Objective To investigate the effect of early active cycle breathing technique(ACBT)on aspiration in patients with dysphagia after partial laryngectomy.Methods A total of 40 patients with laryngeal cancer with dysphagia who were hospitalized in the Department of Otorhinolaryngology of the Third Xiangya Hospital of Central South University in January 2019～January 2022 were selected,and the patients were randomly divided into 20 cases in the observation group and the control group by random number method,the control group was given routine swallowing function training,and the observation group was combined with active cycle of breathing technique(ACBT)on the basis of the control group.The two groups were treated 5 days a week,twice a day,45 minutes each for 2 weeks.The M.D.Anderson Dysphagia Inventory(MDADI),maximum phonation time(MPT),and Standardized Swallowing Assessment(SSA),flexible endoscopic examination of swallowing(FEES)combined with modified invasion and aspiration score(MPAS score)and overall clinical efficacy before and after treatment were compoued between the two groups.Results After 2 weeks of treatment,the swallowing function of both groups improved,but the MDADI scores in the observation group were better than those of in the control group in all cate-gories(P＜0.001),MPT(7.19±1.31)was better than that of the control group(4.29±0.88)(=9.436,P＜0.001),SSA(19.25±1.12)was better than that of the control group(21.20±2.55)(=-2.894,P＜0.05),and FEES combined with MPAS score(1.75±0.85)was better than the control group(2.70±1.34)(=-2.674,P＜0.001),and the overall clinical efficacy(18,90.00％)was better than the control group(12,60.00％)(Z=-3.894,P＜0.001).Conclusion Early application of active breathing and circulation technique combined with swallowing training can improve the swallowing function of patients to a greater extent and reduce the incidence of aspiration compared with swallowing function training alone.

Objective:To analyze and understand the level of occupational external radiation personal dose of radiation workers in a hospital, and provide a reference for radiation protection.Methods:In May 2023, the personal dose monitoring data of all radiation workers in the hospital from 2018 to 2022 were collected, and their occupational external radiation exposure levels were analyzed and evaluated. All radiation workers were divided into radiation diagnosis, radiotherapy, interventional radiology, and nuclear medicine according to their occupational categories.Results:A total of 1626 person-times were monitored from 2018 to 2022, and the average annual effective dose per person (0.13-0.36 mSV) was lower than the national limit of 20 mSv. The average annual dose of nuclear medicine was the highest (0.36 mSv), and interventional radiology was lower (0.13 mSv). The average annual dose of individuals was the highest in 2020 (0.24 mSv) .Conclusion:The average annual effective dose per person of radiation workers in this hospital is lower than the national standard, and it is still necessary to strengthen the inspection of the wearing of personal dosimeters and the using of protective equipment for radiation workers.

Objective:To analyze and understand the level of occupational external radiation personal dose of radiation workers in a hospital, and provide a reference for radiation protection.Methods:In May 2023, the personal dose monitoring data of all radiation workers in the hospital from 2018 to 2022 were collected, and their occupational external radiation exposure levels were analyzed and evaluated. All radiation workers were divided into radiation diagnosis, radiotherapy, interventional radiology, and nuclear medicine according to their occupational categories.Results:A total of 1626 person-times were monitored from 2018 to 2022, and the average annual effective dose per person (0.13-0.36 mSV) was lower than the national limit of 20 mSv. The average annual dose of nuclear medicine was the highest (0.36 mSv), and interventional radiology was lower (0.13 mSv). The average annual dose of individuals was the highest in 2020 (0.24 mSv) .Conclusion:The average annual effective dose per person of radiation workers in this hospital is lower than the national standard, and it is still necessary to strengthen the inspection of the wearing of personal dosimeters and the using of protective equipment for radiation workers.

