Single-Stage Surgical Procedure for Patients with Primary Esophageal and Lung Cancers.

BACKGROUND: The aim of this study was to evaluate the safety and feasibility of simultaneous surgery for patients with primary esophageal and lung cancers. METHODS: Patients with primary esophageal and lung cancers who underwent simultaneous surgical procedures between January 2016 and January 2022 were retrospectively analyzed. The data of patients who underwent esophagectomy and lobectomy (group EL) were compared with those of patients who underwent esophagectomy and sublobar resection (group ES). RESULTS: A total of 21 patients were included with an average age of 64.62 ± 5.24 years. Group EL contained 8 patients and group ES contained 13 patients. All procedures were completed uneventfully with a mean operative time of 251.19 ± 66.93 minutes. Pulmonary complications occurred in six (28.57%) patients. Other complications included anastomotic leakage in 1 patient, pleural effusion requiring drainage in 8 patients, atrial fibrillation in 2 patients, and incision infection in 1 patient. All patients were followed up for 30.23 ± 21.82 months. During the follow-up period, nine patients had a recurrence of cancer and died of tumor progression, and one patient died of a tracheothoracogastric fistula. Complications and mortality in group EL did not increase when compared to those in group ES. CONCLUSION: It is safe and feasible to perform a single-stage surgical procedure for patients with primary esophageal and lung cancers. Simultaneous esophagectomy and lobectomy did not increase postoperative complications or mortality compared with esophagectomy and sublobar resection.

Simultaneous Minimally Invasive Coronary Artery Bypass Grafting and Lung Resection.

BACKGROUND: The best surgical treatment strategy for coexisting coronary artery disease (CAD) and lung cancer (LC) remains controversial. This study analyzed the safety and efficacy of a simultaneous minimally invasive procedure for patients with CAD and LC. METHODS: Patients who underwent simultaneous minimally invasive off-pump coronary artery bypass grafting and lung resection from January 2016 to December 2021 were retrospectively analyzed. The procedure was performed in the fourth intercostal space through a small left anterolateral minithoracotomy. Harvesting of the left internal mammary artery (LIMA) and sewing of the anastomoses were performed under direct vision. Lung resections were performed with or without the assistance of a thoracoscope. RESULTS: Sixteen patients were included with a mean age of 67.13 ± 10.61 years. Procedural success occurred in all patients with a mean operative time of 366.88 ± 94.48 minutes. All patients received at least one coronary artery bypass LIMA graft. Pneumonectomy, lobectomy, segment resection, and wedge resection were performed in one (6.25%), eight (50%), two (12.5%), and five (31.25%) patients, respectively. There were no perioperative deaths or new myocardial infarctions. Complications included one case of postoperative bleeding, two lung infections, two cases of atelectasis, one case of pleural effusion, and one case of cardiac arrhythmia. All the patients were followed up for 1 to 57 months, cancer recurrence occurred in two patients, and one patient died. The remaining patients showed no evidence of tumor recurrence or myocardial infarction. CONCLUSION: This simultaneous minimally invasive procedure is safe and effective for selected patients with CAD and LC.

Two-year Outcomes after Transurethral Prostate Resection Post-prostatic Artery Embolization Versus Transurethral Prostate Resection Alone For Giant Benign Prostatic Hyperplasia.

PURPOSE: To compare the long-term (two-year) efficacy between transurethral resection of the prostate (TURP) after prostatic artery embolization (PAE) and TURP only for patients with giant (>100 mL) benign prostatic hyperplasia. MATERIALS AND METHODS: We retrospectively analyzed data from 61 and 150 patients with giant benign prostatic hyperplasia treated with PAE+TURP or TURP alone, respectively, from January 2015 to March 2020. We compared index changes before and after surgery. RESULTS: The operative time, intraoperative blood loss, postoperative bladder irrigation time, and catheter retention time in the PAE+TURP group were lower than those of the TURP group, while the speed of resection of the lesion and hospitalization costs were more significant (P < 0.05). International prostate symptom score (IPSS), quality of life (QoL), prostate volume, maximum urinary flow rate, detrusor pressure of maximum urinary flow rate, prostate-specific antigen, and urodynamic obstruction were better in the PAE+TURP group than the TURP group at 24 months (P < 0.05). Regarding IPSS and QoL scores at 24 months postoperatively compared with the preoperative period, the PAE+TURP group was better than the TURP group in terms of the storage period, voiding period, and QoL (P < 0.05). The distribution of postoperative adverse event severity classes was comparable between the groups (P = 0.984). CONCLUSION: In contrast to TURP alone, PAE + TURP is more expensive but provides better postoperative outcomes; there is no significant difference in terms of the severity grade distribution of postoperative complications.

