Objective To investigate the value of CT imaging texture analysis in predicting simplified pathological types of thymic epithelial tumors(TETs).Methods The CT data from 114 patients with TETs confirmed by surgical or pathology were analyzed retrospectivel,and the types of TETs were divided into three groups,including low-risk thymoma(LRT)group,high-risk thymoma(HRT)group,and thymic carcinoma(TC)group.First,the texture parameters of CT images were extracted,and then the weighted Rad-score values were obtained,and the predictive performance of the texture features was evaluated by using the receiver operating characteristic(ROC)curve.Results There were 114 TETs patients,including 45 patients with LRT,44 patients with HRT,and 25 patients with TC.Based on CT imaging texture analysis,the area under the curve(AUC)in differentiating LRT and HRT or TC via CT plain scan,arterial phase,and venous phase were 0.776,0.885,and 0.761,respectively.In differentiating HRT from TC,the AUC of CT plain scan,arterial phase,and venous phase were 0.828,0.808,and 0.804,respectively.In differentiating thymoma from TC,the AUC of CT plain scan,arterial phase,and venous phase were 0.808,0.769,and 0.774,respectively.Conclusion CT imaging texture analysis can serve as an effective auxiliary tool for predicting the simplified pathological types of TETs,helping to develop personal-ized treatment plans for TETs patients.CT enhanced scanning of arterial phase texture parameters has the highest differential diag-nostic efficiency.

Objective To investigate the CT and MRI findings of thymic carcinoid.Methods The clinical data of 12 thymic car-cinoid patients were analyzed retrospectively.All patients underwent immunohistochemistry and histopathological typing.All CT and MRI imaging features,including morphology,density,signal,presence/absence of capsule,calcification,degree of enhancements,were further analyzed.Results Irregular contour was identified in 8 cases;heterogeneous internal density or signal in 10 cases;absence of capsule in 9 cases;intratumoral calcification in 8 cases;cystic or necrotic component in 7 cases;intratumoral hemorrhage in 2 cases;pericar-dial or pleural effusion in 6 cases;preoperative metastasis in 2 cases;invasion of surrounding structures(vessels)in 10 cases.On con-trast-enhanced images,there were 2 cases with mild enhancement,6 cases with moderate enhancement,and 4 cases with obvious enhance-ment.And tumor enclosing the mediastinal great vessels was observed in 7 cases,among which 4 cases showed tumor thrombi in the superior vena cava,and intratumoral neovascularization was found in 4 cases.Conclusion Thymic carcinoid patients tend to present certain CT and MRI imaging features,mostly manifesting mild to moderate enhancement,infiltrative growth pattern along the medi-astinal vascular space,and concurrent intratumoral vascular sign,which are of vital significance to clinical diagnosis.

Objective:To explore the effect of family empowerment scheme combined with cardiac rehabilitation guidance on patients with myocardial infarction after percutaneous coronary intervention (PCI) .Methods:Using the convenient sampling method, a total of 100 patients with myocardial infarction who underwent PCI in Affiliated Hospital of Jining Medical University from July 2018 to January 2020 were selected as the research objects. According to the random number table method, they were divided into the control group and the observation group, with 50 cases in each group. The control group was given cardiac rehabilitation guidance, while the observation group was given the family empowerment scheme combined with cardiac rehabilitation guidance. The scores of Chinese version of Family Caregiver Task Inventory (FCTI) and The World Health Organization Quality of Life (WHOQOL) -BREF (WHOQOL-BREF) were compared between the two groups before the intervention and after 3 months of the intervention.Results:After 3 months of intervention, scores of each dimension of the FCTI scale of family members of patients in two groups were lower than those before the intervention and the scores of family members of the observation group were lower than those of the control group, and the differences were statistically significant ( P<0.05) . The scores of each dimension of the WHOQOL-BREF in the observation group were higher than those before intervention and the score in the observation group were higher than that in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The family empowerment scheme combined with cardiac rehabilitation guidance is beneficial to improve the caring ability of family members of patients with myocardial infarction after PCI and improve quality of life of patients.

