statistically significant difference in puncture waiting time,admission waiting time,and screening admission time between the 2 groups(P＜0.05),while there was no statistically significant difference in pathological waiting time(P＞0.05).The treatment completion rate of the test group was higher(P＜0.05).The incidence of lymphedema,chest obstruction and abnormal sensation of upper limbs,subcutaneous hydrops within 6 months after operation and bone marrow suppression,liver function damage,radiation dermatitis and radiation pneumonia in the test group were lower than those in the control group(P＜0.05).The cancer care satisfaction of the test group after surgery and 6 months after surgery were higher than those of the control group(P＜0.05).Conclusion The whole course management information system for breast cancer can optimize the diagnosis and treatment process,raise the diagnosis and treatment efficiency,ensure the treatment completion rate,reduce the treatment complications and improve the cancer care satisfaction.

Objective To analyze the quality of 22 batches of Fritillariae thunbergii bulbus Formula Granules from 12 different manufacturers by using water-extraction reference substance of Fritillariae thunbergii bulbus(ZBM ERS ST)and water-extraction reference substance of Fritillariae hupehensis bulbus(HBBM ERS ST)as references.Methods Ethyl acetate-methanol-triethylamine-water(17∶1∶1∶0.5)was used as the developing solvent for high-performance thin-layer chromatography(HPTLC)fingerprint analysis.The high-performance liquid chromatography(HPLC)fingerprint analysis was performed on a Agilent Eclipse XDB-C18 column(4.6 mm×250 mm,5 μm)with the gradient mobile phase consisted of acetonitrile-0.03%diethylamine solution.The column temperature was set at 25℃and evaporative light-scattering detector was used.The determination was conducted according to standard test method for measurement of Fritillariae thunbergii bulbus Formula Granules(Guangdong PFKL00117).Results The results of HPTLC and HPLC analysis showed that there are significant differences among the 22 batches of Fritillariae thunbergii bulbus Formula Granules.There were 4 batches of Fritillariae thunbergii bulbus Formula Granules from 3 manufacturers among them showed fingerprint characteristics of Fritillariae hupehensis bulbus.The total amount of peimine and peiminine in the remaining 18 batches of Fritillariae thunbergii bulbus Formula Granules was 0.291-3.179 mg·g-1,which were quite different.Conclusion Currently,the quality of Fritillariae thunbergii bulbus Formula Granules on the market varies greatly.Standardized water-extract reference substance has better applicability for the analysis of the quality of Fritillariae thunbergii bulbus Formula Granules than the control medicinal materials.

Objective: To understand the nutritional literacy level and associated factors of primary and secondary school students in Beijing, so as to provide a scientific basis for improving student nutrition. Methods: From October 2022 to May 2023, a multi stage cluster random sampling method was employed to select a total of 14 568 primary, junior and senior high school students from 16 districts (ecluding the Economic Technological Development area) in Beijing. Through a survey questionnaire on nutritional literacy and dietary hehavior of school age children, basic information as well as data on nutritional literacy levels across four dimensions:nutrition related knowledge concepts, food selection, food preparation, and food intake dimensions were obtained. The Wilcoxon rank sum test, Kruskal-Wallis test, Spearman correlation analysis, Chi square test and binary Logistic regression were used for the analysis. Results: The median total score of nutritional literacy among primary and secondary school students in Beijing was 68.8. Approximately 26.0% of primary and secondary school students achieved nutritional literacy standards. The median scores and rates of meeting the standards for nutrition related knowledge concepts, food selection, food preparation and food intake dimensions were 23.0, 42.1%; 17.0, 27.4%; 6.5, 33.5%; 23.0, 33.3%, respectively. There were positive correlations between all pairs of the four dimensions ( r=0.33-0.49, P <0.05). The results of multiple Logistic regression analysis showed that primary school students, junior high school students, female students, suburban students, caregivers with a college education level and a bachelor s degree or above were the positive arrelation factors that promoted the achievement of nutritional literacy standards ( OR =2.21, 1.39, 1.18, 1.27, 1.42, 1.66, P <0.05). Conclusion The literacy level of primary and secondary school students in Beijing needs to be significantly improved. School stage, gender, region and caregiver s education level are associated factors.

