Objective To analyze the feasibility and efficacy of a deep convolutional neural network(DCNN)model based on chest CT images to evaluate bone mineral density(BMD).Methods A total of 1 048 health check subjects'2 096 central level images of lumbar 1 and 2 vertebral bodies were used for experiments and analysis in this retrospective study.According to the results of quanti-tative computed tomography(QCT)BMD measurement,the subjects were divided into three categories:normal,osteopenia,osteopo-rosis(OP).Herein,a DCNN segmentation model was constructed based on chest CT images[training set(n=1 096),tuning set(n=200),and test set(n=800)],the segmentation performance was evaluated using the Dice similarity coefficient(DSC)to com-pare the consistency with the manually sketched region of vertebral body.Then,the DCNN classification models 1(fusion feature construction of lumbar 1 and 2 vertebral bodies)and model 2(image feature construction of lumbar 1 alone)was developed based on the training set(n=530).Model performance was compared in a test set(n=418)by the receiver operating characteristic(ROC)curve analysis.Results When the number of images in the training set(n=300)was adopted,the DSC value was 0.950 in the test set.The results showed that the sensitivity,specificity and area under the curve(AUC)of model 1 and model 2 in diagno-sing osteopenia and OP were 0.716,0.960,0.952;0.941,0.948,0.980;0.638,0.954,0.940;0.843,0.959,0.978,respectively.The AUC value of normal model 1 was higher than that of model 2(0.990 vs 0.983,P=0.033),while there was no significant difference in AUC values between osteopenia and OP(P=0.210,0.546).Conclusion A DCNN may have the potential to evaluate bone mass based on chest CT images,which is expected to become an effective tool for OP screening.

Objective To analyze the clinical features and magnetic resonance imaging(MRI)features of adult diffuse glioma,define the preoperative MRI enhancement grade(ET grade)of the disease,and explore the relationship of ET grade with isocitrate dehydrogenase(IDH)mutation and WHO grade.Methods The clinical data of 306 cases of adult diffuse glioma confirmed by surgery and pathology admitted in our hospital from January 2018 to December 2023 were collected and retrospectively analyzed.There were 169 cases of mutant IDH and 137 cases of wildtype IDH.The differences in gender,age,MRI signal uniformity,clear tumor margin,obvious edema,compression of adjacent ventricles and ET grade were analyzed between the 2 types of IDH patients.A logistic regression model was established to identify the independent influencing factors for IDH mutation,and the correlation of ET grade with IDH status and WHO grade was analyzed.Results There were significant differences in age,whether the MRI signal was uniform,whether the tumor margin was clear,whether the edema was obvious,the compression of the adjacent ventricle and the ET grade in patients with different IDH status.The independent variables were screened by Forward method and then included in the logistic regression model.ET grade,age and tumor margin were independent influencing factors of IDH mutation status and negatively correlated with IDH mutation.For every 1 year increase in age,the probability of mutant IDH in adult diffuse glioma was decreased by 0.93 times.The accuracy of the established regression model for predicting IDH status was 0.859,the sensitivity was 0.852,the specificity was 0.869,and the AUC value was 0.922(0.892～0.952).ET grade was significantly correlated with WHO grade.The most prominent proportion of glioma patients with WHO grade 2 was noET,that with WHO grade 3 was ET2,and that with WHO grade 4 was ET3.Conclusion For adult diffuse glioma,preoperative MRI ET grade is negatively correlated with IDH mutation status,and positively with WHO grade.ET grade is helpful for determination of of IDH mutation status and WHO grade.

Purpose To investigate the predictive value of chest CT-based radiomics for spread through air spaces in stage T1 peripheral type lung cancer.Materials and Methods A total of 173 patients with surgically pathologically confirmed stage T1 non-small cell lung cancer were retrospectively collected and divided into positive group(49 cases)and negative group(124 cases)according to the presence or absence of spread through air spaces.All lesions were randomly divided into training set(122 cases)and validation set(51 cases)according to the ratio of 7∶3.The primary area of lung cancer(the main body of the lesion),the peripheral infiltrative area(a 5-mm annular area expanding outward along the edge of the lesion)and the tumor margin area(a 5-mm annular area retracting inward along the edge of the lesion)were used as areas of interest to extract imaging histological features.Three imaging histological models were established for the primary area of lung cancer,the peripheral infiltrative area and the tumor margin area,and combined with the morphological features of CT to establish three combined models.The efficacy of each model was evaluated and the optimal model was selected.Results The lobulation signs of positive group was significantly more than that of negative group(χ2=9.946,P=0.002).The area under the curve(AUC)of the imaging histological model based on the three regions of interest were 0.899,0.825,0.840 for the training group and 0.876,0.811 and 0.832 for the validation group,respectively.The model with the highest AUC was the primary tumor imaging model(P=0.043,P<0.001,P=0.017),the AUC of the combined model established by adding the lobar sign were 0.917,0.835 and 0.851,respectively.The AUC of the three regions of interest in the validation group were 0.912,0.832,and 0.845 and the highest AUC was found in the primary tumor area(P<0.001,P=0.017,P=0.049).Conclusion It is feasible to study lung cancer with airway metastasis via CT-based radiomics,taken lobulation signs as the risk predictive factor.

