Objective To investigate the clinical application value of predicting the severity of acute pancreatitis(AP)based on MRI-T2WI radiomics nomogram.Methods A total of 375 patients with AP were analyzed retrospectively,who were divided into 281 cases in the training group and 94 cases in the validation group according to the ratio of 3∶1.Based on MRI-T2WI image,man-ual segmentation was performed for the pancreatic parenchyma.The radiomics feature were selected by feature extraction and dimen-sionality reduction,the support vector machine(SVM)classifier were used to construct the radiomics model.Logistic regression analysis was used to screen out independent risk factors,and an radiomics nomogram model was constructed in combined with the Radiomics score(Radscore),and the predictive performances of the models were evaluated.Results Receiver operating characteristic(ROC)curve analysis showed that the predictive efficacy of radiomics nomogram model[training group,area under the curve(AUC)=0.893;val-idation group,AUC=0.889]was higher than that of clinical model(training group,AUC=0.799;validation group,AUC=0.809)and radiomics model(training group,AUC=0.814;validation group,AUC=0.823).Conclusion The radiomics nomogram based on MRI-T2WI radiomics features and independent risk factors has high clinical application value for the prediction of AP severity.

Objective:To understand the current state of ethical competence levels of nurses and analyse the factors that influence them, in order to inform the development of targeted training programmes.Methods:This study adopted a cross-sectional survey method and used convenience sampling to select 825 clinical nurses from Tianjin Chest Hospital as the survey objects from July to August, 2023, and a questionnaire survey was conducted using the General Information Questionnaire, the Ethical Competence Scale, Ethical Competence Support Scale, and Ethical Safety Scale.Results:A total of 818 valid questionnaires were retracted. Among the 818 nurses, 48 were males and 770 were females, the age was (33.19 ± 7.40) years. The total score of nurses ′ Ethical Competence, Ethical Competence Support and Ethical Safety were (118.08 ± 19.96), (215.07 ± 32.02), (48.93 ± 7.55) points, all of which were at a high level. The total score of nurses ′ ethical competence were positively correlated with ethical competence support and ethical safety ( r=0.856, 0.830, both P<0.01); multivariate linear regression analysis showed that the department, the level of ethical competence support, and the level of ethical safety were the influencing factors of the level of ethical competence ( t=5.19, 12.35, 3.88, all P<0.01). Conclusions:Nurses ′ ethical competence, ethical competence support, and ethical safety were at a high level, and the department, the level of ethical competence support, and the level of ethical safety were the factors influencing the level of ethical competence. Nursing managers can provide more ethical education and address ethical issues in multiprofessional discussions, strengthen organizational and personal support for nurses ′ ethical competence, improve nurses ′ ethical safety, and help them implement good ethical care.

Objective:To explore the correlation between the triglyceride glucose (TyG) index and the risk of vitamin D deficiency (VDD) in patients with type 2 diabetes (T2DM).Methods:T2DM patients admitted to the Department of Geriatrics, the Second Xiangya Hospital of Central South University from February 2020 to February 2023 were included. We collected general clinical and biochemical data from patients and calculated the TyG index. Divide the study subjects into VDD group and control (CON) group based on serum 25 hydroxyvitamin D [25 hydroxyvitamin D, 25(OH)D] levels, and compare the general clinical characteristics between the two groups; Pearson rank correlation analysis was used to study the correlation between TyG index and 25(OH)D; According to the third percentile of the TyG index, the study subjects were divided into three groups (Q1, Q2, Q3), and logistic regression analysis was used to explore the association between the TyG index and the risk of VDD.Results:This study included 526 patients with T2DM, including 312 males and 214 females, aged 37 to 78 years old. There were 300 VDD patients, accounting for 57.03%, and 226 in the CON group. The TyG index of VDD patients was higher than that of the CON group ( P<0.05), and there was a negative correlation between the TyG index and serum 25(OH)D levels ( P<0.05). Logistic regression analysis showed that compared with the Q1 group, the risk of VDD in Q3 group patients was 2.892 times higher than that in Q1 group ( OR=2.892, 95% CI: 1.865-4.485, P<0.001). After adjusting for age, gender, smoking, obesity, insulin, oral hypoglycemic drugs, statin use, and blood biochemical indicators, the risk of illness in the Q3 group was 2.303 times higher than that in the Q1 group ( OR=2.303, 95% CI: 1.288-4.117, P=0.005). Conclusions:In T2DM patients, the TyG index is negatively correlated with serum 25 (OH) D levels. T2DM patients with high TyG index have an increased risk of VDD, and the TyG index can be used to observe the possibility of VDD occurrence, which is beneficial for early detection of VDD patients.

