Objective: To provide an automatic method for segmentation and diameter measurement of type B aortic dissection (TBAD). Materials and Methods: Aortic computed tomography angiographic images from 139 patients with TBAD were consecutively collected. We implemented a deep learning method based on a three-dimensional (3D) deep convolutional neural (CNN) network, which realizes automatic segmentation and measurement of the entire aorta (EA), true lumen (TL), and false lumen (FL). The accuracy, stability, and measurement time were compared between deep learning and manual methods. The intra- and inter-observer reproducibility of the manual method was also evaluated. Results: The mean dice coefficient scores were 0.958, 0.961, and 0.932 for EA, TL, and FL, respectively. There was a linear relationship between the reference standard and measurement by the manual and deep learning method (r = 0.964 and 0.991, respectively). The average measurement error of the deep learning method was less than that of the manual method (EA, 1.64% vs. 4.13%; TL, 2.46% vs. 11.67%; FL, 2.50% vs. 8.02%). Bland-Altman plots revealed that the deviations of the diameters between the deep learning method and the reference standard were -0.042 mm (-3.412 to 3.330 mm), -0.376 mm (-3.328 to 2.577 mm), and 0.026 mm (-3.040 to 3.092 mm) for EA, TL, and FL, respectively. For the manual method, the corresponding deviations were -0.166 mm (-1.419 to 1.086 mm), -0.050 mm (-0.970 to 1.070 mm), and -0.085 mm (-1.010 to 0.084 mm). Intra- and inter-observer differences were found in measurements with the manual method, but not with the deep learning method. The measurement time with the deep learning method was markedly shorter than with the manual method (21.7 ± 1.1 vs. 82.5 ± 16.1 minutes, p < 0.001). Conclusion The performance of efficient segmentation and diameter measurement of TBADs based on the 3D deep CNN was both accurate and stable. This method is promising for evaluating aortic morphology automatically and alleviating the workload of radiologists in the near future.

Objective:To investigate the clinicopathological, immunohistochemical and molecular features of small round cell sarcoma (SRCS) of the bone and soft tissue, and to compare the diagnostic value of different techniques.Methods:Seventy-two cases of SRCS of the bone and soft tissue diagnosed at People′s Hospital, Peking University from January 2016 to March 2020 were recruited and retrospectively analyzed for pathological morphology, immunophenotype and fluorescence in situ hybridization (FISH) data. Next generation sequencing (NGS) was performed on 13 difficult cases.Results:In the study cohort, the patients ranged in age from 4-55 years, with a male predominance. The most Ewing′s sarcomas and osteosarcomas occurred in the bone, while CIC-rearranged sarcomas, BCOR-rearranged sarcoma, synovial sarcoma, extraskeletal myxoid chondrosarcoma and FUS-NFATc2 rearranged sarcoma occurred in soft tissue. Histologically, all cases were composed predominantly of small round cells. Most cases were positive for vimentin and CD99, and showed a variable reactivity for neurogenic markers. Muscle marker and epithelial marker were negative for most cases. Combined with clinical features, histopathologic findings, immunophenotype, FISH and NGS, we diagnosed 46 Ewing sarcomas, 14 osteosarcomas, 3 CIC-rearranged sarcomas, 1 BCOR-rearranged sarcoma, 1 synovial sarcoma, 1 clear cell soft tissue sarcoma, 1 extraskeletal myxoid chondrosarcoma, 1 FUS-NFATc2 rearranged sarcoma, and 4 undifferentiated small round cell sarcomas.Conclusions:SRCS of bone and soft tissue is a group of malignant mesenchymal tumors based on morphological features. Most cases can be diagnosed with a combination of clinical characteristics, morphological features and immunohistochemical phenotype, while some cases require such further tests as FISH and NGS technologies, and NGS can be useful in diagnosing and categorizing SRCS.

