Fibromyalgia syndrome （FMS） is a refractory， chronic non-articular rheumatic disease characterized by widespread pain throughout the body， for which there are no satisfactory therapeutic drugs or options. There are rich Chinese medical therapies， and some non-drug therapies， such as acupuncture， Tai Chi， and Ba-Duan-Jin， have shown satisfactory efficacy and safety and definite advantages of simultaneously adjusting mind and body. FMS is taken as a disease responding specifically to traditional Chinese medicine （TCM） by the National Administration of Traditional Chinese Medicine in 2018. In order to clarify the research progress in FMS and the clinical advantages of TCM/integrated Chinese and Western medicine， the China Academy of Chinese Medicine organized a seminar for nearly 20 experts in Chinese and Western medicine， including rheumatology， psychology， acupuncture and moxibustion， and encephalopathy， with the topic of difficulties in clinical diagnosis and treatment of FMS and advantages of TCM and Western medicine. The recommendations were reached on the difficulties in early diagnosis and solutions of FMS， mitigation of common non-specific symptoms， preferential analgesic therapy， TCM pathogenesis and treatment advantages， and direction of treatment with integrated Chinese and Western medicine. FMS is currently facing the triple dilemma of low early correct diagnosis， poor patient participation， and unsatisfactory benefit from pure Western medicine treatment. To solve the above problems， this paper suggests that rheumatologists should serve as the main diagnostic force of this disease， and they should improve patient participation in treatment decision-making， implement exercise therapy， and fully utilize the holistic and multidimensional features of TCM， which is effective in alleviating pain， improving mood， and decreasing adverse events. In addition， it is suggested that FMS treatment should rely on both TCM and Western medicine and adopt multidisciplinary joint treatment， which is expected to improve the standard of diagnosis and treatment of FMS in China.

BACKGROUND:The impact of the endometrium's structure and spiral artery blood flow parameters on the pregnancy rate of artificial insemination by husband remains unclear.This study identified the independent factors and constructed a prediction model with good clinical application efficacy after calibration of other confounding factors. OBJECTIVE:To construct and validate a clinical pregnancy prediction model for artificial insemination by husband based on endometrial structure and uterine spiral artery blood flow parameters. METHODS:A retrospective analysis was conducted on 1 299 patients who underwent artificial insemination by husband treatment at Changzhou Maternal and Child Health Hospital from January 2017 to January 2021.The non-pregnancy group consisted of 1 182 patients,while the pregnancy group included 117 patients.Out of these patients,93 cases were successfully matched between the pregnancy and non-pregnancy groups using a 1∶1 propensity score matching method.Single-factor and multi-factor analyses were used to screen the endometrial structure and uterine spiral artery blood flow parameters to determine their influence on artificial insemination by husband outcomes.The optimal cutoff value was established for each independent influencing factor through receiver operating curve analysis and their risk trend affecting artificial insemination by husband pregnancy outcomes was analyzed using a restricted cubic spline.The clinical efficacy of this combined forecast model was tested by using clinical decision curve and clinical influence curve methods. RESULTS AND CONCLUSION:(1)There was no statistical significance in non-endometrial factors between the pregnancy group and the non-pregnancy group,and the data had a good balance by propensity score matching(P>0.05).(2)Single-factor analysis identified several subendometrial parameters as significant influencing factors of artificial insemination by husband pregnancy outcomes,including vascularization index,flow index,vascular flow index,resistance index,pulsatility index,maximum systolic velocity/end-diastolic velocity,thickness of average junction zone and maximum junction zone from the basal endometrium to the outer myometrium inner layer(P<0.05).(3)Multivariate logistic regression analysis revealed that thickness of average junction zone,pulsatility index,and vascular flow index were independent influencing factors of pregnancy outcomes of artificial insemination by husband,vascular flow index>thickness of average junction zone>pulsatility index.(4)Receiver operating characteristic curve analysis indicated that the area under receiver operating characteristic curve of vascular flow index was 0.704(0.629,0.779),and the optimal cutoff value was 6.26;the area under receiver operating characteristic curve of thickness of average junction zone was 0.660(0.582,0.739),and the optimal cutoff value was 6.38;the area under receiver operating characteristic curve of pulsatility index was 0.642(0.563,0.721),and the optimal cutoff value was 1.18.(5)The restricted cubic spline analysis revealed that artificial insemination by husband pregnancy outcomes were significantly positively affected when the vascular flow index was>6.24 or the thickness of average junction zone was≤6.55 mm,while a negative risk was associated with pulsatility index>1.27.(6)The clinical decision curve and clinical influence curve analyses exhibited that the combined prediction model had the maximum clinical net benefit at the threshold probability value of 0.17-0.93,and the ratio of loss to benefit was consistently less than 1 in the threshold probability range,indicating that the model had good clinical efficacy.(7)It is concluded that after adjusting for other confounding factors outside of the endometrium using propensity score matching and multifactorial logistic regression,the thickness of average junction zone,pulsatility index and vascular flow index were independent factors that influenced pregnancy outcomes of artificial insemination by husband.Through determining their optimal cutoff values and assessing their risk trends,it was confirmed that the combined prediction model had good predictive value and clinical efficacy.