Objective:To evaluate right heart remodeling and right heart function change after pulmonary resection by echocardiography (ECG) .Methods:A total of 50 patients undergoing pneumonectomy received ECG examination to evaluate right ventricular structure and right heart function change before and after partial pulmonary resection .Re-sults:(1) Compared with before operation , there were no significant changes in right ventricular anterior free wall thickness ,right ventricular ejection fraction on 7d and 30d after operation;(2) Compared with before treatment , there were significant rise in pulmonary artery systolic pressure [PASP ,(20.52 ± 2.46) mmHg vs .(49.65 ± 2.17) mmHg] ,pulmonary artery diastolic pressure [PADP ,(10.82 ± 2.04) mmHg vs .(21.93 ± 1.26) mmHg] and pul-monary artery mean pressure [PAMP ,(13.78 ± 3.67) mmHg vs .(26.67 ± 3.28) mmHg] ,and significant rise in pulmonary vascular resistance [PVR ,(187.69 ± 12.46) dyn .s .cm-1 vs .(368.72 ± 11.94) dyn .s .cm-1 ] on 7d after pulmonary resection , P<0.05 all;all above indexes recovered to normal on 30d after treatment ;(3) Com-pared with before operation ,right ventricular Tei index significantly rose [ (0.36 ± 0.05) vs .(0.69 ± 0.13) , P=0.04] on 7d after operation ,the Tei index recovered to normal on 30d after treatment ,P=0.20. Conclusion:Com-pared with before operation , the PASP ,PADP and PAMP significantly rise on 7d after operation ,they recover to normal on 30d after treatment ;there are no significant change in right ventricular structure .

Objective To investigate the predictive value of coagulation state on the occurrence of no-reflow phenomenon after primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI). Methods A total of 187 consecutive patients with the first AMI underwent PCI within 12h post-onset of symptom. The clinical features and angiographic findings were collected. According to the thrombolysis in myocardial infarction (TIMI) flow grade with related artery and myocardial blush grade(MBG), the patients were divided into the no-reflow group (TIMI ≤ 2, or MBG ≤ 1) and the normal reflow group. Blood samples were taken immediately on admission before coronary angiography. The levels of plasma von Willebrand factor(vWF), P-selectin(Ps) and Tissue factor(TF) were measured by enzyme-linked immunosorbent assay. Results 23.5%patients of 187 patients developed the no-reflow phenomenon. The plasma level of vWF and Ps and TF were (4 574 ± 1 677) U/L and (16.8 ± 5.1) ng/mL and (283 ± 81) ng/L in the no-reflow group, and (4 074 ± 1 063) U/L and (14.8 ± 4.2) ng/mL and (254 ± 54) ng/L in the normal group, with significant differences (P = 0.020, 0.010 and 0.007, respectively). The hypercoagulation patients in the no-reflow group were much more than patients in the normal reflow group (P = 0.003). Multivariate stepwise logistic regression analysis revealed that hypercoagulation was independent predictor of no-reflow phenomenon ( OR = 2 . 361 , 95%CI 1 . 083 ~ 5 . 148 , P = 0.031). Conclusion The high levels of plasma vWF, Ps and TF present the evidences of hypercoagulation, which might imply the development of no-reflow after PCI.