Current situation and policy suggestions of medical social work supervision in shanghai / 中华医院管理杂志

Objective:To investigate the current situation of medical social worker supervision in Shanghai, for reference to promote the high-quality development of medical social work.Methods:From June to July 2022, a questionnaire survey was conducted on the in-service medical social workers in all medical institutions with medical social work departments or posts in Shanghai. The questionnaire mainly included demographic information, current status of supervision implementation, and effectiveness of supervision. The data were analyzed descriptively with t test for comparison between groups and the Pearson test was for correlation analysis. Results:A total of 99 medical social workers were included in this study, 65 had received supervision, and medical institutions where 58 people located had established the supervision system. The average scores of actual and expected supervisory support received by medical social workers were 3.71 and 4.20 respectively, and the mean burnout level score was 32.91. The effect of establishing a supervision institutions on burnout was statistically significant ( P<0.05) and actual access to supervision support was negatively associated with burnout ( P<0.05). Conclusions:The overall situation of medical social work supervision in Shanghai was positive, but the demand for supervision was not fully satisfied; Supervision had a positive impact on reducing the burnout level. It is suggested that medical social work should further strengthen the cultivation of supervisory talents, promote the construction of supervisory systems, and improve the quality of supervision.

Clinical value of neonatal transport team participating in the management of twin neonates before transport / 中国小儿急救医学

Objective:To investigate and analyze the necessity and clinical significance of professional neonatal transport team participating in post-natal resuscitation, management and transport of twin neonates after birth.Methods:A total of 298 cases of twin neonates admitted to the Department of Neonatology at the Fifth Medical Center of PLA General Hospital from January 2017 to December 2021 were selected.According to whether the neonatal transport team participated in birth resuscitation and management, they were divided into participation group ( n=136) and case group ( n=162). The resuscitation measures taken after birth, Apgar score, respiratory support during transport, basic information at admission, the first arterial blood gas after admission, complications during hospitalization, length of stay and outcome of the two groups of twins were retrospectively analyzed. Results:Compared with twins in case group, the proportion of tracheal intubation before transport was significantly higher in participation group(5.88% vs.0.62%, χ2=6.997, P=0.013), hospital admissions were significantly shorter[48(7, 115) min vs.87(47, 425) min, Z=-11.593, P<0.001], and significantly lower rates of hypoxia on admission(9.56% vs.17.90%, χ2=4.250, P=0.039), significantly higher percutaneous oxygen saturation[96(86, 100)% vs.95(85, 100)%, Z=-7.274, P<0.001], and higher blood-gas-oxygen partial pressure on admission[(91.02±25.77)mmHg vs.(87.82±25.23)mmHg, t=1.076, P=0.008] were found.The incidence of hypothermia on admission was significantly lower(36.03% vs.47.53%, χ2=4.008, P=0.045), and the differences between two groups were statistically significant( P<0.05). The proportion of critically ill neonates(40.44% vs.24.07%, χ2=9.172, P=0.002), length of hospital-stay[11(4, 76)d vs.9(3, 72) d, Z=-2.684, P=0.014] as well as the intravenous nutrition time[7(0, 42)d vs.5(0, 40) d, Z=-2.470, P=0.014] in participaton group were significantly higher than those in case group, and there were statistically significant differences between two groups( P<0.05). Conclusion:Professional neonatal transport teams play a positive role in neonatal resuscitation and later hospitalization during the pre-transport management of twin neonates.It can improve success rate of tracheal intubation in asphyxia resuscitation of twin neonates.Neonatal transport to the NICU for management takes less time, reducing the incidence of hypoxemia during transport, hypoxia status and hypothermia after admission.Obstetric pediatric medical staff in midwifery hospitals should strengthen the professional training of neonatal asphyxiation resuscitation, improve the skill of neonatal asphyxiation resuscitation and tracheal intubation, and strengthen the post-birth care for twin neonates.

How does price variance among purchase channels affect consumers' cognitive process when shopping online?

