Objective:To analyze the positive detection rate, main genotypes of β-thalassemia in western region of Guangxi Zhuang Autonomous Region (referred to as Guangxi).Methods:Retrospective analysis of 26 189 individuals who underwent gene testing for thalassemia at the Affiliated Hospital of Youjiang Medical University for Nationalities from January 2013 to December 2019. Using the crossing breakpoint PCR (Gap-PCR) and reverse dot blot (RDB) techniques to detect Chinese common type of 7 kinds of α-thalassemia and 17 kinds of β-thalassemia genotypes, high-throughput sequencing(Sanger) was performed for suspected rare β-thalassemia. Gap-PCR was used for suspected deletion β-thalassemia types.Results:β-thalassemia was diagnosed in 4 495 (17.16%) of 26 189 samples. A total of 6 177 alleles of 20 types of β-thalassemia were detected, mainly CD17 (2 712 cases, 43.90%) and CD41-42 (2 240 cases, 36.26%), including 7 rare alleles: Gγ +( Aγδβ) 0, SEA-HPFH, Hb New York, Hb G-Taipei, Hb Hezhou, Hb G-Coushatta and IVS-Ⅱ-81. There were 3 903 case (86.83%) heterozygous, 273 case (6.07%) double heterozygous, and 319 case (7.10%) homozygous among 4 495 β-thalassaemia subjects. A total of 48 genotypes were detected. The two most common genotypes were CD17/β N (1 890 cases, 42.05%) and CD41-42/β N (1 212 cases, 26.96%), accounted for 69.01% (3 102/4 495). Seven rare genotypes were detected: Gγ +( Aγδβ) 0/β N in 3 cases, Hb New York/β N in 3 cases, Hb G-Taipei/β N in 2 cases, SEA-HPFH/β N, Hb Hezhou/β N, Hb G-Coushatta/β N and IVS-Ⅱ-81/β N in 1 case each. A total of 1 041 cases (3.97%, 1 041/26 189) of 116 types of αβ-thalassemia were detected, mainly -- SEA/αα composite CD17/β N (144 cases, 13.83%), followed by -α 3.7/αα composite CD17/β N (112 cases, 10.76%). Conclusions:Western region of Guangxi is a high prevalence area of β-thalassemia, CD17/β N and CD41-42/β N are the main genotypes. The variation spectrum of β-thalassemia is complex and diverse, with rich genotype.

Objective To observe the value of augmented reality(AR)navigation system for assisting CT-guided puncture of pulmonary nodules in dog models.Methods Five healthy dogs were selected,and 4 target lung rings were implanted in each dog to build pulmonary nodule models.Deferring to crossover design,CT-guided punctures were performed with or without AR navigation 2 and 4 weeks after successful modeling,respectively,while punctures with AR navigation were regarded as AR group and the others as conventional group,respectively.The time duration of puncturing,the times of CT scanning,of needle adjustment,and the deviation distance between needle pinpoint to the center of pulmonary nodule shown on three-dimensional reconstruction were compared between groups.Results The duration time of puncture in AR group and conventional group was(13.62±5.11)min and(20.16±4.76)min,respectively.In AR group,the times of CT scanning,of needle adjustment,and the deviation distance was 2.40±0.50,2.75±0.44 and(2.94±1.92)mm,respectively,while in conventional group was 3.10±0.64,3.70±0.57 and(4.90±3.38)mm,respectively.The introduction of AR navigation was helpful to shortening the duration of puncture,reducing times of CT scanning and needle adjustment,also decreasing positioning error of needle pinpoint(all P＜0.05).In contrast,the variance of puncture sequences and dogs had no obvious effect on the results(both P＞0.05).Conclusion AR navigation system could improve accuracy and efficiency in CT-guided puncture of pulmonary nodules in dog models.

Objective To investigate a novel stroke recurrence risk prediction model,which utilized radiomics machine learning methods and specifically combined carotid computed tomography angiography(CT A)with the Essen stroke risk score(ESRS).Methods A total of 136 patients who underwent carotid CT A were analyzed retrospectively.The features of carotid plaque were extrac-ted by machine learning to construct a radiomics feature model,as well as combined with ESRS.Based on clinical outcomes at one-year follow-up,the stroke recurrence risk prediction model was constructed using the logistic regression(LR)machine learning model.To construct an effective and robust model,the dataset was divided into a training set and a validation set in a ratio of 7∶3.The performance of this model was evaluated using area under the curve(AUC)of receiver operating characteristic(ROC)curve,sensi-tivity and specificity.Results The model had strong predictive value.In the training set,AUC,sensitivity and specificity of this model were 0.903,0.796 and 0.761,respectively.In the validation set,AUC,sensitivity and specificity of this model were 0.869,0.667 and 0.850,respectively.Conclusion The stroke recurrence risk prediction model constructed based on radiomics analysis of carotid plaque characteristics in carotid CTA,in combination with the ESRS,can provide reliable predictions for stroke prognosis.

