Objective To explore the risk factors for intracardiac thrombosis in dilated cardiomyopathy(DCM)pa-tients and to construct,validate,and evaluate a nomogram prediction model based on these factors.Methods 88 patients diagnosed with DCM and complicated with intracardiac thrombus,and 544 patients without intracardiac thrombus were included.The participants were randomly divided into training and validation sets at a ratio of 7∶3.Using both univariate and multivariate Logistic regression analyses,independent risk factors for intracardiac thrombosis in DCM patients were identified.A nomogram prediction model was constructed using R software.The model's validity and performance were assessed using the receiver operating characteristic(ROC)curve,the Hos-mer-Lemeshow goodness-of-fit test,calibration curve,and decision curve.Results The binary Logistic regression analysis showed that age,atrial fibrillation,left ventricular end-diastolic diameter(LVEDD),brain natriuretic peptide(BNP),and β-blockers were independently associated with intracardiac thrombosis in DCM patients.Based on these five factors,a nomogram was constructed and validated.The area under the ROC curve for the training set was 0.823(95%CI:0.760～0.887)and0.803(95%CI:0.705～0.901)for the validation set,in-dicating a good discriminative ability.The Hosmer-Lemeshow test results for the calibration curve were(χ2=6.679,P=0.572)for the training set and(χ2=2.588,P=0.958)for the validation set,indicating a good fit between predicted and observed outcomes.The decision curve showed a high net clinical benefit in the threshold range of 0.05～0.92.Conclusion Based on age,atrial fibrillation,LVEDD,BNP,and β-blockers,the nomo-gram prediction model exhibits good discriminative and calibration abilities,and high clinical benefit.It can effec-tively guide clinicians in early intervention of risk factors,reducing the risk of intracardiac thrombosis in DCM pa-tients.

RNA结合蛋白（RBP）由于其独特的生物学功能，目前已经成为肿瘤生物治疗相关靶点筛选的宠儿，很可能为肿瘤生物治疗带来新的机遇。RBP能调控肿瘤细胞及肿瘤微环境免疫细胞和间质细胞的DNA-RNA-蛋白质相互作用网络，进而广泛影响肿瘤发生发展、抗肿瘤免疫应答及肿瘤免疫逃逸过程，目前RBP相关肿瘤生物治疗的研发，主要聚焦在治疗性疫苗、免疫细胞治疗、表观调控治疗等方面，部分研发成果已处于临床试验阶段。随着新理论、新技术的发展以及研究模式的创新，靶向RBP的治疗逐渐摆脱了既往靶向难、疗效欠佳的困局，迎来了新的机遇，通过改良精准靶向和优化组合用药等新策略，为肿瘤生物治疗注入了新的活力，对精准个体化医疗的发展具有重要意义。

To revise GBZ 188 Technical Specification for Occupational Health Surveillance based on national laws, regulations, standards, specifications and legal documents of occupational disease, and combination with the actual situation in China. The main modifications are as follows: the occupational health surveillance for workers exposed to toluene (xylene may implement by reference), bromopropane, methyl iodide, ethylene oxide, chloroacetic acid, indium and its compounds, coal tar, coal tarasphalt, asphalt, β-naphthylamine, dust of metal and its compounds(tin, iron, antimony, barium and its compounds), hard metal dust, erionite dust, low temperature, laser, tick-borne encephalitis virus, Borrelia burgdorferi, and human immunodeficiency virus, for scraper or grind operators, and underground workers using squatting or kneeling position, crawling position, side-lying position, or shoulder position for a long period of time are included. The emergency health screening for workers exposed to arsenic, fluorine and its inorganic compounds, and acrylamide are included. The occupational medical examination (OME) for workers exposed to amino and nitro compounds of benzene, phosgene, monomethylamine, organic fluorine and dimethyl sulfate has been adjusted and made mandatory, with corresponding assessments required upon leaving the job. The special occupational health surveillance for workers exposed to mycobacterium tuberculosis and hepatitis virus is removed. The OME conclusion of reexamination is removed, and standardize recheck/additional inspection requirements. The optional items in OME performed before, during and after leaving post are removed, but the optional items in emergency medical examination are retained. Additional OME items are added. The Guideline for OME Summary Reports is added as informative appendix, and so on. The revised GBZ 188 Technical Specification for Occupational Health Surveillance is more scientific and practical.