Objective:To establish a predictive model that can predict the effectiveness and safety of endoscopic surgery for pediatric upper urinary tract calculi, and evaluate its diagnostic efficacy through internal validation.Methods:The data was selected from the prospective database of pediatric upper tract calculi constructed by Beijing Friendship Hospital Affiliated to Capital Medical University from June 2014 to April 2019. A total of 348 children were recruited in this investigation including 250 boys and 98 girls, with a median age of 3.0 years(Interquartile Range 1.4, 7.0 years). Totally 375 endoscopic surgeries were performed, with an overall stone free rate (SFR) of 88.0% (330/375) and complication rate (CR) of 23.2% (87/375). This research used univariate and multivariate logistic regression analysis to evaluate and screen the predictors of SFR and CR. The nomogram of SFR and CR was established by using the selected predictive factors. The differentiation degree of the model was evaluated by the area under the curve (AUC), the consistency between the prediction probability and the actual risk was evaluated by the calibration curve, and the clinical benefits of the model application were assessed by the decision curve.Results:The results of multivariate analysis demonstrated that stone burden, operation duration, intraoperative perfusion, stone location and operative options were the postoperative predictors of SFR and CR for children. Besides, BMI was also a predictor of postoperative CR. The AUC of the model (model 1: SFR; model 2: CR) based on the above predictive factors was 0.81 and 0.73, respectively. The predictive probability of the calibration curve showed that the model had a good consistency with the actual value. The decision curve showed that the application of model 1 to predict SFR had significant clinical benefits when the threshold value was greater than 20%, and the application of model 2 to predict the postoperative CR had a significant clinical benefit when the threshold was greater than 10%.Conclusions:Nomogram based on stone burden, operation time, intraoperative perfusion, stone location and operative options was validated internally with preferable predictive power on the effectiveness and safety of pediatric endoscopic surgery. This model can be used to predict the clinical effects of pediatric endoscopic lithotripsy. BMI was also an important factor for the safety of pediatric endoscopic procedures.

Objective: To understand the health literacy and relevant factors of cancer prevention consciousness in Chinese urban residents from 2015 to 2017. Methods: A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. The self-designed questionnaire was used to collect the information of demographic characteristics and cancer prevention consciousness focusing on nine common risk factors, including smoking, alcohol, fiber food, food in hot temperature or pickled food, chewing betel nut, helicobacter pylori, moldy food, hepatitis B infection, estrogen, and exercise. The logistic regression model was adopted to identify the influencing factors. Results: The overall health literacy of the cancer prevention consciousness was 77.4% (24 980 participants), with 77.4% (12 018 participants), 79.9% (6 406 participants), 77.2% (1 766 participants) and 74.5% (4 709 participants) in each group (P<0.001). The correct response rates for nine risk factors ranged from 55.2% to 93.0%. The multivariate logistic regression analysis showed that compared with community residents, people with primary school level education or below, and the number of people living together in the family <3, the cancer risk assessment/screening intervention population, cancer patients, those with junior high school level educationor above and the number of people living in the family ≥3 had better health literacy of the cancer prevention consciousness (all P values <0.05). Compared with females, 39 years old and below, government-affiliated institutions or civil servants, from the eastern region, males, older than 40 years, company or enterprise employees, and from the middle or western region had worse health literacy of the cancer prevention consciousness (all P values <0.05). Conclusion The health literacy of the cancer prevention consciousness in Chinese urban residents should be improved. The cancer screening intervention, gender, age, education, occupation, the number of people co-living in the family, and residential region were associated with the health literacy of the cancer prevention consciousness.

