A novel algorithm based on multi-dimensional fusion is proposed for classifying lung nodules.Based on the algorithm for reducing false positives of pulmonary nodules,the optimization is carried out by introducing a high-level feature enhancement soft activation mapping module after obtaining features by the multi-scale feature fusion module to improve the classification ability.To address the imbalance of different nodule data in the actual classification,a balanced mean square error loss is adopted to improve the training effect of the model.A three-dimensional and two-dimensional model fusion method is used to further improve the classification performance.The experiment conducted on a Private Lung dataset proves that the proposed model has a classification accuracy of 93.8％,outperforming the existing methods.

Objective:To observe any effect of endoscopic evaluation of swallowing (FEES) on the functional outcomes of post-stroke patients in the subacute phase.Methods:A retrospective case-control study was conducted of 52 patients who had received an FEES assessment (the FEES group) and 51 who had not (the control group). Both groups received swallowing rehabilitation and intake training based on the results of the FEES assessment and those of a modified volume-viscosity swallowing test. The primary outcome indicator was the incidence of pneumonia. Secondary outcome indicators were the rate of removal of the nasal feeding tube, the length of indwelling of the nasal feeding tube, functional oral intake assessment scale (FOIS) scores, eating technique at discharge, and the length of hospital stay.Results:Compared with the control group, the incidence of pneumonia in the FEES group was significantly lower (7.7% vs. 39.2%). The removal rate of the nasal feeding tube was significantly greater (75.0% vs. 41.0%). The FEES group showed a significant improvement in its average FOIS score. And the proportion of patients who could try partial oral eating or complete oral eating at discharge was significantly higher in the FEES group. Regression analysis indicated that the risk of pneumonia in the FEES group was positively related to the time from onset to the first FEES examination.Conclusion:Early FEES examination after a stroke could reduce the incidence of pneumonia, increase chances of removing the nasal feeding tube and improve the swallowing function and outcome of stroke survivors.

Objective: To explore the relationship between different serum albumin and lymphocyte levels in patients with 2019-novel coronavirus (2019-nCoV) pneumonia (COVID-19). Methods: A retrospective study was performed to identify the characteristics of the clinical data of 205 COVID-19 patients who were hospitalized in the Happy Street of Hanchuan People's Hospital, Xiaogan, Hubei Province from January 24 to February 12, 2020, including their general information, serum albumin (ALB) levels, lymphocyte counts (LYM), percentage of lymphocytes (LYM%) and other laboratory parameter levels. Low ALB group and normal ALB group were demarcated by the concentration of 35g/L, further to identify the differences of LYM and LYM% levels and the incidence of LYM and LYM% decline at different ALB levels between groups,as well as the correlation between ALB and LYM, LYM% levels in hypoalbuminemia conditions . Results: 17.5% of COVID-19 patients were associated with hypoalbuminemia. The levels of LYM and LYM% in the low ALB group were significantly lower than those in the normal ALB group (P <0.001). The incidence of LYM and LYM% decline in the low ALB group was significantly higher than those in the normal ALB group (P <0.001). The levels of LYM and LYM% in the low ALB group were significantly positively correlated with serum ALB concentrations (P <0.05). Conclusions The decrease of lymphocyte levels in COVID-19 patients may be correlated to hypoalbuminemia. COVID-19 patients complicated by hypoalbuminemia should be actively intervened to maintain serum albumin in the normal range.

