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Objective:To investigate the efficacy of the nomogram model based on multiparametric MRI combined with clinical features for differential diagnosis of benign and malignant breast imaging reporting and data system (BI-RADS) 4 lesions.Methods:This study was a cross-sectional study. Clinical and imaging data of 56 patients (66 lesions) with pathologically confirmed BI-RADS 4 breast lesions from January 2020 to June 2022 at Second Affiliated Hospital of Shantou University Medical College were retrospectively analyzed. The patients were all females aged 42 (17, 71) years old. All patients underwent the breast MRI, including T 1WI, T 2WI, diffusion-weighted imaging, diffusion kurtosis imaging (DKI), and dynamic-enhanced MRI (DCE-MRI), and the patient clinical characteristics, imaging characteristics as well as relevant MRI quantitative parameters were recorded. Comparisons of the indicators of benign and malignant BI-RADS 4 lesions were performed by sample t-test , Mann-Whitney U, or χ 2 test. The least absolute shrinkage and selection operator regression was utilized to further select indicators with statistically significant differences in univariate analyses, and finally, nomogram models were constructed and reclassified all the lesions. Results:Of the 66 lesions in 56 patients, 24 lesions were found in 24 malignant patients and 42 lesions in 32 benign patients. The differences in age, body mass index, and menopausal status between benign and malignant patients were statistically significant (all P<0.05); the differences in tumor longest diameter, type of lesion enhancement, time-single intensity curve type, mean diffusivity and mean kurtosis (MK) between benign and malignant lesions were statistically significant (all P<0.05). After feature selection, MK ( OR=27.952, 95% CI 1.301-600.348, P=0.033), age ( OR=1.140, 95%CI 1.040-1.249, P=0.005), and the type of lesion enhancement ( OR=0.045, 95%CI 0.006-0.316, P=0.005) were the independent influences in predicting BI-RADS 4 malignant lesions. Using this to construct a nomogram model, its area under the curve for predicting BI-RADS 4 malignant lesions was 0.946, and the accuracy of reclassifying 66 BI-RADS 4 lesions as benign versus malignant was 86.36% (57/66). Conclusion:The nomogram model constructed with MK from DKI parameters, the type of lesion enhancement from DCE-MRI, and age is valuable in diagnosing the benign and malignant nature of BI-RADS 4 lesions.

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Objective To investigate the correlation between serum neuregulin 4(Nrg4)level and metabolic associated fatty liver disease(MAFLD)in patients with type 2 diabetes mellitus(T2DM).Methods A total of 240 T2DM patients admitted to the Department of Endocrinology of Second People's Hospital of Yichang from June 2021 to August 2022 were collected and divided into simple T2DM group(n=120)and MAFLD group(MAFLD,n=120).120 healthy individuals were selected as the normal control(NC)group.Results The serum Nrg4 decreased gradually from NC group,T2DM group to MAFLD group(P＜0.05).Pearson correlation analysis showed that serum Nrg4 was negatively correlated with WC,HOMA-IR and hs-CRP(P＜0.05),and positively correlated with HDL-C(P＜0.05).Logistic regression analysis showed that Nrg4,WC,HOMA-IR and hs-CRP were the influencing factors of MAFLD.After adjusting for age,sex,smoking history,BMI,TC,TG,HDL-C,LDL-C,FPG,FIns,HbA1c and other factors,serum Nrg4 was still the influencing factor of MAFLD.Conclusion The decrease of serum Nrg4 is a risk factor for T2DM combined with MAFLD.

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CT is an important imaging tool for the diagnosis of novel coronavirus pneumonia (COVID-19), therefore, it′s necessary to strictly control the disinfection of CT workplace and equipment and biosafety to avoid the place from becoming a potential infection source and to reduce the risk of infection of patients and radiological staff. It is also necessary to reduce the CT scan dose to minimize the radiation hazards on patients under the premise of ensuring the CT image quality and diagnostic efficiency. Based on the survey that novel coronavirus residues after disinfection at some CT workplace in domestic and overseas and the application of low-dose CT scan in diagnosis of COVID-19, as well as the current situation of radiological protection management in emergency hospital, this paper summarizes and proposes suggestions on infection control and radiological protection for CT workplace to strengthen the defense line of COVID-19 prevention and control.

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OBJECTIVE To evaluate the genotoxicity of naproxen (NPX) impurities acetylnerolin (Ace). METHODS The genotoxicity of Ace was predicted by ADMET, Derek and Sarah with the quanti?tative structure-activity relationship (QSAR). The chromosomal aberration and bacterial reverse-muta?tion (Ames) tests were performed to verify the above results. In chromosomal aberration tests, CHL cells were incubated with Ace 10, 20 and 40 mg · L-1 for 4 h in the presence or absence of metabolic activation system solution (S9 mix). Methyl methane sulfonate (MMS) 20 mL · L-1 without S9 mix and cyclophosphamide (CP) 12 mg · L-1 with S9 mix served as positive control. The number of chromo?somes in each aberrant metaphase (including fissure, exchange, ring, break and polyploid) was counted and recorded, when the distortion rate less than 5％was considered negative and more than 10％was considered positive. In Ames test, the potential mutagenicity was evaluated using five strains of S. typhimurium ( TA97,TA98,TA100,TA102 and TA1535). They were treated with Ace 5, 25, 125 and 625μg per plate with or without S9 mix and incubated for 48-72 h. When without S9 mix, Dexon 50μg per plate served as positive control for TA97 and TA98, MMS 2.0μL per plate served as positive control for TA100 and TA102, and sodium azide 1.5μg per plate served as positive control for TA1535. When with S9 mix, 2-AF 100 μg per plate served as positive control for TA97, TA98 and TA100, 1, 8-dihydroxyanthraquinone (100μg per plate) served as positive control for TA102 and CP 50μg per plate served as positive control for TA1525. When the number of colonies was at least two-fold that of the negative control, the compound was considered mutagenic. RESULTS Although the Derek and Sarah software predicted that the NPX impurities were not genotoxic, ADMET data showed that Ace could induce chromosomal aberrations. The distortion rate of Ace 40 mg · L-1 was greater than 5％, but less than 10％. The distortion rate of Ace was less than 5％when<20 mg·L-1. Consistent with the results of ADMET, Ace might induce chromosomal aberrations. Ames test results showed that Ace did not signifi?cantly increase the number of bacteria (5-625μg per plate) compared with the negative control. Contrary to the ADMET results, Ace had no mutagenicity. CONCLUSION Ace has potential chromosomal muta?genicity. For life-long usage of NPX, the content of Ace should be reduced from 0.15％of conventional impurities to 0.015％.

