Objective We propose a motion artifact correction algorithm(DMBL)for reducing motion artifacts in reconstructed dental cone-beam computed tomography(CBCT)images based on deep blur learning.Methods A blur encoder was used to extract motion-related degradation features to model the degradation process caused by motion,and the obtained motion degradation features were imported in the artifact correction module for artifact removal.The artifact correction module adopts a joint learning framework for image blur removal and image blur simulation for treatment of spatially varying and random motion patterns.Comparative experiments were conducted to verify the effectiveness of the proposed method using both simulated motion data sets and clinical data sets.Results The experimental results with the simulated dataset showed that compared with the existing methods,the PSNR of the proposed method increased by 2.88%,the SSIM increased by 0.89%,and the RMSE decreased by 10.58%.The results with the clinical dataset showed that the proposed method achieved the highest expert level with a subjective image quality score of 4.417(in a 5-point scale),significantly higher than those of the comparison methods.Conclusion The proposed DMBL algorithm with a deep blur joint learning network structure can effectively reduce motion artifacts in dental CBCT images and achieve high-quality image restoration.

Objective:To detect the cystic fibrosis transmembrane transduction regulator(CFTR)gene mutations and congenital bilateral absence of vas deferens(CBAVD)susceptibility gene mutations in pa-tients with CBAVD,and to explore their association with the risk of CBAVD.Methods:Whole-exome sequencing and Sanger sequencing validation were conducted on the pathogenic genes CFTR,adhesion G protein-coupled receptor G2(ADGRG2),sodium channel epithelial 1 subunit beta(SCNN1B),carbonic anhydrase 12(CA12),and solute carrier family 9 member A3(SLC9A3)in thirteen cases of isolated CBAVD patients.The polymorphic loci,intron and flanking sequences of CFTR gene were amplified by polymerase chain reaction(PCR)followed by Sanger sequencing.Bioinformatics methods were employed for conservative analysis and deleterious prediction of novel susceptibility gene mutations in CBAVD.Ge-netic analysis was performed on the pedigree of one out of thirteen patients with CBAVD to evaluate the risk of inheritance in offspring.Results:Exome sequencing revealed CFTR gene exon mutations in only six of the thirteen CBAVD patients,with six missense mutations c.2684G＞A(p.Ser895Asn),c.4056G＞C(p.Gln1352His),c.2812G＞(p.Val938Leu),c.3068T＞G(p.Ile1023Arg),c.374T＞C(p.Ile125Thr),c.1666A＞G(p.Ile556Val)),and one nonsense mutation(c.1657C＞T(p.Arg553Ter).Among these six patients,two also had the CFTR homozygous p.V470 site,additional-ly,mutations in CFTR gene exon regions were not detected in the remaining seven patients.Within the thirteen CBAVD patients,three carried the homozygous p.V470 polymorphic site,four carried the 5T al-lele,two carried the TG13 allele,and ten carried the c.-966T＞G site.Four CBAVD patients simulta-neously carried 2-3 of the aforementioned CFTR gene mutation sites.Susceptibility gene mutations in CBAVD among the thirteen patients included one ADGRG2 missense mutation c.2312A＞G(p.Asn771Ser),two SLC9A3 missense mutations c.2395T＞C(p.Cys799Arg),c.493G＞A(p.Val165Ile),one SCNN1B missense mutation c.1514G＞A(p.Arg505His),and one CA12 missense mutation c.1061C＞T(p.Ala354Val).Notably,the SLC9A3 gene c.493 G＞A(p.Val165Ile)mutation site was first identi-fied in CBAVD patients.The five mutations exhibited an extremely low population mutation frequency in the gnomAD database,classifying them as rare mutations.Predictions from Mutation Taster and Poly-phen-2 software indicated that the harmfulness level of the SLC9A3 gene c.493G＞A(p.Val165Ile)site and the SCNN1B gene c.1514G＞A(p.Arg505His)site were disease causing and probably damaging.The genetic analysis of one pedigree revealed that the c.1657C＞T(p.Arg553Ter)mutation in the proband was a de novo mutation,as neither the proband's father nor mother carried this mutation.The proband and his spouse conceived a daughter through assisted reproductive technology,and the daughter inherited the proband's pathogenic mutation c.1657C＞T(p.Arg553Ter).Conclusion:CFTR gene mutations remain the leading cause of CBAVD in Chinese patients;however,the distribution and fre-quency of mutations differ from data reported in other domestic and international studies,highlighting the need to expand the CFTR mutation spectrum in Chinese CBAVD patients.The susceptibility genes ADGRG2,SLC9A3,SCNN1B,and CA12 may explain some cases of CBAVD without CFTR mutations.Given the lack of specific clinical manifestations in CBAVD patients,it is recommended that clinicians conduct further physical examinations and consider scrotal or transrectal ultrasound before making a defi-nitive diagnosis.It is advisable to employ CFTR gene mutation testing in preconception genetic screening to reduce the risk of CBAVD and cystic fibrosis in offspring.