The rise of a flourishing online shopping market has expanded the range of purchase channels available to consumers. Meanwhile, the competition among channels has become increasingly fierce. In this study, the changes in cognitive processes caused by price variance among channels were investigated using event-related potentials. Several daily necessities with low or high price variance between a self-operated business channel and third-party seller channels were chosen as the study objects from a well-known electronic business platform. Thirty participants' electroencephalograms were collected while they faced higher or lower price variance during the experiment. The results showed that small price variances between the two channels tended to intensify component N2, while big price variances tended to diminish component P3. These results suggest that N2 may reflect consumers' identification process for price variance and inhibition of a planned response, while P3 may reflect the activation of attention caused by task difficulty due to price variance. These findings indicate that the changes in ERP components N2 and P3 may act as cognitive indices that measure customers' identification and attention distribution when considering product price variances among online purchase channels.

Long-term prediction of sea surface chlorophyll-a concentration based on the combination of spatio-temporal features.

Harmful algal blooms (HABs) events have a serious impact on marine fisheries and marine management. They occur globally with high frequency and are characterized by a long duration and difficult governance. HABs incidents have occurred in the South China Sea (SCS), and the frequency of occurrence has been on the rise in recent decades. Predicting the long-term chlorophyll-a (Chl-a) concentration has the potential to facilitate long-term monitoring and early warning of HABs events. Currently, long-term predictions of ocean circulation and temperature are common, while long-term predictions of marine biochemistry are still in their infancy. Traditional Chl-a prediction methods have problems, such as low accuracy and the inability to carry out long-term predictions. This research improved the CNN-LSTM model by combining spatio-temporal features to predict Chl-a concentrations. This model can extract both the temporal and spatial features of Chl-a, expand the dataset, and improve the prediction accuracy and training speed. The predictions were made using a Chl-a dataset for the Reed Tablemount in the SCS. The time series of Chl-a used was the satellite data of NASA's official website from January 2002 to June 2020. The results indicate that the predictions of the CNN-LSTM model are better than those of the LSTM and SARIMA models. The five-year long-term rolling prediction of Chl-a was carried out, and the three-year Pearson correlation coefficient reached 0.5. The novelty of this study is the realization of a three-year long-term prediction of Chl-a concentrations. The Mann-Kendall trend test method and the least square method were used to fit the straight line to detect the trend of the five-year predicted value and the true value, respectively. The results indicated that the prediction value and true value of the sea surface Chl-a from 2015 to 2020 both exhibited an overall upward trend. In addition, the prediction performance of the model in large-scale prediction is better than that in small-scale prediction.

A randomized controlled study of less invasive surfactant administration of respiratory distress syndrome in preterm infants / 中国小儿急救医学

Objective:To investigate the efficacy and safety of less invasive surfactant administration(LISA) of neonatal respiratory distress syndrome(NRDS).Methods:From July 2017 to December 2018, 50 premature infants with birth weight ≤1 500 g and/or gestational age≤32 weeks diagnosed as NRDS at the Fifth Medical Center of PLA General Hospital were randomly divided into LISA group( n=25)and INSURE group( n=25). The patients in LISA group was inserted fine duct into the trachea through direct laryngoscope under nasal continuous positive airway pressure (nCPAP) and pulmonary surfactant was injected.The INSURE group adopts endotracheal intubation-pulmonary surfactant-nCPAP was performed after unplugging.The changes of vital signs, blood gas indexes, adverse reactions and the incidence of complications were compared between two groups at different time points. Results:There was no significant difference in respiration, heart rate, systolic blood pressure, diastolic blood pressure and PaO 2, PaCO 2, BE, SpO 2 between two groups at different administration time points.Although the pH value of LISA group was lower than that of INSURE group, it was within the normal range.There was no significant difference in bronchopulmonary dysplasia, intraventricular hemorrhage, periventricular leucomalacia and other complications between two groups, and there was no death, air leakage, retinopathy of prematurity and pulmonary hemorrhage in both two groups.In addition, there was no significant difference in hospitalization days, total medical expenses, oxygen use time between the two groups(all P>0.05). Conclusion:Compared with INSURE technology, LISA technology has its feasibility for premature infants with NRDS, but the effectiveness and safety in the practical application need to be further confirmed.