Objective:To report the surgical techniques and clinical outcomes of multi-dimensional fixation of patellar multi-fragmentary fractures with locking plates.Methods:A retrospective study was performed in the 26 patients with patellar multi-fragmentary fracture who had undergone open reduction and 3-D internal fixation with locking plates from November 2016 to July 2020 at Department of Orthopaedic Surgery, The Sixth People's Hospital Affiliated to Shanghai Jiao Tong University. There were 17 males and 9 females, with an average age of 62.6 years (from 31 to 90 years). The patellar fractures were exposed and reduced via the longitudinal anterior midline incision of the knee. After the reduction was initially maintained with a cerclage wire, a trimmed and pre-contoured 3.5 mm locking plate was applied onto the patellar surface. After-wards, locking screws were inserted from the lower pole to the upper pole of the patella, from the anterior to the posterior and from the lateral to the medial, respectively, to complete the multi-planar fixation. Follow-ups assessed the B?stman score, knee pain visual analogue scale (VAS), radiographic image and fracture healing, range of motion of the knee, and complications.Results:All the 26 patients were followed up for 12 to 56 months (average, 28 months). Crutches were used while walking until an average of 1.6 months (from 1 to 3 months) after operation in all patients. At the last follow-up, the B?stman score averaged 27.5 points (from 17 to 30 points), yielding 12 excellent, 13 good and 1 poor case with an excellent to good rate of 96.2% (25/26); the knee pain VAS averaged 1.2 points (from 0 to 5 points); the active knee flexion averaged 125° (from 100° to 150°). No breakage, loosening or displacement of the patellar plates or screws was observed during follow-up, but cerclage wire breakage occurred without any symptom in 11 cases. Four patients complained of hardware irritation, and 4 patients underwent hardware removal after fracture union.Conclusion:Multi-dimensional fixation with locking plates is a viable and safe surgical option for patellar multi-fragmentary fractures, due to its satisfactory therapeutic outcomes.

Objective : To explore the relationship between the levels of plasma lipoprotein⁃associated phospholipase A2 (LP⁃PLA2 ), lipoprotein ( a) [ LP ( a)] and the SYNTAX score in patients with coronary heart disease (CHD) . Methods : A total of 416 patients diagnosed with CHD by coronary angiography ( CAG) were enrolled. According to the SYNTAX score, they were divided into three groups, 364 cases in the low⁃risk group (score of 0 - 22), 39 cases in the medium⁃risk group (score of 23 - 32), and 13 cases in the high⁃risk group (score of 33 or more) . And another 30 cases which CAG showed no significant narrowing of the coronary arteries were selected as the control group (CON), We detected and compared the differences of the levels of LP⁃PLA2 and LP(a) in various groups. According to the levels of LP⁃PLA2 and LP(a), CHD patients were divided into four groups, 225 cases in the LP⁃PLA2 and LP(a) normal group, 35 cases in the only LP(a) elevated group (≥300 mg/L), 43 cases in the only LP⁃PLA2 elevated group (≥175 ng/ml) and 113 cases in the LP⁃PLA2 and LP(a) elevated group. The differences of the SYNTAX score, stenosis degree score and lesion feature score were compared. Pearson correlation and multiple linear regression were used to analyze the correlation between the levels of LP⁃PLA2, LP( a) and the SYNTAX score, stenosis degree score and lesion feature score. Results : The levels of LP⁃PLA2 and LP (a) in the CHD group were significantly higher than those in the CON group (P < 0. 05) . The levels of LP⁃PLA2 and LP(a) in the subgroups according to the SYNTAX score were declining from the high⁃risk group to the low⁃risk group in decending order (P < 0. 05) . The SYNTAX score and stenosis degree score of the LP⁃PLA2 and LP(a) elevated group were significantly higher than those of the only LP⁃PLA2 elevated group, the only LP( a) elevated group, the LP⁃PLA2 and LP(a) normal group (P < 0. 05), but there was no significant difference in lesion feature score among the groups (P > 0. 05) . Pearson correlation analysis showed that the SYNTAX score, stenosis degree score and lesion feature score were positively correlated with the levels of LP⁃PLA2 and LP(a) (P < 0. 05) . The multiple linear regression showed that the SYNTAX score and stenosis degree score were independently correlated with the levels of LP⁃PLA2 and LP( a) after adjusting for confounding effects ( P < 0. 05 ), while lesion feature score was only independently correlated with the levels of LP⁃PLA2 ( P < 0. 05) . Conclusion The levels of LP-PLA2 and LP(a) show a positive correlation with the SYNTAX score in patients with CHD, and both can be used as indicators to determine the severity of coronary artery disease.

Objective:To verify and discuss the consistency and applicability of the semi empirical formula and Monte Carlo simulation method in the radiation shielding calculation for high energy synchrotron radiation source.Methods:The semi empirical formula and Monte Carlo simulation were used to calculate the ambient dose equivalent outside of the shielding.Results:The ratio of Jenkins semi empirical formula result to Monte Carlo simulation result was 111%-153%. The ratio of Sakano semi empirical formula result to Monte Carlo simulation result was 201%.Conclusions:For a single shielding material, the semi empirical formula can be simple and conservative to complete the shielding calculation for high-energy electron accelerator. For a variety of shielding materials, Monte Carlo simulation method should be used.

