Purpose To establish and validate an ultrasound-based radiomics nomogram for predicting ipsilateral axillary lymph node metastasis in stage T1 breast cancer.Materials and Methods 443 stage T1 breast cancer patients in the First Affiliated Hospital of Wannan Medical College from January 2012 to June 2021 were retrospectively collected.All patients were randomly divided into training(n=310)and validation(n=133)group.ITK-SNAP was used to delineate the tumor margins,and Pyradiomics software was used to extract features.Image omics models and Rad-scores were constructed after feature screening.Clinical model,radiomics model and combined diagnostic models were developed,with the combined model's nomogram constructed.The models'predictive values were assessed via receiver operating characteristic curves.Results Multivariate Logistic regression analysis showed that the positive axillary ultrasonography,high echo halo and abundant internal blood supply were the independent risk factors of axillary lymph node metastasis.Then the clinical model was constructed,and imaging omics model was also constructed by feature screening.The combined model,which incorporated clinical and imaging features,demonstrated superior predictive performance.In the training group,the area under the curve for the combined model was 0.822,which was significantly higher than that of the clinical model(0.765)and radiomics model(0.723)(P=0.002 1,P=0.001 8).In the validation group,the area under the curve for the combined model was 0.846,outperforming the imaging omics model(0.686,P=0.001 8)and the clinical model(0.783),though the latter difference was not statistically significant(P=0.111 3).Conclusion Ultrasound-based radiomics combined diagnostic model effectively predicts ipsilateral axillary lymph node metastasis in stage T1 breast cancer,demonstrating high clinical predictive efficiency.

新冠病毒感染疫情严重威胁着世界各国人民的生命健康。目前，对病毒感染的防治研究主要集中在抑制病毒与分子受体的结合上。AXL作为新发现的严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）受体，在协助病毒感染人体呼吸系统中发挥着重要作用，是未来临床干预的潜在靶点。本研究对已发表的单细胞测序数据进行整理和分析，发现AXL在年轻人肺细胞中的表达水平明显高于老年人。人胚肺二倍体成纤维细胞（2BS）是衰老研究的公认细胞株。本文采用2BS细胞构建复制性细胞衰老模型，发现年轻细胞中AXL的蛋白水平明显高于衰老细胞，据此推测年轻人感染的风险可能更高，需要注意防护。我们发现一种羊栖菜褐藻多糖硫酸酯组分（SFW-3）可显著下调年轻2BS细胞中AXL的表达水平，表明SFW-3具有一定的抗SARS-CoV-2感染的研究价值，同时表明2BS细胞株也可作为潜在的SARS-CoV-2体外感染模型。
Humans ; SARS-CoV-2 ; Sargassum/metabolism* ; Diploidy ; Sulfates/metabolism* ; COVID-19 ; Polysaccharides/pharmacology* ; Lung

Objective:To build a three-dimensional evaluation model of single bed efficiency in an obstetrics and gynecology hospital and provide reference for bed management in hospital.Methods:The sample ward and key indicators were determined through interviews. A two-level database was built according to patients′ data from hospital information system. K-means cluster analysis was used to get the beds classified by annual average vacancy(x), annual average turnover(y) and annual average case-mix index per capita(z). The authors built the three-dimensional bed efficiency model with x, y, z as boundaries and analyzed the bed efficiency by comparing the within group average point A k( x k, y k, z k) with the overall average point A0( x, y, z). Whereafter the bed efficiency of each medical work team was analyzed. Results:Thirty-six beds were classified into 4 categories according to utilization efficiency. 50% of the beds(18 beds) were well used, 28%(10 beds) had room for improvement, and 19%(7 beds) may have resource waste. Significant differences existed in bed efficiency among medical work teams.Conclusions:The model in our study can realize in-depth exploration by evaluating bed efficiency from two aspects of the whole ward and each medical work team. This model, which is mainly applicable to the situation where beds are under the charge of fixed medical work groups or doctors, can be adjusted and extended to meet different strategic needs of hospitals.

