Objective:To evaluate the clinical value of different shimming methods at 7.0 T MR in two-dimensional (2D) and three-dimensional (3D) T 2WI. Methods:Totally 23 healthy volunteers were prospectively recruited from the First Medical Center of PLA General Hospital from November, 2022 to May, 2023, including 12 volunteers who underwent 2D shimming mode and 14 volunteers who underwent 3D shimming mode. 2D shimming mode included patient-specific (PS) mode, direct signal control (DSC) mode, the standard circularly polarized (CP) mode, and volume-specific (VS) mode. 3D shimming mode included universal pulses (UP) mode and CP mode. The image quality for the subtentorial and supratentorial region was assessed by the subjective image quality score and signal-to-noise ratio. Comparisons of quantitative indices between multiple groups were performed using repeated-measures ANOVA or Friedman′s test; comparisons of quantitative indices between 2 groups were performed using paired-samples t test or Wilcoxon signed-rank test. Results:The image quality of subtentorial region and SNR was significant differences in 2D T 2WI with PS mode, DSC mode, CP mode and VS mode ( F=26.74, P<0.001; F=28.24, P<0.001), and the image quality score and SNR of PS mode, DSC mode, VS mode were better than CP mode ( P<0.05). In 2D T 2WI, there was no significant difference in image quality score and SNR of supratentorial region in PS mode, DSC mode, CP mode ( P>0.05). Besides, in 3D T 2WI, the image quality score for subtentorial and supratentorial region of UP mode were better than those of CP mode ( Z=-2.74, P=0.006; Z=-3.24, P=0.001); SNR of subtentorial region was significantly better in UP mode than those in CP mode ( t=3.49, P=0.004). But there was no significant difference in SNR of supratentorial region between the UP mode and CP mode in 3D T 2WI ( P>0.05). Conclusion:T 2WI with different shimming methods at 7.0 T MR can provide data support for the clinical application, which is helpful for the accurate diagnosis of patients with subtentorial lesions.

With the continuous promotion of the comprehensive reform of public hospitals, public hospitals urgently need to change the management mode, achieve connotative development, and seek benefits from their own management, which has become an urgent task than ever. The authors expounded the construction and application practice of the hospital intelligent operation management platform, took the information construction as a tool, built the operation data warehouse, established the department accounting model, and explored the construction path of the hospital intelligent operation management, so as to provide a reference for promoting the scientific, refined and informatization of the hospital operation management, and improving the operation management level.

Objective: To analyze factors affecting the delay in the case finding, treatment and diagnosis of tuberculosis among students during 2014-2020，and to provide a reference for the prevention and control measures of tuberculosis among students in Guiyang City. Methods: The medical cases of students with tuberculosis from 2014 to 2020 recorded by "China Disease Prevention and Control Information System" were collected and trend of delays in the detection, treatment, and diagnosis of students with tuberculosis were analyzed, and χ 2 test and multivariate Logistic regression were used to analyze influencing factors. Results: From 2014 to 2020, the rate of delay in the case finding, treatment, and diagnosis of tuberculosis among students in Guiyang showed a relatively stable trend. From 2014 to 2020, Guiyang City reported a total of 1 323 valid cases, the median number of case finding was 16 days,and 48.75% of student TB patients were delayed; the median number of treatment was 11 days, the delay rate of treatment was 43.46%; the median number of diagnosis was 0 day, the diagnosis delay rate was 11.87%. The results of multivariate Logistic regression analysis showed that the floating population was a risk factor for delay in case finding ( OR =1.45), the classification of the source of patients as "other" ( OR =0.19), the level of the first diagnosed unit was county ( OR =0.44), and the type of the first diagnosed unit was general hospital ( OR =0.58) were the protective factors for the delayed case finding of tuberculosis in students( P <0.05). Female ( OR =1.32) and floating population ( OR =1.38) were risk factors for delayed treatment. Floating population ( OR =1.51), rural areas ( OR =4.30), urban fringe ( OR =2.76),non severe patients ( OR =5.99) were risk factors for delayed diagnosis,females ( OR =0.65), ethnic minorities ( OR =0.38), college degree ( OR =0.53), and the first diagnosis unit wae a specialist hospital ( OR =0.22) were protective factors for delayed diagnosis of tuberculosis in students ( P <0.05). Conclusion The rates of tuberculosis case finding and treatment delay among students are common, which warrants targeted prevention and control measures to reduce the incidence of student delays and reduce the risk of tuberculosis cluster epidemics in schools.