Objective:To investigate the features, changing trend, and rules of pneumoconiosis in Jiangsu Province, China, as well as the health status of patients with pneumoconiosis.Methods:From July to October 2019, the patients with pneumoconiosis, reported up to the end of 2018 in Jiangsu Province, were enrolled as respondents, and follow-up and retrospective investigation were performed. A total of 24405 patients with pneumoconiosis were investigated, and related data were collected from the monitoring system of cause of death for residents, pneumoconiosis network reporting system, occupational disease diagnosis institution, management institutions for the reporting of occupational diseases, and related residents' committee or village committee. The patients with pneumoconiosis, who had been reported, were followed up by telephone or on-site visit to obtain the information on their conditions. A descriptive analysis was performed for age of onset, working years, sex, category of industry, type of pneumoconiosis, annual disease onset, geographic distribution, and medical security.Results:Among the 24405 patients, a male/female ratio was 16.81∶1. Of all 24405 patients, 15948 (65.35%) had stage 1 pneumoconiosis, 5289 (21.67%) had stage 2 pneumoconiosis, and 1637 (6.71%) had stage 3 pneumoconiosis. The mean working years for dust exposure was 16.25±9.95 years for all patients, and the mean working years for dust exposure was 15.80±9.95 years for patients with stage 1 pneumoconiosis, 17.82±9.80 years for patients with stage 2 pneumoconiosis, and 16.31±9.90 years for patients with stage 3 pneumoconiosis. The highest number of cases of pneumoconiosis was reported in Wuxi (5744 cases, accounting for 23.54%) , followed by Zhenjiang (4160 cases, accounting for 17.05%) , Xuzhou (3851 cases, accounting for 15.78%) , Yancheng (3340 cases, accounting for 13.69%) , and Suzhou (2948 cases, accounting for 12.08%) . Major types of pneumoconiosis included silicosis (15392 cases, accounting for 63.07%) and coal workers' pneumoconiosis (5253 cases, accounting for 21.52%) . In this survey, 21115 completed follow-up, among whom 15924 survived and 5191 died, 15924 patients with pneumoconiosis survived, among whom 7461 (46.85%) had an age of ≥70 years and 2515 (15.79%) were exposed to dust for 5-9 years. The industries involved were mainly coal mining and washing industry (5687 cases, accounting for 35.71%) and public management, social security, and social organization (3349 cases, accounting for 21.03%) ; in terms of security, 7999 patients (50.23%) were covered by occupational injury insurance, 946 (5.94%) were compensated by employers, 4537 (28.49%) were covered by basic medical insurance for urban and rural residents, 1590 (9.98%) were covered by critical illness insurance, and 5458 (34.28%) were covered by other types of social security, such as medical assistance and poverty relief.Conclusion:Silicosis and coal worker's pneumoconiosis are the key points for the prevention and treatment of pneumoconiosis in Jiangsu Province, and supervision should be strengthened for industries and regions with serious dust hazards.

Objective:To investigate the features, changing trend, and rules of pneumoconiosis in Jiangsu Province, China, as well as the health status of patients with pneumoconiosis.Methods:From July to October 2019, the patients with pneumoconiosis, reported up to the end of 2018 in Jiangsu Province, were enrolled as respondents, and follow-up and retrospective investigation were performed. A total of 24405 patients with pneumoconiosis were investigated, and related data were collected from the monitoring system of cause of death for residents, pneumoconiosis network reporting system, occupational disease diagnosis institution, management institutions for the reporting of occupational diseases, and related residents' committee or village committee. The patients with pneumoconiosis, who had been reported, were followed up by telephone or on-site visit to obtain the information on their conditions. A descriptive analysis was performed for age of onset, working years, sex, category of industry, type of pneumoconiosis, annual disease onset, geographic distribution, and medical security.Results:Among the 24405 patients, a male/female ratio was 16.81∶1. Of all 24405 patients, 15948 (65.35%) had stage 1 pneumoconiosis, 5289 (21.67%) had stage 2 pneumoconiosis, and 1637 (6.71%) had stage 3 pneumoconiosis. The mean working years for dust exposure was 16.25±9.95 years for all patients, and the mean working years for dust exposure was 15.80±9.95 years for patients with stage 1 pneumoconiosis, 17.82±9.80 years for patients with stage 2 pneumoconiosis, and 16.31±9.90 years for patients with stage 3 pneumoconiosis. The highest number of cases of pneumoconiosis was reported in Wuxi (5744 cases, accounting for 23.54%) , followed by Zhenjiang (4160 cases, accounting for 17.05%) , Xuzhou (3851 cases, accounting for 15.78%) , Yancheng (3340 cases, accounting for 13.69%) , and Suzhou (2948 cases, accounting for 12.08%) . Major types of pneumoconiosis included silicosis (15392 cases, accounting for 63.07%) and coal workers' pneumoconiosis (5253 cases, accounting for 21.52%) . In this survey, 21115 completed follow-up, among whom 15924 survived and 5191 died, 15924 patients with pneumoconiosis survived, among whom 7461 (46.85%) had an age of ≥70 years and 2515 (15.79%) were exposed to dust for 5-9 years. The industries involved were mainly coal mining and washing industry (5687 cases, accounting for 35.71%) and public management, social security, and social organization (3349 cases, accounting for 21.03%) ; in terms of security, 7999 patients (50.23%) were covered by occupational injury insurance, 946 (5.94%) were compensated by employers, 4537 (28.49%) were covered by basic medical insurance for urban and rural residents, 1590 (9.98%) were covered by critical illness insurance, and 5458 (34.28%) were covered by other types of social security, such as medical assistance and poverty relief.Conclusion:Silicosis and coal worker's pneumoconiosis are the key points for the prevention and treatment of pneumoconiosis in Jiangsu Province, and supervision should be strengthened for industries and regions with serious dust hazards.