Retrospective analysis of human papillomavirus infection among women in mainland China / 中华微生物学和免疫学杂志

Objective:To retrospectively analyze the prevalence and genotype distribution of human papillomavirus (HPV) among women in mainland China from the introduction of cervical cancer vaccine to its marketing in China, so as to provide data for comparing HPV prevalence after the application and gradual promotion of HPV vaccine.Methods:Related articles published during 2006 to 2016 were retrieved from PubMed, China National Knowledge Infrastructure (CNKI) and Wanfang databases. Data about HPV infection in women receiving physical examination or routine cervical cancer screening and female outpatients were collected and analyzed.Result:A total of 270 articles were retrieved, in which the sampled women were aged from 13 to 90 years old. Seventy-two articles were about HPV infection in women screened for cervical cancer with a sample size of 580 308 people. The overall results showed that during the 11 years, the five most common high-risk HPV genotypes were HPV52, 16, 58, 68 and 18, and the common low-risk HPV genotypes were HPV81, 43 and 6. The distribution of HPV genotypes varied in different regions, but HPV16, 52 and 58 were always the predominant genotypes. Among the 270 collected articles, 200 analyzed HPV infection in female outpatients with a total of 675 035 cases. The results showed that the top five high-risk HPV genotypes with high prevalence were HPV16, 52, 58, 18 and 33, and the common low-risk types were HPV6, 11 and 81. The analysis of HPV infection rate in seven geographical regions indicated that, although the distribution of the commonly circulating high-risk HPV genotypes varied in different regions, HPV16, 52 and 58 remained the predominant genotypes.Conclusions:The present study showed that the prevalence and genotype distribution of HPV infection varied by region, but HPV16, 52 and 58 were always the most common high-risk genotypes and HPV6 was the predominant low-risk genotype in both women screened for cervical cancer and female outpatients. Besides that, the infections of other high-risk genotypes, such as HPV53 and 68, should also be of concern.

Effect of the timing of antenatal corticosteroid administration on preterm neonatal outcomes / 中国小儿急救医学

Objective:To investigate the rate and timing of antenatal corticosteroid administration in the singleton preterm infants in our hospital, and explore the relationship between the timing of antenatal corticosteroid administration associated with the causes of preterm delivery and with neonatal outcomes.Methods:The study was a retrospective chart review of clinical data regarding singleton preterm neonates and their mothers from January 2016 and June 2020 at Peking University International Hospital.Optimal administration timing was defined as the first dose of antenatal dexamethasone given ≥48 h and ≤7 d before delivery.Suboptimal administration timing included any antenatal dexamethasone timing(<48 h or >7 d) that did not meet the optimal criteria.Antenatal dexamethasone administration timings were compared among preterm delivery with different causes.The neonatal outcomes of the optimal and suboptimal administration timing groups were compared.Results:The percentage of antenatal dexamethasone use was 89.16%, with 51.35% receiving optimal dexamethasone.Women with premature rupture of membranes were most likely to receive optimal dexamethasone(63.79%), followed by women with complications of pregnancy and other disorders(54.29%). The optimal dexamethasone rate of the women with cervical incompetence and preterm labor was relatively low(20% and 28%, respectively). The incidence of respiratory distress syndrome(RDS) of optimal administration timing group was lower than that in suboptimal administration timing group among neonates at <34 weeks of gestation( P<0.05). But there was no significant difference in the incidence of severe RDS, bronchopulmonary dysplasia, and need for pulmonary surfactant between two groups( P>0.05). The preterm infants with a gestational age between 34 and 34 + 6 weeks had no severe RDS or bronchopulmonary dysplasia.Compared with suboptimal administration timing group, the incidence of RDS and need for pulmonary surfactant of optimal administration timing group did not decrease significantly( P>0.05). Conclusion:The causes of preterm delivery affect the timing of antenatal dexamethasone administration.Optimizing the timing of antenatal dexamethasone administration can reduce the incidence of RDS among neonates less than 34 weeks of gestation.