Objective We propose a motion artifact correction algorithm(DMBL)for reducing motion artifacts in reconstructed dental cone-beam computed tomography(CBCT)images based on deep blur learning.Methods A blur encoder was used to extract motion-related degradation features to model the degradation process caused by motion,and the obtained motion degradation features were imported in the artifact correction module for artifact removal.The artifact correction module adopts a joint learning framework for image blur removal and image blur simulation for treatment of spatially varying and random motion patterns.Comparative experiments were conducted to verify the effectiveness of the proposed method using both simulated motion data sets and clinical data sets.Results The experimental results with the simulated dataset showed that compared with the existing methods,the PSNR of the proposed method increased by 2.88%,the SSIM increased by 0.89%,and the RMSE decreased by 10.58%.The results with the clinical dataset showed that the proposed method achieved the highest expert level with a subjective image quality score of 4.417(in a 5-point scale),significantly higher than those of the comparison methods.Conclusion The proposed DMBL algorithm with a deep blur joint learning network structure can effectively reduce motion artifacts in dental CBCT images and achieve high-quality image restoration.

Objective To explore the current status and relevance of job burnout and social support among medical staff in the community of Hospitals under the control of Epidemic prevention and control and to provide scientific basis for targeted intervention measures. Methods The job burnout scale and social support scale were used to investigate and analyze the job burnout and social support of medical staff in Dongxihu District, Wuhan. Results Among 294 medical staff, 163 cases (55.44%) had occupational burnout, among which, mild to moderate and severe occupational burnout accounted for 46.26% and 9.18% respectively. The results of partial correlation analysis showed that the total score and various dimensions of the subject's job burnout were negatively correlated with the total score of the subject's social support, subjective support, and support utilization ( P<0.05). Conclusion In the context of normalized epidemic prevention and control of Epidemic prevention and control, medical staff suffered from severe job burnout; the social support of medical staff may affect their job burnout.

Objective:To construct the scientific nursing standards for extracorporeal membrane oxygenation combined with intra-aortic balloon pumping after heart transplantation that meets clinical needs.Methods:Through literature retrieval, case review, and expert interviews, a preliminary letter questionnaire was established for nursing standards of extracorporeal membrane oxygenation combined with intra-aortic balloon pumping after heart transplantation. From February to June 2018, we selected 21 medical and nursing experts in anesthesia, cardiopulmonary bypass, critical care medicine for two rounds of Delphi consultation.Results:Through two rounds of expert consultation, the nursing standards for extracorporeal membrane oxygenation combined with intra-aortic balloon pumping after heart transplantation were determined. The standards included 4 first-level indicators, 10 second-level indicators and 33 third-level indicators.Conclusions:The nursing standards for extracorporeal membrane oxygenation combined with intra-aortic balloon pumping after heart transplantation are scientific and reliable, which provides a reference for the nursing of extracorporeal membrane oxygenation combined with intra-aortic balloon pumping after heart transplantation.

Objective: To compare the disinfection effect of three-hole polypropylene infusion bottle stopper by central sterilization method and groove central sterilization method, and to explore the best method of three-hole polypropylene infusion bottle cap disinfection. Methods: A total of 1 088 bottles of three-pore polypropylene infusion bottles from 10 hospitals in Panzhihua City and the surrounding areas of Chengdu were selected for disinfection, and the effects were compared by fluorescent powder tracing method and bacterial culture method respectively. The two methods were divided into two groups: bottle stopper Central Sterilization group and groove Central Sterilization group. Each nurse sterilized two groups of liquid. Results: The total area of fluorescent powder residues after disinfection of 272 bottles of infusion bottles with different specifications M(P₂₅, P₇₅) was 0.26 (0, 2.51). The total area of fluorescent powder residues M(P₂₅, P₇₅) was 15 (8, 24). There were significant differences in the residual area of fluorescent powder between the two groups after liquid bottle disinfection (Z=-17.31, P<0.01). Thirty-four positive specimens of bacteria culture, 68 bacterial colonies and 158 bottles of infusion bottles were disinfected by central sterilization of 160 bottles. There were 15 positive samples and 30 colonies of bacteria cultured in the bottle disinfected by groove central disinfection method (χ²=2.773, P<0.05). Conclusion The groove center disinfection method is the best disinfection method for the bottle stopper of three-hole polypropylene infusion bottle.

