Objective To propose a method for abdominal multi-organ segmentation assisted by multi-phase CT synthesis.Methods Multi-phase CT synthesis for synthesizing high-quality CT images was used to increase the information details for image segmentation.A transformer block was introduced to help to capture long-range semantic information in cooperation with perceptual loss to minimize the differences between the real image and synthesized image.Results The model was trained using multi-phase CT dataset of 526 total cases from Nanfang Hospital.The mean maximum absolute error(MAE)of the synthesized non-contrast CT,venous phase contrast-enhanced CT(CECT),and delay phase CECT images from arterial phase CECT was 19.192±3.381,20.140±2.676 and 22.538±2.874,respectively,which were better than those of images synthesized using other methods.Validation of the multi-phase CT synthesis-assisted abdominal multi-organ segmentation method showed an average dice coefficient of 0.847 for the internal validation set and 0.823 for the external validation set.Conclusion The propose method is capable of synthesizing high-quality multi-phase CT images to effectively reduce the errors in registration between different phase CT images and improve the performance for segmentation of 13 abdominal organs.

Objective To propose a method for abdominal multi-organ segmentation assisted by multi-phase CT synthesis.Methods Multi-phase CT synthesis for synthesizing high-quality CT images was used to increase the information details for image segmentation.A transformer block was introduced to help to capture long-range semantic information in cooperation with perceptual loss to minimize the differences between the real image and synthesized image.Results The model was trained using multi-phase CT dataset of 526 total cases from Nanfang Hospital.The mean maximum absolute error(MAE)of the synthesized non-contrast CT,venous phase contrast-enhanced CT(CECT),and delay phase CECT images from arterial phase CECT was 19.192±3.381,20.140±2.676 and 22.538±2.874,respectively,which were better than those of images synthesized using other methods.Validation of the multi-phase CT synthesis-assisted abdominal multi-organ segmentation method showed an average dice coefficient of 0.847 for the internal validation set and 0.823 for the external validation set.Conclusion The propose method is capable of synthesizing high-quality multi-phase CT images to effectively reduce the errors in registration between different phase CT images and improve the performance for segmentation of 13 abdominal organs.

Baby warm box belongs to one of the high-risk medical equipment of newborn life support class,the National Health Commission has formulated specific management guidelines for the daily use disinfection of baby warm box.At present,the baby warm box is generally sterilized by manual wiping of chemical disinfection liquid,which has shortcomings such as high labor intensity,low work efficiency,blind disinfection area,and chemical pollution caused by secondary residue of disinfection liquid.Ozone,as a broad spectrum high-efficiency disinfectant,has many significant advantages.Ozone disinfection has been widely used in various fields,but its inherent instability hinders transport and storage,necessitating professional devices for on-site preparation and other characteristics.These characteristics limit the use of ozone disinfection for baby warm box promotion and application.Nevertheless,some scholars have proposed the application report of bed unit ozone sterilizers and disinfection devices in the infant incubator.The study found that these two methods in practical application not only have difficult operation and control of disinfection quality but also change the original safety structure inside the infant warm box.In response,Guidong People's Hospital of Guangxi Zhuang Autonomous Region engineers designed an external injection infant incubator disinfection device and obtained the National Utility Model Patent of China(ZL 2019 2 0520907.9).The disinfection device is mainly composed of a timer,electronic ozone generator,gas supply pipeline and transfer interface,by setting the electronic ozone generator in the safe position at the bottom of the baby warm box,and then through the pipeline to the ozone generator generated by the ozone gas into the box interior to complete the disinfection process.The utilization of ozone effectively ensures the safe disinfection of the infant warm box,thereby holding significant clinical value.

Most patients with initial diagnosed lung cancer are at advanced ages.125I seeds implantation for treating lung cancer has advantages of high intratumoral dose and low radiation damage to surrounding tissue,especially suitable for elderly patients not able to tolerate surgery nor external radiotherapy.The efficacy and prospects of 125I seeds implantation for treating middle-late stage lung cancer in elderly patients were reviewed in this article.