Evaluate the follow-up effect of drug treatment for middle cerebral artery atherosclerotic plaques using high resolution MRI / 中华放射学杂志

Objective:To explore the value of 3.0 T high resolution MRI (HR-MRI) in the follow-up of drug treatment in acute and non-acute ischemic stroke caused by middle cerebral artery (MCA) plaque.Methods:The perspective study enrolled patients with ischemic stroke caused by MCA stenosis from October 2012 to October 2015 in the department of Neurology and Neurosurgery of Changhai Hospital Affiliated to Naval Medical University. All the patients underwent HR-MRI and then were divided into acute and non-acute stroke groups according to the intervels of the last symptom onset to the time of HR-MRI examination. All patients were informed consent to receive antiplatelet drug and intensive lipid therapy and followed up with HR-MRI. The HR-MRI sequence including T 2WI, T 1WI and contrast-enhanced T 1WI of vessel wall, and T 2WI and DWI of brain were routinely performed. T-test of paired samples was used to evaluate the changes of stenosis rate of vascular lumen, plaque enhancement degree, plaque volume and plaque burden on HR-MRI, and the NIHSS score of nervous system and blood biochemical indicators of the patients before and after treatment. Chi square test was used to compare the difference in ischemic event recurrcence between the acute and the non-acute stroke group. Results:A total of 31 acute stroke patients and 20 non-acute stroke patients were enrolled in the study. The mean follow-up time of acute stroke group was (671.71±522.86) days. Compare with the baseline, the stenosis rate of vascular lumen ( P=0.039), plaque enhancement degree ( P<0.001), plaque volume ( P=0.024) and plaque burden ( P=0.031) were all improved after the drug treatment, the NIHSS score of nervous system was also significantly improved, and the levels of total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) in 12 patients were significantly decreased. The mean follow-up time of patients with non-acute stroke was (695.35±555.90) days. The stenosis rate of vascular lumen, plaque enhancement degree, plaque volume and plaque burden were slightly improved, but without statistical significance ( P>0.05). There were no significant changes in NIHSS score of nervous system, TC, triglyceride (TG) and LDL-C ( P>0.05), however the high density lipoprotein cholesterol (HDL-C) was significantly increased than that in the baseline ( P=0.02). During the follow-up period, no new cerebral infarction was found in the DWI images of the two groups. Six patients had transient ischemic attack (TIA) recurrence in the acute stroke group and 5 patients in the non-acute stroke group, there was no significant difference between both groups(χ 2=0.229, P= 0.632). Conclusion:HR-MRI can be used as an important evaluation method for the follow-up of MCA atherosclerotic plaque therapy. After antiplatelet therapy and intensive lipid-lowering therapy, the plaque volume and burden of MCA offending plaque, and plaque enhancement decreased in acute stroke patients but there was no significant change in non-acute patients.

Imaging features of 3 cases with pancreatic schwannoma and literature review / 中华胰腺病杂志

Objective:To improve the current understanding on the imaging features of pancreatic schwannoma.Methods:Clinical data of pancreatic schwannoma patients admitted in Changhai Hospital affiliated with Navy Medical University from January 1989 to January 2019 were retrospectively analyzed, related literature on pancreatic schwannomas was retrieved through the Chinese and English database, and clinical and imaging features of pancreatic schwannoma were analyzed.Results:A total of 84 cases were analyzed, including 3 cases of pancreatic schwannomas in Changhai hospital, and 81 cases reported in the literature. The age of onset was 17-78 years old, with an average of 55 years. There were 30 males and 54 females. The main symptoms were abdominal pain or the detection of pancreatic mass via body check. Pancreatic schwannoma was mainly in pancreatic head, and the lesion has a long diameter of 1-18 cm with an average of 4.6 cm, which can be solid, cystic (most frequent) and cystic-solid. The border of the lesion from the normal tissue was clear, and semi-transparent capsule composed of neural external membrane and fiber were often found. 15 patients underwent endoscopic ultrasonography guided fine needle aspiration, and diagnostic accuracy was 73.3%(11/15). No typical findings for pancreatic schwannoma was detected on CT. MRI was performed in 35 cases, and 12 cases had complete data. The characteristics of target sign were tumor tissue in completely low signal at T 1WI, and in partially low signal and partially high signal at T 2WI, and completely opposite signal characteristics of T 2WI area after T 1 enhancement, referring to the finding that low T 2WI signal part was gradually enhanced to be high signal, but high signal part was not enhanced and in low signal. Conclusions:Pancreatic schwannoma is rare, and its target signs by MRI have imaging features which can help to improve the preoperative diagnosis.