Objective:To investigate and analyze the epidemiological and clinical characteristics of 46 patients with corona virus disease 2019 (COVID-19) in Beijing City.Methods:A retrospective study was conducted to analyze the data of 46 patients with COVID-19 in Beijing from 20th January 2020 to 8th February 2020 at the Fifth Medical Center of the PLA General Hospital in Beijing City. Twelve, 23 and 11 patients were assigned to the mild group, common group and severe group, respectively. The epidemiological history, clinical characteristics, laboratory tests and imaging inspections were analyzed. Statistical analysis used Fisher exact test. If P<0.05, post- hoc test was used for pairwise comparison, and the statistics were corrected by Bonferroni test. Results:Among the 46 patients included in this study, 27 were male and 19 were female. The age range was between 3-79 years old, and the age was (41.8±16.3) years old. The average incubation period was (4.85±3.00) days. A total of 26 cases (56.5%) were clustered patients, and 26 cases had a history of staying in Wuhan, 10 cases had contact with Wuhan personnel. Fever (39 cases, 84.8%), cough (27 cases, 58.7%), and fatigue (25 cases, 54.3%) were the main clinical symptoms for these patients. The decrease in white blood cell counts occurred in 12 patients, four had the decrease in T lymphocyte percentage, 17 had the decrease in CD4 + T lymphocyte counts, seven had the decrease in CD8 + T lymphocyte counts, 21 had the increase level of C reactive protein (45.7%), and interleukin-6 (IL-6) level increased in 32 cases (69.6%), erythrocyte sedimentation rate (ESR) increased in 23 cases (50.0%), serum ferritin level increased in 26 cases (56.5%), and blood lactic acid level increased in nine cases. There were statistically significant differences in the proportion of cases with decreased absolute value of CD8 + T lymphocytes and T lymphocytes counts among the mild, common and severe groups (all P<0.05). Comparing the proportion of cases in the three groups with elevated C reactive protein, IL-6, ESR, serum ferritin and blood lactic acid levels, the differences were statistically significant (all P<0.05). The proportion of cases with elevated C reactive protein levels in severe group was higher than those in mild and common groups. The proportion of cases with elevated IL-6, ESR, and serum ferritin levels in severe and common group were higher than those in mild group. The proportion of cases with elevated blood lactic acid levels in severe group was higher than those in mild group. The differences between the above groups were statistically significant (all adjusted P<0.017). Analysis of chest X-rays results showed that 34 patients (73.9%) had inflammation in the lungs. Conclusions:The epidemiological characteristics of patients with COVID-19 in Beijing City are mainly imported cases and clustered cases. The clinical manifestations are mainly fever, fatigue and cough. C reactive protein, IL-6, ESR, serum ferritin and blood lactic acid levels are higher in severe patients.

Objective:To understand the knowledge awareness and service acceptance of HIV non-occupational post-exposure prophylaxis (nPEP) men who have sex with men (MSM) among college students in three cities of China.Methods:Male college students in 10 universities of Beijing, Shenzhen and Kunming aged 18 and above who had sex with men in the last 3 months were recruited as research objects by cluster stratified sampling from March 15, 2019 to April 14, 2019.Basic information, sexual behavior characteristics, knowledge, and service acceptance of nPEP were collected through online questionnaire survey. Multivariate dichotomy and unconditioned logistic regression model was used to explore related factors about knowledge awareness and service acceptance of nPEP.Results:A total of 293 MSM were surveyed. The average age was (21.0±0.2) years old, and 91.1% (267) were undergraduates. In the last 3 months before the survey, 54.3%(159) used condom each time of sex; 4.4%(13) had intercourse with the HIV infected men, and 9.2% (27)suffered STDs in the past 6 months. The 29.4% (86) had not received HIV testing in the past year. The nPEP knowledge awareness rate was 47.8% (140). The 21.2% (62) counseled nPEP services, and 9.9% (29) received nPEP services. After multiple logistic regression analysis, compared with those who not received HIV testing in the past year, OR(95% CI) value of those who received HIV testing for more than twice in the past year to aware the nPEP knowledge was 3.15 (1.01-9.86). Compared with those who not received HIV testing in the past year, OR(95% CI) value of those who received HIV testing for more than twice in the past year to counsel the nPEP services was 5.29 (1.51-18.51). Compared with those who never used rush in the last 3 months, OR(95% CI) value of those who ever used rush in the last 3 months to receive the nPEP services was 3.86 (0.99-14.98). Compared with those who not sexed with HIV infected in the last 3 months, OR (95% CI) value of those who sexed with HIV infected in the last 3 months to receive the nPEP services was 14.30 (3.35-61.03). Conclusion:The proportions of awareness of nPEP knowledge and acceptance of nPEP services are low. MSM among college students need further health education of the nPEP knowledge to improve the accessibility of services.

