As a common ophthalmic disease, pterygium exhibits a considerably high incidence in global area, particularly in regions with harsh natural environment. While it is unlikely to cause blindness, pterygium frequently disrupts the normal homeostasis of the tear film, leading to discomfort such as dry eyes and foreign body sensation, thereby significantly impairing patients' quality of life. Furthermore, the high surgical intervention rate for pterygium consumes substantial medical resources. Therefore, investigating the underlying mechanisms of pterygium development is essential for its prevention and control. Extensive research has demonstrated the correlation between solar radiation and pterygium occurrence, confirming that ultraviolet rays within solar radiation contribute to the onset and progression of pterygium through multiple pathways, including direct DNA damage to ocular surface cells, oxidative stress-induced injury, involvement in inflammatory regulation, and extracellular matrix remodeling. This paper reviews both domestic and international epidemiological trends of pterygium, as well as the multifaceted mechanisms by which solar radiation influences pterygium development. The aim is to enhance understanding of the relationship between solar exposure and pterygium occurrence, while emphasizing and guiding public awareness of solar radiation protection in clinical practice.

Objective:To explore the application of C-reactive protein(CRP) to prealbumin (PA) ratio(CRP/PA) for diagnosis and prognosis evaluation of sepsis.Methods:By a retrospective study, a total of 95 sepsis patients (sepsis group) and 100 local infection patients(non-sepsis group) treated in Dongying People′s Hospital from September 2021 to September 2022 were enrolled. Sepsis patients were divided into survival group(57 cases) and death group (38 cases) according to the 28-day outcome. The clinical data were collected and CRP/PA was calculated. Multivariate Logistic regression and Cox regression were used to analyze the relationship between various indicators and the occurrence and prognosis of sepsis, and receiver operating characteristic (ROC) curve was drawn to evaluate the diagnostic and prognostic value of CRP/PA for sepsis. Kaplan-Meier survival analysis was used to evaluate the prognostic value of different CRP/PA ratios for patients with sepsis.Results:The systolic blood pressure, diastolic blood pressure, prealbumin were lower and heart rate, respiratory rate, CRP, CRP/PA, procalcitonin were higher in the sepsis group compared to the non-sepsis group: (117.27 ± 11.65) mmHg (1 mmHg = 0.133 kPa) vs. (123.26 ± 10.71) mmHg, (69.42 ± 8.58) mmHg vs. (75.44 ± 6.53) mmHg, (174.09 ± 24.77) g/L vs. (207.13 ± 34.31) g/L, (97.87 ± 12.73) bpm vs. (86.90 ± 10.19) bpm, 22.0(20.00, 25.00) times/min vs. 21.00(19.00, 23.00) times/min, (93.96 ± 19.64) mg/L vs. (77.56 ± 22.54) mg/L, 0.54(0.44, 0.65) vs. 0.37(0.28, 0.46), 3.35(2.16, 4.17) μg/L vs. 1.52(0.81, 2.16) μg/L, there were statistical differences ( P<0.05). Multivariate Logistic regression analysis showed that CRP/PA and procalcitonin were risk factors for sepsis ( P<0.05). The results of ROC curve showed that the area under the curve (AUC) of CRP/PA in diagnosis of sepsis was 0.821, the specificity and sensitivity was 76.0% and 93.7%, respectively. The diastolic blood pressure, prealbumin, neutrophil were higher and the heart rate, respiratory rate, CRP, CRP/PA, lymphocytes, procalcitonin were lower in the survival group compared to the death group: (71.76 ± 8.86) mmHg vs. (67.86 ± 8.10) mmHg, (181.46 ± 24.35) g/L vs. (163.05 ± 21.28) g/L, (63.46 ± 9.88) × 10 9/L vs.(57.13 ± 8.64) × 10 9/L, (95.68 ± 13.48) times/min vs. (101.16 ± 10.88) times/min, 22.00(19.50, 24.00) times/min vs. 24.00(20.00, 28.00) times/min, (88.09 ± 19.35) mg/L vs. (102.76 ± 16.75) mg/L, 0.46(0.41, 0.58) vs. 0.63(0.55, 0.72), 21.00(16.00, 30.00) ×10 9/L vs. 29.50(18.00, 37.30) ×10 9/L, 2.94(2.10, 3.97) μg/L vs. 3.82(2.21, 4.77) μg/L, there were statistical differences ( P<0.05). Multivariate Cox regression analysis showed that CRP/PA and procalcitonin were independent risk factors for the prognosis of sepsis ( P<0.05). The AUC of CRP/PA in predicting the prognosis of sepsis was 0.827, the specificity and sensitivity was 92.1% and 63.8%, respectively. Grouped by the cut-off of CRP/PA (0.48), the 28-day mortality rate of patients in the CRP/PA>0.48 was significantly higher than that of patients in the CRP/PA≤0.48, there was statistical difference ( P<0.01). Conclusions:CRP/PA ratio can be used as an index for diagnosis and prognosis evaluation of sepsis.