Objective To investigate the effects of long-term exposure to three new types of light emitting diode (LED) sources on the behavior, learning, and memory of rats. Methods A total of 160 specific pathogen-free SD rats were divided into eight groups as followed, trichromatic fluorescent lamps color temperature control group, violet-chip full-spectrum white LED group, blue-chip white LED group, and blue-chip full-spectrum white LED group based on the light sources types, with color temperature of 4 000 K and 6 500 K groups in each group using the 4×2 factorial design. There were 20 rats in each group, with half of the rats were males and half females. Rats were exposed to artificial lighting, and the illumination was set at 750 lx. The rats in each group were exposed to different lighting environments for 12 hours per day for 24 weeks. The open-field and step-down tests were conducted in rats after 24 weeks exposure, followed by sacrifice of rats and measurement of organ coefficients. Differences in body weight, organ coefficients, and neurobehavioral indexes of rats in different groups were compared. Results The spleen coefficient of female rats decreased in blue-chip white LED of 6 500 K color temperature group, and the liver coefficient of male rats decreased in the violet-chip full-spectrum white LED of 4 000 K color temperature, blue-chip full-spectrum white LED of 4 000 K color temperature, and blue-chip full-spectrum white LED of 6 500 K color temperature groups, compared with the same-sex rats in trichromatic fluorescent lamps with same-color temperature control group (all P<0.05). The result of different types of light sources compared in the open-field test showed that the index of total distance and movement speed of female rats in the blue-chip full-spectrum white LED group were lower than those in the other three groups, and the time cost to the central area was longer than that in the blue-chip white LED group and the violet-chip full-spectrum white LED group (all P<0.05). The total distance and movement speed of male rats in the blue-chip full-spectrum white LED group were longer or higher than those in the violet-chip full-spectrum white LED group (all P<0.05). Based on the comparison of color temperature, the time and total distance of male rats in 6 500 K color temperature group were lower than that in the 4 000 K color temperature group (both P<0.05). In the step-down test, both male and female rats in the blue-chip full-spectrum white LED group made more errors compared with other three groups with the same gender (all P<0.05). Conclusion Based on the experimental conditions of this study, the blue-chip full-spectrum white light LED affects behavior, learning and memory of the rats, and trichromatic fluorescent lamp has the lowest effect on neurobehavior. The color temperature also affects behavior of the rats, and high color temperature has higher risk.

Objective:To investigate the correlations between perfused lung volumes, visual scores (using perfusion SPECT/CT) and right-heart catheter (RHC) hemodynamic parameters in patients with chronic thromboembolic pulmonary hypertension (CTEPH).Methods:A total of 51 consecutive CTEPH patients (17 males, 34 females, age (59±12) years) in the First Affiliated Hospital of Guangzhou Medical University between March 2015 and July 2019 were retrospectively analyzed. All patients underwent lung perfusion SPECT/CT imaging and RHC examinations. Perfused lung volumes were determined using threshold-based (15%-85%) segmentation. Visual semiquantitative scoring in each lung segment was performed using Begic method. RHC hemodynamic parameters including pulmonary artery systolic pressure (PASP), pulmonary arterial diastolic pressure (PADP), mean pulmonary artery pressure (mPAP), pulmonary arteriolar wedge pressure (PAWP), pulmonary vessel resistance (PVR), cardiac output (CO), cardiac index (CI) were recorded. Spearman correlation analysis was used to evaluate the correlations between perfused lung volumes, visual scores and hemodynamic parameters.Results:There were significant correlations between perfused lung volumes (30%-70% threshold) and mPAP ( rs values: from -0.414 to -0.302, all P<0.05). Among them, perfused lung volumes under the threshold of 40% and 45% were moderately correlated with mPAP ( rs values: -0.414, -0.412, both P<0.05). Perfused lung volume (40% threshold) was moderately negatively correlated with PASP, PADP ( rs values: -0.402, -0.440, both P<0.05), and slightly negatively correlated with PVR ( rs=-0.352, P<0.05). Visual scores were slightly positively correlated with the PADP ( rs=0.311, P<0.05), while there was no correlation between visual scores and other RHC hemodynamic parameters ( rs values: from -0.201 to 0.275, all P>0.05). Conclusion:Perfused lung volumes based on threshold-based segmentation in lung perfusion SPECT/CT imaging can accurately reflect hemodynamic status and may provide useful information for severity assessment of CTEPH.