Objective To observe the value of 5.0T MRI in measuring the volumes of hippocampal formation(HF)subfields in healthy adults.Methods Cranial high-resolution TIWI were prospectively obtained in 23 healthy adult volunteers using 5.0T and 3.0T MR scanners,respectively.HF was divided into 38 subfields,and then the volume of each subfield was measured using FreeSurfer software.The volumes of HF subfield based on 5.0T and 3.0T MR T1WI were compared,and the correlations of the outcomes were analyzed.Results Significant differences of the volumes of bilateral hippocampal tails,left parasubiculum,left molecular layer of hippocampal head,left granular cell-molecular layer-dentate gyrus head,right granular cell-molecular layer-dentate gyrus body,left cornu Ammonis(CA)1 head,left CA3 head,left CA4 head,right fimbria of hippocampus and left hippocampus amygdala transition area were found between 5.0T and 3.0T T1WI(all P＜0.05).The volumes of HF subfields measured based on 5.0T and 3.0T T1WI were moderately to highly positively correlated(all r＞0.5,all P＜0.01).Conclusion 5.0T MRI could be used to measure the volume of HF subfield in adults.

Objective To observe the consistency of 5.0T and 1.5T MR spectroscopy(MRS)for quantitating proton density fat fraction(PDFF)of liver.Methods Lipid emulsion models with lipid content of 0,5％,10％,15％,20％,25％and 30％were prepared.1H-MRS were collected using 5.0T and 1.5T MR scanners,respectively,and PDFF were obtained with jMRUI software.Totally 23 people,including 11 cases of fatty liver and 12 healthy adults were prospectively collected,and volume of interest(VOI)in the liver were selected to acquire 1H-MRS,and PDFF were obtained with jMRUI software and corresponding workstation,respectively.The consistencies of PDFF measured with different methods were analyzed.Results PDFF of lipid emulsion models with lipid content of 0,5％,10％,15％,20％,25％and 30％measured with jMRUI software and workstations based on 5.0T and 1.5T 1H-MRS all had good consistencies and being positively correlated,so were PDFF of liver tissue measured with jMRUI software and workstations based on 5.0T and 1.5T 1H-MRS.Conclusion 5.0T and 1.5T 1H-MRS had good consistency for quantitating liver PDFF.Measuring liver PDFF with workstation in clinical practice was helpful to simplifying workflow.

Objective To construct a UNet fusing patch attention(PA-UNet)model,and to observe its value for segmenting knee cartilage on MRI.Methods Slice and preprocessing were performed on knee MRI selected from Osteoarthritis Initiative-Zuse Institute Berlin dataset.Taken UNet as the backbone network,a PA-UNet model was constructed based on patch attention mechanism.The effect of PA-UNet model and other models for segmenting both femoral cartilage and tibial cartilage were compared by subjective and objective evaluations.Ablation experiments based on UNet,UNet based on SE with layers 2-4(UNet+SE),+UNet,++UNet,+++UNet,+U-Net+,++U-Net++and PA-UNet models were performed to observe the effect of models for segmenting knee cartilage.Results PA-UNet could accurately segment femoral and tibial cartilage in all simple,medium and difficult samples,which had better segmenting effect on small structures than SegNet,UNet and DeepLabv3+models.The Dice similarity coefficient(DSC)and intersection over union of PA-UNet model for segmenting femoral and tibial cartilage were both higher,while Hausdorff distance of PA-UNet model was lower than those of UNet,DeepLabv3+,SA-UNet,RA UNet and SegNet models.DSC of PA-UNet model for segmenting femoral cartilage and tibial cartilage was 88.97％and 82.72％,respectively,both higher than those of UNet,UNet+SE,+UNet,++UNet,++UNet,+UNet+and++UNet++models.Conclusion PA-UNet could segment knee cartilage completely on MRI,especially for small structures.