Objective To observe the imaging findings of embryonal tumor with multilayered rosettes(ETMR).Methods MRI(n=8)and CT(n=6)data of 8 children with pathologically confirmed ETMR were retrospectively reviewed,and the imaging findings were analyzed.Results ETMR present as masses with the maximum diameter of 32-96 mm and clear edges in all 8 cases,located supratentorially in 5 and infratentorially in 3 cases.The supratentorial ETMR were giant cystic solid masses,while the infratentorial ETMR had relatively small volumes.No peritumoral edema was noticed.Cystic solid masses were observed in 6 cases,and the cystic portion presented as low T1WI and high T2WI signals at the edge of the masses.After administration of contrast agents,mild focal uneven enhancement in the solid portion was found in 5 cases,while 1 case was not found enhancement.Among the above 6 cases,the intratumoral bleeding and empty blood vessel shadows within the masses were observed each in 5 cases,while adjacent dura mater invasion was noticed in 3 cases.Two ETMR present as solid masses with focal nodular uneven enhancement,and the enhanced area corresponded to the low signal area on apparent diffusion coefficient(ADC)image,among them,increased choline(Cho)/creatine(Cr)and decreased N-acetyl aspartate(NAA)was found in 1 case.Limited diffusion on diffusion weighted imaging(DWI)were detected in all 8 cases.Among 6 cases who underwent CT scanning,patchy or punctate calcification,corresponding to the low signal area on MRI were detected in 4 cases.Conclusion ETMR mostly present as supratentorial large solid cystic masses with clear edges,and the cystic portion often located at the edge of masses,with characteristic vascular flow voids often accompanied by intratumoral bleeding and some with calcifications but without peritumoral edema,which showed significantly limited diffusion on DWI and weakly inhomogeneous enhancement of the solid part.

Objective:To optimize the preventive maintenance path of electric medical equipment by adopting multi-criteria decision analysis(MCDA),and to verify its optimization effect.Methods:The preventive maintenance paths for electric medical equipment were determined through literature research and management group discussions.An expert meeting was organized to discuss,determine,and demonstrate the preventive maintenance path evaluation criteria,and the weight of the criteria was set.Each preventive maintenance path was scored by experts based on criteria,the score of each maintenance path was calculated using the mean and sorted to form the optimal path.767 electric medical equipment of 7 categories in clinical use in the 960th Hospital of the PLA Joint Logistics Support Force from 2021 to 2022 were selected,conventional preventive maintenance management(referred to as conventional management mode)and preventive maintenance path management optimized by MCDA method(referred to as MCDA management mode)were adopted respectively according to different management modes.The changes in indicators such as failure rate,maintenance time,quality inspection pass rate and maintenance cost of electric medical equipment were compared between the two management models.Results:The failure occurrence rate of electric medical equipment of the MCDA management mode was 8.71%(67/767),which was lower than that of the conventional management mode,the difference was statistically significant(x2=3.960,P<0.05).The equipment maintenance time of the MCDA management mode was(2.24±1.17)days,which was lower than that of the conventional management mode,the difference was statistically significant(t=2.360,P<0.05).The quality inspection qualification rate of the MCDA management model was(96.57±2.74)%,which was higher than that of the conventional management mode,the difference was statistically significant(t=4.342,P<0.05).The average maintenance cost of equipment of the MCDA management model accounted for 2.37%of its assets,which was lower than that of the conventional management mode,the difference was statistically significant(x2=4.261,P<0.05).Conclusion:The MCDA method can provide a quantitative structural model for the optimization of preventive maintenance paths for electric medical equipment,and the optimized preventive maintenance paths can achieve efficient management of electric medical equipment,and focusing on the training of maintenance personnel's technical level can increase the self-repair rate and reduce the failure rate of medical equipment.