Objective: To investigate the high-risk factors for parotid lymph node (PLN) metastasis from nasopharyngeal carcinoma (NPC) and evaluate the feasibility of local intensity-modulated radiotherapy (IMRT) in patients with high-risk NPC. Methods: Clinical data of 440 NPC patients admitted to Department of Radiotherapy of Jiangsu Cancer Hospital from May, 2011 to March, 2017 were collected. The imaging features, treatment strategies and clinical prognosis of PLN metastasis were retrospectively analyzed. The whole group adopts the technique of intensity modulated radiotherapy. Total parotid or partial parotid irradiation, selective PLN irradiation, X-Ray and/or electronic line supplementation, dose 45-60 Gy. The χ² test or Fisher′s accurate probability method test and single factor analysis, Logistic regression model multi-factor analysis. Kaplan-Meier survival analysis, log-rank test differences. Results: PLN was observed in the parotid of 230 cases. At the end of follow-up, 11 patients (2.5%, 11/440) were diagnosed with PLN metastases. Among 11 cases, 9 patients (81.8%) had PLN size ≥5 mm. Multivariate analysis demonstrated that extracapsular spread of level Ⅱ was an independent risk factor for PLN metastasis. The patients with PLN size ≥5 mm or extracapsular spread of level Ⅱ were assigned into the high-risk PLN metastasis group. The patients in the high-risk group were further divided into the radiotherapy and non-radiotherapy subgroups. Survival analysis demonstrated that for 230 patients with PLN metastasis, the local recurrence-free survival (LRFS) significantly differed, whereas the overall survival (OS), disease metastasis-free survival (DMFS) and progression-free survival (PFS) did not considerably differ between the radiotherapy and non-radiotherapy subgroups in the high-risk PLN metastasis patients. Conclusions The PLN metastasis rate of NPC is low. Extracapsular spread of level Ⅱ is an independent risk factor. Radiotherapy of the parotid region is considered for patients with PLN size≥5 mm or those with PLN size<5 mm complicated with extracapsular spread of level Ⅱ.

Colorectal cancer (CRC) is one of the leading causes of death worldwide. Thus, the development of new therapeutic targets for CRC treatment is urgently needed. SGK1 is involved in various cellular activities, and its dysregulation can result in multiple cancers. However, little is known about its roles and associated molecular mechanisms in CRC. In present study, we found that SGK1 was highly expressed in tumor tissues compared with peri-tumor samples from CRC patients. In vitro experiments revealed that SGK1 overexpression promoted colonic tumor cell proliferation and migration and inhibited cell apoptosis induced by 5-fluorouracil (5-FU), while SGK1 shRNA and inhibitors showed the inverse effects. Using CRC xenograft mice models, we demonstrated that knockdown or therapeutic inhibition of SGK1 repressed tumor cell proliferation and tumor growth. Moreover, SGK1 inhibitors increased p27 expression and promoted p27 nuclear accumulation in colorectal cancer cells, and p27 siRNAs could attenuate the repression of CRC cell proliferation induced by SGK1 inhibitors. Collectively, SGK1 promotes colorectal cancer development via regulation of CRC cell proliferation, migration and survival. Inhibition of SGK1 represents a novel strategy for the treatment of CRC.
Animals ; Apoptosis ; Cause of Death ; Cell Proliferation ; Colon ; Colorectal Neoplasms* ; Fluorouracil ; Heterografts ; Humans ; In Vitro Techniques ; Mice ; Repression, Psychology ; RNA, Small Interfering

Objective: To observe the relieving cough and reducing sputum effects of total alkaloid in Atalantia buxifolia and evaluate the safety preliminarily.Methods: The relieving cough and reducing sputum effects of total alkaloid in Atalantia buxifolia were studied by the cough model caused by the irritation of ammonia water and the phenol red output of trachea in mice.The acute toxicity test and maximum tolerance test were carried out to evaluate the safety.Results: The total alkaloid in Atalantia buxifolia at low dose could obviously prolong cough incubation period and decrease cough times in mice, and that at high dose could significantly increase the secretion of phenol red in respiratory tract, and compared with those in the blank group, the differences were statistically significant (P<0.05).In the acute toxicity test, no death showed after the administration with maximum tolerance dosage, and the rate of weight growth had no difference between the blank group and the model group (P>0.05).Conclusion: The relieving cough and reducing sputum effects of total alkaloid in Atalantia buxifolia are notable in the cough model caused by the irritation of ammonia water and the phenol red output of trachea in mice.The maximum tolerable dose test shows the total alkaloid in Atalantia buxifolia is safe.