Based on the theoretical reflection on the reflective function of medical records,the important findings in the practice of medical records writing in the field of palliative care,and conceptual analysis of narrative medicine tools,combined with empirical investigation materials and analysis,this paper focused on the practice of medical records writing for reflection and research.The main contents include defining the concept of narrative medical records,which are medical records used in clinical practice that incorporate narrative content;clarifying their characteristics and functions at different levels;and exploring practical paths for their application in clinical practice.Based on an in-depth exploration of the uniqueness of narrative medicine practice at Peking Union Medical College,it also emphasized the necessity of writing medical records with narrative thinking.Specifically,it focused on using narrative thinking and forms to enhance the improvement of current medical records writing,and further sought a general framework and multiple possibilities for narrative medicine clinical pathways.

The correlation between hearing loss (HL) and physical performance in patients receiving maintenance hemodialysis (MHD) remains poorly investigated. This study explored the association between HL and physical performance in patients on MHD. Methods: This multicenter cross-sectional study was conducted between July 2020 and April 2021 in seven hemodialysis centers in Shanghai and Suzhou, China. The hearing assessment was performed using pure-tone average (PTA). Physical performance was assessed using the Timed Up and Go Test (TUGT), handgrip strength, and gait speed. Results: Finally, 838 adult patients (male, 516 [61.6%]; 61.2 ± 2.6 years) were enrolled. Among them, 423 (50.5%) had mild to profound HL (male, 48.6% and female, 53.4%). Patients with HL had poorer physical performance than patients without HL (p < 0.001). TUGT was positively correlated with PTA (r = 0.265, p < 0.001), while handgrip strength and gait speed were negatively correlated with PTA (r = –0.356, p < 0.001 and r = –0.342, p < 0.001, respectively). Physical performance in patients aged <60 years showed significant dose-response relationships with HL. After adjusting for confounders, the odds ratios (95% confidence intervals) for HL across the TUGT quartiles (lowest to highest) were 1.00 (reference), 1.15 (0.73–1.81), 1.69 (1.07–2.70), and 2.87 (1.69–4.88) (p for trend = 0.005). Conclusion: Lower prevalence of HL was associated with a faster TUGT and a stronger handgrip strength in patients on MHD.

Central venous pressure (CVP) reflects the comprehensive condition of effective blood volume, cardiac function and vascular tone. Clinical monitoring of CVP can indirectly understand and evaluate the dynamic changes of blood volume in patients, and provide a reference for patients to venous fluid. At present, the traditional manual measurement method is widely used for measurement, which has some shortcomings such as zero shift, cumbersome operation (requires two health care workers to cooperate). In order to overcome the above problems, the author invented a new fixable CVP measurement tool and obtained the national utility model patent (ZL 2021 2 1451705.7). The tool is mainly composed of a base plate, a movable frame and a measuring department, etc. When used, the base plate is placed into the back of the patient and pressed and fixed, the movable frame is adjusted, the zero point is found, and the measurement data is read from the measuring department. It has the advantages of simple and convenient operation, small measurement error, wide applicability (different body types) and so on, which is suitable for clinical promotion.

Objective:To explore the application effect of anesthesia management based on cerebral oxygen saturation monitoring in elderly non-small cell lung cancer (NSCLC) radical surgery and its impact on patient cognitive function.Methods:Ninety elderly NSCLC patients who were treated at the Sixth Affiliated Hospital of South China University of Technology from June 2022 to January 2023 were selected. The patients were divided into an observation group ( n=45) and a control group ( n=45) using the envelope method. Both groups underwent radical lung cancer surgery under general anesthesia, while the control group received routine anesthesia management and the observation group received anesthesia management based on cerebral oxygen saturation monitoring. The surgical time, intraoperative blood loss, anesthesia time, remifentanil dosage, and propofol dosage were observed in two groups. At the same time, differences in serum interleukin-6 (IL-6), C-reactive protein (CRP), procalcitonin (PCT), and other levels were compared between the two groups. Results:There was no statistically significant difference in surgical time, intraoperative blood loss, anesthesia time, and remifentanil dosage between the two groups (all P>0.05); The dosage of propofol in the observation group was (880.41±41.06)mg, significantly lower than that in the control group ( P<0.05). The mean arterial pressure (MAP) and heart rate (HR) in the observation group were significantly higher than those in the control group at 5 minutes (T 1) and 30 minutes (T 2) after anesthesia (all P<0.05); The local cerebral oxygen saturation (rSO 2) and bispectral index (BIS) of the observation group at T 1, T 2, and postoperative (T 3) were significantly higher than those of the control group (all P<0.05). The serum levels of IL-6, CRP, PCT, tumor necrosis factor α (TNF-α), and S-100b in the observation group at 24 hours postoperatively were (13.36±1.22)mg/L, (10.08±1.12)ng/L, (0.94±0.15)ng/ml, (11.15±1.26)ng/L, and (1 445.15±180.05)ng/L, respectively, significantly lower than those in the control group (all P<0.05). The MMSE score of the observation group at 24 hours post surgery was (25.78±1.02), significantly higher than that of the control group ( P<0.05). The incidence of postoperative cognitive impairment in the observation group and the control group was 4.44%(2/45) and 8.89%(4/45), respectively, with no statistically significant difference ( P=0.673). Conclusions:Anesthesia management based on cerebral oxygen saturation monitoring has a good application effect in elderly NSCLC radical surgery, with small fluctuations in patient hemodynamic indicators, which can inhibit inflammatory factor levels and have a mild impact on postoperative cognitive function.