Objective:To explore the effects of scenario simulation teaching of junior nurses in a burns department on the fluid resuscitation care of massive burn patients during shock stage.Methods:From March 2018 to July 2019, 25 junior nurses fixed in the Department of Burn of Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine met the inclusion criteria and were recruited in this prospective before-after self-control study, including 21 females and 4 males, aged 23 to 26 years. They had a work experience of 1.0 (1.0, 2.0) years in the Department of Burn. Three teaching scenarios were made according to the three major problems in the fluid resuscitation nursing of extensive burn patients during shock stage. The teaching plans were written based on the theoretical framework of Jeffrie's nursing simulation teaching. The high feasibility and practicability of the teaching plans was verified through expert consultation and evaluation by junior nurses. According to the three scenarios in the teaching plan, the junior nurses were performed with scenario simulation teaching, with 2 hours for each scenario, 6 hours in total. In one month before and after the teaching (hereinafter referred to as before and after teaching), the comprehensive ability of junior nurses was evaluated by the teachers using the self-designed junior nurse comprehensive ability evaluation scale, and their behaviors were evaluated by themselves with Performance Self-rating Scale for Nursing Students on High Simulation Training. Data were statistically analyzed with paired sample t test. Results:After teaching, the scores on communication skills, patient admissions, condition assessments, fluid resuscitation, emergency treatment, drug management, nursing skills, instrument use, teamwork, and humanitarian care and total score in the comprehensive ability evaluation of junior nurses as evaluated by teachers were significantly higher than those before teaching ( t=-8.060, -11.421, -17.232, -24.800, -4.670, -11.916, -12.131, -11.606, -14.632, -13.325, -25.068, P<0.01), with 4 items including fluid resuscitation, condition assessment, nursing skills, and equipment operation having higher scores. After teaching, the nurses' self-rating scores on communication, division of labor and cooperation, clinical decision-making, professional knowledge and skills, and professional development and critical thinking and total score were (4.6±0.4), (4.8±0.3), (4.6±0.3), (4.6±0.4), (4.6±0.4), and (23.2±1.5) points respectively, which were significantly higher than the corresponding scores of (4.1±0.7), (4.2±0.7), (3.9±0.5), (3.7±0.6), (3.9±0.5), and (18.8±2.6) points before teaching ( t=-3.361, -5.721, -6.987, -7.923, -7.922, -7.367, P<0.01). Conclusions:With solving the practical problems in nursing works of fluid resuscitation care of massive burn patients during shock stage as entry point, scenario simulation teaching aims to train the clinical practice ability and adaptability of junior nurses, thereby improving junior nurses' comprehensive ability of clinical practice in the fluid resuscitation care of massive burn patients during shock stage, enhancing their self-confidence and critical thinking ability.

Microbes play important roles in human health and disease. The interaction between microbes and hosts is a reciprocal relationship, which remains largely under-explored. Current com-putational resources lack manually and consistently curated data to connect metagenomic data to pathogenic microbes, microbial core genes, and disease phenotypes. We developed the MicroPhenoDB database by manually curating and consistently integrating microbe-disease associ-ation data. MicroPhenoDB provides 5677 non-redundant associations between 1781 microbes and 542 human disease phenotypes across more than 22 human body sites. MicroPhenoDB also pro-vides 696,934 relationships between 27,277 unique clade-specific core genes and 685 microbes. Dis-ease phenotypes are classified and described using the Experimental Factor Ontology (EFO). A refined score model was developed to prioritize the associations based on evidential metrics. The sequence search option in MicroPhenoDB enables rapid identification of existing pathogenic microbes in samples without running the usual metagenomic data processing and assembly. Micro-PhenoDB offers data browsing, searching, and visualization through user-friendly web interfaces and web service application programming interfaces. MicroPhenoDB is the first database platform to detail the relationships between pathogenic microbes, core genes, and disease phenotypes. It will accelerate metagenomic data analysis and assist studies in decoding microbes related to human dis-eases. MicroPhenoDB is available through http://www.liwzlab.cn/microphenodb and http://lilab2. sysu.edu.cn/microphenodb.

Objective To investigate the expressions of CD28 and CD117 in patients with newly diagnosed multiple myeloma (MM) and their clinical significances. Methods The clinical data of 115 newly diagnosed MM patients in the First Affiliated Hospital of Zhengzhou University from May 2015 to December 2017 were retrospectively analyzed. The expressions of CD28 and CD117 were detected by using multiparameter flow cytometry. The relationship between the expressions of CD28 and CD117 and MM staging and clinical parameters was analyzed. The staging was performed according to the International Staging System (ISS). Results Among these 115 patients, there were 15 patients with CD117 positive and 30 patients with CD28 positive. Erythrocyte sedimentation rate (r ＝ -0.481, P ＝ 0.039), Cˉreactive protein level (r ＝ -0.314, P＝0.015), the proportion of plasma cells detected by bone marrow cytology (r＝-0.027, P＝0.001) were negatively correlated with CD117 positive expressions. CD28 positive expression was positively correlated with lactate dehydrogenase level (r ＝ 0.249, P ＝ 0.033) and ISS stage (r ＝ 0.319, P ＝ 0.017), while it was negatively correlated with hemoglobin level (r ＝ -0.372, P ＝ 0.026). CD28 positive was associated with light chain type, and nonˉsecretory type mostly occurred (P ＝ 0.016). The incidence of osteolytic lesions in CD28 positive group and CD117 positive group was high, but there was no statistical difference between CD28 positive group, CD117 positive group and CD28 negative group, CD117 negative group (P ＝ 0.052, P＝0.479). Conclusions The positive expression of CD117 in the early stage of MM patients is higher than that in the advanced stage, and the expression of CD28 positive in the advanced stage of MM patients is higher than that in the early stage. CD28 and CD117 can be used as indicators of prognosis stratification in the patients with newly diagnosed MM.