Objective To observe the effects of Ganmai Yangxin Decoction on the expression glutamate system in hippocampus of rats with depression;To discuss its mechanism for the treatment of depression.Methods Totally 40 SPF grade SD rats were randomly divided into blank group and modeling group,chronic unpredictable mild stress method was used to establish a depression model.Successfully modeling rats were randomly divided into model group,fluoxetine group and Ganmai Yangxin Decoction group,with 8 rats in each group.The rats in Ganmai Yangxin Decoction group were gavaged with 7.67 g/kg decoction,the fluoxetine group was gavaged with 10 mg/kg fluoxetine,and the blank group and model group were gavaged with 10 mL/kg normal saline,for 4 weeks.and modeling continued while administering the medication.Sucrose preference experiments and forced swimming experiments were used to evaluate the depression status of rats,ELISA was used to detect glutamate content in hippocampal tissue,Nissl staining was used to observe the morphology of neurons in hippocampal CA3 region,immunohistochemical staining was used to detect the expression of GFAP protein in hippocampal CA3 region,Western blot was used to detect the expressions of EAAT1,EAAT2,EAAT3,VGLUT1 and VGLUT2 protein in hippocampal tissue,RT-PCR was used to detect the mRNA expressions of EAAT1,EAAT2 and EAAT3 in hippocampal tissue.Results Compared with the blank group,the body mass of the model group rats decreased(P<0.01),sucrose preference rate decreased,forced swimming immobility time increased(P<0.01),and glutamate content in hippocampal tissue increased(P<0.01),the number of neurons in hippocampal CA3 region decreased,with irregular arrangement and structure changed,the number of Nissl bodies decreased,and the positive expression of GFAP in hippocampal CA3 region decreased(P<0.01),the expressions of EAAT1,EAAT2,EAAT3 protein and mRNA,and VGLUT1 protein in hippocampal tissue decreased(P<0.01),while the expression of VGLUT2 protein increased(P<0.05).Compared with the model group,the Ganmai Yangxin Decoction group and the fluoxetine group showed an increase in body mass(P<0.05),an increase in sucrose preference rate,and a reduction in forced swimming immobility time(P<0.01),and the glutamate content in hippocampal tissue decreased(P<0.01),the number of neurons in the hippocampal CA3 region increased,the structure improved,and there were more Nissl bodies,the positive expression of GFAP in hippocampal CA3 region increased(P<0.01),the expressions of EAAT1,EAAT2,EAAT3 protein and mRNA,and VGLUT1 protein in hippocampal tissue increased(P<0.05,P<0.01).Conclusion Ganmai Yangxin Decoction can improve depression-like behavior in rats,and its mechanism of action is related to up-regulating the expression of glutamate transporters,increasing the number of astrocytes,and reducing glutamate content in hippocampus.

Objective To explore the application and effect of a pulmonary rehabilitation exercise program in patients with moderate to severe COPD based on the Information-Motivation-Behavior Skill(IMB)Model.Methods The convenience sampling method was adopted to select patients with moderate to severe COPD admitted to the department of respiratory and critical care medicine in a tertiary A hospital in Yantai City from October 2021 to February 2022.They were randomly divided into an intervention group(32 cases)and a control group(31 cases).The intervention group was treated with the pulmonary rehabilitation exercise program based on the IMB model on the basis of routine nursing,while the control group was treated with routine nursing.The degree of dyspnea,exercise endurance,quality of life,pulmonary rehabilitation exercise compliance,self-management ability and lung function were compared between the 2 groups before and 6 months after the intervention.Results After intervention,the degree of dyspnea,exercise endurance,quality of life,pulmonary rehabilitation exercise compliance and self-management ability were significantly different between the 2 groups(P＜0.05).There was no statistically significant difference in lung function between the 2 groups after intervention(P＞0.05).Conclusion The pulmonary rehabilitation program based on IMB model can effectively alleviate the symptoms of dyspnea in patients with moderate to severe COPD,improve exercise endurance,improve pulmonary rehabilitation exercise compliance and self-management ability,and improve the patients'quality of life.

