Objective:To assess the rationality of the maximum lesion diameter of 15 mm in prostate imaging reporting and data system(PI-RADS)as a criterion for upgrading a lesion from category 4 to 5 and improve it to enhance the prediction of clinically significant prostate cancer(csPCa).Methods:In this study,the patients who underwent prostate magnetic resonance imaging(MRI)and prostate biopsy at Peking University First Hospital from 2019 to 2022 as a development cohort,and the patients in 2023 as a validation cohort were reviewed.The localization and maximum diameter of the lesion were fully evalua-ted.The area under the curve(AUC)and the cut-off value of the maximum diameter of the lesion to pre-dict the detection of csPCa were calculated from the receiver operating characteristics(ROC)curve.Confounding factors were reduced by propensity score matching(PSM).Diagnostic efficacy was com-pared in the validation cohort.Results:Of the 589 patients in the development cohort,358(60.8％)lesions were located in the peripheral zone and 231(39.2％)were located in the transition zone,and 496(84.2％)patients detected csPCa.The median diameter of the lesions in the peripheral zone was smaller than that in the transition zone(14 mm vs.19 mm,P＜0.001).In the ROC analysis of the maximal diameter on the csPCa prediction,there was no statistically significant difference between the peri-pheral zone(AUC=0.709)and the transition zone(AUC=0.673,P=0.585),and the cut-off values were calculated to be 11.5 mm for the peripheral zone and 16.5 mm for the migrating zone.By calcula-ting the Youden index for the cut-off values in the validation cohort,we found that the categorisation by lesion location led to better predictive results.Finally,the net reclassification index(NRI)was 0.170.Conclusion:15 mm as a criterion for upgrading the PI-RADS score from 4 to 5 is reasonable but too general.The cut-off value for peripheral zone lesions is smaller than that in transitional zone.In the future consideration could be given to setting separate cut-off values for lesions in different locations.

The Hedgehog (HH) signaling pathway plays important roles in gastrointestinal carcinogenesis and the gastrointestinal tumor microenvironment (TME). Aberrant HH signaling activation may accelerate the growth of gastrointestinal tumors and lead to tumor immune tolerance and drug resistance. The interaction between HH signaling and the TME is intimately involved in these processes, for example, tumor growth, tumor immune tolerance, inflammation, and drug resistance. Evidence indicates that inflammatory factors in the TME, such as interleukin 6 (IL-6) and interferon-

Objective:To explore the role of hippocampal γ oscillation abnormality in sepsis-associated encephalopathy (SAE).Methods:Seventy male Sprague-Dawley rats (2-3 months) were randomly (random number) divided into three groups according to the random digital table method: sham, CLP, and CLP + dopamine 4 (D4) receptor agonists RO-10-5824 group. The SAE animal model was established by cecal ligation and puncture (CLP). On day 10-14 after surgery, the open field, novel object recognition, and fear conditioning tests were performed. After that, the hippocampus was collected to measure expressions of parvalbumin (PV) and D4 receptor. In another set of experiment, CA1 local field potential (LFP) were recorded, and the relationship between LFP and time with novel object was analyzed. Independent sample t-test was used for pairwise comparisons, and multiple comparisons were performed by one-way ANOVA, followed by the Tukey multiple comparisons test. Correlation was analyzed using Pearson correlation. Statistical significance was assumed when P<0.05. Results:Compared with the sham group, hippocampal PV (77.54±4.61)%, D4 expression (56.36±3.88)% and γ oscillation power (41.1±8.62)%, object exposure time (36±3) s, new object recognition rate (49±4)%, and scene stiffness time (56±7) s were decreased significantly ( P<0.05). However, RO-10-5824 treatment could increase hippocaml γ oscillation power (92.3±6.7)%, and reverse the decreased new object exposure time (44±3) s and new object recognition rate (63±4)%. Correlation analysis showed that hippocampal γ oscillation power was positively associated with new object exposure time ( r=0.609 2, P=0.015 9). There was no difference in total distance traveled or time spent in the center among groups ( P>0.05). Conclusion:Hippocampal γ oscillation abnormality might play a key role in cognitive impairment associated with SAE.