Objective To explore the application value of virtual monochromatic imaging combined with adaptive statistical iterative reconstruction (ASIR) and automatic spectral imageing mode selection(ASIS) in reducing the radiation dose and contrast dose of CT portal venography.Methods We retrospectively collected 120 cases (80 males and 40 females) who underwent upper abdominal enhancement CT from January 2017 to April 2017.Patients were divided into 3 groups (40 cases in each group) according to the scanning program.Group A used conventional 120 kVp scan,NI =10,contrast agent dosage was 450 mgI/kg of body weight,image was reconstructed with 50％ ASIR technique;Groups B and C used spectral CT mode,NI =10 (Group B),NI =13 (Group C),the amount of contrast agent was 300 mgI/kg of body weight,and the image was reconstructed with 60 keV +50％ ASIR.One-way analysis of variance was used to compare the mean CT values and their differences,image noise,SNR and CNR of portal vein and liver parenchyma in three groups of images.Subjective image quality scores were performed on three groups of images by two senior radiologists.The patient's CTDIvol,DLP were recorded and the E was calculated.Results The amount of contrast agent in group B and C was reduced by about 30％ compared with group A.The portal vein CT values of groups A,B,and C were 168.22± 17.82,209.06±20.07,and 211.03±25.60.The portal vein CT values of group B and C were significantly higher than those of group A,respectively (t =-9.625,-8.680,P ＜ 0.05).The CT value difference between portal vein and liver parenchyma was 60.01± 17.01,106.63±25.83,107.72±25.39,respectively.SNRs were 8.48±1.41,12.64±2.94,10.77±1.94,and CNR were 5.16±1.80,8.13±2.54,7.32±1.84,respectively.The image quality scores were 3.53±0.68,4.75±0.54 and 4.53±0.64,respectively.The CT value difference,SNR,CNR and image quality scores of group B and group C were significantly higher than those in group A(t=-9.536,-9.857,-8.082,-6.064,-6.050,-5.308,-8.912,-6.779,P＜0.05).The CTDIvolof groups A,B and C were (12.15±5.02) mGy,(12.34±4.18) mGy,(10.03±3.13) mGy,DLP were (348.62± 155.99) mGy· cm,(355.56± 131.07) mGy·cm,(287.10±92.25) mGy·cm,respectively,E were (5.23±2.34) mSv,(5.33±1.97) mSv,(4.31±.1.38) mSv,compared with the A and B groups,the CTDI,ol,DLP and E of the C group were significantly lower(t=2.274,2.147,2.147,2.812,2.702,2.702,P＜0.05),and CTDIvol,DLP and E were decreased by 19％.Conclusions In CT portal venography,NI =13,60 keV combined with 50％ ASIR reconstruction and ASIS can be used to personalize the contrast dose and radiation dose of the patient and provide images that meet the diagnostic requirements.

Objective To study the influence of the minimal invasive Nuss procedure on the pulmonary function of post-operative pectus excavatum patients. Methods Conduct retrospective analysis on the data from 676 pectus excavatum patients who were treated by the minimal invasive Nuss procedure from August 2006 to November 2014. Wherein 182 cases have com-plete preoperative and postoperative pulmonary-function data of one year, three years. These cases were divided into 3 groups according to the age, namely, children group( from 6 to 12 years old, 34 cases) , adolescents group( from 13 to 18 years old, 80 cases) , adults group( above 18 years old, 68 cases) , among which there were 71 cases with pulmonary function data of 1 year after removal of steel plate, they were divided into 3 groups in the same way,namely, children group(20 cases), adoles-cents group(22 cases), adults group(29 cases) . To compare and analyze the pulmonary function indicatrix of patients with dif-ferent ages in preoperative stage, 1 year, 3 years postoperative stages and 1 year after dismantling the steel plate stage, and to investigate the influence of the minimal invasive Nuss procedure on the postoperative lung function. Results The pulmonary function indicatrix in preoperative stage, 1 year, 3 years postoperative stages of the children group did not have significant difference(P>0. 05); the FVC, FEV1 indicatrix of adolescents and adults groups declined after operation in 1 year and 3 years compared with the preoperative stage(P<0. 05), FEF 25％ -75％, FEF 50％, FEF75％ were improved after operation in 1 year and 3 years compared with the preoperative stage(P<0. 05);the pulmonary function indicatrix of three age groups in the 1 year after dismantling the steel plate stage had all improved, in which the pulmonary function indicatrix of the children group improves most significantly(P<0. 05). Conclusion After the minimal invasive Nuss procedure before the plate dis-mantling process, the pulmonary function of children patients remains to be similar. Partial ventilatory function was damaged in the adolescents and adults patients. After the plate dismantling process, the pulmonary function indicatrix of each age group hasimproved in different degrees. Improvement effect is the most significant in patients below the age of 12.