Objective To investigate the prevalence and genotypes of Cryptosporidium spp. and Giardia lamblia in dogs and cats from a pet hospital in Shanghai Municipality. Methods A total of 145 fresh fecal samples were collected from pet dogs and cats in a pet hospital in Shanghai Municipality during the period from November 2021 to June 2022, including 99 dog fecal samples and 46 cat fecal samples. The small subunit ribosomal ribonucleic acid (SSU rRNA) gene of Cryptosporidium and the triose phosphate isomerase (TPI) gene of G. lamblia were amplified using nested PCR assay, and the positive amplification products were sequenced from both directions. The sequence assembly was performed using the software Clustal X 2.1, and sequence alignment was conducted using BLAST. A phylogenetic tree was created with the Neighbor-Joining method using MEGA 11.0 to identify parasite species or genotype. Results The overall prevalence of Cryptosporidium and G. lamblia was 20.00% (29/145) in 145 pet dog and cat fecal samples, with the prevalence of 0.69% (1/145) and 19.31% (28/145) in Cryptosporidium and G. lamblia, respectively. G. lamblia was only detected in dog fecal samples, with prevalence of 18.18% (18/99), while the detection rates of Cryptosporidium and G. lamblia were 2.17% (1/46) and 21.74% (10/46) in cat fecal samples. Nucleotide sequence analysis showed that one Cryptosporidium positive sample was characterized as C. felis, and 28 G. lamblia positive samples were all characterized as Giardia assemblage A, which showed 100% sequence homology with human isolates of Giardia. Phylogenetic analysis revealed that the sequences obtained in this study belonged to the same branch with the reported Giardia assemblage A. Conclusions Cryptosporidium and G. lamblia infection was prevalent in pet dogs and cats from the study pet hospital in Shanghai Municipality, and there is a zoonotic risk for the species and genotype. Intensified surveillance of Cryptosporidium and Giardia infection is recommended in pets and their owners, and improved management of pet keeping is required.

Pain is a complex physiological and psychological activity, involving at least three dimensions, including pain sensation, pain emotion, and pain cognition. Acupuncture can clearly relieve the pain sensation of patients and improve pain emotion and pain cognition induced by pain; acupuncture participates in the multi-dimensional regulation of pain through brain regions of the limbic system such as anterior cingulate cortex (ACC), amygdala (AMY), and hippocampus. By analyzing relevant literature, it has been found that the regulation of acupuncture on pain emotion is mainly related to the activation of pertinent opioid receptors in the ACC, the decrease of the expression of extracellular signal-regulated kinase (ERK), and the promotion of the expression of glutamic acid (Glu) A1, metabotropic glutamate receptor-1 (mGluR1), and γ-aminobutyric acid aminobutyric acid (GABA) B2 protein in the AMY. The regulation of acupuncture on pain cognition is mainly related to the elevation of the expression of protein kinase A (PKA) and phospho-p38 mitogen-activated protein kinase (phospho-p38 MAPK) and the inhibition of cyclic adenosine monophosphate (cAMP)/PKA/cAMP response element-binding protein (CREB) signaling pathway in the ACC.

Background: A small shift in high-sensitivity cardiac troponin T (hs-cTnT) assays can lead to different result interpretation and consequent patient management. We explored whether a small bias could be detected using conventional internal quality control (QC) procedures, evaluated the performance of moving average (MA)-based QC procedures, and proposed a new QC procedure based on the moving rate (MR) of positive patient results of hs-cTnT assays. Methods: The ability of conventional QC to detect a 5 ng/L bias was examined using the 1 3s/ 22s/R4s multi-rule procedure as deviation rules.We developed MA and MR procedures for the hs-cTnT assay using eight months of patient data. The performance of different MA or MR procedures was investigated by calculating the median number of patient samples affected until a bias introduced into the dataset was detected (MNPed). After comparing the MNPed across different procedures, we selected an optimal MA or MR procedure for validation. Validation graphs were plotted using the minimum, median, and maximum number of results affected until bias detection. Results: Our conventional QC procedures could not detect a positive bias of 5 ng/L. When a positive bias was introduced, MNPed was much higher using MA than using MR, with cut-off values of 5 ng/L and 14 ng/L, respectively. MR validation charts for optimal procedures provided insight into the MR performance. Conclusions The MR procedure could detect different errors with few false alarms. In the hs-cTnT assay, the MR procedure with a smaller cut-off value outperformed MA and conventional QC procedures for small bias detection.