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Linear alkanes are a class of compounds known to negatively affect the physical performance of lubricant base oils. The ability to rapidly identify and quantify linear alkanes in lubricant base oils would enable oil companies to more effectively evaluate their refinery methods for converting crude oil to lubricant base oils. While mass spectrometry is a powerful method for elucidation of the structures of compounds in complex mixtures, it is not innately quantitative. An approach is presented here for the identification and quantitation of linear alkanes in base oil samples by utilizing GC×GC/EI TOF MS. Identification of the linear alkanes in base oils was achieved based on their retention times in both GC columns as well as their EI mass spectra. Linear alkane model compound mixtures were used to generate calibration plots for quantitation of the linear alkanes in the base oils. The accuracy of this method was greater than 83.8%, within-day precision lower than 6.2%, between-day precision lower than 16.2%, and total precision lower than 17.2%. All noted figures of merit surpass the acceptable limits for a new validated quantitative method, where accuracy must be better than 80% and precision lower than 20% at the lower limit of quantitation. The n-alkane content in both base oil samples was further validated using a GC×GC/FID method (the gold standard for quantitation), which provided nearly identical results to those obtained using the GC×GC/EI TOF MS method. Therefore, GC×GC/EI TOF MS can be used to both identify and quantitate linear alkanes.

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BACKGROUND: GII noroviruses are a common cause of acute gastroenteritis (AGE) outbreaks in institutional settings globally. However, AGE outbreaks caused by GI norovirus, especially the GI.5 genotype, are relatively uncommon. METHODS: In February 2017, an AGE outbreak occurred in a primary school in Shanghai, China. An outbreak investigation was undertaken, and fecal specimens, rectal swabs, and environmental swabs were collected. Pathogen detection was performed and the positive specimens were characterized by gene sequencing. RESULTS: The descriptive epidemiological analysis suggested that this outbreak, involving 19 cases in two classes (designated classes A and B), was a small-scale propagated epidemic and person-to-person transmission was the most plausible transmission mode. The outbreak comprised two peaks, with 15 cases occurring in class A during the main peak and four cases occurring in class B in the subsequent minor peak. The primary attack rate was 38% and the secondary attack rate was 10%. Univariable logistic regression indicated that contacting a suspect case was a risk factor for norovirus infection, with an unadjusted OR of 5.6 (95% CI: 1.6-20.1). Six fecal specimens were positive for GI norovirus, with a single genotype, GI.5 norovirus, being involved, as characterized by genotyping. This outbreak was the first reported outbreak of GI.5 norovirus in China. CONCLUSIONS: This study implies that GI.5 norovirus is a potential agent of outbreaks spread by person-to-person transmission in institutional settings. The investigation highlights the importance of sensitive surveillance, timely isolation of individuals who are ill, adequate hand hygiene, and proper environmental disinfection for prevention and control of AGE outbreaks caused by norovirus.

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Infecciones por Caliciviridae/epidemiología , Infecciones por Caliciviridae/transmisión , Gastroenteritis/epidemiología , Niño , China/epidemiología , Brotes de Enfermedades , Desinfección , Femenino , Gastroenteritis/virología , Genotipo , Higiene de las Manos , Humanos , Masculino , Norovirus/genética , Norovirus/patogenicidad , Instituciones Académicas/estadística & datos numéricos

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Objective To evaluate the effect of fast-track surgery on perioperative nursing care for patients with abdominal surgery. Methods Using FTS and perioperative nursing as keywords, relevant literature was retrieved from the CNKI, Wanfang Med, Cochrane Library and PubMed databases. Articles including patients who underwent abdominal surgery as the research subjects were screened and analyzed with RevMan 5.3. Results Seven articles were included, covering 288 experimental cases and 290 control cases. Patients with FTS nursing had a higher satisfaction with nursing(P<0.05), shorter postoperative hospital stay(Z=6.71,P<0.05), shorter postoperative anal exhaust time(Z=9.08,P<0.05), and lower incidence of postoperative incision infection(Z=2.65,P=0.05),Hospitalization costs were also reduced(Z=11.75,P<0.05). The incidence of complications, including postoperative abdominal infection, anastomotic fistula, intestinal obstruction, and lower extremity deep vein thrombosis, did not increase. Conclusions FTS nursing can improve the satisfaction of patients with abdominal surgery and reduce their hospitalization expenses and recovery time these results indicate that FTS is a safe and feasible nursing measure.