Objective To investigate the role and mechanism of exosomes derived from mesenchymal stem cells in hyperbaric oxygen caused pulmonary oxygen toxicity.Methods Mice were divided into the control group that was exposed to normal air,and hyperbaric oxygen exposure groups treated with phosphate buffer saline(PBS)or exosomes,respectively.PBS and exosome treatment were given one day prior to exposure.Mice were subjected to 0.23 MPa pure oxygen for 8 hours.The lung wet-dry ratio,inflammation,exudation and pathological injury were analyzed,while cell death and antioxidant related molecules were detected.Results Pretreatment with exosome significantly attenuated lung injury caused by hyperbaric oxygen exposure by decreasing the lung wet-dry ratio,inflammation,and cell apoptosis.Conclusion Prophylactic administration of exosomes derived from mesenchymal stem cells can alleviate hyperbaric oxygen induced pulmonary oxygen poisoning by attenuating cell death and inflammation.

Objective:To construct a metrological safety evaluation model for large medical equipment based on the perspective of metrological safety,and to explore its application value in the management of large medical equipment.Methods:According to the different safety risk sources,the diagnosis and treatment area of large medical equipment was divided into five types:light source,electricity,water,radiation and information.The metrological safety assessment indicators were empowered by combining subjective and objective methods,and engineering support strategies were developed according to the metrological safety levels and safety change trends.A total of 48 large medical equipment in clinical use in The 960th Hospital of PLA Joint Logistic Support Force from 2020 to 2023 were selected.The 42 sets of equipment used during 2020 to 2021 adopted the conventional fault maintenance support mode(referred to as the conventional support mode),and the 43 sets of equipment used from 2022-2023(including 37 in conventional mode and 6 newly added)adopted the metrology safety technical support mode(referred to as metrology safety support mode).The metrology safety management ability score,metrological inspection qualification levels and metrological safety management effects of large medical equipment were compared between the two management modes.Results:The evaluation scores of theoretical knowledge,safety awareness,practical operation and emergency level indicators of large medical equipment use management personnel of the metrology safety support model were(17.39±1.38)points,(17.87±1.08)points,(27.68±1.45)points and(27.96±1.24)points,respectively,which were higher than those of the conventional support mode,the difference was statistically significant(t=4.234,4.371,5.832,3.764,P＜0.05).The average metrological inspection qualified rates(％)of medical imaging equipment,life support equipment,clinical laboratory equipment,operating room equipment and other equipment using the metrology safety support mode were(95.19±2.56)％,(95.56±1.79)％,(94.64±2.42)％,(96.20±2.01)％and(93.46±2.22)％,respectively,which were higher than those of the conventional support mode,the difference was statistically significant(t=3.846,2.809,2.405,2.492,2.742,P＜0.05).The proportion of large medical equipment rated as high safety level and low safety level in the metrological safety support model were 67.44％(29/43)and 4.65％(2/43),respectively,the proportion of high safety level was higher than that in the conventional support mode,and the proportion of low safety level was lower than that in the conventional support mode,the difference was statistically significant(x2=4.261,7.085,P＜0.05).Conclusion:The large medical equipment metrological safety support mode based on the safety perspective can improve the safety management ability of personnel related to equipment use and management,improve the operation quality and performance level of equipment,increase the proportion of high-safety level metrology safety of large medical equipment,and reduce the proportion of low-safety level.

Pituitary adenoma is the third most common primary central nervous system tumor in adults.Radiomics can explore and analyze massive quantitative features in medical images,and has been used in the precise diagnosis and treatment of pituitary adenomas.The research progresses of MRI radiomics in pituitary adenoma were reviewed in this article.