Objective:To investigate the knowledge of Sixth Chinese national consensus report on the management of Helicobacter pylori infection ( treatment excluded) (hereinafter referred to as sixth national consensus) and 2022 Chinese national clinical practice guideline on Helicobacter pylori eradication treatment (hereinafter referred to as the guideline)among medical staff from general hospitals in Hainan. Methods:From February 20 to May 7, 2023, a questionnaire survey on the diagnosis and treatment of Helicobacter pylori ( H. pylori) infection was conducted among 1 463 medical staff from 15 general hospitals in Hainan Province. The questionnaire was drawn up according to the sixth national consensus and the guideline, covering knowledge of 6 sections, induding H. pylori related diseases, detection of H. pylori, eradication, prevention and influence factors of eradication of H. pylori, etc. Chi-square test was used for statistical analysis. Results:A total of 1 463 valid questionnaires were collected with the effective responsive rate of 100.00%.The 1 463 subjects included 225 gastroenterologists and 1 238 other medical staff(including 503 physicians from other departments, 264 surgeons and 471 medical technologists and pharmacists). About 78.67%(177/225)of gastroenterologists agreed that the overall infection rate of H. pylori in China was more than 20%, the awareness rate was higher than that of other medical staff (physicians from other departments 65.41%(329/503), surgeons 61.74%(163/264), medical technologists and pharmacists 60.30%(284/471); the following datas were sorted by this position), and the difference was statistically significant ( χ2=30.97, P<0.001). About 51.11%(115/225) of gastroenterologists considered that H. pylori serological antibody test could not be used as a diagnostic method for current infection, the awareness rate was higher than that of other medical staff(22.07%(111/503), 14.02%(37/264), 12.31%(58/471)), and the difference was statistically significant( χ2 =152.66, P<0.001). Proton pump inhibitor and potassium-competitive acid blocker should be discontinued for 2 weeks, and antibiotics and bismuth should be discontinued for 4 weeks before urea breath test, and the awareness rates of gastroenterologists were higher than those of other medical staff (38.67%(87/225) vs. 23.26%(117/503), 19.70%(52/264), 18.47%(87/471); 60.89%(137/225) vs. 26.64%(134/503), 25.76%(68/264), 23.78%(112/471)), and the differences were statistically significant ( χ2 =133.70 and 165.51, both P<0.001). For refractory H. pylori infection, 98.67%(222/225)of gastroenterologists agreed with the individualized diagnosis and treatment of H. pylori infection should be guided by bacterial culture, antibiotic susceptibility test or drug resistance gene test, and the awareness rate was higher than that of other medical staff (91.85%(462/503), 93.56%(247/264), 93.21%(439/471)), and the difference was statistically significant( χ2=20.55, P=0.002). About 70.67% (159/225) of gastroenterologists recommended a bismuth containing quadruple regimen, 80.44% (181/225) supported a 10 to 14 day H. pylori eradication course, and the awareness rates were higher than other medical staff (46.92%(236/503), 33.33%(88/264), 32.91%(155/471); 67.20%(338/503), 59.09%(156/264), 53.93%(254/471)), and the differences were statistically significant ( χ2=111.25 and 59.99, both P<0.001). The understanding rates of the sixth national consensus and the guideline in gastroenterologists was 85.33% (192/225), which was higher than that of other medical staff (64.21%(323/503), 66.67%(176/264), 57.96%(273/471)), and the difference was statistically significant ( χ2=85.47, P<0.001). Conclusions:Gastroenterologists from general hospitals in Hainan Province have a better understanding of the sixth national consensus and the guideline than other medical staff. However, there is still a lack of deep understanding of the sixth national consensus and the guideline, and it is necessary to further strengthen the learning and application of the sixth national consensus and the guideline.

Objective:To explore the application of nasal aesthetic polygon theory in the reconstruction of new domes on nasal tip with autogenous costal cartilage.Methods:From June 2019 to June 2021, 116 patients (26 males and 90 females) received rhinoplasty, CT-assisted examination of the costal cartilage, nasal bone and nasal cartilage was performed, and the autogenous costal cartilaginous cortex was used to make dome reconstruction grafts that were transplanted to the original alar cartilage and partially fixed to the original nasal septum cartilage to form a satisfactory and natural nasal shape.Results:All the patients were followed up for 6-24 months. No cartilaginous, overrotated or underrotated appearance was found in nasal tip. The shape of nasal tip was clear and good, with an obvious performance point and full lower lobule. The nose was tall and straight, and looked natural and beautiful in three dimensions.Conclusions:The nasal aesthetic polygon theory is used to guide the reconstruction of new domes with autogenous costal cartilage in nasal tip surgery. Compared to the cap and shield grafts, the nasal tip is more close to the normal anatomical structure, the shape and texture are more similiar to the natural state and the nasal tip is softer by using autogenous costal cartilage, and so it is an ideal surgical procedure for nasal tip reconstruction.