Objective To investigate the clinical value of deep learning reconstruction(DLR)for flow sensitive black blood(FSBB)sequence in MRI of lenticulostriate artery(LSA).Methods Thirty robust volunteers were prospectively selected,performed scans with conventional FSBB sequences,and divided into DLR-FSBB group and conventional FSBB group according to whether DLR method was used.The signal-to-noise ratio(SNR),contrast-to-noise ratio(CNR)and number of branches of the two groups of images for bilateral LSA were compared,and the overall image quality was evaluated subjectively using Likert score(5-point scale).A paired t-test was used to compare quantitative indicators,SNR and CNR of image quality between the two groups.The Kappa coefficient was applied to eval-uate the consistency of subjective scores between the two observers.Results The SNR and CNR of DLR-FSBB images of cranial bilateral LSA were considerably higher than those of conventional FSBB images(left SNR 34.45±8.21 vs 16.91±4.67,P＜0.001,and right SNR 31.24±6.35 vs 16.02±3.00,P＜0.001;corresponding CNR 19.38±6.37 vs 9.27±3.12,15.82±4.29 vs 8.01±2.27,P＜0.001).The number of branches of LSA was slightly higher in the DLR-FSBB images[4.00(4.00,5.00)vs 3.00(3.00,4.00)on the left side,P＜0.001;3.00(3.00,4.00)vs 3.00(2.00,3.00)on the right side,P=0.003].The subjective score of overall image quality was higher in DLR-FSBB than that in conventional FSBB[reader 1:4.00(4.00,4.00)points vs 3.00(3.00,3.00)points;reader 2:4.00(4.00,4.00)points vs 3.00(3.00,3.00)points,P＜0.001].Conclusion Compared with conventional FSBB sequences,DLR-FSBB sequences of LSA have lower image noise,and vessel branches are displayed more plainly and slightly more numerous.DLR can improve the overall image quality of LSA in conventional FSBB sequences.

Objective:To develop an Arteriovenous Fistula Physical Examination Knowledge, Attitude, and Practice Scale for Hemodialysis Nurses and test its reliability and validity.Methods:Based on the theory of knowledge, attitude, and practice, a preliminary scale draft was formed through a literature review, three rounds of Delphi expert consultation, and a pre-survey. Using convenience sampling, 311 hemodialysis nurses were selected for a survey from December 2022 to February 2023 for item analysis, exploratory factor analysis and reliability testing. Another survey was conducted on 260 hemodialysis nurses from February to June 2023 for confirmatory factor analysis, convergent validity, and discriminant validity testing.Results:The Arteriovenous Fistula Physical Examination Knowledge, Attitude, and Practice Scale for Hemodialysis Nurses included three subscales and five dimensions, with a total of 33 items. The content validity index at the item level was 0.867 to 1.000, and the content validity index at the scale level was 0.992. After exploratory factor analysis, two, one, and two common factors were extracted from the knowledge, attitude, and practice subscales, with cumulative variance contribution rates of 70.114%, 75.192%, and 67.467%, respectively.Confirmatory:factor analysis showed that the model fitted well. The Cronbach's α coefficients of the three subscales were 0.929 to 0.943, the half reliability coefficients were 0.861 to 0.903, and the retest reliability coefficients were 0.824 to 0.874. Conclusions The Arteriovenous Fistula Physical Examination Knowledge, Attitude, and Practice Scale for Hemodialysis Nurses has good reliability and validity and can be used to evaluate the physical examination ability of hemodialysis nurses for arteriovenous fistula.