Geo-authentic habitats of Angelica Sinensis can be deduced from antiquity herbal literature's point of view. To provide basis for quality evaluation of Angelica Sinensis, this article summarized modern achievements in scientific research. To conclude genuine habitats of Angelica Sinensis, the related description of Geo-authentic habitats in ancient materia were reviewed and tested. Professional search strategy on traits and chemical characteristics of Angelica Sinensis were made to retrieve relevant literature in the CNKI database, and then the date on pharmacognostic characteristics and chemical component of crude drug from different origins were refined, and at last the date were comprehensively evaluated by Analysis of Variance, principal component and cluster analysis. and Conclusion Fourteen ancient books and one book of recent time were looked up on Herbalogical study. On this basis, twenty-six ancient origins were refined.Eight corresponding modern origins were finded through locating the place these medicines of dynasties in modern map.Combined with Frequency statistical results of modern origins and the related description of Geo-authentic habitats in ancient materia, genuine habitats of Angelica Sinensis were concluded. They are Gansu and Sichuan provinces. 75 literatures on traits and 1949 literatures on chemical characteristics of Angelica Sinensis were retrieved. The pharmacognostic characteristics of Angelica Sinensis were sumerized according to the traits. date. The results of ANOVA indicate that there exists significant difference in the quality of the samples in Gansu and Yunnan provinces among 6 different origins of Angelica Sinensis. Three principal components whose accumulated variance contribution rate was over90.641％ were obtained. Based on these principal components, samples of Angelica Sinensis from the different planting areas were clustered into three groups by within-groups linkage cluster methods. The results show that Gansu province was the best among 10 habitats. Sichuan, Yunnan Hubei, and Hubei Province were better than others habitats. The result is quite consistent with the genuine habitats of Angelica Sinensis, which is obtained from the textual research on ancient materia. The results obtained in this study can be used as references for evaluating the quality of Dao-di herbs Angelica Sinensis scientifically.

Objective To examine the sleep status and relevant psychosocial factors in patients with colorectal cancer before surgery and improve their sleep quality. Methods A cross?sectional survey method was used. Participants were 107 cases of patients with colorectal cancer from the Department of Anorectal Surgery in The First Hospital ,which is affiliated with China Medical University. The Athens insomnia scale(AIS),Ham?ilton depression scale(HAMD),Hamilton anxiety scale(HAMA),perceived social support scale(PSSS),self?esteem scale(SES),medical cop?ing questionnaire(MCMQ),memorial University of Newfoundland scale of happiness(MUNSH),Eysenck personality questionnaire(EPQ),and Wong?Baker face scale were used to assess preoperative sleep in patients with colorectal cancer and related psychosocial factors. Results Among the 107 cases,there were 24 cases of insomnia,with an insomnia incidence of 22.43%. No statistical differences were found in demographic charac?teristics and clinical characteristics(P>0.05). According to the degree of insomnia,there were significant differences between groups(P<0.05) for depression,anxiety,social support,avoidance,yield,happiness,and EPQ?N. Before the surgery,the degree of depression,anxiety,and EPQ?P had a significant positive effect on the degree of insomnia (P< 0.05). Conclusion The degree of insomnia before surgery in patients with colorectal cancer is closely associated with depression,anxiety,coping styles,social support,and personality characteristics.

OBJECTIVE:To establish the mesoporous carbon nano-drug delivery system (MCNs) with chemotherapy drugs loaded and holding photothermal and photodynamic combined effect,and study its anti-multidrug-resistant tumor effect in vitro. METHODS:MCNs was prepared by low-concentration hydrothermal route,and the MCNs surface was carboxylated by the mixed acid ultrasound method to made MCNs-COOH (MCNC). The morphology and surface properties were evaluated. Adriamycinc (ADR)was loaded into MCNC to fabricate ADR/MCNC via adsorption method. Drug loading capacity was calculated by UV,and drug release profile was investigated by dialysis method. ADR-resistant human breast cancer MCF-7/ADR cells were chosen,and cell uptake and positioning of ADR/MCNC were observed by confocal laser microscopy;cytotoxicity of ADR/MCNC was detected by MTT method;and intracellular reactive oxygen species(ROS)level under NIR irradiation was measured by flow cytometry. RE-SULTS:The particle size of prepared MCNs was about 90 nm,with carboxyl in surface. The specific surface area was 541.62 m2/g,pore volume was 0.34 cm3/g,and pore size distribution was 2.5 nm,with significant photothermal effect. The drug loading ca-pacity of ADR/MCNC was 47.4%,showing pH/NIR responsiveness release characteristics. It can promote ADR in cell uptake and nuclear accumulation and induce MCF-7/ADR cell to generate ROS under NIR irradiation,with significant inhibitory effect. CON-CLUSIONS:MCNs is prepared successfully,and ADR/MCNC has an effect on anti-multidrug-resistant tumors.