Objective:To understand the current situation of the construction of occupational health information system in China and put forward countermeasures and suggestions for the construction of occupational health information system.Methods:In November 2019 and April 2020, a cross-sectional survey was conducted on the occupational health information systems of national, provincial and some central enterprises. A total of 57 occupational health information systems were investigated, including 4 national systems, 44 provincial systems and 9 industrial systems. The terminal type, main function, construction type, user classification and main authority, computer terminal structure, data collection mode, data transmission mode, data docking are analyzed.Results:The four national level systems all adopt B/S structure, and all transmit network data through computer terminals. The main data acquisition mode is online acquisition and external system docking. Among the 44 provincial-level systems, 41 (93.18%) were self built systems, 75.00% (33/44) were computer terminals, and 90.91% (40/44) were B/s structures; 17 (38.64%) systems used multiple data acquisition methods; 13.64% (6/44) systems used multiple data transmission methodsand the main way of data transmission method is network report (88.64%, 39/44) ; 84.09% (37/44) of the system network access mode was Internet mode. Among the nine industry systems, 66.67% (6/9) of them deployed servers in the form of self built computer rooms, 77.78% (7/9) of them supported docking and reserved ports; 66.67% (6/9) of them used computer terminals, and 100.00% (9/9) of them used B/S structure; 77.78% (7/9) of them used manual filling for data collection.Conclusion:The construction of occupational health information system in China has many problems, such as scattered and separate construction, and lack of effective data sharing between related systems, it＇s urgent to unify the standard and plan as a whole.

Objective:To understand the current situation of the construction of occupational health information system in China and put forward countermeasures and suggestions for the construction of occupational health information system.Methods:In November 2019 and April 2020, a cross-sectional survey was conducted on the occupational health information systems of national, provincial and some central enterprises. A total of 57 occupational health information systems were investigated, including 4 national systems, 44 provincial systems and 9 industrial systems. The terminal type, main function, construction type, user classification and main authority, computer terminal structure, data collection mode, data transmission mode, data docking are analyzed.Results:The four national level systems all adopt B/S structure, and all transmit network data through computer terminals. The main data acquisition mode is online acquisition and external system docking. Among the 44 provincial-level systems, 41 (93.18%) were self built systems, 75.00% (33/44) were computer terminals, and 90.91% (40/44) were B/s structures; 17 (38.64%) systems used multiple data acquisition methods; 13.64% (6/44) systems used multiple data transmission methodsand the main way of data transmission method is network report (88.64%, 39/44) ; 84.09% (37/44) of the system network access mode was Internet mode. Among the nine industry systems, 66.67% (6/9) of them deployed servers in the form of self built computer rooms, 77.78% (7/9) of them supported docking and reserved ports; 66.67% (6/9) of them used computer terminals, and 100.00% (9/9) of them used B/S structure; 77.78% (7/9) of them used manual filling for data collection.Conclusion:The construction of occupational health information system in China has many problems, such as scattered and separate construction, and lack of effective data sharing between related systems, it＇s urgent to unify the standard and plan as a whole.

Objective:To investigate the prevention effect of nurse-led peer support system on the postpartum posttraumatic stress disorder of primipara.Methods:A total of 74 cases of primipara were randomly divided into experimental group ( n=37) and control group ( n=37). The control group received routine nursing. The experimental group received nurse-led peer support intervention. The postpartum depression and postpartum posttraumatic stress disorder was assessed by using Edinburgh postnatal depression scale (EPDS) and impact of event scale-revised (IES-R) before and after intervention. Results:Before intervention, the socre of EPDS and IES-R was no statistical difference between experimental group and control group ( P>0.05). After intervention, the scores of EPDS and IES-R were significantly decreased in the experiment group [(5.41 ± 0.49) pionts, (16.56 ± 1.36) pionts] compared to the control group [(16.56 ± 1.36) pionts, (19.01 ± 1.98) pionts], the difference was statistically significant ( P<0.05). Conclusion:Nurse-led peer support system can alliviate postpartum depression and posttraumatic stress disorder status and promote the psychological health of primipara.

Objective To investigate the effects of Nod-like receptor protein 3 inhibitor MCC950 on cognitive function in a mouse model of sepsis-associated encephalopathy (SAE).Methods Ninety adult male C57BL/6 mice were randomly (random number) divided into three groups:the sham + saline group (n=20,sham group),CLP + saline group (n=35,CLP group),and CLP + MCC950 group (n=35,MCC950 group).SAE mouse model was established by cecal ligation and puncture (CLP) surgery.Saline (10 mL/kg) or MCC950 (10 mg/kg) was intraperitoneally injected 30 min before surgery and on day 1,2,4 and 6 after surgery according the grouping.Seven days after surgery,six mice were taken from each group.Western blot was used to detect the hippocampal content of NLRP3,apoptosis-associated specklike protein (ASC),interleukin-1β (IL-1β) and IL-18.The number of NLRP3-positive cells in CA 1 region were detected by immunohistochemical analysis.The remaining mice in each group were used for open field and fear conditioning tests 14 days after surgery.One-way analysis of variance was used for inter-group comparison,and SNK-q test was used for pairwise comparison.A P value ＜0.05 was considered statistically significant.Results Compared the MCC950 group with the CLP group,the freezing time of context test was significantly increased [(137±21) s vs (84±15) s,P=0.013],the hippocampal content of NLRP3,IL-1β and IL-18 were significantly reduced (P＜0.01),and the number of NLRP3-immunoreactive cells per mm2 in CA region were significantly decreased (23±5 vs 74±13,P＜0.01).There was no significant changes in protein level of ASC and results of open field tests (P＞0.05).Conclusions MCC950 administration can improve cognitive function in a mouse model of SAE,which is probably due to the inhibition of NLRP3 inflammasome and downstream inflammatory cytokines IL-1β and IL-18.