Objective To explore the influencing factors of pancreatitis after duodenoscopic common bile duct stone removal surgery(DCBDSR).Methods A total of 387 patients with DCBDSR were included in this study.Patients were divided into the pancreatitis group(36 cases)and the non-pancreatitis group(351 cases).General data and laboratory indexes were compared between the two groups.The influencing factors of postoperative pancreatitis after DCBDSR were analyzed by regression analysis.Results Compared with the non-pancreatitis group,the pancreatitis group had a younger age,a higher proportion of hypertension,hyperlipidemia and pancreatic history,and a higher average number of intubations(P＜0.05).There were no significant differences in gender,body mass index,drinking history,smoking history,diabetes,gallbladder size,number of stones,stone diameter,operation time,number of angiography,aspartate aminotransferase(AST),glutamyl transpeptidase(GTP),alanine aminotransferase(ALT),direct bilirubin(DBIL)and total bilirubin(TBIL)levels between the two groups(P＞0.05).Young age,combined hypertension,concomitant hyperlipidemia,history of pancreatic disease and frequent intubation were independent risk factors for postoperative pancreatitis after DCBDSR.Conclusion Young age,concomitant hypertension,concomitant hyperlipidemia,history of pancreatic disease and frequent intubation are risk factors for developing pancreatitis after DCBDSR.

Objective: To compare and investigate the physicochemical characteristics and antibacterial effect of ZnO nanofilms prepared by atomic layer deposition(ALD) at different deposition cycles. Methods: According to different ALD cycles, four groups were set up (control group, 300, 600 and 1 200 cycles group). Using DEZn and water as precursors, ZnO nanofilms were prepared by ALD on the surface of pure titanium specimens. Surface morphology of the films was observed by scanning electron microscope (SEM); the element composition and crystal type of the films were observed by energy dispersive spectrometer (EDS) and X-Ray Diffraction (XRD); the hydrophilicity and thickness of the films were detected by water contact angle detector and ellipsometer. The cytotoxicity of the films was evaluated by CCK-8 assay. The antibacterial effect against S. aureus in vitro of the films was evaluated by optical density method. Results: The surface morphology of the films was uniform and compact as shown through SEM. The grain size increased with the increase of the number of ALD cycles. EDS results showed that the films were mainly composed of Zn and O elements. XRD results confirmed that the composition of the films was ZnO. Results of water contact angle showed that the films were hydrophobic. The thickness of the films was nanoscale and there was a linear relationship between the thickness and ALD cycles. All experimental groups showed no cytotoxicity. The 1 200 cycles group showed the highest antibacterial rate of 65.9% and 52.3% at 24 and 48 hours respectively, which was the best among all experimental groups. Conclusion The ZnO nanofilms prepared by ALD at different cycles on pure titanium surface are uniform and compact. Thickness of the films increases with the increase of ALD cycles. The films have good biocompatibility and anti-S. aureus effect in vitro. The 1 200 cycles group has the best antibacterial effect.

Objective: To investigate the effects of fiber surface deposited with silicon dioxide films by atomic layer deposition on properties of dental fiber-reinforced composites. Methods : SiO2 films were deposited on the surface of quartz fiber by atomic layer deposition(ALD). Then the quartz fiber was used to manufacture fiber resin composites, which were divided into four groups: A(no soaking agent removal), B(soaking agent removed), C(soaking agent removed and silanization), and D(soaking agent removed, 600 ALD cycles performed and then silanization). Scanning electron microscopy, water contact angle test, hygroscopicity test, CCK8 test and three-point bending test were used to investigate the properties of fiber resin composites. Results: The surface morphology of the quartz fiber treated by ALD was smooth and had no obvious change compared with that before treatment. Moreover, the quartz fiber showed hydrophobicity after silanization. The results of three-point bending test revealed that the mechanical properties of fiber-resin composites modified by ALD were significantly improved(P<0.05). When viewed by scanning electron microscopy, a good interfacial bonding could be seen between quartz fibers and the resin matrix in Group D. In addition, it was found that Group D had low absorbability, low solubility and good biocompatibility. Conclusion It is shown that deposition of SiO2 films on the quartz fiber by ALD can significantly enhance the mechanical properties of fiber-reinforced composites.