Objective? To explore the effects of transcutaneous electrical acupoint stimulation(TEAS) combined with chewing gum on the recovery of gastrointestinal function after colorectal tumor resection. Methods? A total of 156 patients who underwent laparoscopic radical resection of colorectal cancer in Department of Gastrointestinal Surgery in Guangxi Medical University Affiliated Tumor Hospital were selected as participants in this study by convenience sampling from September of 2016 to September of 2017 and divided into the conventional group, TEAS group, combination group with 52 patients in each group based on random number table. The conventional group received conventional nursing care after surgery, and the TEAS group received TEAS intervention apart from that, and the combination group received gum chewing combined with TEAS intervention. The first bowel sounds, first anal exhaust, first anal defecation, first tolerance to solid food, hospitalization time and complications were compared among the three groups. Results? There were significant differences in the first anal exhaust, the first tolerance to solid food and the first defecation time among the three groups (P＜0.01). There was no significant difference in the incidence of complications among the three groups (P＞0.05), but the incidence of intestinal obstruction in the combination group was lower than that in the TEAS group and the conventional group with statistical difference (P＜ 0.05). Conclusions TEAS combined with chewing gum can promote the recovery of gastrointestinal function and reduce the incidence of ileus after radical resection of rectal cancer.

Objective To discuss whether the content and method of pre-job training meet the need of medical trainees and to give some advice on its reformation. Methods 350 trainees enrolled by The First Affiliated Hospital of Chongqing Medical University attended the two-day standardized pre-job training in September, 2016. The self-designed satisfaction questionnaires on contents and method of pre-job training were distributed to all trainees after training, and then the statistical analysis was completed by SPSS 11.0 software. The satisfaction rate higher than80% was deemed as satisfactory, and the satisfaction rate lower than80% was regarded as unsatisfactory. Results 350 questionnaires were distributed in total, with 335 valid responses returned.. The result showed that the number of trainees who were satisfied with the training contents of medical law and rules and regulations, writing norms of medical documents, infection control, medical information technology, medical insurance policy, fire control and personal security and the use of library resources were 321(95.82%), 318(94.93%), 310(92.54%), 302(90.15%), 251(74.93%), 234(69.85%) and 220 (65.67% ) respectively. There were 254 (75.82% ) trainees who were satisfied with the training methods. Conclusions All medical trainees were satisfied with most contents of current pre-job training. However, the trainings on the extension of clinical expertise and the improvement of clinical skills should be added. Almost all trainees were dissatisfied with the training method, which should be diversified. Fur-ther improvement on contents and methods for current pre-job training will be conducive to enhancing the quality of medical trainees.

Cholesteatoma is a non-neoplastic, keratinizing lesion, characterized by the proliferation of epithelium with aberrant micro-architecture into the middle ear or mastoid cavity. The exact pathogenic molecular mechanisms behind the formation and propagation of cholesteatoma remain unclear. Without timely detection and intervention, cholesteatomas can become dangerous and result in numerous intracranial and extracranial complications. In this review, the current researches about inflammatory mediators, enzymatic activity, growth factors, oxidative stress,infection and genetics in acquired cholesteatoma pathogenesis are discussed.
Cholesteatoma, Middle Ear ; pathology ; Ear, Middle ; pathology ; Humans ; Mastoid ; pathology