Objective To discuss the expression of mitochondrial phosphate carrier (PiC) in myocardial injury caused by doxorubicin, and the protective mechanism of curcumin in myocardial injury caused by doxorubicin .Methods 60 adult SD rats were randomly divided into three groups:control group, doxorubicin group, curcumin+doxorubicin group.Control group was injected 0.9% sodium chloride injection (2.5 mL/kg) by rat tail vein injection, one times per week, 6 times in total.Doxorubicin group was injected with 0.5 mg/mL doxorubicin which diluted with 0.9% sodium chloride injection by rat tail vein injection, and the dosage was 1.25 mg/kg(about 0.5 mL).Curcumin+doxorubicin group was injected the same dose doxorubicin as doxorubicin group.After that, 12 mg/mL curcumin injection was added with 30mg/kg by rat tail vein injection.one times per week, 6 times in total.The glutathione peroxidase (Gpx) assay kit, superoxide dismutase (SOD) assay kit and malondialdehyde (MDA) detection kits were used to test the oxidative stress levels in myocardial cells of SD rats.Flow cytometry is used to test the SD rat cardiomyocytes transferred level. Application of Western blot and Real-time PCR technology were used to detect expression of PiC.ResuIts The Gpx activity and SOD vitality in myocardial cells of SD rats in curcumin with doxorubicin group all significantly increased compare with those of doxorubicin group, and all decreased compare with those of control group.But the rate of myocardial apoptosis, content of malondialdehyde and expression of Slc25a3 gene and PiC protein from myocardial cells of SD rats from curcumin with doxorubicin group all significantly increased compare with those of control group , and all decreased compare with those of doxorubicin group.ConcIusion Doxorubicin could increase the expression of PiC in myocardial mitochondria, the levels of oxidative stress, and the apoptosis of myocardial cells, and the effect of curcumin could be effective against the injury induced by doxorubicin .

Objective: To explore the correlation between serum level of high molecular weight adiponectin (HMW-ADPN) and arteriosclerosis. Methods: Clinical data of 87 middle-aged and aged people living in home, who underwent health examinations in Xiangya second hospital from Jan 2011 to Dec 2011, were collected. According to carotid-femoral pulse wave velocity (cf-PWV) = 9 m/s, they were divided into group A (cf-PWV<9 m/s, n=21) and group B (cf-PWV≥9 m/s, n=66). Blood pressure, blood lipid, blood glucose etc. were measured and compared between two groups. Results: Compared with group A, there were significant rise in blood pressure, levels of low density lipoprotein cholesterol, triglyceride and total cholesterol, and significant reduction in levels of high density lipoprotein cholesterol (HDL-C), serum total ADPN and HMW-ADPN in group B, P<0.05 or <0.01. Multiple regression analysis indicated that serum HMW-ADPN (B= - 4.469，P=0.011), total ADPN ((B= - 3.965，P=0.012), HDL-C（B= - 2.077，P=0.015) and systolic blood pressure levels (B= 0.045，P=0.045) were independent predictors of cf-PWV. Conclusion: Serum high molecular weight adiponectin and total adiponectin levels may be protective factors against arteriosclerosis. Its role in predicting occurrence and development of arteriosclerosis is worthy of further study.

Objective: To explore diagnostic value of dynamic electrocardiogram (DCG) on coronary artery disease. Methods: A total of 100 inpatients with “angina pectoris” history from our hospital were enrolled and received 24h DCG measurement. The DCG examination results were compared with those of coronary angiography (CAG) and analyzed then. Results: Among the 100 patients, there were 85 patients with positive DCG, including 70 cases with positive CAG and 15 cases with negative CAG; and 15 patients with normal (negative) DCG, including 10 cases with negative CAG and five cases with positive CAG. With CAG as golden standard, sensitivity, specificity, positive predictive value (accuracy) and negative predictive value of DCG in diagnosis of coronary heart disease were 93.3%, 40.0%, 82.4% and 66.7% respectively. Partial patients had “angina pectoris”, no stenosis in CAG but there’s slow blood flow. Conclusion: Dynamic electrocardiography is one of important measuring methods diagnosing coronary heart disease. It is simple, practical, safe, economic and appropriate for wide application in clinic, but its specificity is just 40.0%, so coronary heart disease cannot be excluded in negative patients.

