Objective:To explore the therapeutic characteristics of population with gout achieving treat-to-target (T2T) indicators through real-world research and evaluate their safety.Methods:A total of 3 287 patients diagnosed with gout by rheumatologists in 21 first-class tertiary hospitals in 10 provinces, municipalities, and autonomous regions in China from January 2015 to December 2021 were included in this polycentric cross-sectional study. The database included patients′ general information, disease characteristics, and clinical application of traditional Chinese and Western medicine treatment measures. SPSS and Excel software were used for data analysis. Frequency analysis, cluster analysis, and factor analysis were used to summarize the characteristics and rules of treatment measures for patients with gout who achieved the target after treatment. The occurrence of adverse events (AE) was recorded during treatment.Results:After treatment, 691 visits (7%) achieved the serum urate (SUA) target, and the most frequent use of urate-lowering therapy (ULT) was febuxostat, followed by benzbromarone. The most common treatment options were following: GroupⅠ: traditional Chinese medicine (TCM) decoction-TCM external treatment-physical exercise-proprietary Chinese medicine; GroupⅡ: ferulic acid-nonsteroidal anti-inflammatory drugs (NSAIDs); Group Ⅲ: allopurinol-sodium bicarbonate-benzbromarone; Group Ⅳ: glucocorticoid-colchicine; Group Ⅴ: febuxostat. A total of 5 898 visits (60%) chieved manifestations of joint pain VAS scores target, and the most frequently used drug to control joint symptoms was NSAIDs. The frequency of use of drugs to control joint symptoms were 2 118 times (usage rate reached 35.9%), while the frequency of ULT were 2 504 times (usage rate reached 42.5%), which was higher than the joint symptom control drug. The most common treatment options were following: Group Ⅰ: proprietary Chinese medicine-TCM decoction-TCM external treatment-physical exercise; Group Ⅱ: NSAIDs-colchicine hormones; Group Ⅲ: allopurinol, Group Ⅳ: benzbromarone; Group Ⅴ: febuxostat. A total of 59 adverse events occurred during treatment.Conclusion:The proportions of gout patients who reach target serum urate level & good control of joint symptoms are both very low, and ULT and anti-inflammatory prescription patterns are very different from international guidelines, so it is necessary to strengthen the standardized management of gout patients. At the same time, life intervention measures account for a certain proportion of the treatment plans for the T2T population, and further exploration is needed.

Objective: To investigate nutrition literacy among parents of students in Bengbu, China, and examine their awareness of school lunches and satisfaction, so as to provide a basis for improving students nutrition. Methods: Using a random cluster sampling method, this study carried out a survey among parents of students in grade 2, grade 5, and grade 8 from four primary and middle schools in the central and surrounding urban areas of Bengbu. A total of 2 051 parents were surveyed. Results: The qualified rate of nutritional knowledge was 13.0% and the qualified rate of nutritional behavior was 63.0%. The qualified rate of nutritional knowledge behavior was 25.1%. The proportion of breakfasts consisting of at least three food groups was 28.3%. Nutritional knowledge was largely acquired through the Internet, accounting for 54.6%. The convenience of school lunches was identified as the main reason that parents opted for the school lunch program (86.7%). Parents satisfaction with school lunches was 56.8%. Conclusion It is necessary to strengthen the nutritional knowledge education of parents, and to enhance communication between schools and parents, as well as between parents and children.