Anemia, Iron-Deficiency ; Humans

Objective To investigate the normal ranges of RET-He and reticulocyte grouping parameters of healthy adults in Wenzhou. Methods A total of 1 000 samples from healthy adults were collected in Wenzhou from August 2008 to February 2010. There were 506 males and 494 females. The individuals were stratified based on age into three groups:20 to 40-year-old group (n = 341 ), ＞40 to 60-year-old group (n =316), and ＞60-year-old group (n =343). All blood samples were drawn in EDTA-K2 anticoagulated blood. Peripheral RET-He and reticulocyte grouping parameters ( IRF, LFR, MFR, HFR)were determined by Sysmex XE-2100 automated hematology analyzer. The instrument was calibrated and validated before testing All specimens were analyzed within 2 hours. RET-He, RET absolute value and RET percentage were normal distribution, the normal range was established by using ((x)-1.96s,(x)+ 1.96 s)method. IRF, LFR, MFR and HFR data were skewed distribution,the normal range was established by using (P2.5 ,P97.5 )percentile method. Results The mean and normal range of RET-He were (33.91 ± 1.77) pg and (30.44 - 37.38) pg in male, (33.97 ± 1.85) pg and (30.34 - 37.60) pg in female,respectively. There was no significant difference between the two groups ( t =-0.533, P＞0.05 ). The mean and normal range of RET absolute value were (0.051±0.023) × 1012/L and (0.006 -0.096)×1012/L in male,which were (0. 037 ±0. 026) × 1012/L and (0 -0. 088) × 1012/L in female, there was significant difference between the two groups ( t = 8. 409, P ＜ 0. 05 ) . The mean and normal range of RET percentage in male were(1.041 ±0.459)% and (0. 141 -1.941)% , and in female were (0.869±0.603)% and (0-2. 051 )%, which showed significant difference (t =5.074,P ＜0. 05). The normal ranges of LFR,MFR,HFR,IRF in male were 0. 951 (0.866 -0.988) ,0.046(0.010 -0.114) ,0. 003(0 -0.023) ,0. 050(0.012-0.134), and in female were 0.096(0.880 -0.991) ,0.039(0.008 -0.113) ,0.002(0-0.016) ,0.040(0.009-0.121), respectively. There were significant differences between the two groups (Z values were -5.044, -4.793, -3.559, -5.075, respectively,all P＜0.05). The means of RET-He in 20 to 40-year-old group, ＞40 to 60-year-old group, ＞ 60-year-old group and all age group were (33.38±1.49),(34.36 ±1.46), (34.12±2.21) and (33.94 +1.81) pg, respectively. The normal ranges were(30.46-36.30), (31.50 -37.22), (29.79 - 38.45) and (30.39 - 37.49) pg, which showed statistical difference( F =28. 072,P ＜0. 05). In addition, the normal range of RET-He in 20 to 40-year-old group was lower than that of ＞ 40 to 60-year-old group and ＞ 60-year-old group ( q values were 9. 970, 7. 791,respectively, P＜0. 05). The normal ranges of LFR, MFR, HFR, IRF in ＞ 60-year-old group were 0.961(0. 878 -0. 992) ,0. 037(0. 007 -0. 105 ) ,0. 002(0 -0. 020) and 0. 039(0. 008 -0. 117) ,while they were 0.953(0. 867 -0.990), 0.045(0.009 -0. 116) ,0.003(0 -0.019) ,0. 050(0. 010 -0. 133) in 20 to 40 -year-old group , and 0. 951 (0.855 -0.989) ,0.047 (0.010 - 0.133 ) ,0.003 ( 0-0.020), 0.049 (0.011-0.149)in ＞40 to 60-year-old group, which showed statistical difference (Z values were -3. 949, -4.236,-4. 373, -4. 973, - 2. 747, - 3. 275, - 3.901, - 4. 185, respectively, all P ＜ 0. 05). There was nodifference between male and female for RET-He, the same normal ranges could be used, but there was significant difference between different age groups. LFR, MFR, HFR and IRF were statistically different between different age groups and different sex groups. The normal ranges should be established by gender and age. Conclusion The normal ranges of RET-He and reticulocyte grouping parameters about healthy adults in Wenzhou are established, which plays an important role in clinical value of RET parameters.