Value of lung ultrasound in diagnosis of transient tachypnea of newborn: a Meta-analysis / 中国小儿急救医学

Objective:To evaluate the value of lung ultrasound in diagnosis of transient tachypnea in newborns.Methods:Chinese and English literature search regarding lung ultrasound for the diagnosis of transient tachypnea of the newborn were retrieved in the PubMed Database, Embase Database, Springer, Cochrane library, Wanfang Database and CNKI from inception to August 2018.The Quality Assessment of Diagnostic Accuracy Studies(QUADAS-2) tool was used to assess the quality of studies.The pooled sensitivity, specificity, positive likelihood ratio(PLR), negative likelihood ratio(NLR), and diagnostic odds radio(DOR) were calculated by Meta-Disc 1.4 software, and SROC curve was drawed.Results:A total of eight articles (five in English and three in Chinese) involving 1 582 patients were included.Meta-analysis showed heterogeneity among studies, and random effect model was used.The pooled sensitivity was 0.70 (95% CI was 0.66~0.74), the pooled specificity was 0.96 (95% CI was 0.94~0.97), PLR was 18.71 (95% CI 8.41~41.63), NLR was 0.12 (95% CI was 0.05~0.29), DOR was 279.96 (95% CI was 48.86~1 604.22), area under SROC(AUC) was 0.99, and Cochran-Q was 0.95, respectively. Conclusion:Pulmonary ultrasound has a preferable value for diagnosis of transient tachypnea in newborns.

Imaging features of 3 cases with pancreatic schwannoma and literature review / 中华胰腺病杂志

Objective@#To improve the current understanding on the imaging features of pancreatic schwannoma.@*Methods@#Clinical data of pancreatic schwannoma patients admitted in Changhai Hospital affiliated with Navy Medical University from January 1989 to January 2019 were retrospectively analyzed, related literature on pancreatic schwannomas was retrieved through the Chinese and English database, and clinical and imaging features of pancreatic schwannoma were analyzed.@*Results@#A total of 84 cases were analyzed, including 3 cases of pancreatic schwannomas in Changhai hospital, and 81 cases reported in the literature. The age of onset was 17-78 years old, with an average of 55 years. There were 30 males and 54 females. The main symptoms were abdominal pain or the detection of pancreatic mass via body check. Pancreatic schwannoma was mainly in pancreatic head, and the lesion has a long diameter of 1-18 cm with an average of 4.6 cm, which can be solid, cystic (most frequent) and cystic-solid. The border of the lesion from the normal tissue was clear, and semi-transparent capsule composed of neural external membrane and fiber were often found. 15 patients underwent endoscopic ultrasonography guided fine needle aspiration, and diagnostic accuracy was 73.3%(11/15). No typical findings for pancreatic schwannoma was detected on CT. MRI was performed in 35 cases, and 12 cases had complete data. The characteristics of target sign were tumor tissue in completely low signal at T1WI, and in partially low signal and partially high signal at T2WI, and completely opposite signal characteristics of T2WI area after T1 enhancement, referring to the finding that low T2WI signal part was gradually enhanced to be high signal, but high signal part was not enhanced and in low signal.@*Conclusions@#Pancreatic schwannoma is rare, and its target signs by MRI have imaging features which can help to improve the preoperative diagnosis.

Typical steppe ecosystems maintain high stability by decreasing the connections among recovery, resistance, and variability under high grazing pressure.

Grasslands in Inner Mongolia have been confronted with unprecedented degradation in recent years. Research on ecosystem stability is important to inform evaluation of the health of degraded grassland ecosystems. We examined synthetic stability, which was defined by the relationships between multiple components of stability, known as multidimensional stability, in grasslands at four stages of degradation (undegraded, slightly degraded, moderately degraded, and intensely degraded) in the Xilin River Basin, Inner Mongolia, China. We analyzed the connections between multidimensional stability and its relationship with four stability components, including community resistance and recovery measured on the basis of plant functional traits, and community functional (aboveground net primary productivity) and structural (Jaccard dissimilarity) variability, calculated on the basis of ten plots from different spatial distributions in a study site. Our results showed that (i) 9 of 17 traits displayed a significant trend along the grazing intensity gradient, indicating a clear turnover of species within communities in response to the grazing intensity gradient; (ii) moderately degraded (C) grasslands showed higher recovery, resistance, and synthetic stability than undegraded (A) and slightly degraded (B) grassland communities overall (recovery: p = 0.026, p = 0.032, for pairs of samples from A and C, and B and C, respectively; resistance: p = 0.024, for a pair of samples from A and C), which conformed with the intermediate disturbance hypothesis and positive diversity-stability relationship; and (iii) the multidimensionality of stability varied between different stages of degradation and were strongly dependent upon the correlations between stability components. Our study is expected to enrich the theory of stability maintenance in grassland ecosystems and provide guidance for grassland restoration and biodiversity conservation.