Objective:To understand the knowledge awareness and service acceptance of HIV non-occupational post-exposure prophylaxis (nPEP) men who have sex with men (MSM) among college students in three cities of China.Methods:Male college students in 10 universities of Beijing, Shenzhen and Kunming aged 18 and above who had sex with men in the last 3 months were recruited as research objects by cluster stratified sampling from March 15, 2019 to April 14, 2019.Basic information, sexual behavior characteristics, knowledge, and service acceptance of nPEP were collected through online questionnaire survey. Multivariate dichotomy and unconditioned logistic regression model was used to explore related factors about knowledge awareness and service acceptance of nPEP.Results:A total of 293 MSM were surveyed. The average age was (21.0±0.2) years old, and 91.1% (267) were undergraduates. In the last 3 months before the survey, 54.3%(159) used condom each time of sex; 4.4%(13) had intercourse with the HIV infected men, and 9.2% (27)suffered STDs in the past 6 months. The 29.4% (86) had not received HIV testing in the past year. The nPEP knowledge awareness rate was 47.8% (140). The 21.2% (62) counseled nPEP services, and 9.9% (29) received nPEP services. After multiple logistic regression analysis, compared with those who not received HIV testing in the past year, OR(95% CI) value of those who received HIV testing for more than twice in the past year to aware the nPEP knowledge was 3.15 (1.01-9.86). Compared with those who not received HIV testing in the past year, OR(95% CI) value of those who received HIV testing for more than twice in the past year to counsel the nPEP services was 5.29 (1.51-18.51). Compared with those who never used rush in the last 3 months, OR(95% CI) value of those who ever used rush in the last 3 months to receive the nPEP services was 3.86 (0.99-14.98). Compared with those who not sexed with HIV infected in the last 3 months, OR (95% CI) value of those who sexed with HIV infected in the last 3 months to receive the nPEP services was 14.30 (3.35-61.03). Conclusion:The proportions of awareness of nPEP knowledge and acceptance of nPEP services are low. MSM among college students need further health education of the nPEP knowledge to improve the accessibility of services.

Objective To investigate the efficacy of leflunomide combined with prednisone in the induction therapy of proliferative lupus nephritis (LN).Methods A prospective,multicenter,randomized controlled clinical trial was conducted in patients with biopsy-proved proliferative lupus nephritis recruited from 15 renal centers from 2013 to 2015.Patients were randomized to two groups.Oral leflunomide or intravenous cyclophosphamide was given to patients in each group.Both groups received a tapering course of oral prednisone therapy.All patients were followed up for 24 weeks.The blood biochemistry,urine index,clinical curative effect and adverse reaction were recorded and analyzed statistically.Results A total of 100 patients were enrolled in this clinical trial,including 48 patients in leflunomide group and 52 patients in cyclophosphamide group.After 24 weeks,the overall response rate was 79％ (95％ CI 67％-90％) in the leflunomide group and 69％ (95％ CI 56％-82％) in the cyclophosphamide group.23％ (95％CI 11％-35％) of patients in leflunomide group showed complete remission compared with 27％ (95％CI 24％-30％) in cyclophosphamide group (P=0.35).The levels of 24-hr urine protein excretion,SLEDAI and anti-dsDNA antibody titers were decreased in patients treated with leflunomide group after 24-weeks treatment.And the levels of serum albumin and complement 3 after treatment were significantly higher compared with these before treatment.There was also no significant difference in changes of 24-hr urine protein excretion,SLEDAI score,anti-dsDNA antibody titers,serum albumin and complement C3 levels after treatment between two groups.Incidence of adverse events did not differ between the leflunomide and cyclophosphamide group.Conclusions Leflunomide combined with prednisone showed same efficacy compared with cyclophosphamide as induction therapy for lupus nephritis.Leflunomide might be an useful medicine in the induction therapy of lupus nephritis.