Objective:To compare the difference of low-level assisted ventilation and T-piece method on respiratory mechanics of patients with invasive mechanical ventilation during spontaneous breathing trial (SBT) within 3 days before extubation.Methods:A retrospective observational study was conducted. Twenty-five patients with difficulty in weaning or delayed weaning from invasive mechanical ventilation who were admitted to department of critical care medicine of the First Affiliated Hospital of Guangzhou Medical University from December 2018 to June 2020, and were in stable condition and entered the weaning stage after more than 72 hours of invasive mechanical ventilation were studied. A total of 119 cases of respiratory mechanical indexes were collected, which were divided into the low-level assisted ventilation group and the T-piece group according to the ventilator method and parameters used during the data collection. The different ventilation modes related respiratory mechanics indexes such as the esophageal pressure (Pes), the gastric pressure (Pga), the transdiaphragmatic pressure (Pdi), the maximum Pdi (Pdimax), Pdi/Pdimax ratio, the esophageal pressure-time product (PTPes), the gastric pressure-time product (PTPga), the transdiaphragmatic pressure-time product (PTPdi), the diaphragmatic electromyography (EMGdi), the maximum diaphragmatic electromyography (EMGdimax), PTPdi/PTPes ratio, Pes/Pdi ratio, the inspiratory time (Ti), the expiratory time (Te) and the total time respiratory cycle (Ttot) at the end of monitoring were recorded and compared between the two groups.Results:Compared with the T-piece group, Pes, PTPes, PTPdi/PTPes ratio, Pes/Pdi ratio and Te were higher in low-level assisted ventilation group [Pes (cmH 2O, 1 cmH 2O = 0.098 kPa): 2.84 (-1.80, 5.83) vs. -0.94 (-8.50, 2.06), PTPes (cmH 2O·s·min -1): 1.87 (-2.50, 5.93) vs. -0.95 (-9.71, 2.56), PTPdi/PTPes ratio: 0.07 (-1.74, 1.65) vs. -1.82 (-4.15, -1.25), Pes/Pdi ratio: 0.17 (-0.43, 0.64) vs. -0.47 (-0.65, -0.11), Te (s): 1.65 (1.36, 2.18) vs. 1.33 (1.05, 1.75), all P < 0.05], there were no significant differences in Pga, Pdi, Pdimax, Pdi/Pdimax ratio, PTPga, PTPdi, EMGdi, EMGdimax, Ti and Ttot between the T-piece group and the low-level assisted pressure ventilation group [Pga (cmH 2O): 6.96 (3.54,7.60) vs. 7.74 (4.37, 11.30), Pdi (cmH 2O): 9.24 (4.58, 17.31) vs. 6.18 (2.98, 11.96), Pdimax (cmH 2O): 47.20 (20.60, 52.30) vs. 29.95 (21.50, 47.20), Pdi/Pdimax ratio: 0.25 (0.01, 0.34) vs. 0.25 (0.12, 0.41), PTPga (cmH 2O·s·min -1): 7.20 (2.54, 9.97) vs. 7.97 (5.74, 13.07), PTPdi (cmH 2O·s·min -1): 12.15 (2.95, 19.86) vs. 6.87 (2.50, 12.63), EMGdi (μV): 0.05 (0.03, 0.07) vs. 0.04 (0.02, 0.06), EMGdimax (μV): 0.07 (0.05, 0.09) vs. 0.07 (0.04, 0.09), Ti (s): 1.20 (0.95, 1.33) vs. 1.07 (0.95, 1.33), Ttot (s): 2.59 (2.22, 3.09) vs. 2.77 (2.35, 3.24), all P > 0.05]. Conclusions:When mechanically ventilated patients undergo SBT, the use of T-piece method increases the work of breathing compared with low-level assisted ventilation method. Therefore, long-term use of T-piece should be avoided during SBT.

Objective    To investigate the clinical value of 3D CT combined with CT-guided Hookwire for localizing small pulmonary nodules in thoracoscopic pulmonary segmentectomy. Methods    From December 2017 to February 2019, 39 patients received thoracoscopic pulmonary segmentectomy in our hospital, including 14 males and 25 females with a mean age of 51.33±11.17 years. Before operation, we used Mimics Medical 20.0 to re-establish the anatomy of lung and locate the small pulmonary nodules with Hookwire guided by CT. Based on the position of Hookwire needle, 3D CT images and simulated surgical methods, thoracoscopic pulmonary segmentectomy was performed accurately. Results    The surgery was successfully completed in 39 patients without a transfer to open procedure. The mean operation time, mean intraoperative blood loss, mean postoperative hospital stay, mean thoracic tube drainage time were 148.97±28.56 min, 27.95±17.57 mL, 6.95±1.68 d, 4.21±1.95 d, respectively. Postoperative complications occurred in 5 patients (12.82%), including atrial fibrillation in 1, pulmonary infection in 1, chylothorax in 1, intrathoracic hemorrhage in 1 and pneumothorax in 1. All actual surgical margins were larger than 3.0 cm. Conclusion    The application of preoperative 3D CT combined with CT-guided Hookwire to localize small pulmonary nodules is helpful for accurate anatomical segmental resection of the lung, making the operation safe .