Cost-effectiveness analysis of rabies immunization strategy based on dynamic-decision tree model / 中华预防医学杂志

Objective@#To evaluate the cost-utility of different immunization strategies for rabies in China, and to provide a reference for determining the optimal immunization strategy.@*Methods@#The system dynamics model was used to simulate the epidemic of canine rabies and a decision tree model was conducted to analysis different immune strategies. Relevant probabilities were obtained through literature search and on-site investigation. Sensitivity analysis was used to explore the important influenced factors.@*Results@#At baseline, from a social perspective, 70% vaccination of dogs was the optimal strategy compared to current vaccination strategy (43% vaccination in dogs, human category-Ⅱ exposure vaccination/category-Ⅲ exposure vaccination combined with RIG). The total cost was 14 084 354 CNY, and the total utility value was 22 078 616.23 QALYs, and the incremental cost-utility ratio was-62 148 147 CNY/QALY; if human vaccination was considered, 55% vaccination of dogs combined with strategy one was the optimal strategy, its incremental cost-utility ratio was-444 620 557 CNY/QALY. The probability that an injured dog carries rabies virus was the most sensitive parameter. When it was greater than 0.005 03, strategy four was the optimal strategy. When it was less than 82/100 000, strategy one was the optimal strategy; when it was between 82/100 000 and 120/100 000, strategy two was the optimal strategy; when it was between 120/100 000 and 503/100 000, strategy two was the optimal strategy.@*Conclusion@#It was conducive to increase the vaccination coverage of canine for the prevention and control of rabies.

Study Progress of Radiomics in Precision Medicine for Lung Cancer / 中国肺癌杂志

Precision medicine, imaging first. Radiomics, a method of machine learning in artificial intelligence, provides valuable diagnostic, prognostic or predictive information through quantitative analysis on the tumor's region of interest to support personalized clinical decisions and improve individualized treatment, which could lay a solid foundation for achieving the precision medicine. This review provides a latest advance of the radiomic application of the precision medicine for lung cancer.

Molecular epidemiological analysis on coxsackievirus B5 in certain areas of China / 中华实验和临床病毒学杂志

Objective@#To study the molecular epidemiology and genetic variation of coxsackievirus B5 (CV-B5) in certain areas in China.@*Methods@#MEGA 6.0 software was used to analyze the complete VP1 region of CV-B5 isolated strains from certain areas of China by retrieving the GenBank nucleotide database. Besides, the phylogenetic tree was constructed, the homology of nucleotide and amino acids were calculated and the rate of evolution was estimated.@*Results@#A total of 189 Chinese CV-B5 isolated strains were included in this study. Most of Chinese CV-B5 isolated strains belonged to genotype C, accounted for 90.5%. Compared with the genotype A, the homology of nucleotide sequences and amino acid sequences of complete VP1 region of 189 Chinese isolated strains were 79.8%-82.8% and 92.6%-97.9%, respectively; moreover, the nucleotide and the amino acid homology of 189 Chinese CV-B5 isolated strains among themselves ranged from 80.3% to 100.0% and ranged from 91.5% to 100.0%, respectively. The estimated rate of evolution of the CV-B5 was 4×10-3 substitutions/site/year.@*Conclusions@#The majority of CV-B5 isolated strains belonged to genotype C, and subgenotype C1 and C2 were co-circulating together in certain areas of China.