Objective: To study the effect of curcumin on cardiac remodeling and heart function change induced by adriamycin in rats. Methods: A total of 50 SD rats were randomly divided into blank control group (n=10), adriamycin group (n=20) and curcumin intervention group (n=20). General conditions of rats, including weight, hair color, diet and activity capacity, were observed. Left ventricular ejection fraction (LVEF), left ventricular fractional shortening (LVFS) and left ventricular end-diastolic dimension (LVEDd) were observed by echocardiography. Rat heart was weighed and levels of cardiac collagen type Ⅰ and Ⅲ were observed using immunohistochemistry method. Results: Compared with blank control group after experiment, there were significant increase in heart weight [(168.53±26)mg vs. (208.34±31)mg], heart weight/body weight [(0.36±0.06) vs. (0.52±0.08)], and significant decrease in body weight [(469.27±34)g vs. (428.47±45)g]; significant increase in LVEDd [(4.87±0.19)mm vs. (7.49±0.83)mm], significant decrease in LVEF [(69.53±6.25)% vs. (41.46±4.38)%] and LVFS [(45.83±3.79)% vs. (17.25±2.92)%] in adriamycin group, P<0.05 all, significant increase in expression rates of collagen type Ⅰ and Ⅲ, P<0.01.Compared with adriamycin group, there were significant increase in body weight (452.46±38)g, significant decrease in heart weight (178.73±38)mg, heart weight/body weight (0.39±0.07); significant decrease in LVEDd (5.96±0.65)mm and significant increase in LVEF (53.12±5.43)% and LVFS (36.57±3.66)%, P <0.05 all; significant decrease in expression rates of collagen type Ⅰ and Ⅲ in curcumin group, P <0.01. Conclusion: Curcumin can improve cardiac remodeling and heart function induced by adriamycin in rats.

Objective To assess the feasibility of characterizing pleural fluid on the basis of spectral imaging features utilizing spectral CT imaging. Methods Gemstone spectral imaging(GSI) was used to examine 20 pleural fluids filled tubes (11 exudates and 9 transudates ) following diagnostic thoracentesis. Effusions were classified as transudates or exudates using laboratory markers based on Light criteria. CT values on 140 kVp QC image were compared between two groups. Using GSI viewer, various CT spectral imaging parameters (CT values on different energy level, effective-Z, iodine-water concentration,calcium-water concentration and calcium-fat concentration ) were calculated and compared between two groups. The difference of these spectral characteristic parameters was evaluated statistically by independent-samples t test. Results According to Light criteria, the mean CT value on QC image of exudates [ ( 19. 56 ±4. 10) HU ] was higher than that of transudates [ ( 13.44 ±3.46) HU] (t =3.002,P =0. 010).Difference of CT value was found more obvious in the lower keV. On 40 keV images, the difference of CT value of two groups was the largest, the mean value of exudates [ (47.49 ± 14. 60) HU ] was significantly higher than that of transudates[ ( 19. 76 ± 6. 85) HU ] ( t = 5.520, P = 0. 000). While On 140 keV, the mean CT value were (9.76 ±4. 16)and (6.22 ±3. 17) HU and the difference of the two group has no statistically significant difference (t =2. 107,P =0. 050). The mean slope rates of exudates (0.51 ± 0.23)was significantly larger than that of transudates (0. 18 ± 0. 08 ) ( t= 4. 287, P = 0. 001 ). The effective-Z (7. 89 ± 0. 16), iodine-water concentration [ (5. 74 ± 1.28 ) g/L], calcium-water concentration[ (7. 89 ±1.78) g/L] and calcium-fat concentration [ (25.95 ± 1.74) g/L] of exudates were significantly higher than those of transudates [ 7.67 ± 0. 07, ( 1.70 ± 0. 95 ) g/L, (2. 53 ± 1.37 ) g/L, ( 20. 82 ± 1.40 ) g/L ] ( t = 4. 080,6. 998,6. 546,6. 301 ,P ＜ 0. 05 ). Conclusions The spectral curve and spectral imaging parameters of exudates is found to be different from transudates. The low energy spectral imaging plays an important role in the characterization of pleural fluid. Gemstone spectral CT imaging provides a new multiparameter method to differentiate transudates and exudates.