Objective:To understand the function of diaphragm and analyze the clinical factors affecting the function of diaphragm by measuring twitch tracheal pressure (TwPtr) in patients with mechanical ventilation and in the weaning phase.Methods:Patients with more than 48 hours of invasive mechanical ventilation admitted to the department of critical care medicine of the First Affiliated Hospital of Guangzhou Medical University from December 2015 to March 2017 were enrolled. After the patient entered the weaning stage, TwPtr of patients was monitored by two-way non repetitive automatic respiratory trigger device, the effects of duration of mechanical ventilation, severe pulmonary infection, sedative application and chronic obstructive pulmonary disease (COPD) on weaning were analyzed.Results:A total of 62 patients were included, of which 45 were male and 17 were female. The average age was (66.8±11.7) years old. Twenty-three cases had severe pneumonia. The absolute value of TwPtr in severe pneumonia group was lower than that in non-severe pneumonia group [cmH 2O (1 cmH 2O = 0.098 kPa): 10.40±5.81 vs. 14.35±5.22, P = 0.021]. However, there was no significant difference in the duration of mechanical ventilation between the severe pneumonia group and non-severe pneumonia group [days: 26 (17, 43) vs. 15 (11, 36), P = 0.091]. In 62 patients with mechanical ventilation, there was a negative correlation between TwPtr and duration of mechanical ventilation ( r = 0.414, P = 0.002), there was also a negative correlation between the duration of mechanical ventilation and TwPtr after the assessment of diaphragm function ( r = 0.277, P = 0.039). There was a linear relationship between TwPtr and sedatives ( r = 0.220, P = 0.040), but there was no correlation between TwPtr and COPD ( r = -0.178, P = 0.166). Conclusions:For patients in the weaning stage of mechanical ventilation, severe pulmonary infection is one of the factors that affect the diaphragm dysfunction. There is a certain correlation between the diaphragm dysfunction and the use of sedatives.

This article summarized the technique research and application status of near-infrared spectroscopy (NIRS), in order to explore hypoxia,qi-deficiency and their connections with typical symptoms. It also discussed NIRS acquired oxygen saturation (SaO2) and its relevant means and methods for information quantification ofqi-deficiency. The accurate obtained SaO2 value was applied in the association with the strength of chest distress in the subjective sensation due toqi-deficiency. According to current data, the normal value,qi-deficiency degree and uncomfortable degree of subjective sensation among patients of different altitudes and ages were summarized. It can be applied to assist TCM physicians in the quick quantification of qi-deficiency.

AIM: To investigate the association of osteoprotegerin ( OPG) gene single nucleotide polymor-phisms (SNPs), 163A/G (rs3102735) and 245T/G (rs3134069), with susceptibility to rheumatoid arthritis (RA) in Chinese Han population .METHODS:A total of 205 patients with RA and 171 healthy control subjects were enrolled into this study.Genotyping was performed by polymerase chain reaction-based restriction fragment length polymorphism and subsequently confirmed by DNA sequencing .Odds ratio ( OR) and 95%confidence intervals ( CI) were calculated for the risk genotypes and alleles .RESULTS: OPG gene polymorphisms 163A/G and 245T/G were conformed to the Hardy-Weinberg equilibrium .The statistical differences in the genotypes of AA , AG and GG at 163A/G locus were found in RA and controls.The G allele was associated with an increased risk of RA , with OR of 1.219 (95%CI:1.066~2.339).No significant difference was observed between RA group and control group with respect to genotypic and allelic frequencies of OPG gene 245T/G (P>0.05).CONCLUSION:The OPG gene 163A/G SNP may be associated with RA susceptibility , and G allele may be the risk factor for developing RA .