Objective To observe the effect of Shenmai injection combined with enteral nutrition (EN) on immune function in patients with severe cardiac insufficiency. Methods Fifty-seven patients with severe cardiac insufficiency admitted to the Department of Critical Care Medicine of Taizhou Hospital of Zhejiang Province from June 2015 to June 2018 were divided into an EN group (31 cases) and an EN group combined with Shenmai injection group (26 cases). The EN group was given EN on the basis of routine western medicine treatment, while in the EN combined with Shenmai injection group was treated additionally by intravenous drip of Shenmai injection 100 mL/d on the basis of above EN group treatment. The efficacies of the two groups were evaluated after consecutive 7-day treatment in the two groups. The changes in levels of subsets of T-lymphocytes (CD3+, CD4+, CD8+, CD4+/CD8+) and immunosuppressive cells CD14+ monocyte human leukocyte antigen DR (HLA-DR) were observed before and after treatment. Results After treatment, the levels of T-cell subsets CD3+, CD4+, CD4+/CD8+ and CD14+ monocytes HLA-DR in the peripheral blood of the two groups were significantly higher than those before treatment [CD3+: EN group was 0.539±0.126 vs. 0.379±0.093,Shenmai injection group was 0.652±0.185 vs. 0.393±0.091; CD4+: EN group was 0.402±0.121 vs. 0.275±0.066,Shenmai injection group was 0.524±0.168 vs. 0.281±0.077; CD4+/CD8+:EN group was 1.83±0.70 vs. 1.11±0.70,Shenmai injection group was 2.81±0.91 vs. 1.19±0.58; CD14+HLA-DR:EN group was (43.3±7.1)% vs. (35.4±5.7)%,Shenmai injection group was (54.9±6.2)% vs. (36.1±8.3)%]; After treatment, CD8+ in EN group decreased (0.223±0.052 vs. 0.253±0.081), while CD8+ in shenmai injection group increased (0.288±0.051 vs. 0.259±0.078), and the increase degrees of the above-mentioned indexes in EN combined with Shenmai injection group were more obvious than those in the EN group after treatment [CD3+: 0.652±0.185 vs. 0.539±0.126, CD4+: 0.524±0.168 vs. 0.402±0.121, CD8+: 0.288±0.051 vs. 0.223±0.052, CD4+/CD8+: 2.81±0.91 vs. 1.83±0.70, CD14+HLA-DR: (54.9±6.2)%, (43.3±7.1)%, all P < 0.05]. Conclusion The combined use of Shenmai injection and early EN can improve the immune function of T-lymphocytes in patients with severe cardiac insufficiency. The mechanism may be related to the enhancement of the activation of T lymphocytes and promotion of the CD14+ monocytes increase and immune function.

Objective: To discuss the effect and safety of continuous pumping for home enteral nutrition after esophagectomy. Methods: The current study retrospectively analyzed the esophageal cancer patients who underwent transthoracic esophagectomy between January 2017 and November 2017 at First Department of Thoracic Surgery, Peking University Cancer Hospital and Institute. There were totally 108 cases, including 88 males and 20 females, with an average age of 62 years. The patients were divided into pump feeding group (n=56) and traditional tube feeding group (n=52). The postoperative short-term safety, weight maintenance, enteral nutrition tolerance and nutritional support complete rate of the 2 groups were compared by χ² test, Fisher exact test and t test, respectively. Results: Compared with traditional tube feeding group, the patient safety in pumping feeding group was significantly better, with complications within 2 months after discharge were 11/52 and 4/56 respectively (χ²=2.393, P=0.035); the weight maintenance was significantly better, the weight loss within 4 weeks after discharge were 3.90 kg and 0.13 kg, respectively (t=7.720, P=0.000); the general enteral complications were significantly lower (26/52 vs. 5/56, χ²=22.225, P=0.000), the nutritional support complete rate was significantly higher (23/52 vs. 55/56, χ²=39.167, P=0.000). Conclusions Continuous pump feeding enteral nutrition support after discharge postoperatively could help improve patient safety after discharge, which is better for weight maintenance of the patients. Pump feeding could also enhance tolerability of tube feeding and ensure the effective accomplishment of nutritional support.