Objective: To explore the prevalence of body weight control behaviors (BWCB) among middle school students in Jiangsu province. Methods: The database was established part from the surveillance of adolescent common disease and health related factors in Jiangsu province in 2017 and analysis were carried out to describe the prevalence rates of four basic BWCB and their comorbidity. Results: Among 18 855 investigators, 75.8% middle school students reported having taken at least one kind of BWCB within 30 days before investigation, the report rates of BWCB of middle school students among male and female were 77.3% and 74.3%(P<0.01), showed decreasing tendency from grade 1 of junior middle school to grade 3 of senior middle school (Kendall’s tau-c=-0.10, P<0.01), those of malnutrition, normal body weight, overweight and obesity were 57.2%, 72.8%, 83.8%, 86.7% respectively and showed increasing tendency(Kendall’s tau-c=0.13, P<0.01). Reported rate of Changing diet structure, physical exercise, reducing diet and taking slimming drug prevalence were 58.7%, 61.0%, 17.9%, 2.6%, orderly. There are 15 combinations of BWCB based on those 4 kinds of behavior. In the highest five types list ,changing diet structure & physical exercise (35.2%) was the most common type, and followed by physical exercise(13.0%), Changing diet structure(9.2%), Changing diet structure & physical exercise & reducing diet(8.6%), Changing diet structure & physical exercise & reducing diet(3.4%), others 6.5%. The proportions of top five kinds of BWCB among middle school students taken BWCB were 46.4%, 17.1%, 12.2%, 11.3%, 4.5%, respectively, accounting for 91.5%. The probabilities of different types of BWCB were similar between urban and town(χ2=9.13, P=0.10), different among sex(χ2=351.17, P<0.01), districts(χ2=140.20, P<0.01), school type and nutrition status(χ2=343.95, 309.62, P<0.01). Conclusion Some overweight or obesity students report on control body weight, while some report taking medicine and reducing diet behavior. Health education on healthy body weight should be implemented for middle school students to cultivate healthy body image so as to keep healthy body weight.

Paclitaxel (PTX)-loaded self-assembling nano-micelles (PTX/NMs) were prepared based on amphiphilic cholesterol-bearing γ-polyglutamic acid (γ-PGA-graft-CH). The properties of PTX/NMs and were investigated. The results indicated that PTX could be entrapped in -PGA-graft-CH NMs. PTX/NMs was characterized with a size of (343.5 ± 7.3) nm, drug loading content of 26.9% ± 0.8% and entrapment efficiency of 88.6% ± 1.7% at the optimized drug/carrier ratio of 1/10, and showed a pH-sensitive sustainable drug-release and less cytotoxicity . release and the pharmacokinetics study in mice showed that the elimination half-life ( ) and area under curve (AUC) of PTX/NMs were significantly higher than those of PTX/polyoxyethylene castor oil (PTX/PCO), and less clearance (CL) of PTX/NMs was also observed. PTX/NMs were distributed higher in liver and tumor than PTX/PCO, and showed a good tumor-inhibiting activity in tumor-bearing mice. This study would lay a foundation on the potential application of -PGA-graft-CH NMs were the antitumor drug-delivery.

Objective To investigate the CT characteristics of retroperitoneal extra-adrenal paraganglioma(PGL).Methods CT findings of 11 patients with pathologically confirmed retroperitoneal extra-adrenal PGL were analyzed retrospectively,and the relevant literature was reviewed.All patients received plain CT as well as contrast-enhancement CT scan.Results All of the 11 tumors were located in the retroperitoneal space around large blood vessels,including 2 functional and 9 unfunctional extra-adrenal paragangliomas.Eight of 11 cases were benign tumors which presented as round or oval masses with sharp margins,separated from surrounding structures clearly;while the rest 3 cases,which with indistinct edge,even more with the invasion of surrounding structures (renal artery,renal venous and pancreas),were confirmed to be malignant.Most of the tumors were heterogeneous on plain CT.It was common to see intratumoral necrosis or cystic degeneration in the tumors (9 cases),while hemorrhage or calcification was uncommon,which was found in 3 and 2 cases,respectively.Homogeneous intensity was only observed in 2 masses with diameter less than 4 cm.On contrast-enhanced CT image, the solid part of the tumors presented continuously significant enhancement.Dilated feeding artery was found in or around the masses (8 cases) in artery phase.Conclusion There are certain characteristics of retroperitoneal extra-adrenal paraganglioma on CT scanning, which are helpful for preoperative diagnosis and treatment of this disease.

Objective To investigate the initial CT characteristics and dynamic changing features of invasive pulmonary aspergillosis (IPA).Methods CT findings of 40 patients with IPA confirmed by histopathology or clinics were analyzed retrospectively,including the initial and follow-up CT features.Results Multiple lesions in the bilateral lung were found in the initial CT of all 40 patients.The coexistence of no less than two different CT features were showed in 27 patients(67.5 ％),and the same CT morphologic feature were showed in 13 patients (32.5 ％).The common features of the initial CT:nodules/masses (34,85.0 ％),halo sign (24,60.0％),patchy opacities (13,32.5 ％),cavities (9,22.5 ％) and wedge opacities adjacent to pleura (3,7.5 ％).The follow-up CT showed that cavities or air meniscus sign emerged in the nodules/masses after an effective treatment in 29 patients (72.5％) of all 40 cases.The lesion volume decreased subsequent to the collapse of the cavities or air meniscus,and then vanished.Conclusion Thoracic CT scanning play an important role in the diagnosis of IPA.Coexistence of the multiple lesions in number and morphology is the most common CT feature.The findings of follow-up CT is characteristic,and can be helpful in guiding the clinical treatment and evaluating therapeutic effect.