Objective:To investigate the value of hemorrhage after thrombolytic (HAT) score and neutrophil to lymphocyte ratio (NLR) in combination predicting symptomatic intracerebral hemorrhage (sICH) after intravenous thrombolysis in patients with acute ischemic stroke (AIS).Methods:Consective patients with AIS received intravenous thrombolysis with ateplase in Tianjin TEDA Hospital from January 2016 to December 2021 were retrospectively enrolled. sICH was defined as cerebral CT showing hemorrhage at any part of the brain after intravenous thrombolysis, and the National Institutes of Health Stroke Scale (NIHSS) score was increased by≥4 compared with the baseline, or there was a manifestation indicating clinical aggravation. Univariate analysis was used to compare the baseline data of sICH group and non-sICH group. A binary multivariate logistic regression model was used to determine the independent influencing factors of sICH. The receiver operating characteristic (ROC) curve was used to evaluate the value of HAT score and NLR in combination predicting sICH. Results:A total of 429 patients with AIS were enrolled. Univariate analysis showed that there were significant differences in atrial fibrillation, systolic blood pressure, NLR, HAT score and NIHSS score between the sICH group and the non-sICH group (all P<0.05). Multivariate analysis showed that NLR (odds ratio [ OR] 1.405, 95% confidence interval [ CI] 1.193-2.958), HAT score ( OR 1.512, 95% CI 1.207-3.169) and NIHSS score ( OR 1.221, 95% CI 1.082-2.634) had significant independent correlation with sICH after adjusting for atrial fibrillation and systolic blood pressure. The ROC curve showed that the areas under the curve of HAT score, NLR and their combination predicting sICH were 0.719 (95% CI 0.609-0.832), 0.723 (95% CI 0.618-0.835) and 0.854 (95% CI 0.765-0.931), respectively. The areas under the curve of the two methods in combination were significantly larger than those of the single method ( P=0.029 and 0.032, respectively), and their sensitivity and specificity were 74.1% and 83.5% respectively. Conclusion:Combined HAT score and NLR is of high value in predicting sICH after intravenous thrombolysis in patients with AIS, and has clinical application potential.

Objective:To analyze the influencing factors of the medical insurance balance of hospitalization expenses for gastric cancer surgery patients under DRG payment, for reference for promoting the reform of DRG payment in public hospitals and controlling hospitalization expenses reasonably.Methods:The gastric cancer patients enrolled in the gastroenterology department of a tertiary comprehensive hospital from January to July 2022 were selected as the research subjects. The indicators such as patient age, medical insurance balance, hospitalization expenses and their composition were extracted from the hospital information management system and the medical insurance settlement system a certain city. Descriptive analysis was conducted for all data, and stepwise multiple linear regression was used to analyze the influencing factors of patients′ medical insurance balance. Monte Carlo simulation method was used to simulate different combination scenarios of various influencing factors to analyze the probability of medical insurance balance.Results:A total of 205 patients were contained, including 117 in the medical insurance balance group and 88 in the loss group. The difference in hospitalization expenses and medical insurance balance between the two groups of patients were statistically significant ( P<0.05). The intervention of medical insurance specialists, correct DRG enrollment, parenteral nutrition preparation costs, anti infective drug costs, examination costs, and consumables costs were the influencing factors of patient medical insurance balance ( P<0.05). Through Monte Carlo simulation verification, patients with different cost parenteral nutrition preparations, or different anti infective drug schemes had the higher probability of medical insurance balance in the scenario where the medical insurance commissioner intervenes and the DRG enrollment was correct. Conclusions:The hospital adopted interventions from medical insurance specialists to ensure the correct DRG enrollment of patients, accurate use of parenteral nutrition and anti infective drugs, and reasonable control the cost of examinations and consumables, which could increase the probability of medical insurance balance for gastric cancer surgery patients. In the future, hospitals should further promote the procurement of drug consumables in bulk, reduce unnecessary examinations, develop standardized perioperative nutritional interventions and anti infection treatment pathways, ensure the accuracy of DRG enrollment, optimize clinical diagnosis and treatment pathways to improve the efficiency of medical insurance fund utilization and provide high-quality medical services for patients.