Various posttranslational modifications (PTMs) participate in nearly all aspects of biological processes by regulating protein functions, and aberrant states of PTMs are frequently implicated in human diseases. Therefore, an integral resource of PTM-disease associations (PDAs) would be a great help for both academic research and clinical use. In this work, we reported PTMD, a well-curated database containing PTMs that are associated with human diseases. We manually collected 1950 known PDAs in 749 proteins for 23 types of PTMs and 275 types of diseases from the literature. Database analyses show that phosphorylation has the largest number of disease associations, whereas neurologic diseases have the largest number of PTM associations. We classified all known PDAs into six classes according to the PTM status in diseases and demonstrated that the upregulation and presence of PTM events account for a predominant proportion of disease-associated PTM events. By reconstructing a disease-gene network, we observed that breast cancers have the largest number of associated PTMs and AKT1 has the largest number of PTMs connected to diseases. Finally, the PTMD database was developed with detailed annotations and can be a useful resource for further analyzing the relations between PTMs and human diseases. PTMD is freely accessible at http://ptmd.biocuckoo.org.
Databases, Protein ; Disease ; genetics ; Gene Regulatory Networks ; Humans ; Phosphorylation ; Protein Processing, Post-Translational ; Proteins ; metabolism ; Search Engine

BACKGROUND: Thoracoscopic surgery has gradually become the major procedure for lung cancer surgery in our department. Its characteristics are minimal trauma and quick recovery, which make approximately 90% of patients discharge from the hospital after surgery. However, the postoperative complications still happen now and then. We analyzed the patients who had been hospitalized for longer than 7 days after thoracoscopic lung cancer surgery, aiming to summarize the types and risk factors of complications, and improve postoperative safety of patients. METHODS: The data were come from the prospective database of Thoracic Surgery Unit One in Peking Cancer Hospital, and patients that underwent thoracoscopic pulmonary surgery between Jan. 2010 and Dec. 2014 with length of stay more than 7 days were included in the study. The classifications of the complications were investigated and graded as mild or severe complications according to modified Claviengrading, the relationship between clinical factors and degrees of complications was also analyzed. RESULTS: The hospitalization of 115 cases were longer than 7 days after surgery, accounting for 10.3% (115/1,112) of the whole patients that underwent surgery during the same period. Eighty-one cases had mild complications, accounting for 7.3% (81/1,112) of the whole cases that underwent surgery during the same period and 70.4% (81/115) of the cases with prolonged length of stay; the proportions of severe complications in both groups were 3.1% (34/1,112) and 29.6% (34/115), respectively; and the proportions of complications that caused perioperative deaths were 0.18% (2/1112) and 1.7% (2/115), respectively. Among all the postoperative complications, the most common was air leakage for more than 5 days after surgery, with a total of 20 cases (1.8% and 17.4%). The other common complications were: atelectasis (19 cases, 1.7% and 16.5%), pulmonary infection (18 cases, 1.6% and 15.7%), etc. The less common complications was bronchopleural fistula (4 cases, 0.36% and 3.5%) with very high risk, and 2 cases died perioperatively due to the combination of acute respiratory distresssyndrome (ARDS). In the clinical factors, only preoperative low pulmonary function (FEV1%<70%) was the potential risk factor for postoperative severe complications (45.8% vs 23.6%, P=0.038). There was no significant difference either regarding the 5 year disease free survival or the 5 year overall survival between mild complication group and severe complication group, with 5 year DFS being 52.2% and 51.9%, respectively (P=0.894) , and 5 year overall survival being 64.0% and 53.5%, respectively (P=0.673). CONCLUSIONS Continuous postoperative air leakage, atelectasis and pulmonary infections were the major causes for prolonged hospitalization after thoracoscopic surgery for lung cancer, and bronchopleural fistula was the most perilous complications. Patients with low preoperative pulmonary function were more likely to have severe postoperative complication, however, this would not influence the long term survival of the patients.
Adult ; Aged ; Aged, 80 and over ; Female ; Hospitalization ; Humans ; Length of Stay ; Lung Neoplasms ; complications ; surgery ; therapy ; Male ; Middle Aged ; Postoperative Complications ; epidemiology ; Postoperative Period ; Prospective Studies ; Thoracic Surgery, Video-Assisted