Objective To investigate the influence of spectral CT monochromatic imaging technique on image quality and liver vol-ume measurement in computed tomography portal venography(CTPV).Methods A total of 120 patients who underwent contrast-enhanced abdominal CT examination were prospectively selected and randomly divided into group A and group B.The group A(n=60)was scanned with conventional parameters such as 120 kVp,Smart mA mode,and image reconstruction of 60％adaptive statistical iterative reconstruction-Veo(ASIR-V);while the group B(n=60)was with instantaneous switching 80/140 kVp,gemstone spectral imaging(GSI)Assist mode,and image reconstruction of 60％ASIR-V.In group B,six subgroups of images from 75 to 50 keV(with 5 keV interval)were recorded as subgroups B1 to B6.On the axial images,the CT values and standard deviation(SD)values of por-tal vein,liver and erector spinae were measured,and then the contrast-to-noise ratio(CNR)of portal vein and liver were calculated.The Liver Segmentation software was used to segment the liver in groups A and B,the liver volumes by automatic segmentation and manual segmentation(golden standard)were recorded,and then the volume difference rate was calculated.The overall image quality and automatic liver segmentation results were evaluated by two radiologists using a 5-point scale.Results In terms of overall image quality,subgroup B6 achieved the highest score and was superior to group A(P＜0.001).In terms of liver segmentation,subgroup B3 had the highest score and was superior to group A(P＜0.001).With the decrease of keV,the CT values,SD values and CNR of portal vein and liver in group B were gradually increased(P＜0.05),in which subgroup B6 was higher than that in group A(P＜0.001).The volume difference rate initially decreased and then increased with the decrease of keV.Except for subgroups B2 and B3,the differences were statistically significant between other subgroups and group A(P＜O.001),and the subgroup B3 had the lowest volume difference rate.Conclusion Spectral CT monochromatic ima-ging technique has an influence on CTPV image quality and liver volume measurement.The 50 keV images are the best for displaying portal vein,and the automatic liver segmentation volume of 65 keV images is closest to the real liver volume.

Objective:To construct an system of optimization and evaluation parameters for the archive management of medical equipment in hospital,and to optimize and improve the quality and effect of the management for the archive of medical equipment of hospital.Methods:The problems existing in the management of the archives of medical equipment in hospitals were analyzed,and the targeted measures were formulated on the basis of the optimization of management mode,the innovation of management process of the archives,the improvement of management system of archives and continuous improvement of the quality of management personnel of equipment archives.The indicator system of optimization and evaluation of the management of medical equipment archives of hospital was constructed from 6 secondary indicators included management mechanism and system construction,personnel training and capacity building,quality of archive management,efficiency of archives review,satisfaction survey of service object,and innovation ability,as well as 18 tertiary indicators under the secondary indicators.The scores of the secondary and tertiary indicators of the evaluation of indicator system between before and after the measures of indicator system of optimization and evaluation of archive management of medical equipment of Peking University School and Hospital of Stomatology were implemented were compared.Results:Before each measure that was formulated by the indicator system of optimization and evaluation of the archive management of medical equipment of hospital was implemented,the comprehensive evaluation score of archive management of medical equipment of hospital was 3.65 points.The comprehensive evaluation score was 4.9 points after the each measure was implemented.After the indicator system was implemented,the median scores of secondary and tertiary indicators were respectively 0.63(0.40-1.50)points and 0.25(0.13-0.50)points,which were all significantly higher than those before they were implemented,and the differences were all statistically significant(Z=-2.23,-3.22,P<0.05).Conclusion:The indicator system of optimization and evaluation of archive management of medical equipment of hospital can improve the quality and effect of archive management of medical equipment of hospital,and provide a basis and guarantee for the whole life cycle management of medical equipment such as procurement decision-making,quality control management,maintenance management,and scrap disposal of medical equipment of hospital.

Humans ; Asthma/drug therapy* ; Biological Therapy

Objective:To analyse the current status of parturients' readiness for discharge, family functioning and psychological consistency, and to explore the relationship readiness for discharge, family functioning and psychological consistency.Methods:This was a cross-sectional study. Using the convenient sampling method, a total of 429 parturient women admitted to Obstetrics Department in two ClassⅢ Grade A hospitals in Yinchuan City from March to July 2022 were selected as the research objects. General Information Questionnaire, Family Assessment Device (FAD) , Readiness for Hospital Discharge Study-New Mother Form (RHDS-NMF) and Sense of Coherence-13 (SOC-13) were used to investigate the patients. A total of 429 questionnaires were sent out in this study, and 418 questionnaires were effectively collected, with an effective recovery rate of 97.44% (418/429) .Results:The total score of RHDS-NMF in 418 parturient women was (131.18±24.96) , the total score of FAD was (127.76±15.57) , and the total score of SOC-13 was (54.59±7.22) . The discharge readiness of parturient women was negatively correlated with family function ( r=-0.332, P<0.01) , while discharge readiness was positively correlated with psychological consistency ( r=0.253, P<0.01) . The mediation effect analysis results showed that psychological consistency played a partial mediating role between family function and discharge readiness in parturient women, with a mediation effect value of -1.105 ( P<0.05) , accounting for 27.1% of the total effect. Conclusions:Psychological consistency plays a partial mediating role between family function and discharge readiness in parturient women. Medical staff should pay attention to the evaluation and intervention of parturients' psychological consistency, enhance their level of psychological consistency and improve readiness for discharge.