Objective: To describe the distribution characteristics of tea consumption in adult twins recruited in the Chinese National Twin Registry (CNTR) and provide clues to genetic and environmental influences on tea consumption. Methods: Enrolled in CNTR during 2010-2018, 25 264 twin pairs aged 18 years and above were included in subsequent analysis. Random effect models were used to estimate tea consumption in the population and regional distribution characteristics. The concordance rate of the behavior and difference in consumption volume of tea within pairs were also described. Results: The mean age of all subjects was (35.38±12.45) years old. The weekly tea consumers accounted for 17.0%, with an average tea consumption of (3.36±2.44) cups per day. The proportion of weekly tea consumers was higher among males, 50-59 years old, southern, urban, educated, and the first-born in the twin pair (P<0.05), and lower among unmarried individuals (P<0.001). Within-pair analysis showed that the concordance rate of tea consumption of monozygotic (MZ) twins was higher than that of dizygotic (DZ) twins and the overall heritability of tea consumption was 13.45% (11.38%-15.51%). Stratified by the characteristics mentioned above, only in males, the concordance rate of MZ showed a tendency to be greater than that of DZ (all P<0.05). The differences in consumption volume of tea within twin pairs were minor in MZ among males (P<0.05), while the differences were not significant in female twins. Conclusion: There were discrepancies in the distribution of tea consumption among twins of different demographic and regional characteristics. Tea consumption was mainly influenced by environmental factors and slightly influenced by genetic factors. The size of genetic factors varied with gender, age, and region, and gender was a potential modified factor.
Adult ; China ; Diet ; Female ; Humans ; Male ; Middle Aged ; Tea ; Twins, Dizygotic ; Twins, Monozygotic ; Young Adult

Osteoporotic vertebral compression fracture (OVCF) can lead to lower back pain and may be even accompanied by scoliosis, neurological dysfunction and other complications, which will affect the daily activities and life quality of patients. Vertebral augmentation is an effective treatment method for OVCF, but it cannot correct unbalance of bone metabolism or improve the osteoporotic status, causing complications like lower back pain, limited spinal activities and vertebral refracture. The post-operative systematic and standardized rehabilitation treatments can improve curative effect and therapeutic efficacy of anti-osteoporosis, reduce risk of vertebral refracture, increase patient compliance and improve quality of life. Since there still lack relevant clinical treatment guidelines for postoperative rehabilitation treatments following vertebral augmentation for OVCF, the current treatments are varied with uneven therapeutic effect. In order to standardize the postoperative rehabilitation treatment, the Spine Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized relevant experts to refer to relevant literature and develop the "Guideline for postoperative rehabilitation treatment following vertebral augmentation for osteoporotic vertebral compression fracture (2022 version)" based on the clinical guidelines published by the American Academy of Orthopedic Surgeons (AAOS) as well as on the principles of scientificity, practicality and advancement. The guideline provided evidence-based recommendations on 10 important issues related to postoperative rehabilitation treatments of OVCF.