Analysis of lipid and calories in 305 breast milk samples from neonatal intensive care unit / 中华实用儿科临床杂志

Objective@#To evaluate the lipid and calorie content in breast milk samples from neonatal intensive care unit of the Fifth Medical Center of Chinese People's Liberation Army General Hospital, and to explore the correlation between the lipid and calorie content of breast milk and perinatal factors, so as to provide ideas and methods for individualized feeding of neonates.@*Methods@#A total of 305 breast milk samples from 183 neonatal mothers in Fifth Me-dical Center of Chinese People′s Liberation Army were tested for fat and calorie by adopting Creamatocrit dynamic breast milk analyzer. All breast milk samples were sent to the breast milk bank of neonatal intensive care unit within 24 hours after collection and refrigeration. Breast milk samples were rewarmed at 37 ℃ for 30 minutes and then determined by the same nurses in the same environment from 1000 to 1100 Am daily. SPSS 17.0 was used for statistical analysis and P<0.05 was used for statistical analysis.@*Results@#The fat content of 305 breast milk samples from 183 infants was (45.65±26.76) g/L and the caloric content was(762.61±206.64) kcal/L(1 kcal=4.184 kJ). There was no significant difference between colostrum, transitional milk and mature milk in terms of fat (F=2.053, P=0.130) and calorie(F=0.830, P=0.437)content.There was no significant difference in colostrum (fat: F=1.119, P=0.331, calorie: F=2.928, P=0.058), transitional milk (fat: F=0.530, P=0.590, calorie: F=1.377, P=0.257), and mature milk (fat: F=0.612, P=0.545, calorie: F=1.101, P=0.337) in terms of fat content and calorie content among different gestational weeks newborns.Multiple linear regression analysis showed that mothers with pregnancy complications were important factors affecting breast milk lipid and calorie content.Mothers with hypertension during pregnancy are important factors affecting the lipid content of mature milk.@*Conclusions@#Breast milk calorie content may be higher than the industry-standard 670 kcal/L, and Creamatocrit dynamic breast milk analyzer can be used to determine the content of breast milk calories and fat, which can be more accurate assessment of neonatal calories and fat intake.Whether the mother is complicated with complications or not during pregnancy is an important factor affecting the colostrum fat and caloric content.

Identification of culprit plaques characteristics of intracranial atherosclerosis: a radiomic study / 国际脑血管病杂志

Objective To investigate the ability of quantitative radiomic method based on highresolution magnetic resonance imaging (HR-MRI) to distinguish between culprit plaques and non-culprit plaques of intracranial atherosclerosis.Methods Patients with middle cerebral artery and basilar artery stenosis underwent HR-MRI in Changhai Hospital Affiliated to the Naval Medical University from September 2013 to October 2016 were analyzed retrospectively.The minimum lumen area,plaque burden,severity of luminal stenosis,intraplaque hemorrhage (IPH),enhancement rate,and 109quantitative radiomic characteristics of the culprit and non-culprit plaques were measured.For clinical features and traditional plaque morphology,multivariate logistic regression models were used to determine independent risk factors for culprit plaque.A random forest-supervised machine learning method was used to determine the radiomic characteristics of distinguishing between symptomatic plaques and asymptomatic plaques.The receiver operating characteristic (ROC) curve was constructed,and the diagnostic efficacy was described by the area under the curve (AUC).Results During the study,158 subjects were enrolled,and they aged (59.42± 11.62) years.The plaques of 75 patients were located in middle cerebral artery,and the plaques of 83 patients were located in basilar artery.There were 111 symptomatic patients and 47 asymptomatic patients.Multivariate logistic regression analysis showed that smoking (odds ratio [OR] 2.724,95％ confidence interval [CI] 1.200-6.183),IPH (OR 11.340,95％ CI 1.441-89.221),and enhancement rate (OR 6.865,95％ CI 1.052-44.802) were the independent risk factors for culprit plaques.The AUC of these three characteristics for predicting symptomatic plaques were 0.605,0.584,and 0.590,respectively.The combination of the three cloud improve the test efficacy for the intracranial atherosclerotic culprit plaques,AUC could reached 0.714.Radiomic analysis showed that 22 radiomic characteristics extracted from T-2 weighted imaging,T1 weighted imaging,and contrast-enhanced T1 weighted imaging were associated with the culprit plaques.Their AUCs were 0.801,0.835,and 0.846,respectively.After the combination of all morphological and radiomic characteristics,AUC could reach 0.976,the accuracy rate was 87.4％.However,the difference was not statistically significant compared to the combined AUC of all radiomic characteristics (0.953) (P=0.275).Conclusion Radiomic analysis could accurately distinguish between the culprit plaques and non-culprit plaques of intracranial atherosclerosis,and is superior to the traditional morphological methods.