Objective:To screen the pivotal genes involved in the occurrence and development of HBV-associated HCC. Additionally, perform validation and biological function analysis to evaluate changes in the expression of pivotal genes and their prognostic value in patients with hepatocellular carcinoma.Methods:The GSE121248 gene expression profile data of HBV-HCC patients were searched and downloaded from the GEO database. The R language was used to compare the differences in gene expression between hepatocellular carcinoma and paracancerous tissues. KEGG and GO function enrichment analyses were performed on the differential genes. PPI plots and pivotal gene screening were carried out through online tools like STRING and Cytoscape software. 369 cases of hepatocellular carcinoma and 160 healthy controls in TCGA and GTEx were used as validation cohorts to verify the expression levels of the pivotal genes. A Kaplan-Meier plot was drawn to evaluate the prognostic value of the pivotal gene.Results:A total of 120 differentially expressed genes were screened, of which 89 were up-regulated and 31 were down-regulated. Differential genes were mainly enriched in the metabolic pathways related to retinol metabolism, cytochrome P450 metabolism, and the p53 signaling pathway. The top 10 differential genes were selected as pivotal genes by the Cytoscape plug-in cytoHubba. There were significant differences in the expression levels of four types of CCNB1, CDK1, RRM2, and TOP2A genes in the validation cohort. All four types of genes were up-regulated. Survival analysis showed that patients with elevated expression levels of four genes had a poorer prognosis, with statistical differences in results.Conclusion:Four types of genes, CCNB1, CDK1, RRM2, and TOP2A, have high expression levels in patients with HBV-HCC and are correlated to shorter survival times, making them a potential target for diagnosis, prognosis, and treatment.

OBJECTIVE: To analyze the clinical features and genetic basis for a Chinese pedigree affected with familial adenomatous polyposis (FAP). METHODS: Clinical information of the patient was collected. Genomic DNA was extracted from peripheral blood sample of the patient and subjected to whole exome sequencing (WES). Candidate variant was verified by Sanger sequencing. RESULTS: The proband, a 33-year-old female, was found to have multiple adenomatous polyps in the intestine. WES revealed that she has harbored a heterozygous variant of the APC gene, namely c.1922dupA (p.N641fs*10), which was unreported previously. Based on the guidelines of the American College of Medical Genetics and Genomics, the variant was predicted to be likely pathogenic. CONCLUSION The c.1922dupA (p.N641fs*10) variant of the APC gene probably underlay the FAP in this pedigree. Above finding has enabled genetic counseling for this family.
Female ; Humans ; Adult ; Pedigree ; Adenomatous Polyposis Coli Protein/genetics* ; Germ-Line Mutation ; Adenomatous Polyposis Coli/genetics* ; China ; Mutation

Objective: To explore the status of PM 2.5 pollution in school classrooms and the student exposure level, and to provide basic data to safeguard the health of students. Methods: This study continuously monitored the PM 2.5 levels of 16 naturally ventilated classrooms in eight primary and secondary schools in Jiamusi for one academic year using an online environmental monitoring instrument. At the same time, outdoor PM 2.5 data was captured for comparative research, and student exposure to PM 2.5 during school hours was evaluated. Results: The average concentration of PM 2.5 in the classroom in the spring and autumn semesters was (26.93±24.7) and (31.85±30.37)μg/m 3, respectively, and the indoor/outdoor ratio ( I/O ) was 0.92 and 0.95, respectively, which indicated a strong correlation between them. The daily average concentration of all classrooms during both semesters was ( 28.93 ±26.85)μg/m 3, which was slightly higher than the average concentration of (27.53±26.53)μg/m 3 during the daytime when students were in school. In addition, the concentration on workdays was higher than that observed on weekends, and this was termed the "weekend effect". The indoor PM 2.5 concentration was lower on higher floors. The comprehensive exposure concentration of students during school was 28.48 μg/m 3 in spring semester and 31.87 μg/m 3 in autumn semester. Conclusion PM 2.5 levels in the classrooms varied according to time, the horizontal space, and the vertical space, and the level of indoor PM 2.5 pollution largely depended on outdoor pollution sources. Differences in PM 2.5 exposure were observed between.

Objective To investigate the effect of the tibiofemoral joint surface with high conformity on total knee prosthesis motion and insert wear. Methods A type of knee prosthesis with a high coronal conformity was designed and manufactured, and its insert wear was studied by in vitro wear testing combined with finite element simulation. ResultsThe mass wear rates calculated by the in vitro wear testing and finite element simulation were (14.29±3.19) mg/MC and 14.67 mg/MC (MC, million cycle), respectively. After five MCs, the areas of the insert wear obtained by both the methods were basically consistent, and severe wear was found to occur in the middle part of the insert. ConclusionsThe result of the finite element simulation coincided with that of the in vitro testing. The wear rate of the tibiofemoral joint surface of the total knee prosthesis with a high coronal conformity was relatively low. The research outcomes have practical significance for the evaluation and clinical application of the total knee prosthesis with a high conformity.