Objective To evaluate the use of Thymidine Kinase 1(TK1)in serum as proliferating tumor marker for gas-tric carcinoma and monitoring marker for the response to operation. Methods Serum level of TK1 expression were de-tected with sensitive chemiluminescence dot-blot assay in were available to detect the level of serum TK1 in 35 cases of normal healthy subject and 68 cases of patients with gastric carcinoma, compared with 43 cases of patients with gastric carcinoma pre-and post-operation. Results The level of serum TK1 were elevated in all subgroups of patients with gastric carcinoma compared to the normal healthy subject(P<0.01),serum TK1 was correlated with TNM stage and histological grade,and not with sex and age; the serum TK1 level in stage Ⅳwas higher in comparison with stage Ⅲ,in stage Ⅲit was higher than that in stage II, in stage IIit was higher than that in stage Ⅰ, and in stage Ⅰit was higher than that in normal healthy subject (P<0.01-0.05); Being lower in the well differentiated and moderately dif-ferentiated than the poorly differentiated (P<0.01-0.05), the level of serum TK1 was higher in the cases of poorly differentiated adenocarcinoma, signet ring cell carcinoma and mucoid adenocarcinoma than those in the cases of well differentiated and moderately differentiated adenocarcinoma (P<0.05), the serum TK1 levels remarkably reduced in patients with gastric carcinoma after operation(P<0.01). Conclusion Detection the level of serum TK1 may be larger clini-cal value for cancer diagnosis,predict disease progression and the curative effect in patients with gastric carcinoma.

Objective To compare the effort intensities in comprehensive quality development of military medical undergraduates of different sorts and to discuss its improvement.Methods Comprehensive quality of undergraduates of 2010 grade (630 persons including 16 cadres) was assessed by comprehensive quality assessment index system.Based on data envelopment analysis,ratio of actual output (comprehensive quality development) against ideal value was taken as progress effectiveness to reflect the comprehensive development.SPSS 16.0 software was used for statistical processing and analysis.Score of each quality was analyzed and nondimensionalize was performed.Undergraduates' progress effectiveness was compared using analysis of variance.Results In September 2011,progress effectiveness of undergraduates without military status was higher than that of soldiers in comprehensive quality,ideology and morality,science,culture,profession,psychological quality and basic ability (F =34.659,49.234,119.273,12.641,103.814,65.105,P ＜ 0.001).Progress effectiveness in the former was higher than that of the latter in physical fitness.(F =7.363,P ＜ 0.01).In March 2012,progress effectiveness of undergraduates without military status was higher than that of soldiers in comprehensive quality,ideology and morality,science,culture,profession,psychological quality,basic ability and physical fitness (F =28.017,10.847,33.559,24.630,48.767,10.460,38.251,P ＜0.01).Conclusions Comprehensive quality development of undergraduates is a continuous dynamic course.One year's observation shows that at early stage,all qualities of undergraduates without military status improve quickly except physical fitness with more subjective efforts.The two sorts of undergraduates belong to forward effect.

Maximum a Posteriori (MAP) method has been widely applied to the ill-posed problem of image reconstruction. The choice of prior is the crucial point on MAP methods. However, the most conventional priors will lead to a blurring of the whole image or cause ladder-like artifacts. We therefore proposed a Tsallis entropy-based prior for positron emission tomography (PET) iterative reconstruction in MAP framework. The method uses a Tsallis entropy-based prior to eliminate the uncertainty between prior information and the estimated images. We tested this method in the phantom image, compared it with the traditional prior methods. the results showed that the proposed algorithm could suppress noise and obtain better reconstructed image quality.
Algorithms ; Artifacts ; Entropy ; Image Processing, Computer-Assisted ; methods ; Phantoms, Imaging ; Positron-Emission Tomography ; methods