Background and objective Pembrolizumab(PEM)has been shown to be effective in clinical trials for the treatment of advanced non-small cell lung cancer(NSCLC),but clinical trials were based on cohorts of patients selected on specific criteria,and whether the findings are consistent with real-world patients is debatable.The aim of this study is to evaluate the efficacy and safety of PEM in the treatment of advanced NSCLC based on real-world data.Methods A retro-spective collection of real-world data from patients with advanced NSCLC receiving PEM was conducted.Propensity score matching was used to eliminate inter-group differences and assess the efficacy and safety of PEM compared to chemotherapy.Results Among 450 matched patients,the incidence rates of any-grade adverse events were 79.87％in the PEM group and86.71％inthe chemotherapy group,while the incidence rates of grade＞3 adverse events were 4.03％and 7.31％,respectively.The objective response rates were 48.63％for PEM and 36.00％for chemotherapy(P=0.011).The median progression-free survival was 15.5 months for PEM and 8.8 months for chemotherapy(P＜0.001),and the median overall survival was not reached for PEM and 26.2 months for chemotherapy(P＜0.001).Conclusion PEM treatment for advanced NSCLC demonstrates favorable survival outcomes and acceptable safety in real-world clinical practice.

Objective To explore the value of the prediction model based on diffusion weighted imaging(DWI)radiomic features and apparent diffusion coefficient(ADC)values in the assessment of p53 gene mutation status in endometrial cancer(EC).Methods The DWI data of 22 p53 wild-type and 60 p53 mutant EC patients were analyzed retrospectively.The DWI radiomic features of the primary lesions were extracted,and the ADC values were calculated.The prediction model was constructed based on support vector machine(SVM)algorithm.The area under the curve(AUC)of the receiver operating characteristic(ROC)curve was used to evaluate the performance of the prediction model.Internal validation was conducted using Bootstrap.Results The ADC value of p53 mutant EC was significantly lower than that of p53 wild-type EC(P=0.002).When comparing the ADC value and radiomics model,the combined ADC-radiomics model demonstrated the highest diagnostic efficacy,achieving an AUC of 0.924,sensitivity of 86.67％,and specificity of 90.91％.In Bootstrap-based validation,the combined ADC-radiomics model also showed high performance with an AUC of 0.904.The calibration curve and clinical decision curve analysis(DCA)showed that the combined ADC-radiomics model not only had better agreement between predicted and actual observed values but also provided better net benefits for the patients concerned.Conclusion The combined ADC-radiomics model achieved a more efficient assessment of p53 status in EC patients.

Objective To explore the underlying molecular mechanism of quercetin in tuberculous ulcer treatment using network phar-macology and molecular docking.Methods We identified quercetin drug targets by searching the PubChem,SwissTarget,and TargetNet databases,then combining our results with those of previous tuberculosis ulcer gene sequencing in our group,thereby obtaining inter-section targets.Using the DAVID database,we performed intersection target gene ontology functional enrichment analysis and signaling pathway enrichment analysis of the Kyoto gene and genome database.We analyzed the intersection target using the STRING database and Cytoscape software and screened the hub node.We used PyMOL and AutoDockTolls software to complete quercetin molecular docking with the hub node,then screened the core drug target of quercetin.Finally,we constructed a macrophage model to verify the above-men-tioned core genes.Results We screened overall 54 drug targets.Our enrichment analysis indicated that the signaling pathways involved in quercetin-mediated tuberculous ulcer treatment were e.g.,metabolic pathways,lipid and atherosclerosis,or the MAPK signaling pathway.In addition,ALOX5,TNF,SRC,MMP9,and EGFRmight be the key genes in quercetin-mediated tuberculous ulcer treatment.Results of our cell culture experiment demonstrated that upon quercetin intervention,SRCand EGFRexpression increased significantly while that of MMP9decreased significantly in M1 and M2 macrophages.Conclusion Quercetin could potentially regulate macrophage polarization by influencing SRC,EGFR,and MMP9expression.