Objective: To investigate the expression of ECT2 (epithelial Transforming sequence 2) gene in human pancreatic ductal adenocarcinoma (PDAC) and its effect on the proliferation and apoptosis of pancreatic cancer cells. Methods: Carcinoma tissues and corresponding para-carcinoma tissues from 35 PDAC patients at Changhai Hospital Affiliated to Naval Medical University from July 2018 to March 2019 were collected for this study. The differentially expressed genes in pancreatic cancer were screened out by using Gene Expression Omnibus (GEO) Database. Then, the related gene expression in PDAC and its relation with patients’survival were analyzed by The Cancer Genome Atlas (TCGA) database. QPCR and immunohistochemistry were used to verify the mRNAand protein expressions of ECT2 in human PDAC samples. To explore the effect of ECT2 on the biological behaviors of pancreatic cancer cells, si-RNA was used to silence the ECT2 gene in pancreatic cancer PANC-1 cells, and CCK-8 proliferation assay and Flow cytometry were used to detect the proliferation and apoptosis rate of PANC-1 cells after ECT2 silence. Finally, the expressions of apoptosis-related proteins were detected by WB. Results: The differentially expressed gene-ECT2, was screened out by analyzing the gene expression profiles of human pancreatic cancer in GEO database. TCGA database analysis showed that ECT2 was highly expressed in pancreatic cancer tissues (t=4.005, P<0.05) and significantly correlated with patients’survival (P< 0.01). Moreover, it is also verified that ECT2 was highly expressed in PDAC tissues at mRNA (1.01±0.06 vs 4.25±0.12; t=24.09， P<0.01) and protein level. After ECT2 silence in PANC-1 cells, the proliferation rate was decreased (P<0.01), while the Tamoxifeninduced apoptosis rate was increased (P<0.01), and the expressions of apoptosis-related proteins (BAX and Bcl-2) were also affected. Conclusion: ECT2 is highly expressed in human pancreatic ductal adenocarcinoma and is related with patients’survival. ECT2 promotes the proliferation and apoptosis resistance of pancreatic cancer cells, providing the basis for exploring ECT2 as a new target for the prognostic judgment and treatment of pancreatic cancer.

Objective: To determine the positional relationship between impacted mandibular third molar(IMTM) and mandibular canal(MC) by CBCT. Methods: 664 IMTMs with root apexes contacted to MCs on panoramic radiograph were further examined by CBCT,the exact positional relationship between IMTMs and MCs was observed and analyzed by I-Dixel software. Results: The 664 cases were divided into lowly(6. 3％),intermediately(60. 7％) and highly(33. 0％) impacted groups by the depth of IMTMs in mandibulae showed on CBCT images. The distance(mm) from the root apexes of IMTMs to the intact superior wall of MCs(n = 329) in lowly, intermediately and highly impacted cases were 1. 39 ± 1. 38,1. 28 ± 1. 03 and 1. 79 ± 1. 54 respectively(P ＜ 0. 05). MCs on the buccal side,lingual side,under the IMTMs and between the root apexes were found in 49. 8％,12. 0％,36. 6％ and 1. 5％ of the cases; the MC wall deffect was found in 65. 8％,27. 5％ and 95. 0％ of the cases with the MCs under,on buccal and lingual side of the IMTMs, respectively(P ＜ 0. 001). Conclusion: CBCT examination is necessary for the determination of the positional relationship between MC canal and IMTM with the root apex cotacted or overlapped to MC.

Objective To study CT numbers correction of kilo?voltage cone?beam CT (KV?CBCT) images for dose calculation. Method Aligning the CBCT images with plan CT images, then obtain the background scatter by subtracting CT images from CBCT images. The background scatter is then processed by low?pass filter. The final CBCT images are acquired by subtracting the background scatter from the raw CBCT. KV?CBCT images of Catphan600 phantom and four patients with pelvic tumors were obtained with the linac?integrated CBCT system. The CBCT images were modified to correct the CT numbers. Finally, compare HU numbers between corrected CBCT and planning CT by paired T test. Evaluate the image quality and accuracy of dose calculation of the modified CBCT images. Results The proposed method reduces the artifacts of CBCT images significantly. The differences of CT numbers were 232 HU, 89 HU, 29 HU and 66 HU for air, fat, muscle and femoral head between CT and CBCT respectively (P= 0?? 39,0?? 66,0?? 59,1).The differences of CT numbers between CT and CBCT was reduced to within 5 HU. And the error of dose calculation with corrected CBCT images was within 2%. Conclusions The CT numbers of corrected CBCT are similar with plan CT images and dose calculations based on the modified CBCT show good agreement with plan CT.