Objective: To explore the levels of IL-22 in thymus damaged by γ-ray total body irradiation (TBI), and to study the role of IL-22 in T cell reconstitution after thymic injury induced by TBI. Methods: To induce thymic injury, mice were treated by sub-lethal TBI. Levels of intra-thymic and circulatory IL-22 were detected by using ELISA assay. Untreated mice were used as control. After receiving sub-lethal TBI, mice were intraperitoneally injected with PBS or recombinant mouse IL-22, which were marked as TBI+PBS or TBI+IL-22, respectively. Mice were monitored for counts of total thymic cells and circulatory white blood cells. Flow cytometry was applied to analyze percentages of thymic epithelial cells (TEC), thymocyte subsets and circulatory T cells. Real-time PCR assay was applied to analyze the mRNA expression levels of Foxn1, Ccl25, Aire and Dll4 in thymus. Results: ①Sub-lethal TBI treated mice expressed higher levels of intra-thymic and circulatory IL-22, compared with untreated ones (all P<0.05). ②After injection of recombinant IL-22, TBI+IL-22 mice had higher levels of intra-thymic IL-22 than TBI+PBS mice (all P<0.05). ③On day 14 after irradiation, real-time PCR assay showed that TBI+IL-22 mice had higher mRNA levels of Foxn1, Ccl25, Aire and Dll4 in thymus compared with TBI+PBS ones. Meanwhile, the TBI+IL-22 mice had higher counts of total thymic cells[(5.93±3.19)×10⁶/ml vs (1.42±0.46)×10⁶/ml, t=3.128, P=0.033] and circulatory white blood cells[(3.08±0.94)×10⁶/ml vs (1.43±0.30)×10⁶/ml, t=3.730, P=0.015] than those of TBI+PBS mice. Flow cytometry analysis indicated that TBI+IL-22 mice had higher counts of TEC and thymocytes than TBI+PBS mice on day 14 after irradiation (all P<0.05). On days 7 and 14 after irradiation, TBI+IL-22 mice had higher counts of circulatory white blood cells and T cells than TBI+PBS mice (all P<0.05). Conclusion Sub-lethal TBI induces upregulation of intra-thymic IL-22, and injecting of recombinant IL-22 increases level of IL-22 in thymus. Injecting of recombinant IL-22 improves recovery of TEC and increases numbers of thymocyte subsets and circulatory T cell after thymic injury.

Objective To investigate the induction and regulatory mechanism of placental trophoblast cell autophagy in women with preeclampsia (PE).Methods Twenty gravidas with severe PE who underwent cesarean section in the Department of Obstetrics and Gynecology of Changzhou Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University from August 2016 to November 2016 were enrolled in PE group.An equal number of normotensive gravidas without proteinuria who also underwent cesarean section during the same period were randomly selected as control group.Placental tissue samples were collected from all gravidas.Ultrastructure of placental trophoblast cells and changes in autophagosome formation were observed by transmission electron microscope.Expressions ofmicrotubule associated protein 1 light chain 3B (MAP1LC3B,or LC3B) and Beclin 1 in placental tissue samples were detected by quantitative real-time polymerase chain reaction (PCR) and Western blot.Activities of protein kinase B (PKB,also known as Akt)/mammalian target of rapamycin (mTOR) pathway in placental tissue samples were detected by Western blot.Two independent samples t-test or Mann-Whitney U test was used for statistical analysis.Results Sparse and disordered villi and many typical autophagosomes were observed in placental trophoblast cells from patients with severe PE.Significantly enhanced expression of LC3B at mRNA and protein levels and increased ratio of LC3-Ⅱ/LC3-Ⅰ were observed in the PE group as compared with the control group [3.37 (2.37-6.11) vs 0.62 (0.25-4.15),1.40±0.17 vs 1.00±0.13,1.57±0.25 vs 1.00±0.31,Zor t=--4.440,3.274 and 3.113,all P＜0.05].No significant difference in the expression ofBeclin 1 at mRNA or protein level in placental tissues was found between the two groups (both P＞0.05).Furthermore,Akt and mTOR phosphorylation in the PE group was significantly suppressed as compared with that in the control group (1.00±0.29 vs 0.64±0.21,1.00±0.32 vs 0.60±0.22,t=--3.672 and-2.895,both P＜0.05).However,the two groups showed no significant difference in the expression of Akt or mTOR protein (both P＞0.05).Conclusions Suppressed activity of Akt/mTOR pathway and enhanced induction of trophoblast cell autophagy are detected in placental tissues of patients with severe PE,indicating that excessive trophoblast cell autophagy,induced by decreased activity of Akt/mTOR pathway,may be the pathogenesis for PE.