OBJECTIVE:To prepare the Indocyanine green gold nanocages(ICG/Biotin-PEG-AuNC-PCM),and study its anti-tumor activity. METHODS:Polyol reduction method was used to prepare silver nanometer cubes (AgNC) as template,ion ex-change reaction was used to prepare gold nanocages (AuNC) to characterize its morphology,particle size,near infrared (NIR) light and heat properties. Organic solvent evaporation method was conducted to prepare the ICG/Biotin-PEG-AuNC-PCM loaded with ICG,1-tetradecanol(PCM),surface modification of biotin polyethylene glycol mercapto(Biotin-PEG-SH). Its particle size, polydispersity index (PDI) and drug loading were detected,and in vitro cumulative release (Q) within 180 min under 37,40 ℃was investigated. Using adriamycin-resistant human breast cancer cells(MCF-7/ADR cells)as objects,MTT method was used to in-vestigate the antitumor activities of ICG,ICG/PEG-AuNC-PCM and ICG/Biotin-PEG-AuNC-PCM,and half inhibitory concentra-tion(IC50)was calculated. RESULTS:AuNC was cubic with particle size of about 60 nm and good light and heat properties. The particle size of ICG/Biotin-PEG-AuNC-PCM was(105±2.8)nm,PDI was 0.261±0.02(n=3). Drug loading was 1.34×108 g/mol AuNC,Q180 min was about 10%under 37℃and Q20 min was about 80%under 40℃. IC50 of ICG,ICG/PEG-AuNC-PCM and ICG/Bi-otin-PEG-AuNC-PCM on MCF-7/ADR cells was 95.2, 29.3, 16.1 μg/mL, respectively. CONCLUSIONS:ICG/Biotin-PEG-AuNC-PCM is successfully prepared,and the antitumor activity on MCF-7/ADR cells is stronger than ICG.

This paper firstly expounded the origin of the ritual-music culture.Then it explored the nature of the ritual-music culture which respects the laws of nature,bases on the position,sticks to the rules,exerts subjective initiative,fulfillseach duty,promotes harmony,unifies objectivity and subjectivity,complements each other and pursuits civilization.Analysis of the ritual-music culture provided inner value pursuit,conscientious code of conduct and healthy mental attitude for the construction of a harmonious doctor-patient relationship,which is of great theoretical and practical significance to handle the doctor-patient relationship properly.

AIM:Increasing evidence indicates that inflammation contributes to the initiation and perpetuation of atrial fibrillation ( AF) .Al-though tumor necrosis factor ( TNF)-αlevels are increased in patients with AF , the role of TNF-αin the pathogenesis of AF remains unclear.Recent research has revealed that T-type Ca2+currents ( ICa,T ) play an important role in the pathogenesis of AF .METH-ODS:In this study , we used the whole-cell voltage-clamp technique and biochemical assays to explore the role of TNF-αin the regula-tion of ICa,T in atrial myocytes.RESULTS:We found that compared with sinus rhythm (SR) controls, T-type calcium channel (TCC) subunit mRNA levels were decreased , while TNF-αexpression levels were increased , in human atrial tissue from patients with AF .In murine atrial myocyte HL-1 cells, after cultured for 24 h, 12.5, 25 and 50 μg/L TNF-αsignificantly reduced the protein expression levels of the TCC α1G subunit in a concentration-dependent manner .The peak current was reduced by the application of 12.5 or 25μg/L TNF-αin a concentration-dependent manner [from ( -15.08 ±1.11) pA/pF in controls to ( -11.89 ±0.83) pA/pF and (-8.54 ±1.55) pA/pF in 12.5 and 25 μg/L TNF-αgroups, respectively].TNF-αapplication also inhibited voltage-dependent inactivation of ICa,T shifted the inactivation curve to the left .CONCLUSION:These results suggest that TNF-αis involved in the path-ogenesis of AF, probably via decreasing ICa,T function in atrium-derived myocytes through impaired channel function and down -regula-tion of channel protein expression .This pathway thus represents a potential pathogenic mechanism in AF .