Objective To investigate the rules of medication and combinations of anti-tumor formulas containing marine Chinese medicinals. Methods The anti-tumor formulas containing marine Chinese medicinal were collected from Marine Chinese Medicinal and Effective formulas, Dictionary of Chinese Marine Medicinals, Marine Chinese Materia Medica, and databases including CNKI. A database was established for data mining by using V2. 5 software of TCM inheritance support system (TCMISS). Results There were totally 251 anti-tumor formulas containing marine Chinese medicinals involved 417 Chinese medicinal including 36 marine Chinese medicinals. The nature of medicinals in these formulas were mainly cold, neutral and warm, flavors of them were mainly bitterness, pungency, sweetness and saltiness,and they mainly entered into meridians of liver,lung,stomach,spleen and heart. The analysis of association rules showed that core combination was Muli (Oyster Shell, Concha Ostreae)-Haizao (Seaweed, Sargassum)-Kunbu (Kelp, Thallus Laminariae), which was commonly combined with medicinals with effects of clearing heart,tonifying,resolving phlegm,dissipating binds,activating blood and resolving stasis in clinical practice. Entropy clustering analysis showed that there were 12 combinations with core medicinals,and they were Haizao-Haigeqiao(Clam Shell,Goncha Meretricis seu Cyclinae)-Kunbu, Zaojiaoci (Chinese Honeylocust Spine, Spina Gleditsiae)-Chuanshanjia (Pangolin Scales,Squama Manitis)-Jiangcan (Batryticated Silkworm, Bombyx Batryticatus), Muxiang (Common Aucklandia Root,Radix Aucklandiae)-Walengzi (Ark Shell, Concha Arcae)-Puhuang (Cattail Pollen, Pollen Typhae), Chansu (Toad Venom, Venenum Bufonis)-Xionghuang (Realgar, Realgar)-Zhenzhu (Pearl,Pernulo),Huangbai(Amur Cork-Tree,Cortex Phellodendri)-Yunaoshi(Fish Otolith,Asteriscus Pseudosciaenae)-Bingpian (Bomeol, Bomeolum Syntheticum), Haima (Sea Horse, Hippocampus)-Qingpi (Green Tangerine Peel, Pericarpium Citri Reticulatae Viride)-Qianniuzi (Pharbitis Seed, Semen Pharbitidis), Haizao-Kunbu-Gancao (Liquorice Root, Radix Glycyrrhizae), Wangbuliuxing (Vaccaria Seed,Semen Vaccariae)-Chuanshanjia-Muli, Fengfang (Hornet Nest, Nidus Vespae)-Walengzi-Qianxie (Scorpion,Scorpio),Shexiang (Musk,Moschus)-Xuejie (Dragon's Blood,Risina Draconis)-Zhenzhu, Huangbai (Amur Cork-Tree, Cortex Phellodendri)-Ruxiang (Frankincense, Olibanum)-Bingpian, and Qingpi-Wulingzhi (Trogopterus Dung, Faeces Trogopterorum)-Dafupi (Shell of Arecanut, Pericarpium Arecae). There were 6 new combinations, and they were Haizao-Haigeqiao-Kunbu-Gancao, Zaojiaoci-Chuanshanjia-Jiangcan-Wangbuliuxing-Muli, Muxiang-Walengzi-Puhuang-Fengfang-Qianxie, Chansu-Xionghuang-Zhenzhu-Shexiang-Xuejie, Huangbai-Yunaoshi-Bingpian-Ruxiang, and Haima-Qingpi-Qianniuzi-Wulingzhi-Dafupi. The high-frequency tumor diseases, totally 47, treated with anti-tumor for-mulas containing marine Chinese medicinals,were successively thyroid tumor,lung cancer,liver cancer, uterine fibroids, nasopharyngeal carcinoma, esophageal cancer, gastric cancer and mammary cancer. Conclusion There are rules to follow in treatment of tumors with marine Chinese medicinal. The different therapeutic effects can be achieved by different medicinal combinations,which has a very important value in guiding clinical medication and new medicinal development.

With more and more non-affiliated hospitals of universities joining the clinical teaching of infectious diseases,there have been some dilemmas on clinical teaching,such as the shortage of staff,teaching experience,poor lecture art and teaching enthusiasm,textbook lag,the shortage of case teaching abd students'fear of infectious disease etc. Countermeasures such as perfecting the organizational structure,formulating preferential policy,clearing historical mission,increasing students' interest in learning,adding new academic progress,enriching teaching methods,setting up experts'supervision will ensure the effective teaching quality.

OBJECTIVETo investigate the short-course and efficient way to treat mumps meningitis.

METHODSTotally 155 cases of mumps meningitis treated by intrathecal injection with dexamethasone only once were enrolled as experimental group and 55 similar cases treated with the common therapy as control.

RESULTSThe time for recoveries of temperature, headache, the pathologic reflexes and the total time of treatment were 32 hours, 15 hours, 12 hours and 3.1 days, respectively, while those of the control group were 58 hours, 24 hours, 32 hours, 6.5 days respectively. There was statistical difference between the two groups (P<0.01 or 0.05).

CONCLUSIONSIntrathecal injection with dexamethasone only once is efficient and safe in the treatment of mumps meningitis.

Anti-Inflammatory Agents ; therapeutic use ; Child ; Child, Preschool ; Dexamethasone ; therapeutic use ; Female ; Humans ; Infant ; Injections, Spinal ; Male ; Meningitis, Viral ; complications ; drug therapy ; Mumps ; complications ; drug therapy ; Treatment Outcome