Objective To investigate the resuscitation outcome after a short period of mild hypothermia in porcine model of prolonged ventricular fibrillation (VF).Methods Fourteen male healthy domestic swine weighting 34 to 36 kg were used.VF was induced electrically and maintained untreated for 11 mins,followed by manual cardiopulmonary resuscitation (CPR) procedure.Two investigators initiated chest compression and bag-valve mask ventilation in pattern of 2 min rotation.A biphasic wave of 120 J electric defibrillation (ED) was attempted 6 mins after CPR.If there was no return of spontaneous circulation (ROSC),CPR was restored and ED was delivered when necessarily.Resuscitation was considered unsuccessful if absence of ROSC for 12 mins.However,if ROSC occurred,animals were randomly (random number) diveded into normothermia (NT) group and hypothermia treatment (CH) group.Animals in CH group were immediately cooled by using intravenous infusion of ice-cold saline and surface cooling.Core temperature was reduced to 32-34 degrees centigrade within 120 mins and maintained at this level for 2 h.Active rewarming was completed within 2 h until baseline body temperature was reached.Data of hemodynamic variables,blood-gas analysis and blood lactate before VF of two groups were recorded.Meawhile,cardiac output (CO),heart rate and Tc after ROSC were recorded.Neurological defect scores (NDS) were evaluated every 24 h until 96 h after ROSC.Variables were compared using either Fisher test or repeated measures analysis of variance,followed by Bonferroni for multiple comparisons.A two-sided P value ＜0.05 was regarded statistically significant.Results There was no significant difference in body weight,mean arterial pressure,CO,pH,pressure of end-tidal carbon dioxide (ETCO2) and lactate between groups before VF.In the period of CPR,there were also no significant difference in total resuscitation time,first shock success rate,ROSC rate,shock ROSC rate,total number of shock and doses of epinephrine.However,animals in CH group survived longer time than that in NT groups [(96.00 ± 0.00) hvs.(49.71 ±43.65) h,P=0.031].Meanwhile,the survival rate of 96 h was significantly higher in CH than that in NT (P ＜ 0.05).For neurological function,there was a obviously better NDS in CH group than that in NT group within ROSC 96 h (P ＜ 0.05).Conclusion Even a short duration of 2 hour mild hypothermia could improve resuscitation outcome in porcine model of 11 minute VF.

Objective Leukoaraiosis (LA) is a set of magnetic changes with white matter diffuse abormality,and it can be caused by brain small vessel disease.Recent studies showed that collagen type Ⅳ alpha 1 (COL4A 1) gene mutation as a single-gene disorder could cause cerebral small vessel disease.We aims to analyze the role of COL4A 1 gene mutations in Chinese patients with LA by targeted gene capture and high throughout sequencing technique.Methods Eleven patients with LA,conformed by imaging in our hospital from March 2012 to September 2014,were chosen in our study;COL4A 1 gene mutations were screened using targeted genomic capture and high throughout sequencing strategy.Missense mutation of SNP loci were verified by Sanger method.Biological information of mutation loci were studied by means of fumtional biology methods.Results A total of 1691 mutation sites were found,including two missense mutations (rs3742207 and rs9515185) and six synonymous mutations.By functional analysis,these two missense mutations showed no effect on protein structure or function.Conclusion COL4A 1 gene may be irrelevant with incidents of LA in Chinese patients.

Objective To study the features and reasons of violent events in medical staff and the public sentiments on them based on a network analysis. Methods The data of violent events in medical staff were down-loaded from Internet. The annual and geographic distribution and reasons of violent events in medical staff, casualties of medi-cal staff and the public opinions on the major Websites were analyzed. Results The number of violent events in medical staff increased to 31 in 2012 from 1 in 2003. The violent events were distributed in 18 provinces of China, the number of casualties was 105 , and 53% of the violent events occurred due to the unsatisfactory therapeutic out-comes in patients. Conclusion The public sentiments on violent events in medical staff tend to increase on Internet and characterized by no signs and direct conflict between patients or their family members before attacking medical staff, and against general medical staff. Public sentiments on violent events in medical staff are easy to become hot events with significant negative effects on the society. Medical institutions and hospitals should prevent such events and play an active role in guiding the public sentiments.

Objective To investigate the possible correlation between obstructive sleep apnea hypopnea syndrome(OSAHS)and serum epithelial neutrophil-activing peptide-78(ENA-78)and VE-cadherin in pregnant patients.Methods One hundred and two pregnant women combined with OSAHS,42 of which were with hypertension,and 36 healthy pregnant women were underwent polysomnography(PSG),and their apnea hypopnea index(AHI)was recorded.Based on the apnea hypopnea index(AHI),they were divided into mild OSAHS group(36 patients),moderate OSAHS group(34 patients)and severe OSAHS group(32 patients)Serum ENA-78 and VE-cadhefin levels were detected by enzyme-linked immunosorbent assay(ELISA),and mean arterial pressure(MAP)was measured simultaneously.Results The values of AHI,MAP,ENA-78 and VE-cadherin in OSAHS with hypertension were significantly higher than those of OSAHS only group(t =13.46,11.65,12.47,13.36,all P ＜ 0.01)and the control group(t =16.72,15.31,16.35,16.73,all P ＜ 0.01).The levels of serum ENA-78 and VE-cadherin were gradually significantly decreased in the order of severe OSAHS group,moderate OSAHS group and mild OSAHS group(P ＜0.01).The AHI of OSAHS group was significantly correlated with MAP,VE-cadherin,ENA-78(r =0.75,0.71,0.68,all P ＜ 0.01).ENA-78 of OSAHS group were positively correlated with MAP and VE-cadherin(r =0.64,0.67,all P ＜ 0.01).Conclusions The condition OSAHS in pregnant patients is closely related to the levels of ENA-78 and VE-cadherin.Pregnancy combined with OSAHS may take part in the pathological process of hypertensive disorder complicating pregnancy.