Background and objective As computed tomography (CT) screening for lung cancer becomes more common in China, so too does detection of pulmonary ground-glass nodules (GGNs). Although anumber of national or international guidelines about pulmonary GGNs have been published,most of these guidelines are produced by respiratory, oncology or radiology physicians, who might not fully understand the progress of modern minimal invasive thoracic surgery, and these current guidelines may overlook or underestimate the value of thoracic surgery in the management of pulmonary GGNs. In addition, the management for pre-invasive adenocarcinoma is still controversial. Based onthe available literature and experience from Shanghai Pulmonary Hospital, we composed this consensus about diagnosis and treatment of pulmonary GGNs. For lesions which are considered as adenocarcinoma in situ, chest thin layer CT scan follow-up is recommended and resection can only be adopt in some specific cases and excision should not exceed single segment resection. For lesions which are considered as minimal invasive adenocarcinoma, limited pulmonary resection or lobectomy is recommended. For lesions which are considered as early stage invasive adenocarcinoma, pulmonary resection is recommend and optimal surgical methods depend on whether ground glass component exist, location, volume and number of the lesions and physical status of patients. Principle of management of multiple pulmonary nodules is that primary lesions should be handled with priority, with secondary lesions taking into account.
.
Adenocarcinoma ; diagnosis ; diagnostic imaging ; surgery ; Adenocarcinoma of Lung ; China ; Consensus ; Hospitals ; Humans ; Lung Neoplasms ; diagnosis ; diagnostic imaging ; surgery ; Physicians ; psychology ; Positron Emission Tomography Computed Tomography ; Practice Guidelines as Topic ; Retrospective Studies ; Solitary Pulmonary Nodule ; diagnosis ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed

Objective To investigate the efficacy of preemptive analgesiawith ultrasound-guided modified dorsal penile nerve block combined ketorolac tromethamine for circumcision in pediatric patients.Methods Forty-five pediatric patients with ASA grade Ⅰ undergoing elective circumcision were randomly divided into 3 groups (n=15 each).The same intravenous compound anesthesia was used in the three groups.The pediatric patients underwent ultrasound-guided modified dorsal penile nerve block with a mixture of 0.1 ml/kg of 0.2% ropivacaine and 0.8% lidocaine before operation in group A and group B.The pediatric patients were given ketorolac tromethamine 1 mg/kg intramuscular injection before operation in group A and group C.The total consumption of propfol and sufentanil, occurrence of intraoperative body movement and respiratory depression, emergence time, time from waking up to going out of PACU and adverse reactions such as postoperative agitation, nausea, vomiting and pruritus were aslo recorded.The requirement for postoperative paracetamol suppositories was recorded.Results Compared with group C, the total consumption of propfol and sufentanil were significantly decreased, incidence of body movement andrespiratory depression were significantly decreased, the emergence time and time from waking up to going out of PACU was significantly shortened, requirement for paracetamol suppositories were significantly decreased in group A and group B(P<0.05).Compared with group B, incidence of requirement for paracetamol suppositories was significantly decreased in group A (P<0.05).No pediatric patients developed postoperative nausea, vomiting, pruritus and incidence of emergence agitation had no statistical difference in the three groups.Conclusion Preemptive analgesia with ultrasound-guided modified dorsal penile nerve block combined ketorolac tromethamine is safe and effective when used for circumcision in pediatric patients, and it has good efficacy of postoperative analgesia.

Outbreaks of pseudorabies (PR) have occurred in southern China since late 2011, resulting in significant economic impacts on the swine industry. To identify the cause of PR outbreaks, especially among vaccinated pigs, 11 pseudorabies virus (PRV) field strains were isolated from Guangdong province during 2013–2014. Their major viral genes (gE, TK, gI, PK, gD, 11K, and 28K) were analyzed in this study. Insertions or deletions were observed in gD, gE, gI and PK genes compared with other PRV isolates from all over the world. Furthermore, sequence alignment showed that insertions in gD and gE were unique molecular characteristics of the new prevalent PRV strains in China. Phylogenetic analysis showed that our isolates were clustered in an independent branch together with other strains isolated from China in recent years, and that they showed a closer genetic relationship with earlier isolates from Asia. Our results suggest that these isolates are novel PRV variants with unique molecular signatures.
Asia ; China* ; Disease Outbreaks ; Genes, Viral ; Herpesvirus 1, Suid* ; Pseudorabies* ; Sequence Alignment ; Swine