We describe the case of a 79-year-old male presented with sudden onset of abdominal pain and mild breathlessness, and complicated acute progressive anemia with haemoglobin which declined from 120 g/L to 70 g/L within five days. An urgent computed tomography an-giography showed acute thoracic aortic dissection, DeBakey type IIIb, a dissecting aneurysm in the proximal descending thoracic aorta start-ing immediately after the origin of the left subclavian artery and extending distally below the renal arteries with evidence of rupture into the right pleural cavity for massive pleural effusion. Plasma D-dimer, brain natriuretic peptide and C reactive protein level were elevated. Our case showed that D-dimer can be used as a‘rule-out’ test in patients with suspected aortic dissection. A raised BNP may exert a protective role through anti-inflammatory endothelial actions in the systemic circulation.

Objective To explore the blood pressure variability (BPV) in pediatric patients undergoing maintenance hemodialysis (MHD) and to assess the factors associated with pre-dialysis BPV (pre-HD BPV).Methods The pediatric patients who undergone regular dialysis for more than twelve months from Oct 2005 to Oct 2011 in hemo dialysis center of Guizhou Provincial People's Hospital were divided into high pre-HD BPV group and low pre-HD BPV group.Baseline characteristics,biochemical indexes and cardiac function parameters measured by echocardiography were collected in both groups and multiple linear regression analysis was performed.Results Pediatric patients in high pre-HD BPV group demonstrated significantly higher inter-dialytic weight growth rate (IDWG),pre-dialysis systolic blood pressure and average amount of dehydration than those in low pre-HD BPV group (P ＜ 0.05),while significantly lower hemoglobin and albumin levels than those in low pre-HD BPV group (P ＜ 0.05).Comparison among laboratory indicators,serum phosphorus and parathyroid hormone demonstrated significant difference between groups (P ＜ 0.05).For all pediatric patients,pre-HD BPV was positively correlated with IDWG (β=0.165),pre-dialysis systolicblood pressure (β=0.259),and iPTH (β=0.187),while negatively correlated with hemoglobin level (β=-0.199).Conclusions Increasing IDWG,higher pre-dialysis systolic blood pressure,anemia and secondary hyperparathyroidism influence BPV in pediatric patients on MHD.

Objective The present study was designed to investigate the risk factors affecting bleeding during percutaneous nephrolithotomy. Methods The records of 218 patients with percutaneous nephrolithotomy procedure by a single surgeon were retrospectively reviewed.The mean age was 48 years ( range,19 -70).One hundred and forty six patients had staghore stones,and 7 patients had previous open or percutaneous nephrolithotomy histories.Forty-one patients had concomitant diabetes mellitus,and 89 cases had hypertension.The following factors including age,sex,BMI,diabetes status,hypertension status,stone type,calix of puncture,previous open or percutaneous nephrolithotomy history,number of accesses,size of accesses,operative time,and surgeon experience were analyzed.Univariate analysis and multivariate step regression analysis were used for statistical assessment. Results 207 procedures were successfully performed,and 11 patients failed because of difficulty to establish the accesses.Single-tract was used in 176 cases and multiple-tract was used in 31 cases.163 cases were performed via a 18 F access and 44 cases via a 24 F access.The mean operative time was 78.4 min.The overall blood transfusion rate was 7.7％,and stone type ( P =0.034),diabetes ( P =0.030),number of accesses ( P =0.019 ),size of accesses ( P =0.008) and operative time (P =0.001 ) were the risk factors affecting blood transfusion requirement.The average hemoglobin (Hb) drop after percutaneous nephrolithotomy procedures was 11.2 g/L,and stone type ( P ＜ 0.001 ),diabetes ( P =0.015 ),number of accesses ( P =0.016),size of accesses ( P ＜ 0.001 ) and operative time ( P ＜ 0.001 ) were the risk factors affecting Hb drop.The following covariates including Hb drop:age,sex,BMI,previous open or percutaneous nephrolithotomy history,hypertension status,calix of puncture and surgeon experience were not risk factors affecting blood transfusion requirement and Hb drop.Multivariate stepwise regression analysis showed that diabetes ( OR =1.75 ),stone type ( OR =1.92),number of accesses ( OR =2.45 ),size of accesses ( OR =1.32) and operative time ( OR =1.66) significantly increased risk of bleeding. Conclusions Stone type,diabetes,number of accesses,size of accesses and operative time were the risk factors affecting blood loss during percutaneous nephrolithotomy.