Objective:To build an in vitro diagnostic(IVD)reagent management system to achieve effective management and monitoring of IVD reagents.Methods:Based on the browser and server(B/S)architecture,the IVD reagent management system was constructed by using the front-end and back-end separation development mode.The front-end adopted the Vue framework and Element-Plus component library to complete the interface design and display,and the back-end adopted the SpringBoot framework for development.The data transmission between the front-end and back-end is delivered using the Network Request Library(Axios)through the JavaScript Object Spectral(JSON)format to enable asynchronous interaction of data.The management and monitoring effects of hospital IVD reagents before and after the application of the system were compared.Results:The IVD reagent management system realized the functions of authority management,system management,warehousing management,outbound management and inventory management of IVD reagents.After the application of the IVD reagent management system,through the systematic reagent timing task early warning,the amount of expired reagents in the hospital was reduced by nearly 60%compared with that before the application,the time required for inventory counting was reduced from about 5 hours before application to 3 hours after application,and the reagent search time was shortened from an average of 15 minutes before application to 7 minutes after application,which was increased by 50%.Conclusion:The IVD reagent management system can realize the sharing and exchange of IVD reagent information,improve the efficiency of collaboration,reduce the error and delay in information transmission,and improve the efficiency of hospital IVD reagent management.

To explore the formation mechanism of static magnetic field artifacts,motion artifacts,chemical shift artifacts and folding artifacts in magnetic resonance imaging(MRI)equipment,and to propose for different artifact failures and common faults using multiple maintenance methods.The artifacts were mainly related to the anomaly of the magnetic field strength,the unoptimized sequence,and the physical limits.The occurrence of static magnetic field artifacts was reduced by using plane avoidance sequence excitation technology,the motion artifacts were eliminated by propeller imaging technology,the occurrence rate of motion artifacts was reduced by reducing hydrogen proton signal interference,and the fold artifacts were suppressed by expanding the scanning field of view,in order to obtain a good resonance image effect and reduce the probability of MRI artifacts,improve the accuracy of medical detection.

OBJECTIVE: To analyze the characteristics of genetic variants in 134 patients diagnosed with Acute myeloid leukemia (AML). METHODS: Clinical data of the 134 patients with AML (non-acute promyelocytic leukemia) initially diagnosed at the 940th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army from June 2017 to June 2022 were retrospectively analyzed. Potential variants of AML-related genes were detected by next-generation sequencing, and the frequency of variants was analyzed by using SPSS v26.0 software, and likelihood ratio χ² test and Fisher exact test were used for data analysis. RESULTS: The patients had included 72 males and 62 females, with a gender ratio of 1.7 : 1 and a median age of 51 years (9 ~ 86 years old). One hundred twenty patients (76.1%) had harbored at least one genetic variant, including 26 (19.4%) having a single variant, 27 (20.1%) having two variants, and 49 (36.6%) having >= 3 variants. 32 (23.9%) had no detectable variants. Genetic variants detected in over 10% of the 134 patients had included NPM1 (n = 24, 17.91%), FLT3-ITD (n = 21, 15.67%), DNMT3A (n = 20, 14.93%), CEBPA (single variant; n = 14, 10.45%), TET2 (n = 14, 10.45%), and NRAS (n = 14, 10.45%). The patients were also divided into low risk, intermediate risk and high risk groups based on their chromosomal karyotypes. The mutational rates for genes in different groups have varied, with 19 patients from the low risk group harboring variants of NRAS (n = 4, 21.05%), KRAS (n = 4, 21.05%), and KIT (n = 2, 10.53%); and 96 patients from the intermediate risk group harboring variants of NPM1 (n = 24, 25.00%), FLT3-ITD (n = 20, 20.83%), DNMT3A (n = 18, 18.75%), CEBPA (n = 12, 12.50%), and TET2 genes (n = 12, 12.50%). The mutational frequencies for the 19 patients from the high risk group were ASXL1 (n = 7, 21.05%), NRAS (n = 3, 15.97%), TP53 (n = 3, 15.79%), and EZH2 (n = 2, 10.53%). A significant difference was found in the frequencies of KIT, NPM1, FLT3-ITD, DNMT3A, and ASXL1 gene variants among the low-risk, medium-risk, and high-risk groups. CONCLUSION AML patients have a high frequency for genetic variants, with 76.1% harboring at least one variant. The frequency of genetic variants have varied among patients with different chromosomal karyotypes, and there are apparent dominant variants. KIT, NPM1, FLT3-ITD, DNMT3A, and ASXL1 may be used as prognostic factors for evaluating their prognosis.
Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Leukemia, Myeloid, Acute/genetics* ; Leukemia, Promyelocytic, Acute ; Nuclear Proteins ; Retrospective Studies ; Child ; Adolescent ; Young Adult ; Adult ; Aged ; East Asian People