Objective:To construct an evaluation index system for(magnetic resonance imaging)MRI equipment allocation management in hospitals,and to provide objective basis for MRI equipment allocation decision-making.Methods:Following the principles of practicality,objectivity and accessibility,the evaluation index system of hospital MRI equipment allocation management was designed and constructed,based on the actual work needs of the hospital,the index system and evaluation rules were determined by combining literature research method,expert seminars,and expert consultation method.The evaluation index system was used to evaluate and analyze the MRI equipment application allocation management of the two hospitals included in the study in 2023(Hospital A and Hospital B),By comprehensively considering hospital grading and index score,the allocation requirements of MRI were quantitatively calculated and evaluated,and comparable and quantifiable evaluation results were achieved.Results:The MRI equipment allocation management index system formed update scenarios,additional scenarios and ladder allocation scenarios,and established relevant evaluation matrices and multi-category indicators based on the allocation scenarios.The evaluation results showed that Hospital A's application for one mid-range MRI equipment was approved,and Hospital B's application was not approved,and the evaluation results were consistent with the actual decision-making.Conclusion:The evaluation index system for hospital MRI allocation management can realize the evaluation of MRI equipment allocation management,provide effective data support for MRI allocation decision-making,and have a guiding role in improving equipment service capabilities,refined management,and optimized resource allocation.

The artificial intelligence based on medical aid diagnosis has been in full swing in these years. How to better and more safely utilize this new technology to improve the diagnostic efficiency and quality of doctors poses new challenges for our hospital management. This paper aims to explore relevant management problems and corresponding solutions from seven aspects:data security, system integration, technical parameters, risks, workflows and diagnosis results by introducing a new intelligent image screening system. After these management problems have been better solved, we found that the intelligent image screening system can improve the diagnostic efficiency and quality of doctors.
Artificial Intelligence ; Hospital Administration

Objective To investigate the risk factors associated with epididymitis after transurethral resection of prostate.Methods A retrospective analysis of 352 patients with benign prostatic hyperplasia (BPH) who underwent transurethral resection of prostate in X'an Aerospace General Hospital from January 2015 to December 2017 was performed.There were 14 cases of epididymitis and 338 cases of nonepididymitis.Measurement data were expressed as ((x) ± s),t test was used for comparison between groups;count data was expressed by rate (％),and chi-square test was used for comparison between groups.Univariate and multivariate logistic regression analyses were used for factors that may lead to post-urethral epididymitis.Results Univariate logistic regression analysis showed that preoperative leukocytic positive,urine glucose positive and prostate volume had significant effects on postoperative epididymitis (P ＜ 0.05).Multivariate logistic regression analysis showed that prostate volume increased (OR =0.182,P =0.005)was an independent risk factor for postoperative epididymitis.Conclusion The enlargement of prostate volume is an independent risk factor for postoperative epididymitis.For large-volume prostate surgery,the purpose of relieving obstruction can be achieved.

The demand for diagnosis and therapy of diseases should be higher in the era of precision medicine.The superparamagnetic iron oxide nanoparticles (SPION) is used in diagnosis,therapy,and monitor of diseases due to its good superparamagnetism,which has always been paid more attention in molecular imaging.The research progresses of SPION in precision medicine were reviewed in this article.

Objective To investigates the efficacy and tolerability of second line treatment with S-1 plus thalidomide in patients with advanced pancreatic cancer.Methods Sixty patients hospitalized in Department of Oncology of Cangzhou Central Hospital from July 2010 to October 2012 were included in this study.All the patients were diagnosed as having pancreatic carcinoma.The patients were randomly divided into two groups,one group was treated with S-1 alone,and the other group was treated with S-1 plus thalidomide.Then the efficacy and toxicity of two groups was evaluated.Results The disease control rates were 36.7％ and 46.7％ in the S-1 alone group and the S-1 plus thalidomide group,and the difference between the two groups was not statistically significant (P =0.31).The progression free survival (PFS) was 2.9 months and 3.3 months,and the difference between the two groups was statistically significant (P ＜ 0.05),the Karnofsky score,pain,sleep and weight improvement rate was 63.3％,46.7％,66.7％ and 53.3％ in combination group,which were significantly better than those in control group (30.0％,13.3％,30.0％ and 20.0％),and the difference between the two groups was statistically significant (P ＜ 0.05).The major adverse events were nausea,vomiting,fatigue and drowsiness,mainly of grades Ⅰ ～ Ⅱ.Conclusions S-1 plus thalidomide as second line treatment of pancreatic cancer can prolong the PSF of patients with advanced pancreatic cancer with excellent safety,and patients' quality of life is also improved.