Objective:To explore the resilience of nurses against COVID-19 in Xixi Hospital of Hangzhou and to analyze its influencing factors.Methods:From February 4th to 5th 2020, this study investigated 193 nurses against COVID-19 at Xixi Hospital of Hangzhou selected by convenience sampling with the general questionnaire, Connor-Davidson Resilience Scale (CD-RISC) and the General Self-Efficacy Scale (GSES) . Pearson correlation and multiple linear regression were used to analyze the influencing factors of resilience.Results:Among 193 nurses, the total score of resilience was (62.60±13.70) ; the scores of three dimensions, optimism, self-reliance and tenacity were (9.59±2.37) , (21.62±4.68) and (31.40±7.74) respectively. The total score of GSES was (28.33±3.55) . Simple correlation showed that there were statistical differences in the total score of CD-RISC and dimension score of tenacity among nurses with different genders, experience of participating in emergent public health events, self-conscious readiness degree and confidence in fulfilling the task ( P<0.05) . Pearson correlation showed that resilience had a positive correlation with the general self-efficacy with a statistical difference ( r=0.474, P<0.01) . Multiple regression analysis demonstrated the influencing factors of nurses against COVID-19 were the self-conscious readiness degree, confidence in fulfilling the task and the general self-efficacy which totally explained 27.6% of the variance. Conclusions:Nurses against COVID-19 have the low level of the resilience which needs to be improved. We should pay more attention to the high-risk population, and provide a positively and effectively psychological intervention to improve the resilience of nurses against COVID-19.

Cyclospora cayetanensis is a foodborne and waterborne pathogen that causes endemic and epidemic human diarrhea worldwide. A few epidemiological studies regarding C. cayetanensis infections in China have been conducted. During 2013, a total of 291 stool specimens were collected from patients with diarrhea at a hospital in urban Shanghai. C. cayetanensis was not detected in any of the stool specimens by traditional microscopy, whereas five stool specimens (1.72%, 5/291) were positive by PCR. These positive cases confirmed by molecular technology were all in the adult group (mean age 27.8 years; 2.94%, 5/170) with watery diarrhea. Marked infection occurred in the rainy season of May and July. Sequence and phylogenetic analyses of the partial 18S rRNA genes of C. cayetanensis isolated showed intra-species diversity of this parasite. This study showed, for the first time, that C. cayetanensis is a pathogen in outpatients with diarrhea in Shanghai, albeit at a low level. However, the transmission dynamics of this parasite in these patients remain uncertain.
Adolescent ; Adult ; China ; epidemiology ; Cyclospora ; genetics ; isolation & purification ; Cyclosporiasis ; epidemiology ; Diarrhea ; etiology ; parasitology ; Feces ; parasitology ; Female ; Humans ; Male ; Middle Aged ; Outpatients ; Phylogeny ; Polymerase Chain Reaction ; RNA, Ribosomal, 18S ; analysis ; Retrospective Studies ; Young Adult

OBJECTIVE: To shorten drug dispensing time of inpatient pharmacy in our hospital, and to enhance the quality of pharmaceutical care.METHODS: The activity of quality control circle (QCC) was carried out by using "shorten drug dispensing time of inpatient pharmacy" as subject. According to the steps of QCC activity, key links and factors that influence the of drug dispensing time in the inpatient pharmacy were found out. Countermeasures were formulated and implemented according to practical reasons. The activity was evaluated by using the drug dispensing time in every 100 medical orders before and after QCC activity. RESULTS: According to the links of "dispensing medical order" and "checking medical order" that spent longest time, the countermeasures were put forward to improve work efficiency, such as rational drug distribution and design, opmitization of the dispensing route, realizing electronic large infusion prescription by strengthening system informatization, strengthening the management of confusing drugs, strengthening staff training and establishing performance appraisal system. The drug dispensing time was shortened from 43. 99 min (before QCC) to 21. 77 min (after QCC), and target achievement rate was 99. 24％. QCC staff showed positive growth in means, responsibility, team cohesion and other aspects. CONCLUSIONS: QCC activity can shorten the time of drug dispensing, improve work efficiency and pharmacist' s ability of solving problem, and help to improve pharmaceutical care in the inpatient pharmacy.