Objective To investigate whether Andrographolide(AG)can alleviate intestinal injury in sepsis by ac-tivating the SLC7A11/GPX4 axis in ferroptosis.Methods Forty rats were randomly divided into sham group(sham group),sepsis group(CLP group),AG low,medium and high dose groups(5,10 and 20 mg/kg).HE staining was used to observe the pathological changes of Intestinal tract.ELISA method was used to determine Inter-leukin 6(IL-6),tumour necrosis factor α(TNF-α),intestinal fatty acid binding protein(I-FABP),D-lactate content.The mechanism of ferroptosis was explored with AG high dose group(AG20 group),forty rats were ran-domly divided into sham group,CLP group,ferroptosis inhibitor(Fer-1)group,AG20+Fer-1 group.HE staining and transmission electron microscopy were used to observe the pathological changes of Intestinal tract.The kits were used to determine oxidative stress MDA,GSH levels and Fe3+content.Western blot was used to detect the protein levels of solute carrier family 7 member 11(SLC7A11),glutathione peroxidase 4(GPX4),and ferritin heavy poly-peptide 1(FTH-1).Results Compared with the sham group,the CLP group showed severe morphological damage to the small intestine,with significantly higher levels of inflammation,I-FABP and D-lactate(all P＜0.05),the AG group reversed these changes in a concentration-dependent manner(all P＜0.05).Compared with the CLP group,the AG20 and Fer-1 groups showed improved pathological damage to the small intestine,with lower levels of MDA and Fe3+and higher levels of GSH,SLC7A11,GPX4 and FTH-1 protein expression increased(all P＜0.05),and pathological injury and oxidative stress were reduced in the AG20+Fer-1 group,and SLC7A11,GPX4 and FTH-1 protein expression increased more significantly(all P＜0.05).Conclusion The mechanism by which AG attenuates intestinal injury in sepsis may be related to SLC7A11/GPX4 axis activation in ferroptosis.

This study aimed to investigate the efficacy and safety of apatinib plus programmed cell death protein 1 (PD-1) blockades for patients with metastatic colorectal cancer (CRC) who were refractory to the standard regimens. In this retrospective study, patients with metastatic CRC who received apatinib plus PD-1 blockades in clinical practice were included. The initial dosage of apatinib was 250 mg or 500 mg, and PD-1 blockades were comprised of camrelizumab, sintilimab and pembrolizumab. Efficacy and safety data were collected through the hospital’s electronic medical record system. From October 2018 to March 2022, a total of 43 patients with metastatic CRC were evaluated for efficacy and safety. The results showed an objective response rate of 25.6% (95% CI, 13.5%-41.2%) and a disease control rate of 72.1% (95% CI, 56.3%-84.7%). The median progression-free survival (PFS) of the cohort was 5.8 months (95% CI, 3.81-7.79), and the median overall survival (OS) was 10.3 months (95% CI, 5.75-14.85). The most common adverse reactions were fatigue (76.7%), hypertension (72.1%), diarrhea (62.8%), and hand-foot syndrome (51.2%).Multivariate Cox regression analysis revealed that Eastern Cooperative Oncology Group (ECOG) performance status and location of CRC (left or right-side) were independent factors to predict PFS of patients with metastatic CRC treated with the combination regimen. Consequently, the combination of apatinib and PD-1 blockades demonstrated potential efficacy and acceptable safety for patients with treatment-refractory metastatic CRC. This conclusion should be confirmed in prospective clinical trials subsequently.

H 1-antihistamines are widely used in the treatment of various allergic diseases, but there are still many challenges in the safe and rational use of H 1-antihistamines in pediatrics, and there is a lack of guidance on the prescription review of H 1-antihistamines for children.In this paper, suggestions are put forward from the indications, dosage, route of administration, pathophysiological characteristics of children with individual difference and drug interactions, so as to provide reference for clinicians and pharmacists.