Objective To investigate the effect of three Scutellaria baicalensis extracts (baicalin,baicalein and wogonin) on the apoptosis of a human cutaneous squamous cell carcinoma cell line,SCL-1.Methods Methyl thiazolyl tetrazolium (MTT) assay was performed to detect the proliferation of cultured SCL-1 cells treated with different concentrations (12.5,25,50,75 and 100 μmol/L) of baicalin,baicalein and wogonin for various durations (12,24 and 48 hours).Some SCL-1 cells were treated with baicalin,baicalein and wogonin of 12.5 μ mol/L respectively for 48 hours followed by the detection of cell apoptosis by double staining with annexin V-fluorescein isothiocyanate/propidium iodide in combination with enzyme-linked immunosorbent assay (ELISA),as well as estimation of cell cycle by flow cytometry.The 50％ inhibitory concentration was determined by line regression model and inner insert method,and statistical analysis was carried out by Student's t test,one-way analysis of variance (ANOVA),and Student-Newman-Keuls-q test.Results Baicalin,baicalein and wogonin all inhibited the proliferation of SCL-1 cells in a dose-and time-dependent manner (all P ＜ 0.01).Under the same conditions (treatment concentration and duration),baicalein showed the strongest inhibitory effect on the proliferation of SCL-1 cells,followed by wogonin and baicalin (all P ＜ 0.01).All the Scutellaria baicalensis extracts induced the apoptosis of SCL-1 cells and arrested them in G1-phase.The percentage of cells in G1 phase was 56.37％ ± 2.41％,74.23％ ± 2.02％ and 64.15％ ± 1.87％,and early apoptosis rate was 8.09％ ± 1.02％,24.13％ ± 0.76％ and 14.45％ ± 1.57％,in SCL-1 cells treated with baicalin,baicalein and wogonin of 12.5 μmol/L for 48 hours,respectively,compared to 45.04％ ± 1.93％ and 4.12％ ± 0.29％ in the untreated control cells respectively (F =83.29,186.37,respectively,both P ＜ 0.01).Similarly,there was a downward trend from baicalein to wogonin and baicalin in the effect on cell apoptosis and cell cycle arrest of SCL-1 cells.Conclusions Scutellaria baicalensis can inhibit the growth and induce the apoptosis of SCL-1 cells,which may provide new ideas for the treatment of cutaneous squamous cell carcinoma with traditional Chinese drugs.

Objective To investigate the relationship between the expressions of Twist and clinical pathological parameters in gastric carcinoma,to explore its significance in judging the prognosis of patients,and to analyze the expression of Twist proteins in the epithelial-mesenchymal transition (EMT) phenomenon.Methods Immunohistochemistry was used to detect the expressions of Twist and EMT relative proteins E-cad,N-cad in 120 cases of gastric carcinoma specimens and corresponding adjacent normal tissue.Analysis The relationship between Twist expression and clinical pathological parameters,and the Twist expression and E-cad,N-cad were analyzed.Results In gastric carcinoma,Twist,E-cad,N-cad positive rates were 59.1％(71/120),36.6 ％ (44/120) and 47.5 ％ (57/120),and in adjacent tissues,the positive rate were 17.5 ％ (21/120),93.3 ％ (112/120) and 11.6 ％ (14/120).There were significant differences in each index between tumor tissues and adjacent tissues (P ＜ 0.05).Patients with Twist positive expression showed higher incidence rates of lymph node metastasis (P ＜ 0.05) and distant metastasis (P ＜ 0.05) than those with Twist negative expression.The expression of Twist was significantly correlated in gastric carcinoma accompanied by low expression of E-cad and abnormal high N-cad expression (P ＜ 0.05).Conclusions Compared with the adjacent tissue,the expression of Twist,E-cad and N-cad have significant differences,and the expression of Twist was closely related to the biological characteristics in gastric carcinoma.The expression of Twist in gastric cancer have negative correlation with the EMT relative factor E-cad,while positive correlation with the N-cad.

This study is to investigate the anti-allergic effect of anthocyanidin and to explore its possible mechanism. The experiments of passive cutaneous anaphylaxis reaction (PCA) and colorimetry were used to determine the effect of anthocyanidin on degranulation of mast cells in vivo. For in vitro study, various concentrations of anthocyanidin (100, 50 and 25 micromol x L(-1)) were added to the culture medium of mast cells cultured with 100 microg x L(-1) of dinitrophenyl (DNP) specific IgE overnight. The azelastine (100 micromol x L(-1)) was selected as the positive control. The antigen (DNP-human serum albumin, DNP-HAS)-induced release of degranulation was measured by enzymatic assay, histamine was determined by EIA, and interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) were measured by Western blotting, separately. In addition, the effects of anthocyanidin on phosphorylation of NF-kappaB, p38MAPK and Akt were observed by Western blotting. The results showed that treatments with anthocyanidin (100 and 50 mg x kg(-1)) were followed by a decrease in PCA of rats. Anthocyanidin (100 and 50 micromol x L(-1)) obviously suppressed the degranulation from mast cells, whereas results from anthocyanidin (100 and 50 micromol x L(-1)) group indicated significant inhibitory effect on histamine, the calcium uptake, TNF-alpha, IL-6, phosphorylation of NF-kappaB, p38MAPK and Akt of mast cells induced by antigen. Anthocyanidin may suppress the anaphylactic reaction by inhibiting the action of mast cells. NF-kappaB, p38MAPK and Akt at least in part contribute to this event.